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Sample records for west point treatment

  1. Technical Basis for Radiological Emergency Plan Annex for WTD Emergency Response Plan: West Point Treatment Plant

    Energy Technology Data Exchange (ETDEWEB)

    Hickey, Eva E.; Strom, Daniel J.

    2005-08-01

    Staff of the King County Wastewater Treatment Division (WTD) have concern about the aftermath of a radiological dispersion event (RDE) leading to the introduction of significant quantities of radioactive material into the combined sanitary and storm sewer system in King County, Washington. Radioactive material could come from the use of a radiological dispersion device (RDD). RDDs include "dirty bombs" that are not nuclear detonations but are explosives designed to spread radioactive material (National Council on Radiation Protection and Measurements (NCRP) 2001). Radioactive material also could come from deliberate introduction or dispersion of radioactive material into the environment, including waterways and water supply systems. This document, Volume 3 of PNNL-15163 is the technical basis for the Annex to the West Point Treatment Plant (WPTP) Emergency Response Plan related to responding to a radiological emergency at the WPTP. The plan primarily considers response to radioactive material that has been introduced in the other combined sanitary and storm sewer system from a radiological dispersion device, but is applicable to any accidental or deliberate introduction of materials into the system.

  2. West Point student drops out / Jorgen Johansson

    Index Scriptorium Estoniae

    Johansson, Jorgen

    2001-01-01

    Läti kohus mõistis välja kahjutasu Juris Matusevics'ilt, kes rikkus Läti kaitsejõududega sõlmitud kokkulepet, mis kohustas teda pärast USA West Pointi sõjaväeakadeemia lõpetamist teenima viis aastat Läti armees

  3. West Nile Virus: Symptoms and Treatment

    Science.gov (United States)

    ... R S T U V W X Y Z # West Nile virus Note: Javascript is disabled or is not supported ... message, please visit this page: About CDC.gov . West Nile Virus Home Prevention Prevención y control Symptoms, Diagnosis, & Treatment ...

  4. Spent fuel treatment at ANL-West

    Energy Technology Data Exchange (ETDEWEB)

    Goff, K.M.; Benedict, R.W.; Levinskas, D.

    1994-12-31

    At Argonne National Laboratory-West (ANL-West) there are several thousand kilograms of metallic spent nuclear fuel containing bond sodium. This fuel will be treated in the Fuel Cycle Facility at ANL-West to produce stable waste forms for storage and disposal. The treatment operations will employ a pyrochemical process that also has applications for treating most of the fuel types within the Department of Energy complex. The treatment equipment is in its last stage of readiness, and operations will begin in the Fall of 1994.

  5. Electrometallurgical treatment demonstration at ANL-West

    Energy Technology Data Exchange (ETDEWEB)

    Goff, K. M.; Benedict, R. W.; Johnson, S. G.; Mariani, R. D.; Simpson, M. F.; Westphal, B. R.

    2000-03-20

    Electrometallurgical treatment (EMT) was developed by Argonne National Laboratory (ANL) to ready sodium-bonded spent nuclear fuel for geological disposal. A demonstration of this technology was successfully completed in August 1999. EMT was used to condition irradiated EBR-II driver and blanket fuel at ANL-West. The results of this demonstration, including the production of radioactive high-level waste forms, are presented.

  6. 78 FR 24816 - Pricing for the 2013 American Eagle West Point Two-Coin Silver Set

    Science.gov (United States)

    2013-04-26

    ... United States Mint Pricing for the 2013 American Eagle West Point Two-Coin Silver Set AGENCY: United... the price of the 2013 American Eagle West Point Two-Coin Silver Set. The coin set will be offered for sale at a price of $139.95. FOR FURTHER INFORMATION CONTACT: Marc Landry, Acting Associate Director for...

  7. The William Faulkner Collection at West Point and the Faulkner Concordances. Occasional Paper No. 2.

    Science.gov (United States)

    Capps, Jack L.; And Others

    A milestone in the broadening humanities curriculum and involvement with Faulkner scholarship at the United States Military Academy at West Point was William Faulkner's visit to the Academy in April 1962. The West Point Faulkner Collection holds a complete set of first editions of the author's books, a major gathering of secondary and association…

  8. FTM-West : fuel treatment market model for U.S. West

    Science.gov (United States)

    Peter J. Ince; Andrew Kramp; Henry Spelter; Ken Skog; Dennis Dykstra

    2006-01-01

    This paper presents FTM–West, a partial market equilibrium model designed to project future wood market impacts of significantly expanded fuel treatment programs that could remove trees to reduce fire hazard on forestlands in the U.S. West. FTM–West was designed to account for structural complexities in marketing and utilization that arise from unconventional size...

  9. The West Bank of Israel - Point of No Return

    Science.gov (United States)

    1989-08-01

    34 Internal social tensions emerging from the prolonged occupation, including intergenerational differences over the benefits and costs of political...Even the old city of Jerusalem, rela- tively incident-free, emits too hostile an atmosphere for the comfort of most Israelis. Except for those...region in an East-West context. * The gradual resolution of other regional conflicts in the world in the new East-West atmosphere , which leaves the

  10. K West integrated water treatment system subproject safety analysis document

    Energy Technology Data Exchange (ETDEWEB)

    SEMMENS, L.S.

    1999-02-24

    This Accident Analysis evaluates unmitigated accident scenarios, and identifies Safety Significant and Safety Class structures, systems, and components for the K West Integrated Water Treatment System.

  11. Early Career Preparation, Experiences, and Commitment of Female and Male West Point Graduates.

    Science.gov (United States)

    1983-01-01

    report. Data Collection All participants in the study were graduates in the Class of 1980, the v first coeducational class at West Point. The sampling...Class of 1980 has been regarded as an unique entity because of its destiny as the first coeducational class. These data will show where this is true and...understand the experiences of the graduates from West Point. This is the first systematic program to assess the effects of coeducation by using as 5-5 .*:. 0

  12. Follow-Up Study of Officer Performance of West Point Graduates. PJ 4086-13

    Science.gov (United States)

    1948-10-12

    No entry IV . Procedure A. Collection of Data 1. Roster cards Including components of graduation total proportional parts for the West Point graduates...variables with 1rado see)s to indicate that promotions did not occur prima,’ily as a function of clase standlng at West Point. Grade correlates very...who had intimate daily contact with raters and those who had no such contact. Tbles IV and V show these correlations and Table VI a summary of the more

  13. Effect of treatment on trigger points.

    Science.gov (United States)

    Majlesi, Javid; Unalan, Halil

    2010-10-01

    Patients with muscle pain complaints commonly are seen by clinicians treating pain, especially pain of musculoskeletal origin. Myofascial trigger points merit special attention because its diagnosis requires examinations skills and its treatment requires specific techniques. If undiagnosed, the patients tend to be overinvestigated and undertreated, leading to chronic pain syndrome. Patients with myofascial pain syndrome present primarily with painful muscle(s) and restricted range of motion of the relevant joint. Palpable painful taut bands are named trigger points and are the main and pathognomonic finding on physical examination. Eliciting local twitch response and referred pain requires experience and examination skills. It may be useful to classify the patient as having acute or chronic, and as having primary or secondary, myofascial pain so the decision on the details of treatment can be curtailed to the needs of each patient. Effective treatment modalities are local heat and cold, stretching exercises, spray-and-stretch, needling, local injection, and high-power pain threshold ultrasound.

  14. The Effects of Peer Group Heterogeneity on the Production of Human Capital at West Point

    OpenAIRE

    David S. Lyle

    2009-01-01

    Understanding how heterogeneity in peer group composition affects academic attainment has important implications for how schools organize students in group settings. The random assignment of cadets to companies at West Point affords an opportunity to investigate this issue empirically. Estimates of the impact of peer group heterogeneity in math SAT scores on freshmen-year academic performance reveals that more heterogeneous peer groups have positive effects on individual grades. High-ability ...

  15. Health Care Marketing at Keller Army Community Hospital West Point, New York

    Science.gov (United States)

    1982-08-01

    Kotler , Philip . Marketing for Nonprofit Organizations. Englewood Cliffs: Prentice-Hall, Inc., 1975. MacStravic, Robin E. Marketing Health Care. Germantown...102 (17 November 1980): 68-81. Kotler , Philip . "What Consumerism Means for Marketers ." Harvard Business Review. (May-June, 1972): 50-56. and Levy...Respondents Opinion (II). These four areas addressed the four Ps’ of the marketing mix. Section lIB dealt with the "product" aspect of West Point

  16. Ottawa National Wildlife Refuge Complex (Ottawa, Cedar Point, West Sister Island NWR's): Annual narrative report: Calendar year 1986

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This annual narrative report for Ottawa NWR, Cedar Point NWR, and West Sister Island NWR outlines Refuge accomplishments during the 1986 calendar year. The report...

  17. Ottawa National Wildlife Refuge Complex (Ottawa, Cedar Point, West Sister Island NWR's): Annual narrative report: Calendar year 1984

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This annual narrative report for Ottawa NWR, Cedar Point NWR, and West Sister Island NWR outlines Refuge accomplishments during the 1984 calendar year. The report...

  18. Ottawa National Wildlife Refuge Complex (Ottawa, Cedar Point, West Sister Island NWR's): Annual narrative report: Calendar year 1981

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This annual narrative report for Ottawa NWR, Cedar Point NWR, and West Sister Island NWR outlines Refuge accomplishments during the 1981 calendar year. The report...

  19. Ottawa National Wildlife Refuge Complex (Ottawa, Cedar Point, West Sister Island NWR's): Annual narrative report: Calendar year 1987

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This annual narrative report for Ottawa NWR, Cedar Point NWR, and West Sister Island NWR outlines Refuge accomplishments during the 1987 calendar year. The report...

  20. "It Could Affect You as a Person, Character-Wise": Promoting Character Development and Preventing Sexual Violence at West Point

    Science.gov (United States)

    Arbeit, Miriam R.

    2017-01-01

    The United States Military Academy at West Point develops cadets into "leaders of character" who will become Army officers. This focus on character presents an opportunity for the prevention of sexual violence through an emphasis on military values. Using constructivist grounded theory, this study examined how cadets experience their own…

  1. Value-Chain Dynamics of the West Point Foundry, 1817-1911: A Historical Case Analysis in Marketing

    Science.gov (United States)

    Petkus, Ed, Jr.

    2013-01-01

    This case provides the opportunity for students to explore marketing and value/supply-chain dynamics in a unique historical context. The West Point Foundry (WPF), located in Cold Spring, New York, was one of the most important manufacturing ventures in the United States from 1817 to 1911. The case outlines the supply-chain details of the WPF as…

  2. Change-point detection for infinite horizon dynamic treatment regimes.

    Science.gov (United States)

    Goldberg, Yair; Pollak, Moshe; Mitelpunkt, Alexis; Orlovsky, Mila; Weiss-Meilik, Ahuva; Gorfine, Malka

    2017-08-01

    A dynamic treatment regime is a set of decision rules for how to treat a patient at multiple time points. At each time point, a treatment decision is made depending on the patient's medical history up to that point. We consider the infinite-horizon setting in which the number of decision points is very large. Specifically, we consider long trajectories of patients' measurements recorded over time. At each time point, the decision whether to intervene or not is conditional on whether or not there was a change in the patient's trajectory. We present change-point detection tools and show how to use them in defining dynamic treatment regimes. The performance of these regimes is assessed using an extensive simulation study. We demonstrate the utility of the proposed change-point detection approach using two case studies: detection of sepsis in preterm infants in the intensive care unit and detection of a change in glucose levels of a diabetic patient.

  3. Dinner and a Conversation: Transgender Integration at West Point and Beyond

    Directory of Open Access Journals (Sweden)

    Morten G. Ender

    2017-03-01

    Full Text Available In 2016, the United States military lifted the ban on transgender members serving and are expected to begin accessions of transgender service members in 2017. A paucity of research exists on transgender matters in the military, especially on attitudes towards cisgender service members. This study deploys a qualitative methodology, comprised of 21 focus groups of undergraduate cadets and advanced schooled Army officers (N = 110, at the United States Military Academy at West Point, New York, using a semi-structured interview protocol. Overall, a diversity of experiences and familiarity with transgender people surfaced among cadets and officers. We distinguish between experiences and familiarity on a spectrum by introducing notions of transgender tourism and cosmopolitanism. Major concerns associated with (uncomfortableness emerged from the focus groups including privacy, physical standards, well-being, and costs. Interventions are offered by the participants based on their major concerns. We recommend education, increased cosmopolitism, privacy considerations, narrowing the civil-military propinquity gap, and more studies of diversity and inclusion issues in the military.

  4. Nocturnal Ozone Depletion Events at the Amphitrite Point Observatory on West Vancouver Island

    Science.gov (United States)

    Garner, N.; Brownsey, D. K.; Tokarek, T. W.; Ye, C. Z.; Yordanov, N. R.; Osthoff, H. D.; Schiller, C. L.; Vingarzan, R.

    2015-12-01

    Routine monitoring stations on the West coast of North America serve to monitor baseline levels of criteria pollutants such as ozone (O3) arriving from the Pacific Ocean. In Canada, the Amphitrite Point Observatory (APO) in Ucluelet on the West coast of Vancouver Island has been added to this network to provide regional baseline measurements. Recently, McKendry and coworkers have reported frequent episodes of nocturnal O3 depletion events (ODEs) at APO (range: 5-20 ppbv) that generally correlate with alongshore winds, elevated levels of carbon dioxide (CO2), and low vertical entrainment but whose cause(s) has (have) remained unclear. In this work, results from the Ozone-depleting reactions in a coastal atmosphere (ORCA) campaign, which took place at APO from July 6 - 31, 2015, are presented. In addition to the long-term measurements that include aerosol size distribution and composition measurements, mixing ratios of speciated monoterpenes (e.g., α- and β-pinene, limonene), molecular halogens (i.e., Cl2, I2), halogen oxides (i.e., OIO), plus a full suite of nitrogen oxides (including N2O5, PAN, PPN, ΣPN, ΣAN, HNO3, HONO, and ClNO2) were quantified. Synoptic conditions at the site varied greatly between nights. During westerly flow of relatively clean marine air, O3 was generally conserved at night, indicating that deposition of O3 to the ocean surface is a minor loss pathway. When the air mass originated from other sectors, episodes of nocturnal ODEs were observed on several occasions, in which mixing ratios of biogenic VOCs were enhanced. These included air masses that originated from densely forested areas to the East, air masses polluted by marine traffic emissions from the southeast, and air masses from the NW that have traveled parallel to the coastline. In this sector, the air was likely in contact with terrestrial vegetation via land-sea breeze circulations. The results suggest that nocturnal ODEs at APO are mainly driven by local or regional processes

  5. Teaching a Second Core Course in Information Technology: A West Point Experience

    Directory of Open Access Journals (Sweden)

    Douglas Wolfe

    2004-02-01

    Full Text Available The United States Military Academy (USMA at West Point has the mission to produce officers for the U.S. Army. As part of the curriculum, the Academy requires all non-ABET major cadets (students to take two courses on information technology (IT with both courses focused on problem solving with technology. The first course is an introductory course offered in the freshman year while the second course is a more detailed course offered in the junior year. The Electrical Engineering and Computer Science Department uses an expanded definition of information technology; that is, any technology that acquires, transmits, processes, or displays information. Information technology is becoming increasingly important in the Army with the development and use of sensors, command and control systems, and other technologies to achieve information dominance. The course is divided into six modules: acquisition of data and sensors, transmission of data and networks, processing of data into information, display of information, legal and ethical issues of IT, and information dominance and operations. Cadets use a four-step problem solving methodology to develop and implement the components of an Information System to solve a real-world problem. The short-term impact of the course on the cadets has been very positive, and we are confident that the long-term impact will be substantial on the cadets and the Army. Cadets are exposed to a number of different technologies, gaining an understanding of how these technologies are used to acquire data, transmit data, process data into information, and display information to support decision making. In addition, the course projects help enforce the problem solving methodology where cadets analyze, design, implement, and test their solutions.

  6. Nutritional Assessment of U.S. Military Academy Cadets at West Point: Part 2. Assessment of Nutritional Intake

    Science.gov (United States)

    1993-10-06

    that represented different pizza sizes, and (M) smaller food items with a circular shape (e.g., cookies, p.ncakes); paperboard shapes (A) that...Ham Assorted Cereals Danish Braid Pineapple -Cherry Sauce Scrambled Eggs Assorted Jellies/Honey Buttered Macaroni Breakfast Steak Yogurt Bar Broccoli...Any City Pizza Philadelphia, Pa. Colonial Hotel New Haven, Conn. Cooking Class (Officers’ Club) West Point Coolidge Comer Pub Brookline, Mass. Corrib

  7. Simultaneous comparisons of treatments at multiple time points

    DEFF Research Database (Denmark)

    Pallmann, Philip; Pretorius, Mias; Ritz, Christian

    2017-01-01

    hypotheses as well as a global test decision. We compare via simulation the powers of multiple contrast tests based on a joint model and multiple marginal models, respectively, and quantify the benefit of incorporating longitudinal correlation, i.e. the advantage over Bonferroni. Practical application.......e. occasion-specific models. Upon parameter and covariance estimation with either modeling approach, we employ a variant of multiple contrast tests that acknowledges correlation between time points and test statistics. This method provides simultaneous confidence intervals and adjusted p-values for elementary......We discuss several aspects of multiple inference in longitudinal settings, focusing on many-to-one and all-pairwise comparisons of (a) treatment groups simultaneously at several points in time, or (b) time points simultaneously for several treatments. We assume a continuous endpoint...

  8. Care support points of Mecklenburg-West Pomerania. Results of a scientific analysis / Pflegestützpunkte in Mecklenburg-Vorpommern. Ergebnisse einer wissenschaftliche Analyse

    Directory of Open Access Journals (Sweden)

    Schmidt Stefan

    2016-07-01

    Full Text Available In the period 2011 – 2013, 13 care support points were set up in Mecklenburg-West Pomerania. They are the joint responsibility of all health and long-term care insurance funds and local government.

  9. [Narrative report for Ottawa National Wildlife Refuge, Cedar Point National Wildlife Refuge, West Sister Island National Wildlife Refuge, Navarre Tract: Calendar year 1966

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This annual narrative report for Ottawa, Cedar Point, and West Sister Island National Wildlife Refuges outlines Refuge accomplishments during the 1966 calendar year....

  10. Critical points in logistic growth curves and treatment comparisons

    Directory of Open Access Journals (Sweden)

    José Raimundo de Souza Passos

    2012-10-01

    Full Text Available Several biological phenomena have a behavior over time mathematically characterized by a strong increasing function in the early stages of development, then by a less pronounced growth, sometimes showing stability. The separation between these phases is very important to the researcher, since the maintenance of a less productive phase results in uneconomical activity. In this report we present methods of determining critical points in logistic functions that separate the early stages of growth from the asymptotic phase, with the aim of establishing a stopping critical point in the growth and on this basis determine differences in treatments. The logistic growth model is fitted to experimental data of imbibition of araribá seeds (Centrolobium tomentosum. To determine stopping critical points the following methods were used: i accelerating growth function, ii tangent at the inflection point, iii segmented regression; iv modified segmented regression; v non-significant difference; and vi non-significant difference by simulation. The analysis of variance of the abscissas and ordinates of the breakpoints was performed with the objective of comparing treatments and methods used to determine the critical points. The methods of segmented regression and of the tangent at the inflection point lead to early stopping points, in comparison with other methods, with proportions ordinate/asymptote lower than 0.90. The non-significant difference method by simulation had higher values of abscissas for stopping point, with an average proportion ordinate/asymptote equal to 0.986. An intermediate proportion of 0.908 was observed for the acceleration function method.

  11. Microcurrent Point Stimulation Applied to Lower Back Acupuncture Points for the Treatment of Nonspecific Neck Pain.

    Science.gov (United States)

    Armstrong, Kelly; Gokal, Raman; Chevalier, Antoine; Todorsky, William; Lim, Mike

    2017-04-01

    Although acupuncture and microcurrent are widely used for chronic pain, there remains considerable controversy as to their therapeutic value for neck pain. We aimed to determine the effect size of microcurrent applied to lower back acupuncture points to assess the impact on the neck pain. This was a cohort analysis of treatment outcomes pre- and postmicrocurrent stimulation, involving 34 patients with a history of nonspecific chronic neck pain. Consenting patients were enrolled from a group of therapists attending educational seminars and were asked to report pain levels pre-post and 48 hours after a single MPS application. Direct current microcurrent point stimulation (MPS) applied to standardized lower back acupuncture protocol points was used. Evaluations entailed a baseline visual analog scale (VAS) pain scale assessment, using a VAS, which was repeated twice after therapy, once immediately postelectrotherapy and again after a 48-h follow-up period. All 34 patients received a single MPS session. Results were analyzed using paired t tests. Results and Outcomes: Pain intensity showed an initial statistically significant reduction of 68% [3.9050 points; 95% CI (2.9480, 3.9050); p = 0.0001], in mean neck pain levels after standard protocol treatment, when compared to initial pain levels. There was a further statistically significant reduction of 35% in mean neck pain levels at 48 h when compared to pain levels immediately after standard protocol treatment [0.5588 points; 95% CI (0.2001, 0.9176); p = 0.03], for a total average pain relief of 80%. The positive results in this study could have applications for those patients impacted by chronic neck pain.

  12. Pittsburgh Coal Bed Point Data (Geology) in Pennsylvania, Ohio, West Virginia, and Maryland

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — This dataset is a point coverage of attributes on data location, thickness of the Pittsburgh coal bed main bench, and its elevation, in feet. The file is also found...

  13. Upper Freeport Coal Bed Point Data (Geology) in Pennsylvania, Ohio, West Virginia, and Maryland

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — This dataset is a point coverage of attributes on data location, thickness of the Upper Freeport coal bed, and its elevation, in feet. The file is also found as an...

  14. Pocahontas No. 3 Coal Bed Point Data (Geology) in West Virginia and Virginia

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — This dataset is a point coverage of the Pocahontas No. 3 coal with attributes on data location, minable thickness, and elevation, in feet. The file is also found as...

  15. Preharvest manual herbicide treatments for controlling American beech in Central West Virginia

    Science.gov (United States)

    Jeffery D. Kochenderfer; James N. Kochenderfer; David A. Warner; Gary W. Miller

    2004-01-01

    Application costs and efficacy were determined for manual preharvest herbicide treatments applied to control American beech (Fagus grandifolia Ehrh.) that was interfering with the establishment and development of black cherry (Prunus serotina Ehrh.) in central West Virginia. The treatments consisted of four levels of basal area...

  16. Comparison between four treatment modalities for active myofascial triggers points

    Directory of Open Access Journals (Sweden)

    Atef Fouda

    2014-06-01

    Full Text Available Aim: The study aimed at the painful trigger points (TrPs for the purpose of ablating muscle spasms and restoring normal muscle length to find the most effective treatment for alleviating pain and improving mouth range of motion in patients with myofascial pain dysfunction. Methods: We enrolled 72 patients with pain and reduced mouth opening due to temporomandibular joint dysfunction. Patients assigned to four groups and four treatment modalities used to treat myofascial TrPs pain. We used mean and standard deviation values. The Mann-Whitney U-test was used to compare the two groups. The Wilcoxon signed-rank test was used to study the changes by the time in mean pain scores. The Student's t-test was used to compare maximum mouth opening (MMO groups. Then paired t-test was also used to study the changes of time in an MMO. Results: The results showed that pulsed electromagnetic field (PEMF therapy is the most effective treatment modality regarding for pain relief. Both the anesthesia and PEMF groups showed a reduction in mean pain scores throughout all follow-up periods, and a statistically significant increase in mean MMO. Conclusion: The findings suggest that PEMF is the most effective treatment for alleviating pain and improving mouth range of motion in patients with myofascial pain.

  17. K West Basin Integrated Water Treatment System (IWTS) E-F Annular Filter Vessel Accident Calculations

    Energy Technology Data Exchange (ETDEWEB)

    RITTMANN, P.D.

    1999-10-07

    Three bounding accidents postdated for the K West Basin integrated water treatment system are evaluated against applicable risk evaluation guidelines. The accidents are a spray leak during fuel retrieval, spray leak during backflushing, and a hydrogen explosion. Event trees and accident probabilities are estimated. In all cases, the unmitigated dose consequences are below the risk evaluation guidelines.

  18. K West Basin Integrated Water Treatment System (IWTS) E-F Annular Filter Vessel Accident Calculations

    Energy Technology Data Exchange (ETDEWEB)

    PIEPHO, M.G.

    2000-01-10

    Four bounding accidents postulated for the K West Basin integrated water treatment system are evaluated against applicable risk evaluation guidelines. The accidents are a spray leak during fuel retrieval, spray leak during backflushing a hydrogen explosion, and a fire breaching filter vessel and enclosure. Event trees and accident probabilities are estimated. In all cases, the unmitigated dose consequences are below the risk evaluation guidelines.

  19. Minimizing fear during dental treatment using ultrasonic points

    Directory of Open Access Journals (Sweden)

    Simone Di Salvo Mastrantonio

    2010-04-01

    Full Text Available Over the last few years, new technologies have been developed to making cavity preparations, among which the diamond burs CVDentus® (CVDentus, São José dos Campos, Brazil are outstanding. These points are produced by chemical deposition from the vapor phase, forming a single diamond stone, with greater durability than the conventional diamond burs. Coupled to the ultrasound appliance, they have several clinical applications in Dentistry with advantages over conventional rotary instruments, such as lower pressure, noise, vibration and heat, as well as reducing the need to use local anesthesia, contributing to minimize patient’s fear and anxiety. The aim of this study was to present the complete restorative dental treatment performed with this system in a child patient with a prior history of non-cooperative behavior. The use of this new technology offered the patient greater comfort, making it possible recondition the patient’s attitude to dental treatment, in addition to favoring conservative cavity preparations to be made.

  20. Transactions of the Army Conference on Applied Mathematics and Computing (7Th) Held in West Point, New York on 6-9 June 1989

    Science.gov (United States)

    1990-02-01

    429 SOLVING THE EULER EQUATIONS USING ADAPTIVE MESH MOTION AND REFINEMENT David C. Arney, Rupak Biswas, and Joseph E...Adaptive Mesh Methods David C. Arney, U.S. Military Academy, West Point, New York, Rupak Biswas and Joseph E. Flaherty, Rensselaer Polytechnic Institute...Sum Military Academy Wes Point, NY 10996-1786 Rupak Biswa Department of Computer Science Rensselaer Polytechnic Institute Troy, NY 12180-3590 Joseph E

  1. Treatment outcomes in patients with multidrug-resistant tuberculosis in north-west Ethiopia.

    Science.gov (United States)

    Alene, Kefyalew Addis; Viney, Kerri; McBryde, Emma S; Tsegaye, Adino Tesfahun; Clements, Archie C A

    2017-03-01

    Multidrug-resistant tuberculosis (MDR-TB) is an emerging public health problem in Ethiopia. The aim of this study was to assess MDR-TB treatment outcomes and determine predictors of poor treatment outcomes in north-west Ethiopia. A retrospective cohort study was conducted using all MDR-TB patients who were enrolled at Gondar University Hospital since the establishment of the MDR-TB programme in 2010. A Cox proportional hazard model was used to identify the predictors of time to poor treatment outcomes, which were defined as death or treatment failure. Of the 242 patients who had complete records, 131 (54%) were cured, 23 (9%) completed treatment, 31 (13%) died, four (2%) experienced treatment failure, 27 (11%) were lost to follow-up, six (2%) transferred out, and 20 (8%) were still on treatment at the time of analysis. The overall cumulative probability survival of the patients at the end of treatment (which was 24 months in duration) was 80% (95% CI: 70%, 87%). The proportion of patients with poor treatment outcomes increased over time from 6% per person-year (PY) during 2010-2012, to 12% per PY during 2013-2015. The independent predictors of time to poor treatment outcome were being anaemic [AHR = 4.2; 95% CI: 1.1, 15.9] and being a farmer [AHR = 2.2; 95% CI: 1.0, 4.9]. Overall, in north-west Ethiopia, the MDR-TB treatment success rate was high. However, poor treatment outcomes have gradually increased since 2012. Being a farmer and being anaemic were associated with poor treatment outcomes. It would be beneficial to assess other risk factors that might affect treatment outcomes such as co-infection with malaria, poverty and other socio-economic and biological risk factors. © 2016 John Wiley & Sons Ltd.

  2. Ethnobotanical survey of folklore plants used in treatment of snakebite in Paschim Medinipur district, West Bengal.

    Science.gov (United States)

    Sarkhel, Sumana

    2014-05-01

    To investigate and collect information from traditional health healers/tribal communities on the use of medicinal plants for treatment of snakebite. The ethno-medicinal study was conducted in 8 villages of the Paschim Medinipur district of West Bengal in 2012-2013 through questionnaire and personal interviews. Following the method of Martin, information about medicinal plants used in snake bite, precise plant parts used, methods of treatment and administration was enquired from the tribal communities (Santhals, Mundas, Lodhas, Bhumijs, Oraon Kherias) of the region. The present study enumerates 20 ethnomedicinal plant species belonging to 16 families used by the tribal communities and medicinal healers of Paschim Medinipur district, West Bengal in treatment of snakebite. Each plant species has been listed alphabetically according to its botanical name, family, vernacular name, part(s) used, mode of preparation/administration. The importance of traditional medicinal system among the tribal communities of Paschim Medinipur district of West Bengal has been highlighted in the present study.

  3. Comparative risk assessments for the city of Pointe-à-Pitre (French West Indies): earthquakes and storm surge

    Science.gov (United States)

    Reveillere, A. R.; Bertil, D. B.; Douglas, J. D.; Grisanti, L. G.; Lecacheux, S. L.; Monfort, D. M.; Modaressi, H. M.; Müller, H. M.; Rohmer, J. R.; Sedan, O. S.

    2012-04-01

    In France, risk assessments for natural hazards are usually carried out separately and decision makers lack comprehensive information. Moreover, since the cause of the hazard (e.g. meteorological, geological) and the physical phenomenon that causes damage (e.g. inundation, ground shaking) may be fundamentally different, the quantitative comparison of single risk assessments that were not conducted in a compatible framework is not straightforward. Comprehensive comparative risk assessments exist in a few other countries. For instance, the Risk Map Germany project has developed and applied a methodology for quantitatively comparing the risk of relevant natural hazards at various scales (city, state) in Germany. The present on-going work applies a similar methodology to the Pointe-à-Pitre urban area, which represents more than half of the population of Guadeloupe, an overseas region in the French West Indies. Relevant hazards as well as hazard intensity levels differ from continental Europe, which will lead to different conclusions. French West Indies are prone to a large number of hazards, among which hurricanes, volcanic eruptions and earthquakes dominate. Hurricanes cause damage through three phenomena: wind, heavy rainfall and storm surge, the latter having had a preeminent role during the largest historical event in 1928. Seismic risk is characterized by many induced phenomena, among which earthquake shocks dominate. This study proposes a comparison of earthquake and cyclonic storm surge risks. Losses corresponding to hazard intensities having the same probability of occurrence are calculated. They are quantified in a common loss unit, chosen to be the direct economic losses. Intangible or indirect losses are not considered. The methodology therefore relies on (i) a probabilistic hazard assessment, (ii) a loss ratio estimation for the exposed elements and (iii) an economic estimation of these assets. Storm surge hazard assessment is based on the selection of

  4. Demographics, nature and treatment of orthopaedic trauma injuries occurring in an agricultural context in the West of Ireland.

    LENUS (Irish Health Repository)

    Byrne, F J

    2011-03-01

    Farming is a major industry in the West of Ireland. This prospective study examined the age profile, nature and treatment of orthopaedic injuries occurring in agricultural surroundings presenting at the Orthopaedic Unit of Merlin Park Hospital, Galway.

  5. Surgical treatment of zygomatic bone fracture using two points fixation versus three point fixation-a randomised prospective clinical trial

    Science.gov (United States)

    2012-01-01

    Background The zygoma plays an important role in the facial contour for both cosmetic and functional reasons; therefore zygomatic bone injuries should be properly diagnosed and adequately treated. Comparison of various surgical approaches and their complications can only be done objectively using outcome measurements which in turn require protocol management and long-term follow up. The preference for open reduction and internal fixation of zygomatic fractures at three points has continued to grow in response to observations of inadequate results from two point and one point fixation techniques. The objectives of this study were to compare the efficacy of zygomatic bone after treatment with ORIF using 2 point fixation and ORIF using 3 point fixation and compare the outcome of two procedures. Methods 100 patients were randomly divided equally into two groups. In group A, 50 patients were treated by ORIF using two point fixation by miniplates and in group B, 50 patients were treated by ORIF using three point fixation by miniplates. They were evaluated for their complications during and after surgery with their advantages and disadvantages and the difference between the two groups was observed. Results A total of 100 fractures were sustained. We found that postoperative complication like decreased malar height and vertical dystopia was more common in those patients who were treated by two point fixation than those who were treated with three point fixation. Conclusions Based on this study open reduction and internal fixation using three point fixation by miniplates is the best available method for the treatment zygomatic bone fractures. PMID:22497773

  6. Attitudes of West African Immigrants in the United States toward Substance Misuse: Exploring Culturally Informed Prevention and Treatment Strategies.

    Science.gov (United States)

    Senreich, Evan; Olusesi, Olatunde A

    2016-01-01

    There is a lack of literature exploring substance misuse issues of the West African-born population in the United States. Thirty-four participants born in West Africa participated in one of three focus groups in a U.S. city to discuss their attitudes toward alcohol and drug use. Based on a qualitative analysis of the discussions, stigmatization of substance abusers and negative attitudes toward U.S. substance abuse treatment were identified as barriers to service utilization for West African immigrants. Community cohesion, importance of family, and a strong sense of spirituality were identified as essential resources to inform substance misuse prevention and treatment strategies.

  7. Diagnosis as the First Critical Point in the Treatment Trajectory

    DEFF Research Database (Denmark)

    Missel, Malene; Pedersen, Jesper H; Hendriksen, Carsten

    2015-01-01

    the patient to face a new life situation, and demands one-on-one supportive care. CONCLUSIONS: Diagnosis is the first critical point for patients with operable lung cancer and disrupts their daily life. Patients need psychosocial support during the period from diagnosis to surgical intervention and patient...

  8. Patient satisfaction with oral urgent treatment (OUT) in North West Tanzania.

    Science.gov (United States)

    Wilson, K; Bouchiba, M; Vithlani, G; Holmes, R

    2013-08-01

    A pilot questionnaire survey was carried out to determine levels of patient satisfaction with oral urgent treatment (OUT) provided by rural clinical officers who had been trained by the charity Bridge2Aid in North West Tanzania. The survey was carried out over a five-day period, among adult patients who had received oral urgent treatment from a trained clinical officer. A satisfaction questionnaire was administered by a team of English-speaking dental students and Swahili-speaking college students under supervision. A total of 140 questionnaires were completed. The overall satisfaction with the OUT service provided by the clinical officers was high, with 93.6% being very satisfied or satisfied. However, some areas were highlighted where improvements could be made: providing a clearer explanation of treatment, improved pain control and reducing costs of treatment.

  9. Experimental data developed to support the selection of a treatment process for West Valley alkaline supernatant

    Energy Technology Data Exchange (ETDEWEB)

    Bray, L.A.; Holton, L.K.; Myers, T.R.; Richardson, G.M.; Wise, B.M.

    1984-01-01

    At the request of West Valley Nuclear Services Co., Inc., the Pacific Northwest Laboratory (PNL) has studied alternative treatment processes for the alkaline PUREX waste presently being stored in Tank 8D2 at West Valley, New York. Five tasks were completed during FY 1983: (1) simulation and characterization of the alkaline supernatant and sludge from the tank. The radiochemical and chemical distributions between the aqueous and solid phase were determined, and the efficiency of washing sludge with water to remove ions such as Na/sup +/ and SO/sub 4//sup 2 -/ was investigated; (2) evaluation of a sodium tetraphenylboron (Na-TPB) precipitation process to recover cesium (Cs) and a sodium titanate (Na-TiA) sorption process to recover strontium (Sr) and plutonium (Pu) from the West Valley Alkaline supernatant. These processes were previously developed and tested at the US Department of Energy's Savannah River Plant; (3) evaluation of an organic cation-exchange resin (Duolite CS-100) to recover Cs and Pu from the alkaline supernatant followed by an organic macroreticular cation exchange resin (Amberlite IRC-718) to recover Sr; (4) evaluation of an inorganic ion exchanger (Linde Ionsiv IE-95) to recover Cs, Sr, and Pu from the alkaline supernatant; and (5) evaluation of Dowex-1,X8 organic anion exchange resin to recover technetium (Tc) from alkaline supernatant. The findings of these tasks are reported. 21 references, 36 figures, 34 tables.

  10. Argonne-West facility requirements for a radioactive waste treatment demonstration

    Energy Technology Data Exchange (ETDEWEB)

    Dwight, C.C.; Felicione, F.S.; Black, D.B.; Kelso, R.B.; McClellan, G.C.

    1995-03-01

    At Argonne National Laboratory-West (ANL-W), near Idaho Falls, Idaho, facilities that were originally constructed to support the development of liquid-metal reactor technology are being used and/or modified to meet the environmental and waste management research needs of DOE. One example is the use of an Argonne-West facility to conduct a radioactive waste treatment demonstration through a cooperative project with Science Applications International Corporation (SAIC) and Lockheed Idaho Technologies Company. The Plasma Hearth Process (PBP) project will utilize commercially-adapted plasma arc technology to demonstrate treatment of actual mixed waste. The demonstration on radioactive waste will be conducted at Argonne`s Transient Reactor Test Facility (TREAT). Utilization of an existing facility for a new and different application presents a unique set of issues in meeting applicable federal state, and local requirements as well as the additional constraints imposed by DOE Orders and ANL-W site requirements. This paper briefly describes the PHP radioactive demonstrations relevant to the interfaces with the TREAT facility. Safety, environmental design, and operational considerations pertinent to the PHP radioactive demonstration are specifically addressed herein. The personnel equipment, and facility interfaces associated with a radioactive waste treatment demonstration are an important aspect of the demonstration effort. Areas requiring significant effort in preparation for the PBP Project being conducted at the TREAT facility include confinement design, waste handling features, and sampling and analysis considerations. Information about the facility in which a radioactive demonstration will be conducted, specifically Argonne`s TREAT facility in the case of PHP, may be of interest to other organizations involved in developing and demonstrating technologies for mixed waste treatment.

  11. Effects of harvesting treatments on the ant community in a Mississippi River bottomland hardwood forest in west-central Mississippi

    Science.gov (United States)

    Lynne C. Thompson; David M. General; Brian Roy Lockhart

    2010-01-01

    We assessed effects that harvesting treatments had on the ant community in a Mississippi River bottomland hardwood forest in west-central MS. Ants were collected on Pittman Island using pitfall traps from July to November in 1996, 1997, and 2000. The forest received three replicated harvesting treatments in 1995, including: 1) uncut controls (check), 2) selection...

  12. A meshless point collocation treatment of transient bioheat problems.

    Science.gov (United States)

    Bourantas, G C; Loukopoulos, V C; Burganos, V N; Nikiforidis, G C

    2014-05-01

    A meshless numerical method is proposed for the solution of the transient bioheat equation in two and three dimensions. The Pennes bioheat equation is extended in order to incorporate water evaporation, tissue damage, and temperature-dependent tissue properties during tumor ablation. The conductivity of the tissue is not assumed constant but is treated as a local function to simulate local variability due to the existence of usually unclear interfacing of healthy and pathological segments. In this way, one avoids the need for accurate identification of the boundaries between pathological and healthy regions, which is a typical problem in medical practice, and sidesteps, evidently, the corresponding mathematical treatment of such boundaries, which is usually a tedious procedure with some inevitable degree of approximation. The numerical results of the new method for test applications of the bioheat transfer equation are validated against analytical predictions and predictions of other numerical methods. 3D simulations are presented that involve the modeling of tumor ablation and account for metabolic heat generation, blood perfusion, and heat ablation using realistic values for the various parameters. An evaluation of the effective medium approximation to homogenize conductivity fields for use with the bioheat equation is also provided. Copyright © 2014 John Wiley & Sons, Ltd.

  13. Prevalence of dental caries and treatment needs in children in coastal areas of West Bengal

    Directory of Open Access Journals (Sweden)

    Dulal Das

    2013-01-01

    Full Text Available Objective: This study was carried out to measure the caries prevalence and treatment needs in school children of 6-14 year old residing in coastal areas of West Bengal. Materials and Methods: A total of 1764 children of 6-14 years age group, studying in different primary and high schools of the coastal areas were examined using World Health Organization criteria (1997 to record the prevalence of dental caries. The treatment needs were also calculated according to that given criteria. Statistical Analysis: The results were subjected to statistical analysis using the Chi-square test and unpaired ′t′ test. Results: Dental caries were founded low in the studied population. The overall all caries prevalence in the permanent dentition was 28.06%, in boys it was 25.39% and in girls it was 30.86%. Therefore caries prevalence in female was higher and which was statistically highly significant (P < 0.05. The most frequently required treatment was one surface filling followed by other treatments irrespective of sex and age group. Discussion: The presence of sea foods containing high fluoride and least availability of refined carbohydrate in the diet may be the reason of lower prevalence. Conclusion: child oral health is always a matter of concern for a developing country so further research is required to explore actual causes.

  14. Prevalence of dental caries and treatment needs in children in coastal areas of West Bengal.

    Science.gov (United States)

    Das, Dulal; Misra, Jiban; Mitra, Malay; Bhattacharya, Bhashwar; Bagchi, Anandamoy

    2013-10-01

    This study was carried out to measure the caries prevalence and treatment needs in school children of 6-14 year old residing in coastal areas of West Bengal. A total of 1764 children of 6-14 years age group, studying in different primary and high schools of the coastal areas were examined using World Health Organization criteria (1997) to record the prevalence of dental caries. The treatment needs were also calculated according to that given criteria. The results were subjected to statistical analysis using the Chi-square test and unpaired 't' test. Dental caries were founded low in the studied population. The overall all caries prevalence in the permanent dentition was 28.06%, in boys it was 25.39% and in girls it was 30.86%. Therefore caries prevalence in female was higher and which was statistically highly significant (P < 0.05). The most frequently required treatment was one surface filling followed by other treatments irrespective of sex and age group. The presence of sea foods containing high fluoride and least availability of refined carbohydrate in the diet may be the reason of lower prevalence. child oral health is always a matter of concern for a developing country so further research is required to explore actual causes.

  15. Clinical features and treatment response of cutaneous leishmaniasis in North-West Ethiopia.

    Science.gov (United States)

    Fikre, Helina; Mohammed, Rezika; Atinafu, Saba; van Griensven, Johan; Diro, Ermias

    2017-10-01

    Cutaneous leishmaniasis (CL) receives far less attention than visceral leishmaniasis. Nevertheless, CL is predominantly caused by a unique species in Ethiopia (L. aethiopica), which is known to cause severe forms such as diffuse (DCL) and mucocutaneous leishmaniasis (MCL). We report on the number and type of CL cases diagnosed, the clinical features, the treatments and treatment outcomes in North-West Ethiopia. This is a retrospective chart record analysis of CL patients treated at the Leishmania Research and Treatment Center (LRTC) of the University of Gondar, Ethiopia. From 178 CL patients seen between January 2014 and December 2015, a total of 154 chart records were retrieved. These included 80 localised CL (LCL), 7 DCL and 67 MCL. The median age was 23 years; 71.4% were male. Most (n = 121, 78.6%) of the lesions were on the face. The median time since onset was 12 months (6-24 months), and 28.6% presented after a trial of traditional medicine. The treatment of all forms of CL mainly consisted of 30 days of IM antimonial injections. Of these, 51/133 (38.3%) required treatment extension or change due to nonresponse. Three cases were treated with liposomal amphotericin B or miltefosine (two received the combination), of which two responded well. CL was found to be complicated and difficult to treat. MCL was common, and patients presented after long delays. There is an urgent need to look for better treatment options for CL and improve access to care. © 2017 John Wiley & Sons Ltd.

  16. Results of the Treatment of Talar Neck Fractures in a West African Hospital

    Directory of Open Access Journals (Sweden)

    AD Kacou

    2011-03-01

    Full Text Available Talar neck fractures (TNFs are complex injuries and treatment is fraught with complications. We retrospectively studied 18 patients with TNFs: 6 Hawkins type-I, 7 type-II, 4 type-III, and 1 type-IV. Five patients with type-I and 2 with type-II fractures were treated conservatively. The remaining 11 patients underwent operative treatment. Open reduction via posterolateral approach was performed in 10 patients while closed reduction was used in one patient. All operatively reduced fractures were stabilized with screws. The following postoperative complications were encountered: wound dehiscence (n=1, avascular necrosis (n=2, and post-traumatic osteoarthritis (n=12. Fifteen patients were available for final evaluation at a mean follow- up period of three years (range 10 months to 6 years. Using the American Orthopaedic Foot and Ankle Society (AOFAS score, the mean for type-I fracture was 96.4 points, 80.2 points for type-II, 68.5 points for type-III and 55 points for type-IV fractures. TNFs remain a devastating injury as the prognosis and outcomes of treatment continued to be hampered by the consequences of injury.

  17. Perspectives on Obesity and Its Treatment: Health Care Providers and the General Public in Rural West Virginia and Urban Baltimore

    Science.gov (United States)

    Menez, Steven; Cheskin, Lawrence; Geller, Gail

    2013-01-01

    Objective: To determine and compare the perspectives of the general public and health care providers (HCPs) on obesity and its treatment in rural West Virginia (WV) and Baltimore, MD. Method: Surveys were completed in both locations by the general public (WV: "n" = 200; Baltimore: "n" = 171) and HCPs (WV: "n" = 25;…

  18. Intravenous immunoglobulin therapy is rarely effective as the initial treatment in West syndrome: A retrospective study of 70 patients.

    Science.gov (United States)

    Matsuura, Ryuki; Hamano, Shin-Ichiro; Hirata, Yuko; Oba, Atsuko; Suzuki, Kotoko; Kikuchi, Kenjiro

    2016-09-15

    To evaluate factors influencing the efficacy and safety of intravenous immunoglobulins (IVIG) therapy for West syndrome. We investigated seizure outcomes in 70 patients who received IVIG treatment for West Syndrome during the first 3months after the onset of epileptic spasms. IVIG was administered for 3 consecutive days (initial IVIG treatment) at dosages ranging from 100 to 500mg/kg/day. If spasms disappeared within 2weeks of the initial treatment, maintenance IVIG treatment was commenced. We evaluated seizure outcomes at 2weeks (initial evaluation), at 2years (long-term evaluation), and the last visit (last follow-up evaluation) after the initial IVIG treatment. We analyzed dosages of IVIG, age at onset of spasms, treatment lag, and etiologies between responders and non-responders. Among the patients, 7/70 (10.0%) had cessation of spasms and resolution of hypsarrhythmia at the initial evaluation. Another 6/70 patients (8.6%) were found to have cessation of spasms at the long-term evaluations. The treatment lag in responders was shorter than that in non-responders (Ptherapy has a good safety profile and we would recommend it for West syndrome cases with drug resistance, severe complications associated with profound brain damage, severe brain atrophy, and in immunocompromised patients. Copyright © 2016 Elsevier B.V. All rights reserved.

  19. Compliance and side effects of prophylactic oseltamivir treatment in a school in South West England.

    Science.gov (United States)

    Wallensten, A; Oliver, I; Lewis, D; Harrison, S

    2009-07-30

    School closure along with mass prophylactic oseltamivir treatment of pupils have been used in England and elsewhere to contain school outbreaks of influenza A(H1N1)v. We evaluated the protective effect, compliance with and side effects of oseltamivir chemoprophylactic treatment with a ten-day course of 1x 75mg given to 11-12-year-old pupils in one school year in a secondary school in South West England closed for ten days in response to a symptomatic laboratory-confirmed pupil. We distributed a questionnaire to pupils in the affected school year in class after the school had re-opened. Questions included symptoms of flu-like illness, compliance with chemoprophylaxis and side effects. All present on the day, 248 (93.2%) participated. Compliance with chemoprophylaxis was high, 77% took the full course, 91% took at least seven days. Fifty-one percent experienced symptoms such as feeling sick (31.2%), headaches (24.3%) and stomach ache (21.1%). Although some children were ill with flu-like symptoms, those tested did not have A(H1N1)v infection. Compliance with oseltamivir chemoprophylaxis was high, although likely side effects were common. The burden of side effects needs to be considered when deciding on mass oseltamivir chemoprophylaxis in children especially given that the symptoms of A(H1N1)v influenza are generally mild.

  20. United States Service Academy Admissions: Selecting for Success at the Military Academy/West Point and as an Officer

    Science.gov (United States)

    2015-01-01

    Service Academy Admissions lastic Aptitude Test (SAT)/ACT scores, high school grade-point averages (HSGPAs), and college success. Geiser and Studley...Together, the two scores explain 22.3 percent of the vari- ance.3 Geiser and Santelices (2007) found that SAT scores and HSGPAs are also positively...Grit: Perseverance and Passion for Long-Term Goals,” Journal of Personality and Social Psychology, Vol. 92, No. 6, 2007, pp. 1087–1101. Geiser

  1. Predictors of engaging in problem gambling treatment: data from the West Virginia Problem Gamblers Help Network.

    Science.gov (United States)

    Weinstock, Jeremiah; Burton, Steve; Rash, Carla J; Moran, Sheila; Biller, Warren; Krudelbach, Norman; Phoenix, Natalie; Morasco, Benjamin J

    2011-06-01

    Gambling help-lines are an essential access point, or frontline resource, for treatment seeking. This study investigated treatment engagement after calling a gambling help-line. From 2000-2007 over 2,900 unique callers were offered an in-person assessment appointment. Logistic regression analyses assessed predictors of (a) accepting the referral to the in-person assessment appointment and (b) attending the in-person assessment appointment. Over 76% of callers accepted the referral and 55% of all callers attended the in-person assessment appointment. This treatment engagement rate is higher than typically found for other help-lines. Demographic factors and clinical factors such as gender, severity of gambling problems, amount of gambling debt, and coercion by legal and social networks predicted engagement in treatment. Programmatic factors such as offering an appointment within 72 hr also aided treatment engagement. Results suggest gambling help-lines can be a convenient and confidential way for many individuals with gambling problems to access gambling-specific treatment. Alternative services such as telephone counseling may be beneficial for those who do not engage in treatment. (PsycINFO Database Record (c) 2011 APA, all rights reserved).

  2. Improved corticosteroid treatment of recalcitrant de Quervain tenosynovitis with a novel 4-point injection technique.

    Science.gov (United States)

    Pagonis, Thomas; Ditsios, Konstantinos; Toli, Paraskevi; Givissis, Panagiotis; Christodoulou, Anastasios

    2011-02-01

    Previously described corticosteroid injection techniques for de Quervain tenosynovitis (DQT) refer to either 1-point or 2-point injection techniques, showing superiority of the latter. The authors' novel 4-point injection technique (point 4 technique) yields more favorable results than do the older techniques. Randomized controlled trial; Level of evidence, 2. The authors treated 2 groups (A and B), each including 24 high-resistance training individuals (randomly allocated to each group) with persistent DQT. Group A received the point 4 technique, and group B, the 2-point injection technique. Follow-up was in 2, 4, 8, and 52 weeks after the first treatment. After 2 weeks of treatment, 7 group A patients were symptom-free, whereas the rest scored better than their group B counterparts on the DASH (Disabilities of the Arm, Shoulder and Hand) Outcome Measure, of whom only 1 was symptom-free. Ten group A patients received repeated injections, in contrast to 19 from group B. Four weeks after the first treatment, 13 group A patients were symptom-free, in contrast to 4 from group B. In group A, 2 patients received repeated injections, in contrast to 20 in group B. Eight weeks after the first treatment, 1 group A patient received repeated injection. One group B patient relapsed, whereas 4 opted for surgical decompression and 16 received repeated injections. Fifty-two weeks after the first treatment, 21 patients in group A were symptom-free, 1 was operated on, and 2 relapsed; in group B, 12 were symptom-free, 9 were operated on, 3 relapsed, and 3 received repeated injections. In high-resistance training athletes, recalcitrant DQT responds more favorably to the novel point 4 technique than to the standard 2-point injection technique.

  3. Two-Point Discrimination Test in the Treatment of Right-handed Females with Lumbosacral Radiculopathy

    Directory of Open Access Journals (Sweden)

    Seyed Reza Saeidian

    2011-12-01

    Full Text Available Non-somatic causes of pain may aggravate painful complaints and complicate the conservative management of diseases such as lumbo-sacral disk root disease. The two-point discrimination test has been used for assessment of diseases, which change patients' skin sensation. This study aims to find out how applicable is two-point discrimination test in the conservative treatment of lumbo-sacral disk diseases. Twenty right-handed females suffering from unilateral lumbo-sacral disk disease were admitted for a conservative treatment from 2006 to 2009. The treatment con-sisted of a week bed rest, physiotherapy, and medication. They were subjected to straight leg raising tests, and their pains were evaluated using visual analog scale. The values of two-point discrimination test were obtained bilaterally for L4, L5 and S1 dermatomes. Changes between the involved and intact lower limbs as well as values of two-point discrimination test before and after the treatment were also compared. In addition, the correlation between the outcome of two-point discrimination, straight leg raising tests, or pain scores were evaluated. There was a significant (P<0.001 difference between the changes in the values of two-point discrimination test, pain scales, or straight leg raising tests in the involved and intact limbs before and after the treatment. However, correlation among variables did not reach statistical significance (P<0.94, r=0.017. The results indicated that although two-point discrimination test is a feasible and objective tool to evaluate patients' improvements during the conservative management of lumbo-sacral disk diseases, there were no strong correlations between two-point discrimination test and straight leg raising tests, or pain scale.

  4. Two-Point Discrimination Test in the Treatment of Right-handed Females with Lumbosacral Radiculopathy

    Science.gov (United States)

    Saeidian, Seyed Reza; Moghaddam, Hadi Fathi; Ahangarpour, Akram; Latifi, Seyed Mahmood

    2011-01-01

    Non-somatic causes of pain may aggravate painful complaints and complicate the conservative management of diseases such as lumbo-sacral disk root disease. The two-point discrimination test has been used for assessment of diseases, which change patients' skin sensation. This study aims to find out how applicable is two-point discrimination test in the conservative treatment of lumbo-sacral disk diseases. Twenty right-handed females suffering from unilateral lumbo-sacral disk disease were admitted for a conservative treatment from 2006 to 2009. The treatment consisted of a week bed rest, physiotherapy, and medication. They were subjected to straight leg raising tests, and their pains were evaluated using visual analog scale. The values of two-point discrimination test were obtained bilaterally for L4, L5 and S1 dermatomes. Changes between the involved and intact lower limbs as well as values of two-point discrimination test before and after the treatment were also compared. In addition, the correlation between the outcome of two-point discrimination, straight leg raising tests, or pain scores were evaluated. There was a significant (P<0.001) difference between the changes in the values of two-point discrimination test, pain scales, or straight leg raising tests in the involved and intact limbs before and after the treatment. However, correlation among variables did not reach statistical significance (P<0.94, r=0.017). The results indicated that although two-point discrimination test is a feasible and objective tool to evaluate patients' improvements during the conservative management of lumbo-sacral disk diseases, there were no strong correlations between two-point discrimination test and straight leg raising tests, or pain scale. PMID:23115415

  5. An Overview of Current Approaches Toward the Treatment and Prevention of West Nile Virus Infection.

    Science.gov (United States)

    Acharya, Dhiraj; Bai, Fengwei

    2016-01-01

    The persistence of West Nile virus (WNV) infections throughout the USA since its inception in 1999 and its continuous spread throughout the globe calls for an urgent need of effective treatments and prevention measures. Although the licensing of several WNV vaccines for veterinary use provides a proof of concept, similar efforts on the development of an effective vaccine for humans remain still unsuccessful. Increased understanding of biology and pathogenesis of WNV together with recent technological advancements have raised hope that an effective WNV vaccine may be available in the near future. In addition, rapid progress in the structural and functional characterization of WNV and other flaviviral proteins have provided a solid base for the design and development of several classes of inhibitors as potential WNV therapeutics. Moreover, the therapeutic monoclonal antibodies demonstrate an excellent efficacy against WNV in animal models and represent a promising class of WNV therapeutics. However, there are some challenges as to the design and development of a safe and efficient WNV vaccine or therapeutic. In this chapter, we discuss the current approaches, progress, and challenges toward the development of WNV vaccines, therapeutic antibodies, and antiviral drugs.

  6. Treatment of Myofascial Trigger Points of Pelvic Floor with Physiotherapeutic Package: A Case Report

    Directory of Open Access Journals (Sweden)

    Esmaeil Shokri

    2015-03-01

    Full Text Available Background: There are various factors that may cause pain and dysfunction in the pelvic region. Myofascial trigger points can likewise contribute in pelvic pain. Common treatments for myofascial trigger points include electrotherapy, laser therapy, massage, ischemic compression, dry-needling, stretch, icing, heating, and biofeedback. Case Report: A 26 year old man with an exertion-related pain that lasted 5 months was referred for physiotherapy consultation. He had no pain at rest but reported a referral pain from perineal region to the anus and muscular stiffness following a bout of physical activity. On palpation there was a trigger point in the perineal region with referral pain to anus. At the beginning of the treatment, the patient was asked to stop his physical activities. The patient received a treatment package which was useful in the management of trigger points. After 7 sessions of treatment the pain was diminished and there was no exercise induced stiffness. The patient was followed for 10 months later and no pain and stiffness was reported. Conclusion: The application of heat, friction massage, stretching, combined with endurance exercise could be an effective treatment for reliving the pain and muscular stiffness caused by trigger points.

  7. A novel point-of-use water treatment method by antimicrobial nanosilver textile material.

    Science.gov (United States)

    Liu, Hongjun; Tang, Xiaosheng; Liu, Qishan

    2014-12-01

    Pathogenic bacteria are one of the main reasons for worldwide water-borne disease causing a big threat to public health, hence there is an urgent need to develop cost-effective water treatment technologies. Nano-materials in point-of-use systems have recently attracted considerable research and commercial interests as they can overcome the drawbacks of traditional water treatment techniques. We have developed a new point-of-use water disinfection kit with nanosilver textile material. The silver nanoparticles were in-situ generated and immobilized onto cotton textile, followed by fixing to a plastic tube to make a water disinfection kit. By soaking and stirring the kit in water, pathogenic bacteria have been killed within minutes. The silver leaching from the kit was insignificant, with values water. Herein, the nanosilver textile water disinfection kit could be a new, efficient and cost-effective point-of-use water treatment method for rural areas and emergency preparedness.

  8. Impact of Heat Treatment on the Freezing Points of Cow and Goat Milk

    Directory of Open Access Journals (Sweden)

    Bohumíra Janštová

    2009-01-01

    Full Text Available The aim of this study was to monitor the impact of heat treatment variables on the freezing point of cow and goat milk. The freezing point (FP was established in 30 bulk tank samples of goat milk and in 30 bulk tank samples of cow milk which were subject to laboratory heat treatment at temperatures of 72 °C (A, 85 °C (B, 95 °C (C, with the same exposition times of 20 s. Freezing point measurements of raw and heat-treated milk were carried out in compliance with the Standard CTS 57 0538 by a thermistor cryoscope. The FP of raw cow milk increased with heat treatment from the initial values of -0.5252 ± 0.0114 °C (O by 0.0023 °C (A, 0.0034 °C (B and 0.0051°C (C. Changes in FP values of goat milk were detected, from its initial value of –0.5530 ± 0.0086 °C there was an increase in the FP depending on the mode of heat treatment due to pasteurization by an average of 0.0028 °C (A, 0.0036 °C (B and 0.0054 °C (C. The dynamics of the changes were similar both in goat and cow milk. Freezing point values in cow and goat milk differed (P ⪬ 0.01 when compared to the freezing point of untreated milk after the individual interventions as well as when compared between each other. An increase in the heat treatment temperature of cow and goat milk causes an increase in the freezing point (a shift towards zero. These results can be used in practice for checking the raw material in dairy industry.

  9. Social service offices as a point of entry into substance abuse treatment for poor South Africans

    Science.gov (United States)

    2012-01-01

    Background In South Africa, district social service offices are often the first point of entry into the substance abuse treatment system. Despite this, little is known about the profile of people presenting with substance-related problems at these service points. This has a negative impact on treatment service planning. This paper begins to redress this gap through describing patterns of substance use and service needs among people using general social services in the Western Cape and comparing findings against the profile of persons attending specialist substance abuse treatment facilities in the region. Methods As part of a standard client information system, an electronic questionnaire was completed for each person seeking social assistance. Data on socio-demographic characteristics, the range of presenting problems, patterns of substance use, perceived consequences of substance use, as well as types of services provided were analysed for the 691 social welfare clients who reported substance use between 2007 and 2009. These data were compared against clients attending substance abuse treatment centres during the same time period. Results Findings indicate that social services offices are used as a way of accessing specialist services but are also used as a service point, especially by groups under-represented in the specialist treatment sector. Women, people from rural communities and people with alcohol-related problems are more likely to seek assistance at social service offices providing low threshold intervention services than from the specialist treatment sector. Conclusions The study provides evidence that social services are a point of entry and intervention for people from underserved communities in the Western Cape. If these low-threshold services can be supported to provide good quality services, they may be an effective and efficient way of improving access to treatment in a context of limited service availability. PMID:22642796

  10. "Make Sure You're Not Getting Yourself in Trouble:" Building Sexual Relationships and Preventing Sexual Violence at the U.S. Military Academy at West Point.

    Science.gov (United States)

    Arbeit, Miriam R

    2017-10-01

    Sexual violence continues to present a problem on college campuses nationwide and among members of the U.S. military. This study attended to patterns of response in how students (cadets) at the U.S. Military Academy (West Point) discussed sexual and romantic relationships, both potential and actual, in order to examine how, if at all, they enact their sexuality-related values. Constructivist grounded theory was used to analyze semistructured interviews with three male and three female cadets from each of the 4 years of the undergraduate program, in which they are intended to become "leaders of character" who will serve as Army officers. Findings indicated limitations in cadets' access to developing and implementing sexuality-related skills within this context. Cadets' fear and distrust erected barriers to their pursuing their desires; the ways in which cadets avoided getting in trouble for sexual harassment or sexual assault shifted responsibility from a potential perpetrator onto a potential victim; and cadets were caught in dilemmas regarding romantic relationships as sources of both emotional support and social stigma. These findings have implications for promoting gender equity and for preventing sexual violence at this institution and at others like it, including both university campuses and other military settings.

  11. Randomized trial of trigger point acupuncture treatment for chronic shoulder pain: a preliminary study.

    Science.gov (United States)

    Itoh, Kazunori; Saito, Shingo; Sahara, Shunsaku; Naitoh, Yuki; Imai, Kenji; Kitakoji, Hiroshi

    2014-04-01

    There is evidence for the efficacy of acupuncture treatment for chronic shoulder pain, but it remains unclear which acupuncture modes are most effective. We compared the effect of trigger point acupuncture (TrP), with that of sham (SH) acupuncture treatments, on pain and shoulder function in patients with chronic shoulder pain. The participants were 18 patients (15 women, 3 men; aged 42-65 years) with nonradiating shoulder pain for at least 6 months and normal neurological findings. The participants were randomized into two groups, each receiving five treatment sessions. The TrP group received treatment at trigger points for the muscle, while the other group received SH acupuncture treatment on the same muscle. Outcome measures were pain intensity (visual analogue scale, VAS) and shoulder function (Constant-Murley Score: CMS). After treatment, pain intensity between pretreatment and 5 weeks after TrP decreased significantly (pShoulder function also increased significantly between pretreatment and 5 weeks after TrP (pshoulder pain. Copyright © 2014. Published by Elsevier B.V.

  12. Root diseases in coniferous forests of the Inland West: potential implications of fuels treatments

    Science.gov (United States)

    Raini C. Rippy; Jane E. Stewart; Paul J. Zambino; Ned B. Klopfenstein; Joanne M. Tirocke; Mee-Sook Kim; Walter G. Thies

    2005-01-01

    After nearly 100 years of fire exclusion, introduced pests, and selective harvesting, a change in forest composition has occurred in many Inland West forests of North America. This change in forest structure has frequently been accompanied by increases in root diseases and/or an unprecedented buildup of fuels. Consequently, many forest managers are implementing plans...

  13. Pre-sowing Treatment for Improving Seed Quality in West African ...

    African Journals Online (AJOL)

    Ten diverse modem West African rice varieties were exposed to six dry heat temperatures (40° C, 45° C, 50° C, 55° C, 60° C and control (32° C) for 24 hours and thereafter seed germination, speed of germination and seedling vigor were investigated. Dry heat temperatures significantly stimulated seed germination above ...

  14. Neuro Emotional Technique for the treatment of trigger point sensitivity in chronic neck pain sufferers: a controlled clinical trial

    National Research Council Canada - National Science Library

    Bablis, Peter; Pollard, Henry; Bonello, Rod

    2008-01-01

    Trigger points have been shown to be active in many myofascial pain syndromes. Treatment of trigger point pain and dysfunction may be explained through the mechanisms of central and peripheral paradigms...

  15. Depression treatment for impoverished mothers by point-of-care providers: A randomized controlled trial.

    Science.gov (United States)

    Segre, Lisa S; Brock, Rebecca L; O'Hara, Michael W

    2015-04-01

    Depression in low-income, ethnic-minority women of childbearing age is prevalent and compromises infant and child development. Yet numerous barriers prevent treatment delivery. Listening Visits (LV), an empirically supported intervention developed for delivery by British home-visiting nurses, could address this unmet mental health need. This randomized controlled trial (RCT) evaluated the effectiveness of LV delivered at a woman's usual point-of-care, including home visits or an ob-gyn office. Listening Visits were delivered to depressed pregnant women or mothers of young children by their point-of-care provider (e.g., home visitor or physician's assistant), all of whom had low levels of prior counseling experience. Three quarters of the study's participants were low-income. Of those who reported ethnicity, all identified themselves as minorities. Participants from 4 study sites (N = 66) were randomized in a 2:1 ratio, to LV or a wait-list control group (WLC). Assessments, conducted at baseline and 8 weeks, evaluated depression, quality of life, and treatment satisfaction. Depressive severity, depressive symptoms, and quality of life significantly improved among LV recipients as compared with women receiving standard social/health services. Women valued LV as evidenced by their high attendance rates and treatment satisfaction ratings. In a stepped model of depression care, LV can provide an accessible, acceptable, and effective first-line treatment option for at-risk women who otherwise are unlikely to receive treatment. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

  16. Treatment of myofascial trigger points in patients with chronic shoulder pain: a randomized, controlled trial

    OpenAIRE

    Stegenga Boudewijn; Dommerholt Jan; de Gast Arthur; Bron Carel; Wensing Michel; Oostendorp Rob AB

    2011-01-01

    Abstract Background Shoulder pain is a common musculoskeletal problem that is often chronic or recurrent. Myofascial trigger points (MTrPs) cause shoulder pain and are prevalent in patients with shoulder pain. However, few studies have focused on MTrP therapy. The aim of this study was to assess the effectiveness of multimodal treatment of MTrPs in patients with chronic shoulder pain. Methods A single-assessor, blinded, randomized, controlled trial was conducted. The intervention group receiv...

  17. Using sorbent waste materials to enhance treatment of micro-point source effluents by constructed wetlands

    OpenAIRE

    Green, Verity; Surridge, Ben; Quinton,John; Matthews, Mike

    2014-01-01

    Sorbent materials are widely used in environmental settings as a means of = enhancing pollution remediation. A key area of environmental concern is that of water pollution, including the need to treat micro-point sources of wastewater pollution, such as from caravan sites or visitor centres. Constructed wetlands (CWs) represent one means for effective treatment of wastewater from small wastewater producers, in part because they are believed to be economically viable and environmentally sustai...

  18. National Pollution Discharge Elimination System (NPDES) Wastewater Treatment Plant Points, Region 9, 2007, US EPA Region 9

    Data.gov (United States)

    U.S. Environmental Protection Agency — Point geospatial dataset representing locations of NPDES Waste Water Treatment Plant Facilities. NPDES (National Pollution Discharge Elimination System) is an EPA...

  19. National Pollution Discharge Elimination System (NPDES) Wastewater Treatment Plant Points, Region 9, 2012, US EPA Region 9

    Data.gov (United States)

    U.S. Environmental Protection Agency — Point geospatial dataset representing locations of NPDES Waste Water Treatment Plant Facilities. NPDES (National Pollution Discharge Elimination System) is an EPA...

  20. National Pollution Discharge Elimination System (NPDES) Wastewater Treatment Plant Points, Region 9, 2011, US EPA Region 9

    Data.gov (United States)

    U.S. Environmental Protection Agency — Point geospatial dataset representing locations of NPDES Waste Water Treatment Plant Facilities. NPDES (National Pollution Discharge Elimination System) is an EPA...

  1. Brine delineation and monitoring with electrical resistivity tomography and electromagnetic borehole logging at the Fort Knox well field near West Point, Kentucky

    Science.gov (United States)

    Henderson, Rory; Unthank, Michael D.; Zettwoch, Douglas D.; Lane, John W.

    2010-01-01

    The potable water system at Fort Knox is threatened by brine contamination from improperly abandoned natural gas exploration wells. The Fort Knox well field is located near the town of West Point, Kentucky, in the flood plain of the Ohio River. At the site, unconsolidated sediments approximately 30 – 40 m thick, overlie shale and porous limestone. Brine is believed to flow vertically from the underlying formations to the unconsolidated aquifer through damaged or leaky well casings under a high hydraulic gradient from the artificially pressurized porous limestone, which is utilized for natural gas storage by a regional energy company. Upon reaching the unconsolidated aquifer, brinecontaminated groundwater enters water supply production wells under the pumping‐induced gradient. As part of the Fort Knox remediation strategy to reduce the impact of brine contamination, electrical resistivity tomography (ERT) and borehole electromagnetic (EM) logs are being collected annually to detect gross changes in subsurface conductivity. The 2009 ERT data show areas of high conductivity on the western (contaminated) side of the site with conductivities more than an order of magnitude higher than on the eastern (uncontaminated) side of the site. The areas of high conductivity are interpreted as brine contamination, consistent with known regions of brine contamination. Conductivities from the EM logs are consistent with the results from the ERT inversions. The EM logs show little change between 2008 and 2009, except for some small changes in the brine distribution in well PZ1. Yearly ERT surveys will be continued to detect new areas of brine contamination and monitor the remediation effort.

  2. Antiretroviral treatment response of HIV-infected children after prevention of mother-to-child transmission in West Africa

    DEFF Research Database (Denmark)

    Ndondoki, Camille; Dicko, Fatoumata; Ahuatchi Coffie, Patrick

    2014-01-01

    INTRODUCTION: We assessed the rate of treatment failure of HIV-infected children after 12 months on antiretroviral treatment (ART) in the Paediatric IeDEA West African Collaboration according to their perinatal exposure to antiretroviral drugs for preventing mother-to-child transmission (PMTCT...... failure was not significantly associated with PMTCT exposure (p=0.15) but was associated with immunodeficiency (aHR 1.6; 95% CI: 1.4-1.9; p=0.001), AIDS clinical events (aHR 1.4; 95% CI: 1.0-1.9; p=0.02) at ART initiation and receiving care in Mali compared to Côte d'Ivoire (aHR 1.2; 95% CI: 1.0-1.4; p=0.......04). CONCLUSIONS: Despite a low data quality, PMTCT-exposed West African children did not have a poorer 12-month response to ART than others. Immunodeficiency and AIDS events at ART initiation remain the main predictors associated with treatment failure in this operational context....

  3. Suitability of point kernel dose calculation techniques in brachytherapy treatment planning.

    Science.gov (United States)

    Lakshminarayanan, Thilagam; Subbaiah, K V; Thayalan, K; Kannan, S E

    2010-04-01

    Brachytherapy treatment planning system (TPS) is necessary to estimate the dose to target volume and organ at risk (OAR). TPS is always recommended to account for the effect of tissue, applicator and shielding material heterogeneities exist in applicators. However, most brachytherapy TPS software packages estimate the absorbed dose at a point, taking care of only the contributions of individual sources and the source distribution, neglecting the dose perturbations arising from the applicator design and construction. There are some degrees of uncertainties in dose rate estimations under realistic clinical conditions. In this regard, an attempt is made to explore the suitability of point kernels for brachytherapy dose rate calculations and develop new interactive brachytherapy package, named as BrachyTPS, to suit the clinical conditions. BrachyTPS is an interactive point kernel code package developed to perform independent dose rate calculations by taking into account the effect of these heterogeneities, using two regions build up factors, proposed by Kalos. The primary aim of this study is to validate the developed point kernel code package integrated with treatment planning computational systems against the Monte Carlo (MC) results. In the present work, three brachytherapy applicators commonly used in the treatment of uterine cervical carcinoma, namely (i) Board of Radiation Isotope and Technology (BRIT) low dose rate (LDR) applicator and (ii) Fletcher Green type LDR applicator (iii) Fletcher Williamson high dose rate (HDR) applicator, are studied to test the accuracy of the software. Dose rates computed using the developed code are compared with the relevant results of the MC simulations. Further, attempts are also made to study the dose rate distribution around the commercially available shielded vaginal applicator set (Nucletron). The percentage deviations of BrachyTPS computed dose rate values from the MC results are observed to be within plus/minus 5.5% for

  4. Suitability of point kernel dose calculation techniques in brachytherapy treatment planning

    Directory of Open Access Journals (Sweden)

    Lakshminarayanan Thilagam

    2010-01-01

    Full Text Available Brachytherapy treatment planning system (TPS is necessary to estimate the dose to target volume and organ at risk (OAR. TPS is always recommended to account for the effect of tissue, applicator and shielding material heterogeneities exist in applicators. However, most brachytherapy TPS software packages estimate the absorbed dose at a point, taking care of only the contributions of individual sources and the source distribution, neglecting the dose perturbations arising from the applicator design and construction. There are some degrees of uncertainties in dose rate estimations under realistic clinical conditions. In this regard, an attempt is made to explore the suitability of point kernels for brachytherapy dose rate calculations and develop new interactive brachytherapy package, named as BrachyTPS, to suit the clinical conditions. BrachyTPS is an interactive point kernel code package developed to perform independent dose rate calculations by taking into account the effect of these heterogeneities, using two regions build up factors, proposed by Kalos. The primary aim of this study is to validate the developed point kernel code package integrated with treatment planning computational systems against the Monte Carlo (MC results. In the present work, three brachytherapy applicators commonly used in the treatment of uterine cervical carcinoma, namely (i Board of Radiation Isotope and Technology (BRIT low dose rate (LDR applicator and (ii Fletcher Green type LDR applicator (iii Fletcher Williamson high dose rate (HDR applicator, are studied to test the accuracy of the software. Dose rates computed using the developed code are compared with the relevant results of the MC simulations. Further, attempts are also made to study the dose rate distribution around the commercially available shielded vaginal applicator set (Nucletron. The percentage deviations of BrachyTPS computed dose rate values from the MC results are observed to be within plus/minus 5

  5. Auricular Point Acupressure for Chronic Low Back Pain: A Feasibility Study for 1-Week Treatment

    Directory of Open Access Journals (Sweden)

    Chao-Hsing Yeh

    2012-01-01

    Full Text Available Objectives. The objective of this one-group, repeated-measures design was to explore the acceptance of auricular point acupressure (APA to reduce chronic low back pain (CLBP and estimate minimum clinically important differences (MCIDs for pain intensity change. Methods. Subjects received 7-day APA treatment. After appropriate acupoints were identified, vaccaria seeds were carefully taped onto each selected auricular point for 7-day. The Brief Pain Inventory Short Form (BPI was used to collect outcome data. Results. A total of 74 subjects participated in the study. Ten subjects dropped out and the retention rate was 87%. Subjects reported a 46% reduction in BPI worst pain, and over 50% reduction in BPI average pain, overall pain severity and pain interference by the end of study, and 62.5% subjects also reported less pain medication use. The MCIDs for the subscale of BPI ranged from .70 to 1.86 points. The percentage improvement of MCIDs from baseline was between 14.5–24.9%. Discussion. APA appears to be highly acceptable to patients with CLBP. A sham group is needed in order to differentiate the true effects of APA from the possible psychological effects of more frequent visits by the auricular therapist and patients’ expectation of the APA treatment.

  6. [Analysis of the key points in the micro-endodontic treatment].

    Science.gov (United States)

    Hou, B X

    2016-08-01

    Micro-endodontic treatment refers to the microscope-assisted endodontic treatment techniques. The microscope offers a stereoscopic, enlarged image under great magnification and illumination at a comfortable working position. It will greatly promote the precision and improve the outcomes of endodontic treatment through enhancing the ability to detect the complexity of the root canal system of teeth that probably cannot be seen by the naked eyes, remove the infectious substances in root canal more efficiently, provide a tight root canal obturation and carry out effective retreatment procedures. The requirements of micro-endodontic treatment are different from the conventional root canal therapy carried out without microscope due to the complicated structure of the microscope. In order to make the use of microscope easier, it is of great importance to learn how to adjust the position of the operator and the patient, preset the angle of objective lens and the eyepiece, select the proper magnification and instruments, practice eye-hand cooperation under the microscope, etc. The purpose of this article was to analyze the key points in the applications of the microscope in endodontic treatment by reviewing the literature together with the author's clinical experience.

  7. Assessment of Nelumbo nucifera and Hydrilla verticillata in the treatment of pharmaceutical industry effluent from 24 Parganas, West Bengal

    Directory of Open Access Journals (Sweden)

    Shamba Chatterjee

    2014-10-01

    Full Text Available Modern day technologies employed in industrialization and unhygienic lifestyle of mankind has led to a severe environmental menace resulting in pollution of freshwater bodies. Pharmaceutical industry effluents cause eutrophication and provide adequate nutrients for growth of pathogenic bacteria. This study has been conducted with aquatic plants water lotus (Nelumbo nucifera and hydrilla (Hydrilla verticillata with an novel aim to treat pharmaceutical industry effluents showing the outcome of the experiments carried out with the effluents collected from rural areas of 24 Parganas, West Bengal, India. Determination of pH, solid suspend, BOD5, NH3-N, MPN and coliform test were used for this notioned purpose. Pharmaceutical waste effluent water treated with water lotus showed less pH, solid suspend, DO, BOD, NH3-N, MPN and coliform bacteria than hydrilla treatment when compared to the control. In conclusion, water lotus is found to be more efficient in treatment of pharmaceutical industry effluent waste water than hydrilla.

  8. Air–sea fluxes of CO2 and CH4 from the Penlee Point Atmospheric Observatory on the south-west coast of the UK

    Directory of Open Access Journals (Sweden)

    M. Yang

    2016-05-01

    Full Text Available We present air–sea fluxes of carbon dioxide (CO2, methane (CH4, momentum, and sensible heat measured by the eddy covariance method from the recently established Penlee Point Atmospheric Observatory (PPAO on the south-west coast of the United Kingdom. Measurements from the south-westerly direction (open water sector were made at three different sampling heights (approximately 15, 18, and 27 m above mean sea level, a.m.s.l., each from a different period during 2014–2015. At sampling heights  ≥  18 m a.m.s.l., measured fluxes of momentum and sensible heat demonstrate reasonable ( ≤  ±20 % in the mean agreement with transfer rates over the open ocean. This confirms the suitability of PPAO for air–sea exchange measurements in shelf regions. Covariance air–sea CO2 fluxes demonstrate high temporal variability. Air-to-sea transport of CO2 declined from spring to summer in both years, coinciding with the breakdown of the spring phytoplankton bloom. We report, to the best of our knowledge, the first successful eddy covariance measurements of CH4 emissions from a marine environment. Higher sea-to-air CH4 fluxes were observed during rising tides (20 ± 3; 38 ± 3; 29 ± 6 µmole m−2 d−1 at 15, 18, 27 m a.m.s.l. than during falling tides (14 ± 2; 22 ± 2; 21 ± 5 µmole m−2 d−1, consistent with an elevated CH4 source from an estuarine outflow driven by local tidal circulation. These fluxes are a few times higher than the predicted CH4 emissions over the open ocean and are significantly lower than estimates from other aquatic CH4 hotspots (e.g. polar regions, freshwater. Finally, we found the detection limit of the air–sea CH4 flux by eddy covariance to be 20 µmole m−2 d−1 over hourly timescales (4 µmole m−2 d−1 over 24 h.

  9. Effects of treatment of myofascial trigger points on the pain of fibromyalgia.

    Science.gov (United States)

    Giamberardino, Maria Adele; Affaitati, Giannapia; Fabrizio, Alessandra; Costantini, Raffaele

    2011-10-01

    Myofascial pain syndromes (MPSs) from trigger points (TrPs) and fibromyalgia syndrome (FMS) are common musculoskeletal pain conditions that frequently coexist in the same patients. In recent decades, it has become evident that these entities greatly influence each other's clinical expression. FMS is mainly rooted in the central nervous system, while TrPs have a peripheral origin. However, the nociceptive impulses from TrPs may have significant impact on symptoms of FMS, probably by enhancing the level of central sensitization typical of this condition. Several attempts have been made to assess the effects of treatment of co-occurring TrPs in FMS. We report the outcomes of these studies showing that local extinction of TrPs in patients with fibromyalgia produces significant relief of FMS pain. Though further studies are needed, these findings suggest that assessment and treatment of concurrent TrPs in FMS should be systematically performed before any specific fibromyalgia therapy is undertaken.

  10. [Endovascular treatment for venous malformations with three-point anhydrous ethanol injection].

    Science.gov (United States)

    Wu, Qizhen; Li, Jiaguang; Lei, Shaorong; Tan, Wuyuan; Long, Jianhong

    2015-08-01

    To explore the safe method with anhydrous ethanol injection in the treatment of venous malformation.
 A total of 96 patients with venous malformation were conducted anhydrous ethanol injection for 245 times through percutaneous puncture by three-point method. The complications were observed. In animal experiment, according to the different concentrations of anhydrous ethanol injection, rats were divided into an anhydrous ethanol group, a 75% ethanol group, a 50% ethanol group and a 25% ethanol group (n=5 in each group), and the damage of vessels after ethanol injection was observed.
 The successful rate for three-point ethanol injection was 88%. The incidence for both skin ulcer and numbness was 0.9% without severe complications in lung and heart. In the animal experiments, the entire vessel wall including outer membrane was damaged in the anhydrous ethanol group. Part of vessel walls, including the inner membrane and muscle layer, were damaged in both the 75% ethanol group and the 50% ethanol group. However, there was no damage in the vessels in the 25% ethanol group.
 With the decrease in ethanol concentration, the vascular damage is decreased and eventually disappeared. Three-point anhydrous ethanol injection is safe and effective.

  11. Is point-of-care accurate for indicating thrombolysis in anticoagulated patients on oral anticoagulation treatments?

    Directory of Open Access Journals (Sweden)

    Tatiana P. Bruch

    Full Text Available The use of oral anticoagulation treatment (OAT in patients with an international normalized ratio (INR higher than 1.7 is a contraindication to thrombolysis in acute ischemic stroke. The aim of the present study is to compare the use of point-of-care (POC coagulometers to the standard coagulation analysis (SCA procedure of the INR as a decision-making test for use with patients taking OAT. Method: Eighty patients on chronic OAT underwent a POC and an SCA during a regular outpatient evaluation. Results: When comparing the abilities of the POC test and the SCA test to identify adequate levels for thrombolysis (≤1.7, the POC had a sensitivity of 96.6% (95%CI 88.4-99.1 and a specificity of 60.0% (95%CI 38.6-78. POC overestimated INR levels by 0.51 points compared to the SCA test. Conclusion: POC has a high sensitivity compared to the SCA test for the identification of patients within the cut-off point for thrombolysis.

  12. Wet needling of myofascial trigger points in abdominal muscles for treatment of primary dysmenorrhoea.

    Science.gov (United States)

    Huang, Qiang-Min; Liu, Lin

    2014-08-01

    To evaluate the effect of wet needling (related to acupuncture) and home stretching exercises on myofascial trigger points (MTrPs) in abdominal muscles for the treatment of dysmenorrhoea. The effect of wet needing of MTrPs in abdominal muscles, supplemented by home stretching exercises, was observed in 65 patients with moderate and severe primary dysmenorrhoea. The MTrPs in the abdominal region were localised and repeatedly needled with lidocaine injection. Menstrual pain was evaluated with a Visual Analogue Scale (VAS) score after every treatment, with the final evaluation made at a 1-year follow-up. Treatment was stopped when the VAS pain score reduced to ≤3. Symptoms scores were analysed with one-way analysis of variance. The mean VAS pain score before treatment was 7.49±1.16. After a single wet needling session, 41 patients had a reduction in their VAS pain score to stretching exercises, justifying further research with controlled trials. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  13. Atmospheric Pressure Glow Discharge for Point-of-Use Water Treatment

    Science.gov (United States)

    Lindsay, Alexander; Byrns, Brandon; Shannon, Steven; Knappe, Detlef

    2012-10-01

    Treatment of biological and chemical contaminants is an area of growing global interest where atmospheric pressure plasmas can make a significant contribution. Addressing key challenges of volume processing and operational cost, a large volume 162 MHz coaxial air-plasma source has been developed.footnotetextByrns (2012) J. Phys. D: Appl. Phys. 45 (2012) 195204 Because of VHF ballasting effects, the electric discharge is maintained at a steady glow, allowing formation of critical non-equilibrium chemistry. High densities, ne = 10^11-10^12, have been recorded. The atmospheric nature of the device permits straightforward and efficient treatment of water samples. [H^+] concentrations in 150 milliliter tap water samples have been shown to increase by 10^5 after five minutes of discharge exposure. Recent literature has demonstrated that increasing acidity is strongly correlated with a solution's ability to deactivate microbial contaminants.footnotetextTraylor (2011) J. Phys. D: Appl. Phys. 44 (2011) 472001 The work presented here will explore the impact of treatment gas, system configuration, and power density on water disinfection and PFC abatement. An array of plasma diagnostics, including OES and electrical measurements, are combined with post-process water analysis, including GC-MS and QT analysis of coliform and E.coli bacteria. Development of volume processing atmospheric plasma disinfection methods offers promise for point-of-use treatments in developing areas of the world, potentially supplementing or replacing supply and weather-dependent disinfection methods.

  14. Evaluating the sustainability of ceramic filters for point-of-use drinking water treatment.

    Science.gov (United States)

    Ren, Dianjun; Colosi, Lisa M; Smith, James A

    2013-10-01

    This study evaluates the social, economic, and environmental sustainability of ceramic filters impregnated with silver nanoparticles for point-of-use (POU) drinking water treatment in developing countries. The functional unit for this analysis was the amount of water consumed by a typical household over ten years (37,960 L), as delivered by either the POU technology or a centralized water treatment and distribution system. Results indicate that the ceramic filters are 3-6 times more cost-effective than the centralized water system for reduction of waterborne diarrheal illness among the general population and children under five. The ceramic filters also exhibit better environmental performance for four of five evaluated life cycle impacts: energy use, water use, global warming potential, and particulate matter emissions (PM10). For smog formation potential, the centralized system is preferable to the ceramic filter POU technology. This convergence of social, economic, and environmental criteria offers clear indication that the ceramic filter POU technology is a more sustainable choice for drinking water treatment in developing countries than the centralized treatment systems that have been widely adopted in industrialized countries.

  15. Using sorbent waste materials to enhance treatment of micro-point source effluents by constructed wetlands

    Science.gov (United States)

    Green, Verity; Surridge, Ben; Quinton, John; Matthews, Mike

    2014-05-01

    Sorbent materials are widely used in environmental settings as a means of enhancing pollution remediation. A key area of environmental concern is that of water pollution, including the need to treat micro-point sources of wastewater pollution, such as from caravan sites or visitor centres. Constructed wetlands (CWs) represent one means for effective treatment of wastewater from small wastewater producers, in part because they are believed to be economically viable and environmentally sustainable. Constructed wetlands have the potential to remove a range of pollutants found in wastewater, including nitrogen (N), phosphorus (P), biochemical oxygen demand (BOD) and carbon (C), whilst also reducing the total suspended solids (TSS) concentration in effluents. However, there remain particular challenges for P and N removal from wastewater in CWs, as well as the sometimes limited BOD removal within these treatment systems, particularly for micro-point sources of wastewater. It has been hypothesised that the amendment of CWs with sorbent materials can enhance their potential to treat wastewater, particularly through enhancing the removal of N and P. This paper focuses on data from batch and mesocosm studies that were conducted to identify and assess sorbent materials suitable for use within CWs. The aim in using sorbent material was to enhance the combined removal of phosphate (PO4-P) and ammonium (NH4-N). The key selection criteria for the sorbent materials were that they possess effective PO4-P, NH4-N or combined pollutant removal, come from low cost and sustainable sources, have potential for reuse, for example as a fertiliser or soil conditioner, and show limited potential for re-release of adsorbed nutrients. The sorbent materials selected for testing were alum sludge from water treatment works, ochre derived from minewater treatment, biochar derived from various feedstocks, plasterboard and zeolite. The performance of the individual sorbents was assessed through

  16. The profile and treatment outcomes of sputum smear positive pulmonary tuberculosis re-treatment cases, in a district medical college of West Bengal, India

    Directory of Open Access Journals (Sweden)

    Abinash Agarwala

    2014-01-01

    Full Text Available Background: In a high tuberculosis (TB burden county like India with different regional demography, knowledge about patient profile has a pivotal role in determining and identifying the factors associated with poor treatment outcomes among TB re-treatment cases. Aim: The aim was to describe the demography and clinical characteristics of TB re-treatment cases and to evaluate the factors associated with poor treatment outcomes among those patients. Settings and Design: A prospective longitudinal cohort study was carried out at chest medicine outdoor from February, 2011 to 2014 in a district medical college of West Bengal, India. Materials and Methods: Sputum smear positive re-treatment pulmonary TB patients attending our chest medicine outdoor during the 3 years study period were evaluated for demographic and clinical characteristics on the basis of previous treatment history and records at the beginning of the study. Patients were followed-up during the 8 months treatment period (Category II treatment regimen under Revised National TB Control Program. At the end of the study period, treatment outcomes were analyzed and factors associated with poor treatment outcomes were identified. Statistical Analysis: All variables were described by proportions, and differences between independent groups were compared using the Chi-square test and Fisher′s exact test, as applicable. Results: Among 74 patients, re-treatment was successful in 75.7% of relapse case, 66.7% of loss to follow-up cases and 53.8% of failure cases. Re-treatment failure was higher (38.5% in treatment failure cases compare to relapse cases (10.8% and initial loss to follow-up cases (16.7%. Young age, male, unmarried, employed who work outside appears to be the risk factors for loss to follow-up. Low body mass index, treatment from the private sector, history of alcoholism, radiological cavitory lesion, larger duration of previous treatment, lesser gap from previous treatment has

  17. [Efficacy comparison of different points combination in the treatment of menopausal insomnia: a randomized controlled trial].

    Science.gov (United States)

    Yang, Song-Bai; Mei, Zhi-Gang; Cai, San-Jin; Lei, Hua-Ping; Sun, Cheng-Hong; Chen, Ling; Zhou, Chuang

    2014-01-01

    To compare the efficacy of different points combination in the treatment of menopausal insomnia. Ninety-six cases of menopausal insomnia were randomized into 3 groups, Xinshu (BL 15), Shenshu (BL 23), Sishencong (EX-HN 1), Shenmen (HT 7), Sanyinjiao (SP 6) were chosen in the restore interaction between the heart and the kidney group (group A, 32 cases); Zhaohai (KI 6), Jiaoxin (KI 8), Shenmai (BL 62), Pucan (BL 61) were chosen in the acupuncturing qiao mai group (group B, 32 cases); auricular Shenmen (TF4) and sensitive spot at the distribution area of auricular vagus nervus were chosen in the ear acupuncture group (group C, 32 cases). Six days made one session and the treatments were finished after 4 courses. The polysomnography (PSG) and Pittsburgh sleep quality index (PSQI) were employed before and after treatment to evaluate the alleviation of insomnia. The parameters of the sleep latency (SL), rapid wave sleep latency (RL) and sleep efficiency (SE) were significantly improved in the three groups, and the differences were statistically significant (P acupuncture has a better curative effect than the restore interaction between the heart and the kidney group and acupuncturing qiao mai group, it is worth of being promoted.

  18. Demographics, nature and treatment of orthopaedic trauma injuries occurring in an agricultural context in the West of Ireland.

    Science.gov (United States)

    Byrne, F J; Waters, P S; Waters, S M; Hynes, S; Ní Thuairisg, C P; O'Sullivan, M

    2011-03-01

    Farming is a major industry in the West of Ireland. This prospective study examined the age profile, nature and treatment of orthopaedic injuries occurring in agricultural surroundings presenting at the Orthopaedic Unit of Merlin Park Hospital, Galway. The cohort consisted of 70 direct or indirect farm employees presenting with orthopaedic injuries caused in an accident occurring on a farm. There were significantly (P < 0.01) more male than female farmers (73 vs. 27%) with a mean age of 63 years (ranging from 13 to 87 years). Average number of out-patient visits related to the injury was 3.6. Injuries involving livestock resulted in the majority of accidents (P < 0.05) with a significant rise in the number of visits with increasing age (P < 0.01) with older patients having more severe injuries. Soft tissue injuries and fractures were commonly encountered. Complex fractures were the slowest injury to heal requiring eight subsequent out-patient visits.

  19. [Comparative observation of corresponding channel point selection for treatment of prolapse of lumbar intervertebral disc].

    Science.gov (United States)

    Tang, Hua-Sheng

    2008-08-01

    To compare clinical therapeutic effects of acupuncture along channel and routine acupuncture on prolapse of lumbar intervertebral disc. One hundred and sixty-five cases were randomly divided into an observation group (n=85) and a control group (n=80). The observation group were treated with acupuncture at corresponding channel points according to types of the Gallbladder Channel and the Bladder Channel, and the control group were treated with acupuncture at routinely selected acupoints. Their therapeutic effects after treatment of 4 courses and their recurrence rates half a year later were observed. The cured and markedly effective rate of 88.2% and the recurrence rate of 24.0% in the observation group were significantly better than 72.5% and 41.4% in the control group, with significant differences between the two groups (both Pprolapse of lumbar intervertebral disc has significant short-term and long-term therapeutic effects.

  20. Effects of music in combination with vibration in acupuncture points on the treatment of fibromyalgia.

    Science.gov (United States)

    Weber, Augusto; Werneck, Lineu; Paiva, Eduardo; Gans, Paulo

    2015-02-01

    Fibromyalgia (FM) is a disease that causes widespread pain and increased sensitivity to pain because of a dysfunction in the central nervous system. This study investigated the effect of music combined with vibration on acupuncture points for the treatment of FM. A total of 120 patients with FM were allocated randomly to four groups (30 patients each). One group listened to a sequence of Bach's compositions. The second group was subjected to vibratory stimuli on a combination of acupuncture points on the skin. The third group (complete) underwent both procedures in a simultaneous and synchronized manner, with inclusion of binaural beats. The fourth group (control) received no stimulation. The participants underwent the experimental procedure during five sessions performed on alternate days. They were assessed by the Fibromyalgia Impact Questionnaire (FIQ) and the Health Assessment Questionnaire (HAQ) before the first session and after the last session (20 days). All groups showed a significant improvement in FIQ and HAQ scores at the evaluation after the intervention. The complete group exhibited the best result on both the FIQ and HAQ (peffect in FM may be substantial. However, comparison between groups revealed that the complete group had the greatest reduction in both FIQ and HAQ, with a significant improvement in HAQ, suggesting that the combined use of music and vibration exerts a greater effect on FM symptoms.

  1. Comparing FAMACHA eye color chart and Hemoglobin Color Scale tests for detecting anemia and improving treatment of bovine trypanosomosis in West Africa.

    Science.gov (United States)

    Grace, D; Himstedt, H; Sidibe, I; Randolph, T; Clausen, P-H

    2007-06-20

    African animal trypanosomosis (AAT) is considered the most important cattle disease in sub-Saharan Africa but its diagnosis in the field is difficult, resulting in inappropriate treatments, excessive delay in treatments and under-treatment. A field study in West Africa investigated the usefulness of anemia in the diagnosis of trypanosomosis. A total of 20,772 cattle blood samples were taken from 121 villages in 3 countries. The average packed cell volume (PCV) of trypanosomosis positive cattle was 23%, versus 28% for negative cattle. In a sub-set of animals, other causes of anemia were investigated showing most of the anemia burden was attributable to trypanosomosis. Anemia was a reasonably accurate indicator of trypanosomosis in the study area, with a sensitivity of 56% and a specificity of 80% and a diagnostic odds ratio of 4.2, the highest of all the signs evaluated (anemia, emaciation, staring coat, lymphadenopathy, fever, lacrimation and salivary or nasal discharge). Having confirmed the usefulness of anemia as a predictor of trypanosomosis, two potential pen-side tests for anemia were evaluated (the first reported trial of their use in cattle), firstly a color chart developed for anemia detection in sheep through visual inspection of conjunctival membranes (FAMACHA) and secondly the Hemoglobin Color Scale (HbCS) developed for assessing hemoglobin levels in human patients by comparing blood drops on filter paper with color standards. In a population of cattle suspected by their owners to be sick with trypanosomosis (n=898) the sensitivity of the HbCS test was 56% and the specificity was 77%, while the sensitivity of the FAMACHA test was 95% and the specificity was 22%. The higher sensitivity but lower specificity suggests the FAMACHA may be useful as a screening test and the HbCS as a confirmatory test. The two tests were also evaluated in cattle randomly selected from the village herd. Using cut-off points to optimize test performance, the HbCS test had a

  2. AUA White Paper on Nonneurogenic Chronic Urinary Retention: Consensus Definition, Treatment Algorithm, and Outcome End Points.

    Science.gov (United States)

    Stoffel, John T; Peterson, Andrew C; Sandhu, Jaspreet S; Suskind, Anne M; Wei, John T; Lightner, Deborah J

    2017-07-01

    The AUA (American Urological Association) QIPS (Quality Improvement and Patient Safety) committee created a white paper on the diagnosis and management of nonneurogenic chronic urinary retention. Recommendations for the white paper were based on a review of the literature and consensus expert opinion from the workgroup. The workgroup defined nonneurogenic chronic urinary retention as an elevated post-void residual of greater than 300 mL that persisted for at least 6 months and documented on 2 or more separate occasions. It is proposed that chronic urinary retention should be categorized by risk (high vs low) and symptomatology (symptomatic versus asymptomatic). High risk chronic urinary retention was defined as hydronephrosis on imaging, stage 3 chronic kidney disease or recurrent culture proven urinary tract infection or urosepsis. Symptomatic chronic urinary retention was defined as subjectively moderate to severe urinary symptoms impacting quality of life and/or a recent history of catheterization. A treatment algorithm was developed predicated on stratifying patients with chronic urinary retention first by risk and then by symptoms. The proposed 4 primary outcomes that should be assessed to determine effectiveness of retention treatment are 1) symptom improvement, 2) risk reduction, 3) successful trial of voiding without catheterization, and 4) stability of symptoms and risk over time. Defining and categorizing nonneurogenic chronic urinary retention, creating a treatment algorithm and proposing treatment end points will hopefully spur comparative research that will ultimately lead to a better understanding of this challenging condition. Copyright © 2017 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  3. National Pollution Discharge Elimination System (NPDES) Wastewater Treatment Plant Outfall Points, Region 9, 2011, US EPA Region 9

    Data.gov (United States)

    U.S. Environmental Protection Agency — Point geospatial dataset representing locations of NPDES outfalls/dischargers for waste water treatment plants which generally represent the site of the discharge....

  4. National Pollution Discharge Elimination System (NPDES) Wastewater Treatment Plant Outfall Points, Region 9, 2012, US EPA Region 9

    Data.gov (United States)

    U.S. Environmental Protection Agency — Point geospatial dataset representing locations of NPDES outfalls/dischargers for waste water treatment plants which generally represent the site of the discharge....

  5. National Pollution Discharge Elimination System (NPDES) Wastewater Treatment Plant Outfall Points, Region 9, 2007, US EPA Region 9

    Data.gov (United States)

    U.S. Environmental Protection Agency — Point geospatial dataset representing locations of NPDES outfalls/dischargers for waste water treatment plants which generally represent the site of the discharge....

  6. Ethnopharmacological use of herbal remedies for the treatment of malaria in the Dangme West District of Ghana.

    Science.gov (United States)

    Asase, Alex; Akwetey, George A; Achel, Daniel G

    2010-06-16

    Malaria is one of the most important diseases in the world. Because of the devastating nature of the disease there is an urgent need to develop new drugs or vaccines for the treatment, prevention and management of the disease. The objective of the present study was to collect and document information on herbal remedies traditionally used for the treatment of malaria in the Dangme West District of Ghana. Data was collected from 67 indigenous households in ten communities in the district using a validated questionnaire. In total, 30 species of plants belonging to 28 genera in 20 families were reported to be used in the preparation of the herbal remedies. Mature leaves were the most (55%) common plant part used and 73.3% of the herbal remedies involved a single plant. Most of the herbal remedies were prepared by boiling and administered orally. The majority (47%) of the species of plants used were collected from their compounds or home gardens. Knowledge about malaria and treatment practices exists in the study area. Herbal remedies were commonly used by people for the treatment of malaria because they were cost-effective. They are also more accessible. Many of the species of plants used have been documented for the treatment of malaria as well as investigated for their phytochemical and antimalarial and/or antiplasmodial activity confirming the results of previous studies as well as rationalization of their traditional use. Five species of plants used in the study area, namely, Bambusa vulgaris Schrad. ex J.C. Wendl. (Poaceae), Deinbollia pinnata Schum. &Thonn. (Sapindaceae), Elaeis guineensis Jacq. (Arecaceae), Greenwayodendron sp. (Annonaceae) and Solanum torvum Sw (Solanaceae), are documented for the first time for their use in the treatment of malaria. "The result of this study provides the basis for further pharmacological studies on the herbal remedies used". Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

  7. Cost analysis of the treatment of severe acute malnutrition in West Africa.

    Science.gov (United States)

    Isanaka, Sheila; Menzies, Nicolas A; Sayyad, Jessica; Ayoola, Mudasiru; Grais, Rebecca F; Doyon, Stéphane

    2017-10-01

    We present an updated cost analysis to provide new estimates of the cost of providing community-based treatment for severe acute malnutrition, including expenditure shares for major cost categories. We calculated total and per child costs from a provider perspective. We categorized costs into three main activities (outpatient treatment, inpatient treatment, and management/administration) and four cost categories within each activity (personnel; therapeutic food; medical supplies; and infrastructure and logistical support). For each category, total costs were calculated by multiplying input quantities expended in the Médecins Sans Frontières nutrition program in Niger during a 12-month study period by 2015 input prices. All children received outpatient treatment, with 43% also receiving inpatient treatment. In this large, well-established program, the average cost per child treated was €148.86, with outpatient and inpatient treatment costs of €75.50 and €134.57 per child, respectively. Therapeutic food (44%, €32.98 per child) and personnel (35%, €26.70 per child) dominated outpatient costs, while personnel (56%, €75.47 per child) dominated in the cost of inpatient care. Sensitivity analyses suggested lowering prices of medical treatments, and therapeutic food had limited effect on total costs per child, while increasing program size and decreasing use of expatriate staff support reduced total costs per child substantially. Updated estimates of severe acute malnutrition treatment cost are substantially lower than previously published values, and important cost savings may be possible with increases in coverage/program size and integration into national health programs. These updated estimates can be used to suggest approaches to improve efficiency and inform national-level resource allocation. © 2016 John Wiley & Sons Ltd.

  8. Treatment of myofascial trigger points in patients with chronic shoulder pain: a randomized, controlled trial

    Directory of Open Access Journals (Sweden)

    Stegenga Boudewijn

    2011-01-01

    Full Text Available Abstract Background Shoulder pain is a common musculoskeletal problem that is often chronic or recurrent. Myofascial trigger points (MTrPs cause shoulder pain and are prevalent in patients with shoulder pain. However, few studies have focused on MTrP therapy. The aim of this study was to assess the effectiveness of multimodal treatment of MTrPs in patients with chronic shoulder pain. Methods A single-assessor, blinded, randomized, controlled trial was conducted. The intervention group received comprehensive treatment once weekly consisting of manual compression of the MTrPs, manual stretching of the muscles and intermittent cold application with stretching. Patients were instructed to perform muscle-stretching and relaxation exercises at home and received ergonomic recommendations and advice to assume and maintain good posture. The control group remained on the waiting list for 3 months. The Disabilities of Arm, Shoulder and Hand (DASH questionnaire score (primary outcome, Visual Analogue Scale for Pain (VAS-P, Global Perceived Effect (GPE scale and the number of muscles with MTrPs were assessed at 6 and 12 weeks in the intervention group and compared with those of a control group. Results Compared with the control group, the intervention group showed significant improvement (P Conclusions The results of this study show that 12-week comprehensive treatment of MTrPs in shoulder muscles reduces the number of muscles with active MTrPs and is effective in reducing symptoms and improving shoulder function in patients with chronic shoulder pain. Trial registration number ISRCTN: ISRCTN75722066

  9. Comparison between the effects of trigger point mesotherapy versus acupuncture points mesotherapy in the treatment of chronic low back pain: a short term randomized controlled trial.

    Science.gov (United States)

    Di Cesare, Annalisa; Giombini, Arrigo; Di Cesare, Mariachiara; Ripani, Maurizio; Vulpiani, Maria Chiara; Saraceni, Vincenzo Maria

    2011-02-01

    The goal of this study was to compare the effects of trigger point (TRP) mesotherapy and acupuncture (ACP) mesotherapy in the treatment of patients with chronic low back pain. Short term randomized controlled trial. 62 subjects with chronic low back pain were recruited at outpatients Physical Medicine and Rehabilitation Clinic at the University of Rome "La Sapienza" in the period between July 2006 and May 2008. Study subjects were assigned to receive 4 weeks treatments with either trigger point mesotherapy (TRP mesotherapy, n=29) or acupoints mesotherapy (ACP mesotherapy, n=33). Pain intensity with a pain visual analogic scale (VAS) and verbal rating scale (VRS) and pain disability with McGill Pain Questionnaire Short Form (SFMPQ), Roland Morris Disability Questionnaire (RMQ) and Oswestry Low Back Pain Disability Questionaire (ODQ). ACP mesotherapy shows a more effective results in VRS and VAS measures in the follow-up (p(VRS)=mesotherapy group. Our results suggest that the response to ACP mesotherapy may be greater than the response to TRP mesotherapy in the short term follow-up. This technique could be nevertheless a viable option as an adjunct treatment in an overall treatment planning of CLBP. Copyright © 2010 Elsevier Ltd. All rights reserved.

  10. Treatment and long term outcome in West syndrome: the clinical reality. A multicentre follow up study.

    Science.gov (United States)

    Lagae, Lieven; Verhelst, Helène; Ceulemans, Berten; De Meirleir, Linda; Nassogne, Marie-Cécile; De Borchgrave, Valerie; D'Hooghe, Marc; Foulon, Martine; Van Bogaert, Patrick

    2010-04-01

    We systematically reviewed the files of 51 infants presenting with infantile spasms and hypsarrhythmia in order to study the initial treatment strategies and the long term outcome. 80% of the infants were classified as symptomatic. In the nine participating centres, different treatment protocols were used, but the large majority of the children received vigabatrin as first line treatment. Second line options included hormonal treatment, topiramate and valproate. The time to reach cessation of infantile spasms was significantly shorter in the cryptogenic group than in the symptomatic group (50% at 13 days versus 66 days respectively) and was irrespective of the treatment used. The late follow up data (>2 years) showed that 60% of the children had epilepsy and that 75% of the children had a delay in their psychomotor development. Again, outcome in the cryptogenic group was better than in the symptomatic group, but also in the cryptogenic group, 50% of the children had a clear developmental delay, even if spasms were controlled early in the course of the disease. Our retrospective study illustrates that not only the underlying brain dysfunction is the major determinant for later outcome in infantile spasms (symptomatic group) but also even a short period of infantile spasms can be responsible for later developmental delay (cryptogenic group). (c) 2010 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  11. Impact of ivermectin on onchocerciasis transmission: Assessing the empirical evidence that repeated ivermectin mass treatments may lead to elimination/eradication in West-Africa

    NARCIS (Netherlands)

    G.J.J.M. Borsboom (Gerard); B.A. Boatin (Boakye); N.J.D. Nagelkerke (Nico); H. Agoua (Hyacinthe); K.L.B. Akpoboua (Komlan); E.W. Soumbey Alley (E. William); Y. Bissan (Yeriba); A. Renz (Anna); L. Yameogo (Laurent); J.H.F. Remme (Jan); J.D.F. Habbema (Dik)

    2003-01-01

    markdownabstract__Background:__ The Onchocerciasis Control Program (OCP) in West Africa has been closed down at the end of 2002. All subsequent control will be transferred to the participating countries and will almost entirely be based on periodic mass treatment with ivermectin. This makes the

  12. Pre-sowing Treatment for Improving Seed Quality in West African ...

    African Journals Online (AJOL)

    I.The seeds were stored at room- temperature for five months to break seed donnancy. The 10 rice varieties were prepared for various dry heat treatments. Table 1: A list of rice varieties, status, origin, year and type utilized for study. SIN DESIGNATION. Status. 1 8W348-1 not released. 2. CISADANE (FARO 51) released. 3.

  13. Surface Observation and Pore Size Analyses of Polypropylene/Low-Melting Point Polyester Filter Materials: Influences of Heat Treatment

    Directory of Open Access Journals (Sweden)

    Lin Jia-Horng

    2016-01-01

    Full Text Available This study proposes making filter materials with polypropylene (PP and low-melting point (LPET fibers. The influences of temperatures and times of heat treatment on the morphology of thermal bonding points and average pore size of the PP/LPET filter materials. The test results indicate that the morphology of thermal bonding points is highly correlated with the average pore size. When the temperature of heat treatment is increased, the fibers are joined first with the thermal bonding points, and then with the large thermal bonding areas, thereby decreasing the average pore size of the PP/LPET filter materials. A heat treatment of 110 °C for 60 seconds can decrease the pore size from 39.6 μm to 12.0 μm.

  14. Factors affecting completion of a 28-day inpatient substance abuse treatment programme at the University Hospital of the West Indies.

    Science.gov (United States)

    Barnaby, L; Gibson, R C

    2008-09-01

    This study investigated factors leading to premature discharge from the residential substance abuse treatment programme at the University Hospital of the West Indies (UHWI). Two hundred and twenty-four patients, mean age 36 +/- 9.75 and age range of 16-66 years were studied The patients, 87.5% men, were admitted to the programme over the period July 1999 to June 2002. Sources of data, including a routine patient-monitoring form and patients' medical records, were reviewed. Data analysis, performed using the Statistical Package for Social Sciences (SPSS), included frequencies, cross-tabulations and analyses of variance (ANOYA). Crack cocaine was the drug of impact for 60% of patients, alcohol for 17% and marijuana for 8%. Treatment ended prematurely for 22.8% of persons whose reasons for leaving included signing out against medical advice or self-discharge (27.4%), absconding (19.6%), fighting (9.8%), drug use (5.9%) and other rule breaking, including sexual acting out (15.7%). Premature discharge was uninfluenced by gender, age, marital status, schooling, employment status or geographical location. There were significantly more premature discharges in persons admitted primarily for crack dependence versus those admitted primarily for alcoholism (p 0.05). The influence of duration of substance use requires further elucidation.

  15. Multi-point optimization of recirculation flow type casing treatment in centrifugal compressors

    Science.gov (United States)

    Tun, Min Thaw; Sakaguchi, Daisaku

    2016-06-01

    High-pressure ratio and wide operating range are highly required for a turbocharger in diesel engines. A recirculation flow type casing treatment is effective for flow range enhancement of centrifugal compressors. Two ring grooves on a suction pipe and a shroud casing wall are connected by means of an annular passage and stable recirculation flow is formed at small flow rates from the downstream groove toward the upstream groove through the annular bypass. The shape of baseline recirculation flow type casing is modified and optimized by using a multi-point optimization code with a metamodel assisted evolutionary algorithm embedding a commercial CFD code CFX from ANSYS. The numerical optimization results give the optimized design of casing with improving adiabatic efficiency in wide operating flow rate range. Sensitivity analysis of design parameters as a function of efficiency has been performed. It is found that the optimized casing design provides optimized recirculation flow rate, in which an increment of entropy rise is minimized at grooves and passages of the rotating impeller.

  16. Treatment of myofascial trigger points in female patients with chronic tension-type headache - A randomized controlled trial

    DEFF Research Database (Denmark)

    Berggreen, S.; Wiik, E.; Lund, Hans

    2012-01-01

    The aim of this study was to evaluate the efficacy of myofascial trigger point massage in the muscles of the head, neck and shoulders regarding pain in the treatment of females with chronic tension-type headache. They were randomized into either a treatment group (n = 20) (one session of trigger...... point massage per week for 10 weeks) or a control group receiving no treatment (n = 19). The patients kept a diary to record their pain on a visual analogue scale (VAS), and the daily intake of drugs (mg) during the 4 weeks before and after the treatment period. The McGill Pain Questionnaire...... and the Short Form (SF-36) Questionnaire 1.1 were completed immediately before and after each treatment period. Morning pain measured on VAS was chosen as the primary outcome. A significant improvement in morning pain was recorded in the treatment group compared with the control group (difference of the change...

  17. Treatment of myofascial trigger points in patients with chronic shoulder pain: a randomized, controlled trial

    Science.gov (United States)

    2011-01-01

    Background Shoulder pain is a common musculoskeletal problem that is often chronic or recurrent. Myofascial trigger points (MTrPs) cause shoulder pain and are prevalent in patients with shoulder pain. However, few studies have focused on MTrP therapy. The aim of this study was to assess the effectiveness of multimodal treatment of MTrPs in patients with chronic shoulder pain. Methods A single-assessor, blinded, randomized, controlled trial was conducted. The intervention group received comprehensive treatment once weekly consisting of manual compression of the MTrPs, manual stretching of the muscles and intermittent cold application with stretching. Patients were instructed to perform muscle-stretching and relaxation exercises at home and received ergonomic recommendations and advice to assume and maintain good posture. The control group remained on the waiting list for 3 months. The Disabilities of Arm, Shoulder and Hand (DASH) questionnaire score (primary outcome), Visual Analogue Scale for Pain (VAS-P), Global Perceived Effect (GPE) scale and the number of muscles with MTrPs were assessed at 6 and 12 weeks in the intervention group and compared with those of a control group. Results Compared with the control group, the intervention group showed significant improvement (P pain (mean difference, 13.8; 95% CI, 2.6 to 25.0), on the VAS-P2 for pain in the past 7 days (mean difference, 10.2; 95% CI, 0.7 to 19.7) and VAS-P3 most severe pain in the past 7 days (mean difference, 13.8; 95% CI, 0.8 to 28.4). After 12 weeks, 55% of the patients in the intervention group reported improvement (from slightly improved to completely recovered) versus 14% in the control group. The mean number of muscles with active MTrPs decreased in the intervention group compared with the control group (mean difference, 2.7; 95% CI, 1.2 to 4.2). Conclusions The results of this study show that 12-week comprehensive treatment of MTrPs in shoulder muscles reduces the number of muscles with active

  18. Treatment of myofascial trigger points in patients with chronic shoulder pain: a randomized, controlled trial.

    Science.gov (United States)

    Bron, Carel; de Gast, Arthur; Dommerholt, Jan; Stegenga, Boudewijn; Wensing, Michel; Oostendorp, Rob A B

    2011-01-24

    Shoulder pain is a common musculoskeletal problem that is often chronic or recurrent. Myofascial trigger points (MTrPs) cause shoulder pain and are prevalent in patients with shoulder pain. However, few studies have focused on MTrP therapy. The aim of this study was to assess the effectiveness of multimodal treatment of MTrPs in patients with chronic shoulder pain. A single-assessor, blinded, randomized, controlled trial was conducted. The intervention group received comprehensive treatment once weekly consisting of manual compression of the MTrPs, manual stretching of the muscles and intermittent cold application with stretching. Patients were instructed to perform muscle-stretching and relaxation exercises at home and received ergonomic recommendations and advice to assume and maintain good posture. The control group remained on the waiting list for 3 months. The Disabilities of Arm, Shoulder and Hand (DASH) questionnaire score (primary outcome), Visual Analogue Scale for Pain (VAS-P), Global Perceived Effect (GPE) scale and the number of muscles with MTrPs were assessed at 6 and 12 weeks in the intervention group and compared with those of a control group. Compared with the control group, the intervention group showed significant improvement (P < 0.05) on the DASH after 12 weeks (mean difference, 7.7; 95% confidence interval (95% CI), 1.2 to 14.2), on the VAS-P1 for current pain (mean difference, 13.8; 95% CI, 2.6 to 25.0), on the VAS-P2 for pain in the past 7 days (mean difference, 10.2; 95% CI, 0.7 to 19.7) and VAS-P3 most severe pain in the past 7 days (mean difference, 13.8; 95% CI, 0.8 to 28.4). After 12 weeks, 55% of the patients in the intervention group reported improvement (from slightly improved to completely recovered) versus 14% in the control group. The mean number of muscles with active MTrPs decreased in the intervention group compared with the control group (mean difference, 2.7; 95% CI, 1.2 to 4.2). The results of this study show that 12-week

  19. Point-of-care urine tests for smoking status and isoniazid treatment monitoring in adult patients.

    Directory of Open Access Journals (Sweden)

    Ioana Nicolau

    Full Text Available Poor adherence to isoniazid (INH preventive therapy (IPT is an impediment to effective control of latent tuberculosis (TB infection. TB patients who smoke are at higher risk of latent TB infection, active disease, and TB mortality, and may have lower adherence to their TB medications. The objective of our study was to validate IsoScreen and SmokeScreen (GFC Diagnostics, UK, two point-of-care tests for monitoring INH intake and determining smoking status. The tests could be used together in the same individual to help identify patients with a high-risk profile and provide a tailored treatment plan that includes medication management, adherence interventions, and smoking cessation programs.200 adult outpatients attending the TB and/or the smoking cessation clinic were recruited at the Montreal Chest Institute. Sensitivity and specificity were measured for each test against the corresponding composite reference standard. Test reliability was measured using kappa statistic for intra-rater and inter-rater agreement. Univariate and multivariate logistic regression models were used to explore possible covariates that might be related to false-positive and false-negative test results. IsoScreen had a sensitivity of 93.2% (95% confidence interval [CI] 80.3, 98.2 and specificity of 98.7% (94.8, 99.8. IsoScreen had intra-rater agreement (kappa of 0.75 (0.48, 0.94 and inter-rater agreement of 0.61 (0.27, 0.90. SmokeScreen had a sensitivity of 69.2% (56.4, 79.8, specificity of 81.6% (73.0, 88.0, intra-rater agreement of 0.77 (0.56, 0.94, and inter-rater agreement of 0.66 (0.42, 0.88. False-positive SmokeScreen tests were strongly associated with INH treatment.IsoScreen had high validity and reliability, whereas SmokeScreen had modest validity and reliability. SmokeScreen tests did not perform well in a population receiving INH due to the association between INH treatment and false-positive SmokeScreen test results. Development of the next generation Smoke

  20. Cost effectiveness of intermittent screening followed by treatment versus intermittent preventive treatment during pregnancy in West Africa

    DEFF Research Database (Denmark)

    Fernandes, Silke; Sicuri, Elisa; Halimatou, Diawara

    2016-01-01

    Background: Emergence of high-grade sulfadoxine-pyrimethamine (SP) resistance in parts of Africa has led to growing concerns about the efficacy of intermittent preventive treatment of malaria during pregnancy (IPTp) with SP. The incremental cost-effectiveness of intermittent screening and treatment...... for ISTp-AL). Cost estimates were obtained from observational studies, health facility costings and public procurement databases. Results were calculated as incremental cost per DALY averted. Finally, the cost-effectiveness changes with decreasing SP efficacy were explored by simulation. Results: Relative...... to IPTp-SP, delivering ISTp-AL to 1000 pregnant women cost US$ 4966.25 more (95 % CI US$ 3703.53; 6376.83) and led to a small excess of 28.36 DALYs (95 % CI -75.78; 134.18), with LBW contributing 81.3 % of this difference. The incremental cost-effectiveness ratio was -175.12 (95 % CI -1166.29; 1267.71) US...

  1. West Nile Virus

    Science.gov (United States)

    ... of Whether Lower Respiratory Tract Infections Improve with Antibacterial Treatment , February 13, 2018 NIH Scientists Adapt New ... ecological patterns in the United States, and insecticide resistance. Read more about West Nile virus biology, genetics ...

  2. How Do We Assess Dissociation in Treatment Seeking Refugees in the West?

    DEFF Research Database (Denmark)

    Palic, Sabina; Elklit, Ask; Armour, Cherie

    Not enough attention is paid to dissociation in treatment of traumatized refugees in western countries. Knowledge about the assessment, the extent, and the content of dissociation in this group is lacking. An evaluation of measures and description of dissociative symptoms was carried out in 86......-D but they showed only moderate classification agreement. The DES was found to be the preferred measure since the SIDES-D seemed to partly tap correlates of lasting psychiatric illness. The DES-Taxon functioned well as an abbreviated version of the DES. Thirty percent of the group was estimated to have pathological...

  3. Hospitals and organizational models based on the intensity of treatment: the internist's point of view

    Directory of Open Access Journals (Sweden)

    Giuseppe Chesi

    2012-01-01

    Full Text Available IntroductionThe type of patients being treated in our hospitals has changed significantly. Today's patients are much older with more complicated, polypathological problems. As a result, hospital organization and management structures must also change, particularly in Internal Medicine. A widely discussed approach, organization according to “intensity of treatment,” could be an appropriate solution from an organizational viewpoint that would also satisfy these new demands.Materials and methodsWith the aid of a questionnaire sent to internists working in the hospitals of Italy's Emilia-Romagna region and the review of the relevant medical literature, we defined structural, organizational, technological, managerial, and staffing characteristics to better determine and classify this model. We analyzed questionnaire responses of 31 internists heading operative units in their hospitals, a relatively homogeneous subgroup with experience in organizing and managing healthcare as well as its clinical aspects.ResultsAnalysis of these questionnaires revealed important points concerning the model: 1 an accurate identification of the medical care on which to base the model; 2 a well-defined strategy for differentiated allocation of staff to structural and technological areas depending on the level of medical care provided in the area; 3 an accurate definition of the types and features of patients targeted by each level of medical care; 4 an early exchange (starting from the patient's arrival in the Emergency Department of information and medical knowledge among Emergency Department physicians and those present during the initial stages of hospitalization; 5 a precise definition of responsibilities in the different areas, operative and collaborative stages among different physicians and medical staff, the different disciplines involved in the process.ConclusionsAmong the physicians responsible for managing complex areas of Internal Medicine in Emilia

  4. Assesing Appropriateness of Antimicrobial Treatment in Hospitalized Patients; A Point Prevalence Study

    Science.gov (United States)

    Reisfeld, Sharon; Assali, Mahdi; Tannous, Elias; Amarny, Kamal; Stein, Michal

    2017-01-01

    Abstract Background Between 20 and 50% of antibiotic therapy in hospitalized patients is considered inappropriate. Inappropriate antibiotic therapy is associated with increased morbidity and mortality. The aim of our study was to evaluate the ratio of appropriate antibiotic therapy among adult patients admitted to a secondary hospital and treated with at least one systemic antibiotic therapy, and to compare different methods for evaluation of appropriateness. Methods This was a point-prevalence study, in which all adult patients admitted to a secondary hospital and treated with systemic antibiotic therapy (orally or intravenous) were included. Appropriateness was evaluated by experts (infectious diseases specialist and a clinical pharmacist specializing in antibiotic therapy), and by ranking 11 quality indicators based on literature recommendations. Agreement between all methods was analyzed. Results 106 patients were included in the study; most of them were treated empirically (78%). Almost half of the patients were treated for urogenital and abdominal infections (44%). Appropriateness ranged from 20-75%, depending on method of evaluation. We found a very low agreement between the more strict definition and experts’ opinion (kappa=0.068), and a medium agreement between the less strict definition and experts’ opinion (kappa=0.45). Respiratory tract infections were treated inappropriately most of the time, according to all evaluation methods. Appropriate blood cultures were taken before starting antibiotic therapy only in 22% of the cases. Conclusion We found a high rate of inappropriate antibiotic therapy in different indications for therapy, both by objective definitions, and by experts’ opinions (although to a lesser amount in the latter). We need to use strict and uniform parameters in order to optimize antibiotic therapy in the hospital. Immediate interventions must be made regarding appropriate blood cultures’ collection, and to improve empiric

  5. Neuro Emotional Technique for the treatment of trigger point sensitivity in chronic neck pain sufferers: A controlled clinical trial

    Directory of Open Access Journals (Sweden)

    Pollard Henry

    2008-05-01

    Full Text Available Abstract Background Trigger points have been shown to be active in many myofascial pain syndromes. Treatment of trigger point pain and dysfunction may be explained through the mechanisms of central and peripheral paradigms. This study aimed to investigate whether the mind/body treatment of Neuro Emotional Technique (NET could significantly relieve pain sensitivity of trigger points presenting in a cohort of chronic neck pain sufferers. Methods Sixty participants presenting to a private chiropractic clinic with chronic cervical pain as their primary complaint were sequentially allocated into treatment and control groups. Participants in the treatment group received a short course of Neuro Emotional Technique that consists of muscle testing, general semantics and Traditional Chinese Medicine. The control group received a sham NET protocol. Outcome measurements included pain assessment utilizing a visual analog scale and a pressure gauge algometer. Pain sensitivity was measured at four trigger point locations: suboccipital region (S; levator scapulae region (LS; sternocleidomastoid region (SCM and temporomandibular region (TMJ. For each outcome measurement and each trigger point, we calculated the change in measurement between pre- and post- treatment. We then examined the relationships between these measurement changes and six independent variables (i.e. treatment group and the above five additional participant variables using forward stepwise General Linear Model. Results The visual analog scale (0 to 10 had an improvement of 7.6 at S, 7.2 at LS, 7.5 at SCM and 7.1 at the TMJ in the treatment group compared with no improvement of at S, and an improvement of 0.04 at LS, 0.1 at SCM and 0.1 at the TMJ point in the control group, (P Conclusion After a short course of NET treatment, measurements of visual analog scale and pressure algometer recordings of four trigger point locations in a cohort of chronic neck pain sufferers were significantly

  6. Evaluation of the Hanford 200 West Groundwater Treatment System: Fluidized Bed Bioreactor

    Energy Technology Data Exchange (ETDEWEB)

    Looney, Brian B. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL); Jackson, Dennis G. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL); Dickson, John O. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL); Eddy-Dilek, Carol A. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL)

    2017-05-12

    A fluidized bed reactor (FBR) in the 200W water treatment facility at Hanford is removing nitrate from groundwater as part of the overall pump-treat-reinject process. Control of the FBR bed solids has proven challenging, impacting equipment, increasing operations and maintenance (O&M), and limiting the throughput of the facility. In response to the operational challenges, the Department of Energy Richland Office (DOE-RL) commissioned a technical assistance team to facilitate a system engineering evaluation and provide focused support recommendations to the Hanford Team. The DOE Environmental Management (EM) technical assistance process is structured to identify and triage technologies and strategies that address the target problem(s). The process encourages brainstorming and dialog and allows rapid identification and prioritization of possible options. Recognizing that continuous operation of a large-scale FBR is complex, requiring careful attention to system monitoring data and changing conditions, the technical assistance process focused on explicit identification of the available control parameters (“knobs”), how these parameters interact and impact the FBR system, and how these can be adjusted under different scenarios to achieve operational goals. The technical assistance triage process was performed in collaboration with the Hanford team.

  7. Good quality of oral anticoagulation treatment in general practice using international normalised ratio point of care testing

    DEFF Research Database (Denmark)

    Løkkegaard, Thomas; Pedersen, Tina Heidi; Lind, Bent

    2015-01-01

    INTRODUCTION: Oral anticoagulation treatment (OACT) with warfarin is common in general practice. Increasingly, international normalised ratio (INR) point of care testing (POCT) is being used to manage patients. The aim of this study was to describe and analyse the quality of OACT with warfarin in...... practices using INR POCT in the management of patients in warfarin treatment provided good quality of care. Sampling interval and diagnostic coding were significantly correlated with treatment quality.......INTRODUCTION: Oral anticoagulation treatment (OACT) with warfarin is common in general practice. Increasingly, international normalised ratio (INR) point of care testing (POCT) is being used to manage patients. The aim of this study was to describe and analyse the quality of OACT with warfarin...

  8. The Treatment Train approach to reducing non-point source pollution from agriculture

    Science.gov (United States)

    Barber, N.; Reaney, S. M.; Barker, P. A.; Benskin, C.; Burke, S.; Cleasby, W.; Haygarth, P.; Jonczyk, J. C.; Owen, G. J.; Snell, M. A.; Surridge, B.; Quinn, P. F.

    2016-12-01

    An experimental approach has been applied to an agricultural catchment in NW England, where non-point pollution adversely affects freshwater ecology. The aim of the work (as part of the River Eden Demonstration Test Catchment project) is to develop techniques to manage agricultural runoff whilst maintaining food production. The approach used is the Treatment Train (TT), which applies multiple connected mitigation options that control nutrient and fine sediment pollution at source, and address polluted runoff pathways at increasing spatial scale. The principal agricultural practices in the study sub-catchment (1.5 km2) are dairy and stock production. Farm yards can act as significant pollution sources by housing large numbers of animals; these areas are addressed initially with infrastructure improvements e.g. clean/dirty water separation and upgraded waste storage. In-stream high resolution monitoring of hydrology and water quality parameters showed high-discharge events to account for the majority of pollutant exports ( 80% total phosphorus; 95% fine sediment), and primary transfer routes to be surface and shallow sub-surface flow pathways, including drains. To manage these pathways and reduce hydrological connectivity, a series of mitigation features were constructed to intercept and temporarily store runoff. Farm tracks, field drains, first order ditches and overland flow pathways were all targeted. The efficacy of the mitigation features has been monitored at event and annual scale, using inflow-outflow sampling and sediment/nutrient accumulation measurements, respectively. Data presented here show varied but positive results in terms of reducing acute and chronic sediment and nutrient losses. An aerial fly-through of the catchment is used to demonstrate how the TT has been applied to a fully-functioning agricultural landscape. The elevated perspective provides a better understanding of the spatial arrangement of mitigation features, and how they can be

  9. [Clinical observation on auricular point sticking for treatment of 25 children of semiluxation of circo-axis vertebrae].

    Science.gov (United States)

    Chang, Ying; Liu, Ya-Bin; He, Jun-Jun

    2006-10-01

    To search for the best method for child semiluxation of circo-axis vertebrae. Fifty cases were randomly divided into a treatment group of 25 cases treated with auricular point sticking, and a control group of 25 cases treated with normal acupuncture. The total effective rate was 92.0% in the treatment group and 64.0% in the control group with a significant difference between the two groups (P circo-axis vertebrae.

  10. Trigger point manual therapy for the treatment of chronic non-cancer pain in adults

    OpenAIRE

    Denneny, D.; Petersen, K.; McLoughlin, R.; Brook, S.; Hassan, S; Williams, ACDEC

    2015-01-01

    This is the protocol for a review and there is no abstract. The objectives are as follows: To determine the effectiveness of trigger point manual therapy for treating chronic non-cancer pain in adults.

  11. Treatment of depression with low-strength transcranial pulsed electromagnetic fields : A mechanistic point of view

    NARCIS (Netherlands)

    van Belkum, S. M.; Bosker, F. J.; Kortekaas, R.; Beersma, D. G. M.; Schoevers, R. A.

    2016-01-01

    Background: Mood disorders constitute a high burden for both patients and society. Notwithstanding the large arsenal of available treatment options, a considerable group of patients does not remit on current antidepressant treatment. There is an urgent need to develop alternative treatment

  12. Remains of the ancient ports and anchorage points at Miyani and Visawada, on the west coast of India: A study based on underwater investigations

    Digital Repository Service at National Institute of Oceanography (India)

    Gaur, A.S.; Sundaresh; Tripati, S.

    as an excellent natural harbour. The important antiquities include varieties of stone anchors, which are very similar to those reported from Dwarka and Bet Dwarka. The identification of ancient anchorage points between water depth of 5 and 15 m is another...

  13. The NGF point-injection for treatment of the sound-perceiving nerve deafness and tinnitus in 68 cases.

    Science.gov (United States)

    Zhou, Feng; Wu, Ping; Wang, Li; Wang, Hai-tao; Zhang, Shao-bin; Lin, Yi; Zhong, Hui; Chen, Yan-Hua

    2009-03-01

    To observe the therapeutic effects of the point-injection with nerve growth factor (NGF) for the sound-perceiving nerve deafness and tinnitus. The 140 cases in this series were randomly divided into a treatment group of 68 cases treated by NGF injection at the points of Yifeng (TE 17) and Wangu (GB 12), and a control group of 72 cases orally taking Xibiling and adenosine triphosphate (ATP) and intramuscular injection with VB1 and VB12. The total effective rate was 78.6% in the treatment group and 31.8% in the control group, with significant difference between the two groups (Pdeafness and tinnitus, NGF point-injection may show good therapeutic effects, but inversely proportional to the illness course, age and the extent of hypoacusis.

  14. The quality of sputum smear microscopy in public-private mix directly observed treatment laboratories in West Amhara region, Ethiopia.

    Science.gov (United States)

    Manalebh, Almaw; Demissie, Meaza; Mekonnen, Daniel; Abera, Bayeh

    2015-01-01

    Ethiopia adopted Public-Private Mix Directly Observed Treatment Short Course Chemotherapy (PPM-DOTS) strategy for tuberculosis (TB) control program. Quality of sputum smear microscopy has paramount importance for tuberculosis control program in resource-poor countries like Ethiopia. A cross-sectional study was conducted to assess the quality of sputum smear microscopy in 37 Public-Private Mix laboratories in West Amhara, Ethiopia. The three external quality assessment methods (onsite evaluation, panel testing and blind rechecking) were employed. Onsite assessment revealed that 67.6% of PPM-DOTS laboratories were below the standard physical space (5 X 6) m2. The average monthly workload per laboratory technician was 19.5 (SD±2.9) slides with 12.8% positivity rate. The quality of Acid Fast Bacilli (AFB) staining reagents was sub-standard. The overall agreement for blind rechecking of 1,123 AFB slides was 99.4% (Kappa = 0.97). Reading of 370 AFB panel slides showed 3.5% false reading (Kappa = 0.92). Moreover, the consistency of reading scanty bacilli slides was lower (93%) compared to 1+, 2+ and 3+ bacilli. Based on blind rechecking and panel testing results, PPM-DOTS site laboratories showed good agreement with the reference laboratory. Physical space and qualities of AFB reagents would be areas of intervention to sustain the quality of sputum smear microscopy. Therefore, regular external quality assessment and provision of basic laboratory supplies for TB diagnosis would be the way forward to improve the quality of sputum smear microscopy services in PPM-DOTS laboratories.

  15. The quality of sputum smear microscopy in public-private mix directly observed treatment laboratories in West Amhara region, Ethiopia.

    Directory of Open Access Journals (Sweden)

    Almaw Manalebh

    Full Text Available Ethiopia adopted Public-Private Mix Directly Observed Treatment Short Course Chemotherapy (PPM-DOTS strategy for tuberculosis (TB control program. Quality of sputum smear microscopy has paramount importance for tuberculosis control program in resource-poor countries like Ethiopia. A cross-sectional study was conducted to assess the quality of sputum smear microscopy in 37 Public-Private Mix laboratories in West Amhara, Ethiopia. The three external quality assessment methods (onsite evaluation, panel testing and blind rechecking were employed. Onsite assessment revealed that 67.6% of PPM-DOTS laboratories were below the standard physical space (5 X 6 m2. The average monthly workload per laboratory technician was 19.5 (SD±2.9 slides with 12.8% positivity rate. The quality of Acid Fast Bacilli (AFB staining reagents was sub-standard. The overall agreement for blind rechecking of 1,123 AFB slides was 99.4% (Kappa = 0.97. Reading of 370 AFB panel slides showed 3.5% false reading (Kappa = 0.92. Moreover, the consistency of reading scanty bacilli slides was lower (93% compared to 1+, 2+ and 3+ bacilli. Based on blind rechecking and panel testing results, PPM-DOTS site laboratories showed good agreement with the reference laboratory. Physical space and qualities of AFB reagents would be areas of intervention to sustain the quality of sputum smear microscopy. Therefore, regular external quality assessment and provision of basic laboratory supplies for TB diagnosis would be the way forward to improve the quality of sputum smear microscopy services in PPM-DOTS laboratories.

  16. Self-treatment of asthma: possibilities and perspectives from the practitioner's point of view.

    NARCIS (Netherlands)

    Thoonen, B.P.A.; Jones, K.; Rooij, H.A. van; Hout, A.C.A. van den; Smeele, I.J.M.; Grol, R.P.T.M.; Schayck, C.P. van

    1999-01-01

    - Objectives - Self-management of asthma is becoming more and more widespread. The implementation of this treatment strategy requires changes in the role and attitude of the GP. These changes may be hindered by obstacles both expected and experienced. As self-treatment of asthma is more common in

  17. Fouling in gravity driven Point-of-Use drinking water treatment systems

    NARCIS (Netherlands)

    Chawla, Charu; Zwijnenburg, A.; Kemperman, Antonius J.B.; Nijmeijer, Dorothea C.

    2017-01-01

    This paper describes fouling in simulated Point-of-Use (PoU) systems based on low pressure hollow fiber ultrafiltration membranes. Various operational configurations such as recirculation of feed, discontinuous vs. continuous filtration, and inside/out vs. outside/in were compared to study their

  18. Treatment of myofascial trigger points in patients with chronic shoulder pain : a randomized, controlled trial

    NARCIS (Netherlands)

    Bron, Carel; de Gast, Arthur; Dommerholt, Jan; Stegenga, Boudewijn; Wensing, Michel; Oostendorp, Rob A. B.

    2011-01-01

    Background: Shoulder pain is a common musculoskeletal problem that is often chronic or recurrent. Myofascial trigger points (MTrPs) cause shoulder pain and are prevalent in patients with shoulder pain. However, few studies have focused on MTrP therapy. The aim of this study was to assess the

  19. Diagnosis as the First Critical Point in the Treatment Trajectory: An Exploration of Operable Lung Cancer Patients' Lived Experiences.

    Science.gov (United States)

    Missel, Malene; Pedersen, Jesper H; Hendriksen, Carsten; Tewes, Marianne; Adamsen, Lis

    2015-01-01

    Significant advances have been made in the surgical treatment of lung cancer while patient experiences with diagnosis, treatment, and rehabilitation remain only sparsely researched. The objective of this study was to investigate how the diagnosis affects the daily lives of patients with operable lung cancer in order to identify their needs for care interventions from the point of diagnosis to hospitalization. We investigated patients' lived experiences from a longitudinal perspective at 4 critical time points during the treatment trajectory; we present here the findings from the first time point, diagnosis. Data were collected through interviews conducted 7 to 10 days following diagnosis of lung cancer. Data from 19 patients are included, and the analysis is based on Ricoeur's interpretation theory. The study framework is inspired by Schutz's phenomenological sociology. The findings are presented as themes that summarize and express the ways in which a diagnosis affects patients' daily lives: the cancer diagnosis comes as a shock, it changes everyday awareness; it presents the patient with an unfamiliar body, disturbs social relationships, forces the patient to face a new life situation, and demands one-on-one supportive care. Diagnosis is the first critical point for patients with operable lung cancer and disrupts their daily life. Patients need psychosocial support during the period from diagnosis to surgical intervention and patient-tailored one-on-one information. This article contributes to the knowledge base of support needs of lung cancer patients. Interventions aimed at supportive care during the period between diagnosis and surgical intervention should be researched.

  20. A genome-wide association study points to multiple loci predicting antidepressant treatment outcome in depression

    Science.gov (United States)

    Binder, Elisabeth B.; Bettecken, Thomas; Uhr, Manfred; Ripke, Stephan; Kohli, Martin A.; Hennings, Johannes M.; Horstmann, Sonja; Kloiber, Stefan; Menke, Andreas; Bondy, Brigitta; Rupprecht, Rainer; Domschke, Katharina; Baune, Bernhard T.; Arolt, Volker; Rush, A. John; Holsboer, Florian; Müller-Myhsok, Bertram

    2015-01-01

    Context Efficacy of antidepressant treatment in depression is unsatisfactory as one in three patients does not fully recover even after several treatment trials. Genetic factors and clinical characteristics contribute to the failure of a favorable treatment outcome. Objective To identify genetic and clinical determinants of antidepressant treatment outcome in depression. Design Genome-wide pharmacogenetic association study with two independent replication samples. Setting We performed a genome-wide association (GWA) study in patients from the Munich-Antidepressant-Response-Signature (MARS) project and in pooled DNA from an independent German replication sample. A set of 328 single nucleotide polymorphisms (SNPs) highly related to outcome in both GWA studies was genotyped in a sample of the Sequenced-Treatment-Alternatives-to-Relieve-Depression (STAR*D) study. Participants 339 inpatients suffering from a depressive episode (MARS sample), further 361 depressed inpatients (German replication sample), and 832 outpatients with major depression (STAR*D sample). Main Outcome Measures We generated a multi-locus genetic variable describing the individual number of alleles of the selected SNPs associated with beneficial treatment outcome in the MARS sample (“response” alleles) to evaluate additive genetic effects on antidepressant treatment outcome. Results Multi-locus analysis revealed a significant contribution of a binary variable categorizing patients as carriers of a high vs. low number of response alleles in predicting antidepressant treatment outcome in both samples, MARS and STAR*D. In addition, we observed that patients with a comorbid anxiety disorder in combination with a low number of response alleles showed the least favorable outcome. Conclusion Our results demonstrate the importance of multiple genetic factors in combination with clinical features to predict antidepressant treatment outcome underscoring the multifactorial nature of this trait. PMID

  1. Sewage Treatment Plant Points, Tutuila AS, 2009, US EPA Region 9

    Data.gov (United States)

    U.S. Environmental Protection Agency — Across the United States, municipal wastewater treatment plants receive and treat sewage and other wastewater collected from homes, businesses, and industries. These...

  2. THE INFECTIVE ENDOCARDITIS (PREVENTION, DIAGNOSIS CRITERIA AND TREATMENT: KEY POINTS 2010

    Directory of Open Access Journals (Sweden)

    A. A. Demin

    2010-01-01

    Full Text Available Key positions of Guidelines on the prevention, diagnosis, and treatment of infective endocarditis issued by the Task Force of ESC in 2009 are explained in the comments. Recent opinions on these items are presented.

  3. Reading the Word. An ecclesiastical interpretation of the Bible in the Orthodox church and its difficulties from the point of view of the Christian West

    Directory of Open Access Journals (Sweden)

    Marcin Składanowski

    2016-08-01

    Full Text Available The article presents a specific ecclesiastical interpretation of the Bible within Orthodox theology and shows some difficulties of this approach from the point of view of Western theological thought. The article discusses the problem of the Orthodox biblical canon and the main difficulties associated with the division between „canonical” and „non-canonical” books. Then the text presents specific elements of Orthodox biblical exegesis, with emphasis on the community of the Church as its primary context. The article also touches the problem of biblical language, and especially importance attached to the text of the Septuagint as well as critical evaluation of certain modern translations of the Bible by Orthodox theologians. The text reveals the elements of the Orthodox approach to the interpretation of the Bible that are valuable for all Christian theological traditions as well as the main theological problems related to it.

  4. A Study of Veterans Administration/Department of Defense Health Care Resources Sharing at Keller Army Community Hospital West Point, New York 10996

    Science.gov (United States)

    1984-04-01

    inventory FEAR Fear Inventory FES Family Environment Scale PDS 163 MEDH Medical History PAIN Pain Questionnaire PROB Problem List SEXH Sexual Experiences...Comnmunity Health Nursing (1) Nurse Anesthetists (2) Inhalation Therapy IPPB Treatments Humidity Aerosol Chest Physiotherapy Arterial Blood Samples OB...find its wyto VA ficilte a mokre often the rlta of political pressure from. individual Sth Pain ethafuconierted action by the VA. In truth,~ tratic

  5. Minimally invasive treatment of cholecysto-choledocal lithiasis: The point of view of the surgical endoscopist

    Science.gov (United States)

    Palma, Giovanni D De

    2013-01-01

    The rate of choledocholithiasis in patients with symptomatic cholelithiasis is estimated to be approximately 10%-33%, depending on the patient’s age. Development of Endoscopic Retrograde Cholangiopancreatography and Laparoscopic Surgery and improvement of diagnostic procedures have influenced new approaches to the management of common bile duct stones in association with gallstones. At present available minimally-invasive treatments of cholecysto-choledocal lithiasis include: single-stage laparoscopic treatment, perioperative endoscopic treatment and endoscopic treatment alone. Published data evidence that, associated endoscopic-laparoscopic approach necessitates increased number of procedures per patient while single-stage laparoscopic treatment is associated with a shorter hospital stay. However, current data does not suggest clear superiority of any one approach with regard to success, mortality, morbidity and cost-effectiveness. Considering the variety of therapeutic options available for management, a critical appraisal and decision-making is required. Endoscopic retrograde cholangiopancreatography/EST should be adopted on a selective basis, i.e., in patients with acute obstructive suppurative cholangitis, severe biliary pancreatitis, ampullary stone impaction or severe comorbidity. In a setting where all facilities are available, decision in the selection of the therapeutic option depends on the patients, the number and size of choledocholithiasis stones, the anatomy of the cystic duct and common bile duct, the surgical history of patients and local expertise. PMID:23977417

  6. Minimally invasive treatment of cholecysto-choledocal lithiasis: The point of view of the surgical endoscopist.

    Science.gov (United States)

    De Palma, Giovanni D

    2013-06-27

    The rate of choledocholithiasis in patients with symptomatic cholelithiasis is estimated to be approximately 10%-33%, depending on the patient's age. Development of Endoscopic Retrograde Cholangiopancreatography and Laparoscopic Surgery and improvement of diagnostic procedures have influenced new approaches to the management of common bile duct stones in association with gallstones. At present available minimally-invasive treatments of cholecysto-choledocal lithiasis include: single-stage laparoscopic treatment, perioperative endoscopic treatment and endoscopic treatment alone. Published data evidence that, associated endoscopic-laparoscopic approach necessitates increased number of procedures per patient while single-stage laparoscopic treatment is associated with a shorter hospital stay. However, current data does not suggest clear superiority of any one approach with regard to success, mortality, morbidity and cost-effectiveness. Considering the variety of therapeutic options available for management, a critical appraisal and decision-making is required. Endoscopic retrograde cholangiopancreatography/EST should be adopted on a selective basis, i.e., in patients with acute obstructive suppurative cholangitis, severe biliary pancreatitis, ampullary stone impaction or severe comorbidity. In a setting where all facilities are available, decision in the selection of the therapeutic option depends on the patients, the number and size of choledocholithiasis stones, the anatomy of the cystic duct and common bile duct, the surgical history of patients and local expertise.

  7. Good quality of oral anticoagulation treatment in general practice using international normalised ratio point of care testing

    DEFF Research Database (Denmark)

    Løkkegaard, Thomas; Pedersen, Tina Heidi; Lind, Bent

    2015-01-01

    INTRODUCTION: Oral anticoagulation treatment (OACT) with warfarin is common in general practice. Increasingly, international normalised ratio (INR) point of care testing (POCT) is being used to manage patients. The aim of this study was to describe and analyse the quality of OACT with warfarin...... collected retrospectively for a period of six months. For each patient, time in therapeutic range (TTR) was calculated and correlated with practice and patient characteristics using multilevel linear regression models. RESULTS: We identified 447 patients in warfarin treatment in the 20 practices using POCT...

  8. Industrial experience of process identification and set-point decision algorithm in a full-scale treatment plant.

    Science.gov (United States)

    Yoo, Changkyoo; Kim, Min Han

    2009-06-01

    This paper presents industrial experience of process identification, monitoring, and control in a full-scale wastewater treatment plant. The objectives of this study were (1) to apply and compare different process-identification methods of proportional-integral-derivative (PID) autotuning for stable dissolved oxygen (DO) control, (2) to implement a process monitoring method that estimates the respiration rate simultaneously during the process-identification step, and (3) to propose a simple set-point decision algorithm for determining the appropriate set point of the DO controller for optimal operation of the aeration basin. The proposed method was evaluated in the industrial wastewater treatment facility of an iron- and steel-making plant. Among the process-identification methods, the control signal of the controller's set-point change was best for identifying low-frequency information and enhancing the robustness to low-frequency disturbances. Combined automatic control and set-point decision method reduced the total electricity consumption by 5% and the electricity cost by 15% compared to the fixed gain PID controller, when considering only the surface aerators. Moreover, as a result of improved control performance, the fluctuation of effluent quality decreased and overall effluent water quality was better.

  9. Analytic treatment of tipping points for social consensus in large random networks

    Science.gov (United States)

    Zhang, W.; Lim, C.; Szymanski, B. K.

    2012-12-01

    We introduce a homogeneous pair approximation to the naming game (NG) model by deriving a six-dimensional Open Dynamics Engine (ODE) for the two-word naming game. Our ODE reveals the change in dynamical behavior of the naming game as a function of the average degree of an uncorrelated network. This result is in good agreement with the numerical results. We also analyze the extended NG model that allows for presence of committed nodes and show that there is a shift of the tipping point for social consensus in sparse networks.

  10. Feasibility and acceptability of point of care HIV testing in community outreach and GUM drop-in services in the North West of England: A programmatic evaluation

    Directory of Open Access Journals (Sweden)

    Jelliman Pauline

    2011-06-01

    Full Text Available Abstract Background In Liverpool, injecting drug users (IDUs, men-who-have-sex-with-men (MSM and UK Africans experience a disproportionate burden of HIV, yet services do not reach out to these groups and late presentations continue. We set out to: increase testing uptake in targeted marginalized groups through a community and genitourinary medicine (GUM-based point of care testing (POCT programme; and conduct a process evaluation to examine service provider inputs and document service user perceptions of the programme. Methods Mixed quantitative, qualitative and process evaluation methods were used. Service providers were trained to use fourth generation rapid antibody/antigen HIV tests. Existing outreach services incorporated POCT into routine practice. Clients completed a semi-structured questionnaire and focus group discussions (FGDs were held with service providers. Results Between September 2009 and June 2010, 953 individuals underwent POCT (GUM: 556 [59%]; community-based sites: 397 [42%]. Participants in the community were more likely to be male (p = 0.028, older (p Conclusions Community and GUM clinic-based POCT for HIV was feasible and acceptable to clients and service providers in a low prevalence setting. It successfully reached target groups, many of whom would not have otherwise tested. We recommend POCT be considered among strategies to increase the uptake of HIV testing among groups who are currently underserved.

  11. Twin Paradox: A Complete Treatment from the Point of View of Each Twin.

    Science.gov (United States)

    Perrin, Robert

    1979-01-01

    Modifies and expands on the treatment of the twin paradox by solving the gravitational field equations and geodesic equations of motion in the traveling twin's reference frame, thus determining the time elapsed on the Earth during the periods of acceleration. (Author/GA)

  12. [A Randomized Controlled Clinical Trial for Treatment of Shoulder-back Myofascial Pain Syndrome with Mild Moxibustion at Trigger Points].

    Science.gov (United States)

    Wang, Lie; Ma, Shuai; Zhao, Yue; Cao, Rui; Wang, Ying; Ma, Tie-Ming

    2016-08-25

    To compare the efficacy difference between the mild moxibustion and acupuncture stimulation at trigger points in the treatment of shoulder and back myofascial pain syndrome (MPS), so as to provide a reference for clinical treatment of MPS. A total of 60 patients with shoulder and back MPS were equally and randomly divided into mild moxibustion group and acupuncture group. The myofascial trigger points in the shoulder and back regions were stimulated with mild moxibustion for 20-100 min every time or punctured with filiform needles by retaining the needles for 30 min after twirling for a while. The treatment was conducted once daily for 10 days. The short-form McGill pain questionnaire (SF-MPQ) including the pain rating index[PRI consisting of 15 descriptors (11 sensory, 4 affective) which are rated on an intensity scale as 0=none, 1=mild, 2=moderate and 3=severe], present pain intensity (PPI) index of the standard MPQ and a visual analogue scale (VAS) was used to assess the patient's pain severity before and after the treatment. Following the treatment, of the two 30 cases of MPS patients in the acupuncture and mild moxibustion groups, 1 and 7 were cured, 11 and 17 experienced marked improvement, 14 and 5 were effective, 4 and 1 was invalid, with the effective rates being 86.7% (26/30) and 96.7%(29/30), respectively. The cured plus markedly effective rate of the mild moxibustion group was significantly better than that of the acupuncture group(P0.05). Mild moxibustion stimulation of myofascial trigger point is effective in relieving shoulder-back MPS, being comparable to that of acupuncture therapy.

  13. Ethnopharmacological survey of medicinal plants practiced by traditional healers and herbalists for treatment of some urological diseases in the West Bank/Palestine.

    Science.gov (United States)

    Jaradat, Nidal Amin; Zaid, Abdel Naser; Al-Ramahi, Rowa; Alqub, Malik A; Hussein, Fatima; Hamdan, Zakaria; Mustafa, Mahmoud; Qneibi, Mohammad; Ali, Iyad

    2017-05-08

    Throughout history, every civilization in the world used plants or their derivatives for treatment or prevention of diseases. In Palestine as in many other countries, herbal medicines are broadly used in the treatment of wide range of diseases including urological diseases. The main objective of this research is to study the use of herbal remedies by herbalists and traditional healers for treatment of various urological diseases in the West Bank regions of Palestine and to assess their efficacy and safety through the literature review of the most cited plants. The study included a survey part, plant identification and a review study. The first part was a cross-sectional descriptive study. Face to face questionnaires were distributed to 150 traditional healers and herbalist in all regions of the West Bank of Palestine. The literature review part was to assess the most cited plants for their efficacy and toxicity. One hundred forty four herbalists and traditional healers accepted to participate in this study which was conducted between March and April, 2016. The results showed that 57 plant species belonging to 30 families were used by herbalists and traditional healers for treatment of various urinary tract diseases in Palestine. Of these, Apiaceae family was the most prevalent. Paronychia argentea, Plantago ovata, Punica granatum, Taraxacum syriacum, Morus alba and Foeniculum vulgare were the most commonly used plant species in the treatment of kidney stones, while Capsella bursa-pastoris, Ammi visnaga and Ammi majus were the most recommended species for treatment of urinary tract infections and Portulaca oleracea used for renal failure. In addition Curcuma longa and Crocus sativus were used for enuresis while Juglans regia, Quercus infectoria, Sambucus ebulus and Zea mays were used for treatment symptoms of benign prostate hyperplasia. Fruits were the most common parts used, and a decoction was the most commonly used method of preparation. Through literature

  14. Numerical study and ex vivo assessment of HIFU treatment time reduction through optimization of focal point trajectory

    Science.gov (United States)

    Grisey, A.; Yon, S.; Pechoux, T.; Letort, V.; Lafitte, P.

    2017-03-01

    Treatment time reduction is a key issue to expand the use of high intensity focused ultrasound (HIFU) surgery, especially for benign pathologies. This study aims at quantitatively assessing the potential reduction of the treatment time arising from moving the focal point during long pulses. In this context, the optimization of the focal point trajectory is crucial to achieve a uniform thermal dose repartition and avoid boiling. At first, a numerical optimization algorithm was used to generate efficient trajectories. Thermal conduction was simulated in 3D with a finite difference code and damages to the tissue were modeled using the thermal dose formula. Given an initial trajectory, the thermal dose field was first computed, then, making use of Pontryagin's maximum principle, the trajectory was iteratively refined. Several initial trajectories were tested. Then, an ex vivo study was conducted in order to validate the efficicency of the resulting optimized strategies. Single pulses were performed at 3MHz on fresh veal liver samples with an Echopulse and the size of each unitary lesion was assessed by cutting each sample along three orthogonal planes and measuring the dimension of the whitened area based on photographs. We propose a promising approach to significantly shorten HIFU treatment time: the numerical optimization algorithm was shown to provide a reliable insight on trajectories that can improve treatment strategies. The model must now be improved in order to take in vivo conditions into account and extensively validated.

  15. [Botulinum toxin in the treatment of adult spasticity. An interdisciplinary German 10-point consensus 2010].

    Science.gov (United States)

    Wissel, J; auf dem Brinke, M; Hecht, M; Herrmann, C; Huber, M; Mehnert, S; Reuter, I; Schramm, A; Stenner, A; van der Ven, C; Winterholler, M; Kupsch, A

    2011-04-01

    Spasticity is one of the major causes of functional impairment in adults with lesions of the central nervous system. For instance, approximately 30% of post-stroke patients suffer from different degrees of spasticity with possible consecutive impairments. Numerous studies or meta-analyses showed that local injections of botulinum toxin in spastic muscles lead to dose-dependent reduction in muscle tone and improvement of passive movements (e. g. facilitated care), especially following repeated injections.However, country-specific regulations and patient-remote administration in German health care often do not allow adequate provision of this therapy. Thus, the present consensus statement based on the EBM analyses of the published international literature tries to highlight recent advances and the standard in the field of local spasticity treatment, aiming to facilitate communication between the decision makers and German reimbursement institutions in health care. Prior to initiation of BoNT-A injections, patient-oriented goals should be identified in a multiprofessional context to assure realistic goals for this specific treatment and patient expectations. In Germany for the treatment of focal spasticity following stroke three products have been approved: Botox® (Pharm Allergan, Ettlingen), Dysport® (Ipsen Pharma, Ettlingen) and Xeomin® (Merz Pharma, Frankfurt/Main). For all preparations safety has been repeatedly shown. Functional improvements have also been illustrated for selected patients concerning hand/arm function and gait. The dose per muscle and the selection of muscles to be injected have to be individualized according to the patient's symptoms and should be accompanied by modern neurorehabilitative therapies such as redression or repetitive activation of the injected and antagonistic muscles.

  16. An Overview: Treatment of Lung Cancer on Researcher Point of View

    OpenAIRE

    Javeria Amin

    2015-01-01

    Cancers is defined as the uncontrolled cell divisions. Cell does not grow maturely and destined to uncontrolled cell growth. When these cells of lungs grow uncontrolled it is called lung cancer. Nowadays mortality rate due to lung cancer is increasing day by day. Many treatment and diagnoses are now a day’s available to deal with lung cancer. Here we disused different method for diagnosis the common types of lung cancer Non-Small Cell Lung Cancer, Small Cell Lung Cancer, Small Cell Lung Cance...

  17. Factors predicting drop out from, and retention in, specialist drug treatment services: A case control study in the North West of England

    Directory of Open Access Journals (Sweden)

    McMinn Alison M

    2008-05-01

    Full Text Available Abstract Background: In the United Kingdom (UK, the National Treatment Agency for Substance Misuse (NTA considers retention to be the best available measure of drug treatment effectiveness. Accordingly, the NTA has set local treatment systems the annual target of retaining 75% of clients for 12 weeks or more, yet little assessment of this target or factors that improve retention has occurred. This study aims to quantify the proportion of people retained in treatment for 12 weeks in the North West of England and to identify factors associated with premature drop out. Methods: The North West National Drug Treatment Monitoring System (NDTMS was used to identify treatment durations for everyone beginning a treatment episode between 1st April 2005 and 31st March 2006 (N = 16626. Odds ratios, chi-square and logistic regression analyses compared clients retained for 12 weeks to clients whose discharge record showed they had prematurely dropped out before 12 weeks. Individuals with other outcomes were excluded from analyses. Results: 75% of clients (N = 12230 were retained for 12 weeks and 10% (N = 1649 dropped out prematurely. Multivariate analysis showed drop out was more likely among Asian drug users (adjusted odds ratio 1.52, 95% CI 1.12 to 2.08 than their white equivalents. Drop out was more likely among residents of Cumbria and Lancashire (adjusted odds ratio 1.80, 95% CI 1.51 to 2.15 and Greater Manchester (adjusted odds ratio 2.00, 95% CI 1.74 to 2.29 than Cheshire and Merseyside and less likely among alcohol users (adjusted odds ratio 0.73, 95% CI 0.59 to 0.91. A significant interaction between age and deprivation was observed. For those aged 18 to 24 years and 25 to 34 years, drop out was significantly more likely among those living in affluent areas. For those in the older age groups the converse effect was observed. Conclusion: In combination, the drug treatment systems of the North West achieved the Government's retention target in 2005

  18. SU-E-T-72: A Retrospective Correlation Analysis On Dose-Volume Control Points and Treatment Outcomes

    Energy Technology Data Exchange (ETDEWEB)

    Roy, A; Nohadani, O [Northwestern University, Evanston, IL (United States); Refaat, T; Bacchus, I; Cutright, D; Sathiaseelan, V; Mittal, B [Northwestern University, Chicago, IL (United States)

    2015-06-15

    Purpose: To quantify correlation between dose-volume control points and treatment outcomes. Specifically, two outcomes are analyzed: occurrence of radiation induced dysphagia and target complications. The results inform the treatment planning process when competing dose-volume criteria requires relaxations. Methods: 32 patients, treated with whole-field sequential intensity modulated radiation therapy during 2009–2010 period, are considered for this study. Acute dysphagia that is categorized into 3 grades is observed on all patients. 3 patients are observed in grade 1, 17 patients in grade 2, and 12 patients in grade 3. Ordinal logistic regression is employed to establish correlations between grades of dysphagia and dose to cervico-thoracic esophagus. Particularly, minimum (Dmin), mean (Dmean), and maximum (Dmax) dose control points are analyzed. Additionally, target complication, which includes local-regional recurrence and/or distant metastasis, is observed on 4 patients. Binary logistic regression is used to quantify correlation between target complication and four dose control points. Namely, ICRU recommended dose control points, D2, D50, D95, and D98 are analyzed. Results: For correlation with dysphagia, Dmin on cervico-thoracic esophagus is statistically significant (p-value = 0.005). Additionally, Dmean on cervico-thoracic esophagus is also significant in association with dysphagia (p-value = 0.012). However, no correlation was observed between Dmax and dysphagia (p-value = 0.263). For target complications, D50 on the target is a statistically significant dose control point (p-value = 0.032). No correlations were observed between treatment complications and D2 (p-value = 0.866), D95 (p-value = 0.750), and D98 (p-value = 0.710) on the target. Conclusion: Significant correlations are observed between radiation induced dysphagia and Dmean (and Dmin) to cervico-thoracic esophagus. Additionally, correlation between target complications and median dose to target

  19. Fertility-sparing treatment of endometrial cancer precursors among young women: a reproductive point of view.

    Science.gov (United States)

    Ricciardi, E; Maniglio, P; Frega, A; Marci, R; Caserta, D; Moscarini, M

    2012-12-01

    Early-stage endometrial cancer and complex atypical hyperplasia are treated with hysterectomy and bilateral salpingo-oophorectomy. An emerging issue among younger women affected is the possibility of a fertility-sparing treatment with progestative therapy and close follow-up. To assess the possibility of conceiving after a diagnosis of atypical endometrial hyperplasia among women younger than 40 years old, in term of delaying definitive treatment and achieving pregnancy. 15 women younger than 40 years old with complex CAH or early carcinoma of the endometrium and a wish to preserve fertility. Progestins were administered orally for at least a 12 weeks period. Endometrial biopsies were used at follow-up. In 11 women, a complete pathological remission of the disease was observed. 4 pregnancies were attained in 4 women. 3 showed progression and underwent definitive surgery at 18 months. 1 showed no response at 24 months and 3 cycles and was counseled to receive a hysterectomy. A conservative approach in patients younger than 40 years appears a valid option, and a progestative therapy trial should be attempted whether a valid consensus is attained. Considering the risk to find AEH at biopsies and eventually a carcinoma at hysterectomy (25% of cases) a careful management is strictly required.

  20. A unified treatment of some perturbed fixed point iterative methods with an infinite pool of operators

    Science.gov (United States)

    Nikazad, Touraj; Abbasi, Mokhtar

    2017-04-01

    In this paper, we introduce a subclass of strictly quasi-nonexpansive operators which consists of well-known operators as paracontracting operators (e.g., strictly nonexpansive operators, metric projections, Newton and gradient operators), subgradient projections, a useful part of cutter operators, strictly relaxed cutter operators and locally strongly Féjer operators. The members of this subclass, which can be discontinuous, may be employed by fixed point iteration methods; in particular, iterative methods used in convex feasibility problems. The closedness of this subclass, with respect to composition and convex combination of operators, makes it useful and remarkable. Another advantage with members of this subclass is the possibility to adapt them to handle convex constraints. We give convergence result, under mild conditions, for a perturbation resilient iterative method which is based on an infinite pool of operators in this subclass. The perturbation resilient iterative methods are relevant and important for their possible use in the framework of the recently developed superiorization methodology for constrained minimization problems. To assess the convergence result, the class of operators and the assumed conditions, we illustrate some extensions of existence research works and some new results.

  1. The treatment of facial palsy from the point of view of physical and rehabilitation medicine.

    Science.gov (United States)

    Shafshak, T S

    2006-03-01

    There are evidences to support recommending the early intake of prednisone (in its appropriate dose of 1 mg/kg body weight for up to 70 or 80 mg/day) or the combined use of prednisone and acyclovir (or valacyclovir) within 72 h following the onset of paralysis in order to improve the outcome of Bell's palsy (BP). Although there may be a controversy about the role of physiotherapy in BP or facial palsy, it seemed that local superficial heat therapy, massage, exercises, electrical stimulation and biofeedback training have a place in the treatment of lower motor facial palsy. However, each modality has its indications. Moreover, some rehabilitative surgical methods might be of benefit for some patients with traumatic facial injuries or long standing paralysis without recovery, but early surgery in BP is usually not recommended. However, few may recommend early surgery in BP when there is 90-100% facial nerve degeneration. The efficacy of acupuncture, magnetic pellets and other modalities of physiotherapy needs further investigation. The general principles and the different opinions in treating and rehabilitating facial palsy are discussed and the need for further research in this field is suggested.

  2. Trigger point dry needling as an adjunct treatment for a patient with adhesive capsulitis of the shoulder.

    Science.gov (United States)

    Clewley, Derek; Flynn, Timothy W; Koppenhaver, Shane

    2014-02-01

    Case report. Prognosis for adhesive capsulitis has been described as self-limiting and can persist for 1 to 3 years. Conservative treatment that includes physical therapy is commonly advised. The patient was a 54-year-old woman with primary symptoms of shoulder pain and loss of motion consistent with adhesive capsulitis. Manual physical therapy intervention initially consisted of joint mobilizations of the shoulder region and thrust manipulation of the cervicothoracic region. Although manual techniques seemed to result in some early functional improvement, continued progression was limited by pain. Subsequent examination identified trigger points in the upper trapezius, levator scapula, deltoid, and infraspinatus muscles, which were treated with dry needling to decrease pain and allow for higher grades of manual intervention. The patient was treated for a total of 13 visits over a 6-week period. After trigger point dry needling was introduced on the third visit, improvements in pain-free shoulder range of motion and functional outcome measures, assessed with the Shoulder Pain and Disability Index and the shortened form of the Disabilities of the Arm, Shoulder and Hand questionnaire, exceeded the minimal clinically important difference after 2 treatment sessions. At discharge, the patient had achieved significant improvements in shoulder range of motion in all planes, and outcome measures were significantly improved. This case report describes the clinical reasoning behind the use of trigger point dry needling in the treatment of a patient with adhesive capsulitis. The rapid improvement seen in this patient following the initiation of dry needling to the upper trapezius, levator scapula, deltoid, and infraspinatus muscles suggests that surrounding muscles may be a significant source of pain in this condition.

  3. Extracorporeal Shock Wave Therapy Versus Trigger Point Injection in the Treatment of Myofascial Pain Syndrome in the Quadratus Lumborum.

    Science.gov (United States)

    Hong, Jin Oh; Park, Joon Sang; Jeon, Dae Geun; Yoon, Wang Hyeon; Park, Jung Hyun

    2017-08-01

    To compare the effectiveness of extracorporeal shock wave therapy (ESWT) and trigger point injection (TPI) for the treatment of myofascial pain syndrome in the quadratus lumborum. In a retrospective study at our institute, 30 patients with myofascial pain syndrome in the quadratus lumborum were assigned to ESWT or TPI groups. We assessed ESWT and TPI treatment according to their affects on pain relief and disability improvement. The outcome measures for the pain assessment were a visual analogue scale score and pain pressure threshold. The outcome measures for the disability assessment were Oswestry Disability Index, Roles and Maudsley, and Quebec Back Pain Disability Scale scores. Both groups demonstrated statistically significant improvements in pain and disability measures after treatment. However, in comparing the treatments, we found ESWT to be more effective than TPI for pain relief. There were no statistically significant differences between the groups with respect to disability. Compared to TPI, ESWT showed superior results for pain relief. Thus, we consider ESWT as an effective treatment for myofascial pain syndrome in the quadratus lumborum.

  4. Good quality of oral anticoagulation treatment in general practice using international normalised ratio point of care testing

    DEFF Research Database (Denmark)

    Løkkegaard, Thomas; Pedersen, Tina Heidi; Lind, Bent

    2015-01-01

    in the management of patients in warfarintreatment provided good quality of care. Sampling intervaland diagnostic coding were significantly correlated withtreatment quality. FUNDING: The study received financial support from theSarah Krabbe Foundation, the General Practitioners’ Educationand Development Foundation......INTRODUCTION: Oral anticoagulation treatment (OACT)with warfarin is common in general practice. Increasingly,international normalised ratio (INR) point of care testing(POCT) is being used to manage patients. The aim of thisstudy was to describe and analyse the quality of OACT withwarfarin......, and Quality in PrimaryCare (KAP-H) – the Capital Region of Denmark. TRIAL REGISTRATION: not relevant....

  5. Caregivers' perception of malaria and treatment-seeking behaviour for under five children in Mandura District, West Ethiopia: a cross-sectional study.

    Science.gov (United States)

    Mitiku, Israel; Assefa, Adane

    2017-04-08

    Early diagnosis and prompt malaria treatment is essential to reduce progression of the illness to severe disease and, therefore, decrease mortality particularly among children under 5 years of age. This study assessed perception of malaria and treatment-seeking behaviour for children under five with fever in the last 2 weeks in Mandura District, West Ethiopia. A community based cross-sectional study was conducted among 491 caregivers of children under five in Mandura District, West Ethiopia in December 2014. Data were collected using interviewer-administered questionnaires. Data were entered into Epi Info version 7 and analysed using SPSS version 20. Multiple logistic regression analyses were conducted to identify the determinants of caregivers' treatment-seeking behaviour. Overall, 94.1% of the respondents perceived that fever is the most common symptom and 70% associated mosquito bite with the occurrence of malaria. Of 197 caregivers with under five children with fever in the last 2 weeks preceding the study 87.8% sought treatment. However, only 38.7% received treatment within 24 h of onset of fever. Determinants of treatment-seeking include place of residence (rural/urban) (AOR 2.80, 95% CI 1.01-7.70), caregivers age (AOR 3.40, 95% CI 1.27-9.10), knowledge of malaria (AOR 4.65, 95% CI 1.38-15.64), perceived susceptibility to malaria (AOR 3.63, 95% CI 1.21-10.88), and perceived barrier to seek treatment (AOR 0.18, 95% CI 0.06-0.52). Majority of the respondents of this study sought treatment for their under five children. However, a considerable number of caregivers first consulted traditional healers and tried home treatment, thus, sought treatment late. Living in rural village, caregivers' age, malaria knowledge, perceived susceptibility to malaria and perceived barrier to seek treatment were important factors in seeking health care. There is a need to focus on targeted interventions, promote awareness and prevention, and address misconceptions about

  6. Selective hydrolysis of wastewater sludge. Part 1. Model calculations and cost benefit analysis for Esbjerg West waste water treatment plant, Denmark

    Energy Technology Data Exchange (ETDEWEB)

    OEstergaard, N. (Eurotec West A/S (DK)); Thomsen, Anne Belinda; Thygesen, Anders; Bangsoe Nielsen, H. (Risoe National Laboratory, DTU (DK)); Rasmussen, Soeren (SamRas (DK))

    2007-09-15

    The project 'Selective hydrolysis of wastewater sludge' investigates the possibilities of utilizing selective hydrolysis of sludge at waste water treatment plants to increase the production of biogas based power and heat, and at the same time reduce power consumption for handling and treatment of nitrogen and sludge as well as for disposal of the sludge. The selective hydrolysis system is based on the fact that an anaerobic digestion before a hydrolysis treatment increases the hydrolysis efficiency, as the production of volatile organic components, which might inhibit the hydrolysis efficiency, are not produced to the same extent as may be the case for a hydrolysis made on un-digested material. Furthermore it is possible to separate ammonia from the sludge without using chemicals; it has, however, proven difficult to treat wastewater sludge, as the sludge seems to be difficult to treat in the laboratory using simple equipment. Esbjerg Wastewater Treatment Plant West, Denmark, is used as model plant for the calculations of the benefits using selective hydrolysis of sludge as if established at the existing sludge digester system. The plant is a traditional build plant based on the activated sludge concept in addition to traditional digester technology. The plant treats combined household and factory wastewater with a considerable amount of the wastewater received from the industries. During the project period Esbjerg Treatment Plant West went through considerable process changes, thus the results presented in this report are based on historical plant characteristics and may be viewed as conservative relative to what actually may be obtainable. (BA)

  7. Effectiveness of a home program of ischemic pressure followed by sustained stretch for treatment of myofascial trigger points.

    Science.gov (United States)

    Hanten, W P; Olson, S L; Butts, N L; Nowicki, A L

    2000-10-01

    Myofascial trigger points (TPs) are found among patients who have neck and upper back pain. The purpose of this study was to determine the effectiveness of a home program of ischemic pressure followed by sustained stretching for the treatment of myofascial TPs. Forty adults (17 male, 23 female), aged 23 to 58 years (mean=30.6, SD=9.3), with one or more TPs in the neck or upper back participated in this study. Subjects were randomly divided into 2 groups receiving a 5-day home program of either ischemic pressure followed by general sustained stretching of the neck and upper back musculature or a control treatment of active range of motion. Measurements were obtained before the subjects received the home program instruction and on the third day after they discontinued treatment. Trigger point sensitivity was measured with a pressure algometer as pressure pain threshold (PPT). Average pain intensity for a 24-hour period was scored on a visual analog scale (VAS). Subjects also reported the percentage of time in pain over a 24-hour period. A multivariate analysis of covariance, with the pretests as the covariates, was performed and followed by 3 analyses of covariance, 1 for each variable. RESULTS Differences were found between the treatment and control groups for VAS scores and PPT. No difference was found between the groups for percentage of time in pain. A home program, consisting of ischemic pressure and sustained stretching, was shown to be effective in reducing TP sensitivity and pain intensity in individuals with neck and upper back pain. The results of this study indicate that clinicians can treat myofascial TPs through monitoring of a home program of ischemic pressure and stretching.

  8. Limnological Assessment of West Point Lake, Georgia

    Science.gov (United States)

    1994-07-01

    exchange at the air-water interface and photosynthesis by phytoplankton and periphyton. Subsequent downstream displacement of this water at the...nepheloid layers and their influence on the manganese cycling and toxicology in Oscillatoria (Cyanobacteria) in lakes," Ph.D. diss., Clemson University

  9. Ethnopharmacological survey of home remedies used for treatment of hair and scalp and their methods of preparation in the West Bank-Palestine.

    Science.gov (United States)

    Zaid, Abdel Naser; Jaradat, Nidal Amin; Eid, Ahmad Mustafa; Al Zabadi, Hamzeh; Alkaiyat, Abdulsalam; Darwish, Saja Adam

    2017-07-05

    Natural products have many uses and purposes, including those linked to pharmaceutics and cosmetics. The aim of this study was to investigate the use of natural remedies for the treatment of hair and scalp disorders in the West Bank, Palestine. An ethnopharmacological survey of herbal remedies and other natural products used in cosmetics and cosmeceuticals was carried out in the West Bank, Palestine. A questionnaire was distributed to 267 herbalists, traditional healers, hairdressers and rural dwellers. Collected information included: the names of plants and other natural products, the parts used, hair conditions, diseases and problems for which these products were used and also their methods of preparation. To identify the most important species used, the factor of informant's consensus (Fic), fidelity level (Fl) and the use-value (UV) were calculated. Collected data showed that 41 plants are utilized for the treatment of hair and scalp disorders, belonging to 27 families; among them Lamiaceae and Rosaceae, which were the most commonly used. Plant oils and their fruits are the most commonly used parts. Hair loss, dandruff, split hair endings and lice treatment, are reported as the most treated disorders. The number of plant species used consisted of 19, 14, 13, and again 13 with a factor of informant's consensus (Fic) for these disorders corresponding to 0.93, 0.94, 0.95 and 0.92, respectively. Fl was 100% for many plants; the highest UV value (0.84) was registered for Lawsonia inermis, which belongs to the Lythraceae family. This study showed that many natural remedies are still used in Palestine for the treatment of scalp and hair disorders as well as for cosmeceutical purposes. This study is of great importance as it allows us to have a greater perspective on our folkloric use of these natural products. A combined scientific effort between informants and the scientific community, working in this field, may help in the discovery of new cosmetics, cosmeceutical

  10. Disease patterns and causes of death of hospitalized HIV-positive adults in West Africa: a multicountry survey in the antiretroviral treatment era.

    Science.gov (United States)

    Lewden, Charlotte; Drabo, Youssoufou J; Zannou, Djimon M; Maiga, Moussa Y; Minta, Daouda K; Sow, Papa S; Akakpo, Jocelyn; Dabis, François; Eholié, Serge P

    2014-01-01

    We aimed to describe the morbidity and mortality patterns in HIV-positive adults hospitalized in West Africa. We conducted a six-month prospective multicentre survey within the IeDEA West Africa collaboration in six adult medical wards of teaching hospitals in Abidjan, Ouagadougou, Cotonou, Dakar and Bamako. From April to October 2010, all newly hospitalized HIV-positive patients were eligible. Baseline and follow-up information until hospital discharge was recorded using standardized forms. Diagnoses were reviewed by a local event validation committee using reference definitions. Factors associated with in-hospital mortality were studied with a logistic regression model. Among 823 hospitalized HIV-positive adults (median age 40 years, 58% women), 24% discovered their HIV infection during the hospitalization, median CD4 count was 75/mm(3) (IQR: 25-177) and 48% had previously received antiretroviral treatment (ART). The underlying causes of hospitalization were AIDS-defining conditions (54%), other infections (32%), other diseases (8%) and non-specific illness (6%). The most frequent diseases diagnosed were: tuberculosis (29%), pneumonia (15%), malaria (10%) and cerebral toxoplasmosis (10%). Overall, 315 (38%) patients died during hospitalization and the underlying cause of death was AIDS (63%), non-AIDS-defining infections (26%), other diseases (7%) and non-specific illness or unknown cause (4%). Among them, the most frequent fatal diseases were: tuberculosis (36%), cerebral toxoplasmosis (10%), cryptococcosis (9%) and sepsis (7%). Older age, clinical WHO stage 3 and 4, low CD4 count, and AIDS-defining infectious diagnoses were associated with hospital fatality. AIDS-defining conditions, primarily tuberculosis, and bacterial infections were the most frequent causes of hospitalization in HIV-positive adults in West Africa and resulted in high in-hospital fatality. Sustained efforts are needed to integrate care of these disease conditions and optimize earlier

  11. Disease patterns and causes of death of hospitalized HIV-positive adults in West Africa: a multicountry survey in the antiretroviral treatment era

    Directory of Open Access Journals (Sweden)

    Charlotte Lewden

    2014-04-01

    Full Text Available Objective: We aimed to describe the morbidity and mortality patterns in HIV-positive adults hospitalized in West Africa. Method: We conducted a six-month prospective multicentre survey within the IeDEA West Africa collaboration in six adult medical wards of teaching hospitals in Abidjan, Ouagadougou, Cotonou, Dakar and Bamako. From April to October 2010, all newly hospitalized HIV-positive patients were eligible. Baseline and follow-up information until hospital discharge was recorded using standardized forms. Diagnoses were reviewed by a local event validation committee using reference definitions. Factors associated with in-hospital mortality were studied with a logistic regression model. Results: Among 823 hospitalized HIV-positive adults (median age 40 years, 58% women, 24% discovered their HIV infection during the hospitalization, median CD4 count was 75/mm3 (IQR: 25–177 and 48% had previously received antiretroviral treatment (ART. The underlying causes of hospitalization were AIDS-defining conditions (54%, other infections (32%, other diseases (8% and non-specific illness (6%. The most frequent diseases diagnosed were: tuberculosis (29%, pneumonia (15%, malaria (10% and cerebral toxoplasmosis (10%. Overall, 315 (38% patients died during hospitalization and the underlying cause of death was AIDS (63%, non-AIDS-defining infections (26%, other diseases (7% and non-specific illness or unknown cause (4%. Among them, the most frequent fatal diseases were: tuberculosis (36%, cerebral toxoplasmosis (10%, cryptococcosis (9% and sepsis (7%. Older age, clinical WHO stage 3 and 4, low CD4 count, and AIDS-defining infectious diagnoses were associated with hospital fatality. Conclusions: AIDS-defining conditions, primarily tuberculosis, and bacterial infections were the most frequent causes of hospitalization in HIV-positive adults in West Africa and resulted in high in-hospital fatality. Sustained efforts are needed to integrate care of these

  12. Oakland, West

    OpenAIRE

    Kwamille, Tasion Shawniece

    2013-01-01

    “Oakland, West” Produced by: Tasion Kwamilele          After World War II, many blacks from the south migrated to Oakland to work in the shipyards; housing discrimination forced blacks to move to West Oakland. But when those jobs died out many Blacks moved from West Oakland and the area became deserted and filled with crime, drugs, violence, and poverty.         The 7.0 Loma Prueta Earthquake, also known as the World Series Quake of 1989, shook the Bay Are...

  13. Total Delay Is Associated with Unfavorable Treatment Outcome among Pulmonary Tuberculosis Patients in West Gojjam Zone, Northwest Ethiopia: A Prospective Cohort Study

    Science.gov (United States)

    Gebreegziabher, Senedu Bekele; Bjune, Gunnar Aksel; Yimer, Solomon Abebe

    2016-01-01

    Background delay in diagnosis and treatment of tuberculosis (TB) may worsen the disease, increase mortality and enhance transmission in the community. This study aimed at assessing the association between total delay and unfavorable treatment outcome among newly diagnosed pulmonary TB (PTB) patients. Methods A prospective cohort study was conducted in West Gojjam Zone, Amhara Region of Ethiopia from October 2013 to May 2015. Newly diagnosed PTB patients who were ≥15 years of age were consecutively enrolled in the study from 30 randomly selected public health facilities. Total delay (the time period from onset of TB symptoms to first start of anti-TB treatment) was measured. Median total delay was calculated. Mixed effect logistics regression was used to analyze factors associated with unfavorable treatment outcome. Results Seven hundred six patients were enrolled in the study. The median total delay was 60 days. Patients with total delay of > 60 days were more likely to have unfavorable TB treatment outcome than patients with total delay of ≤ 60 days (adjusted odds ratio [AOR], 2.33; 95% confidence interval [CI], 1.04–5.26). Human immunodeficiency virus (HIV) positive TB patients were 8.46 times more likely to experience unfavorable treatment outcome than HIV negative TB patients (AOR, 8.46; 95% CI, 3.14–22.79). Conclusions Long total delay and TB/HIV coinfection were associated with unfavorable treatment outcome. Targeted interventions that can reduce delay in diagnosis and treatment of TB, and early comprehensive management of TB/HIV coinfection are needed to reduce increased risk of unfavorable treatment outcome. PMID:27442529

  14. Anterior midline point stop device (AMPS) in the treatment of myogenous TMDs: comparison with the stabilization splint and control group.

    Science.gov (United States)

    Al Quran, Firas A M; Kamal, Mudar S

    2006-06-01

    Two occlusal splints, the full-arch stabilization splint and the anterior midline point stop (AMPS) device, were evaluated for their efficiency in relieving myogenous temporomandibular disorders (TMD). One hundred and fourteen patients with myogenous TMD were distributed into 3 groups. The first group was treated with the AMPS device, the second with the stabilization splint, and the third group was the control group. Pain intensity was scored using the visual analogue scale before treatment and 1 month and 3 months after treatment. Statistical Package for the Social Sciences (SPSS, Chicago, Ill) and multiple comparisons tests were used to compare results before and after treatment and to compare the groups. The use of AMPS device in the first group resulted in a significant improvement after 1 month and 3 months (P < or = .001) and showed a 56.66% pain reduction. A significant improvement was also noticed in the second group (P = .001) with a 47.71% pain reduction. Although pain reduction percentage appeared more in the first group, this was not statistically significant. There was a highly significant difference between groups treated with both kinds of splints and the control group. It was concluded that both types of occlusal splints are beneficial to patients with myogenous TMD.

  15. Treatment of deep vein thrombosis from Iranian traditional medicine and modern medicine points of view: comparative study

    Directory of Open Access Journals (Sweden)

    2017-11-01

    Full Text Available Background and objectives: Recently, deep vein thrombosis (DVT has remained a major cause of morbidity and death. DVT is a serious public health issue and can be complicated by pulmonary embolism and stroke leading to high economic burden. Disease etiologies may include protein C deficiency, protein S deficiency, factor V Leiden gene mutation, prothrombin gene 20210A mutation, antithrombin III deficiency, immobilization, malignancy, nephrotic syndrome, antiphospholipid antibody syndrome, estrogen use, pregnancy and hyperhomocystinemia. From Iranian traditional medicine (ITM point of view, increased blood viscosity is the main cause of DVT. In this study, treatment of DVT has been investigated in ITM comparing with modern medicine. Methods: All data for this review were obtained by search engines such as Google Scholar, Pub Med, SID, and Iranmedex using key words including “deep vein thrombosis” and “treatment”. Results: At present, there is no definite cure for the treatment of DVT in modern medicine and usually anticoagulant drugs such as, low-molecular-weight heparin, unfractionated heparin and warfarin, inferior vena cava filters, catheter-directed thrombolytic therapy and hybrid operative thrombectomy, are recommended; however, herbal remedies have attracted lots of attention and in this regard, sumac (Rhus coriaria, garlic (Allium sativum, turmeric (Curcuma longa and barberry Berberis vulgaris (have been found effective for the treatment of DVT which have been frequently recommended in ITM. Conclusion: In this study, some useful dietary strategies have been presented for the management of DVT which can be helpful for further drug discovery developments.

  16. Alternative Electrode Materials and Ceramic Filter Minimize Disinfection Byproducts in Point-of-Use Electrochemical Water Treatment

    Science.gov (United States)

    Yoon, Yeojoon; Jung, Youmi; Kwon, Minhwan; Cho, Eunha; Kang, Joon-Wun

    2013-01-01

    Abstract Effects of various electrodes and prefiltration to minimize disinfection byproducts (DBPs) in electrochemical water disinfection was evaluated. The target microorganism, Escherichia coli O157:H7, was effectively inactivated even applying a solar-charged storage battery for the electrolysis process. Extent of microbial inactivation decreased with lower water temperature and higher pH in the free chlorine disinfection system. The RuO2/Ti electrode was most efficient because it produced the lowest concentration of chlorate and the highest generation of free chlorine. Prefiltration using a ceramic filter inhibited formation of halogenated DBPs because it removed precursors of DBPs. For safe point-of-use water treatment, the use of a hybrid prefiltration stage with the electrolysis system is strongly recommended to reduce risks from DBPs. The system is particularly suited to use in developing regions. PMID:24381482

  17. Determinants of delay in malaria treatment-seeking behaviour for under-five children in south-west Ethiopia: a case control study

    Directory of Open Access Journals (Sweden)

    Deribew Amare

    2010-11-01

    Full Text Available Abstract Background Prompt diagnosis and timely treatment of malaria within 24 hours after onset of first symptoms can reduce illness progression to severe stages and therefore, decrease mortality. The reason why mothers/caretakers delay in malaria diagnosis and treatment for under-five children is not well studied in Ethiopia. The objective of this study was to assess determinants of malaria treatment delay in under-five children in three districts of south-west Ethiopia. Methods A case control study was conducted from March 15 to April 20, 2010. Cases were under-five children who had clinical malaria and sought treatment after 24 hours of developing sign and symptom, and controls were under-five children who had clinical malaria and sought treatment within 24 hours of developing sign and symptom of malaria. Data were collected by trained enumerators using structured questionnaire. Data were entered in to Epi Info version 6.04 and analyzed using SPSS version 16.0. To identify determinants, multiple logistic regression was done. Results A total of 155 mothers of cases and 155 mothers of controls were interviewed. Mothers of children who were in a monogamous marriage (OR = 3.41, 95% CI: 1.39, 8.34, who complained about the side effects of anti-malarial drugs (OR = 4.96, 95% CI: 1.21, 20.36, who had no history of child death (OR = 3.50, 95% CI: 1.82, 6.42 and who complained about the higher cost of transportation to reach the health institutions (OR = 2.01, 95% CI: 1.17, 3.45 were more likely to be late for the treatment of malaria in under-five children. Conclusion Effective malaria control programmes should address reducing delayed presentation of children for treatment. Efforts to reduce delay should address transport cost, decentralization of services and increasing awareness of the community on early diagnosis and treatment.

  18. A Novel Point-of-Care BioNanoSensor for Rapid HIV Detection and Treatment Monitoring.

    Science.gov (United States)

    Rozmyslowicz, Tomasz; deSa, Johann; Lec, Ryszard; Gaulton, Glen N

    2015-05-01

    We report here a new diagnostic approach to the direct detection of HIV in blood or other body fluids that is rapid, sensitive and potentially applicable in a point-of-care setting. The approach follows on the development of a novel BioNanoSensor (BNS) device that utilizes piezoelectric technology to detect the presence of the HIV surface glycoprotein gp120 in a nanoscale format. The detection range of the BNS device for the biomarker gp120 displayed a low-end sensitivity of 6.5×104 HIV viral particles/ml, while using a small fluid sample (5 µl) and with a reaction time of less then 30 seconds. Performance of this device indicated that the BNS has utility for direct detection of HIV particles prior to, and independent from, antibody formation. Accordingly, this device holds utility to monitor the status of HIV infection both early after exposure to virus as well as during chronic HIV infection. The BNS parameters of small sample volume, compact device size, and detection sensitivity indicate that the BNS is potentially useful in the point-of-care and/or home setting for monitoring decisions regarding HIV treatment on a real-time basis.

  19. Decreasing overuse of therapies in the treatment of bronchiolitis by incorporating evidence at the point of care.

    Science.gov (United States)

    Muething, Stephen; Schoettker, Pamela J; Gerhardt, Wendy E; Atherton, Harry D; Britto, Maria T; Kotagal, Uma R

    2004-06-01

    To describe the effect of evidence-based point-of-care algorithms and rules, based on guideline recommendations, on the overuse of therapies for bronchiolitis. Study design Pre-postintervention for infants first-time episode of bronchiolitis. Data collected for guideline-eligible patients discharged between January 15, 2002, and March 27, 2002, were compared with data collected for guideline-eligible patients discharged from the hospital with a diagnosis of bronchiolitis during the same time period in the first 5 years after the original guideline implementation (1997 to 2001). The primary outcome of interest was use of bronchodilator therapy. Secondary outcomes included use of guideline order sets, resource utilization, length of stay, and readmission. A total of 256 patients from 2002 were compared with 1272 historic patients. In 2002, the odds of receiving any bronchodilator, more than 1, more than 2, and more than 4 bronchodilators were all significantly less than predicted by the 1997 to 2001 year-to-year trend. The odds of receiving a nasopharyngeal wash for respiratory syncytial virus and a chest radiography (OR=0.680, CL=0.476, 0.973) were also significantly lower than what was predicted from use trends of previous years. Evidence-based point-of-care instruments can have a significant effect on unwarranted treatment variation.

  20. Effects of residential wastewater treatment systems on ground-water quality in west-central Jefferson County, Colorado

    Science.gov (United States)

    Hall, Dennis C.; Hillier, D.E.; Nickum, Edward; Dorrance, W.G.

    1981-01-01

    The use of residential wastewater-treatment systems in Evergreen Meadows, Marshdale, and Herzman Mesa, Colo., has degraded ground-water quality to some extent in each community. Age of community; average lot size; slope of land surface; composition, permeability, and thickness of surficial material; density, size , and orientation of fractures; maintenance of wastewater-treatment systems; and presence of animals are factors possibly contributing to the degradation of ground-water quality. When compared with effluent from aeration-treatment tanks, effluent fom septic-treatment tanks is characterized by greater biochemical oxygen demand and greater concentrations of detergents. When compared with effluent from septic-treatment tanks, effluent from aeration-treatment tanks is characterized by greater concentrations of dissolved oxygen, nitrite, nitrate, sulfate, and dissolved solids. (USGS)

  1. Preliminary design of a biological treatment facility for trench water from a low-level radioactive waste disposal area at West Valley, New York

    Energy Technology Data Exchange (ETDEWEB)

    Rosten, R.; Malkumus, D. [Pacific Nuclear, Inc. (United States); Sonntag, T. [New York State Energy Research and Development Authority, NY (United States); Sundquist, J. [Ecology and Environment, Inc. (United States)

    1993-03-01

    The New York State Energy Research and Development Authority (NYSERDA) owns and manages a State-Licensed Low-Level Radioactive Waste Disposal Area (SDA) at West Valley, New York. Water has migrated into the burial trenches at the SDA and collected there, becoming contaminated with radionuclides and organic compounds. The US Environmental Protection Agency issued an order to NYSERDA to reduce the levels of water in the trenches. A treatability study of the contaminated trench water (leachate) was performed and determined the best available technology to treat the leachate and discharge the effluent. This paper describes the preliminary design of the treatment facility that incorporates the bases developed in the leachate treatability study.

  2. The syndromic management of vaginal discharge using single-dose treatments: a randomized controlled trial in West Africa.

    Science.gov (United States)

    Pépin, Jacques; Sobela, François; Khonde, Nzambi; Agyarko-Poku, Thomas; Diakité, Soumaila; Deslandes, Sylvie; Labbé, Annie-Claude; Sylla, Mohamed; Asamoah-Adu, Comfort; Frost, Eric

    2006-09-01

    To evaluate whether single-dose treatments are as effective as standard therapy in the syndromic management of vaginal discharge. A randomized controlled effectiveness trial compared single-dose tinidazole plus fluconazole (TF) with treatment for 7 days with metronidazole plus 3 days of treatment with vaginal clotrimazole (MC) among 1570 women presenting with vaginal discharge at primary health care institutions in Ghana, Guinea, Mali and Togo. Participants were randomly allocated to one of the two treatments by research nurses or physicians using precoded envelopes. Effectiveness was assessed by symptomatic response on day 14. CLINICAL IDENTIFIER ClinicalTrials.gov NCT00313131. The two treatment regimens had similar effectiveness: complete resolution was seen in 66% (TF) and 64% (MC) and partial resolution in 33% (TF) and 34% (MC) of participants (P = 0.26). Effectiveness was similar among subgroups with vulvovaginal candidiasis, Trichomonas vaginalis vaginitis or bacterial vaginosis. The two treatment regimens had a similar effectiveness among human immunodeficiency virus (HIV)-infected (TF: n = 76, 71% complete resolution, 28% partial; MC: n = 83, 72% complete resolution, 25% partial, P = 0.76) and HIV-uninfected women (TF: n = 517, 68% complete, 32% partial; MC: n = 466, 65% complete, 33% partial, P = 0.20). Cervical infections with Neisseria gonorrhoeae, Chlamydia trachomatis and Mycoplasma genitalium were uncommon among women not involved in sex work, were associated with bacterial vaginosis or T. vaginalis vaginitis, and did not alter response to treatment with agents active against vaginal infections. Four-fifths of women not relieved by a single dose of TF had a favourable response when MC was administered as second-line treatment. Single-dose TF is as effective as multiple-dose MC in the syndromic management of vaginal discharge, even among women with HIV-infection. Given its low price and easier adherence, TF should be considered as a first

  3. Estimating Woody Biomass Supply From Thinning Treatments to Reduce Fire Hazard in the U.S. West

    Science.gov (United States)

    Kenneth E. Skog; R. James Barbour

    2006-01-01

    This paper identifies timberland areas in 12 western states where thinning treatments (1) are judged to be needed to reduce fire hazard and (2) may “pay for themselves” at a scale to make investment in forest product processing a realistic option. A web-based tool - Fuel Treatment Evaluator 3.0 - is used to select high-fire-hazard timberland plots from the Forest...

  4. Ethnopharmacological survey about medicinal plants utilized by herbalists and traditional practitioner healers for treatments of diarrhea in the West Bank/Palestine.

    Science.gov (United States)

    Jaradat, Nidal Amin; Ayesh, Ola Ibrahim; Anderson, Cynthia

    2016-04-22

    Folk herbal medicine knowledge and its utilization by aboriginal cultures are not only useful for conservation of cultural traditions and biodiversity, but also useful for community healthcare and drug discovery in the present and in the future. Using a semi-structured questionnaire, an ethnopharmacological survey of medicinal plants used for treatment of diarrhea in the West Bank/Palestine was investigated. Information about fifty medicinal plants used for treatment of diarrhea, including the names of plants, parts used, mode and methods of preparation was obtained from 100 traditional healers and herbalists. This research is the first scientific work in the Middle East to collect data about plants used by traditional healers for treatments of diarrhea and their evidence based effects against this disease. The fidelity levels were 97% for Salvia fruticosa, Teucrium polium and Musa paradisiaca, 95% for Camellia sinensis and Aegle marmelos, 79% for Oryza sativa and Solanum tuberosum, 77% for Quercus boissieri, 66% for Psidium guajava, 56% for Anthemis palestina, 54% for Solanum nigrum and 52% for Juglans regia while the highest use and choice values were for S. fruticosa, T. polium and M. paradisiaca as well as the factor of informant's consensus for medicinal plants used for treatment of diarrhea was 0.505.The leaves were the most commonly used parts, followed by fruits, roots and rhizomes, while decoctions and infusions are the preferred methods of preparation. The Palestinian traditional medicine is rich with herbal remedies for treatment of diarrhea in comparison with other countries, but most of these herbal remedies lack standard in-vitro and in-vivo evaluations to establish their antidiarrheal effects. Therefore, the information obtained can serve as a basis for further phytochemical and pharmacological studies to determine their efficacy and safety which might contribute to a better integration of Palestinian traditional medicine into the national health

  5. Ethnopharmacological survey of herbal remedies used for treatment of various types of cancer and their methods of preparations in the West Bank-Palestine.

    Science.gov (United States)

    Jaradat, Nidal Amin; Al-Ramahi, Rowa; Zaid, Abdel Naser; Ayesh, Ola Ibrahim; Eid, Ahmad Mustafa

    2016-03-08

    Plants have been the primary source of medicines since life on earth; more than 50 % of existing cancer treatments are derived from plants. An ethnopharmacological survey of herbal remedies used in cancer treatment was carried out in the West Bank/ Palestine. A questionnaire was distributed to one hundred and fifty herbalists, traditional healers and rural dwellers. Collected information included the names of plants, the used parts, types of cancers for which these plants were used and also their methods of preparation. To identify the most important species used, Factor of informant's consensus (F(ic)), Fidelity level (Fl) and the Use-value (UV) were calculated. Collected data has shown that 72 plants are utilized for treatment of cancer, belonging to 44 families; from them Compositae and Lamiaceae were the most common. Leaves and fruits were the most commonly used parts, while decoctions, infusions and syrups were the main methods of preparation. Lung cancer was the most common type of cancer treated with these plants and Ephedra alata was the most commonly used plant for treatment of cancer in Palestine. The Fic was high for all the plants; Fl was 100% for many plants, the highest UV (0.72) was for Ephedra alata. This study showed that many herbal remedies are still used by herbalists in Palestine for treatment of cancer; some of them have been approved scientifically while others are not. A combined effort between informants and scientific institutions working in this field can help in the discovery of new anticancer agents. Moreover, scientists must explore the most suitable method of extraction, formulation and dose determination in order to achieve the best benefits from these herbals.

  6. Treatment of subacute posterior knee pain in an adolescent ballet dancer utilizing trigger point dry needling: a case report.

    Science.gov (United States)

    Mason, John S; Tansey, Kimberly A; Westrick, Richard B

    2014-02-01

    Case Report. Dry needling (DN) is an increasingly popular intervention used by clinicians as a treatment of regional neuromusculoskeletal pain. DN is an invasive procedure that involves insertion of a thin monofilament needle directly into a muscle trigger point (MTP) with the intent of stimulating a local twitch response. Current evidence is somewhat limited, but recent literature supports the use of this intervention in specific neuromusculoskeletal conditions. The purpose of this case report is to present the outcomes of DN as a primary treatment intervention in an adolescent subject with subacute posterior knee pain. The subject was a 16-year-old female competitive ballet dancer referred to physical therapy with a two month history of right posterior knee pain. Palpation identified MTPs which reproduced the patient's primary symptoms. In addition to an exercise program promoting lower extremity flexibility and hip stability, the subject was treated with DN to the right gastrocnemius, soleus, and popliteus muscles. The subject reported being pain free on the Numerical Pain Scale and a +7 improvement in perceived change in recovery on the Global Rating of Change at final follow-up. Physical examination demonstrated no observed impairments or functional limitations, including normal mobility, full strength, and unrestricted execution of dance maneuvers. The patient was able to return to high level dance training and competition without physical limitations and resumed pre-injury dynamic movement activities including dancing, running, jumping, and pivoting without pain. DN can be an effective and efficient intervention to assist patients in decreasing pain and returning to high intensity physical activity. Additional research is needed to determine if DN is effective for other body regions and has long-term positive outcomes. Level 4.

  7. TREATMENT OF SUBACUTE POSTERIOR KNEE PAIN IN AN ADOLESCENT BALLET DANCER UTILIZING TRIGGER POINT DRY NEEDLING: A CASE REPORT

    Science.gov (United States)

    Tansey, Kimberly A.; Westrick, Richard B.

    2014-01-01

    Study Design: Case Report. Background and Purpose: Dry needling (DN) is an increasingly popular intervention used by clinicians as a treatment of regional neuromusculoskeletal pain. DN is an invasive procedure that involves insertion of a thin monofilament needle directly into a muscle trigger point (MTP) with the intent of stimulating a local twitch response. Current evidence is somewhat limited, but recent literature supports the use of this intervention in specific neuromusculoskeletal conditions. The purpose of this case report is to present the outcomes of DN as a primary treatment intervention in an adolescent subject with subacute posterior knee pain. Case Description: The subject was a 16‐year‐old female competitive ballet dancer referred to physical therapy with a two month history of right posterior knee pain. Palpation identified MTPs which reproduced the patient’s primary symptoms. In addition to an exercise program promoting lower extremity flexibility and hip stability, the subject was treated with DN to the right gastrocnemius, soleus, and popliteus muscles. Outcomes: The subject reported being pain free on the Numerical Pain Scale and a +7 improvement in perceived change in recovery on the Global Rating of Change at final follow‐up. Physical examination demonstrated no observed impairments or functional limitations, including normal mobility, full strength, and unrestricted execution of dance maneuvers. Discussion: The patient was able to return to high level dance training and competition without physical limitations and resumed pre‐injury dynamic movement activities including dancing, running, jumping, and pivoting without pain. DN can be an effective and efficient intervention to assist patients in decreasing pain and returning to high intensity physical activity. Additional research is needed to determine if DN is effective for other body regions and has long‐term positive outcomes. Level of Evidence: Level 4 PMID:24567862

  8. Chemical treatment response to variations in non-point pollution water quality: results of a factorial design experiment.

    Science.gov (United States)

    Heiderscheidt, Elisangela; Leiviskä, Tiina; Kløve, Bjørn

    2015-03-01

    Chemical treatment of non-point derived pollution often suffers from undesirable oscillations in purification efficiency due to variations in runoff water quality. This study examined the response of the chemical purification process to variations in water quality using a 2(k) factorial design for runoff water rich in humic substances. The four k factors evaluated and the levels applied were: organic matter as dissolved organic carbon (DOC) (20-70 mg/L), suspended solids (SS) (10-60 mg/L), initial water pH (4.5-7), and applied coagulant dosage (ferric sulphate) (35-100 mg/L). Indicators of purification efficiency were residual concentration of DOC, SS and total phosphorus (tot-P). Analysis of variance and factor effect calculations showed that the initial DOC concentration in raw water samples and its interactions with the coagulant dosage applied exerted the most significant influence on the chemical purification process, substantially affecting the residual concentration of DOC, SS and tot-P. The variations applied to the factors SS and pH only slightly affected purification efficiency. The results can be used in the design of purification systems with high organic matter load variation, e.g. peat extraction runoff. Copyright © 2014 Elsevier Ltd. All rights reserved.

  9. Occurrence and fate of selected PPCPs in a conventional sewage treatment plant located in north west UK

    Energy Technology Data Exchange (ETDEWEB)

    Reif, R.; Santos, A.; Judd, S. J.; Lema, J. M.; Omil, F.

    2009-07-01

    Over the last decade, the occurrence of pharmaceutical and personal care products (PPCPs) in wastewater effluents has become an increasing concern. Most of these compounds are released into the environment through sewage treatment plant effluents, due to the fact that these plants are not able to remove many of them in a significant extension. Presently, studies regarding hazardous effects in the aquatic environment are emerging worldwide, but still there is little information available regarding their potential eco toxicological effects. (Author)

  10. Treatment outcomes among HIV-1 and HIV-2 infected children initiating antiretroviral therapy in a concentrated low prevalence setting in West Africa

    Directory of Open Access Journals (Sweden)

    Okomo Uduak

    2012-07-01

    Full Text Available Abstract Background There is little data on responses to combination antiretroviral therapy (cART among HIV-infected children in the West African region. We describe treatment outcomes among HIV-1 and HIV-2 infected children initiating cART in a research clinic in The Gambia, West Africa. Methods All treatment naive HIV-infected children who initiated cART according to the WHO ART guidelines for children between October 2004 and December 2009 were included in the analysis. Kaplan-Meir estimates and sign-rank test were used to investigate the responses to treatment. Results 65 HIV-1 and five HIV-2 infected children aged 10 copies/ml (4.4 – 6.0 respectively. The median age at treatment initiation of the five HIV-2 infected children was 12 years (range: 4.6 – 14.0 while their median baseline CD4+ T cell count and HIV-2 viral load were 140 cells/mm3 (Range: 40 – 570 cells/mm3 and 4.5 log10copies/mL (Range: 3.1 - 4.9 log10copies/mL respectively. Among HIV-1 infected children P = 0.0004, 21% (15 – 22; P = 0.005 and 15% (15 – 25; P = 0.0422 respectively, while the median (IQR increase in absolute CD4 T cell count from baseline to 12, 24 and 36 months for those ≥5 years at ART initiation were 470 cells/mm3 (270 – 650; P = 0.0005, 230 cells/mm3 (30 – 610; P = 0.0196 and 615 cells/mm3 (250 – 1060; P = 0.0180 respectively. The proportions of children achieving undetectable HIV-1 viral load at 6-, 12-, 24- and 36 months of treatment were 24/38 (63.2%, 20/36 (55.6%, 8/22 (36.4% and 7/12 (58.3% respectively. The probability of survival among HIV-1 infected children after 12 months on ART was 89.9% (95% CI 78.8 – 95.3. CD4 T cell recovery was sub-optimal in all the HIV-2 infected children and none achieved virologic suppression. Two of the HIV-2 infected children died within 6 months of starting treatment while the remaining three were lost to follow-up. Conclusions The beneficial effects of cART among

  11. Failure of pyrantel in treatment of human hookworm infections (Ancylostoma duodenale) in the Kimberley region of north west Australia.

    Science.gov (United States)

    Reynoldson, J A; Behnke, J M; Pallant, L J; Macnish, M G; Gilbert, F; Giles, S; Spargo, R J; Thompson, R C

    1997-12-01

    A survey of 108 individuals from a coastal Aboriginal community in north Western Australia revealed that two species of gastrointestinal protozoan parasites (Giardia duodenalis--39.8%, Entamoeba coli--40.7%) and five gastrointestinal helminths (Hymenolepis nana--54.6%, Hookworm [Ancylostoma duodenale]--30.6%, Enterobius vermicularis--6.5%, Trichuris trichiura--2.8%, Strongyloides stercoralis 1.9%) were present. A total of 29 individuals infected with hookworm were offered treatment with either pyrantel pamoate at a single dose rate of 10 mg/kg body weight or albendazole (single 400 mg dose). Seven days after treatment stool samples were examined. Pyrantel had no significant effect against hookworm. In contrast, albendazole cleared hookworm infections completely and reduced the prevalence of Giardia. The former result suggests that locally A. duodenale is resistant to pyrantel and despite its relatively low cost and wide availability, should not be considered a drug of choice at this dose rate in the treatment of hookworm infections (A. duodenale) in endemic regions.

  12. West African Journal of Medicine

    African Journals Online (AJOL)

    _ WEST AFRICAN JOURNAL OF MEDICINE. CLINI CAL PRA CTI CE. Pain Management inAdult Acute Sickle Cell Pain Crisis: A Viewpoint. Chagriner la direction dans la crise de douleur de cellule de faucille adulte: un point de Vue . E. Udezue*, E. HerreraT. ABSTRACT. BACKGROUND: The acute pain crisis of sickle cell ...

  13. [Clinical Trials for Treatment of Acute Lumbar Sprain by Acupuncture Stimulation of "Yaotong" and Local Ashi-points in Combination with Patients' Lumbar Movement].

    Science.gov (United States)

    Liu, Li-Li; Lu, Jing; Ma, Hui-Fang

    2017-02-25

    To observe the clinical effect of acupuncture stimulation of "Yaotong"-point (one acupoint of balance acupuncture therapy) and Ashi-points combined with patients' lumbar movement in the treatment of acute lumbar sprain. Forty-six acute lumbar sprain patients were randomized into treatment group (26 cases) and control group (20 cases) using a random number table. The patients of the treatment group were treated by acupuncture stimulation of "Yaotong"-point[above Yintang (EX-HN 3)] and local Ashi-points for 20 min, and were asked to move the waist simultaneously during acupuncture stimulation. The treatment was conducted once every other day, 3 times a week, one week in total. Those of the control group were treated by oral administration of loxoprofen sodium tablets (60 mg, twice a day, for one week). The pain severity of lumbago and motor function were assessed by using visual analogue scale(VAS) and present pain intensity(PPI)and lumbar range of motion(ROM) separately. Following the treatment, of the 20 and 26 acute lumbar sprain patients in the control and treatment groups, 6(30.0%)and 14(53.8%)were cured, 9 (45.0%) and 11 (42.4%) experienced an improvement in their symptoms, 5 (25.0%) and 1 (3.8%) was invalid, with the effective rates being 75.0% and 96.2%, respectively. Compared with pre-treatment, the ROM and VAS scores were significantly decreased in both the control and treatment groups post-treatment (Plumbar motion function and in pain relief (Plumbar movement is effective in reducing lumbar pain and improving lumbar motor function in the treatment of acute lumbar sprain.

  14. Combined treatment of adenosine nucleoside inhibitor NITD008 and histone deacetylase inhibitor vorinostat represents an immunotherapy strategy to ameliorate West Nile virus infection.

    Science.gov (United States)

    Nelson, Jacob; Roe, Kelsey; Orillo, Beverly; Shi, Pei-Yong; Verma, Saguna

    2015-10-01

    West Nile virus (WNV), a member of the Flaviviridae family, is the leading cause of viral encephalitis in the United States. Despite efforts to control the spread of WNV, there has been an increase in the number of outbreaks and clinical cases with neurological problems. There are no antiviral compounds currently in trials for WNV. NITD008 is an adenosine analogue inhibitor that interrupts the RNA-dependent RNA polymerase of flaviviruses. Previous studies demonstrated NITD008 as a potent antiviral for dengue virus, however this drug was associated with preclinical toxicity. The ability of NITD008 to block WNV replication is only shown in Vero cells. Neuroinflammation is also a major cause of the WNV-associated pathology, therefore we evaluated the effect of NITD008 and a newly characterized anti-inflammatory drug vorinostat (SAHA), a histone deacetylase inhibitor, on WNV replication and disease progression in a mouse model. When administered at 10 and 25mg/kg at days 1-6 after WNV infection in C57BL/6 mice, NITD008 conferred complete protection from clinical symptoms and death, which correlated with reduced viral load in the serum and restriction of virus-CNS entry. Delay of NITD008 treatment to days 3-6 and days 5-9 after infection, when WNV replication was high in the periphery and brain, resulted in the gradual loss of protection against WNV infection. However, co-treatment with SAHA and NITD008 during the CNS phase of disease improved disease outcome significantly by reducing inflammation and neuronal death. Our results support potential synergistic effect of combination therapy of NITD008 with SAHA for the treatment of WNV encephalitis. Copyright © 2015 Elsevier B.V. All rights reserved.

  15. Methodology of adjustment point in the post treatment of gaseous effluents; Metodologia del punto de ajuste en el post tratamiento de efluentes gaseosos

    Energy Technology Data Exchange (ETDEWEB)

    Vizuet G, J.; Molina, G. [ININ, 52045 Ocoyoacac, Estado de Mexico (Mexico)]. e-mail: jvg@nuclear.inin.mx

    2005-07-01

    The methodology to determine the adjustment points of the monitoring system of gaseous discharges is based on the stipulations of the 10CFR20, which are expressed in terms of limit concentrations for the outstanding radionuclides, and of dose limits for the individuals members of the public. Besides the points of liberation properly said, like they are the chimneys of the reactor buildings and of turbine, the points of adjustment of the monitoring instrumentation that watches in real time the discharge of the Treatment system of output gases, to the HVAC of the waste building; they also undergo to the same methodology, with the approaches previously described. (Author)

  16. Treatment of myofascial trigger points in common shoulder disorders by physical therapy: a randomized controlled trial [ISRCTN75722066].

    Science.gov (United States)

    Bron, Carel; Wensing, Michel; Franssen, Jo Lm; Oostendorp, Rob Ab

    2007-11-05

    Shoulder disorders are a common health problem in western societies. Several treatment protocols have been developed for the clinical management of persons with shoulder pain. However available evidence does not support any protocol as being superior over others. Systematic reviews provide some evidence that certain physical therapy interventions (i.e. supervised exercises and mobilisation) are effective in particular shoulder disorders (i.e. rotator cuff disorders, mixed shoulder disorders and adhesive capsulitis), but there is an ongoing need for high quality trials of physical therapy interventions. Usually, physical therapy consists of active exercises intended to strengthen the shoulder muscles as stabilizers of the glenohumeral joint or perform mobilisations to improve restricted mobility of the glenohumeral or adjacent joints (shoulder girdle). It is generally accepted that a-traumatic shoulder problems are the result of impingement of the subacromial structures, such as the bursa or rotator cuff tendons. Myofascial trigger points (MTrPs) in shoulder muscles may also lead to a complex of symptoms that are often seen in patients diagnosed with subacromial impingement or rotator cuff tendinopathy. Little is known about the treatment of MTrPs in patients with shoulder disorders.The primary aim of this study is to investigate whether physical therapy modalities to inactivate MTrPs can reduce symptoms and improve shoulder function in daily activities in a population of chronic a-traumatic shoulder patients when compared to a wait-and-see strategy. In addition we investigate the recurrence rate during a one-year-follow-up period. This paper presents the design for a randomized controlled trial to be conducted between September 2007 - September 2008, evaluating the effectiveness of a physical therapy treatment for non-traumatic shoulder complaints. One hundred subjects are included in this study. All subjects have unilateral shoulder pain for at least six months

  17. Treatment of myofascial trigger points in common shoulder disorders by physical therapy: A randomized controlled trial [ISRCTN75722066

    Directory of Open Access Journals (Sweden)

    Franssen Jo LM

    2007-11-01

    Full Text Available Abstract Background Shoulder disorders are a common health problem in western societies. Several treatment protocols have been developed for the clinical management of persons with shoulder pain. However available evidence does not support any protocol as being superior over others. Systematic reviews provide some evidence that certain physical therapy interventions (i.e. supervised exercises and mobilisation are effective in particular shoulder disorders (i.e. rotator cuff disorders, mixed shoulder disorders and adhesive capsulitis, but there is an ongoing need for high quality trials of physical therapy interventions. Usually, physical therapy consists of active exercises intended to strengthen the shoulder muscles as stabilizers of the glenohumeral joint or perform mobilisations to improve restricted mobility of the glenohumeral or adjacent joints (shoulder girdle. It is generally accepted that a-traumatic shoulder problems are the result of impingement of the subacromial structures, such as the bursa or rotator cuff tendons. Myofascial trigger points (MTrPs in shoulder muscles may also lead to a complex of symptoms that are often seen in patients diagnosed with subacromial impingement or rotator cuff tendinopathy. Little is known about the treatment of MTrPs in patients with shoulder disorders. The primary aim of this study is to investigate whether physical therapy modalities to inactivate MTrPs can reduce symptoms and improve shoulder function in daily activities in a population of chronic a-traumatic shoulder patients when compared to a wait-and-see strategy. In addition we investigate the recurrence rate during a one-year-follow-up period. Methods/Design This paper presents the design for a randomized controlled trial to be conducted between September 2007 – September 2008, evaluating the effectiveness of a physical therapy treatment for non-traumatic shoulder complaints. One hundred subjects are included in this study. All subjects

  18. A comparative evaluation of dental caries status among hearing-impaired and normal children of Malda, West Bengal, evaluated with the Caries Assessment Spectrum and Treatment.

    Science.gov (United States)

    Kar, Sudipta; Kundu, Goutam; Maiti, Shyamal Kumar; Ghosh, Chiranjit; Bazmi, Badruddin Ahamed; Mukhopadhyay, Santanu

    2016-01-01

    Dental caries is one of the major modern-day diseases of dental hard tissue. It may affect both normal and hearing-impaired children. This study is aimed to evaluate and compare the prevalence of dental caries in hearing-impaired and normal children of Malda, West Bengal, utilizing the Caries Assessment Spectrum and Treatment (CAST). In a cross-sectional, case-control study of dental caries status of 6-12-year-old children was assessed. Statistically significant difference was found in studied (hearing-impaired) and control group (normal children). In the present study, caries affected hearing-impaired children found to be about 30.51% compared to 15.81% in normal children, and the result was statistically significant. Regarding individual caries assessment criteria, nearly all subgroups reflect statistically significant difference except sealed tooth structure group, internal caries-related discoloration in dentin, and distinct cavitation into dentine group, and the result is significant at P caries effected hearing-impaired children found about 30.51% instead of 15.81% in normal children, and the result was statistically significant (P caries assessment criteria, nearly all subgroups reflect statistically significant difference except sealed tooth structure group, internal caries-related discoloration in dentin, and distinct cavitation into dentine group. Dental health of hearing-impaired children was found unsatisfactory than normal children when studied in relation to dental caries status evaluated with CAST.

  19. Risk factors for cervical intraepithelial neoplasia in HIV-infected women on antiretroviral treatment in Côte d'Ivoire, West Africa.

    Science.gov (United States)

    Jaquet, Antoine; Horo, Apollinaire; Ekouevi, Didier K; Toure, Badian; Coffie, Patrick A; Effi, Benjamin; Lenaud, Severin; Messou, Eugene; Minga, Albert; Sasco, Annie J; Dabis, François

    2014-01-01

    Facing the dual burden of invasive cervical cancer and HIV in sub-Saharan Africa, the identification of preventable determinants of Cervical Intraepithelial Neoplasia (CIN) in HIV-infected women is of paramount importance. A cervical cancer screening based on visual inspection methods was proposed to HIV-infected women in care in Abidjan, Côte d'Ivoire. Positively screened women were referred for a colposcopy to a gynaecologist who performed directed biopsies. Of the 2,998 HIV-infected women enrolled, 132 (4.4%) CIN of any grade (CIN+) were identified. Women had been followed-up for a median duration of three years [IQR: 1-5] and 76% were on antiretroviral treatment (ART). Their median most recent CD4 count was 452 [IQR: 301-621] cells/mm3. In multivariate analysis, CIN+ was associated with a most recent CD4 count >350 cells/mm3 (OR: 0.3; 95% CI: 0.2-0.6) or ≥200-350 cells/mm3 (OR 0.6; 95% CI 0.4-1.0) (Ref: HIV-infected women with limited or no immune deficiency. Despite the potential impact of immunological recovery on the reduction of premalignant cervical lesions through the use of ART, cervical cancer prevention, including screening and vaccination remains a priority in West Africa while ART is rolled-out.

  20. Antiplasmodial activity and cytotoxicity of plants used in West African traditional medicine for the treatment of malaria.

    Science.gov (United States)

    Ménan, Hervé; Banzouzi, Jean-Théophile; Hocquette, Antoine; Pélissier, Yves; Blache, Yves; Koné, Moussa; Mallié, Michèle; Assi, Laurent Aké; Valentin, Alexis

    2006-04-21

    Eighteen plants originating from Ivory Coast were selected by ethnobotanical survey as plants commonly used by traditional healers for the treatment of malaria. Extracts of these plants were tested on two strains of Plasmodium falciparum: FcM29-Cameroon (chloroquine-resistant strain) and a Nigerian chloroquine-sensitive strain. The powdered plants were used to prepare three kinds of extracts: by decoction in water, in ethanol (95%) and in pentane. A radioactive micromethod allowed the evaluation of the antiplasmodial in vitro activity of the extracts on P. falciparum. Concentrations inhibiting 50% of the parasite growth (IC50) ranged from 18 microg/ml to more than 500 microg/ml for aqueous and ethanol extracts and from 4.3 microg/ml to more than 500 microg/ml for pentane extracts. Cytotoxicity was estimated on A375 melanoma cells and a cytotoxicity/antiplasmodial index (CAR) was calculated for each extract, ranging from 1 to 10. The pentane extracts of Cola caricaefolia and Uvaria afzelii, which revealed the strongest antiplasmodial activity had CAR values of about 10.

  1. EFFECTIVENESS OF PHYSIOTHERAPEUTIC, NON-INVASIVE TREATMENT METHODS FOR PAIN, ASSOCIATED WITH ACTIVE MYOFASCIAL TRIGGER POINTS – A SYSTEMATIC LITERATURE REVIEW

    OpenAIRE

    Spiridonas, Saulius

    2014-01-01

    The purpose of this thesis was to collect and systematically review evidential research about the effectiveness of non-invasive treatment methods towards managing pain. Articles from 2006 to 2014 were used to make sure the research is most up to date. Articles that offered treatment for only latent trigger points were omitted. The method used to write this thesis was a systematic literature review. The search was conducted in several databases such as Physiotherapy Evidence ...

  2. Quantifying the net benefit impacts of the Troy Waste Water Treatment Plant on Steelhead Habitat in the West Fork Little Bear Creek drainage

    Science.gov (United States)

    Sanchez-Murillo, R.; Brooks, E. S.; Boll, J.

    2010-12-01

    Discharge of waste water treatment plants (WWTPs) typically is viewed to result in water quality impairment. However, WWTPs can also be a source of nutrients to enhance the salmonid food web as well as an efficient way to maintain acceptable water temperature regimes and flow conditions during summer. We observed this paradox in West Fork Little Bear Creek (WFLB) in the City of Troy, Idaho. Despite the nutrient load, the WFLB had the highest Steelhead trout density in the watershed, with a mean density of 13.2 fish/100 m2. The objective of this project was to utilize a water quality model, QUAL2kw, and an ecology assessment to examine how the nutrient load from the WWTP affects: a) habitat conditions for steelhead juveniles, and b) physic-chemical parameters. Four monitoring stations were installed from May through November in 2009 and 2010. An undisturbed creek was used as a control site in 2010. Dissolved oxygen (DO), electrical conductivity, temperature, and discharge were measured continuously at each monitoring station. Weekly samples were collected at each monitoring station and analyzed for nitrate, nitrite, ammonia, total Kjeldahl nitrogen, total phosphorous, and orthophosphates. In 2010, Chlorophyll a was analyzed weekly, while bottom algae biomass was determined monthly. Results show that during summer months, the WWTP provides the majority of the flow (0.1 cfs) in the creek. Water samples and DO measurements taken 200 m downstream of the plant during late summer months indicate that nitrification process leads to low DO level well below the state standard of 6 mg/L for cold water biota. However dissolved oxygen levels recover within 1 km downstream. Discharge data suggest that without the flow from the treatment most of the creek would dry during late summer months. Abundance of macroinverbrates, high primary productivity, and sustained flow during summer suggests that the effluent from the WWTP is a net benefit to the Steelhead habitat in the basin

  3. Equal Improvement in Men and Women in the Treatment of Urologic Chronic Pelvic Pain Syndrome Using a Multi-modal Protocol with an Internal Myofascial Trigger Point Wand.

    Science.gov (United States)

    Anderson, Rodney U; Wise, David; Sawyer, Tim; Nathanson, Brian H; Nevin Smith, J

    2016-06-01

    Both men and women require treatment for urologic chronic pelvic pain syndromes (UCPPS), which includes interstitial cystitis/painful bladder syndrome, pelvic floor dysfunction, and chronic prostatitis/chronic pelvic pain syndrome. However, it is unknown if men and women respond differently to a protocol that includes specific physical therapy self-treatment using an internal trigger point wand and training in paradoxical relaxation. We performed a retrospective analysis by gender in a single arm, open label, single center clinical trial designed to evaluate the safety and effectiveness of a protocol for the treatment of UCPPS from October, 2008 to May, 2011. 314 adult men (79.9 %) and 79 (20.1 %) women met inclusion criteria. The median duration of symptoms was 60 months. The protocol required an initial 6-day clinic for training followed by a 6-month self-treatment period. The treatment included self-administered pelvic floor trigger point release with an internal trigger point device for physical therapy along with paradoxical relaxation training. Notable gender differences in prior treatments were observed. Men had a lower median [Interquartile Range] NIH-CPSI score at baseline than women (27 [21, 31] vs. 29 [22, 33], p = 0.04). Using a 1-10 scale with 10 = Most Severe, the median reduction in trigger point sensitivity was 3 units for both men and women after 6 months therapy (p = 0.74). A modified Intention to Treat analysis and a multivariate regression analysis found similar results. We conclude that men and women have similar, significant reductions in trigger point sensitivity with this protocol.

  4. Patients’ and health system’s delays in the diagnosis and treatment of new pulmonary tuberculosis patients in West Gojjam Zone, Northwest Ethiopia: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Senedu Bekele Gebreegziabher

    2016-11-01

    Full Text Available Abstract Background Tuberculosis (TB is a major public health concern in the developing world. Early diagnosis and prompt initiation of treatment is essential for effective TB control. The aim of this study was to determine the length and analyze associated factors of patients’ and health system’s delays in the diagnosis and treatment of new pulmonary TB (PTB patients. Methods A cross-sectional study was conducted in 30 randomly selected public health facilities in West Gojjam Zone, Amhara Region, Ethiopia. Newly diagnosed PTB patients who were ≥15 years of age were consecutively enrolled in the study. Patients’ delay (the time period from onset of TB symptoms to first presentation to a formal health provider and health system’s delay (the time period from first presentation to a formal health provider to first start of TB treatment were measured. Median patients’ and health system’s delays were calculated. Mixed effect logistic regression was used to analyze predictors of patients’ and health system’s delays. Results Seven hundred six patients were enrolled in the study. The median patients’ delay was 18 days (interquartile range [IQR]: 8–34 days and the median health system’s delay was 22 days (IQR: 4–88 days. Poor knowledge of TB (adjusted odds ratio [AOR], 2.33; 95 % confidence interval [CI], 1.34–4.05, first visit to non-formal health provider (AOR, 47.56; 95 % CI, 26.31–85.99, self-treatment (AOR, 10.11; 95 % CI, 4.53–22.56 and patients’ age (≥45 years (AOR, 2.99; 95 % CI, 1.14–7.81 were independent predictors of patients’ delay. Smear-negative TB (AOR, 1.88; 95 % CI, 1.32–2.68 and first visit to public health centers (AOR, 2.22; 95 % CI, 1.52–3.25 and health posts (AOR, 5.86; 95 % CI, 1.40–24.39 were found to be independent predictors of health system’s delay. Conclusions The health system’s delay in this study was long and contributed more than 50 % of the total delay

  5. Patients' and health system's delays in the diagnosis and treatment of new pulmonary tuberculosis patients in West Gojjam Zone, Northwest Ethiopia: a cross-sectional study.

    Science.gov (United States)

    Gebreegziabher, Senedu Bekele; Bjune, Gunnar Aksel; Yimer, Solomon Abebe

    2016-11-11

    Tuberculosis (TB) is a major public health concern in the developing world. Early diagnosis and prompt initiation of treatment is essential for effective TB control. The aim of this study was to determine the length and analyze associated factors of patients' and health system's delays in the diagnosis and treatment of new pulmonary TB (PTB) patients. A cross-sectional study was conducted in 30 randomly selected public health facilities in West Gojjam Zone, Amhara Region, Ethiopia. Newly diagnosed PTB patients who were ≥15 years of age were consecutively enrolled in the study. Patients' delay (the time period from onset of TB symptoms to first presentation to a formal health provider) and health system's delay (the time period from first presentation to a formal health provider to first start of TB treatment) were measured. Median patients' and health system's delays were calculated. Mixed effect logistic regression was used to analyze predictors of patients' and health system's delays. Seven hundred six patients were enrolled in the study. The median patients' delay was 18 days (interquartile range [IQR]: 8-34 days) and the median health system's delay was 22 days (IQR: 4-88 days). Poor knowledge of TB (adjusted odds ratio [AOR], 2.33; 95 % confidence interval [CI], 1.34-4.05), first visit to non-formal health provider (AOR, 47.56; 95 % CI, 26.31-85.99), self-treatment (AOR, 10.11; 95 % CI, 4.53-22.56) and patients' age (≥45 years) (AOR, 2.99; 95 % CI, 1.14-7.81) were independent predictors of patients' delay. Smear-negative TB (AOR, 1.88; 95 % CI, 1.32-2.68) and first visit to public health centers (AOR, 2.22; 95 % CI, 1.52-3.25) and health posts (AOR, 5.86; 95 % CI, 1.40-24.39) were found to be independent predictors of health system's delay. The health system's delay in this study was long and contributed more than 50 % of the total delay. Better TB diagnostic tools to complement sputum smear microscopy are needed to early diagnose PTB cases

  6. What Sexual Behaviors Relate to Decreased Sexual Desire in Women? A Review and Proposal for End Points in Treatment Trials for Hypoactive Sexual Desire Disorder

    Directory of Open Access Journals (Sweden)

    Robert Pyke, MD, PhD

    2017-06-01

    Pyke R and Clayton A. What Sexual Behaviors Relate to Decreased Sexual Desire in Women? A Review and Proposal for End Points in Treatment Trials for Hypoactive Sexual Desire Disorder. Sex Med 2017;5:e73–e83.

  7. 腹部选穴治疗月经愆期疗效观察%Clinical Experience of Abdominal Needle Treatment Qianqi Menstruation of Four Point

    Institute of Scientific and Technical Information of China (English)

    叶青林; 唐巍

    2012-01-01

    目的:探讨腹部选穴治疗月经愆期的临床疗效.方法:腹部选穴取天枢(双)、中脘、气海、关元、血海(右),通过典型病例的分析,观察腹部选穴治疗月经愆期临床效果.结果:3例均用腹部选穴治愈.结论:腹部选穴治疗月经愆期的疗效显著.%Objective:To study the clinical curative effect of abdomen needle treatment QianQi menstruation of four point. Methods; Through the analysis of the typical cases, observe the abdomen needle hole menstrual QianQi effect four treatment. Results and conclusion; Abdominal needle treatment Qianqi menstruation of four point curative effect is distinct.

  8. The use of trigger point "dry" needling under ultrasound guidance for the treatment of myofascial pain (technological innovation and literature review).

    Science.gov (United States)

    Bubnov, Rostyslav V

    2010-01-01

    The aim of the study was to examine the use of trigger point dry needling under ultrasound guidance and myofascial release for the treatment of myofascial pain and to increase the provability of the puncture treatment by visual verification. A review of modern and traditional approaches to myofascial pain treatment is presented in the article. For the first time the trigger point was visualized by ultrasound (US) in this study and ultrasound guided needling therapy of muscles was performed as well. The group of 91 patients, suffered from myofascial pain of different location was included in the study. The patients were treated during last year by patented method (UA patent A 2010 06283). The pain relief effect was registered in 93.3% patients.

  9. Evaluation of fluralaner and afoxolaner treatments to control flea populations, reduce pruritus and minimize dermatologic lesions in naturally infested dogs in private residences in west central Florida USA.

    Science.gov (United States)

    Dryden, Michael W; Canfield, Michael S; Kalosy, Kimberly; Smith, Amber; Crevoiserat, Lisa; McGrady, Jennifer C; Foley, Kaitlin M; Green, Kathryn; Tebaldi, Chantelle; Smith, Vicki; Bennett, Tashina; Heaney, Kathleen; Math, Lisa; Royal, Christine; Sun, Fangshi

    2016-06-28

    A study was conducted to evaluate and compare the effectiveness of two different oral flea and tick products to control flea infestations, reduce pruritus and minimize dermatologic lesions over a 12 week period on naturally infested dogs in west central FL USA. Thirty-four dogs with natural flea infestations living in 17 homes were treated once with a fluralaner chew on study day 0. Another 27 dogs living in 17 different homes were treated orally with an afoxolaner chewable on day 0, once between days 28-30 and once again between days 54-60. All products were administered according to label directions by study investigators. Flea populations on pets were assessed using visual area counts and premise flea infestations were assessed using intermittent-light flea traps on days 0, 7, 14, 21, and once between days 28-30, 40-45, 54-60 and 82-86. Dermatologic assessments were conducted on day 0 and once monthly. Pruritus assessments were conducted by owners throughout the study. No concurrent treatments for existing skin disease (antibiotics, anti-inflammatories, anti-fungals) were allowed. Following the first administration of fluralaner or afoxolaner, flea populations on pets were reduced by 99.0 % and 99.3 %, respectively within 7 days. Flea populations on the fluralaner treated dogs were 0 (100 % efficacy) on days 54-60 and 82-86 after the administration of a single dose on day 0. Administration of 3 monthly doses of afoxolaner reduced flea populations by 100 % on days 82-86. Flea numbers in indoor-premises were markedly reduced in both treatment groups by days 82-86, with 100 % and 98.9 % reductions in flea trap counts in the fluralaner and afoxolaner treatment groups, respectively. Marked improvement was observed in FAD lesion scoring, Atopic Dermatitis lesions scoring (CADESI-4) and pruritus scores with both formulations. In a clinical field investigation conducted during the summer of 2015 in subtropical Florida, a single administration of an oral

  10. Evaluation of sarolaner and spinosad oral treatments to eliminate fleas, reduce dermatologic lesions and minimize pruritus in naturally infested dogs in west Central Florida, USA.

    Science.gov (United States)

    Dryden, Michael W; Canfield, Michael S; Niedfeldt, Emily; Kinnon, Amanda; Kalosy, Kimberly; Smith, Amber; Foley, Kaitlin M; Smith, Vicki; Bress, Todd S; Smith, Nicole; Endrizzi, Mike; Login, Joyce

    2017-08-17

    An in-home investigation of naturally flea infested dogs was conducted in West Central Florida, USA to evaluate and compare the effectiveness of two different oral flea adulticides to control flea infestations, minimize dermatologic lesions and reduce pruritus over an 8-week period. Twenty-nine dogs living in 19 homes and another 26 dogs residing in 16 different homes were orally administered either a sarolaner or spinosad chewable, respectively on day 0 and once between days 28-30. Products were administered by study personnel according to label directions. Flea populations on dogs were estimated using visual area counts and flea infestations in the indoor premises were assessed using intermittent-light flea traps on days 0, 7, 14, 21 and once between days 28-30, 40-45, and 56-60. Assessments of dermatologic lesions were conducted monthly during the study and severity of pruritus was evaluated throughout the study on the same schedule as flea counts were conducted. Concurrent treatments for existing skin disease were not allowed. The administration of sarolaner or spinosad reduced flea populations on dogs by 99.0% and 97.3%, respectively within 7 days. Flea infestations on the sarolaner- and spinosad-treated dogs were reduced by > 99% at every counting period from day 14 post-treatment through the end of the 8-week study. At the end of the study 96.4 and 92.0% of the dogs treated with sarolaner and spinosad, respectively were flea-free. Flea populations in the indoor premises were also markedly reduced the end of the study, with 100 and 99.8% reductions in flea trap counts in the sarolaner and spinosad treatment groups, respectively. FAD lesion scores, atopic dermatitis lesions scores (CADESI-4) and pruritus severity scores were also markedly improved with both formulations. An in-home clinical field study conducted during the summer of 2016 in subtropical Florida demonstrated that two-monthly administrations of either sarolaner or spinosad chewables almost

  11. West Nile Virus: Prevention and Control

    Science.gov (United States)

    ... R S T U V W X Y Z # West Nile virus Note: Javascript is disabled or is not supported ... message, please visit this page: About CDC.gov . West Nile Virus Home Prevention Prevención y control Symptoms, Diagnosis, & Treatment ...

  12. Treatment of primary Sjogren's syndrome with anti-CD20 therapy (rituximab). A feasible approach or just a starting point?

    NARCIS (Netherlands)

    Meiners, Petra M.; Vissink, Arjan; Kallenberg, Cees G. M.; Kroese, Frans G. M.; Bootsma, Hendrika

    2011-01-01

    Introduction: In vitro and in vivo experimental data have suggested new immunopathogenic mechanisms in primary Sjogren's syndrome (pSS). The availability of targeted treatment modalities has opened new ways to selectively target these mechanistic pathways in vivo. Amongst these new treatment

  13. A comparative evaluation of dental caries status among hearing-impaired and normal children of Malda, West Bengal, evaluated with the Caries Assessment Spectrum and Treatment

    Directory of Open Access Journals (Sweden)

    Sudipta Kar

    2016-01-01

    Full Text Available Context: Dental caries is one of the major modern-day diseases of dental hard tissue. It may affect both normal and hearing-impaired children. Aims: This study is aimed to evaluate and compare the prevalence of dental caries in hearing-impaired and normal children of Malda, West Bengal, utilizing the Caries Assessment Spectrum and Treatment (CAST. Settings and Design: In a cross-sectional, case-control study of dental caries status of 6-12-year-old children was assessed. Subjects and Methods: Statistically significant difference was found in studied (hearing-impaired and control group (normal children. In the present study, caries affected hearing-impaired children found to be about 30.51% compared to 15.81% in normal children, and the result was statistically significant. Regarding individual caries assessment criteria, nearly all subgroups reflect statistically significant difference except sealed tooth structure group, internal caries-related discoloration in dentin, and distinct cavitation into dentine group, and the result is significant at P < 0.05. Statistical Analysis Used: Statistical analysis was carried out utilizing Z-test. Results: Statistically significant difference was found in studied (hearing-impaired and control group (normal children. In the present study, caries effected hearing-impaired children found about 30.51% instead of 15.81% in normal children, and the result was statistically significant (P < 0.05. Regarding individual caries assessment criteria, nearly all subgroups reflect statistically significant difference except sealed tooth structure group, internal caries-related discoloration in dentin, and distinct cavitation into dentine group. Conclusions: Dental health of hearing-impaired children was found unsatisfactory than normal children when studied in relation to dental caries status evaluated with CAST.

  14. Tipping Point

    Medline Plus

    Full Text Available ... OnSafety CPSC Stands for Safety The Tipping Point Home > 60 Seconds of Safety (Videos) > The Tipping Point The Tipping Point by CPSC Blogger September 22, 2009 appliance child Childproofing CPSC danger death electrical fall furniture ...

  15. [Scraping technique of stuck needle at Anmian point in the treatment of insomnia: a randomized controlled trial].

    Science.gov (United States)

    Zhang, Quan-Ai; Sun, Xiao-Hui; Lin, Jia-Ju; Li, Xing-Ling

    2013-06-01

    To compare the efficacy difference in the treatment of insomnia between scraping technique of stuck needle and conventional acupuncture at Anmian (Extra). One hundred and thirty one cases were randomized into an Anmian group (68 cases) and a conventional acupuncture group (63 cases). In the Anmian group, Anmian (Extra) was selected. After arrival of qi, the stuck needling was adopted by rotating the needle gently in single direction, 2-3 rounds till the needle body was stuck tightly. Afterwards, the needle tail was touched gently with the index finger to fix the needle body and the needle handle was scraped gently with the thumbnail from bottom to up. The needle was retained for 30 min. In the conventional acupuncture group, Sanyinjiao (SP 6), Shenmen (HT 7) and Baihui (GV 20) were selected and stimulated with reducing technique by rotating the needles. The needles were retained for 30 min. The treatment was given once every day, continuously for 2 weeks in both groups. The score of each factor and the total score in Pittsburgh sleep quality index (PSQI) were assessed before and after treatment in the two groups. Additionally, the efficacies of two groups were evaluated. For the patients in the conventional acupuncture group, the sleep quality and time of falling into spleen after treatment were improved as compared with those before treatment (all P efficiency, sleep disturbance, hypnotic drug and daytime dysfunction, and PSQI total score did not present statistically significant difference as compared with those before treatment (all P > 0.05). After treatment, for the patients in the Anmian group, the factor score and total score in PSQI were apparently improved as compared with those before treatment (P acupuncture group (P acupuncture group. The clinical efficacy in the Anmian group was apparently superior to the conventional acupuncture group. The scraping technique of stuck needle at Anmian (Extra) achieves the superior effect on insomnia as compared with

  16. Bench-scale treatability testing of biological, UV oxidation, distillation, and ion-exchange treatment of trench water from a low-level radioactive waste disposal area at West Valley, New York

    Energy Technology Data Exchange (ETDEWEB)

    Sundquist, J.A.; Gillings, J.C. [Ecology and Environment, Inc. (United States); Sonntag, T.L. [New York State Energy Research and Development Authority (United States); Denault, R.P. [Pacific Nuclear, Inc. (United States)

    1993-03-01

    Ecology and Environment, Inc. (E and E), under subcontract to Pacific Nuclear Services (PNS), conducted for the New York State Energy Research and Development Authority (NYSERDA) treatability tests to support the selection and design of a treatment system for leachate from Trench 14 of the West Valley State-Licensed, Low-Level Radioactive Waste Disposal Area (SDA). In this paper E and E presents and discusses the treatability test results and provides recommendations for the design of the full-scale treatment system.

  17. [Clinical observation on plum-blossom needle on Governor Vessel and point Jiaji (EX-B 2) for treatment of cerebral palsy of involuntary movement].

    Science.gov (United States)

    Han, Xue; Shang, Qing; Ma, Bing-Xiang

    2010-05-01

    To probe into an effective therapy for treatment of cerebral palsy of involuntary movement. Sixty cases were randomly divided into two groups, the control group was treated with routine rehabilitation method (Bobath + Tuina + scalp acupuncture), while the observation group was treated with plum-blossom needle on Governor Vessel and point Jiaji (EX-B 2) on the basis of routine rehabilitation method. After 3 months of treatment, therapeutic effect, total percentage of Gross Motor Function Measurement (GMFM), incurvation reflex and muscular tension fluctuation were compared. The obvious effective rate of 53.3% (16/30) in the observation group was superior to that of 20.0% (6/30) in the control group (P treatment (P treatment of cerebral palsy of involuntary movement can enhance the gross motor function, make the incurvation reflex disappear effectively, relieve the muscular tension fluctuation.

  18. An Update on the Treatment of the Cutaneous Manifestations of Systemic Sclerosis: The Dermatologist's Point of View.

    Science.gov (United States)

    Vitiello, Magalys; Abuchar, Adriana; Santana, Néstor; Dehesa, Luis; Kerdel, Francisco A

    2012-07-01

    Systemic sclerosis is a connective tissue disorder that affects multiple organs. Although the initial symptoms of the disease are vascular, skin involvement is almost universally present in patients with systemic sclerosis. The presence of Raynaud's phenomenon, progressive thickening of the skin, digital ulcers, and calcinosis all correlate proportionally with disease severity. Since no treatment is available to completely prevent the natural course of the disease, emphasis is often placed on managing symptoms and complications. In this review, the authors focus on the management of each one of the skin manifestations seen in systemic sclerosis, as the dermatologist may facilitate the early recognition and treatment of these complications.

  19. Profilometry and subsurface imaging in point of care diagnosis in ocular disease and lymphedema after breast cancer treatment

    Science.gov (United States)

    Sayegh, Samir I.; Taghian, Alphonse

    2013-02-01

    Breast cancer-related lymphedema (BCRL) can be irreversible with profound negative impact on patients' quality of life. Programs that provide screening and active surveillance for BCRL are essential to determine whether early detection and intervention influences the course of lymphedema development. Established methods of quantitatively assessing lymphedema at early stages include "volume" methods such as perometry and bioimpedance spectroscopy. Here we demonstrate 1) Use of topographical techniques analogous to those used in corneal topography 2) Development of point-of-care lymphedema detection and characterization based on off-the-shelf hardward 3) The role of subsurface imaging 4) Multimodal diagnostics and integration yielding higher sensitivity/ specificity.

  20. Platelet-rich plasma versus dry needling of myofascial meridian trigger points in the treatment of plantar fasciitis

    Directory of Open Access Journals (Sweden)

    Reem El Mallah

    2017-01-01

    Conclusion PRP injection is a promising line of treatment for chronic PF with documented ultrasonographic healing effect. Dry needling is a simple and safe technique for treating pain associated with PF, yet it is more invasive and less effective compared with PRP injection.

  1. Analysis of Clinical End Points of Randomised Trials Including Bevacizumab and Chemotherapy versus Chemotherapy as First-line Treatment of Metastatic Colorectal Cancer.

    Science.gov (United States)

    Colloca, G; Venturino, A; Guarneri, D

    2016-10-01

    Progression-free survival is recognised as an appropriate end point for randomised clinical trials of chemotherapy of patients with metastatic colorectal cancer, although it is not clear if it is reliable after chemotherapy plus bevacizumab. A literature search of randomised trials of systemic treatment including chemotherapy plus bevacizumab versus chemotherapy in patients with metastatic colorectal cancer was undertaken. For each trial the differences in overall survival and in either time-to-event or response-related end points were calculated. A Spearman test was carried out between the difference in each end point and the difference in survival. For the end points with the higher relationships with overall survival a regression analysis was carried out and R(2) (proportion of variability explained) was reported. Progression-free survival is closely related to overall survival (r=0.817; R(2)=0.706) and this relationship does not seem to be changed by the discontinuation of bevacizumab. The response-related end points have a better overall performance than the other time-to-event end points, even when only phase III trials are considered. In phase III trials, the disease control rate seems to be strongly related to overall survival (r=0.975; R(2)=0.889) and the overall response rate reports a good performance (r=0.866; R(2)=0.484). An open-label design and the timing of disease radiological evaluation do not seem to interfere with the correlation of differences of progression-free survival and overall survival. A validation of the disease control rate and the overall response rate as a surrogate end point of survival at a patient level and a standardised definition of the timing for their measurement are strongly recommended in trials of chemotherapy plus bevacizumab. Copyright © 2016 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  2. Digital Shoreline Analysis System (DSAS) version 4.3 Transects with Short-Term Linear Regression Rate Calculations for the Sheltered West Beaufort Sea coast of Alaska between the Colville River and Point Barrow

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — This dataset consists of short-term (~33 years) shoreline change rates for the north coast of Alaska between the Colville River and Point Barrow. Rate calculations...

  3. Digital Shoreline Analysis System (DSAS) version 4.3 Transects with Long-Term Linear Regression Rate Calculations for the Exposed West Beaufort Sea coast of Alaska between the Colville River and Point Barrow

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — This dataset consists of long-term (~65 years) shoreline change rates for the north coast of Alaska between the Colville River and Point Barrow. Rate calculations...

  4. Digital Shoreline Analysis System (DSAS) version 4.3 Transects with Long-Term Linear Regression Rate Calculations for the Sheltered West Beaufort Sea coast of Alaska between the Colville River and Point Barrow

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — This dataset consists of long-term (~65 years) shoreline change rates for the north coast of Alaska between the Colville River and Point Barrow. Rate calculations...

  5. Digital Shoreline Analysis System (DSAS) version 4.3 Transects with Short-Term Linear Regression Rate Calculations for the Exposed West Beaufort Sea coast of Alaska between the Colville River and Point Barrow

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — This dataset consists of short-term (~33 years) shoreline change rates for the north coast of Alaska between the Colville River and Point Barrow. Rate calculations...

  6. Managing medical treatment waste and effluent: the point of view of a nuclear medicine practitioner; Gestion des dechets et effluents issus de traitements medicaux: le point de vue d'un praticien de medecine nucleaire

    Energy Technology Data Exchange (ETDEWEB)

    Karcher, G. [Chef du Service de medecine nucleaire de l' Hopital d' adultes de Brabois - CHU, 54 - Nancy (Meurthe-et-Moselle) (France)

    2011-02-15

    The nuclear medicine department of the Nancy CHU hospital is one of the largest in France: 16.000 patients are welcomed each year and 4.000 persons undergo a tomography there. 5 shielded and isolated rooms, dedicated to Iodine{sup 131} treatment, allow the care of 150 to 200 patients each year. The head of the nuclear medicine department gives his meaning about the new regulation on the management of radioactive effluents. According to him, regulations are necessary but the values of the imposed thresholds have to be scientifically justified. Another point is that a lot of money is spent on radiation protection issues while the radioactive risks are almost null, which leads to wasting money. The elaboration of the radioprotection regulations must be made not as a whole but on a specific basis according to the domain: nuclear power plants, research reactors or nuclear medicine, it applies. (A.C.)

  7. Numeric treatment of nonlinear second order multi-point boundary value problems using ANN, GAs and sequential quadratic programming technique

    Directory of Open Access Journals (Sweden)

    Zulqurnain Sabir

    2014-06-01

    Full Text Available In this paper, computational intelligence technique are presented for solving multi-point nonlinear boundary value problems based on artificial neural networks, evolutionary computing approach, and active-set technique. The neural network is to provide convenient methods for obtaining useful model based on unsupervised error for the differential equations. The motivation for presenting this work comes actually from the aim of introducing a reliable framework that combines the powerful features of ANN optimized with soft computing frameworks to cope with such challenging system. The applicability and reliability of such methods have been monitored thoroughly for various boundary value problems arises in science, engineering and biotechnology as well. Comprehensive numerical experimentations have been performed to validate the accuracy, convergence, and robustness of the designed scheme. Comparative studies have also been made with available standard solution to analyze the correctness of the proposed scheme.

  8. School avoidance from the point of view of child and adolescent psychiatry: symptomatology, development, course, and treatment.

    Science.gov (United States)

    Knollmann, Martin; Knoll, Susanne; Reissner, Volker; Metzelaars, Jana; Hebebrand, Johannes

    2010-01-01

    A considerable percentage of children and adolescents who avoid school have mental illnesses. This article reviews the typical manifestations, classification, development, course, and treatment of school-avoiding behavior. Based on a selective review of recent literature, we present findings on the psychopathologically relevant features of school-avoiding children and adolescents, including psychiatric diagnoses, developmental, family-related, and psychological test variables. The emphasis is placed on our own studies of the subject. Although the evidence from the studies that have been performed to date is not definitive, the available findings show that school avoidance is associated with poor mental health and with unfavorable consequences onward into adulthood. Its causes include a number of individual and social stressors that place excessive demands on the affected children and adolescents and lead them to avoid school as a coping attempt. Many preventive and therapeutic interventions are now available, but the existing measures need to be better coordinated, and more effort needs to be directed to the early recognition and treatment of school-avoiding behavior. Physicians should consider the possibility of mental illness. Rather than writing sick notes or prescribing mother-child treatments at health resorts, which rather tend to sustain the problem, they should refer patients promptly to a child and adolescent psychiatrist.

  9. Morphology as the starting point for individualized cancer treatment; La morfologia como punto de partida del tratamiento oncologico individualizado

    Energy Technology Data Exchange (ETDEWEB)

    Sanz Ortega, J.

    2009-07-01

    Historically, the histopathological diagnosis has been essential for the proper treatment of cancer. Today, in the new era of individualized cancer treatment, pathologists acquire a new role for identifying therapeutic targets, detection of hereditary syndromes; to select the most suitable molecular technique for each sample or to assess individual response to neoadjuvant therapy. The objective of this review is to show how we must combine and integrate new gross examination, microscopic and immunohistochemical data with molecular pathology, taking the example of colorectal cancer. Immunohistochemistry for DNA repair genes, the study of K-ras mutations and circumferential resection margin in rectal adenocarcinoma are part of this new reality. Therefore, besides making the correct diagnosis and staging of the tumor, we can play a key role in risk stratification of cancer and individualized treatment. Integration of the molecular study with the morphology and clinical data by pathologists may improve the efficiency of genetic tests and save costs. Phenotype precedes genotype in the clinical management algorithm of the disease. (Author) 19 refs.

  10. West Nile Virus

    Science.gov (United States)

    West Nile virus (WNV) is an infectious disease that first appeared in the United States in 1999. Infected mosquitoes ... and usually go away on their own. If West Nile virus enters the brain, however, it can be life- ...

  11. Vigabatrina no tratamento da síndrome de West: avaliação clínica e eletrencefalográfica em 13 pacientes Treatment of West syndrome with vigabatrin: clinical and electroencephalographic evaluation of 13 patients

    Directory of Open Access Journals (Sweden)

    Adélia Maria de Miranda Henriques-Souza

    2007-03-01

    Full Text Available Avaliamos a eficácia da vigabatrina (VGB como monoterapia inicial para síndrome de West (SW, os seus efeitos colaterais e a evolução a curto prazo do eletrencefalograma (EEG, num estudo prospectivo, aberto e não controlado. A amostra foi de 13 lactentes atendidos entre outubro/2001 a setembro/2002 no ambulatório do IMIP ou em clínica privada. A dose média utilizada da VGB foi 118 mg/kg/dia. Houve supressão dos espasmos em 4 crianças (31%, controle parcial em 3 (23%, ausência de resposta em 5 (38% e piora em 1 (8%. Dos 2 pacientes portadores de esclerose tuberosa, um ficou livre dos espasmos e o outro teve controle parcial. Efeitos colaterais ocorreram em 8 crianças (62% e consistiram de irritabilidade, insônia, sonolência e agitação, sendo todos toleráveis. Ocorreu desaparecimento da hipsarritmia no segundo EEG em 6 crianças (46%, tendo 4 destas ficado livre dos espasmos. Nossos dados sugerem que a VGB é eficaz e bem tolerada como monoterapia inicial para a SW.We evaluated the efficacy of vigabatrin (VGB as a first drug to be used as monotherapy for West syndrome (WS, its side effects and correlations with the electroencephalogram (EEG. The sample consisted of 13 infants examined between October 2001 and September 2002 at IMIP ambulatory patients’ office or private clinic. Administration of vigabatrin was around 118 mg/kg/day. Suppression of spasms was obtained in 4 children (31%, partial control in 3 (23%, 5 of them did not present therapeutic response (38% and just one (8% got worse. On the two patients with tuberous sclerosis, one was seizure-free and in another there was partial control. Side effects happened in 8 children (62% and consisted of irritability, insomnia, somnolence and agitation, and all of them have been well tolerated. The second EEG showed disappearance of hipsarrhythmia in 6 patients (46%. Four of these were seizure-free. We conclude that VGB is effective and well tolerated as initial monotherapy for WS.

  12. The Secret Drama at the Patient's Bedside-Refusal of Treatment Because of the Practitioner's Ethnic Identity: The Medical Staff 's Point of View.

    Science.gov (United States)

    Popper-Giveon, Ariela; Keshet, Yael

    2018-02-01

    Patients' refusal of treatment based on the practitioner's ethnic identity reveals a clash of values: neutrality in medicine versus patient-centered care. Taking the Israeli-Palestinian conflict into account, this article aims at examining Israeli health care professionals' points of view concerning patients' refusal of treatment because of a practitioner's ethnic identity. Fifty in-depth interviews were conducted with 10 managers and 40 health care professionals, Jewish and Arab, employed at 11 public hospitals. Most refusal incidents recorded are unidirectional: Jewish patients refusing to be treated by Arab practitioners. Refusals are usually directed toward nurses and junior medical staff members, especially if recognizable as religious Muslims. Refusals are often initiated by the patients' relatives and occur more frequently during periods of escalation in the conflict. The structural competency approach can be applied to increase awareness of the role of social determinants in shaping patients' ethnic-based treatment refusals and to improve the handling of such incidents.

  13. Olive oil mill wastewaters before and after treatment: a critical review from the ecotoxicological point of view.

    Science.gov (United States)

    Justino, Celine I L; Pereira, Ruth; Freitas, Ana C; Rocha-Santos, Teresa A P; Panteleitchouk, Teresa S L; Duarte, Armando C

    2012-03-01

    The olive oil mill wastewater (OMW) is a problematic and polluting effluent which may degrade the soil and water quality, with critical negative impacts on ecosystems functions and services provided. The main purpose of this review paper is presenting the state of the art of OMW treatments focusing on their efficiency to reduce OMW toxicity, and emphasizing the role of ecotoxicological tests on the evaluation of such efficiency before the up-scale of treatment methodologies being considered. In the majority of research works, the reduction of OMW toxicity is related to the degradation of phenolic compounds (considered as the main responsible for the toxic effects of OMW on seed germination, on bacteria, and on different species of soil and aquatic invertebrates) or the decrease of chemical oxygen demand content, which is not scientifically sound. Batteries of ecotoxicological tests are not applied before and after OMW treatments as they should be, thus leading to knowledge gaps in terms of accurate and real assessment of OMW toxicity. Although the toxicity of OMW is usually high, the evaluation of effects on sub-lethal endpoints, on individual and multispecies test systems, are currently lacking, and the real impacts yielded by its dilution, in freshwater trophic chains of receiving systems can not be assessed. As far as the terrestrial compartment is considered, ecotoxicological data available include tests only with plants and the evaluation of soil microbial parameters, reflecting concerns with the impacts on crops when using OMW for irrigation purposes. The evaluation of its ecotoxicity to other edaphic species were not performed giving rise to a completely lack of knowledge about the consequences of such practice on other soil functions. OMW production is a great environmental problem in Mediterranean countries; hence, engineers, chemists and ecotoxicologists should face this problem together to find an ecologically friend solution.

  14. What's West Nile Virus?

    Science.gov (United States)

    ... OK for Kids? Your Teeth Heart Murmurs What's West Nile Virus? KidsHealth > For Kids > What's West Nile Virus? Print A A A en español ¿Qué es ... Virus del Nilo Occidental? What exactly is the West Nile virus? And why is everyone talking about mosquitoes ? Even ...

  15. Bedrock geologic map of the Spring Valley, West Plains, and parts of the Piedmont and Poplar Bluff 30'x60' quadrangles, Missouri, including the upper Current River and Eleven Point River drainage basins

    Science.gov (United States)

    Weary, David J.; Harrison, Richard W.; Orndorff, Randall C.; Weems, Robert E.; Schindler, J. Stephen; Repetski, John E.; Pierce, Herbert A.

    2015-01-01

    This map covers the drainage basins of the upper Current River and the Eleven Point River in the Ozark Plateaus physiographic province of southeastern Missouri. The two surface drainage basins are contiguous in their headwaters regions, but are separated in their lower reaches by the lower Black River basin in the southeast corner of the map area. Numerous dye-trace studies demonstrate that in the contiguous headwaters areas, groundwater flows from the Eleven Point River basin into the Current River basin. Much of the groundwater discharge of the Eleven Point River basin emanates from Big Spring, located on the Current River. This geologic map and cross sections were produced to help fulfill a need to understand the geologic framework of the region in which this subsurface flow occurs.

  16. Multiple memory systems, multiple time points: how science can inform treatment to control the expression of unwanted emotional memories

    Science.gov (United States)

    Lau-Zhu, Alex; Henson, Richard N.; Holmes, Emily A.

    2018-01-01

    Memories that have strong emotions associated with them are particularly resilient to forgetting. This is not necessarily problematic, however some aspects of memory can be. In particular, the involuntary expression of those memories, e.g. intrusive memories after trauma, are core to certain psychological disorders. Since the beginning of this century, research using animal models shows that it is possible to change the underlying memory, for example by interfering with its consolidation or reconsolidation. While the idea of targeting maladaptive memories is promising for the treatment of stress and anxiety disorders, a direct application of the procedures used in non-human animals to humans in clinical settings is not straightforward. In translational research, more attention needs to be paid to specifying what aspect of memory (i) can be modified and (ii) should be modified. This requires a clear conceptualization of what aspect of memory is being targeted, and how different memory expressions may map onto clinical symptoms. Furthermore, memory processes are dynamic, so procedural details concerning timing are crucial when implementing a treatment and when assessing its effectiveness. To target emotional memory in its full complexity, including its malleability, science cannot rely on a single method, species or paradigm. Rather, a constructive dialogue is needed between multiple levels of research, all the way ‘from mice to mental health’. This article is part of a discussion meeting issue ‘Of mice and mental health: facilitating dialogue between basic and clinical neuroscientists'. PMID:29352036

  17. Selection of an adsorbent for lead removal from drinking water by a point-of-use treatment device.

    Science.gov (United States)

    Sublet, Renaud; Simonnot, Marie-Odile; Boireau, Alain; Sardin, Michel

    2003-12-01

    The removal of lead from drinking water was investigated to develop a point-of-use water filter that could meet the regulation imposed by the new European Directive 98-83 lowering lead concentration in drinking water below 10 microgL(-1). The objective of this research was to assess the potential of different adsorbents (zeolites, resins, activated carbon, manganese oxides, cellulose powder) to remove lead from tap water with a very short contact time. To begin, the repartition of the lead species in a tap water and a mineral water was computed with the computer model CHESS. It showed that in bicarbonated waters lead is mainly under lead carbonate form, either in the aqueous or in the mineral phase. Batch experiments were then conducted to measure the equilibrium adsorption isotherms of the adsorbents. Then, for five of them, dynamic experiments in micro-columns were carried out to assess the outlet lead concentration level. Three adsorbents gave rise to a leakage concentration lower than 10 microgL(-1) and were then selected for prototypes experiments: chabasite, an activated carbon coated with a synthetic zeolite and a natural manganese oxide. The proposed method clearly showed that the measurement of equilibrium isotherms is not sufficient to predict the effectiveness of an adsorbent, and must be coupled with dynamic experiments.

  18. Multi-point injection: A general purpose delivery system for treatment and containment of hazardous and radiological waste

    Energy Technology Data Exchange (ETDEWEB)

    Kauschinger, J.L. [Ground Environmental Services, Alpharetta, GA (United States); Kubarewicz, J. [Jacobs Engineering, Oak Ridge, TN (United States); Van Hoesen, S.D. [Lockheed Martin Energy Systems, Oak Ridge, TN (United States)

    1997-12-31

    The multi-point injection (MPI) technology is a proprietary jetting process for the in situ delivery of various agents to treat radiological and/or chemical wastes. A wide variety of waste forms can be treated, varying from heterogeneous solid waste dumped into shallow burial trenches, bottom sludge (heel material) inside of underground tanks, and contaminated soils with widely varying soil composition (gravel, silts/clays, soft rock). The robustness of the MPI system is linked to the use of high speed mono-directional jets to deliver various types of agents for a variety of applications, such as: pretreatment of waste prior to insitu vitrification, solidification of waste for creating low conductivity monoliths, oxidants for insitu destruction of organic waste, and grouts for creating barriers (vertical, inclined, and bottom seals). The only strict limitation placed upon the MPI process is that the material can be pumped under high pressure. This paper describes the procedures to inject ordinary grout to form solidified monoliths of solid wastes.

  19. Tipping Point

    Medline Plus

    Full Text Available ... en español Blog About OnSafety CPSC Stands for Safety The Tipping Point Home > 60 Seconds of Safety (Videos) > The Tipping Point The Tipping Point by ... danger death electrical fall furniture head injury product safety television tipover tv Watch the video in Adobe ...

  20. The influence of applied heat-treatment on in 718 fatigue life at three point flexural bending

    Directory of Open Access Journals (Sweden)

    J. Belan

    2017-01-01

    Full Text Available The Inconel alloy 718 is an iron-nickel based superalloy with a working temperature up to 650 °C. Presented phases such as γ'' (Ni3Nb, γ' (Ni3Al, and δ (delta – Ni3Nb are responsible for the alloy's unique properties. The δ – delta phase is profitable when situated at grain boundaries in small quantities due to increasing fatigue life. However, at temperatures close to 650 °C the γ'' transforms to δ – delta and causes a decrease in fatigue life. Heat-treatment (800°C/ for 72 hours and its influence on fatigue life are discussed in this paper. Fatigue tests were carried out at room temperature. After the tests we plotted the S-N curves for both stages. SEM (Scanning Electron Microscopy fractography was carried out as well.

  1. Retention and transport of silver nanoparticles in a ceramic porous medium used for point-of-use water treatment.

    Science.gov (United States)

    Ren, Dianjun; Smith, James A

    2013-04-16

    The retention and transport of silver nanoparticles (Ag-NPs) through a ceramic porous medium used for point-of-use drinking water purification is investigated. Two general types of experiments were performed: (i) pulse injections of suspensions of Ag-NPs in aqueous MgSO4 solutions were applied to the ceramic medium, and effluent silver was quantified over time; (ii) Ag-NPs were applied directly to the porous medium during fabrication using a paint-on, dipping, or fire-in method, a synthetic, moderately hard water sample with monovalent and divalent inorganic ions was applied to the ceramic medium, and effluent silver was quantified over time. These latter experiments were performed to approximate real-world use of the filter medium. For experiments with Ag-NPs suspended in the inflow solution, the percentage of applied Ag-NPs retained in the ceramic porous medium ranged from about 13 to 100%. Ag-NP mobility decreased with increasing ionic strength for all cases and to a lesser extent with increasing nanoparticle diameter. Citrate-capped particles were slightly less mobile than proteinate-capped particles. For ceramic disks fabricated with Ag-NPs by the paint-on and dipping methods (where the Ag-NPs are applied to the disks after firing), significant release of nanoparticles into the filter disk effluent was observed relative to the fire-in method (where the nanoparticles are combined with the clay, water, grog, and flour before firing). These results suggest that the fire-in method may be a new and significant improvement to ceramic filter design.

  2. Sleep Quality Among People Living With Chronic Noncancer Pain: Findings From the Pain and Opioids IN Treatment (POINT) Cohort.

    Science.gov (United States)

    Lintzeris, Nicholas; Moodley, Ranira; Campbell, Gabrielle; Larance, Briony; Bruno, Raimondo; Nielsen, Suzanne; Degenhardt, Louisa

    2016-05-01

    To examine sleep disturbances in the POINT cohort study consisting of participants prescribed long-term opioids for chronic noncancer pain (CNCP), and to examine the relationship between sleep and measures of pain, physical and mental health, substance use, and medication use at the baseline interview. A convenience sample of 1243 participants with current CNCP and prescription opioid use were recruited from community settings and underwent a structured interview examining subjective sleep symptoms (Medical Outcomes Study [MOS] Sleep Scale and the Sleep Problems Index [SLP-9]), the pain severity and interference using the Brief Pain Inventory (BPI), mental and physical health symptoms, and recent substance and medication use. Linear regression models assessed independent predictors of SLP-9 scores. The median hours of sleep per night was 6 (IQR, 5 to 7.5), with 26% reporting optimal sleep (7 to 8 hours), and a mean SLP-9 score of 47.3 (SD=20.9). In multivariate analysis, age, frequent/severe headaches, BPI pain severity and pain interference scores, moderate to severe anxiety or depression, daily tobacco use, and benzodiazepine use in the past week were significant predictors of SLP-9 scores and sleep quality. Higher MOS respiratory impairment was observed in men, in those with a high body mass index, frequent/severe headaches, and high pain interference scores, and in patients taking anticonvulsants and antipsychotic medications. Opioid use was not associated with SLP-9 or respiratory sleep impairment. High levels of sleep problems were reported in this community sample of CNCP patients prescribed long-term opioids, and were associated with mental health problems and increased medication use. Nonmedication approaches to addressing sleep problems should be prioritized in this population.

  3. High-power pain threshold ultrasound technique in the treatment of active myofascial trigger points: a randomized, double-blind, case-control study.

    Science.gov (United States)

    Majlesi, Javid; Unalan, Halil

    2004-05-01

    To study what effects a high-power, pain-threshold, static ultrasound technique applied to acute myofascial trigger points of the upper trapezius has on pain and on active cervical lateral bending. Double-blind randomized trial. Physical therapy unit of a private general hospital. Seventy-two adults with acute pain on 1 side of the neck, admitted to the outpatient unit during 1999 and 2000. Not applicable. Visual analog scale and goniometric measurement of active lateral bending of the neck performed daily after treatment sessions and length of treatment (number of therapy sessions). High-power ultrasound applied to the trigger points before stretching the muscle was more effective (P<.05) than conventional ultrasound, and it also significantly (P<.001) decreased the length of therapy. High-power, pain-threshold, static ultrasound technique may be considered in the treatment of patients with acute myofascial pain syndrome, with the understanding that this technique demands more concentration and communication between the patient and the therapist.

  4. Cost-effectiveness of initiating antiretroviral therapy at different points in TB treatment in HIV-TB co-infected ambulatory patients in South Africa

    Science.gov (United States)

    Naidoo, Kogieleum; Grobler, Anneke C; Deghaye, Nicola; Reddy, Tarylee; Gengiah, Santhanalakshmi; Gray, Andrew; Karim, Salim Abdool

    2015-01-01

    Objective Initiation of antiretroviral therapy (ART) during tuberculosis (TB) treatment improves survival in TB-HIV co-infected patients. In patients with CD4+ counts costs and cost effectiveness of starting ART at various time points during TB treatment in patients with CD4+ counts ≥50cells/mm3. Methods In the SAPiT trial, 642 HIV-TB co-infected patients were randomized to three arms, either receiving ART within 4 weeks of starting TB treatment (early treatment arm; Arm-1), after the intensive phase of TB treatment (late treatment arm; Arm-2), or after completing TB treatment (sequential arm; Arm-3). Direct healthcare costs were measured from a provider perspective using a micro-costing approach. The incremental cost per death averted was calculated using the trial outcomes. Results For patients with CD4+ count≥50cells/mm3, median monthly variable costs per patient were $116, $113 and $102 in Arms-1, -2 and -3, respectively. There were 12 deaths in 177 patients in Arm-1, 8 deaths in 180 patients in the Arm-2 and 19 deaths in 172 patients in Arm-3. While the costs were lower in Arm-3, it had a substantially higher mortality rate. The incremental cost per death averted associated with moving from Arm-3 to Arm-2 was $4199. There was no difference in mortality between Arm-1 and Arm-2, but Arm-1 was slightly more expensive. Conclusions Initiation of ART after the completion of the intensive phase of TB treatment is cost effective for patients with CD4+ counts≥50cells/mm3. PMID:26167618

  5. Evolution of the methodological quality of controlled clinical trials for myofascial trigger point treatments for the period 1978-2015: A systematic review.

    Science.gov (United States)

    Stoop, Rahel; Clijsen, Ron; Leoni, Diego; Soldini, Emiliano; Castellini, Greta; Redaelli, Valentina; Barbero, Marco

    2017-08-01

    The methodological quality of controlled clinical trials (CCTs) of physiotherapeutic treatment modalities for myofascial trigger points (MTrP) has not been investigated yet. To detect the methodological quality of CCTs for physiotherapy treatments of MTrPs and demonstrating the possible increase over time. Systematic review. A systematic search was conducted in two databases, Physiotherapy Evidence Database (PEDro) and Medicine Medical Literature Analysis and Retrieval System online (MEDLINE), using the same keywords and selection procedure corresponding to pre-defined inclusion criteria. The methodological quality, assessed by the 11-item PEDro scale, served as outcome measure. The CCTs had to compare at least two interventions, where one intervention had to lay within the scope of physiotherapy. Participants had to be diagnosed with myofascial pain syndrome or trigger points (active or latent). A total of n = 230 studies was analysed. The cervico-thoracic region was the most frequently treated body part (n = 143). Electrophysical agent applications was the most frequent intervention. The average methodological quality reached 5.5 on the PEDro scale. A total of n = 6 studies scored the value of 9. The average PEDro score increased by 0.7 points per decade between 1978 and 2015. The average PEDro score of CCTs for MTrP treatments does not reach the cut-off of 6 proposed for moderate to high methodological quality. Nevertheless, a promising trend towards an increase of the average methodological quality of CCTs for MTrPs was recorded. More high-quality CCT studies with thorough research procedures are recommended to enhance methodological quality. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  6. A Point Source of a Different Color: Identifying a Gap in United States Regulatory Policy for “Green” CSO Treatment Using Constructed Wetlands

    Directory of Open Access Journals (Sweden)

    Zeno F. Levy

    2014-04-01

    Full Text Available Up to 850 billion gallons of untreated combined sewer overflow (CSO is discharged into waters of the United States each year. Recent changes in CSO management policy support green infrastructure (GI technologies as “front of the pipe” approaches to discharge mitigation by detention/reduction of urban stormwater runoff. Constructed wetlands for CSO treatment have been considered among suites of GI solutions. However, these wetlands differ fundamentally from other GI technologies in that they are “end of the pipe” treatment systems that discharge from a point source, and are therefore regulated in the U.S. under the National Pollution Discharge Elimination System (NPDES. We use a comparative regulatory analysis to examine the U.S. policy framework for CSO treatment wetlands. We find in all cases that permitting authorities have used best professional judgment to determine effluent limits and compliance monitoring requirements, referencing technology and water quality-based standards originally developed for traditional “grey” treatment systems. A qualitative comparison with Europe shows less stringent regulatory requirements, perhaps due to institutionalized design parameters. We recommend that permitting authorities develop technical guidance documents for evaluation of “green” CSO treatment systems that account for their unique operational concerns and benefits with respect to sustainable development.

  7. Gamma-rays and heat-treatment conversions of point defects in massive rose quartz from the Borborema Pegmatite Province, Northeast Brazil

    Science.gov (United States)

    Guzzo, Pedro L.; Barreto, Sandra B.; Miranda, Milena R.; Gonzaga, Raysa S. G.; Casals, Sandra A.

    2017-11-01

    An extensive characterization of trace elements and point defects in rose quartz from the Borborema Pegmatite Province (BPP) in the northeast of Brazil was carried out by complementary spectroscopic methods. The aim here was to document the change in the configuration of point defects into the quartz lattice induced by heat-treatment and ionizing radiation. The samples were extracted from the core of two granitic rare element (REL) pegmatites, Taboa (Carnaúba dos Dantas, RN) and Alto do Feio (Pedra Lavrada, PB). The contents of Al, P, Ti, Ni, Fe, Ge, Li, Be, B and K were measured by laser-ablation inductively coupled plasma mass spectrometry (LA-ICP-MS). Polished plates were heat-treated at 500 and 1000 °C and then irradiated with 50 kGy of γ rays. Point defects were characterized by optical (UV-Vis), infrared (IR), and electron paramagnetic resonance (EPR) spectroscopies. In the as-received condition, [AlO4/H]0 centers, Li- and B-dependent OH defects were observed. Point defects related to Al and Li species were significantly affected by heat-treatment at 1000 °C and/or γ radiation. Paramagnetic centers such as [AlO4]0, [GeO4/Li]0, [TiO4/Li]0 and [O2 3-/Li]0 were created by the diffusion of Li+ ions from their original diamagnetic centers related to substitutional Al3+ and OH-species. The smoky color developed after irradiation and the signal intensities of the paramagnetic centers were independent from the original rose color grade. The samples from the Taboa (TB) pegmatite showed the highest concentration of Al, Ti, Fe and Li elements as well as the highest signal intensities for [AlO4]0, [AlO4/H]0, [GeO4/Li]0 and [TiO4/Li]0 centers. Although TB also showed the higher concentration of B element, the intensity of the 3597 cm-1 IR band related to [BO4/H]0 centers was higher for Alto do Feio (AF) samples. This result suggests that the uptake of B into the quartz core of each pegmatite took place through different mechanisms. It was concluded that the change in

  8. QMRA (quantitative microbial risk assessment) and HACCP (hazard analysis and critical control points) for management of pathogens in wastewater and sewage sludge treatment and reuse.

    Science.gov (United States)

    Westrell, T; Schönning, C; Stenström, T A; Ashbolt, N J

    2004-01-01

    Hazard Analysis and Critical Control Points (HACCP) was applied for identifying and controlling exposure to pathogenic microorganisms encountered during normal sludge and wastewater handling at a 12,500 m3/d treatment plant utilising tertiary wastewater treatment and mesophilic sludge digestion. The hazardous scenarios considered were human exposure during treatment, handling, soil application and crop consumption, and exposure via water at the wetland-area and recreational swimming. A quantitative microbial risk assessment (QMRA), including rotavirus, adenovirus, haemorrhagic E. coli, Salmonella, Giardia and Cryptosporidium, was performed in order to prioritise pathogen hazards for control purposes. Human exposures were treated as individual risks but also related to the endemic situation in the general population. The highest individual health risk from a single exposure was via aerosols for workers at the belt press for sludge dewatering (virus infection risk = 1). The largest impact on the community would arise if children ingested sludge at the unprotected storage site, although in the worst-case situation the largest number of infections would arise through vegetables fertilised with sludge and eaten raw (not allowed in Sweden). Acceptable risk for various hazardous scenarios, treatment and/or reuse strategies could be tested in the model.

  9. Calibration of response and remission cut-points on the Beck Depression Inventory-Second Edition for monitoring seasonal affective disorder treatment outcomes.

    Science.gov (United States)

    Reeves, Gloria M; Rohan, Kelly J; Langenberg, Patricia; Snitker, Soren; Postolache, Teodor T

    2012-04-01

    The purpose of this study is to define treatment response and remission cut-point scores for the Beck Depression Inventory-Second Edition (BDI-II) when used to monitor seasonal affective disorder (SAD) treatment. Data from two published randomized clinical trials for SAD were utilized to complete a ROC analysis to define response and remission thresholds for the BDI-II. The Structured Interview Guide for the Hamilton Rating Scale for Depression-Seasonal Affective Disorder Version (SIGH-SAD) was used as a reference standard. Data from the two trials included BDI-II and SIGH-SAD scores for patients at baseline, 6 weeks (post-treatment), and 1 year (next winter). BDI-II score of ≤ 9 was the derived criterion for remission of SAD, and BDI-II score decrease of 50% from baseline was the criterion for treatment response. Study participants were primarily female (94%) and Caucasian (80%) so demographic diversity of the sample was limited. This study validated BDI-II scores compared to the SIGH-SAD reference standard. The BDI-II has greater potential for widespread use by clinicians than the SIGH-SAD to monitor SAD patients because it is a brief self-report instrument that can be conveniently administered in the waiting room. Copyright © 2011 Elsevier B.V. All rights reserved.

  10. Safety and Effectiveness of Bone Marrow Cell Concentrate in the Treatment of Chronic Critical Limb Ischemia Utilizing a Rapid Point-of-Care System

    Directory of Open Access Journals (Sweden)

    Venkatesh Ponemone

    2017-01-01

    Full Text Available Critical limb ischemia (CLI is the end stage of lower extremity peripheral vascular disease (PVD in which severe obstruction of blood flow results in ischemic rest pain, ulcers and/or gangrene, and a significant risk of limb loss. This open-label, single-arm feasibility study evaluated the safety and therapeutic effectiveness of autologous bone marrow cell (aBMC concentrate in revascularization of CLI patients utilizing a rapid point-of-care device. Seventeen (17 no-option CLI patients with ischemic rest pain were enrolled in the study. Single dose of aBMC, prepared utilizing an intraoperative point-of-care device, the Res-Q™ 60 BMC system, was injected intramuscularly into the afflicted limb and patients were followed up at regular intervals for 12 months. A statistically significant improvement in Ankle Brachial Index (ABI, Transcutaneous Oxygen Pressure (TcPO2, mean rest pain and intermittent claudication pain scores, wound/ ulcer healing, and 6-minute walking distance was observed following aBMC treatment. Major amputation-free survival (mAFS rate and amputation-free rates (AFR at 12 months were 70.6% and 82.3%, respectively. In conclusion, aBMC injections were well tolerated with improved tissue perfusion, confirming the safety, feasibility, and preliminary effectiveness of aBMC treatment in CLI patients.

  11. Fixed Points

    Indian Academy of Sciences (India)

    Home; Journals; Resonance – Journal of Science Education; Volume 5; Issue 5. Fixed Points - From Russia with Love - A Primer of Fixed Point Theory. A K Vijaykumar. Book Review Volume 5 Issue 5 May 2000 pp 101-102. Fulltext. Click here to view fulltext PDF. Permanent link:

  12. Tipping Point

    Medline Plus

    Full Text Available ... OnSafety CPSC Stands for Safety The Tipping Point Home > 60 Seconds of Safety (Videos) > The Tipping Point ... 24 hours a day. For young children whose home is a playground, it’s the best way to ...

  13. Malaria cure with sulphadoxine/pyrimethamine combination in 12 semi-immune adults from West-Central Africa with high rates of point mutations in Plasmodium falciparum dhfr and dhps genes.

    Science.gov (United States)

    Berzosa, Pedro J; Puente, Sabino; Benito, Agustìn

    2005-10-01

    We report 12 uncomplicated falciparum-malaria cases from semi-immune people from Central Africa treated with sulfadoxine/pyrimethamine (Fansidar) in a Spanish hospital. We resolved by PCR-RFLP the mutations in dhfr and dhps genes related to resistance to antifolate drugs. The 12 patients presented high frequencies of combined mutations in both genes but they were completely cured after treatment.

  14. The RATPAC (Randomised Assessment of Treatment using Panel Assay of Cardiac markers) trial: a randomised controlled trial of point-of-care cardiac markers in the emergency department.

    Science.gov (United States)

    Goodacre, S; Bradburn, M; Fitzgerald, P; Cross, E; Collinson, P; Gray, A; Hall, A S

    2011-05-01

    To evaluate the clinical effectiveness and cost-effectiveness of using a point-of-care cardiac marker panel in patients presenting to the emergency department (ED) with suspected but not proven acute myocardial infarction (AMI). Multicentre pragmatic open randomised controlled trial and economic evaluation. Six acute hospital EDs in the UK. Adults presenting to hospital with chest pain due to suspected but not proven myocardial infarction, and no other potentially serious alternative pathology or comorbidity. Participants were allocated using an online randomisation system to receive either (1) diagnostic assessment using the point-of-care biochemical marker panel or (2) conventional diagnostic assessment without the panel. All tests and treatments other than the panel were provided at the discretion of the clinician. The primary outcome was the proportion of patients successfully discharged home after ED assessment, defined as patients who had (1) either left the hospital or were awaiting transport home with a discharge decision having been made at 4 hours after initial presentation and (2) suffered no major adverse event (as defined below) during the following 3 months. Secondary outcomes included length of initial hospital stay and total inpatient days over 3 months, and major adverse events (death, non-fatal AMI, life-threatening arrhythmia, emergency revascularisation or hospitalisation for myocardial ischaemia). Economic analysis estimated mean costs and quality-adjusted life-years (QALYs), and then estimated the probability of cost-effectiveness assuming willingness to pay of £20,000 per QALY gained. We randomised 1132 participants to point of care and 1131 to standard care, and analysed 1125 and 1118, respectively [mean age 54.5 years, 1307/2243 (58%) male and 269/2243 (12%) with known coronary heart disease (CHD)]. In the point-of-care group 358/1125 (32%) were successfully discharged compared with 146/1118 (13%) in the standard-care group [odds ratio (OR

  15. West syndrome, vigabatrine, adrenocorticotropic hormone

    Directory of Open Access Journals (Sweden)

    Ünsal Yılmaz

    2014-03-01

    Full Text Available Objective: Limited data are available on the etiology, clinical approach, treatment and outcome in West syndrome. In the present study, we aimed to document clinical characteristics, etiology and treatment response in children with West syndrome. Methods: Hospital charts of children who were diagnosed with West syndrome between July-2011 and December- 2013 and who had a follow-up at least 12-month, were reviewed retrospectively. Results: 38 patients (14 females, 24 males, mean aged 27.1±7.60 months were included. The mean age of seizure onset, interval to diagnosis, and follow-up period were 6.23±4.27 months, 1.36±1.58 months, and 19.3±5.86 months respectively. Perinatal asphyxia (13, tuberous sclerosis (2, cortical dysplasia (2, encephalitis (1, asphyxia due to aspiration (1, congenital cytomegalovirus infection (1, perinatal infarct (1, nonketotic hyperglycinemia (1 and Prader Willi syndrome (1 were the identified causes. The etiology could not be ascertained in the remaining 15 children. Psychomotor development was mildly retarded in 12, moderately retarded in 13, and severely in 13 patients at onset, and did not change significantly at month 12. The initial therapy was synthetic adrenocorticotropic hormone in 11, vigabatrin in 17, levetiracetam in 8 and valproate in 2 patients. At 12th month of therapy, 15 patients were seizure-free, 12 patients showed more than 50% decrease in seizure frequency, and remaining 11 patients showed no significant reduction in seizure frequency. Conclusion: Besides the perinatal asphyxia as most frequent cause, a wide variety of disorders can present as West syndrome. Although, a 12-month-long treatment achieves seizure control in half of the patients, not beneficial effect on psychomotor development was seen. J Clin Exp Invest 2014; 5 (1: 86-92

  16. Future changes in seasonal-mean precipitation over West Africa ...

    African Journals Online (AJOL)

    This points to a non - linear effect of intensified greenhouse forcing on precipitation over West Africa; suggesting that after a particular level of greenhouse gas concentrations further increase may have little or no effect on the regions precipitation. Keywords : West Africa, Precipitation, Climate Change Projections, NorESM 1 ...

  17. future changes in seasonal-mean precipitation over west africa ...

    African Journals Online (AJOL)

    HOD

    This points to a non-linear effect of intensified greenhouse forcing on precipitation over West. Africa; suggesting that after a particular level of greenhouse gas concentrations further increase may have little or no effect on the regions precipitation. Keywords: West Africa, Precipitation, Climate Change Projections, NorESM1-M ...

  18. Immediate effect of ultrasound and ischemic compression techniques for the treatment of trapezius latent myofascial trigger points in healthy subjects: a randomized controlled study.

    Science.gov (United States)

    Aguilera, F Javier Montañez; Martín, Daniel Pecos; Masanet, Rosana Arnau; Botella, Ana Camps; Soler, Lorena Borja; Morell, Francisco Bosch

    2009-09-01

    The purpose of this study was to determine immediate effects of ischemic compression (IC) and ultrasound (US) for the treatment of myofascial trigger points (MTrPs) in the trapezius muscle. Sixty-six volunteers, all CEU-Cardenal Herrera University, Valencia, Spain, personnel, participated in this study. Subjects were healthy individuals, diagnosed with latent MTrPs in the trapezius muscle. Subjects were randomly placed into 3 groups: G1, which received IC treatment for MTrPs; G2, which received US; and G3 (control), which received sham US. The following data were recorded before and after each treatment: active range of motion (AROM) of cervical rachis measured with a cervical range of motion instrument, basal electrical activity (BEA) of muscle trapezius measured with surface electromyography, and pressure tolerance of MTrP measured with visual analogue scale assessing local pain evoked by the application of 2.5 kg/cm(2) of pressure using a pressure analog algometer. The results showed an immediate decrease in BEA of the trapezius muscle and a reduction of MTrP sensitivity after treatment with both therapeutic modalities. In the case of IC, an improvement of AROM of cervical rachis was also been obtained. In this group of participants, both treatments were shown to have an immediate effect on latent MTrPs. The results show a relation among AROM of cervical rachis, BEA of the trapezius muscle, and MTrP sensitivity of the trapezius muscle gaining short-term positive effects with use of IC.

  19. The Manual Stimulation of Acupuncture Points in the Treatment of Post-Traumatic Stress Disorder: A Review of Clinical Emotional Freedom Techniques.

    Science.gov (United States)

    Church, Dawson; Feinstein, David

    2017-08-01

    Background: The manual stimulation of acupuncture points has been combined with components of cognitive and exposure therapies into a clinical and self-help approach known as Emotional Freedom Techniques (EFT). More than 40 clinical trials and four meta-analytic reviews of EFT treatments have demonstrated large effect sizes with a range of conditions, including pain, PTSD (in both civilian and military veteran populations), phobias, anxiety, and depression. Objective: This review describes the approach, with a focus on PTSD in veterans and service members, provides an overview of how EFT is most commonly applied, and outlines obstacles and cautions related to its implementation. Methods: Peer-reviewed clinical trials and meta-analyses of EFT in the treatment of PTSD are assessed to identify the characteristics of the approach that render it suitable for the treatment of PTSD. Results: The literature demonstrates that remediation of PTSD and comorbid conditions is typically accomplished within brief time frames, ranging from one session for phobias to between four and ten sessions for PTSD. Clinical EFT has been shown to regulate stress hormones and limbic function and to improve various neurologic markers of general health. The epigenetic effects of EFT include upregulation of immunity genes and downregulation of inflammation genes. Six dismantling studies have indicated that the acupressure component of EFT is an active ingredient and not placebo. Conclusions: Seven empirically supported strengths of the approach were identified that make it especially suitable for use with veterans and active military: (1) the depth and breadth of treatment effects; (2) the relatively brief timeframes required for successful treatment; (3) the low risk of adverse events; (4) the minimal training time required for the approach to be applied effectively; (5) the simultaneous reduction of physical and psychologic symptoms; (6) the utility and cost-effectiveness of clinical EFT in a

  20. Point-of-care autofluorescence imaging for real-time sampling and treatment guidance of bioburden in chronic wounds: first-in-human results.

    Directory of Open Access Journals (Sweden)

    Ralph S DaCosta

    Full Text Available Traditionally, chronic wound infection is diagnosed by visual inspection under white light and microbiological sampling, which are subjective and suboptimal, respectively, thereby delaying diagnosis and treatment. To address this, we developed a novel handheld, fluorescence imaging device (PRODIGI that enables non-contact, real-time, high-resolution visualization and differentiation of key pathogenic bacteria through their endogenous autofluorescence, as well as connective tissues in wounds.This was a two-part Phase I, single center, non-randomized trial of chronic wound patients (male and female, ≥18 years; UHN REB #09-0015-A for part 1; UHN REB #12-5003 for part 2; clinicaltrials.gov Identifier: NCT01378728 for part 1 and NCT01651845 for part 2. Part 1 (28 patients; 54% diabetic foot ulcers, 46% non-diabetic wounds established the feasibility of autofluorescence imaging to accurately guide wound sampling, validated against blinded, gold standard swab-based microbiology. Part 2 (12 patients; 83.3% diabetic foot ulcers, 16.7% non-diabetic wounds established the feasibility of autofluorescence imaging to guide wound treatment and quantitatively assess treatment response. We showed that PRODIGI can be used to guide and improve microbiological sampling and debridement of wounds in situ, enabling diagnosis, treatment guidance and response assessment in patients with chronic wounds. PRODIGI is safe, easy to use and integrates into the clinical workflow. Clinically significant bacterial burden can be detected in seconds, quantitatively tracked over days-to-months and their biodistribution mapped within the wound bed, periphery, and other remote areas.PRODIGI represents a technological advancement in wound sampling and treatment guidance for clinical wound care at the point-of-care.ClinicalTrials.gov NCT01651845; ClinicalTrials.gov NCT01378728.

  1. Cost-effectiveness analysis of antiviral treatment in the management of seasonal influenza A: point-of-care rapid test versus clinical judgment.

    Science.gov (United States)

    Nshimyumukiza, Léon; Douville, Xavier; Fournier, Diane; Duplantie, Julie; Daher, Rana K; Charlebois, Isabelle; Longtin, Jean; Papenburg, Jesse; Guay, Maryse; Boissinot, Maurice; Bergeron, Michel G; Boudreau, Denis; Gagné, Christian; Rousseau, François; Reinharz, Daniel

    2016-03-01

    A point-of-care rapid test (POCRT) may help early and targeted use of antiviral drugs for the management of influenza A infection. (i) To determine whether antiviral treatment based on a POCRT for influenza A is cost-effective and, (ii) to determine the thresholds of key test parameters (sensitivity, specificity and cost) at which a POCRT based-strategy appears to be cost effective. An hybrid « susceptible, infected, recovered (SIR) » compartmental transmission and Markov decision analytic model was used to simulate the cost-effectiveness of antiviral treatment based on a POCRT for influenza A in the social perspective. Data input parameters used were retrieved from peer-review published studies and government databases. The outcome considered was the incremental cost per life-year saved for one seasonal influenza season. In the base-case analysis, the antiviral treatment based on POCRT saves 2 lives/100,000 person-years and costs $7600 less than the empirical antiviral treatment based on clinical judgment alone, which demonstrates that the POCRT-based strategy is dominant. In one and two way-sensitivity analyses, results were sensitive to the POCRT accuracy and cost, to the vaccination coverage as well as to the prevalence of influenza A. In probabilistic sensitivity analyses, the POCRT strategy is cost-effective in 66% of cases, for a commonly accepted threshold of $50,000 per life-year saved. The influenza antiviral treatment based on POCRT could be cost-effective in specific conditions of performance, price and disease prevalence. © 2015 The Authors. Influenza and Other Respiratory Viruses Published by John Wiley & Sons Ltd.

  2. Six dimensional analysis with daily stereoscopic x-ray imaging of intrafraction patient motion in head and neck treatments using five points fixation masks.

    Science.gov (United States)

    Linthout, Nadine; Verellen, Dirk; Tournel, Koen; Storme, Guy

    2006-02-01

    The safety margins used to define the Planning Target Volume (PTV) should reflect the accuracy of the target localization during treatment that comprises both the reproducibility of the patient positioning and the positional uncertainty of the target, so both the inter- and intrafraction motion of the target. Our first aim in this study was to determine the intrafraction motion of patients immobilized with a five-point thermoplastic mask for head and neck treatments. The five-point masks have the advantage that the patient's shoulders as well as the cranial part of the patient's head is covered with the thermoplastic material that improves the overall immobilization of the head and neck region of the patient. Thirteen patients were consecutively assigned to use a five-point thermoplastic mask. The patients were positioned by tracking of infrared markers (IR) fixed to the immobilization device and stereoscopic x-ray images were used for daily on-line setup verification. Repositioning was carried out prior to treatment as needed; rotations were not corrected. Movements during treatment were monitored by real-time IR tracking. Intrafraction motion and rotation was supplementary assessed by a six-degree-of-freedom (6-D) fusion of x-ray images, taken before and after all 385 treatments, with DRR images generated from the planning CT data. The latter evaluates the movement of the patient within the thermoplastic mask independent from the mask movement, where IR tracking evaluates the movement of the mask caused by patient movement in the mask. These two movements are not necessarily equal to each other. The maximum intrafraction movement detected by IR tracking showed a shift [mean (SD; range)] of -0.1(0.7; 6.0), 0.1(0.6; 3.6), -0.2(0.8;5.5) mm in the vertical, longitudinal, and lateral direction, respectively, and rotations of 0.0(0.2; 1.6), 0.0(0.2; 1.7) and 0.2(0.2; 2.4) degrees about the vertical, longitudinal, and lateral axis, respectively. The standard deviations

  3. Tipping Point

    Medline Plus

    Full Text Available ... Point by CPSC Blogger September 22, 2009 appliance child Childproofing CPSC danger death electrical fall furniture head ... see news reports about horrible accidents involving young children and furniture, appliance and tv tip-overs. The ...

  4. Tipping Point

    Medline Plus

    Full Text Available ... Point by CPSC Blogger September 22, 2009 appliance child Childproofing CPSC danger death electrical fall furniture head ... TV falls with about the same force as child falling from the third story of a building. ...

  5. Increasing equity of access to point-of-use water treatment products through social marketing and entrepreneurship: a case study in western Kenya.

    Science.gov (United States)

    Freeman, Matthew C; Quick, Robert E; Abbott, Daniel P; Ogutu, Paul; Rheingans, Richard

    2009-09-01

    Point-of-use water chlorination reduces diarrhoea risk by 25-85%. Social marketing has expanded access to inexpensive sodium hypochlorite for water treatment, at a cost of less than US$0.01 per day, in Kenya. To increase product access, women's groups in western Kenya were trained to educate neighbours and sell health products to generate income. We evaluated this programme's impact on equity of access to water treatment products in a cross-sectional survey. We surveyed 487 randomly selected households in eight communities served by the women's groups. Overall, 20% (range 5-39%) of households in eight communities purchased and used chlorine, as confirmed by residual chlorine observed in stored water. Multivariate models using illiteracy and the poorest socioeconomic status as a referent showed that persons with at least some primary education (OR 2.5, 95% CI 1.8, 3.5) or secondary education (OR 5.4, 95% CI 1.6, 17.5) and persons in the four wealthiest quintiles (OR 2.5, 95% CI 1.0, 6.0) were more likely to chlorinate stored water. While this implementation model was associated with good product penetration and use, barriers to access to inexpensive water treatment remained among the very poor and less educated.

  6. Capillary compared to venous blood sampling in clozapine treatment: patients׳ and healthcare practitioners׳ experiences with a point-of-care device.

    Science.gov (United States)

    Bogers, Jan P A M; Bui, Hong; Herruer, Martien; Cohen, Dan

    2015-03-01

    Underuse of the antipsychotic clozapine for schizophrenia is an impediment to improving outcomes for patients. Because of its possible severe side effects, including granulocytopenia or even agranulocytosis, clozapine treatment entails regular WBC monitoring, which can be a major drawback for patients and practitioners. The HemoCue WBC DIFF system is a point-of-care device using capillary blood sampling which provides WBC counts with differentials, including granulocytes. We investigated if capillary sampling instead of conventional venous sampling might diminish the burden for patients and practitioners and motivate them to continue clozapine treatment. A randomized cross-over trial design was used to compare the two sampling methods. Patients׳ subjective experiences of various aspects of blood sampling were rated on a 10-cm visual analogue scale (VAS). Patients and practitioners were also asked if they had any preference for venous or capillary sampling and patients were asked if the sampling method influenced their motivation to continue clozapine treatment. Seventy-three patients were included in this study. Three dropped out before completion. The VAS ratings on all five aspects and the total burden experienced showed a consistent pattern favouring capillary blood sampling (psampling at a laboratory and practitioners also preferred it. Using this method might therefore boost clozapine prescription rates. Copyright © 2014 Elsevier B.V. and ECNP. All rights reserved.

  7. Deep dry needling of trigger points located in the lateral pterygoid muscle: Efficacy and safety of treatment for management of myofascial pain and temporomandibular dysfunction

    Science.gov (United States)

    Infante-Cossio, Pedro; Granados-Nunez, Mercedes; Urresti-Lopez, Francisco-Javier; Lopez-Martos, Ricardo; Ruiz-Canela-Mendez, Pablo

    2015-01-01

    Background To determine whether deep dry needling (DDN) of trigger points (TPs) in the lateral pterygoid muscle (LPM) would significantly reduce pain and improve function, compared with methocarbamol/paracetamol medication. Material and Methods Forty-eight patients with chronic myofascial pain located in the LPM were selected and randomly assigned to one of two groups (DDN test group, n=24; drug-treated control group, n=24). The test group received three applications of needling of the LPM once per week for three weeks, while control group patients were given two tablets of a methocarbamol/paracetamol combination every six hours for three weeks. Assessments were carried out pretreatment, 2 and 8 weeks after finishing the treatment. Results A statistically significant difference (pdry needling, lateral pterygoid muscle, randomized controlled trial, temporomandibular disorders. PMID:25662558

  8. Clinical end points for drug treatment trials in BCR-ABL1-negative classic myeloproliferative neoplasms: consensus statements from European LeukemiaNET (ELN) and Internation Working Group-Myeloproliferative Neoplasms Research and Treatment (IWG-MRT).

    Science.gov (United States)

    Barosi, G; Tefferi, A; Besses, C; Birgegard, G; Cervantes, F; Finazzi, G; Gisslinger, H; Griesshammer, M; Harrison, C; Hehlmann, R; Hermouet, S; Kiladjian, J-J; Kröger, N; Mesa, R; Mc Mullin, M F; Pardanani, A; Passamonti, F; Samuelsson, J; Vannucchi, A M; Reiter, A; Silver, R T; Verstovsek, S; Tognoni, G; Barbui, T

    2015-01-01

    The discovery of somatic mutations, primarily JAK2V617F and CALR, in classic BCR-ABL1-negative myeloproliferative neoplasms (MPNs) has generated interest in the development of molecularly targeted therapies, whose accurate assessment requires a standardized framework. A working group, comprised of members from European LeukemiaNet (ELN) and International Working Group for MPN Research and Treatment (IWG-MRT), prepared consensus-based recommendations regarding trial design, patient selection and definition of relevant end points. Accordingly, a response able to capture the long-term effect of the drug should be selected as the end point of phase II trials aimed at developing new drugs for MPNs. A time-to-event, such as overall survival, or progression-free survival or both, as co-primary end points, should measure efficacy in phase III studies. New drugs should be tested for preventing disease progression in myelofibrosis patients with early disease in randomized studies, and a time to event, such as progression-free or event-free survival should be the primary end point. Phase III trials aimed at preventing vascular events in polycythemia vera and essential thrombocythemia should be based on a selection of the target population based on new prognostic factors, including JAK2 mutation. In conclusion, we recommended a format for clinical trials in MPNs that facilitates communication between academic investigators, regulatory agencies and drug companies.

  9. Conditional Survival: An Assessment of the Prognosis of Patients at Time Points After Initial Diagnosis and Treatment of Locoregional Melanoma Metastasis.

    Science.gov (United States)

    Haydu, Lauren E; Scolyer, Richard A; Lo, Serigne; Quinn, Michael J; Saw, Robyn P M; Shannon, Kerwin F; Spillane, Andrew J; Stretch, Jonathan R; McCarthy, William H; Thompson, John F

    2017-05-20

    Purpose Standard cancer staging and prognostic estimates are determined at the time of the patient's initial disease presentation. Conditional survival is an alternative, dynamic assessment from follow-up time points after the initial disease diagnosis and is based on the condition of survivorship. Estimates of conditional survival can provide critical prognostic information for patients and clinicians, guide subsequent cancer follow-up schedules, and influence decisions regarding treatments. The current study presents conditional survival estimates developed from a cohort of 4,540 patients diagnosed with stage III melanoma treated at a single institution. Methods Patients with stage III disease at first melanoma diagnosis (initial; n = 2,042), or who developed locoregional metastasis as a first recurrence some time after primary diagnosis (recurrent; n = 2,498), were assessed. Conditional melanoma-specific survival (MSS) estimates up to 5 years after diagnosis were adjusted for age, sex, and 8th edition American Joint Committee on Cancer (AJCC) stage. Results Older age at diagnosis of stage III disease conveyed a worse prognosis at each conditional survival time point. Males had significantly worse MSS outcomes for up to 2 years of conditional survival, after which males and females had similar MSS. For patients with AJCC stage IIIB and stage IIIC disease, MSS outcomes were similar to those of patients with stage IIIA disease after 3 and 5 years of survivorship, respectively. Conclusion Adjuvant systemic treatments may have the greatest benefit when administered within the first 2 years of stage III melanoma diagnosis, during which period prognosis is significantly worse for male patients of increasing age and AJCC substage. Conditional survival estimates illustrate improved survival prospects for patients with cancer returning for follow-up and may define a finite period of increased risk after diagnosis.

  10. A critical evaluation of two point-of-use water treatment technologies: can they provide water that meets WHO drinking water guidelines?

    Science.gov (United States)

    Murphy, Heather M; McBean, Edward A; Farahbakhsh, Khosrow

    2010-12-01

    Point-of-use (POU) technologies have been proposed as solutions for meeting the Millennium Development Goal (MDG) for safe water. They reduce the risk of contamination between the water source and the home, by providing treatment at the household level. This study examined two POU technologies commonly used around the world: BioSand and ceramic filters. While the health benefits in terms of diarrhoeal disease reduction have been fairly well documented for both technologies, little research has focused on the ability of these technologies to treat other contaminants that pose health concerns, including the potential for formation of contaminants as a result of POU treatment. These technologies have not been rigorously tested to see if they meet World Health Organization (WHO) drinking water guidelines. A study was developed to evaluate POU BioSand and ceramic filters in terms of microbiological and chemical quality of the treated water. The following parameters were monitored on filters in rural Cambodia over a six-month period: iron, manganese, fluoride, nitrate, nitrite and Escherichia coli. The results revealed that these technologies are not capable of consistently meeting all of the WHO drinking water guidelines for these parameters.

  11. The impact of rainfall and seasonal variability on the removal of bacteria by a point-of-use drinking water treatment intervention in Chennai, India.

    Science.gov (United States)

    MacDonald, Morgan C; Juran, Luke; Jose, Jincy; Srinivasan, Sekar; Ali, Syed I; Aronson, Kristan J; Hall, Kevin

    2016-01-01

    Point-of-use water treatment has received widespread application in the developing world to help mitigate waterborne infectious disease. This study examines the efficacy of a combined filter and chemical disinfection technology in removing bacterial contaminants, and more specifically changes in its performance resulting from seasonal weather variability. During a 12-month field trial in Chennai, India, mean log-reductions were 1.51 for E. coli and 1.67 for total coliforms, and the highest concentration of indicator bacteria in treated water samples were found during the monsoon season. Analysis of variance revealed significant differences in the microbial load of indicator organisms (coliforms and E. coli) between seasons, storage time since treatment (TST), and samples with and without chlorine residuals. Findings indicate that the bacteriological quality of drinking water treated in the home is determined by a complex interaction of environmental and sociological conditions. Moreover, while the effect of disinfection was independent of season, the impact of storage TST on water quality was found to be seasonally dependent.

  12. Fast and fuzzy multi-objective radiotherapy treatment plan generation for head and neck cancer patients with the lexicographic reference point method (LRPM)

    Science.gov (United States)

    van Haveren, Rens; Ogryczak, Włodzimierz; Verduijn, Gerda M.; Keijzer, Marleen; Heijmen, Ben J. M.; Breedveld, Sebastiaan

    2017-06-01

    Previously, we have proposed Erasmus-iCycle, an algorithm for fully automated IMRT plan generation based on prioritised (lexicographic) multi-objective optimisation with the 2-phase ɛ-constraint (2pɛc) method. For each patient, the output of Erasmus-iCycle is a clinically favourable, Pareto optimal plan. The 2pɛc method uses a list of objective functions that are consecutively optimised, following a strict, user-defined prioritisation. The novel lexicographic reference point method (LRPM) is capable of solving multi-objective problems in a single optimisation, using a fuzzy prioritisation of the objectives. Trade-offs are made globally, aiming for large favourable gains for lower prioritised objectives at the cost of only slight degradations for higher prioritised objectives, or vice versa. In this study, the LRPM is validated for 15 head and neck cancer patients receiving bilateral neck irradiation. The generated plans using the LRPM are compared with the plans resulting from the 2pɛc method. Both methods were capable of automatically generating clinically relevant treatment plans for all patients. For some patients, the LRPM allowed large favourable gains in some treatment plan objectives at the cost of only small degradations for the others. Moreover, because of the applied single optimisation instead of multiple optimisations, the LRPM reduced the average computation time from 209.2 to 9.5 min, a speed-up factor of 22 relative to the 2pɛc method.

  13. Dissolved inorganic carbon, total alkalinity, pH and other variables collected from profile and discrete sample observations using CTD, Niskin bottle, and other instruments from NOAA Ship Fairweather and R/V Point Sur in the U.S. West Coast California Current System during the 2013 West Coast Ocean Acidification Cruise (WCOA2013) from 2013-08-05 to 2013-08-28 (NCEI Accession 0132082)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This archival package contains data from the third dedicated West Coast Ocean Acidification cruise (Expocode:317W20130803, Cruise ID: WCOA2013), which took place...

  14. What Point-of-Use Water Treatment Products Do Consumers Use? Evidence from a Randomized Controlled Trial among the Urban Poor in Bangladesh

    Science.gov (United States)

    Luoto, Jill; Najnin, Nusrat; Mahmud, Minhaj; Albert, Jeff; Islam, M. Sirajul; Luby, Stephen; Unicomb, Leanne; Levine, David I.

    2011-01-01

    Background There is evidence that household point-of-use (POU) water treatment products can reduce the enormous burden of water-borne illness. Nevertheless, adoption among the global poor is very low, and little evidence exists on why. Methods We gave 600 households in poor communities in Dhaka, Bangladesh randomly-ordered two-month free trials of four water treatment products: dilute liquid chlorine (sodium hypochlorite solution, marketed locally as Water Guard), sodium dichloroisocyanurate tablets (branded as Aquatabs), a combined flocculant-disinfectant powdered mixture (the PUR Purifier of Water), and a silver-coated ceramic siphon filter. Consumers also received education on the dangers of untreated drinking water. We measured which products consumers used with self-reports, observation (for the filter), and chlorine tests (for the other products). We also measured drinking water's contamination with E. coli (compared to 200 control households). Findings Households reported highest usage of the filter, although no product had even 30% usage. E. coli concentrations in stored drinking water were generally lowest when households had Water Guard. Households that self-reported product usage had large reductions in E. coli concentrations with any product as compared to controls. Conclusion Traditional arguments for the low adoption of POU products focus on affordability, consumers' lack of information about germs and the dangers of unsafe water, and specific products not meshing with a household's preferences. In this study we provided free trials, repeated informational messages explaining the dangers of untreated water, and a variety of product designs. The low usage of all products despite such efforts makes clear that important barriers exist beyond cost, information, and variation among these four product designs. Without a better understanding of the choices and aspirations of the target end-users, household-based water treatment is unlikely to reduce

  15. What point-of-use water treatment products do consumers use? Evidence from a randomized controlled trial among the urban poor in Bangladesh.

    Directory of Open Access Journals (Sweden)

    Jill Luoto

    Full Text Available There is evidence that household point-of-use (POU water treatment products can reduce the enormous burden of water-borne illness. Nevertheless, adoption among the global poor is very low, and little evidence exists on why.We gave 600 households in poor communities in Dhaka, Bangladesh randomly-ordered two-month free trials of four water treatment products: dilute liquid chlorine (sodium hypochlorite solution, marketed locally as Water Guard, sodium dichloroisocyanurate tablets (branded as Aquatabs, a combined flocculant-disinfectant powdered mixture (the PUR Purifier of Water, and a silver-coated ceramic siphon filter. Consumers also received education on the dangers of untreated drinking water. We measured which products consumers used with self-reports, observation (for the filter, and chlorine tests (for the other products. We also measured drinking water's contamination with E. coli (compared to 200 control households.Households reported highest usage of the filter, although no product had even 30% usage. E. coli concentrations in stored drinking water were generally lowest when households had Water Guard. Households that self-reported product usage had large reductions in E. coli concentrations with any product as compared to controls.Traditional arguments for the low adoption of POU products focus on affordability, consumers' lack of information about germs and the dangers of unsafe water, and specific products not meshing with a household's preferences. In this study we provided free trials, repeated informational messages explaining the dangers of untreated water, and a variety of product designs. The low usage of all products despite such efforts makes clear that important barriers exist beyond cost, information, and variation among these four product designs. Without a better understanding of the choices and aspirations of the target end-users, household-based water treatment is unlikely to reduce morbidity and mortality substantially

  16. What point-of-use water treatment products do consumers use? Evidence from a randomized controlled trial among the urban poor in Bangladesh.

    Science.gov (United States)

    Luoto, Jill; Najnin, Nusrat; Mahmud, Minhaj; Albert, Jeff; Islam, M Sirajul; Luby, Stephen; Unicomb, Leanne; Levine, David I

    2011-01-01

    There is evidence that household point-of-use (POU) water treatment products can reduce the enormous burden of water-borne illness. Nevertheless, adoption among the global poor is very low, and little evidence exists on why. We gave 600 households in poor communities in Dhaka, Bangladesh randomly-ordered two-month free trials of four water treatment products: dilute liquid chlorine (sodium hypochlorite solution, marketed locally as Water Guard), sodium dichloroisocyanurate tablets (branded as Aquatabs), a combined flocculant-disinfectant powdered mixture (the PUR Purifier of Water), and a silver-coated ceramic siphon filter. Consumers also received education on the dangers of untreated drinking water. We measured which products consumers used with self-reports, observation (for the filter), and chlorine tests (for the other products). We also measured drinking water's contamination with E. coli (compared to 200 control households). Households reported highest usage of the filter, although no product had even 30% usage. E. coli concentrations in stored drinking water were generally lowest when households had Water Guard. Households that self-reported product usage had large reductions in E. coli concentrations with any product as compared to controls. Traditional arguments for the low adoption of POU products focus on affordability, consumers' lack of information about germs and the dangers of unsafe water, and specific products not meshing with a household's preferences. In this study we provided free trials, repeated informational messages explaining the dangers of untreated water, and a variety of product designs. The low usage of all products despite such efforts makes clear that important barriers exist beyond cost, information, and variation among these four product designs. Without a better understanding of the choices and aspirations of the target end-users, household-based water treatment is unlikely to reduce morbidity and mortality substantially in urban

  17. Lessons Learned From The 200 West Pump And Treatment Facility Construction Project At The US DOE Hanford Site - A Leadership For Energy And Environmental Design (LEED) Gold-Certified Facility

    Energy Technology Data Exchange (ETDEWEB)

    Dorr, Kent A. [CH2M HILL Plateau Remediation Company, Richland, WA (United States); Ostrom, Michael J. [CH2M HILL Plateau Remediation Company, Richland, WA (United States); Freeman-Pollard, Jhivaun R. [CH2M HILL Plateau Remediation Company, Richland, WA (United States)

    2012-11-14

    CH2M Hill Plateau Remediation Company (CHPRC) designed, constructed, commissioned, and began operation of the largest groundwater pump and treatment facility in the U.S. Department of Energy's (DOE) nationwide complex. This one-of-a-kind groundwater pump and treatment facility, located at the Hanford Nuclear Reservation Site (Hanford Site) in Washington State, was built in an accelerated manner with American Recovery and Reinvestment Act (ARRA) funds and has attained Leadership in Energy and Environmental Design (LEED) GOLD certification, which makes it the first non-administrative building in the DOE Office of Environmental Management complex to earn such an award. There were many contractual, technical, configuration management, quality, safety, and LEED challenges associated with the design, procurement, construction, and commissioning of this $95 million, 52,000 ft groundwater pump and treatment facility. This paper will present the Project and LEED accomplishments, as well as Lessons Learned by CHPRC when additional ARRA funds were used to accelerate design, procurement, construction, and commissioning of the 200 West Groundwater Pump and Treatment (2W P&T) Facility to meet DOE's mission of treating contaminated groundwater at the Hanford Site with a new facility by June 28, 2012.

  18. Pre-treatment mortality and loss-to-follow-up in HIV-1, HIV-2 and HIV-1/HIV-2 dually infected patients eligible for antiretroviral therapy in The Gambia, West Africa

    Directory of Open Access Journals (Sweden)

    Oko Francis

    2011-07-01

    Full Text Available Abstract Background High early mortality rate among HIV infected patients following initiation of antiretroviral therapy (ART in resource limited settings may indicate high pre-treatment mortality among ART-eligible patients. There is dearth of data on pre-treatment mortality in ART programmes in sub-Sahara Africa. This study aims to determine pre-treatment mortality rate and predictors of pre-treatment mortality among ART-eligible adult patients in a West Africa clinic-based cohort. Methods All HIV-infected patients aged 15 years or older eligible for ART between June 2004 and September 2009 were included in the analysis. Assessment for eligibility was based on the Gambia ART guideline. Survival following ART-eligibility was determined by Kaplan-Meier estimates and predictors of pre-treatment mortality determined by Cox proportional hazard models. Result Overall, 790 patients were assessed as eligible for ART based on their clinical and/or immunological status among whom 510 (64.6% started treatment, 26 (3.3% requested transfer to another health facility, 136 (17.2% and 118 (14.9% were lost to follow-up and died respectively without starting ART. ART-eligible patients who died or were lost to follow-up were more likely to be male or to have a CD4 T-cell count Conclusion Approximately one third of ART-eligible patients did not start ART and pre-treatment mortality rate was found high among HIV infected patients in our cohort. CD4 T-cell count

  19. Child malaria treatment decisions by mothers of children less than five years of age attending an outpatient clinic in south-west Nigeria: an application of the PEN-3 cultural model

    Directory of Open Access Journals (Sweden)

    Airhihenbuwa Collins O

    2010-12-01

    Full Text Available Abstract Background Using the PEN-3 cultural model, this study sought to understand mothers treatment decisions about their child febrile illness by examining positive health beliefs and practices held by mothers, examine existential (unique practices that are indigenous to mothers and have no harmful health consequences, and explore negative beliefs and practices that limit recommended responses to febrile illness in children. Methods This qualitative study was conducted in the paediatric section of an outpatient clinic in south-west Nigeria. A total of 123 mothers with children less than five years of age with febrile illness diagnosed as malaria by physicians were individually interviewed on their treatment-seeking practices prior to visiting the clinic and their reasons for attendance at the clinic. Results For some mothers interviewed, effective treatment from the clinic for their child's febrile illness, coupled with physician's approach with malaria diagnosis and treatment practices was important in generating positive maternal treatment-seeking responses to child febrile illness. In addition, beliefs related to a child teething highlighted existential decisions with treatment-seeking for child febrile illness in this setting. Finally, the belief that febrile illness is not all that severe despite noticeable signs and symptoms was a concerning negative perception shared by some mothers in this study. Conclusion The findings highlight the need to consider not only the responses that may serve as barriers to effective treatment, but also an acknowledgment of the positive and existential responses that are equally critical in influencing mothers' management of malaria in their children.

  20. What Sexual Behaviors Relate to Decreased Sexual Desire in Women? A Review and Proposal for End Points in Treatment Trials for Hypoactive Sexual Desire Disorder.

    Science.gov (United States)

    Pyke, Robert; Clayton, Anita

    2017-06-01

    Counts of satisfying sexual events (SSEs) per month have been criticized as an end point in treatment trials of women with hypoactive sexual desire disorder (HSDD) but grounding improvement in sexual desire by assessing changes in sexual behavior remains of some importance. We conducted a literature review to find validated measurements that are specific sexual behavioral correlates of low sexual desire. We compared expert-proposed criteria for dysfunctional desire, expert-developed sets of scale items, and self-rated scales developed before issuance of, or in accordance with, the Food and Drug Administration's guidance on developing patient-reported outcomes. Behavioral measurements of HSDD were isolated from these sets of criteria or scales. We outline a plan to evaluate such behavioral measurements of HSDD with reference to SSEs. Eleven rating scales, four expert-originated and seven self-rated scales mainly derived from patient input were identified as well validated and relevant to HSDD. Three recent sets of diagnostic criteria for conditions such as HSDD were compared with the scales. Twenty-four different symptoms were found in the scales. Content found relevant to HSDD during development of the rating scales varied highly among measurements, including the self-rated scales developed in conformity with current recommendations for patient-reported outcome measurements. The only item on all sets was desire for sexual activity. Four other items were in approximately at least half the sets: sexual thoughts or fantasies, frequency of sexual activity, receptivity, and initiations. Sexual thoughts or fantasies were in every expert-derived set but in only three of the seven patient-derived sets. Receptivity was in five of the seven expert-derived sets vs two of the seven patient-derived sets. Frequency of sexual activity was in one of the seven expert-derived sets but in five of the patient-derived sets. Initiation was in approximately half the two sets. All other

  1. A Cross-sectional Study of Patients' Satisfaction with Dental Care Facilities: A Survey of Adult Treatment at The University of the West Indies, School of Dentistry.

    Science.gov (United States)

    Balkaran, R L; Osoba, T; Rafeek, R

    2014-09-01

    To determine the level of satisfaction with adult dental care at The University of the West Indies (UWI), School of Dentistry, using the Dental Satisfaction Questionnaire (DSQ) developed by Davies and Ware (1982) and to inferentially explore the factors associated with various patients' demographics. A cross-sectional study was performed among adult dental patients attending UWI adult dental clinics. Data were collected using a self- administered, structured questionnaire which consisted of 19 questions on three subscales of pain management, quality and access (total). Sixty-nine per cent were female, 40% were between 45 and 64 years old, and 31.3% had excellent self-rated dental health status. A Dental Satisfaction Index (DSI overall) of 76.42% satisfaction was found, with the highest satisfaction subscale for quality (81.17%), while access (72%) was the lowest occurring subscale. The mean DSI was 3.57 for the UWI emergency dental clinic and 3.87 for the polyclinic. The difference between the DSI overall in the emergency clinic compared to the polyclinic was statistically significant (p dental care at the UWI dental school. Self-rated oral health status may be important in patients' satisfaction. Policies and strategies promoting preventive dental advice are likely to improve patients' satisfaction with dental care and may lead to increased satisfaction with dental services.

  2. Prevalence of body mass index and body weight cut-off points for in vitro fertilization treatment at U.S. clinics and current clinic weight loss strategy recommendations.

    Science.gov (United States)

    Turner-McGrievy, Gabrielle M; Grant, Breănna L

    2015-09-01

    The goal of this study was to determine how many clinics providing in vitro fertilization (IVF) in the United States require a body mass index (BMI) or body weight cut-off point to determine treatment eligibility. US clinics listed as members on the Society of Assisted Reproduction website in late 2013 were contacted by phone between January and March 2014. Clinic personnel were asked if a BMI or body weight cut-off points was used to determine IVF treatment eligibility and what strategies they recommended for their patients to achieve a healthy body weight. Of the 379 clinics contacted, 347 responded (92% response rate) and 35% (n = 120) reported using a BMI or body weight cut-off points to determine eligibility for IVF treatment. Mean BMI (± SD) cut-off points was 38.4 ± 5.2 kg/m(2) and mean body weight (± SD) cut-off points was 130.2 ± 14.8 kg. Of the clinics using a set cut-off points, half (46%) provided no weight loss recommendations for patients. A sizable portion of US IVF clinics report a required or preferred BMI or body weight cut-off points for treatment. Despite this, most clinics did not provide a recommended program or approach for weight loss with very few clinics reporting an in-house program.

  3. US west coast

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Aerial surveys are conducted along the US west coast to determine distribution and abundance of endangered leatherback turtles (Dermochelys coriacea), loggerhead...

  4. A Large-Area Nanoplasmonic Sensor Fabricated by Rapid Thermal Annealing Treatment for Label-Free and Multi-Point Immunoglobulin Sensing.

    Science.gov (United States)

    Lin, Hana Tzu-Han; Yang, Chuan-Kai; Lin, Chi-Chen; Wu, Albert Meng-Hsin; Wang, Lon A; Huang, Nien-Tsu

    2017-05-02

    Immunoglobulins are important biomarkers to evaluate the immune status or development of infectious diseases. To provide timely clinical treatments, it is important to continuously monitor the level of multiple immunoglobulins. Localized surface plasmon resonance (LSPR)-based nanoplasmonic sensors have been demonstrated for multiplex immunoglobulins detection. However, the sensor fabrication process is usually slow and complicated, so it is not accessible for large-area and batch fabrication. Herein, we report a large-area (2 cm × 2 cm) nanofabrication method using physical vapor deposition followed by a rapid thermal annealing treatment. To optimize the sensor performance, we systematically characterized three fabrication conditions, including (1) the deposition thickness; (2) the maximum annealing temperature, and (3) the annealing time. The corresponding absorbance spectrum profile and surface morphology of the nanostructures were observed by a UV-VIS spectrometer and atomic force microscopy. We then tested the sensitivity of the sensor using a glucose solution at different concentrations. The results showed that the sensor with 10 nm gold deposition thickness under 5-min 900 °C rapid thermal annealing can achieve the highest sensitivity (189 nm RIU-1). Finally, we integrated this nanoplasmonic sensor with a microchannel and a motorized stage to perform a 10-spot immunoglobulin detection in 50 min. Based on its real-time, dynamic and multi-point analyte detection capability, the nanoplasmonic sensor has the potential to be applied in high-throughput or multiplex immunoassay analysis, which would be beneficial for disease diagnosis or biomedical research in a simple and cost-effective platform.

  5. West African Journal of Medicine

    African Journals Online (AJOL)

    The West African Journal of Medicine is owned by the West African College of Physicians and the West African College of Surgeons. Aims: The aims of the Journal are: To provide a medium for international dissemination of information about medical science in West Africa and elsewhere. To furnish a means whereby ...

  6. Estudo das alterações do ponto B durante o tratamento ortodôntico Study of the point B alterations during orthodontic treatment

    Directory of Open Access Journals (Sweden)

    José Soares Marques

    2007-06-01

    exame inicial.AIM: The authors of this study evaluated and compared if alterations in point B region could occur as a result of orthodontic treatment conducted with or without the extraction of the four first premolars. METHODS: Thirty young females, dolicofacials, with Class II, division 1 maloclusion, mean age of 12,3 years in the beginning of the treatment were evaluated cephalometrically. Fifteen of the young females were submitted to extractions of the four first premolars while the remaining fifteen were not. Four cephalometric measurements (IMPA, 1-ND, B-ND and Bperp-GoMe were evaluated and data was analyzed by the Kruskall-Wallis test, Friedman test and Pearson's correlation. RESULTS: The IMPA measurement had a tendency to increase within the group without extractions, but in contrast was significantly decreased within the group with extractions. The 1-ND measurement exhibited a decrease in the group with extractions and a small increase in the other group. The B-ND measurement was slightly decreased in the group with extractions, was not altered in the other group, and significant differences were not observed between these two groups. The Bperp-GoMe measurement was increased in both groups. A positive correlation was observed between IMPA, 1-ND and B-ND in the extraction group, since a decrease of the IMPA implied in a decrease of the 1-ND and a lingual localization of the point B. CONCLUSIONS: Together, these results showed that the orthodontic treatment lead to alterations in point B, towards an anteroposterior position, and a tendency of lingual movement in the extraction group. The vertical evaluation revealed significant alterations in point B in both groups since measurement at the end of the treatment was significantly higher than the one in the beginning.

  7. practice points

    African Journals Online (AJOL)

    Gupta P]. Consulting Proetologist, Gupta Nursing Home, D/ 9, Laxminagar,. NAGPUR- 440022, INDIA. Abstract ... of distinction with other ano-perianal lesions and the best possible approach towards the treatment of the ... African Health Sciences Vol 5 No 4 December 2005 encountered anorectal tuberculous lesions are ...

  8. Performance Of West African Dwarf Sheep Fed Diets Supplemented ...

    African Journals Online (AJOL)

    An experiment to investigate the possible growth promoting effect of rare earth elements (REE) in growing West African dwarf sheep as well as their influence on the haematological and blood serum biochemical changes was conducted for 12 weeks. Forty West African dwarf sheep were allotted to four dietary treatments: a ...

  9. Final Report of the West Point Study Group

    Science.gov (United States)

    1977-07-27

    th Complex Quantum Analysis Mechanics Second MAt AU mm Class Linear Electricity & Algebra Magn ism(junior) -- •#-- Third BA th AD B=I Class...low- ering class standing, thereby adversely affecting branch selection, choice of first duty station, and lineal rank in the Regular Army. 112 The

  10. The West Point Treason in American Drama, 1798-1891.

    Science.gov (United States)

    Shillingsburg, Miriam J.

    1978-01-01

    Discusses several plays concerning the treason of Benedict Arnold to demonstrate the changing taste in nineteenth century American drama. The plays move from neoclassic--with the depiction of the tragic stature of Andre--through the more melodramatic and gothic emphasis on Arnold's vengeful treachery to the unqualified romantic heroism of…

  11. Educating Future Leaders about Space at West Point

    Science.gov (United States)

    2011-01-01

    structure, and cosmology . A secondary outcome of the course is to make Space topics more relevant to current Army operations by providing an...expert systems. In-class practical exercises and laboratory assignments complement the lectures by providing hands-on experience with a variety of

  12. Trends in drop out, drug free discharge and rates of re-presentation: a retrospective cohort study of drug treatment clients in the North West of England

    Directory of Open Access Journals (Sweden)

    McVeigh Jim

    2006-08-01

    Full Text Available Abstract Background Governments aim to increase treatment participation by problematic drug users. In the UK this has been achieved by fiscal investment, an expanded workforce, reduced waiting times and coercive measures (usually criminal justice (CJ led. No assessment of these measures on treatment outcomes has been made. Using established monitoring systems we assessed trends in 'dropped out' and 'discharged drug free' (DDF, since the launch of the national drug strategy, and rates of treatment re-presentation for these cohorts. Methods A longitudinal dataset of drug users (1997 to 2004/05, n = 26,415 was used to identify people who dropped out of, and were DDF from, services for years 1998 to 2001/02, and re-presentations of these people in years to 2004/05. Trends in drop out and DDF, baseline comparisons of those DDF and those who dropped out and outcome comparisons for those referred from the CJ system versus other routes of referral were examined using chi square. Logistic regression analyses identified variables predicting drop out versus DDF and subsequent re-presentation versus no re-presentation. Results The proportion of individuals dropping out has increased from 7.2% in 1998 to 9.6% in 2001/02 (P Conclusion Increasing numbers in treatment is associated with an increased proportion dropping out and an ever-smaller proportion DDF. Rates of drop out are significantly higher for those coerced into treatment via the CJ system. Rates of re-presentation are similar for those dropping out and those DDF. Encouragingly, those who need to re-engage with treatment, particularly those who drop out, are doing so more quickly. The impact of coercion on treatment outcomes and the appropriateness of aftercare provision require further consideration.

  13. IDRC in the West Bank and Gaza

    International Development Research Centre (IDRC) Digital Library (Canada)

    biomedical treatment of psychological trauma resulting from violent conflict. The public view on security. In August 2009, the Palestinian authority committed to modernizing public secu- rity services in the West Bank and Gaza. In the months following that commit- ment, the Palestinian Centre for Policy and Survey Research ...

  14. 76 FR 67637 - West Virginia Regulatory Program

    Science.gov (United States)

    2011-11-02

    ... 38, Series 2. Enrolled Committee Substitute for Senate Bill No. 121 (SB 121) passed the West Virginia..., annuity or both to guarantee treatment of long-term postmining pollutional discharges in lieu of posting a... public review, we cannot guarantee that we will be able to do so. Public Hearing If you wish to speak at...

  15. Experience of adjunctive cannabis use for chronic non-cancer pain: findings from the Pain and Opioids IN Treatment (POINT) study.

    Science.gov (United States)

    Degenhardt, Louisa; Lintzeris, Nicholas; Campbell, Gabrielle; Bruno, Raimondo; Cohen, Milton; Farrell, Michael; Hall, Wayne D

    2015-02-01

    There is increasing debate about cannabis use for medical purposes, including for symptomatic treatment of chronic pain. We investigated patterns and correlates of cannabis use in a large community sample of people who had been prescribed opioids for chronic non-cancer pain. The POINT study included 1514 people in Australia who had been prescribed pharmaceutical opioids for chronic non-cancer pain. Data on cannabis use, ICD-10 cannabis use disorder and cannabis use for pain were collected. We explored associations between demographic, pain and other patient characteristics and cannabis use for pain. One in six (16%) had used cannabis for pain relief, 6% in the previous month. A quarter reported that they would use it for pain relief if they had access. Those using cannabis for pain on average were younger, reported greater pain severity, greater interference from and poorer coping with pain, and more days out of role in the past year. They had been prescribed opioids for longer, were on higher opioid doses, and were more likely to be non-adherent with their opioid use. Those using cannabis for pain had higher pain interference after controlling for reported pain severity. Almost half (43%) of the sample had ever used cannabis for recreational purposes, and 12% of the entire cohort met criteria for an ICD-10 cannabis use disorder. Cannabis use for pain relief purposes appears common among people living with chronic non-cancer pain, and users report greater pain relief in combination with opioids than when opioids are used alone. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  16. Solar disinfection (SODIS): simulation of solar radiation for global assessment and application for point-of-use water treatment in Haiti.

    Science.gov (United States)

    Oates, Peter M; Shanahan, Peter; Polz, Martin F

    2003-01-01

    Haiti and other developing countries do not have sufficient meteorological data to evaluate if they meet the solar disinfection (SODIS) threshold of 3-5 h of solar radiation above 500 W/m2, which is required for adequate microbial inactivation in drinking water. We have developed a mathematical model based on satellite-derived daily total energies to simulate monthly mean, minimum, and maximum 5-h averaged peak solar radiation intensities. This model can be used to assess if SODIS technology would be applicable anywhere in the world. Field measurements were made in Haiti during January 2001 to evaluate the model and test SODIS efficacy as a point-of-use treatment option. Using the total energy from a measured solar radiation intensity profile, the model recreated the intensity profile with 99% agreement. NASA satellite data were then used to simulate the mean, minimum, and maximum 5-h averaged peak intensities for Haiti in January, which were within 98.5%, 62.5%, and 86.0% agreement with the measured values, respectively. Most of the discrepancy was attributed to the heterogeneous nature of Haiti's terrain and the spatial resolution of the NASA data. Additional model simulations suggest that SODIS should be effective year-round in Haiti. Actual SODIS efficacy in January was tested by the inactivation of total coliform, E. coli, and H2S-producing bacteria. Exposure period proved critical. One-day exposure achieved complete bacterial inactivation 52% of the time, while a 2-day exposure period achieved complete microbial inactivation 100% of the time. A practical way of providing people with cold water every morning that has undergone a 2-day exposure would be to rotate three groups of bottles every morning, so two groups are out in the sun and one is being used for consumption.

  17. Hydrogeologic and water-quality data from well clusters near the wastewater-treatment plant, U.S. Marine Corps Air Station, Cherry Point, North Carolina

    Science.gov (United States)

    Murray, L.C.; Daniel, C. C.

    1990-01-01

    Hydrogeologic and ground-water quality data were collected near the wastewater-treatment plant and associated polishing lagoons at the Marine Corps Air Station, Cherry Point, North Carolina, in 1988. Between March and May 1988, two observation wells were installed upgradient and six wells were installed downgradient of the polishing lagoons and sampled for organic and inorganic U.S. Environmental Protection Agency priority pollutants. Placement of the well screens allowed sampling from both the upper and lower parts of the surficial aquifer. Natural gamma-ray geophysical logs were run in the four deepest wells. Lithologic logs were prepared from split-spoon samples collected during the drilling operations. Laboratory hydraulic conductivity tests were conducted on samples of fine-grained material recovered from the two confining units that separate the surficial aquifer and the drinking-water supply aquifer; values ranged from 0.011 to 0.014 foot per day (4x10-6 to 5x10-6 centimeters per second). Static water levels were recorded on April 25, 1988. Relatively low concentrations of purgeable organic compounds (up to 2.2 micrograms per liter for dichlorodifluoromethane), acid and base/neutral extractable compounds (up to 58 micrograms per liter for bis(2-ethylhexyl) phthalate), or pesticides (up to 0.03 micrograms per liter for diazinon and methyl parathion) were detected in water samples collected from all of the wells. Trace metals were detected in concentrations above minimum detectable limits in all of the wells and were found to be higher in water samples collected from the downgradient wells (up to 320 micrograms per liter for zinc) than in water samples from the upgradient wells.

  18. West African crystalline maculopathy.

    Science.gov (United States)

    Browning, David J

    2004-05-01

    To report new observations in West African crystalline maculopathy. Retrospective, observational case series. Three patients drawn from a private retina practice. Review of clinical charts and photographic studies. Distribution of intraretinal crystals and changes after laser photocoagulation, and history of ingesting foods typical in a West African diet but atypical for an American diet. All patients were older than 50 years, had diabetic retinopathy, ate green vegetables not found in American diets, and showed no deleterious effects of the crystals. Kola nut ingestion in 2 patients was remote and sparse, and was unknown in a third patient. The first 2 affected patients originating outside the Ibo tribe of Nigeria are reported. The pattern of retinal crystals can be changed, and the quantity of crystals reduced, by laser photocoagulation of associated diabetic retinopathy. West African crystalline retinopathy is distinguishable from other causes of crystalline retinopathy. It may reflect a component of the West African diet, seems to have diabetic retinopathy as a promoting factor via breakdown of the blood-retina barrier, and can be modified by laser photocoagulation of diabetic retinopathy. Increased awareness of the condition will allow physicians seeing West African immigrants to make the diagnosis and treat the patients appropriately.

  19. Alleyway Points

    DEFF Research Database (Denmark)

    Lunde Nielsen, Espen; Kruse Aagaard, Anders

    2017-01-01

    topografier. Alleyway Points består af en række eksperimenter, som søger at udforske denne sammenvævning af disse to parallelle domæner gennem en pendulering imellem det fysiske og det digitale. En gyde danner rammen om disse forsøg, hvor den etablerede punktsky i sig selv bliver anskuet som en digital......Forskelligartede former for fotogrammetri og 3D-scanning muliggør indfangelse af den fysiske verden i det digitale domæne. Dette har vist sig instrumentelt i et utal af forskellige henseender. Når virkeligheden bliver digitaliseret, bliver den frigjort fra sine materielle forpligtigelser: der er...... dialog og pendulering mellem de to domæner, hvor grænsen mellem, hvad der kan anskues som det virkelige og repræsentionen deraf, bliver gradvis mere utydelig. Dette adskiller sig fra to dominerende diskurser inden for arbejdsgange mellem det virkelige og det digitale, der ofte er ensrettede bevægelser...

  20. Prevalence of metabolic syndrome in human immunodeficiency virus - infected patients from the South-West region of Cameroon, using the adult treatment panel III criteria.

    Science.gov (United States)

    Mbunkah, Herbert Afegenwi; Meriki, Henry Dilonga; Kukwah, Anthony Tufon; Nfor, Omarine; Nkuo-Akenji, Theresa

    2014-01-01

    Several studies have reported that the metabolic syndrome (MS) is more common in subjects with HIV infection than in HIV-negative individuals. HIV infection and the use of Highly Active Antiretroviral Therapy (HAART) have been shown to predispose HIV-infected persons to MS. In this study, we report the prevalence of MS in Cameroonian HIV-infected subjects receiving different combinations of HAART as well as HIV patients who have never received antiretroviral drugs. In this cross-sectional study, 173 treated and untreated HIV-infected out-patients (aged 18-70 years) managed at the Buea and Limbe Regional Hospitals and 50 seronegative individuals (controls) were recruited after obtaining their consent. Ethical approval for this study was obtained from the National Ethics Committee of Cameroon. Metabolic syndrome prevalence was examined using the U.S. National Cholesterol Education Program Adult Treatment Panel III (ATPIII) criteria. Data was analyzed using SPSS® (Statistical Package for the Social Sciences, SPSS Inc., Chicago, IL, USA) version 16. Statistical significance was set at p treatment with HAART may predispose HIV patients to developing cardiovascular diseases and diabetes, in spite of improvements in morbidity and mortality conferred by immune reconstitution as a result of HAART treatment.

  1. Islam and the West

    Directory of Open Access Journals (Sweden)

    Mohd. Kamal Hassan

    1997-06-01

    Full Text Available The scientific and technological developments during the 18th and' the 19th centuries ensured material progress of the West, as well as emergence of the West as the dominating power which colonized the rest of the world. During the post-colonial phase, Islam emerged as a revitalized sociopolitical force. This has been mistaken as a threat by the West, and Islam has been portrayed as the "new enemy after the demise of communism. This is partly an effort to establish a Western identity, which is disintegrating due to lack of a challenge; and partly a reflection of the failure of Muslims to realize the social and ethical ideals of Islam.

  2. A study to determine the effectiveness of chiropractic manipulative therapy and chiropractic manipulative therapy combined with myofascial trigger point therapy in the treatment of chronic mechanical posterior cervical spine pain

    OpenAIRE

    2014-01-01

    M.Tech. (Chiropractic) This unblinded, controlled pilot study was conducted in order to compare the effectiveness of chiropractic manipulative therapy with that of a combined therapy involving chiropractic manipulative therapy and myofascial trigger point therapy (dry needling technique and passive stretching), in the treatment of chronic mechanical posterior cervical spine pain. In executing the comparison, it was hypothesised that both treatment protocols would be effective, but that the...

  3. Effectiveness of Fixed Dose Radioactive Iodine (RAI for the Treatment of Hyperthyroidism: Experience of a Teaching Hospital in South West Nigeria

    Directory of Open Access Journals (Sweden)

    Karounwi Omotayo Ogunjobi

    2013-08-01

    Full Text Available Objective: Using radioactive iodine (RAI as the first line therapy for Graves’ hyperthyroidism and as the treatment of choice for relapsed Graves’ disease is increasing in recent times. However, there has been little consensus on the most appropriate dose to use. So this study is to determine the response of hyperthyroidism to fixed doses of 370 MBq and 555 MBq RAI therapies and determine the incidence of hypothyroidism at 6 months post therapy. Methods: Hyperthyroid patients’ case records treated with radioiodine was retrospectively reviewed to determine the response rate of hyperthyroidism to the two fixed dose regimens. Statistical analysis was done with SPSS version 15.0 and the level of statistical significance was taken as p<0.05. Forty subjects, 6 males (15% and 34 females (85% received RAI therapy for Graves’ hyperthyroidism, mean age was 49.4 years (range, 25-75years. The thyroid function status at 6 months post therapy was available for all subjects. 24 patients (60% received 370 MBq while 16 patients (40% received 555 MBq. Results: The response for fixed doses of 370 MBq and 555 MBq were similar (100%. Also, the incidence of hypothyroidism in these subjects which was 66.6% with fixed dose of 370 MBq and 62.5% with fixed dose of 555 MBq within 6 months post RAI therapy were similar. Conclusion: SRAI is highly effective for the treatment of hyperthyroidism, with a cure rate of 100%. However, it has proved impossible to determine a fixed dose regimen for individual patients accurately to guarantee an euthyroid state. This is because hypothyroidism is a natural predictable sequel of RAI therapy.

  4. West Virginia: Library Automation.

    Science.gov (United States)

    Brown, Thomas M., Ed.

    1996-01-01

    Reviews library automation efforts in West Virginia. Topics include information equity and rural areas, library systems and resource sharing, statewide connectivity, a higher education telecomputing network that has expanded to include elementary and secondary school libraries, multitype library cooperation and staff training, and academic library…

  5. The great West Road

    CERN Multimedia

    1975-01-01

    From right to centre the 'Nationale 84' relying Meyrin to Saint-Genis. The fence limits Lab I on that side. From bottom the road leading to the double inclined tunnel linking Lab I and Lab II. On the foreground the ISR building (left) and the West Hall (centre).

  6. JPRS Report, West Europe.

    Science.gov (United States)

    1988-07-20

    Andalusia , along with a revision of its system of financing retirement and health costs. Its rate of macroeconomic growth now looks low compared...between certain factions of Islam (particularly the Shiites) and the open hostility to the West could pose formidable political problems. This is why

  7. From East to West

    NARCIS (Netherlands)

    Ria Vogels; Simone de Roos; Freek Bucx

    2017-01-01

    Original title: Van oost naar west The accession of Poland to the European Union in 2004, followed by Bulgaria and Romania in 2007, has led to an increase in the number of migrants coming from those countries to the Netherlands. How are the children of these migrants faring in the Netherlands? Are

  8. Temperature, salinity, dissolved oxygen, and other variables collected from profile observations using CTD and other instruments from NOAA Ship FAIRWEATHER and R/V POINT SUR in the West Coast of the United States from 5 Aug to 2013-08-28 (NODC Accession 0119491)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This data set contains the CTD measurements collected by Dr. Gregory C. Johnson of the Pacific Marine Environmental Laboratory during the West Coast Ocean...

  9. Mortality and loss to programme before antiretroviral therapy among HIV-infected children eligible for treatment in The Gambia, West Africa

    Directory of Open Access Journals (Sweden)

    Okomo Uduak

    2012-10-01

    Full Text Available Abstract Background HIV infection among children, particularly those under 24 months of age, is often rapidly progressive; as a result guidelines recommend earlier access to combination antiretroviral therapy (cART for HIV infected children. Losses to follow-up (LTFU and death in the interval between diagnosis and initiation of ART profoundly limit this strategy. This study explores correlates of LTFU and death prior to ART initiation among children. Methods The study is based on 337 HIV-infected children enrolled into care at an urban centre in The Gambia, including those alive and in care when antiretroviral therapy became available and those who enrolled later. Children were followed until they started ART, died, transferred to another facility, or were LTFU. Cox proportional hazards regression models were used to determine the hazard of death or LTFU according to the baseline characteristics of the children. Results Overall, 223 children were assessed as eligible for ART based on their clinical and/or immunological status among whom 73 (32.7% started treatment, 15 (6.7% requested transfer to another health facility, 105 (47.1% and 30 (13.5% were lost to follow-up and died respectively without starting ART. The median survival following eligibility for children who died without starting treatment was 2.8 months (IQR: 0.9 - 5.8 with over half (60% of all deaths occurring at home. ART-eligible children less than 2 years of age and those in WHO stage 3 or 4 were significantly more likely to be LTFU when compared with their respective comparison groups. The overall pre-treatment mortality rate was 25.7 per 100 child-years of follow-up (95% CI 19.9 - 36.8 and the loss to programme rate was 115.7 per 100 child-years of follow-up (95% CI 98.8 - 137. In the multivariable Cox proportional hazard model, significant independent predictors of loss to programme were being less than 2 years of age and WHO stage 3 or 4. The Adjusted Hazard Ratio

  10. Impact of intermittent preventive anti-malarial treatment on the growth and nutritional status of preschool children in rural Senegal (west Africa).

    Science.gov (United States)

    Ntab, Balthazar; Cissé, Badara; Boulanger, Denis; Sokhna, Cheikh; Targett, Geoffrey; Lines, Jo; Alexander, Neal; Trape, Jean-François; Simondon, François; Greenwood, Brian M; Simondon, Kirsten B

    2007-09-01

    Negative consequences of malaria might account for seasonality in nutritional status in children in the Sahel. We report the impact of a randomized, double-blind, placebo-controlled trial of seasonal intermittent preventive anti-malarial treatment on growth and nutritional status in 1,063 Senegalese preschool children. A combination of artesunate and sulfadoxine-pyrimethamine was given monthly from September to November. In the intervention arm, mean weight gain was significantly greater (122.9 +/- 340 versus 42.9 +/- 344 [SD] g/mo, P < 0.0001) and losses in triceps and subscapular skinfold measurements were less (-0.39 +/- 1.01 versus -0.66 +/- 1.01 mm/mo, and -0.15 +/- 0.64 versus -0.36 +/- 0.62 mm/mo, respectively, P < 0.0001 for both). There was no difference in height increments. The prevalence of wasting increased significantly in the control arm (4.6% before versus 9.5% after, P < 0.0001), but remained constant in intervention children: 5.6% versus 7.0% (P = 0.62). The prevention of malaria would improve child nutritional status in areas with seasonal transmission.

  11. Design and manufacturing of WEST Baffle

    Energy Technology Data Exchange (ETDEWEB)

    Batal, Tristan, E-mail: tristan.batal@cea.fr [CEA, IRFM, F-13108 Saint-Paul-Lez-Durance (France); Firdaouss, Mehdi; Richou, Marianne; Ferlay, Fabien; Larroque, Sébastien; Gargiulo, Laurent [CEA, IRFM, F-13108 Saint-Paul-Lez-Durance (France); Dupas, Timothée [SODITECH Ingénierie SA, 1 bis allée des gabians, 06150 Cannes la Bocca (France); Verger, Jean-Marc; Doceul, Louis; Samaille, Franck; Bucalossi, Jérôme [CEA, IRFM, F-13108 Saint-Paul-Lez-Durance (France); Salami, Michael [AVANTIS groupe, 12 route de Saint Mathieu, 06130 Grasse (France)

    2015-10-15

    Highlights: • Disruption's torque in the PFC was simulated thanks to ANSYS. • The ANSYS thermal results comply with WEST project requirements. • The cycling analysis complies with WEST project requirements. • 316L components comply with A level RCC-MRx criteria. - Abstract: The Tore Supra tokamak is being transformed in an X-point divertor fusion device in the frame of the WEST project, launched in support to the Iter tungsten divertor strategy. The WEST Baffle aims to evacuate particles by creating a toroidal pumping throat. It also protects the lower divertor cooling pipes and the passive stabilization plate from heat fluxes. The Baffle is made of actively cooled plasma facing components (PFCs), with underneath a passive stabilization plate and a support beam. The Baffle design is presented in a first part. In a second time the different ANSYS simulations are described: electromagnetic, thermal and mechanical results are presented. The design choices are justified for the different results obtained thanks to the simulation. In a final part, some aspects of the PFC manufacturing are presented.

  12. A study of the provision of hospital based dental General Anaesthetic services for children in the North West of England: Part 2--the views and experience of families and dentists regarding service needs, treatment and prevention.

    Science.gov (United States)

    Goodwin, Michaela; Pretty, Iain A; Sanders, Caroline

    2015-04-09

    Patterns of service delivery and the organisation of Dental General Anaesthesia (DGA) have been found to differ across hospitals. This paper reports on qualitative research aimed to understand the impact of such variation by exploring views and experiences of families receiving care in different hospital sites, as well as dentists involved in referral and delivery of care. Qualitative semi-structured interviews were conducted with 26 people comprising parents (n = 15), dentists working in primary care (n = 6) and operating dentists (n = 5) in relation to DGA. Participants were recruited from areas across the North West of England to ensure a variety referral and treatment experiences were captured. Field notes were made during visits to all settings included in the study and explored alongside interview transcripts to elicit key themes. A variety of positive and negative impacts on children and parents throughout the referral process and operation day were apparent. Key themes established were clustered around three key topics: 1. Organisational and professional concerns regarding referrals, delivery of treatment and prevention. 2. The role of hospital environment and routine on the emotional experiences of children. 3. The influence of the wider social context on dental health. These findings suggest the need and perceived value of: tailored services for children (such as play specialists) and improved information, such as clear guidance regarding wait times and what is to be expected on the day of the procedure. These features were viewed to be helpful in alleviating the stress and anxiety often associated with DGA. While some elements will always be restricted in part to the hospital setting in which they occur, there are several aspects where best practice could be shared amongst hospitals and, where issues such as wait times have been acknowledged, alternative pathways can be explored in order to address areas which can impact negatively on children.

  13. West Nile Virus: Review of the Literature

    Science.gov (United States)

    Petersen, Lyle R.; Brault, Aaron C.; Nasci, Roger S.

    2015-01-01

    IMPORTANCE Since its introduction in North America in 1999,West Nile virus has produced the 3 largest arboviral neuroinvasive disease outbreaks ever recorded in the United States. OBJECTIVE To review the ecology, virology, epidemiology, clinical characteristics, diagnosis, prevention, and control of West Nile virus, with an emphasis on North America. EVIDENCE REVIEW PubMed electronic database was searched through February 5, 2013. United States national surveillance data were gathered from the Centers for Disease Control and Prevention. FINDINGS West Nile virus is now endemic throughout the contiguous United States, with 16 196 human neuroinvasive disease cases and 1549 deaths reported since 1999. More than 780 000 illnesses have likely occurred. To date, incidence is highest in the Midwest from mid-July to early September. West Nile fever develops in approximately 25% of those infected, varies greatly in clinical severity, and symptoms may be prolonged. Neuroinvasive disease (meningitis, encephalitis, acute flaccid paralysis) develops in less than 1% but carries a fatality rate of approximately 10%. Encephalitis has a highly variable clinical course but often is associated with considerable long-term morbidity. Approximately two-thirds of those with paralysis remain with significant weakness in affected limbs. Diagnosis usually rests on detection of IgM antibody in serum or cerebrospinal fluid. Treatment is supportive; no licensed human vaccine exists. Prevention uses an integrated pest management approach, which focuses on surveillance, elimination of mosquito breeding sites, and larval and adult mosquito management using pesticides to keep mosquito populations low. During outbreaks or impending outbreaks, emphasis shifts to aggressive adult mosquito control to reduce the abundance of infected, biting mosquitoes. Pesticide exposure and adverse human health events following adult mosquito control operations for West Nile virus appear negligible. CONCLUSIONS AND

  14. REMOVAL OF CHEMICAL AND MICROBIAL CONTAMINANTS IN DRINKING WATER - WATTS PREMIER M-2400 POINT-OF-ENTRY REVERSE OSMOSIS DRINKINGWATER TREATMENT SYSTEM

    Science.gov (United States)

    The Watts Premier M-2400 POE RO Drinking Water Treatment System was tested at the NSF Drinking Water Treatment Systems Laboratory for removal of the viruses fr and MS2, the bacteria Brevundimonas diminuta, and chemicals aldicarb, benzene, cadmium, carbofuran, cesium, chl...

  15. Concurrent inhibition of TGF-beta and mitogen driven signaling cascades in Dupuytren's disease - Non-surgical treatment strategies from a signaling point of view

    NARCIS (Netherlands)

    Krause, C.; Kloen, P.

    2012-01-01

    Dupuytren's disease (DD) is a benign progressive fibro-proliferative disorder of the fascia palmaris of the hand. Currently, treatment consists of surgical excision with a relatively high recurrence rate and risk of complications. To improve long-term outcome of DD treatment, research focus has

  16. The effect of post-processing treatments on inflection points in current–voltage curves of roll-to-roll processed polymer photovoltaics

    DEFF Research Database (Denmark)

    Lilliedal, Mathilde Raad; Medford, Andrew James; Vesterager Madsen, Morten

    2010-01-01

    Inflection point behaviour is often observed in the current–voltage (IV) curve of polymer solar cells. This phenomenon is examined in the context of flexible roll-to-roll (R2R) processed polymer solar cells in a large series of devices with a layer structure of: PET–ITO–ZnO–P3HT:PCBM–PEDOT:PSS–Ag...

  17. West Virginia's Forests 2008

    Science.gov (United States)

    Richard H. Widmann; Gregory W. Cook; Charles J. Barnett; Brett J. Butler; Douglas M. Griffith; Mark A. Hatfield; Cassandra M. Kurtz; Randall S. Morin; W. Keith Moser; Charles H. Perry; Ronald J. Piva; Rachel Riemann; Christopher W. Woodall

    2012-01-01

    The first full annual inventory of West Virginia's forests reports 12.0 million acres of forest land or 78 percent of the State's land area. The area of forest land has changed little since 2000. Of this land, 7.2 million acres (60 percent) are held by family forest owners. The current growing-stock inventory is 25 billion cubic feet--12 percent more than in...

  18. The West Heslerton Assessment

    Directory of Open Access Journals (Sweden)

    Dominic Powlesland

    1999-03-01

    Full Text Available The excavation of the Early Anglo-Saxon or Anglian Settlement at West Heslerton, North Yorkshire, between 1986 and 1995, represents one of the largest excavations conducted in Britain in the last two decades. The project, funded by English Heritage, combined the fundamental needs of rescue and research archaeology. The excavation has produced a wealth of new evidence which is forcing us to re-evaluate much that has been said about the formative period of the English nation.

  19. West and Central Africa.

    Science.gov (United States)

    Lydie, N; Robinson, N J

    1998-01-01

    This article reviews scientific and other literature during the 1990s that links migration and mobility with the spread of sexually transmitted diseases (STDs), including HIV/AIDS. The focus is on key population groups linked to the spread of HIV and STDs in West and Central Africa: migrant laborers, truck drivers, itinerant traders, commercial sex workers (CSWs), and refugees. Countries with high emigration and immigration tend to have high levels of HIV infection, with the exception of Senegal. The main destination of immigrants are Senegal, Nigeria, and Cote d'Ivoire in West Africa and Cameroon, Congo, Gabon, and Congo in Central Africa. The risk of infection and the spread of HIV is variable among migrants. There is little in the literature that substantiates hypotheses about the strong association between migration and HIV-positive status. Information is needed on the duration, frequency of return visits, living conditions, sexual activities with multiple partners, and information before departure, along the routes, at final destination, and at the time of returns. Action-based research in five West African countries (Burkina Faso, Cote d'Ivoire, Mali, Niger, and Senegal) should produce results in late 1998. Comparable studies in Central Africa are unknown. Regional studies should be complemented by local studies. Prevention would benefit from studies on the relative size of these five population groups by geographic location.

  20. Can pretreatment screening for dhps and dhfr point mutations in Plasmodium falciparum infections be used to predict sulfadoxine-pyrimethamine treatment failure?

    Science.gov (United States)

    Omar, S A; Adagu, I S; Warhurst, D C

    2001-01-01

    This study examines the relationship between malaria treatment failure after sulfadoxine-pyrimethamine (S-P) chemotherapy and presence of mutations in the Plasmodium falciparum dihydropteroate synthase (dhps) and dihydrofolate reductase (dhfr) genes (associated with resistance in vitro to S and P) before treatment. In Kenya, 38 malaria patients in a holoendemic area, and 21 in an epidemic area, participated in the trial in 1997-98. In the 2 areas, drug failure occurred in 76% and 75% of cases where any mutation in dhfr was seen (positive predictive values 76% and 75%: P = 0.003 and 0.008) and an identical association was seen with dhfr Asn-108. In the holoendemic area all occurrences of > or = 2 mutations in dhfr predicted drug failure. Only 3 instances were seen in the epidemic focus, but treatment failed in all. Only in the epidemic focus, 7 (88%) of 8 occurrences of > or = 1 mutations in dhps, and all occurrences of the Gly-437 allele of dhps, predicted failure. Association between mutations in dhps and mutations in dhfr was noted in the combined sites, irrespective of outcome. Although this makes the relationship of combined dhfr and dhps mutations to failure more difficult to interpret, it nevertheless supports S-P selection acting on both genes. In the holoendemic site, treatment success increased with age. In this location, acquired immunity may mask the impact of mutations in dhps, since sulfadoxine is a less effective treatment than pyrimethamine.

  1. Relationship between nongenital tender point tenderness and intravaginal muscle pain intensity: ratings in women with provoked vestibulodynia and implications for treatment.

    Science.gov (United States)

    Phillips, Nancy; Brown, Candace; Bachmann, Gloria; Wan, Jim; Wood, Ronald; Ulrich, Dagny; Bachour, Candi; Foster, David

    2016-12-01

    Vulvodynia is a chronic vulvar pain disorder and fibromyalgia is a chronic widespread musculoskeletal pain disorder, both of unknown etiology. Association of these conditions is well documented. Intravaginal algometer measurement of tenderness to pressure applied to the pelvic floor muscles helps define vulvodynia associated with musculoskeletal factors. Women with both vulvodynia and fibromyalgia might have increased pelvic muscle pain compared to women with vulvodynia alone, defining the possible link of these 2 conditions. We sought to: (1) correlate pain intensity during the nongenital tender point tenderness examination to pain intensity with the vaginal algometer in women with provoked vestibulodynia, and (2) determine whether subjects with provoked vestibulodynia and fibromyalgia had higher pain intensity scores with the vaginal algometer than those without fibromyalgia. In all, 92 subjects referred for vulvar pain were confirmed to have provoked vestibulodynia using the cotton swab test. A diagnosis of fibromyalgia was made if pain was present (numeric rating scale >1) in at least 11 sites of the 18-point nongenital tender point tenderness exam. Vaginal pain sensitivity was measured using an intravaginal pressure algometer, where 0.1, 0.3, and 0.5 kg/cm(2) forces were applied digitally in random assignment by force and location to the right and left iliococcygeus muscle regions and the posterior vaginal wall. Both tender point tenderness and algometer pain intensity were reported on a 0 (no pain) to 10 (worse pain) numeric rating scale. Correlations were computed between the composite pain intensity (total of rating scale from each pressure threshold at specified site) of nongenital and those of iliococcygeus regions and the posterior vaginal wall. Independent t tests were used to determine differences in iliococcygeus regions and the posterior vaginal algometer pain ratings and presence or absence of fibromyalgia. The significance level was at P palpation

  2. West Greenlandic antipassive

    Directory of Open Access Journals (Sweden)

    Bodil Kappel Schmidt

    2004-01-01

    Full Text Available On the basis of syntactic and morphological evidence from West Greenlandic (WG antipassive (AP constructions, I argue against the view that the AP affix is nominal. The fact that the transitivizing and the antipassive affixes in a number of verbs are in complementary distribution, leads me to conclude that they both realize a light verb, transitivizing v, one on the ERG-NOM pattern, the other on the NOM-ACC pattern. Nominalization facts of the two clause types indicate their syntactic structure, with possible implications for the semantic interpretation of the object and the position of the ergative subject.

  3. Assessing the impact of a school-based safe water intervention on household adoption of point-of-use water treatment practices in southern India.

    Science.gov (United States)

    Freeman, Matthew C; Clasen, Thomas

    2011-03-01

    We assessed a pilot project by UNICEF and Hindustan Unilever Limited to improve the quality of drinking water for children in schools through adoption of improved drinking water practices among households in southern India. The intervention consisted of providing classrooms of 200 schools a commercial water purifier, and providing basic hygiene and water treatment information to students, parents, and teachers. We found no evidence that the intervention was effective in improving awareness or uptake of effective water treatment practices at home. A similar proportion of household members in the intervention and control groups boiled their water (P = 0.60), used a ceramic filtration system (P = 0.33), and used a cloth filter (P = 0.89). One year after the launch of the campaign, household ownership of the commercial purifier promoted at schools was higher in the intervention group (26%) than the control group (19%), but this difference was not statistically significant (P = 0.53).

  4. Spirit's Surroundings on 'West Spur,' Sol 305

    Science.gov (United States)

    2005-01-01

    This 360-degree panorama shows the terrain surrounding NASA's Mars Exploration Rover Spirit as of the rover's 305th martian day, or sol, (Nov. 11, 2004). At that point, Spirit was climbing the 'West Spur' of the 'Columbia Hills.' The rover had just finished inspecting a rock called 'Lutefisk' and was heading uphill toward an area called 'Machu Picchu.' Spirit used its navigational camera to take the images combined into this mosaic. The rover's location when the images were taken is catalogued as the mission's site 89, position 205. The view is presented here as a cylindrical projection with geometric seam correction.

  5. Treatment of cranial cruciate ligament rupture in the feline stifle. Biomechanical comparison of a standard fabella-tibial suture and lateral sutures placed between quasi-isometric points.

    Science.gov (United States)

    De Sousa, R; Sutcliffe, M; Rousset, N; Holmes, M; Langley-Hobbs, S J

    2015-01-01

    To determine whether a lateral suture placed with bone anchors between quasi-isometric points in a cat is superior to a standard fabella-tibial suture for the stabilization of cranial cruciate ligament (CrCL) rupture compared to an intact stifle joint. Biomechanical cadaveric study. Six stifle joints with intact cruciate ligaments from three skeletally mature cats were placed in a loading mounting set and tested with axial loads of 20N and 60N at three different joint angles (75°,130° and 160°). The procedure was repeated with a transected CrCL; a stabilized stifle joint after a combination of three lateral suture techniques (fabella-tibial suture technique [SFT]; femoro-tibial suture technique 1 [FTS-1] and femoro-tibial suture technique 2 [FTS-2]). Radiographic examination of the relative position of the tibia to the fixed femur was compared. Stabilization of the stifle joint with lateral sutures had comparable stability to the intact specimens in the cranio-caudal direction (p = 0.2) but not in the proximo-distal direction for the SFT (p = 0.04) and FTS-2 technique (p = 0.03). There was no significant difference between the three stabilization techniques (p >0.05). Lateral sutures placed with bone anchors at quasi-isometric points performed better than SFT and FTS-2 in stabilizing the feline stifle after CrCL rupture in the proximo-distal plane. Biomechanical stability in the cranio-caudal plane after placement of a lateral suture across the feline stifle was similar to the intact CrCL.

  6. Illness beliefs, treatment beliefs and information needs as starting points for patient information--evaluation of an intervention for patients with chronic back pain.

    Science.gov (United States)

    Glattacker, Manuela; Heyduck, Katja; Meffert, Cornelia

    2012-03-01

    The objective of the study was to evaluate an intervention which applied the extended Common Sense Model to the provision of information about illness and treatment during inpatient rehabilitation for patients with chronic back pain. The intervention was evaluated in a sequential control group design (control group N=105; intervention group N=96). Changes with respect to illness and treatment beliefs, satisfaction with information, and health status at the end of rehabilitation were selected as outcome measures. Analyses of covariance were used to assess differences between control and intervention group. Significant time-by-group interactions were shown for causal beliefs, personal control, satisfaction with information about illness and rehabilitation, and for general health. All time-by-group interactions indicated superiority of the intervention group. The intervention group assessed their back pain as personally controllable and their information needs at the end of rehabilitation as being met to a greater extent than did patients who received care as usual. The extended Common Sense Model seems promising as a frame for discussing illness and treatment perceptions as well as information needs in patients with chronic back pain. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  7. Performance Evaluation of West African Dwarf (WAD) Goats fed ...

    African Journals Online (AJOL)

    This study investigated the effect of replacing Pennisetum purpureum with unripe plantain peels on the performance of West African Dwarf Goats. Thirty buck kids with an average weight of 7.00 ± 0.55kg were randomly assigned to three dietary treatment groups with ten bucks per treatment in a completely randomized ...

  8. NATO in History and Civics Textbooks: The West German Case.

    Science.gov (United States)

    Fritzsche, K. Peter

    1990-01-01

    When analyzing the degree to which a balanced presentation of NATO is achieved in West German history and civics textbooks, two standards may be used: first, inclusion of information on NATO's formation, aims, strategies and achievements; and, second, inclusion of the criticisms that have been leveled at NATO from various points of view. This…

  9. Treatment

    National Research Council Canada - National Science Library

    Safaa M. Raghab; Ahmed M. Abd El Meguid; Hala A. Hegazi

    2013-01-01

    ... composed. This paper presents the results of the analyses of leachate treatment from the solid waste landfill located in Borg El Arab landfill in Alexandria using an aerobic treatment process which was applied...

  10. West African Journal of Radiology

    African Journals Online (AJOL)

    The West African Journal of Radiology is an annual publication and the official organ of the Association of Radiologists of West Africa. ... clinical case reports, discoveries and engineering design/fabrication reports related to any branch of imaging modalities, Radiotherapy and allied subjects. ... Table of Contents. Articles ...

  11. Endoscopic capacity in West Africa.

    African Journals Online (AJOL)

    Abstract: Background: Levels of endoscopic demand and capacity in West Africa are unclear. Objectives: This paper aims to: 1. describe the current labor and endoscopic capacity, 2. quantify the impact of a mixed-meth- ods endoscopy course on healthcare professionals in West Africa, and 3. quantify the types of diagnoses ...

  12. Bentyia (Kukyia: a Songhay–Mande meeting point, and a “missing link” in the archaeology of the West African diasporas of traders, warriors, praise-singers, and clerics Bentyia (Kukyia, un point de rencontre songhaï–mandé et un “chaînon manquant” dans l’archéologie des diasporas de commerçants, guerriers, griots et clercs en Afrique de l’Ouest

    Directory of Open Access Journals (Sweden)

    Paulo Fernando de Moraes Farias

    2013-05-01

    Full Text Available The present tragedy in Mali draws our attention to the divisions, tensions and conflicts between West African ethnic groups, religious persuasions, and populations from different regions, in both the present and the past. But a long-term critical perspective on the past brings to light borrowings between cultures, and shows how the mobility of people across West Africa links regional and ethnic histories. The communication axis running from the Aḍagh to the Niger and, along the Niger Valley, from Gao to Busa (in Nigerian Borgu and beyond, is a strategic locus for investigating this mobility and connectivity. It has linked together the Saharan, savannah, and forest zones of West Africa. It was a magnet for diasporas of Soninke praise-singers and Mande warriors and traders. Fishermen and other waterfolk along the river, oral traditionists and other craftspeople, priests and priestesses of African cults, and Islamic clerics, as well as armies, long-distance merchants, and enslaved human beings, moved along it. Although the archeological sites at Bentyia/Kukyia occupy a strategic position on this historical axis, they have not been excavated, whence a serious gap in our knowledge of the history of the eastern Niger Valley and of West Africa as a whole.L'actuelle tragédie malienne attire notre attention sur les divisions, les tensions et les conflits, présents et passés, entre groupes ethniques ouest-africains, confessions religieuses et populations de différentes régions. Mais, une perspective critique sur la longue durée fait apparaître des emprunts entre cultures et nous aide à comprendre comment la mobilité des personnes à travers l'Afrique occidentale relie les histoires régionales et ethniques. L’axe de communication allant de l’Aḍagh au Niger et, le long de la vallée du Niger, de Gao à Busa (au Borgou nigérian et au-delà, est un espace stratégique pour examiner cette mobilité et cette connectivité. Il raccordait les

  13. WEST COAST REGIONAL CARBON SEQUESTRATION PARTNERSHIP

    Energy Technology Data Exchange (ETDEWEB)

    Larry Myer; Terry Surles; Kelly Birkinshaw

    2004-01-01

    The West Coast Regional Carbon Sequestration Partnership is one of seven partnerships which have been established by the US Department of Energy (DOE) to evaluate carbon dioxide capture, transport and sequestration (CT&S) technologies best suited for different regions of the country. The West Coast Region comprises Arizona, California, Nevada, Oregon, Washington, and the North Slope of Alaska. Led by the California Energy Commission, the West Coast Partnership is a consortium of over thirty five organizations, including state natural resource and environmental protection agencies; national labs and universities; private companies working on CO{sub 2} capture, transportation, and storage technologies; utilities; oil and gas companies; nonprofit organizations; and policy/governance coordinating organizations. In an eighteen month Phase I project, the Partnership will evaluate both terrestrial and geologic sequestration options. Work will focus on five major objectives: (1) Collect data to characterize major CO{sub 2} point sources, the transportation options, and the terrestrial and geologic sinks in the region, and compile and organize this data via a geographic information system (GIS) database; (2) Address key issues affecting deployment of CT&S technologies, including storage site permitting and monitoring, injection regulations, and health and environmental risks (3) Conduct public outreach and maintain an open dialogue with stakeholders in CT&S technologies through public meetings, joint research, and education work (4) Integrate and analyze data and information from the above tasks in order to develop supply curves and cost effective, environmentally acceptable sequestration options, both near- and long-term (5) Identify appropriate terrestrial and geologic demonstration projects consistent with the options defined above, and create action plans for their safe and effective implementation A kickoff meeting for the West Coast Partnership was held on Sept 30-Oct

  14. Fluconazole therapy for treatment of invasive candidiasis in Intensive Care patients. Is it still valid from a pharmacological point of view?

    Directory of Open Access Journals (Sweden)

    Mario Musu

    2014-01-01

    Full Text Available Fluconazole – antimycotic belonging to the first generation azoles – is widely used as treatment for invasive candidiasis and candidemia in numerous clinical settings as Neonatal Intensive Care Unit (NICU and adult Intensive Care Unit (ICU, as well as oncology, onco-hematology and solid organ transplantation. More recently use of antimycotics has spread to medical divisions, where fungal infections represent an emerging problem due to population’s ageing, malnourishment and important comorbidities. Fluconazole is effective against numerous Candida species, particularly against albicans, tropicalis and parapsilosis strains. On the other hand, C. krusei is intrinsically resistant to fluconazole and C. glabrata can be sensitive or resistant in a dose dependent fashion. Epidemiological variability is noteworthy and depends on the geographical location of the institution, the clinical setting, and the frequency and intensity of fluconazole employment for invasive candidiasis. In many ICUs fluconazole sensitive C. albicans is cultured in 50% of positive samples, while the remaining 50% show growth of variably sensitive fungal species, often resistant to fluconazole. Due to increasingly frequent emergence of resistant strains of Candida spp., American guidelines (IDSA in 2009, and European ones (ESCMID in 2012, recommended substitution of fluconazole with echinocandines as first line therapy in patients with severe disease, as defined by an APACHE II score greater than 15. Thus fluconazole must be limited to low risk cases, treatment of sensitive strains and de-escalation from echinocandin therapy, after microbiological diagnosis and drug resistance profile characterization.

  15. Research Advances: DNA Computing Targets West Nile Virus, Other Deadly Diseases, and Tic-Tac-Toe; Marijuana Component May Offer Hope for Alzheimer's Disease Treatment; New Wound Dressing May Lead to Maggot Therapy--Without the Maggots

    Science.gov (United States)

    King, Angela G.

    2007-01-01

    This article presents three reports of research advances. The first report describes a deoxyribonucleic acid (DNA)-based computer that could lead to faster, more accurate tests for diagnosing West Nile Virus and bird flu. Representing the first "medium-scale integrated molecular circuit," it is the most powerful computing device of its type to…

  16. WEST-3 wind turbine simulator development. Volume 1: Summary

    Science.gov (United States)

    Sridhar, S.

    1985-01-01

    This report is a summary description of WEST-3, a new real-time wind turbine simulator developed by Paragon Pacific Inc. WEST-3 is an all digital, fully programmable, high performance parallel processing computer. Contained in the report are descriptions of the WEST-3 hardware and software. WEST-3 consists of a network of Computational Units (CUs) working in parallel. Each CU is a custom designed high speed digital processor operating independently of other CUs. The CU, which is the main building block of the system, is described in some detail. A major contributor to the high performance of the system is the use a unique method for transferring data among the CUs. The software aspects of WEST-3 covered in the report include the preparation of the simulation model (reformulation, scaling and normalization), and the use of the system software (Translator, Linker, Assembler and Loader). Also given is a description of the wind turbine simulation model used in WEST-3, and some sample results from a study conducted to validate the system. Finally, efforts currently underway to enhance the user friendliness of the system are outlined; these include the 32-bit floating point capability, and major improvements in system software.

  17. The impact of a single round of community mass treatment with azithromycin on disease severity and ocular Chlamydia trachomatis load in treatment-naïve trachoma-endemic island communities in West Africa.

    Science.gov (United States)

    Last, Anna R; Burr, Sarah E; Harding-Esch, Emma; Cassama, Eunice; Nabicassa, Meno; Roberts, Chrissy H; Mabey, David C W; Holland, Martin J; Bailey, Robin L

    2017-12-28

    Trachoma, a neglected tropical disease, is caused by ocular infection with Chlamydia trachomatis (Ct). The World Health Organization (WHO) recommends three annual rounds of community mass drug treatment with azithromycin (MDA) if the prevalence of follicular trachoma in 1-9 year olds (TF1-9) exceeds 10% at district level to achieve an elimination target of district-level TF1-9 below 5% after. To evaluate this strategy in treatment-naïve trachoma-endemic island communities in Guinea Bissau, we conducted a cross-sectional population-based trachoma survey on four islands. The upper tarsal conjunctivae of each participant were clinically assessed for trachoma and conjunctival swabs were obtained (n = 1507). We used a droplet digital PCR assay to detect Ct infection and estimate bacterial load. We visited the same households during a second cross-sectional survey and repeated the ocular examination and obtained conjunctival swabs from these households one year after MDA (n = 1029). Pre-MDA TF1-9 was 22.0% (136/618). Overall Ct infection prevalence (CtI) was 18.6% (25.4% in 1-9 year olds). Post-MDA (estimated coverage 70%), TF1-9 and CtI were significantly reduced (7.4% (29/394, P < 0.001) and 3.3% (34/1029, P < 0.001) (6.6% in 1-9 year olds, P < 0.001), respectively. Median ocular Ct load was reduced from 2038 to 384 copies/swab (P < 0.001). Following MDA cases of Ct infection were highly clustered (Moran's I 0.27, P < 0.001), with fewer clusters of Ct infection overall, fewer clusters of cases with high load infections and less severe disease. Despite a significant reduction in the number of clusters of Ct infection, mean Ct load, disease severity and presence of clusters of cases of high load Ct infection suggesting the beginning of trachoma control in isolated island communities, following a single round of MDA we demonstrate that transmission is still ongoing. These detailed data are useful in understanding the epidemiology of ocular Ct infection in the context of

  18. First line treatment response in patients with transmitted HIV drug resistance and well defined time point of HIV infection: updated results from the German HIV-1 seroconverter study.

    Science.gov (United States)

    Zu Knyphausen, Fabia; Scheufele, Ramona; Kücherer, Claudia; Jansen, Klaus; Somogyi, Sybille; Dupke, Stephan; Jessen, Heiko; Schürmann, Dirk; Hamouda, Osamah; Meixenberger, Karolin; Bartmeyer, Barbara

    2014-01-01

    Transmission of drug-resistant HIV-1 (TDR) can impair the virologic response to antiretroviral combination therapy. Aim of the study was to assess the impact of TDR on treatment success of resistance test-guided first-line therapy in the German HIV-1 Seroconverter Cohort for patients infected with HIV between 1996 and 2010. An update of the prevalence of TDR and trend over time was performed. Data of 1,667 HIV-infected individuals who seroconverted between 1996 and 2010 were analysed. The WHO drug resistance mutations list was used to identify resistance-associated HIV mutations in drug-naïve patients for epidemiological analysis. For treatment success analysis the Stanford algorithm was used to classify a subset of 323 drug-naïve genotyped patients who received a first-line cART into three resistance groups: patients without TDR, patients with TDR and fully active cART and patients with TDR and non-fully active cART. The frequency of virologic failure 5 to 12 months after treatment initiation was determined. Prevalence of TDR was stable at a high mean level of 11.9% (198/1,667) in the HIV-1 Seroconverter Cohort without significant trend over time. Nucleotide reverse transcriptase inhibitor resistance was predominant (6.0%) and decreased significantly over time (OR = 0.92, CI = 0.87-0.98, p = 0.01). Non-nucleoside reverse transcriptase inhibitor (2.4%; OR = 1.00, CI = 0.92-1.09, p = 0.96) and protease inhibitor resistance (2.0%; OR = 0.94, CI = 0.861.03, p = 0.17) remained stable. Virologic failure was observed in 6.5% of patients with TDR receiving fully active cART, 5,6% of patients with TDR receiving non-fully active cART and 3.2% of patients without TDR. The difference between the three groups was not significant (p = 0.41). Overall prevalence of TDR remained stable at a rather high level. No significant differences in the frequency of virologic failure were identified during first-line cART between patients with TDR

  19. First line treatment response in patients with transmitted HIV drug resistance and well defined time point of HIV infection: updated results from the German HIV-1 seroconverter study.

    Directory of Open Access Journals (Sweden)

    Fabia Zu Knyphausen

    Full Text Available BACKGROUND: Transmission of drug-resistant HIV-1 (TDR can impair the virologic response to antiretroviral combination therapy. Aim of the study was to assess the impact of TDR on treatment success of resistance test-guided first-line therapy in the German HIV-1 Seroconverter Cohort for patients infected with HIV between 1996 and 2010. An update of the prevalence of TDR and trend over time was performed. METHODS: Data of 1,667 HIV-infected individuals who seroconverted between 1996 and 2010 were analysed. The WHO drug resistance mutations list was used to identify resistance-associated HIV mutations in drug-naïve patients for epidemiological analysis. For treatment success analysis the Stanford algorithm was used to classify a subset of 323 drug-naïve genotyped patients who received a first-line cART into three resistance groups: patients without TDR, patients with TDR and fully active cART and patients with TDR and non-fully active cART. The frequency of virologic failure 5 to 12 months after treatment initiation was determined. RESULTS: Prevalence of TDR was stable at a high mean level of 11.9% (198/1,667 in the HIV-1 Seroconverter Cohort without significant trend over time. Nucleotide reverse transcriptase inhibitor resistance was predominant (6.0% and decreased significantly over time (OR = 0.92, CI = 0.87-0.98, p = 0.01. Non-nucleoside reverse transcriptase inhibitor (2.4%; OR = 1.00, CI = 0.92-1.09, p = 0.96 and protease inhibitor resistance (2.0%; OR = 0.94, CI = 0.861.03, p = 0.17 remained stable. Virologic failure was observed in 6.5% of patients with TDR receiving fully active cART, 5,6% of patients with TDR receiving non-fully active cART and 3.2% of patients without TDR. The difference between the three groups was not significant (p = 0.41. CONCLUSION: Overall prevalence of TDR remained stable at a rather high level. No significant differences in the frequency of virologic failure were

  20. Transcranial laser therapy in acute stroke treatment: results of neurothera effectiveness and safety trial 3, a phase III clinical end point device trial.

    Science.gov (United States)

    Hacke, Werner; Schellinger, Peter D; Albers, Gregory W; Bornstein, Natan M; Dahlof, Bjorn L; Fulton, Rachael; Kasner, Scott E; Shuaib, Ashfaq; Richieri, Steven P; Dilly, Stephen G; Zivin, Justin; Lees, Kennedy R

    2014-11-01

    On the basis of phase II trials, we considered that transcranial laser therapy could have neuroprotective effects in patients with acute ischemic stroke. We studied transcranial laser therapy in a double-blind, sham-controlled randomized clinical trial intended to enroll 1000 patients with acute ischemic stroke treated ≤24 hours after stroke onset and who did not undergo thrombolytic therapy. The primary efficacy measure was the 90-day functional outcome as assessed by the modified Rankin Scale, with hierarchical Bayesian analysis incorporating relevant previous data. Interim analyses were planned after 300 and 600 patients included. The study was terminated on recommendation by the Data Monitoring Committee after a futility analysis of 566 completed patients found no difference in the primary end point (transcranial laser therapy 140/282 [49.6%] versus sham 140/284 [49.3%] for good functional outcome; modified Rankin Scale, 0-2). The results remained stable after inclusion of all 630 randomized patients (adjusted odds ratio, 1.024; 95% confidence interval, 0.705-1.488). Once the results of the interim futility analysis became available, all study support was immediately withdrawn by the capital firms behind PhotoThera, and the company was dissolved. Proper termination of the trial was difficult but was finally achieved through special efforts by former employees of PhotoThera, the CRO Parexel and members of the steering and the safety committees. We conclude that transcranial laser therapy does not have a measurable neuroprotective effect in patients with acute ischemic stroke when applied within 24 hours after stroke onset. http://www.clinicaltrials.gov. Unique identifier: NCT01120301. © 2014 American Heart Association, Inc.

  1. Femoroacetabular Impingement: Have We Hit a Global Tipping Point in Diagnosis and Treatment? Results From the InterNational Femoroacetabular Impingement Optimal Care Update Survey (IN FOCUS).

    Science.gov (United States)

    Khan, Moin; Ayeni, Olufemi R; Madden, Kim; Bedi, Asheesh; Ranawat, Anil; Kelly, Bryan T; Sancheti, Parag; Ejnisman, Leandro; Tsiridis, Eleftherios; Bhandari, Mohit

    2016-05-01

    This international survey was conducted to assess the perceptions of orthopaedic surgeons regarding the diagnosis and management of femoroacetabular impingement (FAI) as well as to explore the current demographic characteristics of surgeons performing FAI surgery. A survey was developed using previous literature, focus groups, and a sample-to-redundancy strategy. The survey contained 46 questions and was e-mailed to national orthopaedic associations and orthopaedic sports medicine societies for member responses. Members were contacted on multiple occasions to increase the response rate. Nine hundred orthopaedic surgeons from 20 national and international organizations completed the survey. Surgeons responded across 6 continents, 58.2% from developed nations, with 35.4% having sports fellowship training. North American and European surgeons reported significantly greater exposure to hip arthroscopy during residency and fellowship training in comparison to international respondents (48.0% and 44.5% respectively, v 25.6%; P 100 cases per year) were significantly more likely to have practiced for more than 20 years (odds ratio [OR], 1.91; 95% confidence interval [CI], 1.01 to 3.63), to be practicing at an academic hospital (OR, 2.25; 95% CI, 1.22 to 4.15), and to have formal arthroscopy training (OR, 46.17; 95% CI, 20.28 to 105.15). High-volume surgeons were over two-fold more likely to practice in North America and Europe (OR, 2.26; 95% CI, 1.08 to 4.72). The exponential rise in the diagnosis and surgical management of FAI appears to be driven largely by experienced surgeons in developed nations. Significant variability exists regarding the diagnosis and management of FAI. Our analysis suggests that although FAI management is early in the innovation cycle, we are at a tipping point toward wider uptake and use. Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  2. Additional effects of transcranial direct-current stimulation and trigger-point injection for treatment of myofascial pain syndrome: a pilot study with randomized, single-blinded trial.

    Science.gov (United States)

    Choi, Yoon-Hee; Jung, Sung-Jin; Lee, Chang Han; Lee, Shi-Uk

    2014-09-01

    Chronic pain caused by myofascial pain syndrome (MPS) results in generalized and debilitating conditions. Trigger-point injection (TPI) is the mainstay of MPS management to reduce acute and localized pain. Other adjunctive intervention to modulate the central pain pathway might be helpful if they are combined with TPI. Transcranial direct-current stimulation (tDCS), which is a form of neurostimulation, has been reported to be safe and effective in treating chronic pain by changing cortical excitability. To determine whether there is an additional effect of tDCS and TPI to reduce pain in patients with MPS. Twenty-one patients with newly diagnosed MPS of shoulder girdle muscles. Patients were randomly assigned into 1 of 3 groups (2 active and 1 sham stimulation groups) and received TPI. Immediately after TPI, tDCS (2 mA for 20 minutes on 5 consecutive days) was administered. For the active stimulation groups, tDCS was applied over 2 different locations (primary motor cortex and dorsolateral prefrontal cortex [DLPFC]). Visual analogue scale (VAS), Pain Threshold Test, and short form of the McGill Pain Questionnaire were measured before and immediately after stimulation for 5 consecutive days. The mean VAS values were decreased in all three groups after 5 days. There was a significant change between before and after stimulation only in the DLPFC group. The significant change in the mean VAS value was shown from after the second stimulation session (p=0.031), and this remained significant until the last stimulation session (p=0.027). This study suggests that tDCS over DLPFC may have additional effects with TPI to reduce pain in patients with MPS. tDCS over DLPFC can be used to reverse central pain pathway by modulating cortical plasticity.

  3. West Nile Virus Drug Discovery

    Directory of Open Access Journals (Sweden)

    Siew Pheng Lim

    2013-12-01

    Full Text Available The outbreak of West Nile virus (WNV in 1999 in the USA, and its continued spread throughout the Americas, parts of Europe, the Middle East and Africa, underscored the need for WNV antiviral development. Here, we review the current status of WNV drug discovery. A number of approaches have been used to search for inhibitors of WNV, including viral infection-based screening, enzyme-based screening, structure-based virtual screening, structure-based rationale design, and antibody-based therapy. These efforts have yielded inhibitors of viral or cellular factors that are critical for viral replication. For small molecule inhibitors, no promising preclinical candidate has been developed; most of the inhibitors could not even be advanced to the stage of hit-to-lead optimization due to their poor drug-like properties. However, several inhibitors developed for related members of the family Flaviviridae, such as dengue virus and hepatitis C virus, exhibited cross-inhibition of WNV, suggesting the possibility to re-purpose these antivirals for WNV treatment. Most promisingly, therapeutic antibodies have shown excellent efficacy in mouse model; one of such antibodies has been advanced into clinical trial. The knowledge accumulated during the past fifteen years has provided better rationale for the ongoing WNV and other flavivirus antiviral development.

  4. Injecting drug use via femoral vein puncture: preliminary findings of a point-of-care ultrasound service for opioid-dependent groin injectors in treatment

    Directory of Open Access Journals (Sweden)

    Senbanjo Richard

    2012-01-01

    Full Text Available Abstract Background Within the UK, injecting in the femoral vein (FV, often called 'groin injecting', is a serious cause of risk and harm. This study aimed to use ultrasound scanning as a means to engage groin injectors (GIs, examine their femoral injecting sites and assess their venous health, with the intention of developing improved responses. Methods Between September 2006 and March 2009, GIs attending a network of community drug treatment centres in South East England were invited to attend an ultrasound 'health-check' clinic. This paper provides a narrative account of the scanning procedure and operation of the service, with descriptive statistical analysis of GIs who attended. The analysis uses a structured, specially-developed clinical data set that incorporates a categorisation for the severity of FV damage. Case studies using ultrasound images and a link to a video are provided to illustrate the range of presentations encountered and the categorisations used for severity. Results A total of 160 groin scans (76 bilateral and 8 unilateral were performed in 84 GIs. The majority were men (69.0% and the mean age of the sample was 36.8 years. The mean duration of drug use and injecting drug use was 19.7 years and 13.8 years, respectively. FV damage at the injecting site in the right groin was graded as minimal in 20 patients (25%, moderate in 27 (33.8%, severe in 16 (20.0% and very-severe in 17 (21.3%. Corresponding figures for left FV were 24 (30.0%, 22 (27.5%, 18 (22.5% and 16 (20.0%. Wide variation was observed in the time to the development of these grades of FV damage. Conclusions Modern, portable ultrasound scanners make it possible to examine the venous health of GIs in community treatment settings. Ultrasound scanning identified extensive FV damage, much hitherto-unrecognised in this population. These findings should further alert clinicians, policy-makers and patients to the urgent need for effective harm reduction responses to GI

  5. Comparison of Dose When Prescribed to Point A and Point H for Brachytherapy in Cervical Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Gang, Ji Hyeong; Gim, Il Hwan; Hwang, Seon Boong; Kim, Woong; Im, Hyeong Seo; Gang, Jin Mook; Gim, Gi Hwan; Lee, Ah Ram [Dept. of Radiation Oncology, Korea Institute of Radiological and Medical Sciences, Seou (Korea, Republic of)

    2012-09-15

    The purpose of this study is to compare plans prescribed to point A with these prescribed to point H recommended by ABS (American Brachytherapy Society) in high dose rate intracavitary brachytherapy for cervical carcinoma. This study selected 103 patients who received HDR (High Dose Rate) brachytherapy using tandem and ovoids from March 2010 to January 2012. Point A, bladder point, and rectal point conform with Manchester System. Point H conforms with ABS recommendation. Also Sigmoid colon point, and vagina point were established arbitrarily. We examined distance between point A and point H. The percent dose at point A was calculated when 100% dose was prescribed to point H. Additionally, the percent dose at each reference points when dose is prescribed to point H and point A were calculated. The relative dose at point A was lower when point H was located inferior to point A. The relative doses at bladder, rectal, sigmoid colon, and vagina points were higher when point H was located superior to point A, and lower when point H was located inferior to point A. This study found out that as point H got located much superior to point A, the absorbed dose of surrounding normal organs became higher, and as point H got located much inferior to point A, the absorbed dose of surrounding normal organs became lower. This differences dose not seem to affect the treatment. However, we suggest this new point is worth being considered for the treatment of HDR if dose distribution and absorbed dose at normal organs have large differences between prescribed to point A and H.

  6. Trade networks in West Africa

    DEFF Research Database (Denmark)

    Walther, Olivier

    2014-01-01

    To date, most of the literature on trade networks in West Africa has considered networks in a metaphorical way. The aim of this paper is to go one step further by showing how social network analysis may be applied to the study of regional trade in West Africa. After a brief review of the literature......, this exploratory paper investigates two main issues related to regional trade. We start by discussing how recent developments in regional trade in West Africa have contributed to challenging the social structure of traders. We then discuss the changes that have affected the spatiality of regional trade by looking...

  7. JPRS Report, West Europe.

    Science.gov (United States)

    1988-01-26

    on Difficulties 36130018b Copenhagen AKTUELT in Danish 1 Nov 87 p9 [Interview with Danish Prime Minister Poul Schlüter by Karen Thisted: "The...declining. This is the very point, he stated, where we have to start in order to stop the creeping erosion of the FRG as a production location

  8. JPRS Report, West Europe.

    Science.gov (United States)

    1988-02-03

    the actual population. Interviews: Con- ducted in person at randomly chosen points. Control and supervision: there was dual control during the field...1988 41 SOCIAL (1) SEXO o (4) EDAO (5) EDUCACION (2) Meier , 1%) i -38 3(M9 »64 v M+ fc; %E-^; fe (10) Mujf satisfeaio 5 .3 ■>,-.i

  9. West Coast Fishing Closures, 2015

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — These data delineate state and federally managed ocean areas off the West Coast of the United States that are closed to or have restrictions on commercial or...

  10. Verbal aspects in West Greenlandic

    DEFF Research Database (Denmark)

    Trondhjem, Naja Blytmann

    2017-01-01

    In this article, lexical aspectual types in West Greenlandic are investigated in the five aspectual types, states, achievements, semelfactives, activities and accomplishments. It is shown that derivational verbalizing affixes include aspectual type congruent with the lexical aspect and how...

  11. Lassa fever: another threat from West Africa.

    Science.gov (United States)

    Brosh-Nissimov, Tal

    2016-01-01

    Lassa fever, a zoonotic viral infection, is endemic in West Africa. The disease causes annual wide spread morbidity and mortality in Africa, and can be imported by travelers. Possible importation of Lassa fever and the potential for the use of Lassa virus as an agent of bioterrorism mandate clinicians in Israel and other countries to be vigilant and familiar with the basic characteristics of this disease. The article reviews the basis of this infection and the clinical management of patients with Lassa fever. Special emphasis is given to antiviral treatment and infection control.

  12. Cold war, quantum foundations, and East-West collaboration

    Energy Technology Data Exchange (ETDEWEB)

    Skaar-Jacobsen, Anja [Niels Bohr Archive, Copenhagen (Germany)

    2011-07-01

    It is well-known that the cultural cold war changed the ideological line in the Soviet Union from the late 1940s and that this had serious implications for the autonomy of research in genetics and quantum foundations in the East bloc. However, besides the more narrow concern from the point of view of research in quantum foundations, I suggest that the ideological impact on quantum foundations also constituted an obstacle for attempts by Western physicists to bring about a rapprochement between physics in the east and west in general. In connection with re-establishing East-West co-operation between physicists after Stalin's death in 1953 this obstacle needed to be cleared away. In my talk I discuss these issues and how the Institute for Theoretical Physics in Copenhagen came to be an important meeting place for physicists from the East and West from the mid-1950s.

  13. Why the West?

    Directory of Open Access Journals (Sweden)

    Marc Ferguson

    2009-03-01

    Full Text Available La cuestión de cómo "Occidente" llegó a dominar el mundo durante la era moderna se ha debatido recientemente entre los historiadores. El debate se ha polarizado entre quienes ven en la "modernidad" como resultado de un 'milagro', el proceso cultural único generado en el seno del mismo Occidente, y aquellos que cuestionan este "milagro" como paradigma eurocéntrico, y buscan otros factores para entender y explicar el dominio occidental del mundo económico y político. La literatura tradicional, representada por David Landes en su reciente “La riqueza y la pobreza de las naciones”, atribuye el éxito europeo a sus valores culturales únicos, a sus instituciones sociales y sus prácticas políticas. Este éxito fue completamente "impulsado desde dentro” por estas características. Recientemente, varios historiadores han cuestionado este "paradigma del milagro" como eurocéntrica, y miran a otros factores para comprender y explicar el dominio occidental del mundo económico y político. Después de examinar los recientes trabajos de los historiadores frente a este problema, este artículo trata de colocar la expansión europea en un contexto global, y la comprensión de la Revolución Industrial como una transformación global. Esta perspectiva nos permite entender los cambios tecnológicos y económicos Europeos en el contexto más amplio de patrones de interacción económica y cultural de todo el mundo._____________ABSTRACT:The question of how 'the West' came to dominate the globe during the modern era has been debated recently among historians. The debate has been polarized between those who view 'modernity' as the result of a 'European miracle', the culturally unique and internally generated project of the West, and those who question this 'European miracle' paradigm as Eurocentric, and look to other factors to understand and explain Western economic and political world dominance. The traditional narrative, represented by David

  14. West Europe Report

    Science.gov (United States)

    1987-03-19

    ritual end-of- year speech on a single theme: that of responsibility, linked with the recurring leitmotiv of a steadfast institutional point of...That bitterness has also not healed ." We asked: "Mr Altikulac, it is said that during your tenure as Chairman of the RAC, you sent your father and...They think it is very original." Of course they like it. They would even like a gypsy song and dance group in Sulukule. In addition, YOK [Higher

  15. JPRS Report, West Europe.

    Science.gov (United States)

    1998-06-01

    reconnaissance, commu- nications and air transport . —Elimination of duplication through more specific mis- sion definitions and points of emphasis. For...the country" or—more difficult yet—between " transito " [transit] and "escala" [stopover] of nuclear weapons in Spanish ports. On the basis of a...34continued ban on transporting , deploying or storing nuclear weapons on Spanish soil." From a strictly linguistic standpoint, an argument can thus be made

  16. HACCP (Hazard Analysis and Critical Control Points) to guarantee safe water reuse and drinking water production--a case study.

    Science.gov (United States)

    Dewettinck, T; Van Houtte, E; Geenens, D; Van Hege, K; Verstraete, W

    2001-01-01

    To obtain a sustainable water catchment in the dune area of the Flemish west coast, the integration of treated domestic wastewater in the existing potable water production process is planned. The hygienic hazards associated with the introduction of treated domestic wastewater into the water cycle are well recognised. Therefore, the concept of HACCP (Hazard Analysis and Critical Control Points) was used to guarantee hygienically safe drinking water production. Taking into account the literature data on the removal efficiencies of the proposed advanced treatment steps with regard to enteric viruses and protozoa and after setting high quality limits based on the recent progress in quantitative risk assessment, the critical control points (CCPs) and points of attention (POAs) were identified. Based on the HACCP analysis a specific monitoring strategy was developed which focused on the control of these CCPs and POAs.

  17. A Microbiological and Nutritional Evaluation of the West African ...

    African Journals Online (AJOL)

    The quality attributes of Kilishi, a West African dried meat product were studied over an eight week storage period comparing traditional production and packaging systems with a potassium sorbate treatment system and simple modern packaging. Changes in chemical composition and microbiological counts are reported.

  18. Buruli ulcer in West Africa: Strategies for early detection and ...

    African Journals Online (AJOL)

    Buruli ulcer in West Africa: Strategies for early detection and treatment in the antibiotic era. ... delay and disease progression. Community-based surveillance and health education modeled after the village health worker programs used in the eradication of Guinea worm may be successfully applied in BU endemic areas.

  19. Effect of exogenous progesterone on oestrus response of West ...

    African Journals Online (AJOL)

    Twenty-four (24) healthy, parous West African dwarf (WAD) does aged 2 – 3 years were used to study the effects of varying doses of progesterone on oestrus synchronization and plasma progesterone levels. The does were randomly assigned to 4 treatment groups consisting of 12.5, 25.0 and 37.5 mg progesterone ...

  20. Treatment

    Directory of Open Access Journals (Sweden)

    Safaa M. Raghab

    2013-08-01

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

  1. Inhibition of West Nile virus multiplication in cell culture by anti-parkinsonian drugs

    Directory of Open Access Journals (Sweden)

    Ana Belen Blazquez

    2016-03-01

    Full Text Available West Nile virus (WNV is a mosquito-borne flavivirus maintained in a transmission cycle between mosquitoes and birds, but it can also infect other vertebrates, including humans, in which it can cause neuroinvasive diseases. To date, no licensed vaccine or therapy for human use against this pathogen is yet available. A recent approach to search for new antiviral agent candidates is the assessment of long-used drugs commonly administered by clinicians to treat human disorders in drug antiviral development. In this regard, as patients with West Nile encephalitis frequently develop symptoms and features of parkinsonism, and cellular factors altered in parkinsonism, such as alpha-synuclein, have been shown to play a role on WNV infection, we have assessed the effect of four drugs (L-dopa, Selegiline, Isatin and Amantadine, that are used as therapy for Parkinson´s disease in the inhibition of WNV multiplication. L-dopa, Isatin, and Amantadine treatments significantly reduced the production of infectious virus in all cell types tested, but only Amantadine reduced viral RNA levels. These results point to antiparkinsonian drugs as possible therapeutic candidates for the development of antiviral strategies against WNV infection.

  2. Inhibition of West Nile Virus Multiplication in Cell Culture by Anti-Parkinsonian Drugs.

    Science.gov (United States)

    Blázquez, Ana B; Martín-Acebes, Miguel A; Saiz, Juan-Carlos

    2016-01-01

    West Nile virus (WNV) is a mosquito-borne flavivirus maintained in a transmission cycle between mosquitoes and birds, but it can also infect other vertebrates, including humans, in which it can cause neuroinvasive diseases. To date, no licensed vaccine or therapy for human use against this pathogen is yet available. A recent approach to search for new antiviral agent candidates is the assessment of long-used drugs commonly administered by clinicians to treat human disorders in drug antiviral development. In this regard, as patients with West Nile encephalitis frequently develop symptoms and features of parkinsonism, and cellular factors altered in parkinsonism, such as alpha-synuclein, have been shown to play a role on WNV infection, we have assessed the effect of four drugs (L-dopa, Selegiline, Isatin, and Amantadine), that are used as therapy for Parkinson's disease in the inhibition of WNV multiplication. L-dopa, Isatin, and Amantadine treatments significantly reduced the production of infectious virus in all cell types tested, but only Amantadine reduced viral RNA levels. These results point to antiparkinsonian drugs as possible therapeutic candidates for the development of antiviral strategies against WNV infection.

  3. Mapping and analysis of West Nile virus-specific monoclonal antibodies: prospects for vaccine development

    NARCIS (Netherlands)

    Throsby, Mark; ter Meulen, Jan; Geuijen, Cecile; Goudsmit, Jaap; de Kruif, John

    2007-01-01

    Seasonal epidemics of West Nile virus (WNV) infection now occur throughout North America, causing clinical symptoms ranging from fever to encephalitis. There are no specific treatment options or licensed vaccines. Several classically developed vaccine candidates are being evaluated in clinical

  4. The Points Of Language

    Science.gov (United States)

    Meier, Richard P.; Lillo-Martin, Diane

    2017-01-01

    Signed languages display a variety of pointing signs that serve the functions of deictic and anaphoric pronouns, possessive and reflexive pronouns, demonstratives, locatives, determiners, body part labels, and verb agreement. We consider criteria for determining the linguistic status of pointing signs. Among those criteria are conventionality, indexicality, phonological compositionality, being subject to grammatical constraints, and marking the kinds of grammatical distinctions expected of pronouns. We conclude that first-person points meet all these proposed criteria, but that nonfirst person points are in part gestural. Lastly, we review evidence for the grammaticization over time of systems of pointing signs within signed languages. PMID:28603596

  5. EFECTO DEL PUNTO DE PRECLORACIÓN SOBRE LA FORMACIÓN DE TRIHALOMETANOS EN PROCESOS CONVENCIONALES DE POTABILIZACIÓN DE AGUA EFFECT OF THE PRECHLORINATION POINT ON THE TRIHALOMETHANES FORMATION IN CONVENTIONAL WATER TREATMENT PROCESS

    Directory of Open Access Journals (Sweden)

    Sindy Arjona-Rodríguez

    2012-06-01

    Full Text Available En las plantas de potabilización es muy común el uso de cloro como desinfectante para controlar el riesgo microbiológico que presentan las aguas superficiales; sin embargo, este producto puede reaccionar con la materia orgánica natural (MON favoreciendo la formación de subproductos orgánicos no deseados. En la planta Puerto Mallarino de la ciudad de Cali (Colombia, se evaluó a escala real el efecto del punto de precloración sobre la formación de trihalometanos (THM analizando dos secuencias de tratamiento: 1. Precloración-Coagulación-Clarificación y 2. Coagulación-Clarificación-Precloración. En promedio, los resultados evidenciaron menor formación de THM en la secuencia 2 (0,71 µg/L comparado con la secuencia 1 (12,88 µg/L, representando una reducción del 94,5%. En ambas condiciones se redujo el riesgo químico sin comprometer la calidad microbiológica del agua clarificada.On the drinking water treatment plants is normal the use of chlorine as disinfectant to control the microbiological risk that the superficial waters present; however, this product can be reacts with the organic natural matter (MON favoring the formation of undesirable organics by-products. In Puerto Mallarino drinking water treatment plant based in Cali (Colombia, the effect of prechlorination point over the generation of trihalomethanes (THM was evaluated at full scale. Two treatment sequences were considered: 1. Prechlorination-Coagulation-Clarification and 2. Coagulation-Clarification-Prechlorination. In average, results show a lower THM formation in the sequence 2 (0,71 µg/L if compared with the sequence 1 (12,88 µg/L, which represents a 94,5% reduction. In both conditions, chemical risk was reduced without compromising the microbiological quality of clarified water.

  6. West African Journal of Radiology: Journal Sponsorship

    African Journals Online (AJOL)

    West African Journal of Radiology: Journal Sponsorship. Journal Home > About the Journal > West African Journal of Radiology: Journal Sponsorship. Log in or Register to get access to full text downloads.

  7. Team West Virginia/Rome Final Report

    Energy Technology Data Exchange (ETDEWEB)

    Korakakis, Dimitris [West Virginia Univ., Morgantown, WV (United States)

    2017-04-10

    Overall, the team, West Virginia University (WVU) and University of Rome Tor Vergata (UTV), has a goal of building an attractive, low-cost, energy-efficient solar-powered home that represents both the West Virginian and Italian cultures.

  8. West Indian Prose Fiction in the Sixties

    Science.gov (United States)

    Brathwaite, Edward

    1971-01-01

    A Review and critical discussion of the West Indian prose fiction in the sixties by one of the best-known poets of the Carribean and a member of the faculty of the University of West Indies, Jamaica. (JM)

  9. WEST AFRICAN JOURNAL OF MEDICINE

    African Journals Online (AJOL)

    West African Journal of Medicine Vol. 31, No. 1 January–March, 2012. Departments of *Community Health, University of Uyo Teaching Hospital, Uyo, Nigeria, †Community Medicine, University College. Hospital, Ibadan, Nigeria ...... (Okada) crashes in Benin City, Nigeria. Prehosp Disaster Med 2009 Jul–Aug;. 24: 356–9 .

  10. Upgrading of the West Area

    CERN Multimedia

    1983-01-01

    The rejigged main hall (EHW1) in the West Area: on background, below the crane, is the brown yoke of the Omega magnet which had been resited. The upgrading was completed by the time in July when 400 GeV protons arrived. See Annual Report 1983 p. 107.

  11. Improvisation in West African Musics.

    Science.gov (United States)

    Locke, David

    1980-01-01

    Discussed is music of the sub-Sahara. Vocal, instrumental, and dance drumming from the Sudan Desert, the North Coast, East Horn, Central and West Africa, and contrapuntal yodeling of Pygmies is described. For African musicians, the ability to improvise, and creativity, are gifts from God. Includes selected readings and recordings. (KC)

  12. Verbal aspects in West Greenlandic

    DEFF Research Database (Denmark)

    Trondhjem, Naja Blytmann

    2017-01-01

    In this article, lexical aspectual types in West Greenlandic are investigated in the five aspectual types, states, achievements, semelfactives, activities and accomplishments. It is shown that derivational verbalizing affixes include aspectual type congruent with the lexical aspect and how the as...

  13. Metamorphic Rocks in West Irian

    NARCIS (Netherlands)

    Wegen, van der G.

    1971-01-01

    Low-grade metamorphics of West Irian occur to the east of Geelvink Bay associated with two narrow belts of basic and ultrabasic igneous rocks which represent ophiolitic suites of an eugeosynclinical development beginning in Early Mesozoic time. In both of these belts there are indications of

  14. West Nile Virus Neuroinvasive Disease

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2009-07-01

    Full Text Available Epidemiological features of West Nile Virus (WNV disease among children (<18 years of age reported to the Centers for Disease Control and Prevention from 1999 through 2007 were analyzed and compared with those of adult WNV neuroinvasive disease (WNND, in a study at CDC&P, Fort Collins, CO.

  15. Africa, Sociocultural Overviews: West Africa

    NARCIS (Netherlands)

    Richards, P.

    2015-01-01

    This article offers an overview of social worlds, values, and material and nonmaterial cultures of the region south of the Sahara from Mauritania to Cameroon. Attention is paid, in particular, to modes of social solidarity and the cultural dynamics of community formation in West African settings.

  16. Endoscopic capacity in West Africa.

    African Journals Online (AJOL)

    edge among participants after didactics, objective data paired with subjective responses was more useful than either alone. Of 23 patients who received endoscopy, 7 required endoscopic intervention with 6 having gastric or esophageal varices. Currently the endoscopic capacity in West Africa is not sufficient. A formal GI ...

  17. Primary Schooling in West Bengal

    Science.gov (United States)

    Sen, Amartya

    2010-01-01

    With his Nobel Prize award money, Amartya Sen set up the Pratichi Trust which carries out research, advocacy and experimental projects in basic education, primary health care, and women's development in West Bengal and Bangladesh. Professor Sen himself took active interest in this work--helping set the agenda, looking at the evidence from…

  18. WEST AFRICAN JOURNAL OF MEDICINE

    African Journals Online (AJOL)

    user1

    Mots-clés: maladie de Parkinson, l'homocystéine, le Nigeria, la gravité, le handicap. WEST AFRICAN JOURNAL OF MEDICINE. ORIGINAL ARTICLE. ABSTRACT. BACKGROUND:Hyperhomocysteinaemia (HHcy) is as a long- term sequelum of levodopa therapy in Parkinson's disease. (PD). Information on its frequency and ...

  19. The West in Early Cinema

    NARCIS (Netherlands)

    Verhoeff, Nanna

    2006-01-01

    Verhoeff investigates the emergence of the western genre, made in the first two decades of cinema (1895-1915). By analyzing many unknown and forgotten films from international archives she traces the relationships between films about the American West, their surrounding films, and other popular

  20. WEST AFRICAN JOURNAL OF MEDICINE

    African Journals Online (AJOL)

    be a form of reversal to childhood.11. Among the American Indians dementia is considered to be a ..... to stigma.15. The Hausa- Fulani communities are found in many countries of the West-. African sub-region and cultural and religious inclinations are similar. It is thus reasonable to speculate that the findings of this study ...

  1. Arthurdale: Homesteading in West Virginia.

    Science.gov (United States)

    Hornyak, Deanna

    1996-01-01

    Recounts the history of the first subsistence community founded under the National Industrial Recovery Act during the Great Depression. Arthurdale, West Virginia, provided unemployed workers with rural homes on small plots where they could grow food and supply other needs through part-time industrial employment. A progressive community school…

  2. WEST AFRICAN JOURNAL OF MEDICINE

    African Journals Online (AJOL)

    user1

    Mots-clés: dyspepsie, gastrite, ulcère duodénal, sensibilité, spécificité. WEST AFRICAN JOURNAL OF MEDICINE. ORIGINAL ARTICLE. ABSTRACT. BACKGROUND: Increasing endoscopy workload in open- access services necessitates adoption of appropriateness criteria to check abuse and improve yield. OBJECTIVE: ...

  3. 33 CFR 110.189a - Key West Harbor, Key West, Fla., naval explosives anchorage area.

    Science.gov (United States)

    2010-07-01

    ... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 false Key West Harbor, Key West, Fla..., Key West, Fla., naval explosives anchorage area. (a) The anchorage ground. A circular area with its... this section shall be enforced by the Commander, U.S. Naval Base, Key West, Fla., and any other...

  4. Trigger Points: An Anatomical Substratum

    Directory of Open Access Journals (Sweden)

    Flávia Emi Akamatsu

    2015-01-01

    Full Text Available This study aimed to bring the trapezius muscle knowledge of the locations where the accessory nerve branches enter the muscle belly to reach the motor endplates and find myofascial trigger points (MTrPs. Although anatomoclinical correlations represent a major feature of MTrP, no previous reports describing the distribution of the accessory nerve branches and their anatomical relationship with MTrP are found in the literature. Both trapezius muscles from twelve adult cadavers were carefully dissected by the authors (anatomy professors and medical graduate students to observe the exact point where the branches of the spinal accessory nerve entered the muscle belly. Dissection was performed through stratigraphic layers to preserve the motor innervation of the trapezius muscle, which is located deep in the muscle. Seven points are described, four of which are motor points: in all cases, these locations corresponded to clinically described MTrPs. The four points were common in these twelve cadavers. This type of clinical correlation between spinal accessory nerve branching and MTrP is useful to achieve a better understanding of the anatomical correlation of MTrP and the physiopathology of these disorders and may provide a scientific basis for their treatment, rendering useful additional information to therapists to achieve better diagnoses and improve therapeutic approaches.

  5. Geodesics on Point Clouds

    Directory of Open Access Journals (Sweden)

    Hongchuan Yu

    2014-01-01

    Full Text Available We present a novel framework to compute geodesics on implicit surfaces and point clouds. Our framework consists of three parts, particle based approximate geodesics on implicit surfaces, Cartesian grid based approximate geodesics on point clouds, and geodesic correction. The first two parts can effectively generate approximate geodesics on implicit surfaces and point clouds, respectively. By introducing the geodesic curvature flow, the third part produces smooth and accurate geodesic solutions. Differing from most of the existing methods, our algorithms can converge to a given tolerance. The presented computational framework is suitable for arbitrary implicit hypersurfaces or point clouds with high genus or high curvature.

  6. West Nile virus encephalitis in organ transplant recipients: another high-risk group for meningoencephalitis and death.

    Science.gov (United States)

    DeSalvo, Debby; Roy-Chaudhury, Prabir; Peddi, Ram; Merchen, Todd; Konijetti, Krishna; Gupta, Manish; Boardman, Robyn; Rogers, Christin; Buell, Joseph; Hanaway, Michael; Broderick, Joseph; Smith, Roger; Woodle, E Steve

    2004-02-15

    West Nile virus infection has been spreading westward across the continental United States since 1999. Although it often presents as a mild, self-limiting viral illness, it can result in a devastating meningoencephalitis in some patient populations, particularly the elderly. We report in this article on two immunosuppressed transplant patients who developed a severe meningoencephalitis caused by mosquito-borne West Nile virus infection. Suggestions for the prevention, diagnosis, and treatment of West Nile virus infection in this patient population are described.

  7. Nickel Curie Point Engine

    Science.gov (United States)

    Chiaverina, Chris; Lisensky, George

    2014-01-01

    Ferromagnetic materials such as nickel, iron, or cobalt lose the electron alignment that makes them attracted to a magnet when sufficient thermal energy is added. The temperature at which this change occurs is called the "Curie temperature," or "Curie point." Nickel has a Curie point of 627 K, so a candle flame is a sufficient…

  8. Model Breaking Points Conceptualized

    Science.gov (United States)

    Vig, Rozy; Murray, Eileen; Star, Jon R.

    2014-01-01

    Current curriculum initiatives (e.g., National Governors Association Center for Best Practices and Council of Chief State School Officers 2010) advocate that models be used in the mathematics classroom. However, despite their apparent promise, there comes a point when models break, a point in the mathematical problem space where the model cannot,…

  9. Holographic Three point Functions

    DEFF Research Database (Denmark)

    Bissi, Agnese

    gravitons and a point like graviton and its dual counterpart, namely two Schur polynomials and a single trace chiral primary. Secondly we compute the one loop correction to planar, non extremal three point functions of two heavy and one light operators, both from the gauge and string side in the Frolov...

  10. Point of View.

    Science.gov (United States)

    Davis, Jonathan; Davis, Lisa

    1999-01-01

    Presents a learning activity plan for teachers or librarians that helps students comprehend the author's craft element of "point of view." Focus is on first and third person point of view. Outlines student motivation methods, the procedure, extension/application activities, and assessment. Includes an activity worksheet. (AEF)

  11. Multiplex PCR point of care testing versus routine, laboratory-based testing in the treatment of adults with respiratory tract infections: a quasi-randomised study assessing impact on length of stay and antimicrobial use.

    Science.gov (United States)

    Andrews, Denise; Chetty, Yumela; Cooper, Ben S; Virk, Manjinder; Glass, Stephen K; Letters, Andrew; Kelly, Philip A; Sudhanva, Malur; Jeyaratnam, Dakshika

    2017-10-10

    Laboratory-based respiratory pathogen (RP) results are often available too late to influence clinical decisions such as hospitalisation or antibiotic treatment due to time delay in transport of specimens and testing schedules. Ward-based i.e. point of care (POC) testing providing rapid results may alter the clinical management pathway. FilmArray® RP polymerase chain reaction (PCR) systems were placed in three in-patient and out-patient medical areas. Patients presenting with influenza-like illness /upper respiratory tract infection +/- lower RTI were recruited between January-July 2015. FilmArray® POC testing occurred on even days of the month (intervention) or routine, laboratory-based RP PCR testing +/- atypical serology on odd days (control). The primary outcome was length of hospital stay. The secondary outcomes were impact on the use of antimicrobials, readmissions, all-cause mortality, length of ward stay and turn-around time (TAT) (time to result from admission). Of 606 eligible patients, 545 (89.9%) were included; 211 in the control arm and 334 in the intervention arm. 20% of control arm patients and 24% of intervention arm patients had an RP detected. POC testing was not associated with the primary outcome measure, length of stay, but reduced the TAT from 39.5 h to 19.0 h, p FilmArray® testing. Despite this, POC testing allowed time-critical antivirals to be given significantly faster, appropriate mycoplasma treatment and results were available considerably faster than routine, laboratory-based testing. Ward-staff of all grades performed POC testing without difficulty suggesting potential use across many divergent healthcare settings. Further studies evaluating the implementation of rapid respiratory PCR POC testing and the effect on length of stay and antimicrobial use are required. ISRCTN10470967 , Retrospectively Registered, 30/6/2015.

  12. [West Nile virus. II. Immunopathophysiology in humans].

    Science.gov (United States)

    Lanteri, Marion C; Diamond, Michael S; Norris, Philip J; Busch, Michael P

    2011-04-01

    Since its emergence in 1999 in America, West Nile virus (WNV) has become the leading cause of arboviral encephalitis in the United States. The infection is often asymptomatic but, when clinical manifestations occur, a broad range of symptoms is observed from flu-like symptoms to more serious neurological disorders that can sometimes lead to death. No treatment or vaccine is available for humans. Ongoing studies are trying to understand the host-virus dynamics that lead to the development of severe neurological symptoms in a minority of infected subjects. The amount of knowledge that was gained from parallel studies in animals and humans, comparing asymptomatic and symptomatic individuals, and using what was known of other Flaviviruses, will eventually translate to the development of potential therapeutic and prophylactic solutions. This review presents a synthesis of the most relevant findings concerning the immune response to WNV and its impact on disease outcome and gives an overview of the most promising therapeutic and prophylactic solutions.

  13. Prevalence of rheumatoid arthritis in the French West Indies: Results of the EPPPRA study in Martinique.

    Science.gov (United States)

    Brunier, Lauren; Bleterry, Marie; Merle, Sylvie; Derancourt, Christian; Polomat, Katlyn; Dehlinger, Véronique; Deligny, Christophe; Jean-Baptiste, Georges; Arfi, Serge; Banydeen, Rishika; De Bandt, Michel

    2017-07-01

    Studies suggest that rheumatoid arthritis (RA) is less frequent in African populations. However, no recent precise data exists for Afro-Caribbeans. The EPPPRA project is a prospective epidemiological survey to describe prevalence and clinical aspects of RA in the French West Indies (Martinique, Guadeloupe, French Guiana). EPPPRA involved all rheumatologists from the French West Indies who included all patients with a known clinical diagnosis of RA, during a one-year period. We outline here results for Martinique. EPPPRA estimated an overall world age-standardized prevalence of RA at 0.10% [95% CI 0.09% to 0.11%] in Martinique, with a high female predominance (88.1%) and 93.1% of self-reported Afro-Caribbeans. Mean age at diagnosis was 49.6±16.0 years. A majority of subjects presented at least 4 criteria points from the 1987 American College of Rheumatology (ACR) classification (94.4%) and at least 6 points (78.2%) from the 2010 ACR/European League Against Rheumatism (EULAR) classification. A high immune seropositivity rate was highlighted (84.2%). Despite functional impact observed in 40.5% of patients, 71.4% presented a low disease activity level. Methotrexate was the most common ongoing treatment (73%), followed by biotherapies (24.4%). Numerous patients (68.6%) received a steroid regimen. Cardiovascular risk factors were very frequent, contrasting with a very low tobacco use (8.7%), CONCLUSION: This work outlines low standardized prevalence of RA in a French Afro-Caribbean population with specific characteristics (high female predominance, high immune seropositivity, low tobacco use). Despite easy access to care and biotherapies, approximately half of RA patients still present destructive disease with functional impact. Copyright © 2016 Société française de rhumatologie. Published by Elsevier SAS. All rights reserved.

  14. Effect on mortality of point-of-care, urine-based lipoarabinomannan testing to guide tuberculosis treatment initiation in HIV-positive hospital inpatients: a pragmatic, parallel-group, multicountry, open-label, randomised controlled trial.

    Science.gov (United States)

    Peter, Jonny G; Zijenah, Lynn S; Chanda, Duncan; Clowes, Petra; Lesosky, Maia; Gina, Phindile; Mehta, Nirja; Calligaro, Greg; Lombard, Carl J; Kadzirange, Gerard; Bandason, Tsitsi; Chansa, Abidan; Liusha, Namakando; Mangu, Chacha; Mtafya, Bariki; Msila, Henry; Rachow, Andrea; Hoelscher, Michael; Mwaba, Peter; Theron, Grant; Dheda, Keertan

    2016-03-19

    HIV-associated tuberculosis is difficult to diagnose and results in high mortality. Frequent extra-pulmonary presentation, inability to obtain sputum, and paucibacillary samples limits the usefulness of nucleic-acid amplification tests and smear microscopy. We therefore assessed a urine-based, lateral flow, point-of-care, lipoarabinomannan assay (LAM) and the effect of a LAM-guided anti-tuberculosis treatment initiation strategy on mortality. We did a pragmatic, randomised, parallel-group, multicentre trial in ten hospitals in Africa--four in South Africa, two in Tanzania, two in Zambia, and two in Zimbabwe. Eligible patients were HIV-positive adults aged at least 18 years with at least one of the following symptoms of tuberculosis (fever, cough, night sweats, or self-reported weightloss) and illness severity necessitating admission to hospital. Exclusion criteria included receipt of any anti-tuberculosis medicine in the 60 days before enrolment. We randomly assigned patients (1:1) to either LAM plus routine diagnostic tests for tuberculosis (smear microscopy, Xpert-MTB/RIF, and culture; LAM group) or routine diagnostic tests alone (no LAM group) using computer-generated allocation lists in blocks of ten. All patients were asked to provide a urine sample of at least 30 mL at enrolment, and trained research nurses did the LAM test in patients allocated to this group using the Alere Determine tuberculosis LAM Ag lateral flow strip test (Alere, USA) at the bedside on enrolment. On the basis of a positive test result, the nurses made a recommendation for initiating anti-tuberculosis treatment. The attending physician made an independent decision about whether to start treatment or not. Neither patients nor health-care workers were masked to group allocation and test results. The primary endpoint was 8-week all-cause mortality assessed in the modified intention-to-treat population (those who received their allocated intervention). This trial is registered with Clinical

  15. Short-Term Effects of Kinesio Taping and Cross Taping Application in the Treatment of Latent Upper Trapezius Trigger Points: A Prospective, Single-Blind, Randomized, Sham-Controlled Trial

    Directory of Open Access Journals (Sweden)

    Tomasz Halski

    2015-01-01

    Full Text Available Kinesio taping (KT may be a new treatment in patients with myofascial trigger points (MTrPs. A new method available for taping practitioners is cross taping (CT. The main objective was to determine how CT, KT, and medical adhesive tape (sham group affect the subjective assessment of resting bioelectrical activity and pain of the upper trapezius muscle (UT in patients with MTrPs. 105 volunteers were recruited to participate. The primary outcome was resting bioelectrical activity of UT muscle as assessed by surface electromyography (sEMG in each group and pain intensity on a visual analog scale (VAS. Assessments were collected before and after intervention and after the 24-hours follow-up. No significant differences were observed in bioelectrical activity of UT between pre-, post-, and follow-up results. In three groups patients had significantly lower pain VAS score after the intervention (CT—p<0.001, KT—p<0.001, and sham—p<0.01. The Kruskal-Wallis ANOVA showed no significant differences in almost all measurements between groups. The application of all three types of tapes does not influence the resting bioelectrical activity of UT muscle and may not lead to a reduction in muscle tone in the case of MTrPs.

  16. Permafrost degradation in West Greenland

    DEFF Research Database (Denmark)

    Foged, Niels Nielsen; Ingeman-Nielsen, Thomas

    2012-01-01

    Important aspects of civil engineering in West Greenland relate to the presence of permafrost and mapping of the annual and future changes in the active layer due to the ongoing climatically changes in the Arctic. The Arctic Technology Centre (ARTEK) has worked more than 10 years on this topic...... and the first author has been involved since 1970 in engineering geology, geotechnical engineering and permafrost related studies for foundation construction and infrastructures in towns and communities mainly in West Greenland. We have since 2006 together with the Danish Meteorological Institute, Greenland...... by HIRHAM climate projections for Greenland up to 2075. The engineering modelling is based on a risk assessment methodology based on a flow diagram which classify the risk of permafrost degradation causing settlement and stability problems for buildings and infrastructures based on relatively simple...

  17. Interesting Interest Points

    DEFF Research Database (Denmark)

    Aanæs, Henrik; Dahl, Anders Lindbjerg; Pedersen, Kim Steenstrup

    2012-01-01

    Not all interest points are equally interesting. The most valuable interest points lead to optimal performance of the computer vision method in which they are employed. But a measure of this kind will be dependent on the chosen vision application. We propose a more general performance measure based...... position. The LED illumination provides the option for artificially relighting the scene from a range of light directions. This data set has given us the ability to systematically evaluate the performance of a number of interest point detectors. The highlights of the conclusions are that the fixed scale...

  18. Do acupuncture points exist?

    Energy Technology Data Exchange (ETDEWEB)

    Yan Xiaohui; Zhang Xinyi [Department of Physics, Surface Physics Laboratory (State Key Laboratory), and Synchrotron Radiation Research Center of Fudan University, Shanghai 200433 (China); Liu Chenglin [Physics Department of Yancheng Teachers' College, Yancheng 224002 (China); Dang, Ruishan [Second Military Medical University, Shanghai 200433 (China); Huang Yuying; He Wei [Beijing Synchrotron Radiation Facility, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100039 (China); Ding Guanghong [Shanghai Research Center of Acupuncture and Meridian, Pudong, Shanghai 201203 (China)

    2009-05-07

    We used synchrotron x-ray fluorescence analysis to probe the distribution of four chemical elements in and around acupuncture points, two located in the forearm and two in the lower leg. Three of the four acupuncture points showed significantly elevated concentrations of elements Ca, Fe, Cu and Zn in relation to levels in the surrounding tissue, with similar elevation ratios for Cu and Fe. The mapped distribution of these elements implies that each acupuncture point seems to be elliptical with the long axis along the meridian. (note)

  19. Thermomechanical simulation of WEST actively cooled upper divertor

    Energy Technology Data Exchange (ETDEWEB)

    Batal, T., E-mail: tristan.batal@cea.fr; Richou, M.; Guilhem, D.; Firdaouss, M.; Larroque, S.; Ferlay, F.; Missirlian, M.; Bucalossi, J.

    2016-11-15

    The Tore Supra tokamak is being transformed in an x-point divertor fusion device in the frame of the WEST (W-for tungsten-Environment in Steady-state Tokamak) project, launched in support to the ITER tungsten divertor strategy. The WEST project aims to test ITER-like W monoblock Plasma Facing Units (PFU). This ITER-like divertor will be tested under long plasma discharge up to 1000 s, with high heat flux density up to 20 MW/m{sup 2}. This paper presents the results of ANSYS thermal-structural simulations of the WEST upper divertor. The upper divertor is made of twelve 30° sectors, each one composed of 38 PFU. The PFUs are actively cooled CuCrZr heat sinks and the incidence surface is coated with a thin tungsten layer. The fixing system is made of pins engaged in slotted holes. Besides, the fixing system of the sector assembly is the same as WEST lower divertor, so one upper divertor sector can be used indifferently in upper or Lower position during transitional operation phases in WEST. The total surface of the upper divertor is 8 m{sup 2}, and it has to be able to extract up to 4 MW in steady-state, with peak heat flux values up to 8 MW/m{sup 2}. The fixing system was designed to handle structural loads such as forces and torques resulting from halo and eddy current, respectively, especially during disruptions and Vertical Displacement Event (VDE). The torque resulting from eddy current is first calculated thanks to an internal CEA ANSYS APDL routine. Then the ANSYS structural and thermal-structural simulations of the PFU are presented, and its design is validated thanks to A-level RCC-MRx criteria. Finally, the most conservative load case is determined in order to validate the design of the pins and the support structure.

  20. Publication point indicators

    DEFF Research Database (Denmark)

    Elleby, Anita; Ingwersen, Peter

    2010-01-01

    The paper presents comparative analyses of two publication point systems, The Norwegian and the in-house system from the interdiscplinary Danish Institute for International Studies (DIIS), used as case in the study for publications published 2006, and compares central citation-based indicators...... with novel publication point indicators (PPIs) that are formalized and exemplified. Two diachronic citation windows are applied: 2006-07 and 2006-08. Web of Science (WoS) as well as Google Scholar (GS) are applied to observe the cite delay and citedness for the different document types published by DIIS......, journal articles, book chapters/conference papers and monographs. Journal Crown Indicator (JCI) calculations was based on WoS. Three PPIs are proposed: thePublication Point Ratio (PPR), which measures the sum of obtained publiacation points over the sum of the ideal pointws for the same set of documents...

  1. Triple Point Topological Metals

    Directory of Open Access Journals (Sweden)

    Ziming Zhu

    2016-07-01

    Full Text Available Topologically protected fermionic quasiparticles appear in metals, where band degeneracies occur at the Fermi level, dictated by the band structure topology. While in some metals these quasiparticles are direct analogues of elementary fermionic particles of the relativistic quantum field theory, other metals can have symmetries that give rise to quasiparticles, fundamentally different from those known in high-energy physics. Here, we report on a new type of topological quasiparticles—triple point fermions—realized in metals with symmorphic crystal structure, which host crossings of three bands in the vicinity of the Fermi level protected by point group symmetries. We find two topologically different types of triple point fermions, both distinct from any other topological quasiparticles reported to date. We provide examples of existing materials that host triple point fermions of both types and discuss a variety of physical phenomena associated with these quasiparticles, such as the occurrence of topological surface Fermi arcs, transport anomalies, and topological Lifshitz transitions.

  2. Point/Counterpoint

    DEFF Research Database (Denmark)

    Ungar, David; Ernst, Erik

    2007-01-01

    Point Argument: "Dynamic Languages (in Reactive Environments) Unleash Creativity," by David Ungar. For the sake of creativity, the profession needs to concentrate more on inventing new and better dynamic languages and environments and less on improving static languages. Counterpoint Argument...

  3. Iowa Geologic Sampling Points

    Data.gov (United States)

    Iowa State University GIS Support and Research Facility — Point locations of geologic samples/files in the IGS repository. Types of samples include well cuttings, outcrop samples, cores, drillers logs, measured sections,...

  4. Bedrock Outcrop Points Compilation

    Data.gov (United States)

    Vermont Center for Geographic Information — A compilation of bedrock outcrops as points and/or polygons from 1:62,500 and 1:24,000 geologic mapping by the Vermont Geological Survey, the United States...

  5. Allegheny County Address Points

    Data.gov (United States)

    Allegheny County / City of Pittsburgh / Western PA Regional Data Center — This dataset contains address points which represent physical address locations assigned by the Allegheny County addressing authority. Data is updated by County...

  6. Arctic climate tipping points.

    Science.gov (United States)

    Lenton, Timothy M

    2012-02-01

    There is widespread concern that anthropogenic global warming will trigger Arctic climate tipping points. The Arctic has a long history of natural, abrupt climate changes, which together with current observations and model projections, can help us to identify which parts of the Arctic climate system might pass future tipping points. Here the climate tipping points are defined, noting that not all of them involve bifurcations leading to irreversible change. Past abrupt climate changes in the Arctic are briefly reviewed. Then, the current behaviour of a range of Arctic systems is summarised. Looking ahead, a range of potential tipping phenomena are described. This leads to a revised and expanded list of potential Arctic climate tipping elements, whose likelihood is assessed, in terms of how much warming will be required to tip them. Finally, the available responses are considered, especially the prospects for avoiding Arctic climate tipping points.

  7. National Wetlands Inventory Points

    Data.gov (United States)

    Minnesota Department of Natural Resources — Wetland point features (typically wetlands that are too small to be as area features at the data scale) mapped as part of the National Wetlands Inventory (NWI). The...

  8. Non-alcoholic Fatty Liver Disease: East Versus West

    Science.gov (United States)

    Agrawal, Swastik; Duseja, Ajay K

    2012-01-01

    Non-alcoholic fatty liver disease (NAFLD) is an important cause of liver disease worldwide with prevalence ranging from 10% to 30% in various countries. It has become an important cause of unexplained rise in transaminases, cryptogenic cirrhosis, and cryptogenic hepatocellular carcinoma. Pathogenesis is related to obesity, insulin resistance, oxidative stress, lipotoxicity, and resultant inflammation in the liver progressing to fibrosis. Pharmacological treatment in patients with NAFLD is still evolving and the treatment of these patients rests upon lifestyle modification with diet and exercise being the cornerstones of therapy. While there are many similarities between patients with NAFLD from Asia and the West, there are certain features which make the patients with NAFLD from Asia stand apart. This review highlights the data on NAFLD from Asia comparing it with the data from the West. PMID:25755421

  9. Indexing Moving Points

    DEFF Research Database (Denmark)

    Agarwal, Pankaj K.; Arge, Lars Allan; Erickson, Jeff

    2003-01-01

    We propose three indexing schemes for storing a set S of N points in the plane, each moving along a linear trajectory, so that any query of the following form can be answered quickly: Given a rectangle R and a real value t, report all K points of S that lie inside R at time t. We first present...... an indexing structure that, for any given constant >0, uses O(N/B) disk blocks and answers a query in O((N/B)1/2+ +K/B) I/Os, where B is the block size. It can also report all the points of S that lie inside R during a given time interval. A point can be inserted or deleted, or the trajectory of a point can...... be changed, in O(logB2 N) I/Os. Next, we present a general approach that improves the query time if the queries arrive in chronological order, by allowing the index to evolve over time. We obtain a tradeoff between the query time and the number of times the index needs to be updated as the points move. We...

  10. Herbicide hardwood crop tree release in central West Virginia

    Science.gov (United States)

    Jeffrey D. Kochenderfer; Shepard M. Zedaker; James E. Johnson; David W. Smith; Gary W. Miller

    2001-01-01

    Chemical crop tree release treatments were applied to young hardwood stands at three sites in central West Virginia to evaluate the effectiveness of glyphosate as Accord (41.5% SL), imazapyr as Arsenal AC (53.1% SL) and Chopper (27.6% EC), and triclopyr as Garlon 3A (44.4% triethylamine salt SL), and Garlon 4 (61.6% butoxyethyl ester EC) using hack-and-squirt injection...

  11. Ottawa National Wildlife Refuge Complex (Ottawa NWR, Cedar Point NWR, Darby Division, Navarre Division) : 1973 Annual Narrative Report

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This annual narrative report for Ottawa National Wildlife Refuge, Cedar Point National Wildlife Refuge, West Sister Island National Wildlife Refuge, Navarre Unit,...

  12. Rising costs of both sewage treatment and the production of potable water associated with increasing levels of pollution in a portion of the crocodile-west Marico water management area

    CSIR Research Space (South Africa)

    Roux, SP

    2010-04-01

    Full Text Available terms is the analysis of the costs incurred by municipal and private entities responsible for waste water treatment and potable water purification. Technology used to treat relative good quality water less than a decade ago must now be viewed as outdated...

  13. [Mechanisms of muscle pain : significance of trigger points and tender points].

    Science.gov (United States)

    Brezinschek, H-P

    2008-12-01

    Fibromyalgia syndrome (FMS) and myofascial pain syndrome (MPS) belong to the group of chronic non-inflammatory pain syndromes affecting muscles and tendinous insertions. Important criteria in the diagnosis of both diseases are the presence of "tender points" and "trigger points". According to ACR criteria FMS is characterized by the presence of tender points whereas trigger points are typically found in MPS.The main difference is that until now tender points could only be defined in terms of their localization, whereas trigger points can be found upon palpation which may cause a specific referred pain pattern. In addition, analysis of trigger points by microdialysis demonstrated elevated levels of pro-inflammatory substances at these sites. Moreover, local treatment of trigger points either by manipulative therapy or injection appears to be most effective for prompt relief of symptoms.

  14. COMBINED GEOMETRIC/RADIOMETRIC POINT CLOUD MATCHING FOR SHEAR ANALYSIS

    Directory of Open Access Journals (Sweden)

    S. Gehrke

    2012-07-01

    Full Text Available In the recent past, dense image matching methods such as Semi-Global Matching (SGM became popular for many applications. The SGM approach has been adapted to and implemented for Leica ADS line-scanner data by North West Geomatics (North West in co-operation with Leica Geosystems; it is used in North West’s production workflow. One of the advantages of ADS imagery is the calibrated color information (RGB and near infrared, extending SGM-derived point clouds to dense “image point clouds” or, more general, information clouds (info clouds. With the goal of automating the quality control of ADS data, info clouds are utilized for Shear Analysis: Three-dimensional offsets of adjacent ADS image strips are determined from a pattern of info cloud pairs in strip overlaps by point cloud matching. The presented approach integrates geometry (height and radiometry (intensity information; matching is based on local point-to-plane distances for all points in a given cloud. The offset is derived in a least squares adjustment by applying it to each individual distance computation equation. Using intensities in addition to heights greatly benefits the offset computation, because intensity gradients tend to occur more frequently than height gradients. They can provide or complement the required information for the derivation of planimetric offset components. The paper details the combined geometric/radiometric point cloud matching approach and verifies the results against manual measurements.

  15. Grizzly West: A Failed Attempt to Reintroduce Grizzly Bears in the Mountain West

    OpenAIRE

    Douglas M. Richardson

    2016-01-01

    Reviewed: Grizzly West: A Failed Attempt to Reintroduce Grizzly Bears in the Mountain West. By Michael M. Dax. Lincoln, NE: University of Nebraska Press, 2015. x + 289 pp. US$ 37.50. ISBN 978-0-8032-6673-5.

  16. Population Structure of West Greenland Narwhals

    DEFF Research Database (Denmark)

    Riget, F.; Dietz, R.; Møller, P.

    The hypothesis that different populations of narwhals in the West Greenland area exist has been tested by different biomarkers (metal and organochlorine concentrations, stable isotopes and DNA). Samples of muscle, liver, kidney, blubber and skin tissues of narwhals from West Greenland have been...... isotopes could not support the population structure with two West Greenland populations suggested by the genetic study....... analysed for heavy metals, organochlorines, stable isotopes and DNA. The obtained results of metal concentrations and DNA were included in the existing database, whereas no previous data on organochlorines and stable isotopes in West Greenland narwhals existed. The metal and POP concentrations and stable...

  17. PowerPoint Presentation

    Indian Academy of Sciences (India)

    Table of contents. PowerPoint Presentation · CHANDIPURA VIRUS · Slide 3 · Slide 4 · Slide 5 · VIRUSES · PROPERTIES OF VIRUSES · CLASSIFICATION OF VIRUSES · VIRUS FAMILIES · VIRUS FAMILIES – contd · General Classification · Slide 12 · Slide 13 · Slide 14 · Slide 15 · Slide 16 · Slide 17 · Slide 18 · Slide 19.

  18. ACCESS Pointing Control System

    Science.gov (United States)

    Brugarolas, Paul; Alexander, James; Trauger, John; Moody, Dwight; Egerman, Robert; Vallone, Phillip; Elias, Jason; Hejal, Reem; Camelo, Vanessa; Bronowicki, Allen; hide

    2010-01-01

    ACCESS (Actively-Corrected Coronograph for Exoplanet System Studies) was one of four medium-class exoplanet concepts selected for the NASA Astrophysics Strategic Mission Concept Study (ASMCS) program in 2008/2009. The ACCESS study evaluated four major coronograph concepts under a common space observatory. This paper describes the high precision pointing control system (PCS) baselined for this observatory.

  19. Hillclimbing saddle point inflation

    Science.gov (United States)

    Kawana, Kiyoharu; Sakai, Katsuta

    2018-03-01

    Recently a new inflationary scenario was proposed in [1] which can be applicable to an inflaton having multiple vacua. In this letter, we consider a more general situation where the inflaton potential has a (UV) saddle point around the Planck scale. This class of models can be regarded as a natural generalization of the hillclimbing Higgs inflation [2].

  20. Publication point indicators

    DEFF Research Database (Denmark)

    Elleby, Anita; Ingwersen, Peter

    2010-01-01

    with novel publication point indicators (PPIs) that are formalized and exemplified. Two diachronic citation windows are applied: 2006-07 and 2006-08. Web of Science (WoS) as well as Google Scholar (GS) are applied to observe the cite delay and citedness for the different document types published by DIIS...

  1. New Novae snack point

    CERN Multimedia

    2012-01-01

    Located next to the car park by the flag poles, a few metres from the Main CERN Reception (building 33), a new snack point catered by Novae will open to the public on Wednesday 8 August. More information will be available in the next issue of the Bulletin!

  2. Holographic Three point Functions

    DEFF Research Database (Denmark)

    Martirosyan, Ara

    . In the spirit of understanding this problem better, the thesis discusses the divergences appearing in the calculation of structure constants involving two giant and one point-like gravitons in the string theories on AdS_5 x S^5 and AdS_4 x S^7/Z_k backgrounds. Coherent state approach for the tree-level...

  3. PowerPoint Presentation

    Indian Academy of Sciences (India)

    Table of contents. PowerPoint Presentation · There are 5 Speakers- The Ultimate dream is to get the Road map for connectivity to NE · Witnessing the Revolution · Some History · Slide 5 · Itanium® Processor Family Roadmap ... Growth of Wireless & Internet- Source Motorola · Convergence · Internet Alone is Not Enough…

  4. Colposcopy services in the West Midlands region.

    Science.gov (United States)

    Woodman, C B; Jordan, J A

    1989-10-07

    A survey of all 72 consultant gynaecologists in the West Midlands region was carried out to determine their views on colposcopy services. All districts provided a colposcopy service and 47 consultants practised colposcopy. The consultants differed considerably in their views on criteria for referring women for investigation after smears. All but one thought that a positive smear result was an indication for immediate referral but whereas 55 thought that women with one or more inflammatory smear should be referred, 17 did not believe this to be necessary. Sixty seven consultants thought a preoperative colposcopic assessment desirable, but 10 had to ration referrals because of limited resources. Four forms of treatment were used: 17 districts had a carbon dioxide laser, eight used low voltage diathermy loop excision, two had only a cold coagulator, and one used only cold cautery. There was widespread dissatisfaction with resources and about the increasing amount of time spent on the service at the expense of other work. Consultants were also concerned about the relevance of much of what was done to the aim of the screening programme--reducing mortality from cervical cancer. Although additional resources are needed in some districts, referral policies, indications for colposcopic assessment, training, choice of treatment, and the value of follow up need to be reviewed if the service is to be improved.

  5. 78 FR 79061 - Noise Exposure Map Notice; Key West International Airport, Key West, FL

    Science.gov (United States)

    2013-12-27

    ... Federal Aviation Administration Noise Exposure Map Notice; Key West International Airport, Key West, FL... Administration (FAA) announces its determination that the Noise Exposure Maps submitted by Monroe County for the...: This notice announces that the FAA finds that the Noise Exposure Maps submitted for the Key West...

  6. Lessons Learned from the 200 West Pump and Treatment Facility Construction Project at the US DOE Hanford Site - A Leadership for Energy and Environmental Design (LEED) Gold-Certified Facility - 13113

    Energy Technology Data Exchange (ETDEWEB)

    Dorr, Kent A.; Freeman-Pollard, Jhivaun R.; Ostrom, Michael J. [CH2M HILL Plateau Remediation Company, P.O. Box 1600, MSIN R4-41, 99352 (United States)

    2013-07-01

    CH2M Hill Plateau Remediation Company (CHPRC) designed, constructed, commissioned, and began operation of the largest groundwater pump and treatment facility in the U.S. Department of Energy's (DOE) nationwide complex. This one-of-a-kind groundwater pump and treatment facility, located at the Hanford Nuclear Reservation Site (Hanford Site) in Washington State, was built to an accelerated schedule with American Recovery and Reinvestment Act (ARRA) funds. There were many contractual, technical, configuration management, quality, safety, and Leadership in Energy and Environmental Design (LEED) challenges associated with the design, procurement, construction, and commissioning of this $95 million, 52,000 ft groundwater pump and treatment facility to meet DOE's mission objective of treating contaminated groundwater at the Hanford Site with a new facility by June 28, 2012. The project team's successful integration of the project's core values and green energy technology throughout design, procurement, construction, and start-up of this complex, first-of-its-kind Bio Process facility resulted in successful achievement of DOE's mission objective, as well as attainment of LEED GOLD certification (Figure 1), which makes this Bio Process facility the first non-administrative building in the DOE Office of Environmental Management complex to earn such an award. (authors)

  7. Lessons Learned from the 200 West Pump and Treatment Facility Construction Project at the US DOE Hanford Site - A Leadership for Energy and Environmental Design (LEED) Gold-Certified Facility

    Energy Technology Data Exchange (ETDEWEB)

    Dorr, Kent A.; Ostrom, Michael J.; Freeman-Pollard, Jhivaun R.

    2013-01-11

    CH2M Hill Plateau Remediation Company (CHPRC) designed, constructed, commissioned, and began operation of the largest groundwater pump and treatment facility in the U.S. Department of Energy’s (DOE) nationwide complex. This one-of-a-kind groundwater pump and treatment facility, located at the Hanford Nuclear Reservation Site (Hanford Site) in Washington State, was built to an accelerated schedule with American Recovery and Reinvestment Act (ARRA) funds. There were many contractual, technical, configuration management, quality, safety, and Leadership in Energy and Environmental Design (LEED) challenges associated with the design, procurement, construction, and commissioning of this $95 million, 52,000 ft groundwater pump and treatment facility to meet DOE’s mission objective of treating contaminated groundwater at the Hanford Site with a new facility by June 28, 2012. The project team’s successful integration of the project’s core values and green energy technology throughout design, procurement, construction, and start-up of this complex, first-of-its-kind Bio Process facility resulted in successful achievement of DOE’s mission objective, as well as attainment of LEED GOLD certification, which makes this Bio Process facility the first non-administrative building in the DOE Office of Environmental Management complex to earn such an award.

  8. Screening and Early Detection of Gastric Cancer: East Versus West.

    Science.gov (United States)

    Suh, Yun-Suhk; Yang, Han-Kwang

    2015-10-01

    Low ratio of mortality over incidence of gastric cancer in Asian countries including Korea and Japan could be explained by early detection after screening, different treatment strategy, or genetic disparity between the East and West. Early detection after screening program for gastric cancer and subsequent surgical treatment including appropriate lymph node dissection has been developed successfully in high risk areas such as East Asian countries. Even in countries with a low prevalence of gastric cancer, a specific screening program is recommended for any high-risk population. Copyright © 2015 Elsevier Inc. All rights reserved.

  9. Spirit's Surroundings on 'West Spur,' Sol 305 (Vertical)

    Science.gov (United States)

    2005-01-01

    This 360-degree panorama shows the terrain surrounding NASA's Mars Exploration Rover Spirit as of the rover's 305th martian day, or sol, (Nov. 11, 2004). At that point, Spirit was climbing the 'West Spur' of the 'Columbia Hills.' The rover had just finished inspecting a rock called 'Lutefisk' and was heading uphill toward an area called 'Machu Picchu.' Spirit used its navigational camera to take the images combined into this mosaic. The rover's location when the images were taken is catalogued as the mission's site 89, position 205. The view is presented here as a vetical projection with geometric seam correction.

  10. Spirit's Surroundings on 'West Spur,' Sol 305 (Polar)

    Science.gov (United States)

    2005-01-01

    This 360-degree panorama shows the terrain surrounding NASA's Mars Exploration Rover Spirit as of the rover's 305th martian day, or sol, (Nov. 11, 2004). At that point, Spirit was climbing the 'West Spur' of the 'Columbia Hills.' The rover had just finished inspecting a rock called 'Lutefisk' and was heading uphill toward an area called 'Machu Picchu.' Spirit used its navigational camera to take the images combined into this mosaic. The rover's location when the images were taken is catalogued as the mission's site 89, position 205. The view is presented here as a polar projection with geometric seam correction.

  11. ARM West Antarctic Radiation Experiment (AWARE) Field Campaign Report

    Energy Technology Data Exchange (ETDEWEB)

    Lubin, Daniel [Univ. of California, San Diego, CA (United States). Scripps Inst. of Oceanography; Bromwich, David H [Ohio State University; Vogelmann, Andrew M [Brookhaven National Lab. (BNL), Upton, NY (United States); Verlinde, Johannes [Pennsylvania State Univ., University Park, PA (United States); Russell, Lynn M [Univ. of California, San Diego, CA (United States). Scripps Inst. of Oceanography

    2017-09-15

    The U.S. Department of Energy (DOE) Atmospheric Radiation Measurement (ARM) West Antarctic Radiation Experiment (AWARE) is the most technologically advanced atmospheric and climate science campaign yet fielded in Antarctica. AWARE was motivated be recent concern about the impact of cryospheric mass loss on global sea level rise. Specifically, the West Antarctic Ice Sheet (WAIS) is now the second largest contributor to rising sea level, after the Greenland Ice Sheet. As steadily warming ocean water erodes the grounding lines of WAIS components where they meet the Amundsen and Bellingshausen Seas, the retreating grounding lines moving inland and downslope on the underlying terrain imply mechanical instability of the entire WAIS. There is evidence that this point of instability may have already been reached, perhaps signifying more rapid loss of WAIS ice mass. At the same time, the mechanical support provided by adjacent ice shelves, and also the fundamental stability of exposed ice cliffs at the ice sheet grounding lines, will be adversely impacted by a warming atmosphere that causes more frequent episodes of surface melting. The surface meltwater damages the ice shelves and ice cliffs through hydrofracturing. With the increasing concern regarding these rapid cryospheric changes, AWARE was motivated by the need to (a) diagnose the surface energy balance in West Antarctica as related to both summer season climatology and potential surface melting, and (b) improve global climate model (GCM) performance over Antarctica, such that future cryospheric projections can be more reliable.

  12. A Question That Counts in French West Indies Maritime Archaeology: Linking Historical and Archaeological Sources

    OpenAIRE

    Guibert, Jean-Sébastien

    2014-01-01

    International audience; This paper presents part of the results of historical research for a PhD thesis focusing on seafaring and maritime activityin Guadeloupe, French West Indies (FWI). Additionally, it discusses the possible identification of five shipwreck sitesthat appear to date to the 19th century: Anse à la Barque, Pointe-à-Pitre, Baie des Saintes, Sainte-Anne and Le Mouleshipwrecks.

  13. Further study of the variability in the frequency of typhoon formation over the West Pacific ocean

    Energy Technology Data Exchange (ETDEWEB)

    Ding, Y.H.; Reiter, E.R.

    1980-01-01

    This paper presents a study of the variability in the frequency of typhoon formation over the West Pacific ocean, emphasizing the effects of the large-scale sea-air system on the activity of typhoons. Some important relationships between typhoon formation and the climatological aspect of air-sea interaction are pointed out.

  14. Point clouds in BIM

    Science.gov (United States)

    Antova, Gergana; Kunchev, Ivan; Mickrenska-Cherneva, Christina

    2016-10-01

    The representation of physical buildings in Building Information Models (BIM) has been a subject of research since four decades in the fields of Construction Informatics and GeoInformatics. The early digital representations of buildings mainly appeared as 3D drawings constructed by CAD software, and the 3D representation of the buildings was only geometric, while semantics and topology were out of modelling focus. On the other hand, less detailed building representations, with often focus on ‘outside’ representations were also found in form of 2D /2,5D GeoInformation models. Point clouds from 3D laser scanning data give a full and exact representation of the building geometry. The article presents different aspects and the benefits of using point clouds in BIM in the different stages of a lifecycle of a building.

  15. Precise Point Positioning

    DEFF Research Database (Denmark)

    Zhang, Xiaohong

    could be achievable depending on the observation session length, and kinematic positioning accuracy can reach cm to dm level. Furthermore, a new method for airborne lidar system misalignment calibration was described in detail. The proposed method was a so called ‘stepwise geometric misalignment......This report presents the results of investigations to determine accurate positions of aircrafts in airborne surveys (airborne gravity and airborne lidar) using precise point positioning, and also introduces a new so called “stepwise geometric misalignment determination” method to retrieve...... determination’ based on the relationship between the point clouds on regular objects (e.g. flat top buildings) and the ground truth of the objects used for calibration. In order to extract the footprints on the objects, filtering was implemented before the calibration. Three example tests have been made...

  16. the Fixed Point Consideration

    Directory of Open Access Journals (Sweden)

    Penumurthy Parvateesam Murthy

    2013-01-01

    Full Text Available A fixed point theorem is presented for single-valued map with using generalized φ-weak contractive condition involving various combinations of dx,y on a complete metric space. Our result is an extension as well as a generalization of Alber and Guerre-Delabriere (1997 in particular. It also generalizes the results of Rhoades (2001, Choudhury and Dutta, (2000, and Dutta and Choudhury, (2008.

  17. Oscillating stagnation point flow

    Science.gov (United States)

    Grosch, C. E.; Salwen, H.

    1982-01-01

    A solution of the Navier-Stokes equations is given for an incompressible stagnation point flow whose magnitude oscillates in time about a constant, non-zero, value (an unsteady Hiemenz flow). Analytic approximations to the solution in the low and high frequency limits are given and compared with the results of numerical integrations. The application of these results to one aspect of the boundary layer receptivity problem is also discussed.

  18. Critical point predication device

    Energy Technology Data Exchange (ETDEWEB)

    Matsumura, Kazuhiko [Toshiba Corp., Kawasaki, Kanagawa (Japan); Kariyama, Koji

    1996-12-13

    An operation for predicting a critical point by using a existent reverse multiplication method has been complicated, and an effective multiplication factor could not be plotted directly to degrade the accuracy for the prediction. The present invention comprises a detector counting memory section for memorizing the counting sent from a power detector which monitors the reactor power, a reverse multiplication factor calculation section for calculating the reverse multiplication factor based on initial countings and current countings of the power detector, and a critical point prediction section for predicting the criticality by the reverse multiplication method relative to effective multiplication factors corresponding to the state of the reactor core previously determined depending on the cases. In addition, a reactor core characteristic calculation section is added for analyzing an effective multiplication factor depending on the state of the reactor core. Then, if the margin up to the criticality is reduced to lower than a predetermined value during critical operation, an alarm is generated to stop the critical operation when generation of a period of more than a predetermined value predicted by succeeding critical operation. With such procedures, forecasting for the critical point can be easily predicted upon critical operation to greatly mitigate an operator`s burden and improve handling for the operation. (N.H.)

  19. Anal Cancer Treatment

    Science.gov (United States)

    ... Professional Anal Cancer Treatment Anal Cancer Prevention Research Anal Cancer Treatment (PDQ®)–Patient Version General Information About Anal Cancer Go to Health Professional Version Key Points ...

  20. Briefing : West Africa and its oil

    NARCIS (Netherlands)

    Ellis, S.

    2003-01-01

    The US war on terrorism and preparations for war against Iraq have enormously increased the strategic value of West African oil reserves. This comes at a time when there have been massive new discoveries in offshore waters. This article focuses on the increased US interests in West African oil. It

  1. West African Journal of Applied Ecology

    African Journals Online (AJOL)

    The focus of the West African Journal of Applied Ecologyis on ecology, agriculture and water pollution. It aims to serve as an avenue for lecturers and researchers in West Africa to publish their work. Other websites related to this journal are http://apps.ug.edu.gh/wajae/.

  2. Future markers of the West Greenlandic

    DEFF Research Database (Denmark)

    Trondhjem, Naja Blytmann

    2010-01-01

    and aspect grammaticalization in West Greenlandic and Chukchi. In: La dynamique et la culture inuit. /Nicole Tersis et Michèle Terrien (eds.) p. 151-175. Kristoffersen, Lars (1991) Verbal derivation and inflection in a functional grammar of West Greenlandic. Magisterkonferens, Københavns Universitet...

  3. Archives: West African Journal of Medicine

    African Journals Online (AJOL)

    Items 1 - 40 of 40 ... Archives: West African Journal of Medicine. Journal Home > Archives: West African Journal of Medicine. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register · Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives. 1 - 40 of ...

  4. Provision of domiciliary dental care in North and West Belfast.

    Science.gov (United States)

    Stevens, Anne; Crealey, Grainne E; Murray, Ashley M

    2008-07-01

    To determine the level of domiciliary care currently provided for patients by general dental practitioners (GDPs) and to investigate factors that influence the provision of domiciliary dental care in an area of high socioeconomic deprivation in North and West Belfast. A descriptive study, involving a self-administered postal questionnaire sent to GDPs (n=89) in North and West Belfast. A valid response rate of 67% was achieved. Almost 20% of responding GDPs reported that they did not routinely offer domiciliary dental care. Of those who did, prosthetic treatment was undertaken most commonly, and other more time-consuming treatments such as fillings were referred to the Community Dental Services (CDS). Many GDPs reported not having a full range of domiciliary equipment, with only half of the GDPs surveyed carrying emergency drugs. Reasons cited for not providing the service were lack of time, the perception that patients would be too difficult to manage, and not having the appropriate equipment. The majority of responding dentists (85%) felt that domiciliary care should be referred to the community service. The rate of domiciliary care provision in North and West Belfast appears to be falling, despite it being an area of high socioeconomic deprivation where the demand for the service is growing. The general perception was that domiciliary care is too time-consuming, that the patients are too difficult to manage, and that there was a lack of appropriate equipment. As a result, the majority of GDPs in North and West Belfast felt that the CDS should care for all domiciliary patients.

  5. Status of the new WEST plasma control system

    Energy Technology Data Exchange (ETDEWEB)

    Ravene, Nathalie, E-mail: nathalie.ravenel@gmail.com [IRFM, CEA, F-13108 Saint Paul lez Durance (France); Nouailletas, Rémy; Signoret, Jacqueline; Guillerminet, Bernard [IRFM, CEA, F-13108 Saint Paul lez Durance (France); Treutterrer, Wolfgang [Max-Planck-Institut für Plasmaphysik, Boltzmannstraße 2, 85748 Garching (Germany); Spring, Anett [Max-Planck-Institut für Plasmaphysik, Teilinstitut Greifswald, Wendelsteinstraße 1, D-17491 Greifswald (Germany); Masand, Harish; Dhongde, Jasraj; Bhandarkar, Manisha [Institute for Plasma Research (IPR), Near Indira Bridge, Bhat, Gandhinagar, 382 428 Gujarat (India); Rapson, Chris [Max-Planck-Institut für Plasmaphysik, Boltzmannstraße 2, 85748 Garching (Germany); Laqua, Heike; Lewerentz, Marc [Max-Planck-Institut für Plasmaphysik, Teilinstitut Greifswald, Wendelsteinstraße 1, D-17491 Greifswald (Germany); Moreau, Philippe; Brémond, Sylvain; Allegretti, Ludovic [IRFM, CEA, F-13108 Saint Paul lez Durance (France); Raupp, Gerhard [Max-Planck-Institut für Plasmaphysik, Boltzmannstraße 2, 85748 Garching (Germany); Werner, Andreas [Max-Planck-Institut für Plasmaphysik, Teilinstitut Greifswald, Wendelsteinstraße 1, D-17491 Greifswald (Germany); Laurent, François Saint; Nardon, Eric [IRFM, CEA, F-13108 Saint Paul lez Durance (France)

    2016-11-15

    The WEST (W – for Tungsten – Environment in Steady state Tokamak) project is aiming at minimizing technology and operational risks of a full tungsten actively cooled divertor on ITER. It was started in 2013 and consists in transforming the Tore Supra tokamak into an X point divertor device, while taking advantage of its long discharge capability. To operate the next coming operations of WEST, new controllers are required. These developments are an opportunity to develop a new Plasma Control System (PCS) architecture featuring build-in real time handling of both plasma and plants events, thus addressing key ITER needs. The Tore Supra PCS will be refurbished including a new Pulse Schedule Editor (PSE). The main idea is to use a time segmented approach to describe the pulse schedule with a full integration of event handling both on PCS and PSE. Further to detailed requirement specifications and architecture design, two software tools were selected to define and execute a whole plasma discharge defined as a set of time segments. The PCS real-time framework (RTF) is based on an upgraded version of the AUG framework, called DCS (Discharge Control System). The PSE is the Xedit application used on WEGA and under further development for W7-X facility. This paper reports on the status of the new WEST PCS developments. The on-going developments to adapt DCS to the Tore Supra Control infrastructure networks (new real-time network, chronology system and pulse supervision) will be reported. The required preparations for the use of Xedit will be presented, mainly the appropriate formal description of the WEST control system and the implementation of the mapping between the Xedit experiment configuration and DCS configuration files.

  6. Human Rights in the West

    Directory of Open Access Journals (Sweden)

    Jorgen S. Nielsen

    1996-12-01

    Full Text Available One of the areas of conflict between Islam and the West in today’s world is the concern for human rights. This has sometimes been criticized in the Muslim world as a form of neo-imperialism. It is therefore necessary to understand the various dimensions of human rights, and the various phases through which this concern has grown. In the earliest form, it was an assertion of the rights of the landed aristocracy against those of the monarch. The French revolution, with its emphasis on "liberty, equality and fraternity," for all individuals, provided another dimension. There were many occasions on which individual and organized religion came into conflict during the Middle Ages. The experience of World War II, particularly the atrocities of the Nazis, led to the internationalization of individual rights.

  7. Introduction to myofascial trigger points in dogs.

    Science.gov (United States)

    Wall, Rick

    2014-06-01

    In dogs, muscles make up 44%-57% of total body weight and can serve as source of both pain and dysfunction when myofascial trigger points are present. However, rarely is muscle mentioned as a generator of pain in dogs, and even less mentioned is muscle dysfunction. The veterinary practitioner with interest in pain management, rehabilitation, orthopedics, and sports medicine must be familiar with the characteristics, etiology, and precipitating factors of myofascial trigger points. Additionally, the development of examination and treatment skill is needed to effectively manage myofascial trigger points in dogs. Copyright © 2014 Elsevier Inc. All rights reserved.

  8. Vernal Point and Anthropocene

    Science.gov (United States)

    Chavez-Campos, Teodosio; Chavez S, Nadia; Chavez-Sumarriva, Israel

    2014-05-01

    The time scale was based on the internationally recognized formal chronostratigraphical /geochronological subdivisions of time: The Phanerozoic Eonathem/Eon; the Cenozoic Erathem/Era; the Quaternary System/Period; the Pleistocene and Holocene Series/Epoch. The Quaternary was divided into: (1) The Pleistocene that was characterized by cycles of glaciations (intervals between 40,000 and 100,000 years). (2) The Holocene that was an interglacial period that began about 12,000 years ago. It was believed that the Milankovitch cycles (eccentricity, axial tilt and the precession of the equinoxes) were responsible for the glacial and interglacial Holocene periods. The magnetostratigraphic units have been widely used for global correlations valid for Quaternary. The gravitational influence of the sun and moon on the equatorial bulges of the mantle of the rotating earth causes the precession of the earth. The retrograde motion of the vernal point through the zodiacal band is 26,000 years. The Vernal point passes through each constellation in an average of 2000 years and this period of time was correlated to Bond events that were North Atlantic climate fluctuations occurring every ≡1,470 ± 500 years throughout the Holocene. The vernal point retrogrades one precessional degree approximately in 72 years (Gleissberg-cycle) and approximately enters into the Aquarius constellation on March 20, 1940. On earth this entry was verify through: a) stability of the magnetic equator in the south central zone of Peru and in the north zone of Bolivia, b) the greater intensity of equatorial electrojet (EEJ) in Peru and Bolivia since 1940. With the completion of the Holocene and the beginning of the Anthropocene (widely popularized by Paul Crutzen) it was proposed the date of March 20, 1940 as the beginning of the Anthropocene. The date proposed was correlated to the work presented in IUGG (Italy 2007) with the title "Cusco base meridian for the study of geophysical data"; Cusco was

  9. Tipping point leadership.

    Science.gov (United States)

    Kim, W Chan; Mauborgne, Renée

    2003-04-01

    When William Bratton was appointed police commissioner of New York City in 1994, turf wars over jurisdiction and funding were rife and crime was out of control. Yet in less than two years, and without an increase in his budget, Bratton turned New York into the safest large city in the nation. And the NYPD was only the latest of five law-enforcement agencies Bratton had turned around. In each case, he succeeded in record time despite limited resources, a demotivated staff, opposition from powerful vested interests, and an organization wedded to the status quo. Bratton's turnarounds demonstrate what the authors call tipping point leadership. The theory of tipping points hinges on the insight that in any organization, fundamental changes can occur quickly when the beliefs and energies of a critical mass of people create an epidemic movement toward an idea. Bratton begins by overcoming the cognitive hurdles that block organizations from recognizing the need for change. He does this by putting managers face-to-face with operational problems. Next, he manages around limitations on funds, staff, or equipment by concentrating resources on the areas that are most in need of change and that have the biggest payoffs. He meanwhile solves the motivation problem by singling out key influencers--people with disproportionate power due to their connections or persuasive abilities. Finally, he closes off resistance from powerful opponents. Not every CEO has the personality to be a Bill Bratton, but his successes are due to much more than his personality. He relies on a remarkably consistent method that any manager looking to turn around an organization can use to overcome the forces of inertia and reach the tipping point.

  10. The Temporal Tipping Point

    DEFF Research Database (Denmark)

    Hermann, A. K.

    2016-01-01

    and analyses of their journalistic works, this paper offers a study of ethnographic journalism suggesting that slow time operates in at least three separate registers. First, in terms of regimentation, ethnographic journalism is mostly long-form pieces that demand time-consuming research and careful writing...... and editing. Second, in terms of representation, practitioners report on the quotidian rather than urgent events. Third, deceleration is an essential tool for acquiring an insider's perspective. Ethnographic journalists describe a point during reporting at which their attitudes begin to change and they start...

  11. Fractal-based point processes in DNA and physiology

    Science.gov (United States)

    Bickel, David

    2000-03-01

    Unlike Poisson processes with no memory or short-term memory, fractal-based point processes have long-range correlations in event counts. The scaling of this dependence is quantified by the exponent of the growth in the variance of counts as the duration of the window increases [1]. In addition, the correlation codimension quantifies the intermittency of events for stationary point processes [2] and has been generalized to quantify the intermittency of events for nonstationary-rate point processes [3]. Fractal-based point processes can model nucleotide substitutions in DNA evolution [4], purine appearances in DNA composition, muscle movements in human activity [2], and heart beats in human physiology [3]. References: [1] S. Thurner, et. al, Fractals 5, 565 (1997). [2] D. R. Bickel, Physica A 265, 634 (1999). [3] D. R. Bickel, Physics Letters A 262, 251 (1999). [4] D. R. Bickel and B. J. West, Molecular Biology and Evolution 15, 967 (1998).

  12. WEST AFRICAN JOURNAL OF MEDICINE

    African Journals Online (AJOL)

    with AEDs. However, at the time of survey only 24.1% (n=7) were on orthodox treatment with antiepileptic drugs. (AEDs), 55.2% (n=16) on traditional treatment and 65.5% (n=19) on spiritual treatment. The observed difference between the ever users and users at the time of survey was statistically significant for spiritual and ...

  13. Point of Technique

    African Journals Online (AJOL)

    .

    Minimally invasive techniques are becoming popular choice for the recent times. These techniques are lowering the cost ... Through a skin incision which extends 2 cm medially from the left anterior-superior iliac Spine ... very invasive surgical procedure , less invasive procedures are becoming the first treatment options and ...

  14. Mise au point

    African Journals Online (AJOL)

    31 mai 2013 ... Patients et method : thirty patients underwent primary treatment for verrucous carcinoma of the larynx in the period bet- ween 1992 and 2007. ... It's a low grade and well differentiated squamous cell carcinoma. It is a slow growing tumor and locally .... Verrucous carcinoma of the oral cavity. SUrGerY, 1948 ;.

  15. Relative Critical Points

    Directory of Open Access Journals (Sweden)

    Debra Lewis

    2013-05-01

    Full Text Available Relative equilibria of Lagrangian and Hamiltonian systems with symmetry are critical points of appropriate scalar functions parametrized by the Lie algebra (or its dual of the symmetry group. Setting aside the structures – symplectic, Poisson, or variational – generating dynamical systems from such functions highlights the common features of their construction and analysis, and supports the construction of analogous functions in non-Hamiltonian settings. If the symmetry group is nonabelian, the functions are invariant only with respect to the isotropy subgroup of the given parameter value. Replacing the parametrized family of functions with a single function on the product manifold and extending the action using the (coadjoint action on the algebra or its dual yields a fully invariant function. An invariant map can be used to reverse the usual perspective: rather than selecting a parametrized family of functions and finding their critical points, conditions under which functions will be critical on specific orbits, typically distinguished by isotropy class, can be derived. This strategy is illustrated using several well-known mechanical systems – the Lagrange top, the double spherical pendulum, the free rigid body, and the Riemann ellipsoids – and generalizations of these systems.

  16. Reassessing Function Points

    Directory of Open Access Journals (Sweden)

    G.R. Finnie

    1997-05-01

    Full Text Available Accurate estimation of the size and development effort for software projects requires estimation models which can be used early enough in the development life cycle to be of practical value. Function Point Analysis (FPA has become possibly the most widely used estimation technique in practice. However the technique was developed in the data processing environment of the 1970's and, despite undergoing considerable reassessment and formalisation, still attracts criticism for the weighting scoring it employs and for the way in which the function point score is adapted for specific system characteristics. This paper reviews the validity of the weighting scheme and the value of adjusting for system characteristics by studying their effect in a sample of 299 software developments. In general the value adjustment scheme does not appear to cater for differences in productivity. The weighting scheme used to adjust system components in terms of being simple, average or complex also appears suspect and should be redesigned to provide a more realistic estimate of system functionality.

  17. Point of Care Ultrasound

    DEFF Research Database (Denmark)

    Dietrich, Christoph F; Goudie, Adrian; Chiorean, Liliana

    2017-01-01

    Over the last decade, the use of portable ultrasound scanners has enhanced the concept of point of care ultrasound (PoC-US), namely, "ultrasound performed at the bedside and interpreted directly by the treating clinician." PoC-US is not a replacement for comprehensive ultrasound, but rather allows...... to continent and from country to country. This World Federation for Ultrasound in Medicine and Biology position paper discusses the current status and future perspectives of PoC-US. Particular attention is given to the different uses of PoC-US and its clinical significance, including within emergency...... and critical care medicine, cardiology, anesthesiology, rheumatology, obstetrics, neonatology, gynecology, gastroenterology and many other applications. In the future, PoC-US will be more diverse than ever and be included in medical student training....

  18. Point Pollution Sources Dimensioning

    Directory of Open Access Journals (Sweden)

    Georgeta CUCULEANU

    2011-06-01

    Full Text Available In this paper a method for determining the main physical characteristics of the point pollution sources is presented. It can be used to find the main physical characteristics of them. The main physical characteristics of these sources are top inside source diameter and physical height. The top inside source diameter is calculated from gas flow-rate. For reckoning the physical height of the source one takes into account the relation given by the proportionality factor, defined as ratio between the plume rise and physical height of the source. The plume rise depends on the gas exit velocity and gas temperature. That relation is necessary for diminishing the environmental pollution when the production capacity of the plant varies, in comparison with the nominal one.

  19. Latent myofascial trigger points.

    Science.gov (United States)

    Ge, Hong-You; Arendt-Nielsen, Lars

    2011-10-01

    A latent myofascial trigger point (MTP) is defined as a focus of hyperirritability in a muscle taut band that is clinically associated with local twitch response and tenderness and/or referred pain upon manual examination. Current evidence suggests that the temporal profile of the spontaneous electrical activity at an MTP is similar to focal muscle fiber contraction and/or muscle cramp potentials, which contribute significantly to the induction of local tenderness and pain and motor dysfunctions. This review highlights the potential mechanisms underlying the sensory-motor dysfunctions associated with latent MTPs and discusses the contribution of central sensitization associated with latent MTPs and the MTP network to the spatial propagation of pain and motor dysfunctions. Treating latent MTPs in patients with musculoskeletal pain may not only decrease pain sensitivity and improve motor functions, but also prevent latent MTPs from transforming into active MTPs, and hence, prevent the development of myofascial pain syndrome.

  20. The Point Mass Concept

    Directory of Open Access Journals (Sweden)

    Lehnert B.

    2011-04-01

    Full Text Available A point-mass concept has been elaborated from the equations of the gravitational field. One application of these deductions results in a black hole configuration of the Schwarzschild type, having no electric charge and no angular momentum. The critical mass of a gravitational collapse with respect to the nuclear binding energy is found to be in the range of 0.4 to 90 solar masses. A second application is connected with the speculation about an extended symmetric law of gravitation, based on the options of positive and negative mass for a particle at given positive energy. This would make masses of equal polarity attract each other, while masses of opposite polarity repel each other. Matter and antimatter are further proposed to be associated with the states of positive and negative mass. Under fully symmetric conditions this could provide a mechanism for the separation of antimatter from matter at an early stage of the universe.

  1. The Point Mass Concept

    Directory of Open Access Journals (Sweden)

    Lehnert B.

    2011-04-01

    Full Text Available A point-mass concept has been elaborated from the equations of the gravitational field. One application of these deductions results in a black hole configuration of the Schwarzschild type, having no electric charge and no angular momentum. The critical mass of a gravitational collapse with respect to the nuclear binding energy is found to be in the range of 0.4 to 90 solar masses. A second application is connected with the spec- ulation about an extended symmetric law of gravitation, based on the options of positive and negative mass for a particle at given positive energy. This would make masses of equal polarity attract each other, while masses of opposite polarity repel each other. Matter and antimatter are further proposed to be associated with the states of positive and negative mass. Under fully symmetric conditions this could provide a mechanism for the separation of antimatter from matter at an early stage of the universe.

  2. Critical Points of Contact

    DEFF Research Database (Denmark)

    Jensen, Ole B.; Morelli, Nicola

    2011-01-01

    In contemporary urban societies multiple networks and systems interact, overlap, exist in parallel, converge, conflict etc. creating unforeseen complexity and less transparency. By exploring how layered networks of physical movement, service information, goods delivery, commercial communication etc....... are connected (and disconnected) we get a much better understanding of how to design and intervene regardless if we are thinking about public spaces in the city or new systems of service design. The many networks orchestrating and facilitating contemporary everyday life are dependent on the strategic sites...... where the networks meet and establish contact. Thus we argue for the usefulness of the notion of Critical Point of Contact (CPC) to deepen our understanding of the actual life within networks. En route to this notion we draw upon theories within as diverse realms such as interaction design, service...

  3. Thallium in the hydrosphere of south west England

    Energy Technology Data Exchange (ETDEWEB)

    Law, Sin [School of Geography, Earth and Environmental Sciences, University of Plymouth, Drake Circus, Plymouth PL4 8AA (United Kingdom); Turner, Andrew, E-mail: aturner@plymouth.ac.uk [School of Geography, Earth and Environmental Sciences, University of Plymouth, Drake Circus, Plymouth PL4 8AA (United Kingdom)

    2011-12-15

    Thallium is a highly toxic metal whose environmental concentrations, distributions and behaviour are not well understood. In the present study we measure the concentrations of Tl in filtered and unfiltered samples of rain, tap, river, estuarine and waste waters collected from south west England. Dissolved Tl was lowest (<20 ng L{sup -1}) in tap water, rain water, treated sewage and landfill effluents, estuarine waters, and rivers draining catchments of sandstones and shales. Concentrations up to about 450 ng L{sup -1} were observed in rivers whose catchments are partly mineralized and where metal mining was historically important, and the highest concentration ({approx}1400 ng L{sup -1}) was measured in water abstracted directly from an abandoned mine. Compared with other trace metals measured (e.g. As, Cd, Co, Cr, Cu, Ni, Pb, Zn), Tl has a low affinity for suspended particles and undergoes little removal by conventional (hydroxide precipitation) treatment of mine water. - Highlights: > Thallium concentrations have been measured in natural and waste waters from south west England. > Dissolved concentrations spanned three orders of magnitude and were highest in water from an abandoned mine. > Inputs associated with historical metal mine workings are the most important to the regional hydrosphere. - Concentrations of dissolved thallium in waters of south west England span two orders of magnitude and are greatest in water from an abandoned mine.

  4. September 2002 Lidar Point Data of Southern California Coastline: Dana Point to Point La Jolla

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This data set contains lidar point data from a strip of Southern California coastline (including water, beach, cliffs, and top of cliffs) from Dana Point to Point La...

  5. May 2002 Lidar Point Data of Southern California Coastline: Dana Point to Point La Jolla

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This data set contains lidar point data from a strip of Southern California coastline (including water, beach, cliffs, and top of cliffs) from Dana Point to Point La...

  6. IPC - Isoelectric Point Calculator.

    Science.gov (United States)

    Kozlowski, Lukasz P

    2016-10-21

    Accurate estimation of the isoelectric point (pI) based on the amino acid sequence is useful for many analytical biochemistry and proteomics techniques such as 2-D polyacrylamide gel electrophoresis, or capillary isoelectric focusing used in combination with high-throughput mass spectrometry. Additionally, pI estimation can be helpful during protein crystallization trials. Here, I present the Isoelectric Point Calculator (IPC), a web service and a standalone program for the accurate estimation of protein and peptide pI using different sets of dissociation constant (pKa) values, including two new computationally optimized pKa sets. According to the presented benchmarks, the newly developed IPC pKa sets outperform previous algorithms by at least 14.9 % for proteins and 0.9 % for peptides (on average, 22.1 % and 59.6 %, respectively), which corresponds to an average error of the pI estimation equal to 0.87 and 0.25 pH units for proteins and peptides, respectively. Moreover, the prediction of pI using the IPC pKa's leads to fewer outliers, i.e., predictions affected by errors greater than a given threshold. The IPC service is freely available at http://isoelectric.ovh.org Peptide and protein datasets used in the study and the precalculated pI for the PDB and some of the most frequently used proteomes are available for large-scale analysis and future development. This article was reviewed by Frank Eisenhaber and Zoltán Gáspári.

  7. Ebola vaccine and treatment.

    Science.gov (United States)

    Takada, Ayato

    2015-01-01

    Filoviruses (Ebola and Marburg viruses) cause severe hemorrhagic fever in humans and nonhuman primates. No effective prophylaxis or treatment for filovirus diseases is yet commercially available. The recent outbreak of Ebola virus disease in West Africa has accelerated efforts to develop anti-Ebola virus prophylaxis and treatment, and unapproved drugs were indeed used for the treatment of patients during the outbreak. This article reviews previous researches and the latest topics on vaccine and therapy for Ebola virus disease.

  8. Point Charges and Polygonal Linkages

    NARCIS (Netherlands)

    Khimshiashvili, Giorgi; Panina, Gaiane; Siersma, Dirk; Zolotov, Vladimir

    We investigate the critical points of Coulomb potential of point charges placed at the vertices of a planar polygonal linkage. It is shown that, for a collection of positive charges on a pentagonal linkage, there is a unique critical point in the set of convex configurations which is the point of

  9. Basin Centroid Points for Unregulated Streamgagages in and near West Virginia 1930-2011

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — Correlation of flows at pairs of streamgages were evaluated using a Spearman’s rho correlation coefficient to better identify gages that can be used as index gages...

  10. A Prospective Evaluation of Stress Fractures/Overuse Injuries in a Population of West Point Cadets

    National Research Council Canada - National Science Library

    Wade, Charles

    1997-01-01

    The objective of this study was to examine the effect of physical training in adolescent males and females on the interrelationship of the hypothaliunic-pituitary-gonadal axis, bone mineral density...

  11. Group Selection Methods and Contribution to the West Point Leadership Development System (WPLDS)

    Science.gov (United States)

    2015-08-01

    their own groups from observation in the class and prior knowledge. The Cadets in MA205 completed a 20 question survey on a Sharepoint site focused...strongly agree. The survey was timed through Sharepoint and any Cadet who took shorter than 1 minute to complete was not included in the analysis

  12. CTC Sentinel. Volume 1, Issue 1, December 2007. West Point Releases First Issue of CTC Sentinel

    Science.gov (United States)

    2007-12-01

    Hamam Hassan , “Saddam was the First to Attract Is- lamic Organizations and Later Regretted it” (Arabic), al- Hayat, February 25, 2006. DECEMBER 2007...Muhammad Hamdi al-Ahdal, was also removed from the scene in November 2003 when he was arrested at a wedding in Sana`a. Following a series of

  13. Ancient technology of jetties and anchoring points along the west coast of India

    Digital Repository Service at National Institute of Oceanography (India)

    Gaur, A.S.; Vora, K.H.

    The Indian coast, with a long history of maritime activities, has been dotted with several ancient ports. The evidence for this exists in port-related structures on the shore and in relics lying in the sea adjacent. Marine archaeological...

  14. Native American Historic Context for the United States Military Academy, West Point, New York

    Science.gov (United States)

    2006-04-01

    Delaware,” pp 385-387 in Vol 1 of Handbook of American Indians North of Mexico, Frederick W. Hodge, ed. 2 vols. Bureau of American Ethnology ... Ethnology Bulletin 145; and Monique J. Tyndall, 2004, “Ridge Hill Yonkers, New York: Study of the Weckquasgeek Chieftancy and the Present Site Known as...Indian Tribes of North America,” Smithsonian Institution Bureau of American Ethnology Bulletin 145. 33 Swanton, 1952. 14 (site of Peekskill), and

  15. Native American Historic Context for the United States Military Academy, West Point, New York

    National Research Council Canada - National Science Library

    Mann, Diane K

    2006-01-01

    The United States Military Academy (USMA) is required by Federal laws, Executive Orders, and implementing regulations to conduct consultations with Native American tribes under specific circumstances...

  16. Energy Optimization Assessment at U.S. Army Installations: West Point Military Academy, NY

    Science.gov (United States)

    2008-09-01

    10,000 sq ft roof: • office building, air-conditioned, used 7 days/wk • existing dark roof: bitumen , white granular, reflectance 0.25 • Energy Star... foam on top of it all. This will reduce the heat and cool losses to virtually nothing (compared to the walls and windows of this around 1930s...m2 of ceiling area per yr (= 30,379 BTU/sq ft). Adding 6 in. of mineral wool and 6 in. of foam : Annual energy loss is 0.1 W/m2, °C * 3,313 degree

  17. Assessment of Psychophysiological Differences of West Point Cadets and Civilian Controls Immersed within a Virtual Environment

    Science.gov (United States)

    2009-01-01

    zone of the VE. Safe zones consisted mainly of a road surrounded by a desert landscape and were free of gunfire and other loud noises . The combat...acknowledged by an encouraging body of research. Some of the work in this area has addressed affective processes: anxiety disorders, pain...each experimental run. The total length of each run was 210 seconds. An acoustic startle probe was used to elicit startle eyeblink responses. The

  18. Lower Kittanning Coal Bed Point Data (Chemistry) in Pennsylvania, Ohio, West Virginia, and Maryland

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — This dataset (located by latitude and longitude) is a subset of the geochemical dataset found in Chap. E, Appendix 2, Disc 1, and used in this study of the Lower...

  19. Upper Freeport Coal Bed Point Data (Chemistry) in Pennsylvania, Ohio, West Virginia, and Maryland

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — This dataset (located by latitude and longitude) is a subset of the geochemical dataset found in Chap. D, Appendix 8, Disc 1, and used in this study of the Upper...

  20. Pocahontas No. 3 Coal Bed Point Data (Chemistry) in Virginia and West Virginia

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — This dataset (located by latitude and longitude) is a subset of the geochemical dataset found in Chap. H, Appendix 2, Disc 1, and used in this study of the...

  1. Pond Creek Coal zone Point Data (Chemistry) in Virginia and West Virginia

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — This dataset (located by latitude and longitude) is a subset of the geochemical dataset found in Chap. H, Appendix 2, Disc 1, and used in this study of the...

  2. Fire Clay Coal Zone Point Data (Chemistry) in Kentucky, Virginia and West Virginia

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — This dataset (located by latitude and longitude) is a subset of the geochemical dataset found in Chap. F, Appendix 7, Disc 1, and used in this study of the Fire Clay...

  3. Fisheries and Limnological Studies on West Point Reservoir, Alabama-Georgia. Phase IV.

    Science.gov (United States)

    1984-05-01

    Agri. Exp. Stat. Bull. 477. 21 pp. Echelle, A. A., and J. B. Mense . 1968. Forage value of Mississippi silverside in Lake Texoma. Proc. Okla. Acad. Sci...drawdown control on fish populations in Elephant Butte Reservoir, New Mexico . Pages 265-286 in G. E. Hall, ed. Reservoir fisheries and limnology. Spec. Publ

  4. Novel Lessons on Behavioral Ethics from the U.S. Military Academy at West Point

    Science.gov (United States)

    Offstein, Evan H.; Dufresne, Ronald L.; Childers, J. Stephen, Jr.

    2017-01-01

    After a spate of business ethics crises over the past two decades, management educators were put on notice: considerably more was needed to improve the ethical grounding of our graduating students. Taking stock of our progress, we contend that management education remains well short of achieving this charge and cannot be content with the state of…

  5. Fisheries and Limnological Studies on West Point Reservoir, Alabama-Georgia. Phase V.

    Science.gov (United States)

    1984-12-01

    samplers used in the littoral areas of the lake. Thirty-two of these taxa were members of the Chironomidae. Cladocerans (water fleas) and chironomids...1979), Bayne et al. (1980), Shelton et al. (1981) and Lawrence et al. (in review ) which are job completion reports for Phases I through IV...zooplankters were identified plus the three dominant taxa within each major group (rotifers, copepods, cladocerans ) were identified for each station

  6. The Combating Terrorism Center at West Point: Radical Islamic Ideology in Southeast Asia

    Science.gov (United States)

    2009-01-01

    admirer of Turkey’s Mustafa Kemal Ataturk , split with Sarekat Islam in 1927 to form the Indonesian National Party (Partai Nasional Indonesia, or...PNI). By contrast, Kartosuwirjo, who grieved for the Ottoman caliphate and bemoaned the secularizing reforms of Ataturk , went on to become the vice

  7. Water Quality Management Studies. West Point Lake, Chattahoochee River, Alabama-Georgia.

    Science.gov (United States)

    1984-08-01

    energy from the sun and transforms it into chemical energy in the photosynthetic process. Measurement of this photosynthetic pigment can give insight...RESAMPLING * 0.?UFC/FSə -11 LIVESTOCK OR POULTRY WASTE IN MIXED POPULATION FC/FS(=0.7 PREDOMINANCE OF LIVESTOCK OR POULTRY WASTES0 0 0 Figure 13.--Range of

  8. H09108: NOS Hydrographic Survey , West of Point La Jolla, California, 1970-04-23

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The National Oceanic and Atmospheric Administration (NOAA) has the statutory mandate to collect hydrographic data in support of nautical chart compilation for safe...

  9. IAU South West Asian ROAD

    Science.gov (United States)

    Mickaelian, Areg; Azatyan, Naira; Farmanyan, Sona; Mikayelyan, Gor

    2016-10-01

    Armenia is hosting the IAU South West Asian (SWA) Regional Office of Astronomy for Development (ROAD). It is a county of ancient astronomy and is also rich in modern astronomical facilities and infrastructures, hence may successfully serve as a regional center for various activities. Byurakan Astrophysical Observatory (BAO) has 2.6m and 1m Schmidt, as well as a number of smaller telescopes that are an observational basis for joint projects and collaborations. Armenian Virtual Observatory (ArVO) is hosting astronomical databases, such as the Digitized First Byurakan Survey (DFBS) and may also serve as a basis for development of VO structures in this region. Recently we have conducted a number of new activities; a meeting on ``Relation of Astronomy to other Sciences, Culture and Society" (RASCS) was organized by BAO and Armenian Astronomical Society (ArAS) in Oct 2014 in Byurakan. Activities related to Archaeoastronomy and Astronomy in Culture (AAC) were initiated as well. Discussions on future Armenian-Iranian collaboration in astronomy were carried out, including an Armenian-Iranian Astronomical Workshop held in Oct 2015 in Byurakan. Similar workshops have been carried out between BAO and Abastumani Astronomical Observatory (AbAO, Georgia) since 1974.

  10. Human rights trauma and the mental health of West Papuan refugees resettled in Australia.

    Science.gov (United States)

    Rees, Susan; Silove, Derrick M; Tay, Kuowei; Kareth, Moses

    2013-08-19

    To document the extent and nature of human rights violations and other traumatic events reported by West Papuan refugees resettled in Australia and to assess trauma-related psychological disorders, distress and disability. Australian-based sample, mixed-methods design with 44 participants, conducted in Australia between October 2007 and November 2010 in communities in North Queensland and Melbourne. West Papuan refugees aged 18 years and over (88% response rate). Post-traumatic stress disorder (PTSD) symptoms (Harvard Trauma Questionnaire) and premigration potentially traumatic events (PTEs), psychological distress (Kessler Psychological Distress Scale [K10]), post-migration living difficulties, days out of role. Of the 44 West Papuan refugees, 40 reported one or more PTE, including inability to access medical care for family (40), lack of food and water (39) and lack of access to medical treatment (38). The most frequent postmigration stressors were separation from and worries about family members remaining in West Papua (43) and being unable to return home in an emergency because of ongoing conflict (41). Twenty-six participants reached a lower threshold for PTSD symptoms of 2.0, and 13 reached the clinical threshold of 2.5. Fourteen reported severe psychological distress. West Papuan refugees resettled in Australia report a wide range of premigration PTEs including human rights violations, as well as symptoms of PTSD and distress. The data add to concerns about the state of human rights and mental health among West Papuans.

  11. West African Journal of Medicine

    African Journals Online (AJOL)

    Aetiology, Clinical Features and Treatment Outcome of Intrauterine. Adhesion in Ilorin, Central ... treatment. CONCLUSION: The incidence of intrauterine adhesion among gynaecological patients in this study is lower than those from previous reviews elsewhere in the country. However ..... the volume of evidences supporting.

  12. Sahel, North-West Nigeria

    African Journals Online (AJOL)

    Nneka Umera-Okeke

    Table 1: Result of correlation of Rainfall data from CRU data set with measured data from NIMET (Yelwa Station). Data Point. Multiple R. R Square Adjusted R ... regression on x. In Augi town, lowest rainfall was recorded in 1982 with annual rainfall of 379.3mm. Other years of significantly low rains are 1973 (379.7mm), 1987 ...

  13. Regionalization in West Africa : the process of developing a common West African currency

    OpenAIRE

    Sveen, Heidi Walbye

    2004-01-01

    Monetary integration has been on the West African political agenda for a long time. It has been regarded as an important development strategy by for instance the Economic Community of West African States (ECOWAS) where 15 states are organized. Eight ECOWAS countries have a monetary co-operation through the Franc Zone, which is a unique post-colonial relation between France and former French colonies. In West Africa the Zone is organized in Union Économic et Monetaire Ouest Africaine (UEMOA). ...

  14. Legume Diversity Patterns in West Central Africa

    NARCIS (Netherlands)

    Estrella, de la M.; Mateo, M.A.; Wieringa, J.J.; Mackinder, B.; Munoz, J.

    2012-01-01

    Objectives - Species Distribution Models (SDMs) are used to produce predictions of potential Leguminosae diversity in West Central Africa. Those predictions are evaluated subsequently using expert opinion. The established methodology of combining all SDMs is refined to assess species diversity

  15. Teaching Scandinavian Interaction Design in West Africa

    DEFF Research Database (Denmark)

    Sørensen, Jannick Kirk

    2016-01-01

    Methods for interaction design have emerged and established themselves first in a Scandinavian context, later in US context and in the rest of the developed world. While good usability and good user experiences are important to all users of ICT, the question is whether the methods and techniques...... that were mainly developed in Scandinavia, Europe and US are suitable for ICT development in West Africa? Can ideals for user-involvement be directly transferred? This paper aims to initiate a discussion of the communication of interaction design knowledge in West Africa by discussing whether insights from...... Scandinavian Participatory design can be used to localize the learning process and make interaction design methods sensitive to the West African context. The paper is based on the author’s reflection on his experiences teaching interaction design in West Africa....

  16. West Coast Rockfish Conservation Areas, 2015

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — These data delineate Rockfish Conservation Areas (RCA) off the West Coast of the United States for 2015. There are three types of areas closures depicted in this...

  17. NNDSS - Table II. West Nile to Zika

    Data.gov (United States)

    U.S. Department of Health & Human Services — NNDSS - Table II. West Nile to Zika - 2018. In this Table, provisional cases of selected notifiable diseases (≥1,000 cases reported during the preceding year), and...

  18. NNDSS - Table II. West Nile virus disease

    Data.gov (United States)

    U.S. Department of Health & Human Services — NNDSS - Table II. West Nile virus disease - 2017. In this Table, provisional cases of selected notifiable diseases (≥1,000 cases reported during the preceding...

  19. FAQ: West Nile Virus and Dead Birds

    Science.gov (United States)

    ... Related Links Mosquito Surveillance Software West Nile Virus & Dead Birds Recommend on Facebook Tweet Share Compartir On ... What should I do if I find a dead bird? State and local agencies have different policies ...

  20. West Bank Gaza Geo-MIS System

    Data.gov (United States)

    US Agency for International Development — The Geo-MIS System is USAID/West Bank and Gaza's primary system for capturing and managing projectrelated information. Its purpose is to assist USAID and its...