WorldWideScience

Sample records for year post approval

  1. Seven-year cost-effectiveness of ProDisc-C total disc replacement: results from investigational device exemption and post-approval studies.

    Science.gov (United States)

    Radcliff, Kris; Lerner, Jason; Yang, Chao; Bernard, Thierry; Zigler, Jack E

    2016-05-01

    OBJECTIVE The purpose of this study was to evaluate the 7-year cost-effectiveness of cervical total disc replacement (CTDR) versus anterior cervical discectomy and fusion (ACDF) for the treatment of patients with single-level symptomatic degenerative disc disease. A change in the spending trajectory for spine care is to be achieved, in part, through the selection of interventions that have been proven effective yet cost less than other options. This analysis complements and builds upon findings from other cost-effectiveness evaluations of CTDR through the use of long-term, patient-level data from a randomized study. METHODS This was a 7-year health economic evaluation comparing CTDR versus ACDF from the US commercial payer perspective. Prospectively collected health care resource utilization and treatment effects (quality-adjusted life years [QALYs]) were obtained from individual patient-level adverse event reports and SF-36 data, respectively, from the randomized, multicenter ProDisc-C total disc replacement investigational device exemption (IDE) study and post-approval study. Statistical distributions for unit costs were derived from a commercial claims database and applied using Monte Carlo simulation. Patient-level costs and effects were modeled via multivariate probabilistic analysis. Confidence intervals for 7-year costs, effects, and net monetary benefit (NMB) were obtained using the nonparametric percentile method from results of 10,000 bootstrap simulations. The robustness of results was assessed through scenario analysis and within a parametric regression model controlling for baseline variables. RESULTS Seven-year follow-up data were available for more than 70% of the 209 randomized patients. In the base-case analysis, CTDR resulted in mean per-patient cost savings of $12,789 (95% CI $5362-$20,856) and per-patient QALY gains of 0.16 (95% CI -0.073 to 0.39) compared with ACDF over 7 years. CTDR was more effective and less costly in 90.8% of probabilistic

  2. 30 CFR 14.10 - Post-approval product audit.

    Science.gov (United States)

    2010-07-01

    ..., AND APPROVAL OF MINING PRODUCTS REQUIREMENTS FOR THE APPROVAL OF FLAME-RESISTANT CONVEYOR BELTS General Provisions § 14.10 Post-approval product audit. (a) Approved conveyor belts will be subject to... based. MSHA will select an approved conveyor belt to be audited; the selected belt will be...

  3. 13 CFR 302.18 - Post-approval requirements.

    Science.gov (United States)

    2010-01-01

    ... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Post-approval requirements. 302.18 Section 302.18 Business Credit and Assistance ECONOMIC DEVELOPMENT ADMINISTRATION, DEPARTMENT OF COMMERCE... Federal cost principles (collectively, “Post-Approval Requirements”). A Recipient's failure to comply with...

  4. Real-world evidence analysis of palbociclib prescribing patterns for patients with advanced/metastatic breast cancer treated in community oncology practice in the USA one year post approval.

    Science.gov (United States)

    Kish, J K; Ward, M A; Garofalo, D; Ahmed, H V; McRoy, L; Laney, J; Zanotti, G; Braverman, J; Yu, H; Feinberg, B A

    2018-05-02

    Rapidly evolving understanding of cancer biology has presented novel opportunities to translate that understanding into clinically relevant therapy. Palbociclib, a novel, first-in-class cyclin-dependent kinase (CDK) 4/6 inhibitor was approved in the USA in February 2015 for the treatment of advanced/metastatic breast cancer. We examined real-world evidence in the first year post approval to understand the clinical and demographic characteristics of patients treated with palbociclib in community oncology practices and the dosing, treatment, and complete blood count (CBC) monitoring patterns. This was a retrospective observational study of structured data from a US electronic medical record (EMR) database. Female patients receiving palbociclib after 31 January 2015 were followed through 31 March 2016. Our methodological rules were constructed to aggregate drugs received according to the order in which they are given, i.e., identify the line of therapy as first, second, or third line, etc., using treatment order and course description fields from the EMR. There were 763 patients initiating palbociclib who met the selection criteria. Of those, 612 (80.2%) received palbociclib concomitantly with letrozole. Mean follow up was 6.4 months and mean age at palbociclib initiation was 64 years. Of patients with a known starting dose (n = 417), 79.9% started on palbociclib 125 mg. Dose reductions were observed in 20.1% of patients. Percentages of patients according to line of therapy at initiation of palbociclib were first-line, 39.5%; second-line, 15.7%; third-line, 13.1%; and fourth-line therapy or later, 31.7%. On average, two CBC tests were conducted during the first cycle of palbociclib treatment. Overall, 74.6% of patients had a neutropenic event during follow up including 47.3% and 8.0% of patients with a grade 3 or 4 occurrence, respectively. Real-world palbociclib use one year post US approval demonstrates a more heterogeneous patient population than that

  5. 30 CFR 71.301 - Respirable dust control plan; approval by District Manager and posting.

    Science.gov (United States)

    2010-07-01

    ... District Manager and posting. 71.301 Section 71.301 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION... plan; approval by District Manager and posting. (a) The District Manager will approve respirable dust control plans on a mine-by-mine basis. When approving respirable dust control plans, the District Manager...

  6. Defending submission-year analyses of new drug approvals.

    Science.gov (United States)

    Carpenter, Daniel P

    2003-01-01

    In response to the critique of Mary Olsen, Daniel Carpenter, on behalf of his co-authors, addresses the issue of analysis based on the year a new drug is submitted for Food and Drug Administration (FDA) approval, not the year it is approved. Both substantive knowledge of the FDA drug review process and sound social science theory favor submission-year averaging. The history and bureaucratic mechanics of the Center for Drug Evaluation and Review (CDER) conform to the author's assumption. The statistical theory of optimal experimentation also points to the beginning of review as a locus for effects upon decisions.

  7. Pharmacovigilance of biologicals : dynamics in post-approval safety learning

    NARCIS (Netherlands)

    Vermeer, N.S.

    2015-01-01

    Regulatory decisions to allow new drugs on the market by definition have to accept a certain level of uncertainty about the full benefit-risk balance. Pre-approval studies typically provide information on a limited number of patients over a relative short follow-up period, and handle strict

  8. Quality assurance of approved out of programme psychiatry training and research over the past 5 years

    Science.gov (United States)

    Osman-Hicks, Victoria; Graham, Hannah; Leadbetter, Peter; Brittlebank, Andrew

    2015-01-01

    Aims and method This paper intends to analyse the number of applications, trainee demographic and approval rate of those applying for out of programme training (OOPT) or out of programme research (OOPR) between January 2008 and April 2013 using the committee’s anonymised database. We also describe the process of application and approval by the Quality Assurance Committee. Results There were 90 applications, including 10 resubmissions during the 64-month period. Most applicants (77%) were higher trainees; 53% of applicants were from the London deanery; 60% of applications were for research posts and higher degrees (OOPR). Overall, 64% were approved by the committee: 70% for OOPRs and 53% for OOPTs. Clinical implications This paper shows with transparency the breakdown of applications to the Quality Assurance Committee. Around two-thirds of applications to the committee are supported (64%). Relatively few psychiatry trainees (2.5%) have applied for an OOPT or an OOPR over the past 5 years. PMID:26191450

  9. 13 CFR 307.6 - Economic Adjustment Assistance post-approval requirements.

    Science.gov (United States)

    2010-01-01

    ... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Economic Adjustment Assistance post-approval requirements. 307.6 Section 307.6 Business Credit and Assistance ECONOMIC DEVELOPMENT... § 302.18 of this chapter: (a) Strategy Grants shall comply with the applicable provisions of part 303 of...

  10. Partner approval and intention to use contraception among Zanzibari women presenting for post-abortion care.

    Science.gov (United States)

    Esber, Allahna; Foraker, Randi E; Hemed, Maryam; Norris, Alison

    2014-07-01

    We examined the effect of partner approval of contraception on intention to use contraception among women obtaining post-abortion care in Zanzibar. Our data source was a 2010 survey of 193 women obtaining post-abortion care at a large public hospital in Zanzibar. We used multivariable logistic regression analysis to assess associations between partner approval and intention to use contraception. Overall, 23% of participants had used a contraceptive method in the past, and 66% reported intending to use contraception in the future. We found that partner approval of contraception and ever having used contraception in the past were each associated with intending to use contraception in the future. In the multivariable model, adjusting for past contraception use, partner approval of contraception was associated with 20 times the odds of intending to use contraception (odds ratio, 20.25; 95% confidence interval, 8.45-48.56). We found a strong association between partner approval and intention to use contraception. Efforts to support contraceptive use must include both male and female partners. Public health and educational efforts to increase contraceptive use must include men and be targeted to both male and female partners. Given that male partners are often not present when women obtain health care, creative efforts will be required to meet men in community settings. Copyright © 2014 Elsevier Inc. All rights reserved.

  11. Constructing target product profiles (TPPs) to help vaccines overcome post-approval obstacles

    OpenAIRE

    Lee, Bruce Y.; Burke, Donald S.

    2009-01-01

    As history has demonstrated, post-approval obstacles can impede a vaccine’s use and potentially lead to its withdrawal. Addressing these potential obstacles when changes in a vaccine’s technology can still be easily made may improve a vaccine’s chances of success. Augmented vaccine target product profiles (TPPs) can help vaccine scientists better understand and anticipate these obstacles and galvanize conversations among various vaccine stakeholders (e.g., scientists, marketers, business deve...

  12. A Good Year: FDA Approved Nine New Cancer Drugs in 2014

    Science.gov (United States)

    In 2014, the Food and Drug Administration (FDA) approved 41 drugs that had not been approved previously for any indication, the most in nearly 20 years. Of these 41 novel drugs, 9 were approved for the treatment of cancer or cancer-related conditions.

  13. Ten Years Back, Five Years Forward: The Data Seal of Approval

    Directory of Open Access Journals (Sweden)

    Ingrid Dillo

    2015-02-01

    Full Text Available If we want to share data, the long-term storage of those data in a trustworthy digital archive is an essential condition. Trust is the basis of storing and sharing data. That trust must be present in the various stakeholders involved. Certification of digital archives can make an important contribution to the confidence of these stakeholders in the digital archives.Ten years ago DANS was assigned the task of developing a Seal of Approval for digital data to ensure that archived data can still be found, understood and used in the future. In 2009 this Data Seal of Approval (DSA was transferred to an international body, the DSA Board, which has managed and further developed the guidelines and the peer review process ever since.The objectives of the DSA are to safeguard data, ensure high quality and guide reliable management of data for the future without requiring implementation of new standards, regulations or heavy investments. The DSA contains 16 guidelines for applying and verifying quality aspects concerning the creation, storage, use and reuse of digital data.Based on feedback from data archives that applied for a DSA and different case studies we have gained some insight into the benefits of DSA. Still, the impact of having the Seal is not easy to measure. Seal holders usually refer to qualitative benefits in the form of increased awareness of the value of their repositories to their communities, funders and publishers.Ten years down the line we can safely state that the Data Seal of Approval has proven its added value. If we try to look five years into the future, what can we expect? There are different developments: a growing interest in DSA among European research infrastructures, the collaboration between DSA and the ISCU World Data System under the umbrella of the RDA (Research Data Alliance and the European Commission is showing a growing interest in certification services.The success of DSA also provides the challenge to further

  14. Post-marketing research and its outcome for novel anticancer agents approved by both the FDA and EMA between 2005 and 2010: A cross-sectional study.

    Science.gov (United States)

    Zeitoun, Jean-David; Baron, Gabriel; Vivot, Alexandre; Atal, Ignacio; Downing, Nicholas S; Ross, Joseph S; Ravaud, Philippe

    2018-01-15

    Post-marketing research in oncology has rarely been described. We aimed to characterize post-marketing trials for a consistent set of anticancer agents over a long period. We performed a cross-sectional analysis of post-marketing trials registered at ClinicalTrials.gov through September 2014 for novel anticancer agents approved by both the US Food and Drug Administration and the European Medicines Agency between 2005 and 2010. All relevant post-marketing trials were classified according to indication, primary outcome, starting date, sponsors, and planned enrollment. Supplemental indications were retrieved from regulatory documents and publication rate was assessed by two different methods. Ten novel anticancer agents were eligible: five were indicated for hematologic malignancies and the remaining five for solid cancers (three for kidney cancer). We identified 2,345 post-marketing trials; 1,362 (58.1%) targeted an indication other than the originally approved one. We observed extreme variations among drugs in both number of post-marketing trials (range 8-530) and overall population to be enrolled per trial (1-8,381). Post-marketing trials assessed almost all types of cancers, the three most frequently studied cancers being leukemia, kidney cancer and myeloma. In all, 6.6% of post-marketing trials had a clinical endpoint as a primary outcome, and 35.9% and 54.1% had a safety or surrogate endpoint, respectively, as a primary outcome. Nine drugs obtained approval for supplemental indications. The publication rate at 10 years was 12.3 to 26.1% depending on the analysis method. In conclusion, we found that post-marketing research in oncology is highly heterogeneous and the publication rate of launched trials is low. © 2017 UICC.

  15. Post Neonatal Tetanus in Calabar, Nigeria: A 10 Year Review ...

    African Journals Online (AJOL)

    1997-01-01

    A 10 year retrospective study of post neonatal tetanus in University of Calabar Teaching Hospital was carried out. The study period spanned from January 1, 1997 to December 31, 2006. The aim was to determine the incidence of post neonatal tetanus and associated bio-characteristics. Information was extracted from case ...

  16. 77 FR 24399 - Approval and Promulgation of Implementation Plans; Georgia; Atlanta; Ozone 2002 Base Year...

    Science.gov (United States)

    2012-04-24

    ... Promulgation of Implementation Plans; Georgia; Atlanta; Ozone 2002 Base Year Emissions Inventory AGENCY... approve the ozone 2002 base year emissions inventory, portion of the state implementation plan (SIP... technology (RACT), contingency measures, a 2002 base- year emissions inventory and other planning SIP...

  17. 77 FR 42686 - Approval and Promulgation of Air Quality Implementation Plans; Maryland; the 2002 Base Year...

    Science.gov (United States)

    2012-07-20

    ... Promulgation of Air Quality Implementation Plans; Maryland; the 2002 Base Year Inventory AGENCY: Environmental... matter (PM 2.5 ) 2002 base year emissions inventory portion of the Maryland State Implementation Plan... National Ambient Air Quality Standard (NAAQS) SIP. EPA is proposing to approve the 2002 base year PM 2.5...

  18. Vocations: The Link between Post-Compulsory Education and the Labour Market. What the Research Says For... Qualification & Approval Bodies

    Science.gov (United States)

    Wheelahan, Leesa; Buchanan, John; Yu, Serena

    2015-01-01

    This summary pulls together the relevant key findings for qualification and approval bodies from the research program "Vocations: The Link between Post-Compulsory Education and the Labour Market." The program was comprised of three different strands: (1) pathways from VET in Schools, (2) pathways within and between vocational education…

  19. OGJ200 companies posted strong financial year in 1997

    International Nuclear Information System (INIS)

    Beck, R.J.; Bell, L.

    1998-01-01

    Companies on the OGJ200 list of publicly traded oil and gas producers in the US posted a second straight strong financial year in 1997. Net income slipped but was still at the second highest level on record. Most other indicators of financial and operating performance remained at high levels or posted increases in 1997. As always, data for this year's list reflect the prior year's operations. The paper discusses and presents data for the following: assets, revenue, stockholder's equity, drilling activity, financial performance, group operation, changes in the group, the top 20 companies, and the fastest growing companies

  20. 77 FR 24440 - Approval and Promulgation of Implementation Plans; Georgia; Atlanta; Ozone 2002 Base Year...

    Science.gov (United States)

    2012-04-24

    ... ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 52 [EPA-R04-OAR-2010-0021(b); FRL-9661-9] Approval and Promulgation of Implementation Plans; Georgia; Atlanta; Ozone 2002 Base Year Emissions Inventory AGENCY... 2002 base year emissions inventory portion of the state implementation plan (SIP) revision submitted by...

  1. Vesical Calculus 10 Years Post Missing Intrauterine Contraceptive ...

    African Journals Online (AJOL)

    Vesical Calculus 10 Years Post Missing Intrauterine. Contraceptive Device. Abdullahi Abdulwahab-Ahmed, Oluwagbemiga Olabisi Ogunleye. INTRODUCTION. Intrauterine contraceptive devices (IUCD) are acceptable means of contraception world over.[1-4] There have been reports of its migration to other adjourning sites ...

  2. Intermediate Term (3-6 Years Post Surgery) Outcome of ...

    African Journals Online (AJOL)

    Post-operatively, the 5 eyes had VA ranging from 6/60 to NLP, after a variable follow-up period of 3-6 years. Complications included development of tough vascularized retroprosthetic membrane (4 eyes) and infective endophthalmitis in one eye. Conclusion: The intermediate-term outcome of keratoprosthesis surgery in ...

  3. Predictors of subjective health status 10 years post-PCI

    NARCIS (Netherlands)

    van den Berge, Jan C.; Dulfer, Karolijn; Utens, Elisabeth M. W. J.; Hartman, Eline M. J.; Daemen, Joost; van Geuns, Robert J.; van Domburg, Ron T.

    2016-01-01

    Subjective health status is an increasingly important parameter to assess the effect of percutaneous coronary intervention (PCI) in clinical practice. Aim of this study was to determine medical and psychosocial predictors of poor subjective health status over a 10 years' post-PCI period. We included

  4. Worldwide, 3-Year, Post-Marketing Surveillance Experience with Tofacitinib in Rheumatoid Arthritis.

    Science.gov (United States)

    Cohen, Stanley; Curtis, Jeffrey R; DeMasi, Ryan; Chen, Yan; Fan, Haiyun; Soonasra, Arif; Fleischmann, Roy

    2018-06-01

    Post-marketing surveillance (PMS) is an integral part of monitoring adverse events (AEs) following approval of new drugs. Tofacitinib is an oral Janus kinase inhibitor for the treatment of rheumatoid arthritis (RA). An analysis of PMS reports was conducted to evaluate the safety of tofacitinib in a post-marketing setting. Worldwide tofacitinib PMS data received in the Pfizer safety database from November 6, 2012 (first marketing authorization of tofacitinib) to November 5, 2015 were analyzed. Serious AEs (SAEs) of interest were reviewed and reporting rates (RRs) were calculated by dividing the number of SAEs by the estimated 100 patient-years of exposure. Patient exposure was calculated based on estimated worldwide sales and an estimated daily regimen of tofacitinib 5 mg twice daily. During the 3-year reporting period, worldwide post-marketing exposure to tofacitinib since approval was estimated to be 34,223 patient-years. In total, 9291 case reports (82.9% non-serious) were received and 25,417 AEs, 102 fatal cases, and 4352 SAEs were reported. The RRs (per 100 patient-years) for SAEs of interest by Medical Dictionary for Regulatory Activities System Organ Class were 2.57 for infections, 0.91 for gastrointestinal disorders, 0.60 for respiratory disorders, 0.45 for neoplasms, 0.43 for cardiac disorders, and 0.12 for hepatobiliary disorders. Although there are limitations to these data, no new safety risks were revealed in this real-world setting compared with the safety profile identified in the tofacitinib RA clinical development program. Any risks identified through the tofacitinib development program and PMS will continue to be monitored through pharmacovigilance surveillance. Pfizer Inc.

  5. 77 FR 60094 - Approval and Promulgation of Air Quality Implementation Plans; West Virginia; The 2002 Base Year...

    Science.gov (United States)

    2012-10-02

    ... Promulgation of Air Quality Implementation Plans; West Virginia; The 2002 Base Year Inventory for the... proposing to approve the fine particulate matter (PM 2.5 ) 2002 base year emissions inventory portion of the... Standard (NAAQS) SIP. EPA is proposing to approve the 2002 base year PM 2.5 emissions inventory for the...

  6. 77 FR 60087 - Approval and Promulgation of Air Quality Implementation Plans; West Virginia; The 2002 Base Year...

    Science.gov (United States)

    2012-10-02

    ... Promulgation of Air Quality Implementation Plans; West Virginia; The 2002 Base Year Inventory for the... proposing to approve the fine particulate matter (PM 2.5 ) 2002 base year emissions inventory portion of the... National Ambient Air Quality Standard (NAAQS) SIP. EPA is proposing to approve the 2002 base year PM 2.5...

  7. 77 FR 60085 - Approval and Promulgation of Air Quality Implementation Plans; West Virginia; The 2002 Base Year...

    Science.gov (United States)

    2012-10-02

    ... Promulgation of Air Quality Implementation Plans; West Virginia; The 2002 Base Year Inventory for the... proposing to approve the fine particulate matter (PM 2.5 ) 2002 base year emissions inventory portion of the... Quality Standard (NAAQS) SIP. EPA is proposing to approve the 2002 base year PM 2.5 emissions inventory...

  8. Physical inactivity post-stroke: a 3-year longitudinal study.

    Science.gov (United States)

    Kunkel, Dorit; Fitton, Carolyn; Burnett, Malcolm; Ashburn, Ann

    2015-01-01

    To explore change in activity levels post-stroke. We measured activity levels using the activPAL™ in hospital and at 1, 2 and 3 years' post-stroke onset. Of the 74 participants (mean age 76 (SD 11), 39 men), 61 were assessed in hospital: 94% of time was spent in sitting/lying, 4% standing and 2% walking. Activity levels improved over time (complete cases n = 15); time spent sitting/lying decreased (p = 0.001); time spent standing, walking and number of steps increased (p = 0.001, p = 0.028 and p = 0.03, respectively). At year 3, 18% of time was spent in standing and 9% walking. Time spent upright correlated significantly with Barthel (r = 0.69 on admission, r = 0.68 on discharge, both p inactive for the majority of time. Time spent upright improved significantly by 1 year post-stroke; improvements slowed down thereafter. Poor activity levels correlated with physical and psychological measures. Larger studies are indicated to identify predictors of activity levels. Implications for Rehabilitation Activity levels (measured using activPAL™ activity monitor), increased significantly by 1 year post-stroke but improvements slowed down at 2 and 3 years. People with stroke were inactive for the majority of their day in hospital and in the community. Poor activity levels correlated with physical and psychological measures. Larger studies are indicated to identify the most important predictors of activity levels.

  9. Atypical presentation of macrophagic myofasciitis 10 years post vaccination.

    LENUS (Irish Health Repository)

    Ryan, Aisling M

    2012-02-03

    Macrophagic myofasciitis (MMF) is an uncommon inflammatory disorder of muscle believed to be due to persistence of vaccine-derived aluminium hydroxide at the site of injection. The condition is characterised by diffuse myalgias, arthralgia and fatigue. We describe a patient with histologically confirmed MMF whose presentation was atypical with left chest and upper limb pain beginning more than 10 years post vaccination. Treatment with steroids led to symptomatic improvement. Although rare, clinicians should consider MMF in cases of atypical myalgia.

  10. Post-Closure Inspection Report for the Tonopah Test Range, Nevada, for Calendar Year 2014

    Energy Technology Data Exchange (ETDEWEB)

    Silvas, A. J. [National Security Technologies, LLC, Las Vegas, NV (United States). Nevada Test Site; Lantow, Tiffany A. [National Security Technologies, LLC, Las Vegas, NV (United States). Nevada Test Site

    2015-03-25

    This report provides the results of the annual post-closure inspections conducted at the closed Corrective Action Units (CAUs) located on the Tonopah Test Range (TTR), Nevada. This report covers calendar year 2014 and includes inspection and repair activities completed at the following CAUs; CAU 400: Bomblet Pit and Five Points Landfill (TTR); CAU 407: Roller Coaster RadSafe Area (TTR); CAU 424: Area 3 Landfill Complexes (TTR); CAU 453: Area 9 UXO Landfill (TTR); and CAU 487: Thunderwell Site (TTR) Inspections were conducted according to the post-closure plans in the approved Closure Reports and subsequent correspondence with the Nevada Division of Environmental Protection. The post-closure inspection plans and subsequent correspondence modifying the requirements for each CAU are included in Appendix B. The inspection checklists are included in Appendix C. Photographs taken during inspections are included in Appendix D. The annual post-closure inspections were conducted on May 28, 2014. Maintenance was required at CAU 407. Animal burrows were backfilled and erosion repairs were performed. Vegetation monitoring was performed at CAU 407 in June 2014. The vegetation monitoring report is included in Appendix E.

  11. Malaria in Sri Lanka: one year post-tsunami

    DEFF Research Database (Denmark)

    Briët, Olivier J T; Galappaththy, Gawrie N L; Amerasinghe, Priyanie H

    2006-01-01

    One year ago, the authors of this article reported in this journal on the malaria situation in Sri Lanka prior to the tsunami that hit on 26 December 2004, and estimated the likelihood of a post-tsunami malaria outbreak to be low. Malaria incidence has decreased in 2005 as compared to 2004 in most...... districts, including the ones that were hit hardest by the tsunami. The malaria incidence (aggregated for the whole country) in 2005 followed the downward trend that started in 2000. However, surveillance was somewhat affected by the tsunami in some coastal areas and the actual incidence in these areas may...... have been higher than recorded, although there were no indications of this and it is unlikely to have affected the overall trend significantly. The focus of national and international post tsunami malaria control efforts was supply of antimalarials, distribution of impregnated mosquito nets...

  12. Post-Closure Inspection Report for the Tonopah Test Range, Nevada, For Calendar Year 2011

    International Nuclear Information System (INIS)

    2012-01-01

    This report provides the results of the annual post-closure inspections conducted at the closed Corrective Action Units (CAUs) located on the Tonopah Test Range (TTR), Nevada. This report covers calendar year 2011 and includes inspection and repair activities completed at the following CAUs: (1) CAU 400: Bomblet Pit and Five Points Landfill (TTR); (2) CAU 407: Roller Coaster RadSafe Area (TTR); (3) CAU 424: Area 3 Landfill Complexes (TTR); (4) CAU 453: Area 9 UXO Landfill (TTR); and (5) CAU 487: Thunderwell Site (TTR) Inspections were conducted according to the post-closure plans in the approved Closure Reports. The post-closure inspection plan for each CAU is included in Appendix B. The inspection checklists are included in Appendix C, field notes are included in Appendix D, and photographs taken during inspections are included in Appendix E. The annual post-closure inspections were conducted May 3 and 4, 2011. Maintenance was performed at CAU 424, CAU 453, and CAU 487. At CAU 424, two surface grade monuments at Landfill Cell A3-3 could not be located during the inspection. The two monuments were located and marked with lava rock on July 13, 2011. At CAU 453, there was evidence of animal burrowing. Animal burrows were backfilled on July 13, 2011. At CAU 487, one use restriction warning sign was missing, and wording was faded on the remaining signs. A large animal burrow was also present. The signs were replaced, and the animal burrow was backfilled on July 12, 2011. As a best management practice, the use restriction warning signs at CAU 407 were replaced with standard Federal Facility Agreement and Consent Order signs on July 13, 2011. Vegetation monitoring was performed at the CAU 400 Five Points Landfill and CAU 407 in June 2011, and the vegetation monitoring report is included in Appendix F.

  13. Post-Closure Inspection Report for the Tonopah Test Range, Nevada, For Calendar Year 2011

    Energy Technology Data Exchange (ETDEWEB)

    NSTec Environmental Restoration

    2012-02-21

    This report provides the results of the annual post-closure inspections conducted at the closed Corrective Action Units (CAUs) located on the Tonopah Test Range (TTR), Nevada. This report covers calendar year 2011 and includes inspection and repair activities completed at the following CAUs: (1) CAU 400: Bomblet Pit and Five Points Landfill (TTR); (2) CAU 407: Roller Coaster RadSafe Area (TTR); (3) CAU 424: Area 3 Landfill Complexes (TTR); (4) CAU 453: Area 9 UXO Landfill (TTR); and (5) CAU 487: Thunderwell Site (TTR) Inspections were conducted according to the post-closure plans in the approved Closure Reports. The post-closure inspection plan for each CAU is included in Appendix B. The inspection checklists are included in Appendix C, field notes are included in Appendix D, and photographs taken during inspections are included in Appendix E. The annual post-closure inspections were conducted May 3 and 4, 2011. Maintenance was performed at CAU 424, CAU 453, and CAU 487. At CAU 424, two surface grade monuments at Landfill Cell A3-3 could not be located during the inspection. The two monuments were located and marked with lava rock on July 13, 2011. At CAU 453, there was evidence of animal burrowing. Animal burrows were backfilled on July 13, 2011. At CAU 487, one use restriction warning sign was missing, and wording was faded on the remaining signs. A large animal burrow was also present. The signs were replaced, and the animal burrow was backfilled on July 12, 2011. As a best management practice, the use restriction warning signs at CAU 407 were replaced with standard Federal Facility Agreement and Consent Order signs on July 13, 2011. Vegetation monitoring was performed at the CAU 400 Five Points Landfill and CAU 407 in June 2011, and the vegetation monitoring report is included in Appendix F.

  14. Post-Closure Inspection Report for the Tonopah Test Range, Nevada, for Calendar Year 2013

    Energy Technology Data Exchange (ETDEWEB)

    Silvas, A. J.

    2014-03-03

    This report provides the results of the annual post-closure inspections conducted at the closed Corrective Action Units (CAUs) located on the Tonopah Test Range (TTR), Nevada. This report covers calendar year 2013 and includes inspection and repair activities completed at the following CAUs: • CAU 400: Bomblet Pit and Five Points Landfill (TTR) • CAU 407: Roller Coaster RadSafe Area (TTR) • CAU 424: Area 3 Landfill Complexes (TTR) • CAU 453: Area 9 UXO Landfill (TTR) • CAU 487: Thunderwell Site (TTR) Inspections were conducted according to the post-closure plans in the approved Closure Reports and subsequent correspondence with the Nevada Division of Environmental Protection. The post-closure inspection plans and subsequent correspondence modifying the requirements for each CAU are included in Appendix B. The inspection checklists are included in Appendix C. Field notes are included in Appendix D. Photographs taken during inspections are included in Appendix E. The annual post-closure inspections were conducted on May 14, 2013. Maintenance was performed at CAU 400, CAU 424, and CAU 453. At CAU 400, animal burrows were backfilled. At CAU 424, erosion repairs were completed at Landfill Cell A3-3, subsidence was repaired at Landfill Cell A3-4, and additional lava rock was placed in high-traffic areas to mark the locations of the surface grade monuments at Landfill Cell A3-3 and Landfill Cell A3-8. At CAU 453, two areas of subsidence were repaired and animal burrows were backfilled. Vegetation monitoring was performed at the CAU 400 Five Points Landfill and CAU 407 in June 2013. The vegetation monitoring report is included in Appendix F.

  15. Post-Closure Inspection Report for the Tonopah Test Range, Nevada, For Calendar Year 2007

    Energy Technology Data Exchange (ETDEWEB)

    NSTec Environmental Restoration

    2008-06-01

    This report provides the results of the semiannual post-closure inspections conducted at the closed Corrective Action Unit (CAU) sites located on the Tonopah Test Range (TTR), Nevada. This report covers calendar year 2007 and includes inspection and repair activities completed at the following nine CAUs: (1) CAU 400: Bomblet Pit and Five Points Landfill (TTR); (2) CAU 404: Roller Coaster Lagoons and Trench (TTR); (3) CAU 407: Roller Coaster RadSafe Area (TTR); (4) CAU 423: Area 3 Underground Discharge Point, Building 0360 (TTR); (5) CAU 424: Area 3 Landfill Complexes (TTR); (6) CAU 426: Cactus Spring Waste Trenches (TTR); (7) CAU 427: Area 3 Septic Waste Systems 2, 6 (TTR); (8) CAU 453: Area 9 UXO Landfill (TTR); and (9) CAU 487: Thunderwell Site (TTR). In a letter from the Nevada Division of Environmental Protection (NDEP) dated December 5, 2006, NDEP concurred with the request to reduce the frequency of post-closure inspections of CAUs at TTR to an annual frequency. This letter is included in Attachment B. Post-closure inspections were conducted on May 15-16, 2007. All inspections were conducted according to the post-closure plans in the approved Closure Reports. The post-closure inspection plan for each CAU is included in Attachment B, with the exception of CAU 400. CAU 400 does not require post-closure inspections, but inspections of the vegetation and fencing are conducted as a best management practice. The inspection checklists for each site inspection are included in Attachment C, the field notes are included in Attachment D, and the site photographs are included in Attachment E. Vegetation monitoring of CAU 400, CAU 404, CAU 407, and CAU 426 was performed in May 2007, and the vegetation monitoring report is included in Attachment F. Maintenance and/or repairs were performed at CAU 453. Animal burrows observed during the annual inspection at CAU 453 were backfilled on August 1, 2007. At this time, the TTR post-closure site inspections should continue as

  16. Post-Closure Inspection Report for the Tonopah Test Range, Nevada, For Calendar Year 2007

    International Nuclear Information System (INIS)

    NSTec Environmental Restoration

    2008-01-01

    This report provides the results of the semiannual post-closure inspections conducted at the closed Corrective Action Unit (CAU) sites located on the Tonopah Test Range (TTR), Nevada. This report covers calendar year 2007 and includes inspection and repair activities completed at the following nine CAUs: (1) CAU 400: Bomblet Pit and Five Points Landfill (TTR); (2) CAU 404: Roller Coaster Lagoons and Trench (TTR); (3) CAU 407: Roller Coaster RadSafe Area (TTR); (4) CAU 423: Area 3 Underground Discharge Point, Building 0360 (TTR); (5) CAU 424: Area 3 Landfill Complexes (TTR); (6) CAU 426: Cactus Spring Waste Trenches (TTR); (7) CAU 427: Area 3 Septic Waste Systems 2, 6 (TTR); (8) CAU 453: Area 9 UXO Landfill (TTR); and (9) CAU 487: Thunderwell Site (TTR). In a letter from the Nevada Division of Environmental Protection (NDEP) dated December 5, 2006, NDEP concurred with the request to reduce the frequency of post-closure inspections of CAUs at TTR to an annual frequency. This letter is included in Attachment B. Post-closure inspections were conducted on May 15-16, 2007. All inspections were conducted according to the post-closure plans in the approved Closure Reports. The post-closure inspection plan for each CAU is included in Attachment B, with the exception of CAU 400. CAU 400 does not require post-closure inspections, but inspections of the vegetation and fencing are conducted as a best management practice. The inspection checklists for each site inspection are included in Attachment C, the field notes are included in Attachment D, and the site photographs are included in Attachment E. Vegetation monitoring of CAU 400, CAU 404, CAU 407, and CAU 426 was performed in May 2007, and the vegetation monitoring report is included in Attachment F. Maintenance and/or repairs were performed at CAU 453. Animal burrows observed during the annual inspection at CAU 453 were backfilled on August 1, 2007. At this time, the TTR post-closure site inspections should continue as

  17. Pathophysiological links between traumatic brain injury and post-traumatic headaches [version 1; referees: 3 approved

    Directory of Open Access Journals (Sweden)

    Robert L. Ruff

    2016-08-01

    Full Text Available This article reviews possible ways that traumatic brain injury (TBI can induce migraine-type post-traumatic headaches (PTHs in children, adults, civilians, and military personnel. Several cerebral alterations resulting from TBI can foster the development of PTH, including neuroinflammation that can activate neural systems associated with migraine. TBI can also compromise the intrinsic pain modulation system and this would increase the level of perceived pain associated with PTH. Depression and anxiety disorders, especially post-traumatic stress disorder (PTSD, are associated with TBI and these psychological conditions can directly intensify PTH. Additionally, depression and PTSD alter sleep and this will increase headache severity and foster the genesis of PTH. This article also reviews the anatomic loci of injury associated with TBI and notes the overlap between areas of injury associated with TBI and PTSD.

  18. Post-Closure Inspection Report for the Tonopah Test Range, Nevada, for Calendar Year 2009

    International Nuclear Information System (INIS)

    2010-01-01

    This report provides the results of the annual post-closure inspections conducted at the closed Corrective Action Unit (CAU) sites located on the Tonopah Test Range (TTR), Nevada. This report covers calendar year 2009 and includes inspection and repair activities completed at the following seven CAUs: (1) CAU 400: Bomblet Pit and Five Points Landfill (TTR); (2) CAU 407: Roller Coaster RadSafe Area (TTR); (3) CAU 424: Area 3 Landfill Complexes (TTR); (4) CAU 426: Cactus Spring Waste Trenches (TTR); (5) CAU 453: Area 9 UXO Landfill (TTR); (6) CAU 484: Surface Debris, Waste Sites, and Burn Area (TTR); and (7) CAU 487: Thunderwell Site (TTR). The annual post-closure inspections were conducted May 5-6, 2009. All inspections were conducted according to the post-closure plans in the approved Closure Reports. The post-closure inspection plan for each CAU is included in Attachment B, with the exception of CAU 400. CAU 400 does not require post-closure inspections, but inspections of the vegetation and fencing are conducted as a best management practice. The inspection checklists for each site inspection are included in Attachment C, the field notes are included in Attachment D, and the site photographs are included in Attachment E. Vegetation monitoring of CAU 400, CAU 404, CAU 407, and CAU 426 was performed in June 2009, and the vegetation monitoring report is included in Attachment F. Maintenance was performed at CAU 453. Animal burrows observed during the annual inspection were backfilled, and a depression was restored to grade on June 25, 2009. Post-closure site inspections should continue as scheduled. Vegetation survey inspections have been conducted annually at CAUs 400, 404, 407, and 426. Discontinuation of vegetation surveys is recommended at the CAU 400 Bomblet Pit and CAU 426, which have been successfully revegetated. Discontinuation of vegetation surveys is also recommended at CAU 404, which has been changed to an administrative closure with no inspections

  19. Post-Closure Inspection Report for the Tonopah Test Range, Nevada, for Calendar Year 2009

    Energy Technology Data Exchange (ETDEWEB)

    NSTec Environmental Restoration

    2010-05-28

    This report provides the results of the annual post-closure inspections conducted at the closed Corrective Action Unit (CAU) sites located on the Tonopah Test Range (TTR), Nevada. This report covers calendar year 2009 and includes inspection and repair activities completed at the following seven CAUs: · CAU 400: Bomblet Pit and Five Points Landfill (TTR) · CAU 407: Roller Coaster RadSafe Area (TTR) · CAU 424: Area 3 Landfill Complexes (TTR) · CAU 426: Cactus Spring Waste Trenches (TTR) · CAU 453: Area 9 UXO Landfill (TTR) · CAU 484: Surface Debris, Waste Sites, and Burn Area (TTR) · CAU 487: Thunderwell Site (TTR) The annual post-closure inspections were conducted May 5–6, 2009. All inspections were conducted according to the post-closure plans in the approved Closure Reports. The post-closure inspection plan for each CAU is included in Attachment B, with the exception of CAU 400. CAU 400 does not require post-closure inspections, but inspections of the vegetation and fencing are conducted as a best management practice. The inspection checklists for each site inspection are included in Attachment C, the field notes are included in Attachment D, and the site photographs are included in Attachment E. Vegetation monitoring of CAU 400, CAU 404, CAU 407, and CAU 426 was performed in June 2009, and the vegetation monitoring report is included in Attachment F. Maintenance was performed at CAU 453. Animal burrows observed during the annual inspection were backfilled, and a depression was restored to grade on June 25, 2009. Post-closure site inspections should continue as scheduled. Vegetation survey inspections have been conducted annually at CAUs 400, 404, 407, and 426. Discontinuation of vegetation surveys is recommended at the CAU 400 Bomblet Pit and CAU 426, which have been successfully revegetated. Discontinuation of vegetation surveys is also recommended at CAU 404, which has been changed to an administrative closure with no inspections required. Vegetation

  20. 77 FR 75933 - Approval and Promulgation of Air Quality Implementation Plans; West Virginia; The 2002 Base Year...

    Science.gov (United States)

    2012-12-26

    ... email. The www.regulations.gov Web site is an ``anonymous access'' system, which means EPA will not know... Promulgation of Air Quality Implementation Plans; West Virginia; The 2002 Base Year Emissions Inventory for the...: Proposed rule. SUMMARY: EPA is proposing to approve the 2002 base year emissions inventory portion of the...

  1. 29 CFR 37.64 - What procedures must the Director follow when CRC has completed a post-approval compliance review?

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 1 2010-07-01 2010-07-01 true What procedures must the Director follow when CRC has completed a post-approval compliance review? 37.64 Section 37.64 Labor Office of the Secretary of Labor... (WIA) Compliance Procedures § 37.64 What procedures must the Director follow when CRC has completed a...

  2. Case Report: Ischaemic appendicitis post mesenteric biopsy [version 1; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Marianna Zukiwskyj

    2016-01-01

    Full Text Available A common indication for laparoscopic mesenteric lymph node biopsy is to provide a tissue diagnosis in the absence of palpable peripheral nodes via a minimally invasive approach.  There are no reports to date of ischaemia to the appendix as a complication of this procedure.   We report the case of a 34-year-old lady who underwent a mesenteric biopsy for a lesion found incidentally on CT to investigate longstanding abdominal pain, and 2 days later required an appendicectomy for ischaemic appendicitis.

  3. Post-Closure Inspection Report for Corrective Action Unit 453: Area 9 UXO Landfill Tonopah Test Range, Nevada, Calendar Year 2000; TOPICAL

    International Nuclear Information System (INIS)

    K. B. Campbell

    2001-01-01

    Post-closure monitoring requirements for the Area 9 Unexploded Ordnance Landfill (Corrective Action Unit[CAU] 453) (Figure 1) are described in Closure Report for Corrective Action Unit 453: Area 9 UXO Landfill, Tonopah Test Range, Nevada, report number DOE/NV-284. The Closure Report (CR) was submitted to the Nevada Division of Environmental Protection (NDEP) on August 5,1999. The CR (containing the Post-Closure Monitoring Plan) was approved by the NDEP on September 10,1999. Post-closure monitoring at CAU 453 consists of the following: (1) Site inspections done twice a year to evaluate the condition of the unit; (2) Verification that the site is secure; (3) Notice of any subsidence or deficiencies that may compromise the integrity of the unit; (4) Remedy of any deficiencies within 90 days of discovery; and (5) Preparation and submittal of an annual report. Site inspections were conducted on June 20, 2000 and November 21, 2000. Both site inspections were conducted after NDEP approval of the CR, and in accordance with the Post-Closure Monitoring Plan in the NDEP-approved CR. This report includes copies of the inspection checklists, photographs, recommendations, and conclusions. The Post-Closure Inspection Checklists are found in Attachment A, a copy of the field notes is found in Attachment B, and inspection photographs are found in Attachment C

  4. Post-approval monitoring and oversight of U.S.-initiated human subjects research in resource-constrained countries.

    Science.gov (United States)

    Brown, Brandon; Kinsler, Janni; Folayan, Morenike O; Allen, Karen; Cáceres, Carlos F

    2014-06-01

    The history of human subjects research and controversial procedures in relation to it has helped form the field of bioethics. Ethically questionable elements may be identified during research design, research implementation, management at the study site, or actions by a study's investigator or other staff. Post-approval monitoring (PAM) may prevent violations from occurring or enable their identification at an early stage. In U.S.-initiated human subjects research taking place in resource-constrained countries with limited development of research regulatory structures, arranging a site visit from a U.S. research ethics committee (REC) becomes difficult, thus creating a potential barrier to regulatory oversight by the parent REC. However, this barrier may be overcome through the use of digital technologies, since much of the world has at least remote access to the Internet. Empirical research is needed to pilot test the use of these technologies for research oversight to ensure the protection of human subjects taking part in research worldwide.

  5. Companion diagnostics: a regulatory perspective from the last 5 years of molecular companion diagnostic approvals.

    Science.gov (United States)

    Roscoe, Donna M; Hu, Yun-Fu; Philip, Reena

    2015-01-01

    Companion diagnostics are essential for the safe and effective use of the corresponding therapeutic products. The US FDA has approved a number of companion diagnostics used to select cancer patients for treatment with contemporaneously approved novel therapeutics. The processes of co-development and co-approval of a therapeutic product and its companion diagnostic have been a learning experience that continues to evolve. Using several companion diagnostics as examples, this article describes the challenges associated with the scientific, clinical and regulatory hurdles faced by FDA and industry alike. Taken together, this discussion is intended to assist manufacturers toward a successful companion diagnostics development plan.

  6. Case Report: 84 year-old woman with alien hand syndrome [version 1; referees: 2 approved, 1 approved with reservations

    Directory of Open Access Journals (Sweden)

    Ihtesham Aatif Qureshi

    2016-07-01

    Full Text Available Background: Alien hand syndrome [AHS] is a rare and ill-defined neurological disorder. It produces complex, goal-directed motion of one hand that is involuntarily instigated. This syndrome characteristically arises after brain trauma, brain surgery, stroke or encephalitis. We describe a case of AHS in a patient who had a previous episode of subarachnoid hemorrhage affecting the left frontal lobe and corpus callosum. Case presentation: An 84-year-old woman presented to the emergency department complaining of headaches and several episodes of her left arm moving as if it was groping around trying to grab at her own body. A computed tomography scan of the head demonstrated an acute left superior frontal hemorrhage with compression of the corpus callosum. Transcranial Doppler report showed no significant abnormality in the insonated vessels. After being stabilized for the acute bleed, she was treated with clonazepam 0.5 mgat night for the uncontrolled hand movements. Her movements resolved by her next month follow up. The diagnosis of AHS was made based on her clinical presentation, characterization of the movement and localization correlating with findings in neuroimaging. Conclusion: We document a rare neurologic disorder seen in patients presenting with a history of previous strokes and a typical description of involuntary and unintentional, uncontrolled unilateral arm movements with repetitive grasping. The present case has a combination of frontal and callosal lesions.  These findings appear to support a potential destruction leading to the rare syndrome.

  7. 78 FR 46552 - Approval and Promulgation of Air Quality Implementation Plans; State of Colorado; Second Ten-Year...

    Science.gov (United States)

    2013-08-01

    ... ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 52 [EPA-R08-OAR-2011-0659; FRL-9840-6] Approval and Promulgation of Air Quality Implementation Plans; State of Colorado; Second Ten-Year Carbon Monoxide Maintenance Plan for Colorado Springs AGENCY: Environmental Protection Agency (EPA). ACTION: Proposed rule...

  8. 78 FR 46861 - Approval and Promulgation of Air Quality Implementation Plans; State of Colorado; Second Ten-Year...

    Science.gov (United States)

    2013-08-02

    ... ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 52 [EPA-R08-OAR-2011-0658; FRL-9840-8] Approval and Promulgation of Air Quality Implementation Plans; State of Colorado; Second Ten-Year Carbon Monoxide Maintenance Plan for Greeley AGENCY: Environmental Protection Agency (EPA). ACTION: Proposed rule. SUMMARY...

  9. 78 FR 57573 - Approval and Promulgation of Air Quality Implementation Plans; State of Colorado Second Ten-Year...

    Science.gov (United States)

    2013-09-19

    ... ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 52 [EPA-R08-OAR-2012-0475; FRL-9901-05-Region 8] Approval and Promulgation of Air Quality Implementation Plans; State of Colorado Second Ten-Year PM 10 Maintenance Plan for Aspen AGENCY: Environmental Protection Agency (EPA). ACTION: Proposed rule. SUMMARY: EPA...

  10. 78 FR 41342 - Approval and Promulgation of Air Quality Implementation Plans; State of Colorado Second Ten-Year...

    Science.gov (United States)

    2013-07-10

    ... ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 52 [EPA-R08-OAR-2010-0389; FRL-9831-9] Approval and Promulgation of Air Quality Implementation Plans; State of Colorado Second Ten-Year PM 10 Maintenance Plan for Ca[ntilde]on City AGENCY: Environmental Protection Agency (EPA). ACTION: Proposed rule. SUMMARY: EPA...

  11. 78 FR 41307 - Approval and Promulgation of Air Quality Implementation Plans; State of Colorado; Second Ten-Year...

    Science.gov (United States)

    2013-07-10

    ... ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 52 [EPA-R08-OAR-2010-0389; FRL-9832-1] Approval and Promulgation of Air Quality Implementation Plans; State of Colorado; Second Ten-Year PM 10 Maintenance Plan for Ca[ntilde]on City AGENCY: Environmental Protection Agency (EPA). ACTION: Direct final rule. SUMMARY...

  12. 78 FR 56185 - Approval and Promulgation of Air Quality Implementation Plans; State of Colorado; Second Ten-Year...

    Science.gov (United States)

    2013-09-12

    ... ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 52 [EPA-R08-OAR-2011-0708; FRL-9900-87-Region 8] Approval and Promulgation of Air Quality Implementation Plans; State of Colorado; Second Ten-Year Carbon Monoxide Maintenance Plan for Fort Collins AGENCY: Environmental Protection Agency (EPA). ACTION: Proposed...

  13. Kaposi sarcoma appearing 20 year post renal transplant | Yassir ...

    African Journals Online (AJOL)

    A kidney- transplanted Saudi patient presented with a skin rash for which he was treated as fungal infection .The patient developed these lesions 20 years after transplantation. The clinical picture was that of Kaposi\\'s sarcoma which was confirmed by histopathology .The patient developed these lesions after he was shifted ...

  14. Vesical Calculus 10 Years Post Missing Intrauterine Contraceptive ...

    African Journals Online (AJOL)

    Intravesical migration of intrauterine contraceptive device (IUCD) is rare. Early diagnosis of this rare entity is difficult because of its non‑specific manifestations and very low index of suspicion. We present this case of bladder stone following intravesical migration of IUCD found to have been missing since insertion 10 years ...

  15. POST-CLOSURE INSPECTION REPORT FOR THE TONOPAH TEST RANGE, NEVADA, FOR CALENDAR YEAR 2004

    Energy Technology Data Exchange (ETDEWEB)

    BECHTEL NEVADA

    2005-04-01

    This Post-Closure Inspection Report provides an analysis and summary of the semi-annual inspections conducted at the Tonopah Test Range (TTR) during Calendar Year 2004. The report includes the inspection and/or repair activities completed at the following nine Corrective Action Units (CAUs) located at TTR, Nevada: (1) CAU 400: Bomblet Pit and Five Points Landfill (TTR); (2) CAU 404: Roller Coaster Lagoons and Trench (TTR); (3) CAU 407: Roller Coaster RadSafe Area (TTR); (4) CAU 423: Area 3 Underground Discharge Point, Building 0360 (TTR) (5) CAU 424: Area 3 Landfill Complexes (TTR); (6) CAU 426: Cactus Spring Waste Trenches (TTR); (7) CAU 427: Area 3 Septic Waste Systems 2,6 (TTR); (8) CAU 453: Area 9 UXO Landfill (TTR); and (9) CAU 487: Thunderwell Site (TTR). Site inspections were conducted on July 7,2004, and November 9-10,2004. All inspections were conducted according to the post-closure plans in the approved Closure Reports (CRs). The post-closure inspection plan for each CAU is included in Appendix B, with the exception of CAU 400 and CAU 423. CAU 400 does not require post-closure inspections, but inspections of the vegetation and fencing are conducted as a best management practice. In addition, post-closure inspections are not currently required at CAU 423; however, the CR is being revised to include inspection requirements. The inspection checklists for each site inspection are included in Appendix C, the field notes are included in Appendix D, and the site photographs are included in Appendix E. Vegetation monitoring of CAU 400, CAU 404, CAU 407, and CAU 426 was performed in June 2004, and the vegetation monitoring report is included in Appendix F. In addition, topographic survey results of two repaired landfill cells in CAU 424 are included in Appendix G. Maintenance and/or repairs were performed at the CAU 400 Five Points Landfill, CAU 407, CAU 424, CAU 427, and CAU 487. CAU 400 repairs included mending the fence, reseeding of a flood damaged area, and

  16. GW LIBRAE: STILL HOT EIGHT YEARS POST-OUTBURST

    Energy Technology Data Exchange (ETDEWEB)

    Szkody, Paula; Mukadam, Anjum S. [Department of Astronomy, University of Washington, Box 351580, Seattle, WA 98195 (United States); Gänsicke, Boris T.; Chote, Paul; Toloza, Odette [Department of Physics, University of Warwick, Coventry CV4 7AL (United Kingdom); Nelson, Peter; Myers, Gordon; Waagen, Elizabeth O. [AAVSO, 48 Bay State Road, Cambridge, MA 02138 (United States); Sion, Edward M. [Department of Astrophysics and Planetary Science, Villanova University, Villanova, PA 19085 (United States); Sullivan, Denis J. [School of Chemical and Physical Sciences, Victoria University of Wellington, P.O. Box 600, Wellington (New Zealand); Townsley, Dean M., E-mail: szkody@astro.washington.edu [Department of Physics and Astronomy, University of Alabama, Tuscaloosa, AL 35487 (United States)

    2016-08-01

    We report continued Hubble Space Telescope ( HST ) ultraviolet spectra and ground-based optical photometry and spectroscopy of GW Librae eight years after its largest known dwarf nova outburst in 2007. This represents the longest cooling timescale measured for any dwarf nova. The spectra reveal that the white dwarf still remains about 3000 K hotter than its quiescent value. Both ultraviolet and optical light curves show a short period of 364–373 s, similar to one of the non-radial pulsation periods present for years prior to the outburst, and with a similar large UV/optical amplitude ratio. A large modulation at a period of 2 hr (also similar to that observed prior to outburst) is present in the optical data preceding and during the HST observations, but the satellite observation intervals did not cover the peaks of the optical modulation, and so it is not possible to determine its corresponding UV amplitude. The similarity of the short and long periods to quiescent values implies that the pulsating, fast spinning white dwarf in GW Lib may finally be nearing its quiescent configuration.

  17. Psychopathology 8 1/2 years post parasuicide.

    Science.gov (United States)

    Curran, S; Fitzgerald, M; Greene, V T

    1999-01-01

    There are few long-term follow-up studies of parasuicides incorporating face-to-face interviews. To date no study has evaluated the prevalence of psychiatric morbidity at long-term follow-up of parasuicides using diagnostic rating scales, nor has any study examined parental bonding issues in this population. We attempted a prospective follow-up of 85 parasuicide cases an average of 8 1/2 years later. Psychiatric morbidity, social functioning, and recollections of the parenting style of their parents were assessed using the Clinical Interview Schedule, the Social Maladjustment Scale, and the Parental Bonding Instrument, respectively. Thirty-nine persons in total were interviewed, 19 of whom were well and 20 of whom had psychiatric morbidity. Five and died during the follow-up period, 3 by suicide. Migration, refusals, and untraceability were common. Parasuicide was associated with parental overprotection during childhood. Long-term outcome is poor, especially among those who engaged in repeated parasuicides.

  18. Post-Closure Inspection Report for the Tonopah Test Range, Nevada. For Calendar Year 2015, Revision 0

    International Nuclear Information System (INIS)

    Matthews, Patrick; Petrello, Jaclyn

    2016-01-01

    This report provides the results of the annual post-closure inspections conducted at the closed corrective action units (CAUs) located on the Tonopah Test Range (TTR), Nevada. This report covers calendar year 2015 and includes inspection and repair activities completed at the following CAUs; CAU 400: Bomblet Pit and Five Points Landfill (TTR); CAU 407: Roller Coaster RadSafe Area (TTR); CAU 424: Area 3 Landfill Complexes (TTR); CAU 453: Area 9 UXO Landfill (TTR); and CAU 487: Thunderwell Site (TTR) Inspections were conducted according to the post-closure plans in the approved closure reports and subsequent correspondence with the Nevada Division of Environmental Protection. The post-closure inspection plans and subsequent correspondence modifying the requirements for each CAU are included in Appendix B. The inspection checklists are included in Appendix C. Field notes are included in Appendix D. The annual post-closure inspections were conducted on May 12, 2015. Maintenance was required at CAU 453. Cracking along the north trench was repaired. One monument is missing at CAU 424; it will be replaced in 2016. Postings at CAUs 407, 424, 453, and 487 contain contact information for TTR Security. It was noted that protocols may not be in place to ensure that the U.S. Department of Energy, National Nuclear Security Administration Nevada Field Office (NNSA/NFO) is notified if access is needed at these sites. NNSA/NFO is working with the U.S. Air Force and Sandia to determine whether more appropriate contact information or new protocols are warranted for each CAU. Based on these inspections, there has not been a significant change in vegetation, and vegetation monitoring was not recommended at CAU 400 or CAU 407 in 2015.

  19. Post-Closure Inspection Report for the Tonopah Test Range, Nevada. For Calendar Year 2015, Revision 0

    Energy Technology Data Exchange (ETDEWEB)

    Matthews, Patrick [Navarro, Las Vegas, NV (United States); Petrello, Jaclyn [Navarro, Las Vegas, NV (United States)

    2016-03-01

    This report provides the results of the annual post-closure inspections conducted at the closed corrective action units (CAUs) located on the Tonopah Test Range (TTR), Nevada. This report covers calendar year 2015 and includes inspection and repair activities completed at the following CAUs; CAU 400: Bomblet Pit and Five Points Landfill (TTR); CAU 407: Roller Coaster RadSafe Area (TTR); CAU 424: Area 3 Landfill Complexes (TTR); CAU 453: Area 9 UXO Landfill (TTR); and CAU 487: Thunderwell Site (TTR) Inspections were conducted according to the post-closure plans in the approved closure reports and subsequent correspondence with the Nevada Division of Environmental Protection. The post-closure inspection plans and subsequent correspondence modifying the requirements for each CAU are included in Appendix B. The inspection checklists are included in Appendix C. Field notes are included in Appendix D. The annual post-closure inspections were conducted on May 12, 2015. Maintenance was required at CAU 453. Cracking along the north trench was repaired. One monument is missing at CAU 424; it will be replaced in 2016. Postings at CAUs 407, 424, 453, and 487 contain contact information for TTR Security. It was noted that protocols may not be in place to ensure that the U.S. Department of Energy, National Nuclear Security Administration Nevada Field Office (NNSA/NFO) is notified if access is needed at these sites. NNSA/NFO is working with the U.S. Air Force and Sandia to determine whether more appropriate contact information or new protocols are warranted for each CAU. Based on these inspections, there has not been a significant change in vegetation, and vegetation monitoring was not recommended at CAU 400 or CAU 407 in 2015.

  20. Empowering first year (post-matric) students in basic research skills ...

    African Journals Online (AJOL)

    Post-matric students from under-resourced (historically disadvantaged) black high schools generally encounter difficulties in their academic work at university. The study reported here was intended to empower first year (post-matric) students from these schools with basic research skills in a bid to counteract the effects of ...

  1. Quality of Life during the First Two Years Post Stroke : The Restore4Stroke Cohort Study

    NARCIS (Netherlands)

    van Mierlo, Maria L.; van Heugten, Caroline M.; Post, Marcel W. M.; Hajos, Tibor R. S.; Kappelle, L. Jaap; Visser-Meily, Johanna M. A.

    2016-01-01

    BACKGROUND: Little information is available about the course of quality of life (QoL) post stroke and how dependency on activities of daily living (ADL) influences this course. The aim of this study was therefore to describe the course of QoL from 2 months up to 2 years post stroke and to study the

  2. Tonopah Test Range Post-Closure Inspection Annual Report, Tonopah Test Range, Nevada, Calendar Year 2003

    Energy Technology Data Exchange (ETDEWEB)

    U.S. Department of Energy, National Nuclear Security Administration Nevada Site Office; Bechtel Nevada

    2004-04-01

    This post-closure inspection report provides documentation of the semiannual inspection activities, maintenance and repair activities, and conclusions and recommendations for calendar year 2003 for eight corrective action units located on the Tonopah Test Range, Nevada.

  3. POST-CLOSURE INSPECTION REPORT FOR THE TONOPAH TEST RANGE, NEVADA FOR CALENDAR YEAR 2005

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2006-06-01

    This post-closure inspection report includes the results of inspections, maintenance and repair activities, and conclusions and recommendations for Calendar Year 2005 for nine Corrective Action Units located on the Tonopah Test Range , Nevada.

  4. Lack of proportionality. Seven specifications of public interest that override post-approval commercial interests on limited access to clinical data

    Directory of Open Access Journals (Sweden)

    Strech Daniel

    2012-07-01

    Full Text Available Abstract For the protection of commercial interests, licensing bodies such as the EMA and health technology assessment institutions such as NICE restrict full access to unpublished evidence. Their respective policies on data transparency, however, lack a systematic account of (1 what kinds of commercial interests remain relevant after market approval has been granted, (2 what the specific types of public interest are that may override these commercial interests post approval, and, most importantly, (3 what criteria guide the trade-off between public interest and legitimate measures for the protection of commercial interest. Comparing potential commercial interests with seven specifications of relevant public interest reveals the lack of proportionality inherent in the current practices of EMA and NICE.

  5. Post-Closure Inspection Report for Corrective Action Unit 404: Roller Coaster Sewage Lagoons and North Disposal Trench Tonopah Test Range, Nevada, Calendar Year 2000

    Energy Technology Data Exchange (ETDEWEB)

    K. B. Campbell

    2001-06-01

    Post-closure monitoring requirements for the Roller Coaster Sewage Lagoons and North Disposal Trench (Corrective Action Unit [CAW 404]) (Figure 1) are described in Closure Report for Corrective Action Unit 404, Roller Coaster Sewage Lagoons and North Disposal Trench, Tonopah Test Range, Nevada, report number DOE/NV--187. The Closure Report (CR) was submitted to the Nevada Division of Environmental Protection (NDEP) on September 11, 1998. Permeability results of soils adjacent to the engineered cover and a request for closure of CAU 404 were transmitted to the NDEP on April 29, 1999. The CR (containing the Post-Closure Monitoring Plan) was approved by the NDEP on May 18, 1999. Post-closure monitoring at CAU 404 consists of the following: (1) Site inspections done twice a year to evaluate the condition of the unit; (2) Verification that the site is secure; (3) Notice of any subsidence or deficiencies that may compromise the integrity of the unit; (4) Remedy of any deficiencies within 90 days of discovery; and (5) Preparation and submittal of an annual report. Site inspections were conducted on June 19, 2000, and November 21, 2000. The site inspections were conducted after completion of the revegetation activities (October 30, 1997) and NDEP approval of the CR (May 18, 1999). All site inspections were conducted in accordance with the Post-Closure Monitoring Plan in the NDEP-approved CR. This report includes copies of inspection checklists, photographs, recommendations, and conclusions. The Post-Closure Inspection Checklists are found in Attachment A, a copy of the field notes is found in Attachment B, and copies of the inspection photographs are found in Attachment C.

  6. Post-Closure Inspection Report for Corrective Action Unit 404: Roller Coaster Sewage Lagoons and North Disposal Trench Tonopah Test Range, Nevada, Calendar Year 2000; TOPICAL

    International Nuclear Information System (INIS)

    K. B. Campbell

    2001-01-01

    Post-closure monitoring requirements for the Roller Coaster Sewage Lagoons and North Disposal Trench (Corrective Action Unit[CAW 404]) (Figure 1) are described in Closure Report for Corrective Action Unit 404, Roller Coaster Sewage Lagoons and North Disposal Trench, Tonopah Test Range, Nevada, report number DOE/NV-187. The Closure Report (CR) was submitted to the Nevada Division of Environmental Protection (NDEP) on September 11, 1998. Permeability results of soils adjacent to the engineered cover and a request for closure of CAU 404 were transmitted to the NDEP on April 29, 1999. The CR (containing the Post-Closure Monitoring Plan) was approved by the NDEP on May 18, 1999. Post-closure monitoring at CAU 404 consists of the following: (1) Site inspections done twice a year to evaluate the condition of the unit; (2) Verification that the site is secure; (3) Notice of any subsidence or deficiencies that may compromise the integrity of the unit; (4) Remedy of any deficiencies within 90 days of discovery; and (5) Preparation and submittal of an annual report. Site inspections were conducted on June 19, 2000, and November 21, 2000. The site inspections were conducted after completion of the revegetation activities (October 30, 1997) and NDEP approval of the CR (May 18, 1999). All site inspections were conducted in accordance with the Post-Closure Monitoring Plan in the NDEP-approved CR. This report includes copies of inspection checklists, photographs, recommendations, and conclusions. The Post-Closure Inspection Checklists are found in Attachment A, a copy of the field notes is found in Attachment B, and copies of the inspection photographs are found in Attachment C

  7. Academic posts at The University of Melbourne - 28 years of history.

    Science.gov (United States)

    Manski-Nankervis, Jo-Anne; Vergara, Edward; Daniel, Deepa; Young, Doris

    2011-12-01

    General practice registrars have the opportunity to undertake an academic post during their training. This 12 month part time post provides an opportunity to train in various facets of the emerging area of primary care research. The Department of General Practice (DGP) at The University of Melbourne (UoM) has hosted academic registrars for the past 28 years. Over this time, some important changes have occurred.

  8. Nightguard vital bleaching: side effects and patient satisfaction 10 to 17 years post-treatment.

    Science.gov (United States)

    Boushell, Lee W; Ritter, André V; Garland, Glenn E; Tiwana, Karen K; Smith, Lynn R; Broome, Angela; Leonard, Ralph H

    2012-06-01

      The long-term patient satisfaction and safety of nightguard vital bleaching (NGVB) requires further evaluation.   The purpose of this study was to evaluate patients' satisfaction and identify side effects of NGVB up to 17 years post-treatment.   Thirty-one participants who had completed previous NGVB studies using 10% carbamide peroxide were contacted at least 10 years post-treatment (range 10-17 years, average 12.3 years). Participants reported shade satisfaction (very satisfied [VS], partially satisfied [PS], or not satisfied [NS]) as well as potential complications. Participants had teeth # 6 to 11 examined for tooth vitality, gingival inflammation (Löe's Gingival Index [GI]), and radiographically for external cervical resorption (ECR).   All of the participants had successful lightening of their teeth. Sixty-one percent (19) had not retreated their teeth. Of those who had not retreated their teeth and who responded to the question of whitening satisfaction, 31% (4/13) were VS, 54% (7/13) were PS, and 15% (2/13) were NS with their current shade. Of those who had retreated their teeth, all were VS or PS. Ninety-one percent of the examined teeth had GI = 0 (normal), 7% had GI = 1 (mild inflammation), and 2% had GI = 2 (moderate inflammation). Sixty-nine percent of teeth tested responded to a cold stimulus. Radiographs did not detect ECR or apical lesions. No participant reported having a gingival biopsy post-treatment, and 87% would whiten again.   Patient satisfaction with NGVB may last as long as 12.3 years in average (range 10-17 years) post-treatment. GI and ECR findings were considered within the normal expectations for the sample studied, suggesting minimal clinical post-NGVB side effects up to 17 years. Nightguard vital bleaching provides patient satisfaction with minimal side effects up to 17 years post-treatment. © 2011 Wiley Periodicals, Inc.

  9. Predictors of subjective health status 10 years post-PCI.

    Science.gov (United States)

    van den Berge, Jan C; Dulfer, Karolijn; Utens, Elisabeth M W J; Hartman, Eline M J; Daemen, Joost; van Geuns, Robert J; van Domburg, Ron T

    2016-06-01

    Subjective health status is an increasingly important parameter to assess the effect of percutaneous coronary intervention (PCI) in clinical practice. Aim of this study was to determine medical and psychosocial predictors of poor subjective health status over a 10 years' post-PCI period. We included a series of consecutive PCI patients (n = 573) as part of the RESEARCH registry, a Dutch single-center retrospective cohort study. These patients completed the 36-item Short-Form Health Survey (SF-36) at baseline and 10 years post-PCI. We found 6 predictors of poor subjective health status 10 years post-PCI: SF-36 at baseline, age, previous PCI, obesity, acute myocardial infarction as indication for PCI, and diabetes mellitus (arranged from most to least numbers of sub domains). SF-36 scores at baseline, age, and previous PCI were significant predictors of subjective health status 10 years post-PCI. Specifically, the SF-36 score at baseline was an important predictor. Thus assessment of subjective health status at baseline is useful as an indicator to predict long-term subjective health status. Subjective health status becomes better by optimal medical treatment, cardiac rehabilitation and psychosocial support. This is the first study determining predictors of subjective health status 10 years post-PCI.

  10. The One-Year Attributable Cost of Post-Stroke Dysphagia

    Science.gov (United States)

    Bonilha, Heather Shaw; Simpson, Annie N.; Ellis, Charles; Mauldin, Patrick; Martin-Harris, Bonnie; Simpson, Kit

    2014-01-01

    With the recent emphasis on evidence-based practice and healthcare reform, understanding the cost of dysphagia management has never been more important. It is helpful for clinicians to understand and objectively report the costs associated with dysphagia when they advocate for their services in this economy. Having carefully estimated cost of illness, inputs are needed for cost-effectiveness analyses that help support the value of treatments. This study sought to address this issue by examining the 1-year cost associated with a diagnosis of dysphagia post-stroke in South Carolina. Furthermore, this study investigated whether ethnicity and residence differences exist in the cost of dysphagia post-stroke. Data on 3,200 patients in the South Carolina Medicare database from 2004 who had ICD-9 codes for ischemic stroke, 434 and 436, were retrospectively included in this study. Differences between persons with and without dysphagia post-stroke were compared with respect to age, gender, ethnicity, mortality, length of stay, comorbidity, rurality, discharge disposition, and cost to Medicare. Univariate analyses and a gamma-distributed generalized linear multivariable model with a log link function were completed. We found that the 1-year cost to Medicare for persons with dysphagia post ischemic stroke was $4,510 higher than that for persons without dysphagia post ischemic stroke when controlling for age, comorbidities, ethnicity, and proportion of time alive. Univariate analysis revealed that rurality, ethnicity, and gender were not statistically significantly different in comparisons of individuals with or without dysphagia post-stroke. Post-stroke dysphagia significantly increases post-stroke medical expenses. Understanding the expenditures associated with post-stroke dysphagia is helpful for optimal allocation and use of resources. Such information is needed to conduct cost-effectiveness studies. PMID:24948438

  11. The one-year attributable cost of post-stroke dysphagia.

    Science.gov (United States)

    Bonilha, Heather Shaw; Simpson, Annie N; Ellis, Charles; Mauldin, Patrick; Martin-Harris, Bonnie; Simpson, Kit

    2014-10-01

    With the recent emphasis on evidence-based practice and healthcare reform, understanding the cost of dysphagia management has never been more important. It is helpful for clinicians to understand and objectively report the costs associated with dysphagia when they advocate for their services in this economy. Having carefully estimated cost of illness, inputs are needed for cost-effectiveness analyses that help support the value of treatments. This study sought to address this issue by examining the 1-year cost associated with a diagnosis of dysphagia post-stroke in South Carolina. Furthermore, this study investigated whether ethnicity and residence differences exist in the cost of dysphagia post-stroke. Data on 3,200 patients in the South Carolina Medicare database from 2004 who had ICD-9 codes for ischemic stroke, 434 and 436, were retrospectively included in this study. Differences between persons with and without dysphagia post-stroke were compared with respect to age, gender, ethnicity, mortality, length of stay, comorbidity, rurality, discharge disposition, and cost to Medicare. Univariate analyses and a gamma-distributed generalized linear multivariable model with a log link function were completed. We found that the 1-year cost to Medicare for persons with dysphagia post ischemic stroke was $4,510 higher than that for persons without dysphagia post ischemic stroke when controlling for age, comorbidities, ethnicity, and proportion of time alive. Univariate analysis revealed that rurality, ethnicity, and gender were not statistically significantly different in comparisons of individuals with or without dysphagia post-stroke. Post-stroke dysphagia significantly increases post-stroke medical expenses. Understanding the expenditures associated with post-stroke dysphagia is helpful for optimal allocation and use of resources. Such information is needed to conduct cost-effectiveness studies.

  12. 77 FR 45304 - Approval and Promulgation of Air Quality Implementation Plans; Virginia; The 2002 Base Year...

    Science.gov (United States)

    2012-07-31

    ... Promulgation of Air Quality Implementation Plans; Virginia; The 2002 Base Year Inventory AGENCY: Environmental... particulate matter (PM 2.5 ) 2002 base year emissions inventory portion of the Virginia State Implementation... base year PM 2.5 emissions inventory in accordance with the requirements of the Clean Air Act (CAA...

  13. Post-Closure Inspection Report for the Tonopah Test Range, Nevada: For Calendar Year 2017, Revision 0

    Energy Technology Data Exchange (ETDEWEB)

    Alvarado, Juan; Matthews, Patrick

    2018-05-01

    This report provides the results of the annual post-closure inspections conducted at the closed corrective action units (CAUs) located on the Tonopah Test Range (TTR) and the Nevada Test and Training Range (NTTR). This report covers calendar year 2017 and includes visual inspection and repair activities completed at the following CAUs: • CAU 400: Bomblet Pit and Five Points Landfill (TTR) • CAU 407: Roller Coaster RadSafe Area (TTR) • CAU 424: Area 3 Landfill Complexes (TTR) • CAU 453: Area 9 UXO Landfill (TTR) • CAU 487: Thunderwell Site (TTR) Visual inspections were conducted according to the post-closure plans in the approved closure reports and subsequent correspondence with the Nevada Division of Environmental Protection. The annual post-closure inspections were conducted on May 23, 2017. No maintenance or repair issues were noted at CAU 400 and CAU 487. Maintenance items and subsequent repairs include the following: • CAU 407: A large animal burrow was observed in the southeast corner of the cover during the inspection. Two additional animal burrows were discovered during repair actions. All cover defects were repaired on January 9, 2018. • CAU 424: CAS 03-08-002-A304 (Landfill Cell A3-4): A new monument was installed and the subsidence area was repaired on January 9, 2018. • CAU 424: CAS 03-08-002-A308 (Landfill Cell A3-8): Lava rock, used to mark the two eastern monument locations, was noted as missing during the inspection. The lava rock was replaced on January 9, 2018. • CAU 453: Five large animal burrows, located near the east–central portion of cover, was noted during the inspection. Eight additional animal burrows were discovered during repair actions. All cover defects were repaired on January 9, 2018.

  14. Post-operative delirium is associated with increased 5-year mortality.

    Science.gov (United States)

    Moskowitz, Eliza E; Overbey, Douglas M; Jones, Teresa S; Jones, Edward L; Arcomano, Todd R; Moore, John T; Robinson, Thomas N

    2017-12-01

    Post-operative delirium is associated with increased short term morbidity and mortality. Limited data exists on long term outcomes for older adults with postoperative delirium. We hypothesize that postoperative delirium is associated with increased 5-year mortality. Patients ≥50 years undergoing elective operations with planned intensive care unit (ICU) admissions were prospectively enrolled. The Confusion Assessment Method ICU (CAM-ICU) was used to diagnose delirium. The primary outcome variable was 5-year mortality. 172 patients were enrolled with an average age of 64 years. The overall incidence of delirium was 44% (75/172). At 5-years post-operatively, mortality was higher (59%, 41/70) in patients with delirium compared to patients without delirium (13%, 12/94, p delirium were 7.35 fold greater (95% CI: 1.49-36.18). Postoperative delirium is associated with increased long term mortality. Published by Elsevier Inc.

  15. 77 FR 60339 - Approval and Promulgation of Air Quality Implementation Plans; Pennsylvania; The 2002 Base Year...

    Science.gov (United States)

    2012-10-03

    ....regulations.gov Web site is an ``anonymous access'' system, which means EPA will not know your identity or... Promulgation of Air Quality Implementation Plans; Pennsylvania; The 2002 Base Year Inventory for the Pittsburgh... particulate matter (PM 2.5 ) 2002 base year emissions inventory portion of the Pennsylvania State...

  16. Evaluation of Nutritional Status Post Laparoscopic Sleeve Gastrectomy-5-Year Outcomes.

    Science.gov (United States)

    Al-Mutawa, Aliaa; Al-Sabah, Salman; Anderson, Alfred Kojo; Al-Mutawa, Mohammad

    2017-12-01

    Obesity is considered a public health problem and has led to advancements in bariatric surgery. Laparoscopic sleeve gastrectomy (LSG) had become the most performed procedure worldwide; however, its consequences on nutritional status in the short and long term are of concern. A retrospective analysis of medical records and bariatric database of patients who underwent LSG from October 2008-September 2015 at Al-Amiri Hospital, Kuwait, was performed. Data regarding nutritional status along with demographic data were collected over a 5-year follow-up period. One thousand seven hundred ninety-three patients comprising of 74% females and 26% males were included. The greatest % total body weight loss (%TBWL) was at 18 months post-LSG (33%), corresponding to a % excess weight loss (%EWL) of 73.8%. With regard to nutritional status, vitamin B1 showed a significant drop at 3-5 years post-op in comparison to pre-op value, but stayed within the normal range throughout the study. Red blood cells count, hemoglobin, and hematocrit also showed a significant drop starting from 6 months post-op until the fifth year of follow-up. On the other hand, vitamins B6 and B12 showed a significant increase at 6 months post-op and decreased afterwards, but did not reach pre-op values. Vitamin D also showed a significant increase throughout the study period from deficient value at the pre-op time, but remained insufficient. Albumin, transferrin, folate, ferritin, iron, and vitamin B2 showed no significant changes at 5 years post-LSG compared to pre-op values. Little is known about the nutritional status and optimal nutritional care plan post-LSG, especially in the longer term. Nutritional deficiencies were prevalent prior and post-LSG. Some of the nutritional parameters improved and even reached the abnormal high level post-LSG. These observations highlight the importance of pre- and post-operative nutritional assessment and tailored supplementation to ensure optimal nutritional status.

  17. One-year post-primary antibody persistence and booster immune ...

    African Journals Online (AJOL)

    One-year post-primary antibody persistence and booster immune response to a DTaP-IPV//PRP~T vaccine (Pentaxim) given at 18 - 19 months of age in South African children primed at 6, 10 and 14 weeks of age with the same vaccine.

  18. Post-fire response of coast redwood one year after the Mendocino lightning complex fires

    Science.gov (United States)

    Robert B. Douglas; Tom. Bendurel

    2012-01-01

    Coast redwood (Sequoia sempervirens) forests have undergone significant changes over the past century and are now in state more conducive for wildfires. Because fires have been uncommon in redwood forests over the past 80 years, managers have limited data to make decisions about the post-fire environment. In June 2008, a series of lightning storms...

  19. Post-fire saguaro community: impacts on associated vegetation still apparent 10 years later

    Science.gov (United States)

    Marcia Narog; Ruth Wilson

    2005-01-01

    Fire impacts on saguaro (Carnegiea gigantea) associated vegetation were studied in unburned and burned areas over a 10 year post-fire period after the 1993 Vista View fire, Tonto National Forest, Arizona. Many associated species, crucial for saguaro survival, regenerate by vegetative growth after fire. Bushes were the most common nearest-neighbor,...

  20. Monitoring raptors post-breeding migration on the Elba island, Arcipelago Toscano; years 2005-2006

    Directory of Open Access Journals (Sweden)

    Lorenzo Vanni

    2012-09-01

    Full Text Available Raptors post-reproductive migration was monitored over a two year period (2005-2006 in Arcipelago Toscano. This paper is a first attempt to analyze the migration patterns of the most abundant species (Circus aeruginosus, Pernis apivorus and Accipiter nisus, trying to define their timing and peak passage period.

  1. Common symptoms during pregnancy to predict depression and health status 14 years post partum.

    Science.gov (United States)

    Khatun, Mohsina; Clavarino, Alexandra M; Callaway, Leonie; Alati, Rosa; Najman, Jake M; Williams, Gail; Al Mamun, Abdullah

    2009-03-01

    To examine the prospective association between symptoms commonly experienced during pregnancy and the mental and general health status of women 14 years post partum. Data used were from the Mater-University of Queensland Study of Pregnancy, a community-based prospective birth cohort study begun in Brisbane, Australia, in 1981. Logistic regression analyses were conducted. Data were available for 5118 women. Women who experienced a higher burden of symptoms during pregnancy were at greater risk of becoming depressed and reporting poorer health status 14 years post partum. Women who experienced major problems during pregnancy were 4 times more likely to be depressed and nearly 8 times more likely to report poorer health status 14 years after the index pregnancy compared with women who experienced few problems. Findings suggest that pregnant women who experience common symptoms during pregnancy are likely to experience poorer mental and self-reported general health 14 years after the pregnancy.

  2. A summary report on researches carried out by post-doctoral fellows on fiscal year 2001

    International Nuclear Information System (INIS)

    2002-07-01

    The Japan Nuclear Cycle Development Institute (JNC) introduced the post-doctoral fellows system since fiscal year 1997, to intend to promote talents encouragement by supplying researching environments to young researchers with scholarship of doctor. This system aims not only to independently promote his own research theme certified by JNC by a young researcher with rich initiatives within a period of two or three years to obtain business as a researcher, but also to effectively progress a researching business of JNC. This report contains summaries on 17 items researching results on fiscal year 2001, of which 6 items are finished on this fiscal year. (G.K.)

  3. 78 FR 14020 - Approval and Promulgation of Air Quality Implementation Plans; Delaware; the 2002 Base Year...

    Science.gov (United States)

    2013-03-04

    ..., procedures and methodologies for the base year emissions inventory submitted by DNREC. EPA found the process.... Petitions for Judicial Review Under section 307(b)(1) of the CAA, petitions for judicial review of this... finality of this action for the purposes of judicial review nor does it extend the time within which a...

  4. 78 FR 63148 - Approval and Promulgation of Implementation Plans; Tennessee; Bristol; 2010 Lead Base Year...

    Science.gov (United States)

    2013-10-23

    ... Tennessee, through the Tennessee Department of Environment and Conservation (TDEC) on April 11, 2013. The... per year within the Bristol Area is Exide Technologies Facility, a lead acid battery manufacturing and recycling facility which processes lead and reclaimed lead into batteries for the auto industry. Pursuant to...

  5. 75 FR 68251 - Approval and Promulgation of Air Quality Implementation Plans; Pennsylvania; 2002 Base Year...

    Science.gov (United States)

    2010-11-05

    ....regulations.gov or e-mail. The http://www.regulations.gov Web site is an ``anonymous access'' system, which... emissions inventory was calculated using EPA's MOBILE6.2 and the Highway Performance Monitoring System model... Promulgation of Air Quality Implementation Plans; Pennsylvania; 2002 Base Year Emission Inventory, Reasonable...

  6. 77 FR 72966 - Approval and Promulgation of Air Quality Implementation Plans; Maryland; The 2002 Base Year...

    Science.gov (United States)

    2012-12-07

    ... Environment (MDE), on June 6, 2008. The emissions inventory is part of the June 6, 2008 SIP revision that was....regulations.gov Web site. Although listed in the electronic docket, some information is not publicly available... (Revision 08-05). II. Summary of SIP Revision The 2002 base year emissions inventory submitted by MDE on...

  7. 77 FR 73313 - Approval and Promulgation of Air Quality Implementation Plans; Maryland; The 2002 Base Year...

    Science.gov (United States)

    2012-12-10

    ... Department of the Environment (MDE), on June 6, 2008 for Baltimore, Maryland. The emissions inventory is part... year PM 2.5 emissions inventory for Baltimore, Maryland submitted by MDE in accordance with the... www.regulations.gov or email. The www.regulations.gov Web site is an ``anonymous access'' system...

  8. 77 FR 61513 - Approval and Promulgation of Air Quality Implementation Plans; Maryland; The 2002 Base Year...

    Science.gov (United States)

    2012-10-10

    ... Environment (MDE), on April 3, 2008. The emissions inventory is part of the April 3, 2008 SIP revision that... Web site. Although listed in the electronic docket, some information is not publicly available, i.e... 2002 base year emissions inventory submitted by MDE on April 3, 2008 includes emissions estimates that...

  9. Behavioural skills in 7 year old children born post-term

    DEFF Research Database (Denmark)

    Olesen, Annette Wind; Olsen, Jørn; Zhu, Jin Liang

    2014-01-01

    Abstract Objective: To study behavioural skills at the age of seven in a Danish population of children born post-term. Design: Cohort study. Setting: The Danish National Birth Cohort; children born from 1997 to 2003. Population: Data was obtained from a cohort of about 100,000 women...... and their children. All singletons born in gestational week 39-45 were identified, and then restricted to children whose mothers filled out a Strength and Difficulties Questionnaire (STQ) when they were seven years of age. The study population constituted 33842 singletons (21249 born at term and 12593 born post...

  10. Post-silking Factor Consequences for N Efficiency Changes Over 38 Years of Commercial Maize Hybrids

    Directory of Open Access Journals (Sweden)

    Keru Chen

    2017-10-01

    Full Text Available Hybrid selection in maize (Zea mays L. over the decades has increased post-silking dry matter (PostDM and nitrogen (PostN accumulation, often with an accompanying increase in one or more N use efficiency (NUE metrics such as partial factor productivity (PFP, N conversion efficiency (NCE, and N internal efficiency (NIE. More certainty on the underlying mechanisms of how PostDM and PostN changes over time have contributed to NUE gains or losses in modern-era hybrids can only be realized by directly comparing hybrids of different eras in the context of production-system-relevant management systems. A two-year and two-location field study was conducted in Indiana with two N rates (55 and 220 kg N ha−1, three plant densities (54,000, 79,000, and 104,000 plants ha−1 and eight commercial hybrids that were released by a single seed company from 1967 to 2005. The main treatment effects of N rate, density, and hybrid dominated the PostDM and PostN responses, and there were no significant two-way or three-way interactions. Total dry matter at maturity gains averaged 80 kg ha−1 year−1 of hybrid release when averaged over locations, plant densities and N rates. Total N contents at maturity increased 0.68 kg ha−1 year−1, primarily due to annual increases in grain N content (0.8 kg ha−1 year−1. Post-silking N uptake rate increased 0.44 kg ha−1 year−1 for these era hybrids in more favorable production site-years. Slopes of grain N concentration increases per unit PostN gain were similar for all hybrids. Gains in average PFP over time were considerably higher at the low N rate (0.9 kg ha−1 year−1 than at the high N rate (0.3 kg kg−1 year−1. Hybrid gains in NIE were evident from 1967 to 1994, but not thereafter. The low N rate and higher plant densities also increased relative NIE and NCE values, but without hybrid interactions. There was no consistent trend of NIE or NCE gains in these hybrids primarily because grain and whole-plant N

  11. Severity of Giardia infection associated with post-infectious fatigue and abdominal symptoms two years after

    Directory of Open Access Journals (Sweden)

    Rortveit Guri

    2009-12-01

    Full Text Available Abstract Background A high rate of post-infectious fatigue and abdominal symptoms two years after a waterborne outbreak of giardiasis in Bergen, Norway in 2004 has previously been reported. The aim of this report was to identify risk factors associated with such manifestations. Methods All laboratory confirmed cases of giardiasis (n = 1262 during the outbreak in Bergen in 2004 received a postal questionnaire two years after. Degree of post-infectious abdominal symptoms and fatigue, as well as previous abdominal problems, was recorded. In the statistical analyses number of treatment courses, treatment refractory infection, delayed education and sick leave were used as indices of protracted and severe Giardia infection. Age, gender, previous abdominal problems and symptoms during infection were also analysed as possible risk factors. Simple and multiple ordinal logistic regression models were used for the analyses. Results The response rate was 81% (1017/1262, 64% were women and median age was 31 years (range 3-93, compared to 61% women and 30 years (range 2-93 among all 1262 cases. Factors in multiple regression analysis significantly associated with abdominal symptoms two years after infection were: More than one treatment course, treatment refractory infection, delayed education, bloating and female gender. Abdominal problems prior to Giardia infection were not associated with post-infectious abdominal symptoms. More than one treatment course, delayed education, sick leave more than 2 weeks, and malaise at the time of infection, were significantly associated with fatigue in the multiple regression analysis, as were increasing age and previous abdominal problems. Conclusion Protracted and severe giardiasis seemed to be a risk factor for post-infectious fatigue and abdominal symptoms two years after clearing the Giardia infection.

  12. Maternal anxiety, risk factors and parenting in the first post-natal year.

    Science.gov (United States)

    Seymour, M; Giallo, R; Cooklin, A; Dunning, M

    2015-03-01

    The antecedents and consequences of maternal post-natal anxiety have received comparatively less attention than depression despite being one of the most frequently reported mental health difficulties experienced by parents following childbirth. The aim of this study was to extend emerging literature on post-natal anxiety by investigating the prevalence of maternal anxiety symptoms, and its relationship with parenting behaviours (i.e. warmth, hostility) and experiences (i.e. parenting efficacy and satisfaction) within the first post-natal year. The psychosocial risk factors for post-natal anxiety symptoms were also explored. A community sample of 224 Australian mothers of infants (aged 0-12 months) completed a self-report questionnaire. Mothers in the current sample reported significantly more symptoms of anxiety compared with a normative sample. Approximately 18% of mothers reported mild to extremely severe symptoms of anxiety, with a high proportion experiencing co-morbid depressive symptoms. Maternal anxiety was associated with low parenting warmth, involvement, efficacy and satisfaction, and high parenting hostility. Yet, co-morbid depression and anxiety was more strongly associated with these parenting behaviours and experiences than anxiety alone. A range of psychosocial risk factors (e.g. education, sleep, relationship quality) were associated with maternal post-natal anxiety symptoms, providing opportunities for early identification and targeted early intervention. © 2014 John Wiley & Sons Ltd.

  13. Herpes zoster vaccine live: A 10 year review of post-marketing safety experience.

    Science.gov (United States)

    Willis, English D; Woodward, Meredith; Brown, Elizabeth; Popmihajlov, Zoran; Saddier, Patricia; Annunziato, Paula W; Halsey, Neal A; Gershon, Anne A

    2017-12-19

    Zoster vaccine is a single dose live, attenuated vaccine (ZVL) indicated for individuals ≥50 years-old for the prevention of herpes zoster (HZ). Safety data from clinical trials and post-licensure studies provided reassurance that ZVL is generally safe and well tolerated. The objective of this review was to provide worldwide post-marketing safety information following 10 years of use and >34 million doses distributed. All post-marketing adverse experience (AE) reports received worldwide between 02-May-2006 and 01-May-2016 from healthcare professionals following vaccination with ZVL and submitted to the MSD AE global safety database, were analyzed. A total of 23,556 AE reports, 93% non-serious, were reported. Local injection site reactions (ISRs), with a median time-to-onset of 2 days, were the most frequently reported AEs followed by HZ. The majority of HZ reports were reported within 2 weeks of vaccination and considered, based on time-to-onset, pathogenesis of HZ, and data from clinical trials, to be caused by wild-type varicella-zoster virus (VZV). HZ confirmed by PCR analysis to be VZV Oka/Merck vaccine-strain was identified in an immunocompetent individual 8 months postvaccination and in 4 immunocompromised individuals. Disseminated HZ was reported very rarely (marketing use, was favorable and consistent with that observed in clinical trials and post-licensure studies. Copyright © 2017 Elsevier Ltd. All rights reserved.

  14. Male breast cancer: 20-year survival data for post-mastectomy radiotherapy.

    Science.gov (United States)

    Eggemann, Holm; Ignatov, Atanas; Stabenow, Roland; von Minckwitz, Gunter; Röhl, Friedrich Wilhelm; Hass, Peter; Costa, Serban-Dan

    2013-08-01

    The goal of this population-based study was to determine the impact of post-mastectomy radiation therapy on long-term overall survival (OS) of male patients with breast cancer. We investigated 20-year OS rates of 664 patients diagnosed with primary stage I-III breast cancer in former East Germany between 1970 and 1989. Patients had a radical mastectomy with axillary lymph node dissection without systemic adjuvant therapy. Median follow-up time was 26.2 years (range 19-38 years). 52.4% of the patients had post-mastectomy radiotherapy. Radiotherapy showed different effects in each stage group after 20 years. Whereas there was an OS trend for radiotherapy to harm patients with stage I disease (hazard ratio (HR) 1.45; 95% confidence interval (CI) 0.98-2.15; p = 0.065), radiotherapy showed no benefit in patients with stage II disease (HR 0.82; 95% CI 0.62-1.1; p = 0.15). There was a significant survival benefit for patients with stage III disease receiving radiotherapy (HR 0.60; 95% CI 0.41-0.88; p = 0.008). Post-mastectomy radiotherapy is associated with longer OS in male patients with stage III breast cancer. Male breast cancer patients at stages I and II do not seem to benefit from radiotherapy, but obsolete irradiation techniques might explain adverse long-term effects in earlier stages.

  15. Permanence and diffusion of borax-copper hydroxide remedial preservative applied to unseasoned pine posts : 10 year update

    Science.gov (United States)

    Douglas Crawford; Stan Lebow; Mike West; Bill Abbott

    2005-01-01

    In 1993, unseasoned pine posts were treated with groundline remedial treatment containing 3.1% copper hydroxide and 40% sodium tetraborate decahydrate (borax). The soundness of the posts was periodically evaluated using a push test. After 3.5, 6.5, and 10 years, sections were taken from two posts to determine retention of borax and copper hydroxide below ground to 36...

  16. Training nuclear technicians in two-year, post-secondary educational programs

    International Nuclear Information System (INIS)

    Hull, D.M.; Roney, M.W.

    1975-01-01

    An available and economical supply to future manpower requirements for various types of nuclear technicians can be met by developing and/or restructuring two-year, post-secondary programs at local educational institutions. The Technical Education Research Centers program is under contract from the U.S. Office of Education to delineate the job requirements and develop curricula and instructional materials for two-year, post-secondary training of nuclear technicians. Six job categories have been identified along with corresponding tasks which the technician performs. These categories are: Reactor Operator, Nuclear Instrumentation Technician, Nuclear QA/QC Technician, Radiochemistry Technician, Radiation Protection Technician and Nuclear Medicine Technician. For the first five categories curricula have been established, courses have been described, and instructional materials are being written

  17. Post-translational control of RIPK3 and MLKL mediated necroptotic cell death [version 1; referees: 4 approved

    Directory of Open Access Journals (Sweden)

    James M. Murphy

    2015-11-01

    Full Text Available Several programmed lytic and necrotic-like cell death mechanisms have now been uncovered, including the recently described receptor interacting protein kinase-3 (RIPK3-mixed lineage kinase domain-like (MLKL-dependent necroptosis pathway. Genetic experiments have shown that programmed necrosis, including necroptosis, can play a pivotal role in regulating host-resistance against microbial infections. Alternatively, excess or unwarranted necroptosis may be pathological in autoimmune and autoinflammatory diseases. This review highlights the recent advances in our understanding of the post-translational control of RIPK3-MLKL necroptotic signaling. We discuss the critical function of phosphorylation in the execution of necroptosis, and highlight the emerging regulatory roles for several ubiquitin ligases and deubiquitinating enzymes. Finally, based on current evidence, we discuss the potential mechanisms by which the essential, and possibly terminal, necroptotic effector, MLKL, triggers the disruption of cellular membranes to cause cell lysis.

  18. Twenty-Five Years of Gene Therapy for ADA-SCID: From Bubble Babies to an Approved Drug.

    Science.gov (United States)

    Ferrua, Francesca; Aiuti, Alessandro

    2017-11-01

    Twenty-five years have passed since first attempts of gene therapy (GT) in children affected by severe combined immunodeficiency (SCID) due to adenosine deaminase (ADA) defect, also known by the general public as bubble babies. ADA-SCID is fatal early in life if untreated. Unconditioned hematopoietic stem cell (HSC) transplant from matched sibling donor represents a curative treatment but is available for few patients. Enzyme replacement therapy can be life-saving, but its chronic use has many drawbacks. This review summarizes the history of ADA-SCID GT over the last 25 years, starting from first pioneering studies in the early 1990s using gamma-retroviral vectors, based on multiple infusions of genetically corrected autologous peripheral blood lymphocytes. HSC represented the ideal target for gene correction to guarantee production of engineered multi-lineage progeny, but it required a decade to achieve therapeutic benefit with this approach. Introduction of low-intensity conditioning represented a crucial step in achieving stable gene-corrected HSC engraftment and therapeutic levels of ADA-expressing cells. Recent clinical trials demonstrated that gamma-retroviral GT for ADA-SCID has a favorable safety profile and is effective in restoring normal purine metabolism and immune functions in patients >13 years after treatment. No abnormal clonal proliferation or leukemia development have been observed in >40 patients treated experimentally in five different centers worldwide. In 2016, the medicinal product Strimvelis™ received marketing approval in Europe for patients affected by ADA-SCID without a suitable human leukocyte antigen-matched related donor. Positive safety and efficacy results have been obtained in GT clinical trials using lentiviral vectors encoding ADA. The results obtained in last 25 years in ADA-SCID GT development fundamentally contributed to improve patients' prognosis, together with earlier diagnosis thanks to newborn screening. These advances

  19. Eight-year follow-up data from the U.S. clinical trial for Sientra's FDA-approved round and shaped implants with high-strength cohesive silicone gel.

    Science.gov (United States)

    Stevens, W Grant; Harrington, Jennifer; Alizadeh, Kaveh; Broadway, David; Zeidler, Kamakshi; Godinez, Tess B

    2015-05-01

    On March 9, 2012, the Food and Drug Administration (FDA) approved Sientra's premarket approval application for its portfolio of silicone gel breast implants based on their review of Sientra's 3-year study data from the largest pivotal silicone gel breast implant study to date. This included the first approval of shaped breast implants in the United States. The authors provide an update to the 8-year safety and effectiveness of the Sientra High-Strength silicone gel breast implants. The Sientra Core study is an ongoing 10 year open-label, prospective, multi-center clinical study, which includes 1788 patients implanted with 3506 Sientra implants across four indications (Primary Augmentation, Revision Augmentation, Primary Reconstruction, and Revision Reconstruction). For the safety analysis, the incidence of post-operative complications, including all breast implant-related adverse effects (eg, infection, asymmetry), was estimated based on Kaplan-Meier risk rates. The effectiveness analyses include surgeon and patient satisfaction and changes in bra/cup size. Through 8 years, the overall risk of rupture was 4.6%, the risk of capsular contracture was 11.8% (rates were lower when using True Texture™), and the risk of reoperation was 28.3%. Out of the 580 reoperations in 456 patients, over half of all reoperations were due to cosmetic reasons (n = 299). The most common reasons for reoperation were capsular contracture (19.0%), style and/or size change (18.4%), and asymmetry (8.8%). Patient satisfaction remains high through 8 years, with 87% indicating that their breast implants make them feel more feminine than prior to enrollment. Safety data from the FDA Core study continues to support a comprehensive safety and effectiveness profile of Sientra's portfolio of round and shaped implants through 8 years. 3 Therapeutic. © 2015 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: journals.permissions@oup.com.

  20. Deep Vadose Zone Treatability Test for the Hanford Central Plateau. Interim Post-Desiccation Monitoring Results, Fiscal Year 2015

    Energy Technology Data Exchange (ETDEWEB)

    Truex, Michael J. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Strickland, Christopher E. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Oostrom, Martinus [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Johnson, Christian D. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Tartakovsky, Guzel D. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Johnson, Timothy C. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Clayton, Ray E. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Chronister, Glen B. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2015-09-01

    A field test of desiccation is being conducted as an element of the Deep Vadose Zone Treatability Test Program. The active desiccation portion of the test has been completed. Monitoring data have been collected at the field test site during the post-desiccation period and are reported herein. This is an interim data summary report that includes about 4 years of post-desiccation monitoring data. The DOE field test plan proscribes a total of 5 years of post-desiccation monitoring.

  1. First year post-construction monitoring of birds at Wind Turbine Test Centre Østerild

    DEFF Research Database (Denmark)

    Therkildsen, Ole Roland; Balsby, Thorsten Johannes Skovbjerg; Groom, Geoffrey Brian

    2015-01-01

    The Department of Bioscience, Aarhus University was commissioned by the DanishNature Agency to undertake a bird monitoring programme of a national testcentre for wind turbines near Østerild in Thy, Denmark. Here we present the results from the first year of the post-construction studies. Whooper...... swan, taiga bean goose, pink-footed goose, common crane, light-bellied brent goose, white-tailed eagle and nightjar were included as focal species in the ornithological investigations. In addition, species specific data on all bird species occurring regularly in the study area were collected....... On the basis of an intermediate assessment of collision risk, the potential impacts of the combined structures on the bird species occurring in the study area were considered unlikely to be significant. However, given the uncertainties in the assessment,  the post-construction programme will continue...

  2. One year follow-up of post-partum-onset depression: the role of depressive symptom severity and personality disorders.

    Science.gov (United States)

    Uguz, Faruk; Akman, Cemal; Sahingoz, Mine; Kaya, Nazmiye; Kucur, Rahim

    2009-06-01

    Long-term follow-up and risk factors of persistent post-partum depression (PPD) are fairly unknown compared with its prevalence in the developing countries. In this study, we did a follow-up measure of PPD and examined the factors, which were associated with PPD 1-year post-partum. Our sample comprised of 34 women. Depressive symptoms were assessed by the Edinburgh post-natal depression scale (EPDS) 6 weeks post-partum, and women with scores >12 on this scale was categorised as depressed. Personality disorders were determined at the same occasion by means of the Structured Clinical Interview for DSM-III-R personality disorders (SCID-II). One year post-partum EPDS was completed. The rate of PPD 1-year post-partum was 32.4%, and it was unrelated to age at assessment, primiparity, number of children, employment status, economical status and educational level. Women depressed 1-year post-partum had significantly higher basal scores of EPDS and more often also a diagnosis of any axis II disorder; and specifically dependent and obsessive-compulsive personality disorders. In our sample, the predictors of 1-year post-partum PPD were having higher basal score of EPDS and the existence of a personality disorder. This study suggests that women with PPD, scoring high in the EPDS scale 6 weeks post-partum and having a personality disorder, run a higher risk for depression at 1-year follow-up.

  3. Understanding the post-surgical bariatric experiences of patients two or more years after surgery.

    Science.gov (United States)

    Liu, Rebecca H; Irwin, Jennifer D

    2017-11-01

    In Canada, one year after bariatric surgery follow-up appointments become less frequent and surgical recipients must cope with weight management more independently. Up to 50% of patients experience weight regain by two years post-surgery. Understanding the lived experiences of those who have gone through the bariatric process may shed light on what is needed to support others moving forward. Therefore, the purpose of the study was to gain an understanding of the physical, psychological, social, and clinic-related experiences of individuals who have undergone bariatric surgery at least two years prior. The purpose of the study was to gain an understanding of the physical, psychological, social, and clinic-related experiences of individuals who have undergone bariatric surgery at least two years prior. In-depth, individual semi-structured interviews lasting approximately 60 min were conducted. Interviews were transcribed verbatim and inductive content analysis was used to identify emerging themes. Methods were employed throughout to support data trustworthiness. Participants (n = 28; 21 female) were primarily middle-aged (mean: 49.7 ± 12.7 years old), Caucasian (71%), and completed bariatric surgery more than three years. The data fell naturally into four primary themes, namely physical changes and challenges, psychological experiences, social functioning and support, and clinic-related experiences and reflections. Generally, participants described positive improvements in their physical, psychological, and social state since surgery. However, concerns pertaining to several unanticipated outcomes of the surgery were underscored and informed the recommendations for other patients to be prepared to relearn about ones' body, utilize the support services available, and be aware that social relationships may change and/or require tending. Participants' insights can be used to help others meet with long-term success post-bariatric surgery.

  4. Two years post-tsunami in Thailand: who still needs assistance?

    Science.gov (United States)

    Isaranuwatchai, Wanrudee; Guerriere, Denise; Andrews, Gavin J; Coyte, Peter C

    2013-06-01

    On 26 December 2004, 280 000 people lost their lives in the Asia-Pacific region. A massive earthquake struck Indonesia, triggering a tsunami that affected several countries, including Thailand. This tsunami had important implications for the health status of Thai citizens and health planning, and thus there is a need to study its long-term impact. This cohort study identified determinants of health service utilization (outpatient services, inpatient services, home care, medications and informal care) 1 and 2 years post-tsunami in Thailand. A two-part model with a multivariate logistic regression for each part was used to identify determinants of the propensity and intensity of utilization. Of 1943 participants, 1889 (97.2%) participated at 1 year and 1814/1889 (96.0%) at 2 years. Common determinants of health service utilization in post-tsunami settings were age, marital status, education level, employment status, number of health conditions and (physical and mental) health status. Knowing the determinants of health service use, health providers may be able to establish programmes for, or to carefully monitor populations, who are more likely to use services. The study results may be used to inform requests for health resources or to assist the development of guidelines for long-term disaster recovery planning.

  5. Adherence to vaccination guidelines post splenectomy: A five year follow up study.

    Science.gov (United States)

    Boam, Tristan; Sellars, Peter; Isherwood, John; Hollobone, Chloe; Pollard, Cristina; Lloyd, David M; Dennison, Ashley R; Garcea, Giuseppe

    Following a splenectomy patients are at increased risk of significant infections. In its most severe form, overwhelming post-splenectomy infection (OPSI) has a mortality rate of up to 80%. In this study we aim to establish the adherence to vaccination and antibiotic national guidelines in splenectomised patients. A retrospective study of 100 patients who underwent splenectomy (21 emergency, 79 elective), in two teaching hospitals was undertaken over a five-year period. Patients were followed up for five years. Hospital and GP records were reviewed for adherence to pre, intra and postoperative vaccination, thromboprophylaxis and antibiotic guidance. Eighty-six eligible patients (91.5%) received their Haemophilus influenzae B, meningococcal C and pneumococcus vaccinations peri-operatively. Eighty-one (86%) received post-operative antibiotics. Ninety-nine percent of patients received thromboprophylaxis treatment. Eighty-nine (95%) were treated with long-term antibiotic prophylaxis. Only 20 patients (23%) had an emergency supply of antibiotics. Ninety-five percent of patients were administered an annual influenza vaccination and 84% of eligible patients received a five-year pneumococcal booster vaccination. Improvement in the management of this patient cohort can be achieved by a multidisciplinary approach involving adherence to national guidelines, standardised trust protocols, patient information leaflets and advice detailing risk of infection, standardised GP letters and a splenectomy register to monitor and manage this vulnerable group of patients. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  6. Post-Closure Inspection Report for Corrective Action Unit 424: Area 3 Landfill Complexes Tonopah Test Range, Nevada Calendar Year 2001; TOPICAL

    International Nuclear Information System (INIS)

    K. B. Campbell

    2002-01-01

    Corrective Action Unit (CAU) 424, the Area 3 Landfill Complexes at Tonopah Test Range, consists of eight Corrective Action Sites (CASs), seven of which are landfill cells that were closed previously by capping. (The eighth CAS, A3-7, was not used as a landfill site and was closed without taking any corrective action.) Figure 1 shows the general location of the landfill cells. Figure 2 shows in more detail the location of the eight landfill cells. CAU 424 closure activities included removing small volumes of soil containing petroleum hydrocarbons, repairing cell covers that were cracked or had subsided, and installing above-grade and at-grade monuments marking the comers of the landfill cells. Post-closure monitoring requirements for CAU 424 are detailed in Section 5.0, Post-Closure Inspection Plan, contained in the Closure Report for Corrective Action Unit 424: Area 3 Landfill Complexes, Tonopah Test Range, Nevada, report number DOE/NV-283, July 1999. The Closure Report (CR) was approved by the Nevada Division of Environmental Protection (NDEP) in July 1999. The CR includes compaction and permeability results of soils that cap the seven landfill cells. As stated in Section 5.0 of the NDEP-approved CR, post-closure monitoring at CAU 424 consists of the following: (1) Site inspections conducted twice a year to evaluate the condition of the unit. (2) Verification that landfill markers and warning signs are in-place, intact, and readable. (3) Notice of any subsidence, erosion, unauthorized use, or deficiencies that may compromise the integrity of the landfill covers. (4) Remedy of any deficiencies within 90 days of discovery. (5) Preparation and submittal of an annual report. Site inspections were conducted on May 16, 2001, and November 6, 2001. The inspections were preformed after the NDEP approval of the CR. This report includes copies of the inspection checklist, photographs, recommendations, and conclusions. The Post-Closure Inspection Checklists are found in

  7. Five years post whiplash injury: Symptoms and psychological factors in recovered versus non-recovered

    Directory of Open Access Journals (Sweden)

    Stålnacke Britt-Marie

    2010-07-01

    Full Text Available Abstract Background Few studies have focused on the differences between persons who are recovered after whiplash injury and those who suffer from persistent disability. The primary aim of this study was therefore to examine differences in symptoms, psychological factors and life satisfaction between subjects classified as recovered and those with persistent disability five years after whiplash injury based on the Neck Disability Index (NDI. Methods A set of questionnaires was answered by 158 persons (75 men, 83 women to assess disability (NDI, pain intensity (VAS, whiplash-related symptoms (Rivermead Post-Concussion Symptoms Questionnaire, RPQ, post-traumatic stress (Impact of Event Scale, IES, depression (Beck's depression inventory, BDI and life satisfaction (LiSat-11. The participants were divided into three groups based on the results of the NDI: recovered (34.8%, mild disability (37.3% and moderate/severe disability (27.3%. Results The moderate/severe group reported significantly higher VAS, BDI and IES scores and lower level of physical health and psychological health compared to the mild and the recovered groups. Less significant differences were reported between the mild and the recovered groups. Conclusions The group with the highest disability score reported most health problems with pain, symptoms, depression, post-traumatic stress and decreased life satisfaction. These findings indicate that classifying these subjects into subgroups based on disability levels makes it possible to optimize the management and treatment after whiplash injury.

  8. Post-Closure Inspection Report for the Tonopah Test Range, Nevada, For Calendar Year 2010

    International Nuclear Information System (INIS)

    2011-01-01

    This report provides the results of the annual post-closure inspections conducted at the closed Corrective Action Units (CAUs) located on the Tonopah Test Range (TTR), Nevada. This report covers calendar year 2010 and includes inspection and repair activities completed at the following seven CAUs: (1) CAU 400: Bomblet Pit and Five Points Landfill (TTR); (2) CAU 407: Roller Coaster RadSafe Area (TTR); (3) CAU 424: Area 3 Landfill Complexes (TTR); (4) CAU 426: Cactus Spring Waste Trenches (TTR); (5) CAU 453: Area 9 UXO Landfill (TTR); (6) CAU 484: Surface Debris, Waste Sites, and Burn Area (TTR); and (7) CAU 487: Thunderwell Site (TTR).

  9. Post-Closure Inspection Report for the Tonopah Test Range, Nevada, for Calendar Year 2012

    Energy Technology Data Exchange (ETDEWEB)

    NSTec Environmental Restoration

    2013-01-28

    This report provides the results of the annual post-closure inspections conducted at the closed Corrective Action Units (CAUs) located on the Tonopah Test Range (TTR), Nevada. This report covers calendar year 2012 and includes inspection and repair activities completed at the following CAUs: · CAU 400: Bomblet Pit and Five Points Landfill (TTR) · CAU 407: Roller Coaster RadSafe Area (TTR) · CAU 424: Area 3 Landfill Complexes (TTR) · CAU 453: Area 9 UXO Landfill (TTR) · CAU 487: Thunderwell Site (TTR)

  10. Twenty-five years of post-Bretton Woods experience: some lessons

    Directory of Open Access Journals (Sweden)

    H. ASKARI

    1999-03-01

    Full Text Available In 1971 many academic economists were predicting that the Bretton Woods system of fixed parities would collapse. Some, most notably Milton Friedman, became excited about the possibility of a floating system because the benefits of international capital mobility can only be achieved through the flexibility in the exchange rate. These economists argued that a floating exchange rate system can ensure positive results more than the fixed parities system. Twenty-five years later, however, there is still no consensus on the matter. The author reviews the post-Bretton Woods experience to highlight some policies and approaches that might be helpful for the future.

  11. Factors involved in the persistence of stress urinary incontinence from pregnancy to 2 years post partum.

    Science.gov (United States)

    Arrue, Miren; Diez-Itza, Irene; Ibañez, Larraitz; Paredes, Jone; Murgiondo, Arantzazu; Sarasqueta, Cristina

    2011-12-01

    To identify factors involved in the persistence of stress urinary incontinence (SUI) from pregnancy to 2 years post partum. In a longitudinal study at Donostia Hospital, San Sebastián, Spain, 458 primigravid women were recruited from April to October 2007. SUI was diagnosed via the 2002 International Continence Society definition. Severity was assessed via the Incontinence Severity Index, and impact on quality of life via the International Consultation on Incontinence Questionnaire. Means (Student t test and analysis of variance) and percentages (χ(2) and Fisher exact tests) were compared, and multiple logistic regression analysis was performed with variables that were significant or close to significant in a univariate analysis (Ppregnancy. Incontinence severity was slight or moderate in most cases and the impact on quality of life was low. A higher body mass index (BMI) in pregnant women at term was the only factor found to be associated with persistent SUI (odds ratio 1.19; 95% confidence interval 1.08-1.32). Higher BMI in pregnant women at term was an independent risk factor for the persistence of SUI from pregnancy to 2 years post partum. Copyright © 2011 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  12. Earnings management behavior of the initial public offering (IPO) firms during pre-IPO, IPO, and post-IPO years

    DEFF Research Database (Denmark)

    Farooq, Omar; Benali, Meryem

    2012-01-01

    This paper examines the pattern of earnings management around the IPO year in Morocco during the period between 2001 and 2007. Our results show that earnings management reaches its maximum level during the year of an IPO followed earnings management during the pre-IPO years and the post-IPO years...

  13. Depressive, anxiety and post-traumatic stress disorders at six years after occupational injuries.

    Science.gov (United States)

    Chin, Wei-Shan; Shiao, Judith Shu-Chu; Liao, Shih-Cheng; Kuo, Chun-Ya; Chen, Chih-Chieh; Guo, Yue Leon

    2017-09-01

    The aim of this study is to determine the prevalence rates of depressive, anxiety and PTSDs, and the risk factors for psychological symptoms at 6 years after occupational injury. This longitudinal study followed workers who were occupationally injured in 2009. Psychological symptoms and return to work were assessed at 3 and 12 months after injury. Injured workers who had completed the initial questionnaire survey at 3 or 12 months after injury were recruited. A self-administered questionnaire was mailed to the participants. For workers with high Brief Symptom Rating Scale and Post-traumatic Symptom Checklist scores, an in-depth psychiatric evaluation was performed using the Mini-international Neuropsychiatric Interview. A total of 570 workers completed the questionnaire (response rate, 28.7%). Among them, 243 (42.6%) had high psychological symptom scores and were invited for a phone interview; 135 (55.6%) completed the interview. The estimated rates of major depression and post-traumatic stress disorder (PTSD)/partial PTSD were 9.2 and 7.2%, respectively, and both these rates were higher at 6 years after injury than at 12 months after injury (2.0 and 5.1%). After adjustment for family and social factors, the risk factors for high psychological scores were length of hospitalization immediately after injury, affected physical appearance, repeated occupational injuries, unemployment, and number of quit jobs after the injury. At 6 years after occupational injury, the re-emergence of psychiatric disorders was observed. Relevant factors for poor psychological health were severity of injury and instability of work. Periodic monitoring of psychological and physical health and economic stability are warranted.

  14. Diversion and injection of buprenorphine-naloxone film two years post-introduction in Australia.

    Science.gov (United States)

    Larance, Briony; Mattick, Richard; Ali, Robert; Lintzeris, Nicholas; Jenkinson, Rebecca; White, Nancy; Kihas, Ivana; Cassidy, Rosemary; Degenhardt, Louisa

    2016-01-01

    We report 2 years of post-marketing surveillance of the diversion and injection of buprenorphine-naloxone (BNX) film following its introduction in 2011. Interviews were conducted with people who inject drugs regularly (PWID) (2004-2013), opioid substitution therapy clients (2013, n = 492) and key experts (n = 44). Key outcomes were unsanctioned removal of supervised doses, diversion, injection and street price. Prevalence of past 6-month injection among PWID was adjusted for background availability of opioid substitution therapy medications using sales data. Among out-of-treatment PWID, the levels of regular (weekly+) BNX film injection were comparable to methadone and BNX tablets, and lower than mono-buprenorphine, adjusting for background availability. Fewer BNX film clients [3%; 95% (CI) 1-5] regularly injected their medication than mono-buprenorphine clients (25%; 95% CI 11-39), but at levels equivalent to those among methadone (3%; 95% CI 1-6) and BNX tablet clients (2%; 95% CI 0-6). Key experts perceived BNX film needed less supervised dosing time as it dissolved rapidly and was harder to remove from the mouth than sublingual tablets; however, removal of supervised doses was higher among BNX film clients (15%; 95% CI: 10-20) than methadone clients (3%; 95% CI 1-6), and not significantly different from BNX tablet (11%; 95% CI 2-21) and mono-buprenorphine clients (31%; 95% CI 16-46). Two years post-introduction, levels of BNX film diversion and injection remained comparable with those for methadone and BNX tablets, and lower than mono-buprenorphine. We found no evidence that BNX film has lower non-adherence and diversion than the tablet formulation. [Larance B, Mattick R, Ali R, Lintzeris N, Jenkinson R, White N, Kihas I, Cassidy R, Degenhardt L. Diversion and injection of buprenorphine-naloxone film two years post-introduction in Australia. Drug Alcohol Rev 2015]. © 2015 Australasian Professional Society on Alcohol and other Drugs.

  15. Post-operative megavoltage irradiation of minor salivary gland malignancies - 30 year follow-up

    International Nuclear Information System (INIS)

    Birdwell, Sandra H.; Terris, David J.; Fee, Willard E.; Goffinet, Don R.

    1996-01-01

    Purpose/Objective: To describe the clinical presentation, treatment techniques, outcome, and complications of a large single institutional experience with long-term follow-up after surgery and post-operative radiation therapy for the treatment of minor salivary gland malignancies. Materials and Methods: Fifty-five patients with minor salivary gland tumors were treated definitively between 1966 and 1995. Patients were staged using the 1992 AJCC staging system according to the anatomic site of origin. Follow-up averaged 7.2 years. The mean age at treatment was 54 years. There were 35 men and 20 women. Thirty patients had involved surgical margins and 25 had negative surgical margins. All patients were treated with 4-6 MeV linear accelerators. Radiation techniques included 3 field isocentric or opposed lateral pair techniques depending on the site of origin. The mean radiation dose was 60 Gy (range 50-70 Gy). Survival, both actuarial and relapse free, was determined from the treatment completion date using the method of Kaplan and Meier. Standard statistical tests (Gehan, Cox) were used to calculate the significance of covariates. Results: Minor salivary gland histologic diagnoses included 32 cases of adenoid cystic carcinoma, 15 adenocarcinomas, 7 mucoepidermoid carcinomas, and 1 pleomorphic adenoma. Eight patients had Stage I tumors, 13 had Stage II, another 13 had Stage III lesions, while 21 had Stage IV tumors (locally advanced but non-metastatic). Twenty-five tumors involved the nasal cavity-paranasal sinuses, 23 arose from the oral cavity, 5 from the oropharynx, and 2 from the glottis. Patients with adenoid cystic carcinomas had improved local control and overall survival compared with those with adenocarcinomas (p = 0.03, 0.02, respectively). Malignancies arising from the palate had improved local control rates compared with tumors arising from other anatomic sites (p = 0.04). Patients with Stage I and II disease had improved freedom from relapse compared with

  16. Factors determining access to oral health services among children aged less than 12 years in Peru [version 1; referees: 2 approved, 1 approved with reservations

    Directory of Open Access Journals (Sweden)

    Diego Azañedo

    2017-09-01

    Full Text Available Background: Understanding problems of access to oral health services requires knowledge of factors that determine access. This study aimed to evaluate factors that determine access to oral health services among children aged <12 years in Peru between 2014 and 2015. Methods: We performed a secondary data analysis of 71,614 Peruvian children aged <12 years and their caregivers. Data were obtained from the Survey on Demography and Family Health 2014-2015 (Encuesta Demográfica y de Salud Familiar - ENDES. Children’s access to oral health services within the previous 6 months was used as the dependent variable (i.e. Yes/No, and the Andersen and col model was used to select independent variables. Predisposing (e.g., language spoken by  tutor or guardian, wealth level, caregivers’ educational level, area of residence, natural region of residence, age, and sex and enabling factors (e.g. type of health insurance were considered. Descriptive statistics were calculated, and multivariate analysis was performed using generalized linear models (Poisson family. Results: Of all the children, 51% were males, 56% were aged <5 years, and 62.6% lived in urban areas. The most common type of health insurance was Integral Health Insurance (57.8%, and most respondents were in the first quintile of wealth (31.6%. Regarding caregivers, the most common educational level was high school (43.02% and the most frequently spoken language was Spanish (88.4%. Univariate analysis revealed that all variables, except sex and primary educational level, were statistically significant. After adjustment, sex, area of residence, and language were insignificant, whereas the remaining variables were statistically significant. Conclusions: Wealth index, caregivers’ education level, natural region of residence, age, and type of health insurance are factors that determine access to oral health services among children aged <12 years in Peru. These factors should be considered when

  17. Post-fire hydrologic response in Central Portugal. A four years study at microplot scale.

    Science.gov (United States)

    Vieira, Diana; Malvar, Maruxa; Martins, Martinho; Machado, Ana; Nunes, João; Keizer, Jacob

    2014-05-01

    Wildfires are a natural phenomenon in regions with a Mediterranean-type climate. However, their present-day widespread occurrence in southern Europe is unprecedented and strongly reflects human activity such as ignition, land-use changes, land abandonment and introduction of highly flammable plantations. Besides wildfires, post-fire management practices such as plowing, terracing, clearcutting and logging should also be considered, since their occurrence is getting increasingly common. And, in a long-term period these practices seem to be executed intercalated with repeated fire occurrences in the same site, sharing the impacts together with fire in an escalated degradational effect. In this sense, the work presented here concerns four years of runoff and erosion data at microplot scale after the wildfire, comparing different land management practices that occurred before the fire. Preliminary results indicate that in four years of monitoring, runoff is constantly higher in plowed sites than in the unplowed ones, with the exception of the first year. Regarding soil losses the plowed plots present always higher sediment rates than the unplowed ones. The comparison between two unplowed sites with different land uses, indicate higher runoff and erosion risk for pine comparatively to the eucalypt ones, however the reduced soil depth in the first can have an important role in these differences. Following these facts, the aim of the present work is to answer the following research questions: i) Do these four years of observations fit with the window of disturbance model presented by Prosser and Williams (1998). or the alternative version by Wittenberg and Inbar (2009)?; ii) Does pre-fire disturbances (wildfire, land use changes and land management practices) still have repercussions after wildfire?; In what sense does four years of intensive monitoring provides that one year couldn't provide?

  18. 78 FR 78797 - Approval and Promulgation of Air Quality Implementation Plans; State of Colorado; Second Ten-Year...

    Science.gov (United States)

    2013-12-27

    ... the exception of one aspect of the plan's contingency measures. EPA's proposed approval includes the... contact the individual listed in the FOR FURTHER INFORMATION CONTACT section to view the hard copy of the docket. You may view the hard copy of the docket Monday through Friday, 8:00 a.m. to 4:00 p.m., excluding...

  19. Post-Closure Inspection Report for the Tonopah Test Range, Nevada, For Calendar Year 2008

    International Nuclear Information System (INIS)

    2009-01-01

    This report provides the results of the annual post-closure inspections conducted at the closed Corrective Action Unit (CAU) sites located on the Tonopah Test Range (TTR), Nevada. This report covers calendar year 2008 and includes inspection and repair activities completed at the following ten CAUs: CAU 400: Bomblet Pit and Five Points Landfill (TTR) CAU 404: Roller Coaster Lagoons and Trench (TTR) CAU 407: Roller Coaster RadSafe Area (TTR) CAU 423: Area 3 Underground Discharge Point, Building 0360 (TTR) CAU 424: Area 3 Landfill Complexes (TTR) CAU 426: Cactus Spring Waste Trenches (TTR) CAU 427: Area 3 Septic Waste Systems 2, 6 (TTR) CAU 453: Area 9 UXO Landfill (TTR) CAU 484: Surface Debris, Waste Sites, and Burn Area (TTR) CAU 487: Thunderwell Site (TTR)

  20. Post-Closure Inspection Report for the Tonopah Test Range, Nevada, For Calendar Year 2008

    Energy Technology Data Exchange (ETDEWEB)

    NSTec Environmental Restoration

    2009-03-19

    This report provides the results of the annual post-closure inspections conducted at the closed Corrective Action Unit (CAU) sites located on the Tonopah Test Range (TTR), Nevada. This report covers calendar year 2008 and includes inspection and repair activities completed at the following ten CAUs: CAU 400: Bomblet Pit and Five Points Landfill (TTR) CAU 404: Roller Coaster Lagoons and Trench (TTR) CAU 407: Roller Coaster RadSafe Area (TTR) CAU 423: Area 3 Underground Discharge Point, Building 0360 (TTR) CAU 424: Area 3 Landfill Complexes (TTR) CAU 426: Cactus Spring Waste Trenches (TTR) CAU 427: Area 3 Septic Waste Systems 2, 6 (TTR) CAU 453: Area 9 UXO Landfill (TTR) CAU 484: Surface Debris, Waste Sites, and Burn Area (TTR) CAU 487: Thunderwell Site (TTR)

  1. Post-irradiation brain-necrosis resulting in apoplexia and death after 33 years of irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Froehlich, A [Foevarosi Laszlo Korhaz, Budapest (Hungary). Korbonctani es Korszoevettani Oszt.

    1980-04-01

    A case of post-irradiation brain-necrosis resulting in apoplexia of the cerebellum after 33 years of irradiation (19984 r.) of a presumptive cerebellar tumour is reported. The pathohistologic study revealed symptoms of the ''late'' damage and the vascular changes appeared to be the most prominent. The thickening of the vessel walls, hyperplasia of collagen fibres and deposition of calcium in the media, were the most characteristic lesions revealed. In some of the small vessels isolated calcification of the media was observed. It seems most probable that in the development of apoplexia vascular alterations could play an important role. In the available literature no report has been found on a similarly long interval elapsing between the irradiation and death.

  2. Post-irradiation brain-necrosis resulting in apoplexia and death after 33 years of irradiation

    International Nuclear Information System (INIS)

    Froehlich, A.

    1980-01-01

    A case of post-irradiation brain-necrosis resulting in apoplexia of the cerebellum after 33 years of irradiation (19984 r.) of a presumptive cerebellar tumour is reported. The pathohistologic study revealed symptoms of the ''late'' damage and the vascular changes appeared to be the most prominent. The thickening of the vessel walls, hyperplasia of collagen fibres and deposition of calcium in the media, were the most characteristic lesions revealed. In some of the small vessels isolated calcification of the media was observed. It seems most probable that in the development of apoplexia vascular alterations could play an important role. In the available literature no report has been found on a similarly long interval elapsing between the irradiation and death. (author)

  3. Bobath or motor relearning programme? A follow-up one and four years post stroke.

    Science.gov (United States)

    Langhammer, Birgitta; Stanghelle, Johan K

    2003-11-01

    The purpose of this follow-up one and four years post stroke was to find out whether the initial physiotherapy approach had had any long-term effects on mortality, motor function, postural control, activities of daily living, life quality, follow-up from community services and living conditions. A randomized controlled trial of first time ever stroke patients. Group 1 (n = 33) and group 2 (n = 28) had initial physiotherapy according to the Motor Relearning Programme and Bobath, respectively. The Motor Assessment Scale (MAS), the Sødring Motor Evaluation Scale (SMES), the Barthel ADL Index, the Nottingham Health Profile (NHP) and Berg Balance Scale were used. The following parameters were also registered: incidence of new strokes, other diseases, use of assistive devices, the patient's accommodation and use of services from the community. The mortality rates were similar in the two groups. In both groups the motor function, postural control and ADL had decreased rapidly, leaving many of the patients dependent and with a high risk of falling. Life quality had increased compared to the acute stage, but was still low in comparison with healthy persons. Patients in both groups lived at home, but were dependent on help from relatives and community services. Physiotherapy as follow-up service was seldom used. The initial physiotherapy approach did not seem to have a major influence on the patients' ability to cope in the long-term. This follow-up at one and four years post stroke showed no major influence of two different initial physiotherapy regimens on long-term function. The study confirmed a rapid deterioration of ADL and motor function and an increased dependence on relatives. The study reveals a gap between the intense treatment in the acute phase and little or no follow-up of physiotherapy treatment or other rehabilitation activities later.

  4. Relationship between functional disability and costs one and two years post stroke

    Science.gov (United States)

    Lekander, Ingrid; Willers, Carl; von Euler, Mia; Lilja, Mikael; Sunnerhagen, Katharina S.; Pessah-Rasmussen, Hélène; Borgström, Fredrik

    2017-01-01

    Background and purpose Stroke affects mortality, functional ability, quality of life and incurs costs. The primary objective of this study was to estimate the costs of stroke care in Sweden by level of disability and stroke type (ischemic (IS) or hemorrhagic stroke (ICH)). Method Resource use during first and second year following a stroke was estimated based on a research database containing linked data from several registries. Costs were estimated for the acute and post-acute management of stroke, including direct (health care consumption and municipal services) and indirect (productivity losses) costs. Resources and costs were estimated per stroke type and functional disability categorised by Modified Rankin Scale (mRS). Results The results indicated that the average costs per patient following a stroke were 350,000SEK/€37,000–480,000SEK/€50,000, dependent on stroke type and whether it was the first or second year post stroke. Large variations were identified between different subgroups of functional disability and stroke type, ranging from annual costs of 100,000SEK/€10,000–1,100,000SEK/€120,000 per patient, with higher costs for patients with ICH compared to IS and increasing costs with more severe functional disability. Conclusion Functional outcome is a major determinant on costs of stroke care. The stroke type associated with worse outcome (ICH) was also consistently associated to higher costs. Measures to improve function are not only important to individual patients and their family but may also decrease the societal burden of stroke. PMID:28384164

  5. Relationship between functional disability and costs one and two years post stroke.

    Directory of Open Access Journals (Sweden)

    Ingrid Lekander

    Full Text Available Stroke affects mortality, functional ability, quality of life and incurs costs. The primary objective of this study was to estimate the costs of stroke care in Sweden by level of disability and stroke type (ischemic (IS or hemorrhagic stroke (ICH.Resource use during first and second year following a stroke was estimated based on a research database containing linked data from several registries. Costs were estimated for the acute and post-acute management of stroke, including direct (health care consumption and municipal services and indirect (productivity losses costs. Resources and costs were estimated per stroke type and functional disability categorised by Modified Rankin Scale (mRS.The results indicated that the average costs per patient following a stroke were 350,000SEK/€37,000-480,000SEK/€50,000, dependent on stroke type and whether it was the first or second year post stroke. Large variations were identified between different subgroups of functional disability and stroke type, ranging from annual costs of 100,000SEK/€10,000-1,100,000SEK/€120,000 per patient, with higher costs for patients with ICH compared to IS and increasing costs with more severe functional disability.Functional outcome is a major determinant on costs of stroke care. The stroke type associated with worse outcome (ICH was also consistently associated to higher costs. Measures to improve function are not only important to individual patients and their family but may also decrease the societal burden of stroke.

  6. Embedding Evidence-based Practice Education into a Post-graduate Physiotherapy Program: Eight Years of pre-Post Course Evaluations.

    Science.gov (United States)

    Perraton, L; Machotka, Z; Grimmer, K; Gibbs, C; Mahar, C; Kennedy, K

    2017-04-01

    Little has been published about the effectiveness of training postgraduate physiotherapy coursework students in research methods and evidence-based practice (EBP) theory. Graduate qualities in most universities include lifelong learning. Inclusion of EBP in post-graduate coursework students' training is one way for students to develop the knowledge and skills needed to implement current best evidence in their clinical practice after graduation, thereby facilitating lifelong learning. This paper reports on change in confidence and anxiety in knowledge of statistical terminology and concepts related to research design and EBP in eight consecutive years of post-graduate physiotherapy students at one Australian university. Pre-survey/post-survey instruments were administered to students in an intensive 3-week post-graduate course, which taught health research methods, biostatistics and EBP. This course was embedded into a post-graduate physiotherapy programme from 2007 to 2014. The organization and delivery of the course was based on best pedagogical evidence for effectively teaching adult physiotherapists. The course was first delivered each year in the programme, and no other course was delivered concurrently. There were significant improvements in confidence, significantly decreased anxiety and improvements in knowledge of statistical terminology and concepts related to research design and EBP, at course completion. Age, gender and country of origin were not confounders on learning outcomes, although there was a (non-significant) trend that years of practice negatively impacted on learning outcomes (p = 0.09). There was a greater improvement in confidence in statistical terminology than in concepts related to research design and EBP. An intensive teaching programme in health research methods and biostatistics and EBP, based on best practice adult physiotherapy learning principles, is effective immediately post-course, in decreasing anxiety and increasing

  7. [Twenty-year History and Future Challenges in Transparency Enhancement of Review Process for Approval: Focus on Public Release of Review Reports regarding New Drugs and Medical Devices].

    Science.gov (United States)

    Morimoto, Kazushige; Kawasaki, Satoko; Yoshida, Yasunori

    2015-01-01

    For 20 years, the Ministry of Health, Labour and Welfare (MHLW, formerly Ministry of Health and Welfare (MHW)) has been trying to increase transparency of the review process for approving reports in order to promote the rational use of newly approved drugs and medical devices. The first Summary Basis of Approval (SBA) was published by MHW in 1994. In 1999, evaluation reports were prepared by MHW and the Pharmaceuticals and Medical Devices Evaluation Center to make them available to the public. In 2005, a notice from the Chief Executive of the Pharmaceuticals and Medical Devices Agency (PMDA) made procedures for public release of information on reviewing applications for new drugs. In 2006, 90 review reports of newly approved drugs and eight medical devices were revealed on PMDA websites. The dissemination of information by the United States Food and Drug Administration (FDA) and that of the European Medicines Agency (EMA) were studied and compared with that of the MHLW and PMDA. While common technical documents (CTD) for new drugs and summary technical documents (STED) for new medical devices have been released by PMDA, such documents are not released by the FDA and EMA. The European Public Assessment Report (EAPR) summary for the public is an interesting questionnaire approach that uses the "What," "How" and "Why" format. Finally, future proposals for the next decade are also outlined.

  8. Shark fisheries in the Southeast Pacific: A 61-year analysis from Peru [version 2; referees: 1 approved, 2 approved with reservations

    Directory of Open Access Journals (Sweden)

    Adriana Gonzalez-Pestana

    2016-04-01

    Full Text Available Peruvian waters exhibit high conservation value for sharks. This contrasts with a lag in initiatives for their management and a lack of studies about their biology, ecology and fishery. We investigated the dynamics of Peruvian shark fishery and its legal framework identifying information gaps for recommending actions to improve management. Further, we investigated the importance of the Peruvian shark fishery from a regional perspective. From 1950 to 2010, 372,015 tons of sharks were landed in Peru. From 1950 to 1969, we detected a significant increase in landings; but from 2000 to 2011 there was a significant decrease in landings, estimated at 3.5% per year. Six species represented 94% of landings: blue shark (Prionace glauca, shortfin mako (Isurus oxyrinchus, smooth hammerhead (Sphyrna zygaena, common thresher (Alopias vulpinus, smooth-hound (Mustelus whitneyi and angel shark (Squatina californica. Of these, the angel shark exhibits a strong and significant decrease in landings: 18.9% per year from 2000 to 2010. Peru reports the highest accumulated historical landings in the Pacific Ocean; but its contribution to annual landings has decreased since 1968. Still, Peru is among the top 12 countries exporting shark fins to the Hong Kong market. Although the government collects total weight by species, the number of specimens landed as well as population parameters (e.g. sex, size and weight are not reported. Further, for some genera, species-level identification is deficient and so overestimates the biomass landed by species and underestimates the species diversity. Recently, regional efforts to regulate shark fishery have been implemented to support the conservation of sharks but in Peru work remains to be done.

  9. Law No. 16.226 submission to account and budget balance execution: approve corresponding financial year 1990

    International Nuclear Information System (INIS)

    1991-01-01

    Articulate 215 of the Submission to Account and Budget Balance execution of the Oriental Republic of the Uruguay the placing of central nuclear of generation of electric energy,public and private will require approval for law. To be able to Executive it will remit to the General Assembly all the necessary information on the characteristics of the power station installation including a study of the environmental Impact result made for the Ministry of Territorial Housing Ordering and Environment [es

  10. Development of a Post-Graduate Year 2 Pharmacy Residency in Clinical Pharmacogenetics

    Science.gov (United States)

    Hoffman, James M.; Gammal, Roseann S.; Relling, Mary V.; Crews, Kristine R.

    2017-01-01

    Purpose The structure and development of an innovative clinical pharmacogenetics post-graduate year 2 (PGY2) ASHP-accredited residency program is described. Summary The advent of the era of genomics has left practitioners wondering how to interpret the data obtained from sequencing and genotyping patients. In order to train the next leaders in the area of implementing pharmacogenetics, St. Jude Children’s Research Hospital established the first accredited residency program in clinical pharmacogenetics. The 12-month long PGY2 residency was created in accordance with the ASHP standards for advanced practice residencies. The resident learns to optimize patient outcomes through the expert provision of evidence-based, patient-centered precision medicine as an integral part of an interdisciplinary team. The resident gains hands-on experience in a dynamic environment regarding all aspects of running a clinical pharmacogenetics service. Since the first resident graduated in 2012, the program has graduated one resident each year. Conclusion To fill a need for pharmacists trained in pharmacogenetics, an innovative PGY2 residency in clinical pharmacogenetics was successfully developed. Upon completion of the program, residents are equipped with the clinical skills and necessary experience to drive precision medicine forward and lead the implementation of pharmacogenetics in various healthcare settings. PMID:28274984

  11. Corrective Action Management Unit Report of Post-Closure Care Activities Calendar Year 2017.

    Energy Technology Data Exchange (ETDEWEB)

    Ziock, Robert [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Little, Bonnie Colleen [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2018-02-01

    The Corrective Action Management Unit (CAMU) at Sandia National Laboratories, New Mexico (SNL/NM) consists of a containment cell and ancillary systems that underwent regulatory closure in 2003 in accordance with the Closure Plan in Appendix D of the Class 3 Permit Modification (SNL/NM September 1997). The containment cell was closed with wastes in place. On January 27, 2015, the New Mexico Environment Department (NMED) issued the Hazardous Waste Facility Operating Permit (Permit) for Sandia National Laboratories (NMED January 2015). The Permit became effective February 26, 2015. The CAMU is undergoing post-closure care in accordance with the Permit, as revised and updated. This CAMU Report of Post-Closure Care Activities documents all activities and results for Calendar Year (CY) 2017 as required by the Permit. The CAMU containment cell consists of engineered barriers including a cover system, a bottom liner with a leachate collection and removal system (LCRS), and a vadose zone monitoring system (VZMS). The VZMS provides information on soil conditions under the cell for early leak detection. The VZMS consists of three monitoring subsystems, which include the primary subliner (PSL), a vertical sensor array (VSA), and the Chemical Waste Landfill (CWL) sanitary sewer (CSS) line. The PSL, VSA, and CSS monitoring subsystems are monitored quarterly for soil moisture concentration, the VSA is monitored quarterly for soil temperature, and the VSA and CSS monitoring subsystems are monitored annually for volatile organic compound (VOC) concentrations in the soil vapor at various depths. Baseline data for the soil moisture, soil temperature, and soil vapor were established between October 2003 and September 2004.

  12. Self-reported quality of life predicts mortality 7 years post implant in patients with an implantable cardioverter defibrillator

    DEFF Research Database (Denmark)

    Andersen, Christina Maar; Veen, Barbara van; Theuns, Dominic A M J

    2018-01-01

    (SD) age=58 (12) consecutively implanted between 2003 and 2010. Patients completed the SF-36. The eight subscales and the physical and mental component summary scores were used as predictors of mortality 7 years post implant. Results: At 7-year follow-up, 33.7% (132/392) of the patients had died...

  13. IVF culture medium affects post-natal weight in humans during the first 2 years of life

    NARCIS (Netherlands)

    Kleijkers, Sander H. M.; van Montfoort, Aafke P. A.; Smits, Luc J. M.; Viechtbauer, Wolfgang; Roseboom, Tessa J.; Nelissen, Ewka C. M.; Coonen, Edith; Derhaag, Josien G.; Bastings, Lobke; Schreurs, Inge E. L.; Evers, Johannes L. H.; Dumoulin, John C. M.

    2014-01-01

    Is post-natal growth during the first 2 years of life in IVF singletons affected by type of medium used for culturing human embryos during an IVF treatment? The in vitro culture of human embryos in medium from Cook resulted in singletons with a lower weight during the first 2 years of life compared

  14. Immunotherapy Combination Approved for Advanced Kidney Cancer

    Science.gov (United States)

    FDA has approved the combination of the immunotherapy drugs nivolumab (Opdivo) and ipilimumab (Yervoy) as an initial treatment for some patients with advanced kidney cancer. The approval is expected to immediately affect patient care, as this Cancer Currents post explains.

  15. Early medical skull surgery for treatment of post-traumatic osteomyelitis 5,000 years ago.

    Directory of Open Access Journals (Sweden)

    Pierpaolo Petrone

    Full Text Available Here we describe the findings of a unique example of the early techniques adopted in neurosurgery around 5000 years ago, consisting in a double well healed skull trephination associated with a post-cranial traumatic event occurring intra vitam to a young male from the Early Chalcolithic cemetery of Pontecagnano (South Italy, ca. 4,900 - 4,500 cal BP. Morphological, X-ray and 3D-CT scan skull-cap evaluation revealed that the main orifice was produced by scraping, obtained by clockwise rotary motion of a right-handed surgeon facing the patient, while the partial trephination was carried out by using a stone point as a drilling tool. In both cases, bone regrowth is indicative of the individual's prolonged postoperative survival and his near-complete recovery. The right femur shows a poorly healed mid-shaft fracture presumably induced by a high energy injury, and a resulting chronic osteomyelitis, affecting both femurs by hematogenous spread of the infection. Our observations on the visual and radiological features of skull and femur lesions, along with evidence on the timing of experimental bone regrowth vs. healing of lower limb fractures associated to long-term bone infections now suggest that this young man underwent a double skull trephination in order to alleviate his extremely painful condition induced by chronic osteomyelitis, which is thought to have been the cause of death.

  16. Tetracapsuloides bryosalmonae persists in brown trout Salmo trutta for five years post exposure.

    Science.gov (United States)

    Soliman, Hatem; Kumar, Gokhlesh; El-Matbouli, Mansour

    2018-01-31

    Tetracapsuloides bryosalmonae is a malacosporean parasite and the causative agent of proliferative kidney disease (PKD) that seriously impacts farmed and wild salmonids. The parasite's life cycle includes an invertebrate host, the bryozoan Fredericella sultana, and a vertebrate host, salmonid fish. The persistence of T. bryosalmonae in brown trout Salmo trutta for up to 2 yr following exposure is well documented. Results from the present study confirmed that one brown trout that had recovered from PKD did not completely clear the parasite from its tissues and that T. bryosalmonae could persist in brown trout for up to 5 yr post exposure. Furthermore, recovered infected brown trout can release viable T. bryosalmonae spores that are able to infect specific pathogen-free F. sultana colonies. T. bryosalmonae DNA was detected by PCR in every organ, and parasite stages were observed in the kidney, spleen and liver following immunohistochemistry. This finding indicates that T. bryosalmonae-infected brown trout can act as asymptomatic carriers and release the parasite for several years after the initial infection, acting as a reservoir of infection, and contributing to the dissemination of the parasite to new areas.

  17. Marijuana use and service utilization among adolescents 7 years post substance use treatment.

    Science.gov (United States)

    Campbell, Cynthia I; Sterling, Stacy; Chi, Felicia W; Kline-Simon, Andrea H

    2016-11-01

    In an environment of increasingly liberal attitudes towards marijuana use and legalization, little is known about long-term trajectories of marijuana use among clinical samples of adolescents, and how these trajectories relate to health services utilization over time. Latent growth curve analysis was used to identify distinct trajectories of marijuana use in a clinical sample of adolescents (N=391) over 7 years post substance use treatment in an integrated health system. We examined psychiatric problems and polysubstance use associated with the identified trajectory groups using general linear models. Nonlinear mixed-effects logistic regressions were used to examine associations between health services use and the trajectory groups. We identified three marijuana use trajectory groups: (1) Abstinent (n=117); (2) Low/Stable use (n=174); and (3) Increasing use (n=100). Average externalizing and anxiety/depression scores were significantly lower over time for the Abstinent group compared to the Increasing and Low/Stable groups. The Low Stable and the Increasing group had fewer psychiatric visits over time (ptreatment services over time compared with the Abstinent group (pmarijuana use patterns, one of which indicated a group of adolescents at risk of increased use over time. These individuals have greater psychiatric and polysubstance use over time, but may not be accessing needed services. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  18. Chemical Waste Landfill Annual Post-Closure Care Report Calendar Year 2014

    Energy Technology Data Exchange (ETDEWEB)

    Mitchell, Michael Marquand [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Little, Bonnie Colleen [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2015-03-01

    The CWL is a 1.9-acre remediated interim status landfill located in the southeastern corner of SNL/NM Technical Area III (Figures 2-1 and 2-2) undergoing post-closure care in accordance with the PCCP (NMED October 2009 and subsequent revisions). From 1962 until 1981, the CWL was used for the disposal of chemical and solid waste generated by SNL/NM research activities. Additionally, a small amount of radioactive waste was disposed of during the operational years. Disposal of liquid waste in unlined pits and trenches ended in 1981, and after 1982 all liquid waste disposal was terminated. From 1982 through 1985, only solid waste was disposed of at the CWL, and after 1985 all waste disposal ended. The CWL was also used as a hazardous waste drum-storage facility from 1981 to 1989. A summary of the CWL disposal history is presented in the Closure Plan (SNL/NM December 1992) along with a waste inventory based upon available disposal records and information.

  19. Assessment of first-year post-graduate residents: usefulness of multiple tools.

    Science.gov (United States)

    Yang, Ying-Ying; Lee, Fa-Yauh; Hsu, Hui-Chi; Huang, Chin-Chou; Chen, Jaw-Wen; Cheng, Hao-Min; Lee, Wen-Shin; Chuang, Chiao-Lin; Chang, Ching-Chih; Huang, Chia-Chang

    2011-12-01

    Objective Structural Clinical Examination (OSCE) usually needs a large number of stations with long test time, which usually exceeds the resources available in a medical center. We aimed to determine the reliability of a combination of Direct Observation of Procedural Skills (DOPS), Internal Medicine in-Training Examination (IM-ITE(®)) and OSCE, and to verify the correlation between the small-scale OSCE+DOPS+IM-ITE(®)-composited scores and 360-degree evaluation scores of first year post-graduate (PGY(1)) residents. Between 2007 January to 2010 January, two hundred and nine internal medicine PGY1 residents completed DOPS, IM-ITE(®) and small-scale OSCE at our hospital. Faculty members completed 12-item 360-degree evaluation for each of the PGY(1) residents regularly. The small-scale OSCE scores correlated well with the 360-degree evaluation scores (r = 0.37, p ITE(®) score with small-scale OSCE+DOPS scores [small-scale OSCE+DOPS+IM-ITE(®)-composited scores] markedly enhanced their correlation with 360-degree evaluation scores (r = 0.85, p ITE(®)-composited scores suggested that both methods were measuring the same quality. Our results showed that the small-scale OSCE, when associated with both the DOPS and IM-ITE(®), could be an important assessment method for PGY(1) residents. Copyright © 2011. Published by Elsevier B.V.

  20. Changes in Inmates’ Substance Use and Dependence From Pre-Incarceration to One Year Post-Release

    Science.gov (United States)

    Tangney, June P.; Folk, Johanna B.; Graham, David M.; Stuewig, Jeffrey B.; Blalock, Daniel V.; Salatino, Andrew; Blasko, Brandy B.; Moore, Kelly E.

    2016-01-01

    Purpose To assess changes in inmates’ misuse of substances from pre- to post-incarceration. Methods In Study 1, professionals (n = 162) and laypersons (n = 50) predicted how jail inmates’ substance misuse would change from pre-incarceration to post-release. In Study 2, a longitudinal study of 305 jail inmates, we examined actual changes in substance use and dependence from pre-incarceration to the first year post-incarceration, as well as whether changes varied as a function of demographic, criminal justice, treatment, and personality factors. Results Professionals and laypersons predicted little change in substance misuse whereas, in fact, inmates’ frequency of substance use and dependence decreased substantially from pre-incarceration to post-release. Sharper decreases were observed for inmates who were female, younger, more educated, serving longer sentences, enrolled in substance abuse treatment, high in shame-proneness, and low in criminogenic thinking. Race, first time incarceration, transfer to other correctional facilities, mandated community supervision (probation), and guilt-proneness did not predict changes in substance use or dependence. Conclusions Although substance misuse decreased, this remains a population high in need of substance abuse treatment both upon arrest and at one year post-incarceration; 60% of former inmates met at least one DSM-IV criterion for substance dependence at one year post-release. PMID:27458324

  1. A CROSS-SECTIONAL MORPHOLOGICAL AND FUNCTIONAL EVALUATION OF FILTERING BLEBS FIVE YEARS POST TRABECULECTOMY

    Directory of Open Access Journals (Sweden)

    Jyoti Shetty

    2017-06-01

    Full Text Available BACKGROUND After trabeculectomy, wound remodelling and fibrosis continues lifelong and can affect bleb filtration. Ethnicity plays an important role in wound healing. Wound modulation with Mitomycin C affects the morphology as well as long-term functional success of the bleb. The aim of the study is to assess the morphology of blebs 5 years post trabeculectomy using clinical methods (slit lamp biomicroscopy and Moorfields Bleb Grading System MBGS along with Anterior Segment Optical Coherence Tomography (ASOCT and to correlate it with its functional outcome. MATERIALS AND METHODS This prospective cross-sectional study evaluated 40 eyes of 30 patients who had undergone trabeculectomy with adjuvant mitomycin C and had a postoperative duration of 5 years or more. Following a comprehensive ophthalmic examination, grading of filtering bleb was performed using MBGS. Internal bleb morphology was imaged using AS-OCT. RESULTS At the time of surgery, the age of the patients ranged from 33-71 years. The average postoperative duration was 8.6 ± 3.3 years. Based on slit lamp biomicroscopy, we found that 47% of the total blebs were diffuse, 30% were cystic and 23% were flat. MBGS parameters were studied in relation to bleb type on slit lamp. Bleb height (p=0.001 and central bleb vascularity (p=0.010 were found to have statistically significant association. There is a statistically significant agreement between the bleb type on slit lamp examination and morphological classification based on AS-OCT at p<0.05 (p=0.000. We observed complete success in 90% of eyes and qualified success in 100%. IOP at the time of study was found to have negative correlation with total bleb height on AS-OCT (r: -0.3592; p=0.022909. CONCLUSION This case series with a long-term followup period showed that trabeculectomy augmented with Mitomycin C (MMC can achieve good long-term IOP control. The filtering bleb morphology using clinical methods (slit lamp biomicroscopy and MBGS and

  2. Post traumatic stress symptoms in the first years of conjugal bereavement

    NARCIS (Netherlands)

    Schut, Henk; de Keijser, Adrianus; van den Bout, Jan; Dijkhuis, Jos

    1990-01-01

    Bereavement is generally regarded as one of the most stressful events one can encounter. Yet, bereavement research and the study of post-traumatic stress seem to be mainly developing along separate lines. Strictly speaking, post-traumatic stress disorder can only occur after encountering events

  3. Post-Closure Inspection Report for Corrective Action Unit 427: Septic Waste Systems 2 and 6 Tonopah Test Range, Nevada Calendar Year 2000; TOPICAL

    International Nuclear Information System (INIS)

    K. B. Campbell

    2001-01-01

    Post-closure inspection requirements for the Area 3 Septic Waste Systems 2 and 6 (Corrective Action Unit[CAU] 427) (Figure 1) are described in Closure Report for Corrective Action Unit 427. Area 3 Septic Waste Systems 2 and 6. Tonopah Test Range, Nevada, report number DOE/NV-561. The Closure Report (CR) was submitted to the Nevada Division of Environmental Protection (NDEP) on August 16, 1999. The CR (containing the Post-Closure Inspection Plan) was approved by the NDEP on August 27, 1999. The annual post-closure inspection at CAU 427 consists of the following: Verification of the presence of all leachfield and septic tank below-grade markers; Verification that the warning signs are in-place, intact, and readable; and Visual observation of the soil and asphalt cover for indications of subsidence, erosion, and unauthorized use. The site inspections were conducted on June 20, 2000, and November 21, 2000. All inspections were made after NDEP approval of the CR and were conducted in accordance with the Post-Closure Inspection Plan in the NDEP-approved CR. No maintenance or repairs were conducted at the site. This report includes copies of inspection checklists, photographs, recommendations, and conclusions. Copies of the Post-Closure Inspection Checklists are found in Attachment A, a copy of the field notes is found in Attachment B, and a copy of the inspection photographs is found in Attachments C

  4. Comparing Socialist and Post-Socialist Television Culture. Fifty Years of Television in Croatia

    Directory of Open Access Journals (Sweden)

    Zrinjka Peruško

    2014-06-01

    Full Text Available This article builds a theoretical model for comparative analysis of media culture based on the notion of genre, and applies it to a comparative analysis of television as a cultural form in socialist and post-socialist Croatia. The paper explores how the shares and generic composition of program modes of information, entertainment and fiction change in time, and how the contribution of different genres to program flow and modes varies with the changes of political, economic and technological context. Longitudinal trends in television flows are comparatively evaluated in relation to trends in genre developments in Europe and their relationship to the changes in the cultural role of television. The results show a decrease in the information and an increase in the fiction mode between socialism and democracy, with some similarities of the Croatian and western television culture in relation to genre and mode composition and flow, albeit with a belated introduction of neo television genres. Notwithstanding the limited freedom of expression and ideological content, which necessarily influenced socialist media culture, television as a cultural form in Croatia developed in concert with the global program flows. The article is based on original content analysis of television schedules where the unit of analysis is a televisions program listing. The analogue television universe is represented by longitudinal data for 1959, 1969, 1979, 1989, 1999, and 2009. The stratified systematic sample (N=3934 for each chosen year consists of two constructed weeks from a universe of all listed programs broadcast on all free to air television channels with a national reach license.

  5. Twenty years of post-apartheid archiving: have we reckoned with the ...

    African Journals Online (AJOL)

    Verne

    flood of post-1990 memory work, the transformed national ... 1 Nelson Mandela, Long Walk to Freedom (Abacus,. 1994), p.617. ... term to describe: the processes whereby those who are traumatised .... no short-cut to the liberatory future our.

  6. [Post-gastrectomy reconstruction versus enteral alimentation--a one year follow-up study].

    Science.gov (United States)

    Kostov, D; Balabanova, G; Vasilev, B; Plachkov, I; Ignatov, G

    2000-01-01

    This is a report on various post-gastrectomy reconstructive procedures, proceeding from personal experience had with 14 patients undergoing gastrectomy for carcinoma of the stomach and five patients with operations of esophagus and stomach for various pathological conditions. An assessment is done of the reconstructive methods used on the ground of objective indicators. All patients are subjected to enteral alimentation through nutritive jejunostomy. In the pre- and postoperatived periods, the trophic state of patients is evaluated on basis of biochemical, anthropometric and immunologic study data. Postoperatively, in those with small-intestinal reservoir a lower degree negative symptomatology is established, along with life style improvement. Post-gastrectomy patients presenting I-II (UICC) stage of the oncological disease are indicated for small-intestinal reservoir formation. In the overall therapeutic approach to post-gastrectomy patients adequate clinical therapeutic feeding proves absolutely indispensable.

  7. DTI study of Children with Congenital Hydrocephalus: 1 Year Post-Surgical Outcomes

    Science.gov (United States)

    Mangano, Francesco T.; Altaye, Mekibib; McKinstry, Robert C.; Shimony, Joshua S.; Powell, Stephanie K.; Phillips, Jannel M.; Barnard, Holly; Limbrick, David D.; Holland, Scott K.; Jones, Blaise V.; Dodd, Jonathon; Simpson, Sarah; Deanna, Mercer; Rajagopal, Akila; Bidwell, Sarah; Yuan, Weihong

    2016-01-01

    Object To investigate white matter structural abnormalities using diffusion tensor imaging (DTI) in children with hydrocephalus before CSF diversionary surgery (including ventriculoperitoneal shunting and endoscopic third ventriculoscopy) and the course of recovery post-surgery in association with neuropsychological and behavioral outcome. Methods This was a prospective study that included 54 children with congenital hydrocephalus (21F/33M; age range: 0.03–194.5 months) who underwent surgery and 64 normal controls (30F/34M, age range: 0.30–197.75 months). DTI and neurodevelopmental outcome data were collected once in the control group and at pre-surgery, 3-month, and 12-month post-surgery in the patients. DTI measures, including fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) values were extracted from the genu of corpus callosum (gCC) and the posterior limb of internal capsule (PLIC). Group analysis was performed first cross-sectionally to quantify DTI abnormalities at three time points by comparing the controls and the patients group at the three time points separately. Longitudinal comparisons were conducted pairwise between different time points in patients whose data were acquired at multiple time points. Neurodevelopmental data were collected and analyzed using the Adaptive Behavior Assessment System, Second Edition (ABAS-II) and the Bayley Scales of Infant Development, Third Edition (Bayley-III). Correlation analyses were performed between DTI and behavioral outcomes. Results Significant DTI abnormalities were found in both the gCC (lower FA and higher MD, AD, and RD) and the PLIC (higher FA, lower AD and RD) at pre-surgery. The DTI measures in the gCC remained mostly abnormal at 3-month and 12-month post-surgery. The DTI abnormalities in the PLIC were significant in FA and AD at 3-month post-surgery but did nor persist when tested at 12-month post-surgery. Significant longitudinal DTI changes in the

  8. Urinary incontinence and vaginal squeeze pressure two years post-cesarean delivery in primiparous women with previous gestational diabetes mellitus

    OpenAIRE

    Barbosa, Angélica Mércia Pascon; Dias, Adriano; Marini, Gabriela; Calderon, Iracema Mattos Paranhos; Witkin, Steven; Rudge, Marilza Vieira Cunha

    2011-01-01

    OBJECTIVE: To assess the prevalence of urinary incontinence and associated vaginal squeeze pressure in primiparous women with and without previous gestational diabetes mellitus two years post-cesarean delivery. METHODS: Primiparous women who delivered by cesarean two years previously were interviewed about the delivery and the occurrence of incontinence. Incontinence was reported by the women and vaginal pressure evaluated by a Perina perineometer. Sixty-three women with gestational diabetes ...

  9. The effect of herd of origin by year on post-weaning traits of young ...

    African Journals Online (AJOL)

    Data consisted of post-weaning traits of beef bulls tested between 1990 and 2003, with available weaning weight (WWT) and weaning management group information as well as weaning weights of their contemporaries. A multiple-trait animal model including ADG, DFI, SDH and SCR, together with WWT was used.

  10. FOOD PROCESSING TECHNOLOGY, A SUGGESTED 2-YEAR POST HIGH SCHOOL CURRICULUM.

    Science.gov (United States)

    KNOEBEL, ROBERT M.; AND OTHERS

    ADMINISTRATORS, ADVISORY COMMITTEES, SUPERVISORS, AND TEACHERS MAY USE THIS GUIDE IN PLANNING AND DEVELOPING NEW PROGRAMS OR EVALUATING EXISTING PROGRAMS IN POST-HIGH SCHOOL FOOD PROCESSING TECHNOLOGY. BASIC MATERIALS WERE PREPARED BY THE STATE UNIVERSITY OF NEW YORK AGRICULTURAL AND TECHNICAL COLLEGE AT MORRISVILLE AND FINAL PREPARATION WAS…

  11. The Disability Rate of 5-Year Post-Stroke and Its Correlation Factors: A National Survey in China.

    Science.gov (United States)

    Yang, Yang; Shi, Yu-Zhi; Zhang, Ning; Wang, Shuo; Ungvari, Gabor S; Ng, Chee H; Wang, Yi-Long; Zhao, Xing-Quan; Wang, Yong-Jun; Wang, Chun-Xue; Xiang, Yu-Tao

    2016-01-01

    Few studies on long-term functional outcome have been conducted in post-stroke patients in China. The objective of this study was to conduct a nationwide survey in China to investigate the 5-year prevalence of post-stroke disability and its correlation factors. A total of 893 patients with ischemic stroke were included. Demographic, clinical and neuro-imaging information were collected with standardized instruments that assessed stroke severity, depression, cognitive impairment, stroke recurrence and physical disability. Disability was assessed with the modified Ranking Score (mRS), of which a cutoff score ≥2 indicates disability. Statistical analysis included chi-square tests, two independent samples t-tests, Mann-Whitney U test and multiple logistic regression analysis. The frequency of disability in this study population was 45%. Multivariate analyses revealed that older age, lower education level, previous history of stroke, stroke severity at admission, depression, cognitive impairment at 3 months, and stroke recurrence within 5 years follow up were all significantly associated with post-stroke disability. The disability rate in 5-year post-stroke was high in Chinese patients. Treatment of depression, secondary prevention of stroke and rehabilitation may benefit disabled patients with stroke in China.

  12. Clinicopathological Spectrum of Endometrial Changes in Peri-menopausal and Post-menopausal Abnormal Uterine Bleeding: A 2 Years Study.

    Science.gov (United States)

    Damle, Rajshri P; Dravid, N V; Suryawanshi, Kishor H; Gadre, Arundhati S; Bagale, Priya S; Ahire, Neelam

    2013-12-01

    Abnormal uterine bleeding is the Common presenting complaint in Gynaecology Outpatient Department in all age groups. It is due to the anovulatory cycles which are commonly seen in adolescent and peri-menopausal women. Abnormal uterine bleeding is caused by wide variety of organic or non-organic causes. Histopathological examination of endometrial sample remains the gold standard for diagnosis of endometrial pathology. To study the clinicopathological spectrum of endometrium in abnormal uterine bleeding in peri-menopausal and post-menopausal age groups. The study included prospective analysis of 119 cases of endometrial samples in patients of abnormal uterine bleeding above 40 years of age. The specimens were routinely processed and H&E stained slides were studied. Patients were categorized into peri-menopausal (40-49 years) and post-menopausal (> 50 years) age group. A total of 119 specimens of endometrium were analyzed. Maximum number (73.94%) of cases were from peri-menopausal age group. The most common presenting complaint was menorrhagia (48.86%) followed by post-menopausal bleeding (26.05%). In peri-menopausal age group proliferative endometrium (35.22%) was the predominant histopathological pattern followed by endometrial hyperplasia (23.86%). Atrophic endometrium (25.80%) was the most frequent finding followed by endometrial hyperplasia (19.35%) in post-menopausal age group. Three cases of endometrial carcinoma were reported in post-menopausal age group only. A thorough histopathological work up and clinical correlation is mandatory in cases of abnormal uterine bleeding above the age of 40 years to find out organic lesions. Careful screening can detect early cancer of endometrium which has excellent prognosis and it will help in further management.

  13. Differences in total and allergen specific IgE during pregnancy compared with 1 month and 1 year post partum.

    Science.gov (United States)

    Perry, Lee M; Ownby, Dennis R; Wegienka, Ganesa R; Peterson, Edward L; Woodcroft, Kimberly J; Joseph, Christine L; Johnson, Christine C

    2009-10-01

    Pregnancy alters the function of many body systems, including the immune system. However, little is known regarding the effect of pregnancy on maternal IgE levels or atopy. To determine whether pregnancy consistently influences serum levels of total or allergen specific IgE. Blood samples were obtained from 764 women during the third trimester of pregnancy and 1 month post partum. A third sample was obtained from 106 of these women 1 year post partum. Samples were analyzed for total and specific IgE to 8 regionally common allergens using a commercially available system. Sensitization was defined as an allergen specific IgE level of 0.35 kU of allergen per liter or higher to any allergen. Total IgE increased significantly post partum, both at 1 month (40.36 vs 35.37 IU/mL intrapartum; P = .001) and at 1 year (44.97 vs 37.00 IU/mL intrapartum; P = .005). Allergen specific IgE decreased significantly at 1 month for cat, dog, ragweed, timothy grass, and egg (P = .001 to P = .02) but not for dust mite, cockroach, or Alternaria (P = .15 to P = .90). Similar patterns of change in total and specific IgE were seen at 1 year. However, on average, only 3.5% of participants changed sensitization status to the individual allergens studied during the 1 year of observation. Compared with intrapartum levels, total IgE levels increased significantly at 1 month and 1 year post partum. Conversely, at the same time points, IgE levels specific for common allergens significantly declined to most but not all allergens. Few women changed their sensitization status over 1 year.

  14. The Effect of Post Traumatic Stress Disorder on Military Leadership: An Historical Perspective

    Science.gov (United States)

    2011-05-19

    Post Traumatic Stress Disorder ( PTSD ) on military leadership. For over twenty years, the United States Army has used the Be...Introduction Multiple deployment cycles to Iraq and Afghanistan combat zones and the increase in Post - Traumatic Stress Disorder ( PTSD ) have resulted...Approved for Public Release; Distribution is Unlimited The Effect of Post Traumatic Stress Disorder on Military Leadership: An

  15. POST-CLOSURE INSPECTION REPORT FOR CORRECTIVE ACTION UNIT 92: AREA 6 DECON POND FACILITY, NEVADA TEST SITE, NEVADA FOR CALENDAR YEAR 2005

    International Nuclear Information System (INIS)

    2006-01-01

    This Post-Closure Inspection Report provides an analysis and summary of inspections for Corrective Action Unit (CAU) 92, Area 6 Decon Pond Facility, Nevada Test Site, Nevada. CAU 92 was closed in accordance with the Resource Conservation and Recovery Act (RCRA) Part B Operational Permit (Nevada Division of Environmental Protection (NDEP), 1995) and the Federal Facility Agreement and Consent Order of 1996. Closure activities were completed on February 16, 1999, and the Closure Report (U.S. Department of Energy, Nevada Operations Office, 1999) was approved and a Notice of Completion issued by the NDEP on May 11, 1999. CAU 92 consists of two Corrective Action Sites (CASs): CAS 06-04-01, Decon Pad Oil/Water Separator; and CAS 06-05-02, Decontamination Pond (RCRA). Both CASs have use restrictions; however, only CAS 06-05-02 requires post-closure inspections. Visual inspections of the cover and fencing at CAS 06-05-02 are performed quarterly. Additional inspections are conducted if precipitation occurs in excess of 1.28 centimeters (cm) (0.50 inches [in]) in a 24-hour period. This report covers calendar year 2005. Quarterly site inspections were performed in March, June, September, and December of 2005. All observations indicated the continued integrity of the unit. No issues or concerns were noted, and no corrective actions were necessary. Copies of the inspection checklists and field notes completed during each inspection are included in Appendix A. Five additional inspections were performed after precipitation events that exceeded 1.28 cm (0.50 in) within a 24-hour period during 2005. No significant changes in site conditions were noted during these inspections, and no corrective actions were necessary. Copies of the inspection checklists and field notes completed during each inspection are included in Appendix A. Precipitation records for 2005 are included in Appendix C

  16. Differentiating maternal fatigue and depressive symptoms at six months and four years post partum: Considerations for assessment, diagnosis and intervention.

    Science.gov (United States)

    Giallo, Rebecca; Gartland, Deirdre; Woolhouse, Hannah; Brown, Stephanie

    2015-02-01

    fatigue and depressive symptoms are common among women in the postpartum period, and it has been proposed that fatigue is a risk factor for later depression. To progress this research, there is a need to clarify the conceptual and measurement issue of whether these two sets of symptoms are distinct constructs. There is also a need to determine whether they are distinct constructs beyond the postnatal period. The aim of the study was to assess the construct and discriminant validity of fatigue and depressive symptoms as measured by the SF-36 Vitality subscale (SF-36) and the Edinburgh Postnatal Depression Scale (EPDS) at six months and at four years post partum. data from over 1000 women participating in the Maternal Health Study, a longitudinal study of women׳s physical and psychological health and recovery after childbirth were used. confirmatory factor analysis revealed a two-factor model of fatigue and depressive symptoms represented as distinct but related constructs was a better fit to the data than a one-factor model of fatigue and depression sharing the same underlying construct at both six months and four years post partum. this study provides empirical evidence that maternal fatigue and depression in the first year after having a baby and at four years post partum are best understood as separate psychological constructs or experiences. The findings have important implications for clinical practice, in particular underlining the importance of differentiating tiredness from depression. Copyright © 2014 Elsevier Ltd. All rights reserved.

  17. 75 FR 68733 - Approval and Promulgation of One-Year Extension for Attaining the 1997 8-Hour Ozone Standard for...

    Science.gov (United States)

    2010-11-09

    ... 4th Max 8-hr Site ID County/state Year (ppm) 10-001-0002 Kent/Delaware 2009 .066 10-003-1007 New... Management District v. EPA, 472 F.3d 882 (DC Cir. 2006), modified and rehearing den., 489 F.3d 1245 (DC Cir...

  18. Contact Between Birth and Adoptive Families During the First Year Post-Placement: Perspectives of Lesbian, Gay, and Heterosexual Parents

    OpenAIRE

    Farr, Rachel H.; Goldberg, Abbie E.

    2014-01-01

    Despite growing visibility of lesbian- and gay-parent adoption, only one qualitative study has examined birth family contact among adoptive families with lesbian and gay parents (Goldberg, Kinkler, Richardson, & Downing, 2011). We studied adoptive parents’ (34 lesbian, 32 gay, and 37 heterosexual; N = 103 families) perspectives of birth family contact across the first year post-placement. Using questionnaire and interview data, we found few differences in openness dynamics by parental sexual ...

  19. The International Space of the Danish Testing Community in the Post-war Years

    DEFF Research Database (Denmark)

    Andreasen, Karen Egedal; Ydesen, Christian

    2016-01-01

    International forums and organizations, as well as non-governmental organizations, have played a considerable role in societal developments since the end of World War II. Many changes in post-war Danish public schools like standardized educational testing were formed in dialogue with or initiated......, and up to the end of the Cold War. Exploring the transnational angle is a highly relevant and interesting research topic because it contributes to a deeper understanding of the origin, development and design of Danish school policy and school practice, and the influence from transnational spaces....

  20. Post-War Migration Flows and Disparities in Mortality from Age 50 Years Onwards

    DEFF Research Database (Denmark)

    Zarulli, Virginia

    2016-01-01

    these inequalities being an important social and geopolitical feature of an area, there is still little empirical evidence on this effect. This paper contributes to deepening the knowledge about this phenomenon by investigating whether post-war internal migration in Italy affected the pattern of mortality inequality...... effect. However, low-educated individuals are employed in heavier and riskier jobs. They thus undergo a faster health selection due to exposure to a higher mortality risk that selects the most robust individuals. This paper hypothesised that the interplay of these mechanisms might have produced...

  1. 75 FR 43069 - Approval of One-Year Extension for Attaining the 1997 8-Hour Ozone Standard in the Baltimore...

    Science.gov (United States)

    2010-07-23

    ... Nonattainment Area 4th Max 8-HR Site ID County/State Year (ppm) 24-003-0014 Anne Arundel, MD 2009 0.070 24-005..., South Coast Air Quality Management District v. EPA, 472 F.3d 882 (DC Cir. 2006), modified and rehearing den., 489 F.3d 1245 (DC Cir. 2007). The severe area requirements are more stringent than both the...

  2. Urinary incontinence and vaginal squeeze pressure two years post-cesarean delivery in primiparous women with previous gestational diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Angélica Mércia Pascon Barbosa

    2011-01-01

    Full Text Available OBJECTIVE: To assess the prevalence of urinary incontinence and associated vaginal squeeze pressure in primiparous women with and without previous gestational diabetes mellitus two years post-cesarean delivery. METHODS: Primiparous women who delivered by cesarean two years previously were interviewed about the delivery and the occurrence of incontinence. Incontinence was reported by the women and vaginal pressure evaluated by a Perina perineometer. Sixty-three women with gestational diabetes and 98 women without the disease were screened for incontinence and vaginal pressure. Multiple logistic regression models were used to evaluate the independent effects of gestational diabetes. RESULTS: The prevalence of gestational incontinence was higher among women with gestational diabetes during their pregnancies (50.8% vs. 31.6% and two years after a cesarean (44.8% vs. 18.4%. Decreased vaginal pressure was also significantly higher among women with gestational diabetes (53.9% vs. 37.8%. Maternal weight gain and newborn weight were risk factors for decreased vaginal pressure. Maternal age, gestational incontinence and decreased vaginal pressure were risk factors for incontinence two years after a cesarean. In a multivariate logistic model, gestational diabetes was an independent risk factor for gestational incontinence. CONCLUSIONS: The prevalence of incontinence and decreased vaginal pressure two years post-cesarean were elevated among women with gestational diabetes compared to women who were normoglycemic during pregnancy. We confirmed an association between gestational diabetes mellitus and a subsequent decrease of vaginal pressure two years post-cesarean. These results may warrant more comprehensive prospective and translational studies.

  3. In the 25th year of bioethics publishing: new challenges of the post-truth era.

    Science.gov (United States)

    Jesani, Amar

    2017-01-01

    As IJME enters its 25th year of publication, all of us closely associated with the journal look back on this journey with a degree of satisfaction. Not only has the only bioethics journal published from India survived for 24 years, it has also produced some extraordinary successes. As you read this issue, we will be celebrating the 12th year of the biennial National Bioethics Conferences - the sixth NBC will take place in Pune from January 13 to 15, 2017.

  4. Nine-Year Core Study Data for Sientra's FDA-Approved Round and Shaped Implants with High-Strength Cohesive Silicone Gel.

    Science.gov (United States)

    Stevens, W Grant; Calobrace, M Bradley; Harrington, Jennifer; Alizadeh, Kaveh; Zeidler, Kamakshi R; d'Incelli, Rosalyn C

    2016-04-01

    Since approval in March 2012, data on Sientra's (Santa Barbara, CA) silicone gel implants have been updated and published regularly to provide immediate visibility to the continued safety and performance of these devices. The 9 year follow-up data support the previously published data confirming the ongoing safety and efficacy of Sientra silicone gel breast implants. The authors provide updated 9 year study data for Sientra's round and shaped silicone gel breast implants. The Core Study is an ongoing 10 year study that enrolled 1788 patients with 3506 Sientra implants across four indications (primary augmentation, revision-augmentation, primary reconstruction, and revision-reconstruction). For the safety analysis, Kaplan-Meier risk rates were calculated to evaluate postoperative complications, including all breast implant-related adverse effects. For the effectiveness analyses, results were presented through 8 years as patient satisfaction scores were assessed at even years. Through 9 years, the overall risk of capsular contracture was 12.6%. Smooth devices (16.6%, 95% CI, 14.2%, 19.5%) had a statistically significantly higher rate of capsular contracture compared to textured devices (8.0%, 95% CI, 6.2%, 10.4%). Out of the 610 reoperations in 477 patients, over half of all reoperations were due to cosmetic reasons (n = 315; 51.6%). Patient satisfaction remains high through 8 years, with 90% of primary augmentation patients indicating their breast implants look natural and feel soft. The 9-year follow-up data from the ongoing Core Study of the Sientra portfolio of HSC and HSC+ silicone gel breast implants reaffirm the very strong safety profile as well as continued patient satisfaction. 2 Therapeutic. © 2016 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: journals.permissions@oup.com.

  5. Results of 24 years of selection for post-weaning weight on the ...

    African Journals Online (AJOL)

    Tobias

    The annual genetic trend estimates were 0.98 ± 0.17 kg/year for W378 and 0.27 ± 0.15 kg/year for ... some foundation females of the government herd. .... matrix of all animals born from 1979, using Quaas (1976) algorithms and Boldman et al.

  6. The post-Yugoslav space on a demographic crossway: 25 years after the collapse of Yugoslavia

    Directory of Open Access Journals (Sweden)

    Josipovič Damir

    2016-01-01

    Full Text Available The aim of the article is to integrally assess the demographic changes after 1990. It is presumed that considerable variations exist in terms of intensity of demographic processes. The following analyses encompassed the relevant national or regional statistics, employing methodological adjustment in order to enable data comparison. Herewith, the changing definitions of population presented a special analytical problem. The so-called principle of “permanent” residence was largely replaced with the principle of “usual” residence. By way of the usual residence it was possible to single out the present population and thus to approach the analysis. The main goal was to assess the direct and indirect demographic loss within the post-Yugoslav space. The combined analysis showed that the whole post Yugoslav area suffered a loss of about 5 million inhabitants (including the permanent emigration of the former guest-workers. Except from Slovenia, and stagnating Montenegro and Macedonia, all other countries from the Yugoslav space have lost more or less of their population. Losing a quarter of its pre-war population, Bosnia-Herzegovina suffered the most (1.093 million, but the high loss was determined also for the neighboring Serbia and Croatia. Serbia within its pre-war territory lost almost a million or one tenth of its population, while Croatia lost more than half a million or one ninth of its population. The three core Yugoslav areas lost more than 2.5 million. The analyses confirmed the striking regional differences as well. The highest relative depopulation was recorded in Republika Srpska of Bosnia-Herzegovina.

  7. Metabolic syndrome and fatal outcomes in the post-stroke event: a 5-year cohort study in Cameroon.

    Directory of Open Access Journals (Sweden)

    Eric Vounsia Balti

    Full Text Available BACKGROUND AND PURPOSE: Determinants of post-acute stroke outcomes in Africa have been less investigated. We assessed the association of metabolic syndrome (MetS and insulin resistance with post-stroke mortality in patients with first-ever-in-lifetime stroke in the capital city of Cameroon (sub-Saharan Africa. METHODS: Patients with an acute first-stroke event (n = 57 were recruited between May and October 2006, and followed for 5 years for mortality outcome. MetS definition was based on the Joint Interim Statement 2009, insulin sensitivity/resistance assessed via glucose-to-insulin ratio, quantitative insulin sensitivity check index and homeostatic model assessment. RESULTS: Overall, 24 (42% patients deceased during follow-up. The prevalence of MetS was higher in patients who died after 28 days, 1 year and 5 years from any cause or cardiovascular-related causes (all p≤0.040. MetS was associated with an increased overall mortality both after 1 year (39% vs. 9% and 5 years of follow-up (55% vs. 26%, p = 0.022. Similarly, fatal events due to cardiovascular-related conditions were more frequent in the presence of MetS both 1 year (37% vs. 9% and 5 years after the first-ever-in-lifetime stroke (43% vs. 13%, p = 0.017. Unlike biochemical measures of insulin sensitivity and resistance (non-significant, in age- and sex-adjusted Cox models, MetS was associated with hazard ratio (95% CI of 2.63 (1.03-6.73 and 3.54 (1.00-12.56 respectively for all-cause and cardiovascular mortality 5 years after stroke onset. CONCLUSION: The Joint Interim Statement 2009 definition of MetS may aid the identification of a subgroup of black African stroke patients who may benefit from intensification of risk factor management.

  8. Race and Sex Differences in Post-Myocardial Infarction Angina Frequency and Risk of 1-Year Unplanned Rehospitalization.

    Science.gov (United States)

    Hess, Connie N; Kaltenbach, Lisa A; Doll, Jacob A; Cohen, David J; Peterson, Eric D; Wang, Tracy Y

    2017-02-07

    Race and sex disparities in in-hospital treatment and outcomes of patients with acute myocardial infarction (MI) have been described, but little is known about race and sex differences in post-MI angina and long-term risk of unplanned rehospitalization. We examined race and sex differences in post-MI angina frequency and 1-year unplanned rehospitalization to identify factors associated with unplanned rehospitalization, testing for whether race and sex modify these relationships. Using TRANSLATE-ACS (Treatment With Adenosine Diphosphate Receptor Inhibitors: Longitudinal Assessment of Treatment Patterns and Events after Acute Coronary Syndrome) data, we examined 6-week and 1-year angina frequency and 1-year unplanned rehospitalization stratified by race and sex among MI patients treated with percutaneous coronary intervention. We used multivariable logistic regression to assess factors associated with unplanned rehospitalization and tested for interactions among angina frequency, race, and sex. A total of 11 595 MI patients survived to 1 year postdischarge; there were 66.6% white male patients, 24.3% white female patients, 5.3% black male patients, and 3.8% black female patients. Overall, 29.7% had angina at 6 weeks, and 20.6% had angina at 1 year postdischarge. Relative to white patients, black patients were more likely to have angina at 6 weeks (female: 44.2% versus 31.8%; male: 33.5% versus 27.1%; both Prace or sex (adjusted 3-way P interaction =0.41). One-fifth of MI patients treated with percutaneous coronary intervention report 1-year postdischarge angina, with black and female patients more likely to have angina and to be rehospitalized. Better treatment of post-MI angina may improve patient quality of life and quality of care and help to lower rates of rehospitalization overall and particularly among black and female patients, given their high prevalence of post-MI angina. URL: http://www.clinicaltrials.gov. Unique identifier: NCT01088503. © 2017 American

  9. A comparison of the immune response between early exposed and 1 year post exposure to Bacillus anthracis in Indonesia

    Science.gov (United States)

    Redhono, D.; Kusumawardani, A.; Dirgahayu, P.

    2018-03-01

    Anthrax is one of the zoonotic diseases that usually affects animals and can be transmitted to humans. Immune response of the body during an infection is the presence of antibodies as an effort to defend the body and it will survive for some time in the blood. The aim study is to find out how the initial response to the formation of antibodies and how these antibodies survive after one year. This study is cohort to people exposed to anthrax and found 130 people exposed to anthrax. The most risk factor was direct contact and consumed infected animal meat, which was 34.6%. Clinical manifestations of the skin were 12.3% and all respondents showed positive IgG. While 87.7% did not show any anthrax symptoms. IgG serum examination after 1 year of exposure to anthrax obtained 3.8% still detected antibodies in the body. The relationship between IgG titers with clinical manifestations of anthrax at one year post-outbreak is highly significant p 0.028. In conclusion a significant association between the clinical manifestation with antibody serum anthrax and it still detected after one-year post outbreaks of anthrax.

  10. Post-traumatic stress symptoms, parenting stress and mother-child relationships following childbirth and at 2 years postpartum.

    Science.gov (United States)

    McDonald, Sarah; Slade, Pauline; Spiby, Helen; Iles, Jane

    2011-09-01

    This study examined the prevalence of childbirth-related post-traumatic stress (PTS) symptoms at 2 years postpartum and the relationship between such symptoms and both self-reported parenting stress and perceptions of the mother-child relationship. 81 women completed measures of childbirth-related PTS symptoms at 6 weeks and 3 months postpartum; these results were used in an exploration of their predictive links with mother-child relationship and parenting measures at 2 years. 17.3% of respondents reported some PTS symptoms at a clinically significant level at 2 years postpartum. However, these symptoms were only weakly linked to parenting stress and were not related to mothers' perceptions of their children. However earlier PTS symptoms within 3 months of childbirth did show limited associations with parenting stress at 2 years but no association with child relationship outcomes once current depression was taken into account. Implications for clinical practice and the concept of childbirth-related post-traumatic stress disorder are discussed.

  11. Kidney function and specific mortality in 60-80 years old post-myocardial infarction patients: A 10-year follow-up study.

    Directory of Open Access Journals (Sweden)

    Ellen K Hoogeveen

    Full Text Available Chronic kidney disease (CKD is highly prevalent among older post-myocardial infarction (MI patients. It is not known whether CKD is an independent risk factor for mortality in older post-MI patients with optimal cardiovascular drug-treatment. Therefore, we studied the relation between kidney function and all-cause and specific mortality among older post-MI patients, without severe heart failure, who are treated with state-of-the-art pharmacotherapy. From 2002-2006, 4,561 Dutch post-MI patients were enrolled and followed until death or January 2012. We estimated Glomerular Filtration Rate (eGFR with cystatin C (cysC and creatinine (cr using the CKD-EPI equations and analyzed the relation with any and major causes of death using Cox models and restricted cubic splines. Mean (SD for age was 69 years (5.6, 79% were men, 17% smoked, 21% had diabetes, 90% used antihypertensive drugs, 98% used antithrombotic drugs and 85% used statins. Patients were divided into four categories of baseline eGFRcysC: ≥90 (33%; reference, 60-89 (47%, 30-59 (18%, and <30 (2% ml/min/1.73m2. Median follow-up was 6.4 years. During follow-up, 873 (19% patients died: 370 (42% from cardiovascular causes, 309 (35% from cancer, and 194 (22% from other causes. After adjustment for age, sex and classic cardiovascular risk factor, hazard ratios (95%-confidence intervals for any death according to the four eGFRcysC categories were: 1 (reference, 1.4 (1.1-1.7, 2.9 (2.3-3.6 and 4.4 (3.0-6.4. The hazard ratios of all-cause and cause-specific mortality increased linearly below kidney functions of 80 ml/min/1.73 m2. Weaker results were obtained for eGFRcr. To conclude, we found in optimal cardiovascular drug-treated post-MI patients an inverse graded relation between kidney function and mortality for both cardiovascular as well as non-cardiovascular causes. Risk of mortality increased linearly below kidney function of about 80 ml/min/1.73 m2.

  12. Post-marketing surveillance of CustomBone Service implanted in children under 7 years old.

    Science.gov (United States)

    Frassanito, Paolo; Tamburrini, Gianpiero; Massimi, Luca; Di Rocco, Concezio; Nataloni, Angelo; Fabbri, Greta; Caldarelli, Massimo

    2015-01-01

    The CustomBone Service is a bioceramic implant suitable for cranial repair in both adults and children, although there are no clinical data about its use in children under 7 years of age. This surveillance study investigates the outcome in this age group. Twenty-eight children under 7 years old (range, 2.5-6 years) received CustomBone Service from July 2006 to May 2013 in 16 international hospitals. Data of 23 children (12 males and 11 females), harboring 24 prosthesis, were available with a minimum follow-up of 1 year. Sites of the cranial defect were frontal or parietal (20.8 % each), parieto-temporal (16.7 %), fronto-parietal or occipital (12.5 % each), fronto-parieto-temporal or fronto-temporal (8.3 % each). Initial diseases were trauma (54.2 %), malformation (37.5 %), or tumor of the bone/skin (8.3 %). Rupture of the implant occurred in a single case during the implant (1/26 surgeries, 3.8 %) and the cranial repair was achieved by means of the back-up prosthesis. Five adverse events were registered during the follow-up period consisting of three cases of fracture and two of exposure/infection of the prosthesis. All cases required the removal of the device (20.8 %). The failure rate of CustomBone Service under 7 years of age was higher than reported in adults and children over 7 years old (20.8 vs. 3.8 %), However, CustomBone Service may be considered a valid option under 7 years old since other materials are burdened by more significant rates of complications in the long-term period. Due to specific properties of this material, indication to CustomBone Service in toddlers should be carefully evaluated by the surgeon on a case-by-case basis.

  13. Institutional care and iron deficiency increase ADHD symptomology and lower IQ 2.5-5 years post-adoption.

    Science.gov (United States)

    Doom, Jenalee R; Georgieff, Michael K; Gunnar, Megan R

    2015-05-01

    Increased ADHD symptomology and lower IQ have been reported in internationally adopted (IA) children compared to non-adopted peers (Hostinar, Stellern, Schaefer, Carlson & Gunnar, 2012; Kreppner, O'Connor & Rutter, 2001). However, it is unclear whether these outcomes are due to institutional deprivation specifically or to co-occurring micronutrient deficiencies that disrupt brain development (Fuglestad, Rao & Georgieff, 2008b). In this study, IA children were compared to children raised in their biological families to examine differences in ADHD symptomology and IQ 2.5-5 years post-adoption and to assess the contributions of iron deficiency (ID) and duration of deprivation to these cognitive outcomes. ADHD symptoms (parent- and experimenter-reported) and IQ were evaluated in 88 IA (M = 62.1 months, SD = 2.4) and 35 non-adopted children (M = 61.4 months, SD = 1.6). IA children were assessed 29-64 months post-adoption (M = 41.9 months, SD = 10.2). ID was assessed during the initial post-adoption medical visit in 69 children, and children were classified into four groups by iron status, ranging from normal to ID anemia (most severe). IA children had greater ADHD symptomology, p IQ, p = .001, than non-adopted children. Within the IA group, children with more severe ID at adoption had greater ADHD symptomology, r(69) = 0.40, p = .001, and lower IQ, r(68) = -0.28, p IQ, r(85) = -.08, p = .52. Longitudinal results indicate improvement in IQ from 12 months post-adoption to age 5 for children with greater ID severity at adoption and longer duration of institutional care but no improvement in ADHD symptoms. These results signify continuing effects of early deprivation and ID on ADHD symptoms and IQ years after adoption. A video abstract of this article can be viewed at http://www.youtube.com/watch?v=vUFDAS3DD1c. © 2014 John Wiley & Sons Ltd.

  14. The first year post-Chernobyl events in the Republic of Moldova

    International Nuclear Information System (INIS)

    Bahnarel, I.

    2009-01-01

    The accident at Chernobyl NPP lead to the increasing of background radiation and to the radioactive contamination on the whole area of the Republic of Moldova. The first signs of decrease of radiation situation in Moldova after the accident were revealed in the second part of April 28, 1986. The radiation background reached 100-120 μR/hour. The content of artificial radio-nuclides in air, water, soil, foodstuffs increased. Monitoring of radiation background on the territory of the Republic of Moldova in the post- Chernobyl period was analyzed constantly. During this time the workers of sanitary-and-epidemiologic institution made more than 20,000 measurements of radiation background, 3,000 radiochemical investigations and 700 using gamma-spectrometry researches. In this period radiological laboratories made workshops for the paramedical workers, where they defined the objectives of activity for medical institutions in new conditions. The Ministry of Public Health banned food, in which the content of radioactive iodine, cesium and strontium was high.

  15. Building a four year post-secondary curriculum in educational science and technology

    NARCIS (Netherlands)

    Plomp, T.; Verhagen, Pleunes Willem

    1982-01-01

    This report begins by providing background information on educational technology in the Netherlands, differences between a four-year program in the Netherlands and undergraduate programs in the United States, and the structure of Dutch university programs. The need for a Department of Educational

  16. Self-Perception of Medical Students' Knowledge and Interest in Disaster Medicine: Nine Years After the Approval of the Curriculum in German Universities.

    Science.gov (United States)

    Wunderlich, Robert; Ragazzoni, Luca; Ingrassia, Pier Luigi; Corte, Francesco Della; Grundgeiger, Jan; Bickelmayer, Jens Werner; Domres, Bernd

    2017-08-01

    Following the recommendations of the World Association for Disaster and Emergency Medicine (WADEM; Madison, Wisconsin USA) to develop standards for training the undergraduates in disaster-relevant fields (2004), a German curriculum was approved in 2006. This paper aims to describe the level of training and interest of medical students nine years later. Problem The aim of this study was to assess the self-perception of medical students' knowledge and interest in disaster medicine nine years after the implementation of a standardized disaster medicine curriculum in German medical schools. This prospective, cross-sectional, observational study was conducted with medical students in Germany using a web-based, purpose-designed questionnaire consisting of 27 mandatory and 11 optional questions. Nine hundred ninety-two students from 36 of 37 medical schools in Germany participated. More than one-half of medical students were aware of the field of disaster medicine. One hundred twenty-one students undertook training internally within their university and 307 undertook training externally at other institutions. Only a small content of the curriculum was taught. A difference in self-perception of knowledge between trained and untrained participants was found, despite the level of training being low in both groups. Participants were generally highly motivated to learn disaster medicine in a variety of institutions. German students are still largely not well educated regarding disaster medicine, despite their high motivation. The curriculum of 2006 was not implemented as originally planned and the number of trained students still remains low as the self-perception of knowledge. Currently, there is no clear and standardized training concept in place. A renewal in the agreement of implementation of the curriculum at medical schools should be targeted in order to follow the recommendation of WADEM. Wunderlich R Ragazzoni L Ingrassia PL Della Corte F Grundgeiger J Bickelmayer JW

  17. Hydrodynamically induced dryout and post dryout important to heavy water reactors: A yearly progress report

    International Nuclear Information System (INIS)

    Ishii, M.; Revankar, S.T.; Babelli, I.; Lele, S.

    1992-06-01

    Recently, the safety of low pressure liquid cooled nuclear reactors has become a very important issue with reference to the operation of the heavy water reactors at Savannah River Plant. Under accident conditions such as loss-of-flow or loss-of-coolant, these reactors typically encounter unstable two-phase flow which may lead to the occurrence of dryout and subsequent fuel failure. An analytical study using the one-dimensional drift flux model was carried out to investigate the two-phase flow instability for Westinghouse Savannah River Site reactor. The analysis indicates that the first and higher order instabilities exist in the possible transient operational conditions. The instabilities are encountered at higher heat fluxes or lower flow rates. The subcooling has a stabilizing effect except at very low subcooling. An experimental loop has been designed and constructed to study the CBF induced by various flow instabilities. Details of this test loop are presented. Initial test results have been presented. The two-phase flow regimes and hydrodynamic behaviors in the post dryout region have been studied under propagating rewetting conditions. The effect of subcooling and inlet velocity on flow transition as well as on the quench front propagation was investigated. The test liquid was Freon 113 which was introduced into the bottom of the quartz test section whose walls were maintained well above the film boiling temperature of the test liquid, via a transparent heat transfer fluid. The flow regimes observed down stream of the upward moving quench front were the rough wavy, the agitated, and the dispersed droplet/ligaments. A correlation for the flow regime transition between the inverted annular and the dispersed droplet/ligament flow patterns was developed. The correlation showed a marked dependence on the void fraction at the CBF location and hence on the flow regime encountered in the pre-CBF region

  18. Lung function in 6 years old children born very preterm and fed different diets post discharge

    DEFF Research Database (Denmark)

    Toftlund, Line Hedegaard; Agertoft, Lone; Halken, Susanne

    Background: Research has shown that being born preterm may affect lung capacity later in childhood. It is though unknown if type of early nutrition influences lung capacity and the risk of developing asthma in childhood. Aim: The aim was to investigate if type of early nutrition has an impact...... on lung function and the possible risk of developing asthma among 6 year old children born very preterm. Method: A prospective, randomized, interventional multicentre study on nutrition of a preterm birth cohort has been established and described previously. The inclusion criteria were gestational age...... ≤ 32 weeks. From hospital discharge to 4 month corrected age, the children received three different types of nutrition: A: Human milk (HM) B: HM enriched with fortifier (HMF) C: Preterm formula (PF). At the age of 6 years, the children performed an occlusion test (Rocc) and a lung resistance test...

  19. [Publicly employed physicians--war years and post-war judicial process].

    Science.gov (United States)

    Schiøtz, A

    1995-12-10

    During the Second World War, publicly employed medical officers in Norway were given a role which disharmonized in many ways with the role they had before 9 April 1940. They had been employed on terms which included loyalty towards employer, colleagues and patients. After the outbreak of the war and for five years to come, loyalties were put to the test. At the same time their actual services became more demanding. Their daily work was complicated by various laws and regulations, and the political situation in general hindered personal and professional development and free communication between doctors and patients, and between colleagues. After the war the central medical administration was relentless and the sanctions against those who had supported the occupying powers were exceptionally hard. The author emphasizes the doctors' personal experiences during the war and the first postwar years. The most important sources are personal testimonies, as they come forth in public records, biographies and interviews.

  20. No Racial Difference in Rehabilitation Therapy Across All Post-Acute Care Settings in the Year Following a Stroke.

    Science.gov (United States)

    Skolarus, Lesli E; Feng, Chunyang; Burke, James F

    2017-12-01

    Black stroke survivors experience greater poststroke disability than whites. Differences in post-acute rehabilitation may contribute to this disparity. Therefore, we estimated racial differences in rehabilitation therapy utilization, intensity, and the number of post-acute care settings in the first year after a stroke. We used national Medicare data to study 186 168 elderly black and white patients hospitalized with a primary diagnosis of stroke in 2011. We tabulated the proportion of stroke survivors receiving physical, occupational, and speech and language therapy in each post-acute care setting (inpatient rehabilitation facility, skilled nursing facility, and home health agency), minutes of therapy, and number of transitions between settings. We then used generalized linear models to determine whether racial differences in minutes of physical therapy were influenced by demographics, comorbidities, thrombolysis, and markers of stroke severity. Black stroke patients were more likely to receive each type of therapy than white stroke patients. Compared with white stroke patients, black stroke patients received more minutes of physical therapy (897.8 versus 743.4; P rehabilitation therapy utilization or intensity after accounting for patient characteristics. It is unlikely that differences in rehabilitation utilization or intensity are important contributors to racial disparities in poststroke disability. © 2017 American Heart Association, Inc.

  1. Two years post-stroke, Luxembourgish informal caregivers’ life satisfaction and their couple and family repercussions

    OpenAIRE

    Lurbe-Puerto, Katia; Baumann, Michèle; Le Bihan, Etienne

    2010-01-01

    This study aims to improve our understanding of the changes in the couple and family lives of stroke survivors’ caregivers and to analyse the relationships between the Caregivers’ Life Satisfaction (CLS) and the social and emotional repercussions of the caregiving role, two years after this event. Life satisfaction, optimism about the future, happiness and other subjective well-being aspects have attracted the European policymakers, leading to the Eurofund to introduce a “life satisfaction” d...

  2. Latvian Chernobyl clean-up workers dynamics of morbidity 15 years of the post radiation period

    International Nuclear Information System (INIS)

    Zvagule, T.; Eglite, M.; Bruvere, R.; Gabruseva, N.; Feldmane, G.

    2003-01-01

    Nearly 1.0% of the male population of Latvia were sent (1986-1991) to Chernobyl to assist in the clean-up activities after the nuclear power plant accident (1986). The prevalence of all types of diseases, dynamic of breaking out of the key symptoms and interferon status were evaluated in respect to date of work, duration of work and kind of work in the whole clean-up workers group and in the particular group with seizures of unconsciousness. The disease incidence in clean-up workers from Latvia exceeds that observed in age and sex matched male population. Most had several diseases each and their poly-symptomatic sicknesses exhibited tendency to progress even 10-14 years after the exposure (during 1996-2000). Diseases of nervous, digestive and circulatory system, mental disorders and diseases of muscles and connective tissue were the most frequent. The primary outset of symptoms being low in the first 2-3 years after the work gradually increased during the following 10 years. Leukopenia was predominant in 1990-1993 and leucocytosis in 1997-2000. Ability of leukocytes to produce interferons was significantly decreased. Since the external radiation doses did not exceed 50 centyGy (cGy) there is sufficient reasons to believe that the principal cause of the gradually increased frequency of health problems is the long-life radioisotopes incorporated in the clean-up workers bodies as permanent radiation and toxic compounds source. (authors)

  3. Case report: transpalatal arch resulting in soft tissue damage of the tongue 3 years post-orthodontic treatment.

    Science.gov (United States)

    Noar, Joe; Woods, Eva; Hodgson, Tim

    2015-03-01

    Whilst transient effects of orthodontic appliances on the oral mucosa are well recognized, chronic lesions, persisting post therapy are unusual. We describe a persistent lingual mucosal defect related to a transpalatal arch (TPA) in a healthy 19-year-old female. The asymptomatic lesion is presently being monitored, however, surgical revision in the future may be requested by the patient if the area fails to remodel. Clinical Relevance: Soft tissue trauma to the tongue by anchorage reinforcing appliances may result in long-term effects that could require surgical management.

  4. Contact Between Birth and Adoptive Families During the First Year Post-Placement: Perspectives of Lesbian, Gay, and Heterosexual Parents.

    Science.gov (United States)

    Farr, Rachel H; Goldberg, Abbie E

    Despite growing visibility of lesbian- and gay-parent adoption, only one qualitative study has examined birth family contact among adoptive families with lesbian and gay parents (Goldberg, Kinkler, Richardson, & Downing, 2011). We studied adoptive parents' (34 lesbian, 32 gay, and 37 heterosexual; N = 103 families) perspectives of birth family contact across the first year post-placement. Using questionnaire and interview data, we found few differences in openness dynamics by parental sexual orientation. Most reported some birth mother contact, most had legally finalized their adoption, and few described plans to withhold information from children. We discuss implications for clinical practice, policy, and research.

  5. The Chernobyl – Thirty Years After The Post – Accidental Radiological – Hygienic and Medical Consequences

    Directory of Open Access Journals (Sweden)

    G. G. Onishchenko

    2016-01-01

    Full Text Available As the result of the Chernobyl NPP accident more than 200 thousand square kilometers of the European territories were contaminated by Cs-137 in the amount of above 37 kBq/m2 (1 Ci/km2 . Belorussia, Russia and Ukraine amount up to 70% of this entire affected area. More than 600 000 people were engaged in the accidental cleanup operations, 340000 were evacuated or relocated within 1986-1991. The early stage evacuation efficacy is confirmed by the absence of acute radiation syndrome among the population and by the prevented collective dose which amounts to no less than 10 000 man/Sv. The effective measure to reduce the internal radiation dose to the population at the early accidental stage was introduction of maximum tentative permissive levels of radionuclide content in the foodstuffs.Among the identified post -accident medical consequences of the Chernobyl is the radiation syndrome found in 134 emergency cleanup workers within the first 24 hours of the accident’s development. Out of that number, 28 people died within the first four months, 19 people died before 2006. The accident’s liquidators developed radiation -induced leukemia ( the attributive risk value is 45-60% . People exposed to high radiation doses display the statistically significant 18% morbidity increase of all types of solid cancers at the doses above 150 mSv. There is the statistically significant information indicating the increased amount of thyroid cancer morbidity among those who were just children and teenagers at the time of the accident. The adverse psychological consequences are accounted for not just the fear of overexposure but also for the disturbance of the habitual lifestyle especially mindful of the forced relocation.The longterm protection measures, radionuclide decay and selfcleaning of the contaminated areas resulted in the drastic reduction of the population dose in the radioactively contaminated territories. In 2015, only in some settlements of the Briansk

  6. Twenty years of „post-communism”: the radiography of a political failure

    Directory of Open Access Journals (Sweden)

    Aurora Martin

    2011-11-01

    Full Text Available This empirical view on the current „state” of Romania has as main objective to emphasize that the contemporary economic crisis actually revealed some other escalated crises in the very heart of the Romanian society. The vicious circle determined by three crises – one political, another social-institutional and last, but not least, a cultural one, continuously weakened the state for the last twenty years. Romania will overcome the economic crisis but the key for walking out of the above-mentioned circle would be the real transformation of its core systems – political, institutional and educational.

  7. Personality disorder features as predictors of symptoms five years post-treatment.

    Science.gov (United States)

    Jansson, Irene; Hesse, Morten; Fridell, Mats

    2008-01-01

    Personality disorders are associated with dysfunction in a variety of areas. Recent longitudinal research has shown that personality disorders are also predictive of problems later in life, as well as of poor response to treatment of depression and anxiety. This study assessed whether personality disorder features were associated with psychiatric symptoms in a cohort of women treated for substance abuse in Sweden. Patients were diagnosed with personality disorders using the Structured Clinical Interview for DSM-IV (SCID-II) personality questionnaire and SCID-II interview, and were then administered a self-report questionnaire designed to measure symptoms of psychiatric illness, the Symptoms Checklist-90 (SCL-90), during and five years after treatment. Concurrently, features of all personality disorders, except histrionic, were associated with SCL-90 score. At five-year follow-up, most personality disorders remained associated with SCL-90 score, with the exception of paranoid and schizoid personality disorder. After controlling for baseline score on the SCL-90, conduct disorder, borderline personality disorder, and narcissistic personality disorder remained significantly associated with symptoms at follow-up. After controlling for abstinence and baseline score, only borderline personality disorder features remained associated with SCL-90 score at follow-up. Patients with personality disorders should be monitored after treatment for psychiatric symptoms.

  8. Deep Vadose Zone Treatability Test for the Hanford Central Plateau: Interim Post-Desiccation Monitoring Results, Fiscal Year 2014

    Energy Technology Data Exchange (ETDEWEB)

    Truex, Michael J. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Strickland, Christopher E. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Johnson, Christian D. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Johnson, Timothy C. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Clayton, Ray E. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Chronister, Glen B. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2014-09-01

    Over decades of operation, the U.S. Department of Energy (DOE) and its predecessors have released nearly 2 trillion L (450 billion gal.) of liquid into the vadose zone at the Hanford Site. Much of this discharge of liquid waste into the vadose zone occurred in the Central Plateau, a 200 km2 (75 mi2) area that includes approximately 800 waste sites. Some of the inorganic and radionuclide contaminants in the deep vadose zone at the Hanford Site are at depths below the limit of direct exposure pathways, but may need to be remediated to protect groundwater. The Tri-Party Agencies (DOE, U.S. Environmental Protection Agency, and Washington State Department of Ecology) established Milestone M 015 50, which directed DOE to submit a treatability test plan for remediation of technetium-99 (Tc-99) and uranium in the deep vadose zone. These contaminants are mobile in the subsurface environment and have been detected at high concentrations deep in the vadose zone, and at some locations have reached groundwater. Testing technologies for remediating Tc-99 and uranium will also provide information relevant for remediating other contaminants in the vadose zone. A field test of desiccation is being conducted as an element of the DOE test plan published in March 2008 to meet Milestone M 015 50. The active desiccation portion of the test has been completed. Monitoring data have been collected at the field test site during the post-desiccation period and are reported herein. This is an interim data summary report that includes about 3 years of post-desiccation monitoring data. The DOE field test plan proscribes a total of 5 years of post-desiccation monitoring.

  9. Post-Closure Inspection and Monitoring Report for the Salmon, Mississippi, Site Calendar Year 2007

    International Nuclear Information System (INIS)

    2008-01-01

    This report summarizes inspection and monitoring activities performed on and near the Salmon, Mississippi, Site in calendar year 2007. The Draft Long-Term Surveillance and Maintenance Plan for the Salmon Site, Lamar County, Mississippi (DOE 2007) specifies the submittal of an annual report of site activities and the results of sample analyses. This report is submitted to comply with that requirement. The Tatum Salt Dome was used by the U.S. Atomic Energy Commission (AEC) for underground nuclear testing during the cold war. The land surface above the salt dome, the Salmon Site, is located in Lamar County, Mississippi, approximately 12 miles west of Purvis (Figure 1). The U.S. Department of Energy (DOE), the successor to the AEC, is responsible for long-term surveillance and maintenance of the site. The DOE Office of Legacy Management (LM) was assigned this responsibility effective October 2006

  10. Post-Closure Inspection, Sampling, and Maintenance Report for the Salmon, Mississippi, Site Calendar Year 2010

    International Nuclear Information System (INIS)

    2011-01-01

    This report summarizes the annual inspection, sampling, measurement, and maintenance activities performed at the Salmon, Mississippi, Site in calendar year 2010. The draft Long-Term Surveillance and Maintenance Plan for the Salmon Site, Lamar County Mississippi (DOE 2007) specifies the submittal of an annual report of site activities with the results of sample analyses. The Salmon, MS, Site is a federally owned site located in Lamar County, MS, approximately 12 miles west of Purvis, MS, and about 21 miles southwest of Hattiesburg, MS (Figure 1). The U.S. Department of Energy (DOE), a successor agency to the U.S. Atomic Energy Commission (AEC), is responsible for the long-term surveillance and maintenance of the 1,470-acre site. DOE's Office of Legacy Management (LM) is the operating agent for the surface and subsurface real estate.

  11. Post-Closure Inspection, Sampling, and Maintenance Report for the Salmon, Mississippi, Site Calendar Year 2009

    Energy Technology Data Exchange (ETDEWEB)

    None

    2010-10-01

    This report summarizes the annual inspection, sampling, and maintenance activities performed on and near the Salmon, Mississippi, Site in calendar year 2009. The draft Long-Term Surveillance and Maintenance Plan for the Salmon Site, Lamar County, Mississippi (DOE 2007) specifies the submittal of an annual report of site activities and the results of sample analyses. This report complies with the annual report requirement. The Salmon, MS, Site is located in Lamar County, MS, approximately 12 miles west of Purvis, MS, and about 21 miles southwest of Hattiesburg, MS The site encompasses 1,470 acres and is not open to the general public. The U.S. Department of Energy (DOE), a successor agency to the U.S. Atomic Energy Commission (AEC), is responsible for the long-term surveillance and maintenance of the site. The DOE Office of Legacy Management (LM) was assigned responsibility for the site effective October 1, 2006

  12. Post-Closure Inspection, Sampling, and Maintenance Report for the Salmon, Mississippi, Site Calendar Year 2010

    Energy Technology Data Exchange (ETDEWEB)

    None

    2011-03-01

    This report summarizes the annual inspection, sampling, measurement, and maintenance activities performed at the Salmon, Mississippi, Site in calendar year 2010. The draft Long-Term Surveillance and Maintenance Plan for the Salmon Site, Lamar County Mississippi (DOE 2007) specifies the submittal of an annual report of site activities with the results of sample analyses. The Salmon, MS, Site is a federally owned site located in Lamar County, MS, approximately 12 miles west of Purvis, MS, and about 21 miles southwest of Hattiesburg, MS (Figure 1). The U.S. Department of Energy (DOE), a successor agency to the U.S. Atomic Energy Commission (AEC), is responsible for the long-term surveillance and maintenance of the 1,470-acre site. DOE's Office of Legacy Management (LM) is the operating agent for the surface and subsurface real estate.

  13. A case of post-radiation constrictive pericarditis developing 12 years after radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

    Sakuraba, Motoki; Tanaka, Jun-ichi; Ikeda, Shingo; Kigawa, Ikutaro; Fukuda, Sachito; Wanibuchi, Yasuhiko [Mitsui Memorial Hospital, Tokyo (Japan)

    1997-11-01

    A 70-year-old woman underwent radical mastectomy for carcinoma of the left breast in 1982. Postoperative radiation therapy was given in a total dose of 50 Gy for parasternal and left subclavian nodes. Symptoms of heart failure such as exertional dyspnea, facial edema, and hepatomegaly manifested in 1992. Cardiac catheterization revealed marked elevation of mean right atrial pressure and right ventricular end-diastolic pressure. The pressure wave form of the right ventricle showed the so called ``dip and plateau`` feature. Pericardiectomy without using extracorporeal circulation was performed in 1994. Operative findings and pathological study results were compatible with radiation-induced constrictive pericarditis. She rapidly recovered from heart failure after this operation, and has done very well to date. (author)

  14. The Ross Procedure in Patients among the Pediatric Population, Post Ten Years of Experience

    Directory of Open Access Journals (Sweden)

    Andrey A. Ivanov

    2013-09-01

    Full Text Available The aim of the study was to analyze the results of the surgical treatment in pediatric patients who had undergone the Ross procedure.Material and Methods: The study involved 114 patients between 12 days to 18 years in age. The early and late (up to 5 years results of the treatment were studied. The examination included echocardiography, catheterization of the cardiac chambers and angiocardiography. The case distribution of patients based on diagnosis was as follows: isolated aortic valve stenosis (IAVS in 38 (33.3% patients, aortic valve insufficiency (AVI in 33 (28.9%, and combined heart defects in 56 patients (49.1%.Results: The death rate was 6.14% during the early postoperative period and 1.14% in the late postoperative period; the actuarial survival in the long-term was 98.86%. The complication rate was 51.5%. The most frequent complication was pericarditis (25.6%, whereas cardiac and respiratory failure occurred in 7.6% of the cases and cardiac arrhythmias in 6.1% of the cases. The average time spent in the intensive care unit was 3.48 ± 2.90 days; the hospitalization period on average was 24.70±10.87 days. After surgery, there was a tendency of the echocardiographic parameters to move toward normalization. The frequency of reoperation in the late period was 23.7%, the main reason for which being the conduit dysfunction in the position of the pulmonary artery (PA.Conclusion: The clinical efficacy of the Ross procedure in the treatment of aortic valve malformations in the pediatric group was confirmed. However, in some cases, the need to perform repeated operations due to the increase in the ring size and an increase in the neo-aortic insufficiency during the somatic growth process.

  15. Post-Closure Inspection Report for Corrective Action Unit 92: Area 6 Decon Pond Facility, Nevada Test Site, Nevada, for Calendar Year 2006

    International Nuclear Information System (INIS)

    NSTec Environmental Restoration

    2007-01-01

    This Post-Closure Inspection Report provides an analysis and summary of inspections for Corrective Action Unit (CAU) 92, Area 6 Decon Pond Facility. CAU 92 was closed according to the ''Resource Conservation and Recovery Act'' (RCRA) Part B Operational Permit (Nevada Division of Environmental Protection [NDEP], 1995) and the ''Federal Facility Agreement and Consent Order'' (FFACO) of 1996 (FFACO, 1996). Closure activities were completed on February 16, 1999, and the Closure Report (U.S. Department of Energy, Nevada Operations Office, 1999) was approved and a Notice of Completion issued by NDEP on May 11, 1999. CAU 92 consists of two Corrective Action Sites (CASs), CAS 06-04-01, Decon Pad Oil/Water Separator; and CAS 06-05-02, Decontamination Pond (RCRA). Both CASs have use restrictions; however, only CAS 06-05-02 requires post-closure inspections. Visual inspections of the cover and fencing at CAS 06-05-02 are performed quarterly. Additional inspections are conducted if precipitation occurs in excess of 1.28 centimeters (cm) (0.50 inches [in.]) in a 24-hour period. This report covers calendar year 2006. Quarterly site inspections were performed in March, June, September, and December of 2006. All observations indicated the continued integrity of the unit. No issues or concerns were noted, and no corrective actions were necessary. Copies of the inspection checklists and field notes completed during each inspection are included in Appendix A of this report, and photographs taken during the site inspections are included in Appendix B of this report. One additional inspection was performed after a precipitation event that exceeded 1.28 cm (0.50 in.) within a 24-hour period during 2006. No significant changes in site conditions were noted during this inspection, and no corrective actions were necessary. A copy of the inspection checklist and field notes completed during this additional inspection is included in Appendix A of this report. Precipitation records for 2006

  16. Coarse woody debris and soil respiration 6 years post-tornado in a Piedmont forest blowdown

    Science.gov (United States)

    Oldfield, C.; Peterson, C. J.

    2017-12-01

    Severe wind disturbances can rapidly change carbon pools and fluxes in forests, causing a site to switch from a carbon sink to a source in a matter of minutes. Moreover, salvage logging after a disturbance can result in disturbed and compacted soil, altered woody debris carbon pools, and seedling mortality, all of which may further alter carbon dynamics beyond that caused by the disturbance itself. We measured down dead wood and soil respiration in the summer of 2017 at Boggs Creek Recreation Area in the Piedmont of northeast Georgia, the site of a severe tornado in 2011. Down dead wood and soil respiration were compared in control (intact forest), salvaged, and unsalvaged areas. Megagrams per hectare of down dead wood was significantly higher in the unsalvaged condition than the control or salvage logging condition (ANOVAs, pdead wood was not significantly different in the control when compared to the salvage logging condition (p=0.99). Soil respiration was significantly higher in the salvage logged condition than the control (pdead wood in a forest, and salvage logging may lead to greater soil respiration years after the initial disturbance, both of which will influence the time elapsed before a disturbed forest switches from carbon source to carbon sink. Further research is needed to determine the duration of these effects, along with the carbon consequences for other forest carbon pools.

  17. Symptoms of Post-Traumatic Stress Disorder Among Young Children 2 Years After the Great East Japan Earthquake.

    Science.gov (United States)

    Fujiwara, Takeo; Yagi, Junko; Homma, Hiroaki; Mashiko, Hirofumi; Nagao, Keizo; Okuyama, Makiko

    2017-04-01

    The aim of this study was to investigate the prevalence of post-traumatic stress disorder (PTSD) and its association with each traumatic experience among 5- to 8-year-old children 2 years after the Great East Japan Earthquake. Children ages 5-8 years who were in selected preschool classes on March 11, 2011, in 3 prefectures affected by the earthquake and 1 prefecture that was unaffected, participated in the study (N=280). PTSD symptoms were assessed through questionnaires completed by caregivers and interviews by psychiatrists or psychologists conducted between September 2012 and May 2013 (ie, 1.5-2 years after the earthquake). Among children who experienced the earthquake, 33.8% exhibited PTSD symptoms. Of the different traumatic experiences, experiencing the earthquake and the loss of distant relatives or friends were independently associated with PTSD symptoms; prevalence ratios: 6.88 (95% confidence interval [CI]: 2.06-23.0) and 2.48 (95% CI: 1.21-5.08), respectively. Approximately 1 in 3 young children in the affected communities exhibited PTSD symptoms, even 2 years after the Great East Japan Earthquake. These data may be useful for preventing PTSD symptoms after natural disasters and suggest the importance of providing appropriate mental health services for children. (Disaster Med Public Health Preparedness. 2017;11:207-215).

  18. Post-transplant increased levels of serum sCD30 is a marker for prediction of kidney allograft loss in a 5-year prospective study.

    Science.gov (United States)

    Delgado, Julio C; Pavlov, Igor Y; Shihab, Fuad S

    2009-12-01

    Levels of sCD30 represent a biomarker for early outcome in kidney transplantation. The purpose of this study was to determine the role of sCD30 levels for prediction of graft loss in the late post-transplant period. Sera were collected immediately pre-transplant and yearly thereafter for up to 5-year post-transplant in 37 primary renal transplant recipients. Levels of serum sCD30 were tested using a fluorescent microsphere assay. Levels of sCD30 significantly decreased after transplantation and remained normal in 34 patients without graft loss up to 5-year post-transplant. Elevated levels of serum sCD30 preceded the increase of serum creatinine in patients with subsequent graft loss. Elevated levels of serum sCD30 post-transplant might be a marker for predicting subsequent graft loss in the post-transplant period.

  19. An advanced communication skills course for fourth-year, post-clerkship students.

    Science.gov (United States)

    Towle, Angela; Hoffman, Joanne

    2002-11-01

    A novel five-module advanced communication skills course entitled "Doctor-Patient Relationships" was planned and implemented in 2000-01 at the University of British Columbia (UBC). The course was part of the final four-month component of the new MD undergraduate program: Effective Skills for Medical Practice. The goals of the communication skills course were to (1) address problems experienced by the students so far; (2) address deficiencies in achieving the UBC exit competencies; (3) help the students pass the Medical Council of Canada examinations, in particular objectives related to the Considerations of the Legal, Ethical, and Organizational aspects of the practice of medicine (CLEO); and (4) help students prepare for their roles beyond undergraduate medicine (residency, independent practice). The course was developed by an interdisciplinary team (family practice, pathology, pediatrics, psychiatry, surgery) with input from students. The broad strengths and weaknesses of their communication skills training were identified by seven third-year medical students who kept logs over the course of their clinical clerkships to document their learning of communication skills. Analysis of these logs plus feedback meetings with the students revealed attitudinal and skills issues that needed to be addressed in the new course. The goals and principles of the course were in part agreed upon by focus groups with students, attended by faculty observers, to ensure their relevance to students. The first module "Beyond the Mask: Surviving and Thriving in Residency Training" is designed to focus students' attention on the personal relevance of developing excellence in communication skills in preparation for residency training. It includes a video of residents talking about their experiences of communication problems to trigger reflection and discussion. In the remaining four modules the students are required to put communication skills together with their medical knowledge. Each

  20. Rwanda: a country still in post war syndrome--twelve years later.

    Science.gov (United States)

    Brown, Geraldine

    2006-01-01

    Rwanda, a small country in Central Africa is still trying to survive and rebuild itself some 12 years after the initial deadly war between two ethnic rival groups, the Hutus and the Tutsis. Since my visit in October, 1994, with a handpicked health team (two senior nursing students, an internal medicine physician, social worker, and a nurse volunteer from the District of Columbia community) on a six week mission that was a collaborative effort between Howard University and the Washington, DC based organization, Africare, Inc., very little has happened to better the lives of the citizens. The task at-hand was to assist in the promotion and repairing of a near-fatal health care delivery system, that occurred just six months after the major attack in April. Rwanda experienced a war, noted as the most brutal in the memory of the country, that killed so many people and destroyed so much of the country and its resources. Since our mission, so much has been written and new concerns have surfaced such as "Hotel Rwanda", a million dollar plus movie that truthfully tells the story of how a real-life person actually saved some 1,200 countrymen in what is carefully termed a "genocide", and the book "Left to Tell", written by a female Tutsi survivor, Immaculee Ilibagiza tells the story of how she survived the genocide and discovered that "with God all things are possible." This present article has attempted to discuss the genocide and how it relates, bringing a connection from within the inner world to the outer world through my experience of "having been there and done that" as seen by the naked human eyes.

  1. The Burden of Leprosy in Cameroon: Fifteen Years into the Post-elimination Era.

    Science.gov (United States)

    Tabah, Earnest Njih; Nsagha, Dickson Shey; Bissek, Anne-Cecile Zoung-Kanyi; Bratschi, Martin W; Njamnshi, Theophilus Ngeh; Plushke, Gerd; Njamnshi, Alfred Kongnyu

    2016-10-01

    Cameroon achieved the elimination target of leprosy in 2000, and has maintained this status ever since. However, a number of health districts in the country continue to report significant numbers of leprosy cases. The aim of this study was to assess the burden of leprosy in Cameroon from 2000 to 2014. We obtained and analysed using the new leprosy burden concept of analysis, leprosy surveillance data collected between 2000 and 2014 from the National Leprosy Control Programme. Cameroon achieved leprosy elimination in 2000, registering a prevalence rate of 0.94/10,000 population. The prevalence rate dropped further to reach 0.20/10,000 population (78% reduction) in 2014. Similarly, the new case detection rate dropped from 4.88/100,000 population in 2000 to 1.46/100,000 population (85.3% reduction) in 2014. All 10 regions of the country achieved leprosy elimination between 2000 and 2014; however, 10 health districts were still to do so by 2014. The number of high-leprosy-burden regions decreased from 8 in 2000 to 1 in 2014. Seven and two regions were respectively medium and low-burdened at the end of 2014. At the health districts level, 18 remained at the high-leprosy-burdened level in 2014. The leprosy prevalence and detection rates as well as the overall leprosy burden in Cameroon have dropped significantly between 2000 and 2014. However, a good number of health districts remain high-leprosy-burdened. The National Leprosy Control Programme should focus efforts on these health districts in the next coming years in order to further reduce the burden of leprosy in the country.

  2. Caregiver burden and emotional problems in partners of stroke patients at two months and one year post-stroke : Determinants and prediction

    NARCIS (Netherlands)

    Kruithof, Willeke J.; Post, Marcel W. M.; van Mierlo, Maria L.; van den Bos, Geertrudis A. M.; de Man-van Ginkel, Janneke M.; Visser-Meily, Johanna M. A.

    2016-01-01

    Objectives: (a) To determine levels of and factors explaining partners' burden, anxiety and depressive symptoms at two months post-stroke, (b) to predict partners' burden, anxiety and depressive symptoms at one year post-stroke based on patient and partner characteristics available at two months

  3. What "likes" have got to do with it: Exposure to peers' alcohol-related posts and perceptions of injunctive drinking norms.

    Science.gov (United States)

    Boyle, Sarah C; Smith, Daniel J; Earle, Andrew M; LaBrie, Joseph W

    2018-01-01

    Examine 1) whether observed social reinforcements (i.e., "likes") received by peers' alcohol-related social media posts are related to first-year college students' perceptions of peer approval for risky drinking behaviors; and 2) whether associations are moderated by students' alcohol use status. First-year university students (N = 296) completed an online survey in September, 2014. Participants reported their own alcohol use, friends' alcohol use, perceptions of the typical student's approval for risky drinking, and ranked 10 types of social media posts in terms of the relative numbers of "likes" received when posted by peers. Observed social reinforcement (i.e., "likes") for peers' alcohol-related posts predicted perceptions of peer approval for risky drinking behaviors among non-drinking students, but not drinking students. For first-year college students who have not yet initiated drinking, observing peers' alcohol-related posts to receive abundant "likes" may increase perceptions of peer approval for risky drinking.

  4. Safety Profile of Eslicarbazepine Acetate as Add-On Therapy in Adults with Refractory Focal-Onset Seizures: From Clinical Studies to 6 Years of Post-Marketing Experience.

    Science.gov (United States)

    Gama, Helena; Vieira, Mariana; Costa, Raquel; Graça, Joana; Magalhães, Luís M; Soares-da-Silva, Patrício

    2017-12-01

    Eslicarbazepine acetate was first approved in the European Union in 2009 as adjunctive therapy in adults with partial-onset seizures with or without secondary generalization. The objective of this study was to review the safety profile of eslicarbazepine acetate analyzing the data from several clinical studies to 6 years of post-marketing surveillance. We used a post-hoc pooled safety analysis of four phase III, double-blind, randomized, placebo-controlled studies (BIA-2093-301, -302, -303, -304) of eslicarbazepine acetate as add-on therapy in adults. Safety data of eslicarbazepine acetate in special populations of patients aged ≥65 years with partial-onset seizures (BIA-2093-401) and subjects with moderate hepatic impairment (BIA-2093-111) and renal impairment (BIA-2093-112) are also considered. The incidences of treatment-emergent adverse events, treatment-emergent adverse events leading to discontinuation, and serious adverse events were analyzed. The global safety database of eslicarbazepine acetate was analyzed for all cases from post-marketing surveillance from 1 October, 2009 to 21 October, 2015. From a pooled analysis of four phase III studies, it was concluded that the incidence of treatment-emergent adverse events, treatment-emergent adverse events leading to discontinuation, and adverse drug reactions were dose dependent. Dizziness, somnolence, headache, and nausea were the most common treatment-emergent adverse events (≥10% of patients) and the majority were of mild-to-moderate intensity. No dose-dependent trend was observed for serious adverse events and individual serious adverse events were reported in less than 1% of patients. Hyponatremia was classified as a possibly related treatment-emergent adverse event in phase III studies (1.2%); however, after 6 years of post-marketing surveillance it represents the most frequently (10.2%) reported adverse drug reaction, with more than half of these cases occurring with eslicarbazepine acetate at

  5. Three-year post-transplant medicare payments in kidney transplant recipients: Associations with pre-transplant comorbidities

    Directory of Open Access Journals (Sweden)

    Gerardo Machnicki

    2011-01-01

    Full Text Available Little is known about the influence of pre-transplant comorbidities on post-transplant expenditures. We estimated the associations between pre-transplant comorbidities and post-transplant Medicare costs, using several comorbidity classification systems. We included recipients of first-kidney deceased donor transplants from 1995 through 2002 for whom Medicare was the primary payer for at least one year pre-transplant (N = 25,175. We examined pre-transplant comorbidities as classified by International Classification of Diseases (ICD-9-CM codes from Medicare claims with the Clinical Cla-ssifications Software (CCS and Charlson and Elixhauser algorithms. Post-transplant costs were calcu-lated from payments on Medicare claims. We developed models considering Organ Procurement and Transplantation Network (OPTN variables plus: 1 CCS categories, 2 Charlson, 3 Elixhauser, 4 num-ber of Charlson and 5 number of Elixhauser comorbidities, independently. We applied a novel regression methodology to account for censoring. Costs were estimated at individual and population levels. The comorbidities with the largest impact on mean Medicare payments included cardiovascular disease, ma-lignancies, cerebrovascular disease, mental conditions and functional limitations. Skin ulcers and infec-tions, rheumatic and other connective tissue disease and liver disease also contributed to payments and have not been considered or described previously. A positive graded relationship was found between costs and the number of pre-transplant comorbidities. In conclusion, we showed that expansion beyond the usually considered pre-transplant comorbidities with inclusion of CCS and Charlson or Elixhauser comorbidities increased the knowledge about comorbidities related to augmented Medicare payments. Our expanded methodology can be used by others to assess more accurately the financial implications of renal transplantation to Medicare and individual transplant centers.

  6. Nursing students' intentions to use research as a predictor of use one year post graduation: a prospective study.

    Science.gov (United States)

    Forsman, Henrietta; Wallin, Lars; Gustavsson, Petter; Rudman, Ann

    2012-09-01

    Graduating nursing students are expected to have acquired the necessary skills to provide research-based care to patients. However, recent studies have shown that new graduate nurses report their extent of research use as relatively low. Because behavior intention is a well-known predictor of subsequent behavior, this gives reasons to further investigate graduating nursing students' intentions to use research in clinical practice after undergraduate study. To investigate graduating nursing students' intentions to use research in clinical practice and, furthermore, to investigate whether intention in itself and as a mediating variable can predict subsequent research use behavior in clinical practice one year post graduation. A follow-up study was performed of graduating nursing students in their final semester of undergraduate study (2006) and at one year post graduation (2008). Data were collected within the larger national survey LANE (Longitudinal Analysis of Nursing Education). A sample of 1319 respondents was prospectively followed. Graduating nursing students' intentions to use research instrumentally were studied as a predictor of their subsequent instrumental research use one year post graduation. A statistical full mediation model was tested to evaluate the effects of intention and factors from undergraduate study on subsequent research use in daily care. Thirty-four percent of the nursing students intended to use research on more than half or almost every working shift in their future clinical practice. Intention showed a direct effect on research use behavior. In addition, significant indirect effects on research use were shown for capability beliefs (regarding practicing the principles of evidence-based practice) and perceived support for research use (from campus and clinical education), where intention acted as a mediating factor for those effects. Students rated a modest level of intention to use research evidence. Intentions close to graduation acted

  7. The role of surgery in the treatment of post-infarction ventricular tachycardia. A 5 year experience.

    Science.gov (United States)

    Martinelli, L; Goggi, C; Graffigna, A; Salerno, J A; Chimienti, M; Klersy, C; Viganò, M

    1987-01-01

    The purpose of this report is to present a 5 year experience in electrophysiologically guided surgical treatment of post-infarction ventricular tachycardia (VT) in a consecutive series of 39 patients. In every case the arrhythmia was not responsive to pluripharmacological therapy. The diagnostic steps included preoperative endocardial, intraoperative epi- and endocardial mapping, automatically carried out when possible. Surgical techniques were: classic Guiraudon's encircling endocardial ventriculotomy (EEV), partial EEV, endocardial resection (ER), cryoablation or combined procedures. The hospital mortality was of 4 patients (10%). During the follow-up period (1-68 mo), 4 patients (11%) died of cardiac non-VT related causes. Among the survivors, 90% are in sinus rhythm. The authors consider electrophysiologically guided surgery a safe and reliable method for the treatment of post-infarction VT and suggest more extensive indications. They stress the importance of automatic mapping in pleomorphic and non-sustained VT, and the necessity of tailoring the surgical technique to the characteristics of each case.

  8. Post-traumatic stress disorder in adult victims of cluster munitions in Lebanon: a 10-year longitudinal study.

    Science.gov (United States)

    Fares, Jawad; Gebeily, Souheil; Saad, Mohamad; Harati, Hayat; Nabha, Sanaa; Said, Najwane; Kanso, Mohamad; Abdel Rassoul, Ronza; Fares, Youssef

    2017-08-18

    This study aims to explore the short-term and long-term prevalence and effects of post-traumatic stress disorder (PTSD) among victims of cluster munitions. A prospective 10-year longitudinal study that took place in Lebanon. Two-hundred-and-forty-four Lebanese civilian victims of submunition blasts, who were injured in 2006 and were over 18 years old, were interviewed. Included were participants who had been diagnosed with PTSD according to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) and the PTSD Checklist - Civilian Version in 2006. Interviewees were present for the 10-year follow-up. PTSD prevalence rates of participants in 2006 and 2016 were compared. Analysis of the demographical data pertaining to the association of long-term PTSD with other variables was performed. p Values <0.05 were considered statistically significant for all analyses (95% CI). All the 244 civilians injured by cluster munitions in 2006 responded, and were present for long-term follow-up in 2016. The prevalence of PTSD decreased significantly from 98% to 43% after 10 years (p<0.001). A lower long-term prevalence was significantly associated with male sex (p<0.001), family support (p<0.001) and religion (p<0.001). Hospitalisation (p=0.005) and severe functional impairment (p<0.001) post-trauma were significantly associated with increased prevalence of long-term PTSD. Symptoms of negative cognition and mood were more common in the long run. In addition, job instability was the most frequent socioeconomic repercussion among the participants (88%). Psychological symptoms, especially PTSD, remain high in war-affected populations many years after the war; this is particularly evident for Lebanese civilians who were victimised by cluster munitions. Screening programmes and psychological interventions need to be implemented in vulnerable populations exposed to war traumas. Officials and public health advocates should consider the socioeconomic implications, and

  9. A 5-year old male with “leukemic form” of disseminated post-transplant lymphoproliferative disorder

    Directory of Open Access Journals (Sweden)

    Saadiya Haque

    2010-03-01

    Full Text Available Post-transplant lymphoproliferative disorder (PTLD represents an abnormal lymphoid proliferation that occurs in recipients of solid organ or bone marrow allograft. It includes a diverse group of diseases ranging from polymorphic B-cell hyperplasia to frank malignant lymphoma. Clinical presentation is variable, ranging from asymptomatic to generalized lymphadenopathy, mononucleosis-like syndrome, nodal or extranodal tumors (usually gastrointestinal tract, systemic lymphomatous involvement, and rare (less than 1% of cases fulminant disseminated disease. PTLD is more common in children than in adults. Younger patients usually present with mononucleosis-like symptoms. We present an unusual case of a 5-year old male who developed a widely disseminated leukemic form of PTLD, involving lymph nodes, tonsils, multiple organs, bone marrow, cerebrospinal fluid, and peripheral blood.

  10. First year post-construction monitoring of bats and birds at Wind Turbine Test Centre Østerild

    DEFF Research Database (Denmark)

    The Department of Bioscience, Aarhus University was commissioned by the Danish Nature Agency to undertake a bat and bird monitoring programme of a national test centre for wind turbines near Østerild in Thy, Denmark. Here we present the results from the first year of the post-construction studies...... and lakes. High activities were recorded throughout the monitoring period at ponds and lakes. Overall, the bat activity level was higher in 2013 than in 2011 at ponds and lakes. Bat activity was higher near the wind turbines than at nearby forest edges. These differences suggest that bats exploit the food...... resources that accumulate on the turbine towers some nights. Whooper swan, taiga bean goose, pink-footed goose, common crane, light-bellied brent goose, white-tailed eagle and nightjar were included as focal species in the ornithological investigations. In addition, species specific data on all bird species...

  11. Computational analysis of perturbations in the post-fusion Dengue virus envelope protein highlights known epitopes and conserved residues in the Zika virus [version 2; referees: 3 approved

    Directory of Open Access Journals (Sweden)

    Sandeep Chakraborty

    2016-09-01

    Full Text Available The dramatic transformation of the Zika virus (ZIKV from a relatively unknown virus to a pathogen generating global-wide panic has exposed the dearth of detailed knowledge about this virus. Decades of research in the related Dengue virus (DENV, finally culminating in a vaccine registered for use in endemic regions (CYD-TDV in three countries, provides key insights in developing strategies for tackling ZIKV, which has caused global panic to microcephaly and Guillain-Barre Syndrome. Dengue virus (DENV, a member of the family Flaviviridae, the causal agent of the self-limiting Dengue fever and the potentially fatal hemorrhagic fever/dengue shock syndrome, has been a scourge in tropical countries for many centuries. The recently solved structure of mature ZIKV (PDB ID:5IRE has provided key insights into the structure of the envelope (E and membrane (M proteins, the primary target of neutralizing antibodies. The previously established MEPP methodology compares two conformations of the same protein and identifies residues with significant spatial and electrostatic perturbations. In the current work, MEPP analyzed the pre-and post-fusion DENV type 2 envelope (E protein, and identified several known epitopes (His317, Tyr299, Glu26, Arg188, etc. (MEPPitope. These residues are overwhelmingly conserved in ZIKV and all DENV serotypes, and also enumerates residue pairs that undergo significant polarity reversal. Characterization of α-helices in E-proteins show that α1 is not conserved in the sequence space of ZIKV and DENV. Furthermore, perturbation of α1 in the post-fusion DENV structure includes a known epitope Asp215, a residue absent in the pre-fusion α1. A cationic β-sheet in the GAG-binding domain that is stereochemically equivalent in ZIKV and all DENV serotypes is also highlighted due to a residue pair (Arg286-Arg288 that has a significant electrostatic polarity reversal upon fusion. Finally, two highly conserved residues (Thr32 and Thr40, with

  12. An analysis of characteristics of post-authorisation studies registered on the ENCePP EU PAS Register [version 2; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Robert Carroll

    2017-11-01

    Full Text Available Background: The objective of this study was to investigate the study design characteristics of Post-Authorisation Studies (PAS requested by the European Medicines Agency which were recorded on the European Union (EU PAS Register held by the European Network of Centres for Pharmacoepidemiology and Pharmacovigilance (ENCePP. Methods: We undertook a cross-sectional descriptive analysis of all studies registered on the EU PAS Register as of 18th October 2016. Results: We identified a total of 314 studies on the EU PAS Register, including 81 (26% finalised, 160 (51% ongoing and 73 (23% planned. Of those studies identified, 205 (65% included risk assessment in their scope, 133 (42% included drug utilisation and 94 (30% included effectiveness evaluation. Just over half of the studies (175; 56% used primary data capture, 135 (43% used secondary data and 4 (1% used a hybrid design combining both approaches. Risk assessment and effectiveness studies were more likely to use primary data capture (60% and 85% respectively as compared to 39% and 14% respectively for secondary. The converse was true for drug utilisation studies where 59% were secondary vs. 39% for primary. For type 2 diabetes mellitus, database studies were more commonly used (80% vs 3% chart review, 3% hybrid and 13% primary data capture study designs whereas for studies in oncology, primary data capture were more likely to be used (85% vs 4% chart review, and 11% database study designs. Conclusions: Results of this analysis show that PAS design varies according to study objectives and therapeutic area.

  13. A post audit and inverse modeling in reactive transport: 50 years of artificial recharge in the Amsterdam Water Supply Dunes

    Science.gov (United States)

    Karlsen, R. H.; Smits, F. J. C.; Stuyfzand, P. J.; Olsthoorn, T. N.; van Breukelen, B. M.

    2012-08-01

    SummaryThis article describes the post audit and inverse modeling of a 1-D forward reactive transport model. The model simulates the changes in water quality following artificial recharge of pre-treated water from the river Rhine in the Amsterdam Water Supply Dunes using the PHREEQC-2 numerical code. One observation dataset is used for model calibration, and another dataset for validation of model predictions. The total simulation time of the model is 50 years, from 1957 to 2007, with recharge composition varying on a monthly basis and the post audit is performed 26 years after the former model simulation period. The post audit revealed that the original model could reasonably predict conservative transport and kinetic redox reactions (oxygen and nitrate reduction coupled to the oxidation of soil organic carbon), but showed discrepancies in the simulation of cation exchange. Conceptualizations of the former model were inadequate to accurately simulate water quality changes controlled by cation exchange, especially concerning the breakthrough of potassium and magnesium fronts. Changes in conceptualization and model design, including the addition of five flow paths, to a total of six, and the use of parameter estimation software (PEST), resulted in a better model to measurement fit and system representation. No unique parameter set could be found for the model, primarily due to high parameter correlations, and an assessment of the predictive error was made using a calibration constrained Monte-Carlo method, and evaluated against field observations. The predictive error was found to be low for Na+ and Ca2+, except for greater travel times, while the K+ and Mg2+ error was restricted to the exchange fronts at some of the flow paths. Optimized cation exchange coefficients were relatively high, especially for potassium, but still within the observed range in literature. The exchange coefficient for potassium agrees with strong fixation on illite, a main clay mineral in

  14. IVF culture medium affects post-natal weight in humans during the first 2 years of life.

    Science.gov (United States)

    Kleijkers, Sander H M; van Montfoort, Aafke P A; Smits, Luc J M; Viechtbauer, Wolfgang; Roseboom, Tessa J; Nelissen, Ewka C M; Coonen, Edith; Derhaag, Josien G; Bastings, Lobke; Schreurs, Inge E L; Evers, Johannes L H; Dumoulin, John C M

    2014-04-01

    Is post-natal growth during the first 2 years of life in IVF singletons affected by type of medium used for culturing human embryos during an IVF treatment? The in vitro culture of human embryos in medium from Cook resulted in singletons with a lower weight during the first 2 years of life compared with singletons born after embryo culture in medium from Vitrolife. In a previous study, we reported that type of medium used for culturing human IVF embryos during the first few days after fertilization until fresh embryo transfer significantly affects fetal growth and consequently birthweight of the resulting singletons. From July 2003 to December 2006, a total of 1432 IVF treatment cycles with fresh embryo transfer were randomly allocated to have all embryos cultured in medium from Vitrolife AB (n = 715) or from Cook (n = 717). Two years after delivery, questionnaires were sent to the parents of all children requesting data about weight, height and head circumference around 1, 2, 3, 4, 6, 7.5, 9, 11, 14, 18 and 24 months of age. These measurements were collected as part of the children's health programme at municipal infant welfare centres in the Netherlands by health professionals unaware of this study. Patients requiring donor oocytes or applying for PGD were excluded from the study. From the 294 live born singletons that fulfilled our inclusion criteria, 29 were lost to follow-up. The remaining 265 singletons (Cook group: 117, Vitrolife group: 148) were included in the analysis. Data analysis included linear regression, to compare cross-sectionally weight standard deviation score (SDS), height SDS and head circumference, and the first order Berkey-Reed model for a longitudinal analysis of the growth data. Singletons in the Vitrolife group were heavier during the first 2 years of life compared with singletons in the Cook group. Cross-sectional analyses showed that adjusted weight SDS differed between groups at 1 (0.35 ± 0.14, P = 0.010), 2 (0.39 ± 0.14, P = 0

  15. Post-traumatic stress disorder and its predictors among bereaved Tibetan adolescents four years after the Yushu earthquake: a cross-sectional survey in China.

    Science.gov (United States)

    Dongling, Liu; Hui, Chen; Ling, Ma; Wenqian, Bie; Zailiang, Liu; Changying, Chen

    2017-04-01

    To examine the prevalence of post-traumatic stress disorder symptoms and to explore the predictive factors of post-traumatic stress disorder symptoms among bereaved adolescents four years after the Yushu earthquake. On 14 April 2010, the 7·1-magnitude Yushu earthquake occurred in the high-altitude, hypoxia-prone regions primarily inhabited by ethnic minorities. Many adolescents lost their parents during the earthquake. This study examined post-traumatic stress disorder and its predictors among bereaved Tibetan adolescents four years after the trauma in China. This was a cross-sectional descriptive study. This study used a cross-sectional design with 830 bereaved adolescents. Participant demographic data included gender, age and grade, and the earthquake exposure variables included the deceased relatives, whether they were buried, injured or amputated (non-life-threatening) and whether they witnessed a burial, injury or death. The post-traumatic stress disorder Checklist-Civilian version was used to assess the symptoms and prevalence of post-traumatic stress disorder, and the Coping Style Scale assessed coping styles. The results indicated that the prevalence of post-traumatic stress disorder was 19·3%. Individuals who were buried, injured or amputated (non-life-threatening), who witnessed a burial, injury or death, who suffered severe property loss during the earthquake and who had negative coping skills were the most likely individuals to have post-traumatic stress disorder symptoms. The presence of post-traumatic stress disorder was very prevalent among adolescents four years after the Yushu earthquake. Effective mental health services should be developed to facilitate postdisaster recovery for bereaved adolescents at high risk for post-traumatic stress disorder. The findings in this study improve our understanding of post-traumatic stress disorder and related risk factors in bereaved adolescents in non-Western communities, providing useful information for

  16. Evaluation of plant species composition after thirteen years post coal mining rehabilitation in East Kutai District of East Kalimantan, Indonesia

    Science.gov (United States)

    Komara, L. L.; Murtinah, V.; Arbain

    2018-04-01

    Coal mining leaving large overburden which needs to be rehabilitated by conducting reclamation and re-vegetation. This study objective was to evaluate plant species composition after thirteen years of re-vegetation activities in a coal mining rehabilitation site in KutaiTimur District, East Kalimantan, with coordinate 00º33’23”-00º38’17” NL and 117º23’55”-117º23’20” EL. This study compared rehabilitation site with the natural forest conditions sites. There were found 28 plant species in the rehabilitation site, consisting of 19 wood species (Cassia siamea and Ficus uncinata) and 9 non-wood species (Nephrolepis biserata and Miscanthus javanica).In comparison, 36 species were found in the natural forest condition, consisting of 25 woody species (Nephelium eriopetalum and Macaranga hypoleuca)and 11 non-wood species (Fordia splendidisima and Saurauia umbellata). Woody species diversity indices in the rehabilitation site after 13 years post mining (i.e., 2,21) was lower than in the natural forest sites (3,01); while the diversity indices for non-wood species were relatively similar (1,48 and 1,96 in the rehabilitation and natural forest sites respectively). Species richness of non-wood species was low, but it has a high coverage per species in this site.To restore rehabilitation site woody species to its assumed natural conditions, 22woody species should be planted.

  17. Suspected adverse reactions to contrast media in Campania Region (Italy): results from 14 years of post-marketing surveillance.

    Science.gov (United States)

    Sessa, Maurizio; Rossi, Claudia; Mascolo, Annamaria; Grassi, Enrico; Fiorentino, Sonia; Scavone, Cristina; Reginelli, Alfonso; Rotondo, Antonio; Sportiello, Liberata

    2015-01-01

    During the last years in Italy, contrast media (CM) use increased. An increase of monitoring activities on CM-induced adverse drug reaction (ADR) is necessary, also in our regional territory. The main aim of this study was to give a preliminary evaluation of all Spontaneous Reports of ADRs (SRA) attributed to CM sent to Campania Pharmacovigilance Regional Center (CRFVC) from 01 January 2001 to 31 October 2014. For each SRA we evaluated: frequency and source, ADRs onset (time to event, seriousness and outcome), socio-demographic characteristics and risk factors of cases, the most reported CM (checking for pharmacodynamic and pharmacokinetic interactions). A total of 111 SRA were sent to CRFVC; specialist in radiology was the main source of reports. Ninety-seven SRA (87.3%) were referable to hypersensitivity reactions. Thirty-four SRA (30.6%) reported serious ADRs. The most reported CM were iopamidol, gadobenic acid and gadoteric acid. We identified two SRA induced by pharmacokinetic and/or pharmacodynamic interactions. During 14 years of post-marketing surveillance, only few SRA concerning CM-induced ADRs were sent to CRFVC probably due to underreporting. We aim to improve monitoring activity on CM-induced ADRs especially in hospitals. Most reported ADR and CM were in line with current body of literature.

  18. Ten Years of Post-Fire Vegetation Recovery following the 2007 Zaca Fire using Landsat Satellite Imagery

    Science.gov (United States)

    Hallett, J. K. E.; Miller, D.; Roberts, D. A.

    2017-12-01

    Forest fires play a key role in shaping eco-systems. The risk to vegetation depends on the fire regime, fuel conditions (age and amount), fire temperature, and physiological characteristics such as bark thickness and stem diameter. The 2007 Zaca Fire (24 kilometers NE of Buellton, Santa Barbara County, California) burned 826.4 km2 over the course of 2 months. In this study, we used a time series of Landsat 5 Thematic Mapper and Landsat 8 Operational Land Imager imagery, to evaluate plant burn severity and post fire recovery as defined into classes of above average recovery, normal recovery, and below average recovery. We spectrally unmixed the images into green vegetation (GV), non-photosynthetic vegetation (NPV), soil surface (SOIL), and ash with a spectral library developed using Constrained Reference Endmember Selection (CRES). We delineated the fire perimeter using the differenced Normalized Burn Ratio (dNBR) and evaluated changes in this index and the Normalized Difference Vegetation Index through time. The results showed an immediate decline in GV and NPV fractions, with a rise in soil and ash fractions directly following the fire, with a slow recovery in GV fraction and a loss of bare soil cover. The was a sharp increase in the ash fraction following the fire and gradual decrease in the year after. Most areas have recovered as of 2017, with prominent recovery in the center of the burn scar and reduced recovery in areas to the south. These results indicate how post-fire vegetation varies based on initial burn severity and pre-fire GV and NPV fractions.

  19. Kidney function and specific mortality in 60-80 years old post-myocardial infarction patients : A 10-year follow-up study

    NARCIS (Netherlands)

    Hoogeveen, Ellen K.; Geleijnse, Johanna M.; Giltay, Erik J.; Soedamah-Muthu, S.S.; De Goede, Janette; Oude Griep, Linda M.; Stijnen, Theo; Kromhout, Daan; Shimosawa, Tatsuo

    2017-01-01

    Chronic kidney disease (CKD) is highly prevalent among older post-myocardial infarction (MI) patients. It is not known whether CKD is an independent risk factor for mortality in older post-MI patients with optimal cardiovascular drug-treatment. Therefore, we studied the relation between kidney

  20. Post Approval Human Papillomavirus Vaccine Uptake Is Higher in Minorities Compared to Whites in Girls Presenting for Well-Child Care

    Directory of Open Access Journals (Sweden)

    Susan C. Modesitt

    2013-07-01

    Full Text Available Since introduction of the human papillomavirus (HPV vaccine, there remains low uptake compared to other adolescent vaccines. There is limited information postapproval about parental attitudes and barriers when presenting for routine care. This study evaluates HPV vaccine uptake and assesses demographics and attitudes correlating with vaccination for girls aged 11–12 years. A prospective cohort study was performed utilizing the University of Virginia (UVA Clinical Data Repository (CDR. The CDR was used to identify girls aged 11–12 presenting to any UVA practice for a well-child visit between May 2008 and April 2009. Billing data were searched to determine rates of HPV vaccine uptake. The parents of all identified girls were contacted four to seven months after the visit to complete a telephone questionnaire including insurance information, child’s vaccination status, HPV vaccine attitudes, and demographics. Five hundred and fifty girls were identified, 48.2% of whom received at least one HPV vaccine dose. White race and private insurance were negatively associated with HPV vaccine initiation (RR 0.72, 95% CI 0.61–0.85 and RR 0.85, 95% CI 0.72–1.01, respectively. In the follow-up questionnaire, 242 interviews were conducted and included in the final cohort. In the sample, 183 (75.6% parents reported white race, 38 (15.7% black race, and 27 (11.2% reported other race. Overall 85% of parents understood that the HPV vaccine was recommended and 58.9% of parents believed the HPV vaccine was safe. In multivariate logistic regression, patients of black and other minority races were 4.9 and 4.2 times more likely to receive the HPV vaccine compared to their white counterparts. Safety concerns were the strongest barrier to vaccination. To conclude, HPV vaccine uptake was higher among minority girls and girls with public insurance in this cohort.

  1. Understanding young adult physical activity, alcohol and tobacco use in community colleges and 4-year post-secondary institutions: A cross-sectional analysis of epidemiological surveillance data

    Directory of Open Access Journals (Sweden)

    Lust Katherine

    2010-04-01

    Full Text Available Abstract Background Young adults experience many adverse health behavior changes as they transition from adolescence into adulthood. A better understanding of the relationships between health promoting and risky health behaviors may aid in the development of health promotion interventions for various types of young adult post-secondary students. Therefore, the purpose of this study was to examine associations between alcohol and tobacco use and physical activity among 2-year and 4-year college students. Methods Cross-sectional analyses were conducted using 2007 survey data, collected as part of an on-going post-secondary health surveillance system in Minnesota. Students were randomly selected to participant from 14 Minnesota colleges and universities (six 2-year community and/or technical colleges, eight 4-year post-secondary institutions. The 2007 surveillance data included 9,931 respondents. Results The prevalence of demographic characteristics and health behaviors (e.g., physical activity, tobacco use differed between young adults attending 2-year and 4-year post-secondary institutions; in general, those attending 2-year institutions are representative of more at-risk populations. Overall, higher levels of moderate, vigorous and strengthening physical activity were associated with higher levels of alcohol consumption and lower levels of smoking. In general, despite the disparities in the prevalence of these risk behaviors, the associations between the behaviors did not differ substantially between 2-year and 4-year post-secondary populations. Conclusions These findings illustrate links between leading risk behaviors. Interventions targeting multiple risk behaviors among young adults may warrant further consideration. Overall, future research is needed to support and inform young adult health promotion efforts that may be implemented in a wide array of post-secondary institutions.

  2. Transition and Change: The Prospective Effects of Post-Traumatic Stress on Smoking Trajectories in the First Year of College

    Science.gov (United States)

    Read, Jennifer P.; Wardell, Jeffrey D.; Vermont, Leah N.; Colder, Craig R.; Ouimette, Paige; White, Jacquelyn

    2014-01-01

    College matriculation begins a period of transition that is marked by new freedoms and responsibilities by and increases in a variety of risky behaviors, including smoking. Trauma and post-traumatic stress disorder (PTSD) are well-established risk factors for smoking outcomes, and thus may be a point of intervention for college smoking. Yet, no studies have examined associations among trauma, PTSD, and smoking in college students. The present study provides such an examination. Matriculating student smokers (N=346) completed surveys in September (T1) and at five subsequent time points (T2-T6) over their first year of college. With latent growth analysis, we modeled smoking trajectories conditioned on PTSD symptom status (i.e., No PTSD Symptoms vs. Partial PTSD vs. Full PTSD). Results showed that, although smoking tended to decline during the first semester for all groups, significant risk for escalation in smoking during the second semester was conferred specifically by the presence of PTSD at matriculation. Interventions that offer support and resources to students entering college with PTSD may help to prevent smoking behaviors from escalating, and may ultimately prevent the adoption of daily smoking in later adulthood. PMID:22888814

  3. Ultrasonography and radiography to identify early post traumatic myosistis ossificans in an 18-year-old male: a case report.

    Science.gov (United States)

    Yochum, Alicia M; Reckelhoff, Kenneth; Kaeser, Martha; Kettner, Norman W

    2014-06-01

    The purpose of this case report is to describe a patient with post traumatic myositis ossificans (PTMO) of the anterior thigh following blunt trauma and discuss the incidence, clinical presentation, management, and imaging findings. An 18-year-old male presented to a chiropractic clinic with a chief complaint of left knee pain and reduced range of motion after an impact injury to his left anterior thigh during hurdling 6 weeks earlier. Immediately after the injury, he presented to the emergency department where radiography of the left knee was negative and he was diagnosed with a muscle sprain. Follow-up radiography and ultrasonography of the left knee in a chiropractic radiology department revealed ossification consistent with PTMO within his vastus intermedius. The patient underwent a course of rehabilitation for 2 months including ice, class IV cold laser and vibration applied to his anterior thigh, and myofascial release of his quadriceps musculature with targeted and progressive rehabilitative exercises. His left knee pain resolved within 2 weeks of care. He resumed sports participation (American football) pain-free, while wearing protective padding over the affected thigh, 1 month after presentation, which was approximately 2 1/2 months following his injury. This case demonstrates that ultrasonography may have the capability to detect early phases of PTMO approximately 2 weeks prior to radiographic evidence and to monitor progression throughout its course.

  4. Generation Gap in the Plays of the First Post-war Years in West and East Germany

    Directory of Open Access Journals (Sweden)

    Anzhela Rafizovna Lisenko

    2017-09-01

    Full Text Available In this article the author deals with dramatic art of West and East Germany in the first post-war years and studies the issue of fathers and sons in works “The Man Outside” (“Draußen vor der Tür” by W. Borchert (1947, West Germany and “Wie Tiere des Waldes” by F. Wolf (1948, East Germany. The main topic of both plays is the war issue, the motive of guilt and responsibility growing into a generation gap. The representatives of the younger generation try to find out how their “fathers” could let fascism and war happen, why the “children” who had gone to war were forced to kill and to be killed. In the setting of the main conflict the one with authorities and God in both plays arises, there is an issue of depreciation of human life, a madness issue. As a result of comparison of plays the author comes to a conclusion that despite the common topic and the main conflict of plays the resolution becomes different. The play of East German F. Wolf has a more optimistic nature. The total hopelessness of a situation is observed in the work of Borchert. It is probably connected with the fact that optimism and belief in better future were important components of the socialist ideology and the principle of a socialist realism dominating in East Germany.

  5. DNA quality and quantity from up to 16 years old post-mortem blood stored on FTA cards.

    Science.gov (United States)

    Rahikainen, Anna-Liina; Palo, Jukka U; de Leeuw, Wiljo; Budowle, Bruce; Sajantila, Antti

    2016-04-01

    Blood samples preserved on FTA cards offer unique opportunities for genetic research. DNA recovered from these cards should be stable for long periods of time. However, it is not well established as how well the DNA stored on FTA card for substantial time periods meets the demands of forensic or genomic DNA analyses and especially so for from post-mortem (PM) samples in which the quality can vary upon initial collection. The aim of this study was to evaluate the time-dependent degradation on DNA quality and quantity extracted from up to 16 years old post-mortem bloodstained FTA cards. Four random FTA samples from eight time points spanning 1998 to 2013 (n=32) were collected and extracted in triplicate. The quantity and quality of the extracted DNA samples were determined with Quantifiler(®) Human Plus (HP) Quantification kit. Internal sample and sample-to-sample variation were evaluated by comparing recovered DNA yields. The DNA from the triplicate samplings were subsequently combined and normalized for further analysis. The practical effect of degradation on DNA quality was evaluated from normalized samples both with forensic and pharmacogenetic target markers. Our results suggest that (1) a PM change, e.g. blood clotting prior to sampling, affects the recovered DNA yield, creating both internal and sample-to-sample variation; (2) a negative correlation between the FTA card storage time and DNA quantity (r=-0.836 at the 0.01 level) was observed; (3) a positive correlation (r=0.738 at the level 0.01) was found between FTA card storage time and degradation levels. However, no inhibition was observed with the method used. The effect of degradation was manifested clearly with functional applications. Although complete STR-profiles were obtained for all samples, there was evidence of degradation manifested as decreased peak heights in the larger-sized amplicons. Lower amplification success was notable with the large 5.1 kb CYP2D6 gene fragment which strongly supports

  6. Cognitive activity limitations one year post-trauma in patients admitted to sub-acute rehabilitation after severe traumatic brain injury

    DEFF Research Database (Denmark)

    Sommer, Jens Bak; Norup, Anne; Poulsen, Ingrid

    2013-01-01

    Objective: To examine cognitive activity limitations and predictors of outcome 1 year post-trauma in patients admitted to sub-acute rehabilitation after severe traumatic brain injury. Subjects: The study included 119 patients with severe traumatic brain injury admitted to centralized sub-acute re......Objective: To examine cognitive activity limitations and predictors of outcome 1 year post-trauma in patients admitted to sub-acute rehabilitation after severe traumatic brain injury. Subjects: The study included 119 patients with severe traumatic brain injury admitted to centralized sub......-acute rehabilitation in the Eastern part of Denmark during a 5-year period from 2005 to 2009. Methods: Level of consciousness was assessed consecutively during rehabilitation and at 1 year post-trauma. Severity of traumatic brain injury was classified according to duration of post-traumatic amnesia. The cognitive...... subscale of Functional Independence MeasureTM (Cog-FIM) was used to assess cognitive activity limitations. Multivariate logistic regression analyses were performed to identify predictors of an independent level of functioning. Results: The majority of patients progressed to a post-confusional level...

  7. Self-Perceived Participation and Autonomy at 1-Year Post Stroke: A Part of the Stroke Arm Longitudinal Study at the University of Gothenburg (SALGOT Study).

    Science.gov (United States)

    Törnbom, Karin; Hadartz, Kristin; Sunnerhagen, Katharina S

    2018-04-01

    Identifying factors predicting the long-term outcome of participation and autonomy after stroke is essential for developing individualized rehabilitation interventions. The aim was to describe self-assessed participation and autonomy and to explore factors associated with the same at 1 year post stroke. Participants consisted of 79 persons (mean age = 67) with a first-time stroke at the 1-year follow-up. To investigate perceived participation and autonomy at 1 year, a self-assessment questionnaire, the Impact on Participation and Autonomy-English version (IPA-E) was used. Multivariate logistic regression models were performed using age, gender, stroke severity, and functional dependency at discharge as potential contributors to the perceived level of participation and autonomy. A high percentage (70%-88%) evaluated their functions as fair to very good within all domains of the IPA-E at 1 year post stroke. However, around a fifth experienced their Family role as poor to very poor. Participants' functional dependency at discharge significantly influenced the outcome for the domains of Family role (odds ratio [OR] = 5.66, P Autonomy indoors (OR = 3.44, P autonomy at 1 year post stroke. The results also indicate that supporting indoor autonomy and social relations of persons with stroke during the acute rehabilitation is important to enhance participation and autonomy at 1 year post stroke. Copyright © 2018 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  8. The Work behind Weight-Loss Surgery: A Qualitative Analysis of Food Intake after the First Two Years Post-Op.

    Science.gov (United States)

    Geraci, Angela A; Brunt, Ardith; Marihart, Cindy

    2014-01-01

    Purpose. Obesity has reached epidemic proportions in the U.S. and has nearly doubled worldwide since 1980. Bariatric surgery is on the rise, but little focus has been placed on the psychosocial impacts of surgery. The purpose of this study was to explore experiences of patients who have undergone bariatric surgery at least two years before to gain an understanding of the successes and challenges they have faced since surgery. Methods. This study used a phenomenological approach, to investigate the meaning and essence of bariatric patients with food after surgery. Semi-structured interviews were conducted on a sample of nine participants who had undergone surgery at least two years prior. Findings. Two main themes regarding food intake emerged from the data: (a) food after the first year post-surgery and (b) bariatric surgery is not a magic pill. Upon further analysis, food after the first year post-surgery had four subthemes emerge: diet adherence after the first year post-surgery, food intolerances, amount of food, and tendencies toward coping with food do not magically disappear. Conclusion. Findings revealed that post-operative diet and exercise adherence becomes increasingly difficult as weight loss slows. Many participants find that only after the first year after surgery the work really begins.

  9. Approval plans issues and innovations

    CERN Document Server

    Katz, Linda S

    2013-01-01

    How can you, as an acquisition librarians, keep current on the output of hundreds of publishers? The answer, of course, is that you cannot. For over 30 years, approval plans have been used by librarians to acquire current titles, save staff time, and build core collections. Even today, these reasons seem appropriate, as libraries try to maintain up-to-date collections and control personnel and operating budgets. However, as shown in Approval Plans: Issues and Innovations, the use of approval plans is not so simple and straightforward; their use is subject to complex procedures and policies--an

  10. OMB Recommended vs Approved Operating Budget

    Data.gov (United States)

    Montgomery County of Maryland — This dataset includes the Fiscal Year 2015 County Executive Recommended and County Council Approved operating budgets for Montgomery County, for comparison purposes....

  11. Hyperbaric oxygen therapy can improve post concussion syndrome years after mild traumatic brain injury - randomized prospective trial.

    Directory of Open Access Journals (Sweden)

    Rahav Boussi-Gross

    Full Text Available Traumatic brain injury (TBI is the leading cause of death and disability in the US. Approximately 70-90% of the TBI cases are classified as mild, and up to 25% of them will not recover and suffer chronic neurocognitive impairments. The main pathology in these cases involves diffuse brain injuries, which are hard to detect by anatomical imaging yet noticeable in metabolic imaging. The current study tested the effectiveness of Hyperbaric Oxygen Therapy (HBOT in improving brain function and quality of life in mTBI patients suffering chronic neurocognitive impairments.The trial population included 56 mTBI patients 1-5 years after injury with prolonged post-concussion syndrome (PCS. The HBOT effect was evaluated by means of prospective, randomized, crossover controlled trial: the patients were randomly assigned to treated or crossover groups. Patients in the treated group were evaluated at baseline and following 40 HBOT sessions; patients in the crossover group were evaluated three times: at baseline, following a 2-month control period of no treatment, and following subsequent 2-months of 40 HBOT sessions. The HBOT protocol included 40 treatment sessions (5 days/week, 60 minutes each, with 100% oxygen at 1.5 ATA. "Mindstreams" was used for cognitive evaluations, quality of life (QOL was evaluated by the EQ-5D, and changes in brain activity were assessed by SPECT imaging. Significant improvements were demonstrated in cognitive function and QOL in both groups following HBOT but no significant improvement was observed following the control period. SPECT imaging revealed elevated brain activity in good agreement with the cognitive improvements.HBOT can induce neuroplasticity leading to repair of chronically impaired brain functions and improved quality of life in mTBI patients with prolonged PCS at late chronic stage.ClinicalTrials.gov NCT00715052.

  12. Hyperbaric oxygen therapy can improve post concussion syndrome years after mild traumatic brain injury - randomized prospective trial.

    Science.gov (United States)

    Boussi-Gross, Rahav; Golan, Haim; Fishlev, Gregori; Bechor, Yair; Volkov, Olga; Bergan, Jacob; Friedman, Mony; Hoofien, Dan; Shlamkovitch, Nathan; Ben-Jacob, Eshel; Efrati, Shai

    2013-01-01

    Traumatic brain injury (TBI) is the leading cause of death and disability in the US. Approximately 70-90% of the TBI cases are classified as mild, and up to 25% of them will not recover and suffer chronic neurocognitive impairments. The main pathology in these cases involves diffuse brain injuries, which are hard to detect by anatomical imaging yet noticeable in metabolic imaging. The current study tested the effectiveness of Hyperbaric Oxygen Therapy (HBOT) in improving brain function and quality of life in mTBI patients suffering chronic neurocognitive impairments. The trial population included 56 mTBI patients 1-5 years after injury with prolonged post-concussion syndrome (PCS). The HBOT effect was evaluated by means of prospective, randomized, crossover controlled trial: the patients were randomly assigned to treated or crossover groups. Patients in the treated group were evaluated at baseline and following 40 HBOT sessions; patients in the crossover group were evaluated three times: at baseline, following a 2-month control period of no treatment, and following subsequent 2-months of 40 HBOT sessions. The HBOT protocol included 40 treatment sessions (5 days/week), 60 minutes each, with 100% oxygen at 1.5 ATA. "Mindstreams" was used for cognitive evaluations, quality of life (QOL) was evaluated by the EQ-5D, and changes in brain activity were assessed by SPECT imaging. Significant improvements were demonstrated in cognitive function and QOL in both groups following HBOT but no significant improvement was observed following the control period. SPECT imaging revealed elevated brain activity in good agreement with the cognitive improvements. HBOT can induce neuroplasticity leading to repair of chronically impaired brain functions and improved quality of life in mTBI patients with prolonged PCS at late chronic stage. ClinicalTrials.gov NCT00715052.

  13. A case report of spontaneous rupture of a renal angiomyolipoma in a post-partum 21-year-old patient.

    Science.gov (United States)

    Lucky, Marc A; Shingler, Simon N; Stephenson, Richard N

    2009-10-01

    Renal angiomyolipomas (AML) are benign tumours containing vascular, smooth muscle and fatty elements. The majority of renal AML run an asymptomatic, benign course. The main associated complication is that of retro-peritoneal or intra-tumoural haemorrhage. Treatment options include conservative management versus interventional procedures such as total or partial nephrectomy, cryotherapy or embolization. We describe a case of symptomatic, spontaneous rupture of AML in the immediate post-partum period of a patient treated under our care. This case highlights the presentation in the form of an acute abdomen in the immediate post-partum period. This is important as acute abdomen following delivery can be attributed to a number of other causes. It also demonstrates that further complications of renal angiomyolipoma rupture can arise, emphasising the importance of post treatment vigilance for signs of infection, further haemorrhage and post embolic events.

  14. RESULTS OF TRITIUM TRACKING AND GROUNDWATER MONITORING AT THE HANFORD SITE 200 AREA STATE APPROVED LAND DISPOSAL SITE. FISCAL YEAR 2008

    International Nuclear Information System (INIS)

    Erb, D.B.

    2008-01-01

    The Hanford Site's 200 Area Effluent Treatment Facility (ETF) processes contaminated aqueous wastes derived from Hanford Site facilities. The treated wastewater occasionally contains tritium, which cannot be removed by the ETF prior to the wastewater being discharged to the 200 Area State-Approved Land Disposal Site (SALDS). During the first 11 months of fiscal year 2008 (FY08) (September 1, 2007, to July 31, 2008), approximately 75.15 million L (19.85 million gal) of water were discharged to the SALDS. Groundwater monitoring for tritium and other constituents, as well as water-level measurements, is required for the SALDS by State Waste Discharge Permit Number ST-4500 (Ecology 2000). The current monitoring network consists of three proximal (compliance) monitoring wells and nine tritium-tracking wells. Quarterly sampling of the proximal wells occurred in October 2007 and in January/February 2008, April 2008, and August 2008. The nine tritium-tracking wells, including groundwater monitoring wells located upgradient and downgradient of the SALDS, were sampled in January through April 2008. Water-level measurements taken in the three proximal SALDS wells indicate that a small groundwater mound is present beneath the facility, which is a result of operational discharges. The mound increased in FY08 due to increased ETF discharges from treating groundwater from extraction wells at the 200-UP-l Operable Unit and the 241-T Tank Farm. Maximum tritium activities increased by an order of magnitude at well 699-48-77A (to 820,000 pCi/L in April 2008) but remained unchanged in the other two proximal wells. The increase was due to higher quantities of tritium in wastewaters that were treated and discharged in FY07 beginning to appear at the proximal wells. The FY08 tritium activities for the other two proximal wells were 68,000 pCi/L at well 699-48-77C (October 2007) and 120,000 pCi/L at well 699-48-77D (October 2007). To date, no indications of a tritium incursion from the

  15. SU-F-T-491: Photon Beam Matching Analysis at Multiple Sites Up to Twelve Years Post Installation

    Energy Technology Data Exchange (ETDEWEB)

    Able, C [Florida Cancer Specialists - New Port Richey, New Port Richey, FL (United States); Zakikhani, R [Florida Cancer Specialists - Largo, Largo, FL (United States); Yan, K [Florida Cancer Specialists- Tampa, Tampa, FL (United States); Sha, D [Florida Cancer Specialist - New Port Richey, New Port Richey, FL (United States); Chopra, A [Florida Cancer Specialist - Brooksville, Spring Hill, FL (United States)

    2016-06-15

    Purpose: To determine if the photon beams associated with several models of accelerators are matched with ‘Golden Beam’ data (VGBD) to assess treatment planning modeling and delivery. Methods: Six accelerators’ photon beams were evaluated to determine if they matched the manufacturer’s (Varian Medical Systems, Inc.) VGBD. Additional direct comparisons of the 6X and 18X beams using the manufacturer’s specification of Basic and Fine beam matching were also performed. The Cseries accelerator models were 21 EX (3), IX (2), and a IX Trilogy, ranging from three to twelve years post installation. Computerized beam scanning was performed (IBA Blue Phantom 2) with 2 CC13 ion chambers in water at 100 cm SSD. Dmax (10 cm2 field size), percentage depth dose (6 cm2, 10 cm2, 20 cm2, and 30 cm2 field sizes) and beam uniformity (10 cm2, 30 cm2 and 40 cm2 field sizes) were evaluated. Results: When comparing the beams with VGBD using the ‘Basic’ matching criteria, all beams were within the specifications ( 1.5mm at dmax, 1% PDD, and 2% Profiles). When considering the “Fine” matching criteria ( 1.5mm at dmax, 0.5% PDD, and 2% Profiles), only three of six 6MV beams and two of six high energy (five 18MV & one 15MV) beams passed. Direct comparisons between accelerators using the Clinac IX (installed 2012) as the reference beam datasets resulted in all 6 MV and 18MV beams meeting both the “Basic” and “Fine” criterion with the exception of two accelerators. Conclusion: Linear accelerators installed up to nine years apart are capable of meeting the manufacturers beam matching criteria for “Basic” matching. Without any adjustments most beams, when evaluated, may meet the “Fine” match criteria. The use of a single dataset (VGBD or designated accelerator reference data) for treatment planning commissioning is acceptable and can provide quality treatment delivery.

  16. Avelumab: First Global Approval.

    Science.gov (United States)

    Kim, Esther S

    2017-05-01

    Avelumab (Bavencio ® ) is an intravenously administered programmed cell death ligand-1-blocking human antibody initially developed by EMD Serono Inc. (the biopharmaceutical division of Merck KGaA, Darmstadt, Germany) [now jointly developed and commercialized by EMD Serono Inc. and Pfizer] for the treatment of various tumours. It has received accelerated approval in the USA for the treatment of metastatic Merkel cell carcinoma (mMCC) in adults and paediatric patients aged ≥12 years. The marketing authorization application for avelumab in the treatment of mMCC is undergoing regulatory review in the EU, the biologics license application for avelumab in the treatment of urothelial carcinoma is undergoing priority review by the FDA, and avelumab is in various stages of development internationally for a variety of cancers. This article summarizes the milestones in the development of avelumab leading to this first approval for mMCC.

  17. Course of social support and relationships between social support and patients' depressive symptoms in the first 3 years post-stroke

    NARCIS (Netherlands)

    Kruithof, Willeke J.; Post, Marcel W. M.; van Leeuwen, Christel M.; Schepers, Vera P. M.; van den Bos, Geertrudis A. M.; Visser-Meily, Johanna M. A.

    2015-01-01

    To describe the course of social support (everyday support, support in problem situations and esteem support) from initial inpatient rehabilitation until 3 years post-stroke and to examine the cross-sectional and longitudinal relationships of social support with depressive symptoms. Prospective

  18. Course of social support and relationships between social support and patients’ depressive symptoms in the first 3 years post-stroke

    NARCIS (Netherlands)

    Kruithof, Willeke J.; Post, Marcel W. M.; van Leeuwen, Christel M.; Schepers, Vera P. M.; van den Bos, Geertrudis A. M.; Visser-Meily, Johanna M. A.

    Objective: To describe the course of social support (everyday support, support in problem situations and esteem support) from initial inpatient rehabilitation until 3 years post-stroke and to examine the cross-sectional and longitudinal relationships of social support with depressive symptoms.

  19. Recurrent bacterial meningitis occurring five years after closed head injury and caused by an intranasal post-traumatic meningo-encephalocele.

    Science.gov (United States)

    Giunta, G.; Piazza, I.

    1991-01-01

    A case of atypical presentation of a post-traumatic intranasal meningo-encephalocele is described in a patient with a history of recurrent bacterial meningitis occurring 5 years after closed head injury. The usefulness of the CT and MRI findings in diagnostic evaluation of this lesion is emphasized. Images Figure 1 Figure 2 PMID:2068033

  20. Health care in patients 1 year post-stroke in general practice : research on the utilisation of the Dutch Transmural Protocol transient ischaemic attack/cerebrovascular accident

    NARCIS (Netherlands)

    de Weerd, L.; Rutgers, A.W.F.; Groenier, K.H.; van der Meer, K.

    2012-01-01

    This study evaluates the kind of aftercare that ischaemic stroke patients receive and the extent that aftercare fulfils the criteria of the 'Dutch Transmural Protocol transient ischaemic attack/cerebrovascular accident'. Fifty-seven patients were interviewed 1 year post-stroke about secondary

  1. Feelings of being disabled as a prognostic factor for mortality in men and women post-PCI up to 12 years

    NARCIS (Netherlands)

    Bergman, M.J.; Utens, E.M.W.J.; de Jager, T.A.J.; Radhoe, S.P.; Daemen, J.; Lenzen, M.J.; van Domburg, R.T.; Dulfer, K.

    2017-01-01

    Background It remains unclear whether feelings of being disabled are a relevant psychological factor that determines long term outcome after percutaneous coronary intervention (PCI). Therefore, we evaluated ‘feelings of being disabled’ as an independent risk factor for mortality 12 years post-PCI.

  2. Feelings of being disabled as a prognostic factor for mortality in men and women post-PCI up to 12years

    NARCIS (Netherlands)

    Bergmann, Michael J.; Utens, Elisabeth M. W. J.; de Jager, Tom A. J.; Radhoe, Sumant P.; Daemen, Joost; Lenzen, Mattie J.; van Domburg, Ron T.; Dulfer, Karolijn

    2017-01-01

    It remains unclear whether feelings of being disabled are a relevant psychological factor that determines long term outcome after percutaneous coronary intervention (PCI). Therefore, we evaluated 'feelings of being disabled' as an independent risk factor for mortality 12years post-PCI. The study

  3. Neorealist landscapes. Habitat and collective housing in Italy and Spain in the post- war years. 1943-1963

    Directory of Open Access Journals (Sweden)

    Colella, Federico

    2016-03-01

    Full Text Available Starting point for this research is the analysis of relationship between Italian and Spanish culture in the post-war era, especially in the field of cinematography, in order to describe possible correspondences or differences in the contemporary architectural and urban production, especially in social housing. Neorealism is the artistic movement that characterizes these years, in which economic, social and political problems weigh on these countries: it was born in Italy and influenced cinematography of different European countries, including Spain. Through comparison between some films, we can define a common urban landscape, with the aim to represent context in which the architecture of Italy and Spain, as in the neorealist cinema, seek new references and a more sensitive look on reality. El Punto de partida de este trabajo de investigación es el análisis de las similitudes existentes entre la cultura Italiana y la Española de la época de la posguerra, sobre todo en el campo de la cinematografía, con el fin de fijar posibles analogías y diferencias en la producción contemporánea arquitectónica y urbanística, especialmente de vivienda social. El Neorrealismo, es la corriente artística que mejor define estos años, en los cuales las grandes dificultades en el panorama económico, social y político, marcan la situación de los dos países: se trata de una expresión cultural que nace en Italia y que influenció distintas cinematografías europeas, entre las cuales la española. A través la comparación de algunas películas, es posible definir un paisaje urbano común, que representa el contexto en el cual se desarrolla la arquitectura de los dos países que, como en el cinema neorrealista, tratará de buscar nuevas referencias y de plantear una mirada más sensible hacia la realidad de la época.

  4. Five-year follow-up data from the U.S. clinical trial for Sientra's U.S. Food and Drug Administration-approved Silimed® brand round and shaped implants with high-strength silicone gel.

    Science.gov (United States)

    Stevens, W Grant; Harrington, Jennifer; Alizadeh, Kaveh; Berger, Lewis; Broadway, David; Hester, T Roderick; Kress, Donald; dʼIncelli, Rosalyn; Kuhne, JoAnn; Beckstrand, Maggi

    2012-11-01

    In March of 2012, the U.S. Food and Drug Administration approved Sientra's application for premarket approval for its Silimed brand silicone gel implants, based on data from the largest silicone gel breast implant study to date. This was the first approval for shaped silicone gel breast implants. This article presents the results of Sientra's study through 5 years. Sientra's study is an ongoing, 10-year, open-label, prospective, multicenter clinical study designed to assess the safety and effectiveness of Sientra's implants in patients undergoing augmentation and reconstruction. A total of 1788 subjects were implanted with 3506 implants, including 1116 primary augmentation, 363 revision-augmentation, 225 primary reconstruction, and 84 revision-reconstruction subjects. Physical evaluations and complications were recorded at each visit. Effectiveness was measured by postimplantation bra cup size and assessment of subject satisfaction and quality of life. Of the 1788 subjects, 571 underwent magnetic resonance imaging to assess silent rupture. Safety endpoints were analyzed using the Kaplan-Meier method. Across all cohorts, the risk of rupture was 1.8 percent (95 percent CI, 1.2 to 2.6 percent), the risk of capsular contracture (Baker grade III/IV) was 9.0 percent (95 percent CI, 7.6 to 10.6 percent), and the risk of reoperation was 23.8 percent (95 percent CI, 21.8 to 26.0 percent). Over 99 percent of surgeons reported satisfaction with the postoperative results, and subject satisfaction remained high 5 years after implantation. The 5-year results of Sientra's study continue to provide a comprehensive safety and effectiveness profile of Sientra's portfolio of Silimed brand shaped and round implants. Therapeutic, IV.

  5. Safety and Effectiveness of Mirabegron in Patients with Overactive Bladder Aged ≥75 Years: Analysis of a Japanese Post-Marketing Study.

    Science.gov (United States)

    Yoshida, Masaki; Nozawa, Yumiko; Kato, Daisuke; Tabuchi, Hiromi; Kuroishi, Kentarou

    2017-09-12

    A 12-week post-marketing study was conducted to provide real-world data on Japanese patients with overactive bladder (OAB) initiating treatment with mirabegron. This post-hoc analysis focused on safety and effectiveness of mirabegron in patients aged ≥75 versus Similar changes were observed for I-PSS QoL in both groups. In a real-world clinical setting, mirabegron was well-tolerated and effective in patients aged ≥75 and <75 years. © 2017 John Wiley & Sons Australia, Ltd.

  6. A journey to zero: reduction of post-operative cesarean surgical site infections over a five-year period.

    Science.gov (United States)

    Hickson, Evelyn; Harris, Jeanette; Brett, David

    2015-04-01

    Surgical site infections (SSI) are a substantial concern for cesarean deliveries in which a surgical site complication is most unwelcome for a mother with a new infant. Steps taken pre- and post-operatively to reduce the number of complications may be of substantial benefit clinically, economically, and psychologically. A risk-based approach to incision management was developed and implemented for all cesarean deliveries at our institution. A number of incremental interventions for low-risk and high-risk patients including pre-operative skin preparations, standardized pre- and post-operative protocols, post-operative nanocrystalline silver anti-microbial barrier dressings, and incisional negative pressure wound therapy (NPWT) were implemented sequentially over a 5-y period. A systematic clinical chart review of 4,942 patients spanning all cesarean deliveries between 2007-2012 was performed to determine what effects the interventions had on the rate of SSI for cesarean deliveries. The percentage of SSI was reduced from 2.13% (2007) to 0.10% (2012) (poperative SSIs were avoided: A total cost saving of nearly $5,000,000. Applying a clinical algorithm for assessing the risk of surgical site complication and making recommendations on pre-operative and post-operative incision management can result in a substantial and sustainable reduction in cesarean SSI.

  7. A Journey to Zero: Reduction of Post-Operative Cesarean Surgical Site Infections over a Five-Year Period

    OpenAIRE

    Hickson, Evelyn; Harris, Jeanette; Brett, David

    2015-01-01

    Background: Surgical site infections (SSI) are a substantial concern for cesarean deliveries in which a surgical site complication is most unwelcome for a mother with a new infant. Steps taken pre- and post-operatively to reduce the number of complications may be of substantial benefit clinically, economically, and psychologically.

  8. A More-than-Social Movement: The Post-Human Condition of Quality in the Early Years

    Science.gov (United States)

    Arndt, Sonja; Tesar, Marek

    2016-01-01

    This article explores quality in early childhood education by de-elevating the importance of the human subject and experience, and heightening instead a focus on and tensions with the post-human. The argument traces the intricate web of "qualities" woven throughout entanglements of subjects, objects and things that constitute what is…

  9. Stuck in a Mismatch? The Persistence of Overeducation during Twenty Years of the Post-Communist Transition in Poland

    Science.gov (United States)

    Kiersztyn, Anna

    2013-01-01

    This paper examines long-term changes in the persistence of overeducation among individual workers, focusing on the relationship between the rate of those changes and the general economic situation. All analyses are based on data from the Polish Panel Survey (POLPAN) conducted throughout the post-communist transition period, 1988-2008. The results…

  10. Two-year post-discharge costs of care among patients treated with transcatheter or surgical aortic valve replacement in Germany.

    Science.gov (United States)

    Kaier, Klaus; von Kampen, Frederike; Baumbach, Hardy; von Zur Mühlen, Constantin; Hehn, Philip; Vach, Werner; Zehender, Manfred; Bode, Christoph; Reinöhl, Jochen

    2017-07-11

    This study presents data on post-discharge costs of care among patients treated with transcatheter or surgical aortic valve replacement over a two year period. Based on a prospective clinical trial, post-discharge utilization of health services and status of assistance were collected for 151 elderly patients via 2250 monthly telephone interviews, valued using standardized unit costs and analysed using two-part regression models. At month 1 post-discharge, total costs of care are substantially elevated (monthly mean: €3506.7) and then remain relatively stable over the following 23 months (monthly mean: €622.3). As expected, the majority of these costs are related to in-hospital care (~98% in month 1 post-discharge and ~72% in months 2-24). Patients that died during follow-up were associated with substantially higher cost estimates of in-hospital care than those surviving the two-year study period, while patients' age and other patient characteristics were of minor relevance. Estimated costs of outpatient care are lower at month 1 than during the rest of the study period, and not affected by the event of death during follow-up. The estimated costs of nursing care are, in contrast, much higher in year 2 than in year 1 and differ substantially by gender and type of procedure as well as by patients' age. Overall, these monthly cost estimates add up to €10,352 for the first and €7467.6 for the second year post-discharge. Substantial cost increases at month 1 post-discharge and in case of death during follow-up are the main findings of the study, which should be taken into account in future economic evaluations on the topic. Application of standardized unit costs in combination with monthly patient interviews allows for a far more precise estimate of the variability in post-discharge health service utilization in this group of patients than the ones given in previous studies. German Clinical Trial Register Nr. DRKS00000797 .

  11. Predicting adherence to health care recommendations using health promotion behaviours in kidney transplant recipients within 1-5 years post-transplant.

    Science.gov (United States)

    Lin, Su-Yueh; Fetzer, Susan J; Lee, Po-Chang; Chen, Ching-Huey

    2011-12-01

    This study examined health promotion behaviours of kidney transplant recipients, 1-5 years after transplant and identified the risk factors predicting non-adherence to post-transplant recommendations. Non-adherence to health care recommendations and health promotion behaviours is one of the top three reasons for graft loss following kidney transplantation. A cross-sectional study. Kidney transplant recipients (n=101) in southern Taiwan completed a self reported survey, the Kidney Transplant Health Promotion Behavior and Healthcare Provider Support survey. Kidney transplant patients had better adherence with medication and least adherence with regular exercise health promotion behaviours. Age, post kidney transplant time, health care provider support and financial satisfaction accounted for 37·2% of the explained variance in monitoring and management for rejection and infection. Marital status, post kidney transplant time and gender accounted for 16·2% of the explained variance in infection prevention. Age was the sole predictor of exercise (odds ratio=1·08, p=0·025). Health promotion behaviours declined with time and perceived healthcare provider support decreased at the third (p=0·04) post kidney transplant year. In this study, young, single, males were identified as requiring specific strategies to improve post kidney transplant health promotion behaviours. The need for health promotion must be continually reinforce by healthcare providers throughout the lifespan of a kidney transplant recipient. Understanding the changes of health behaviours of post kidney transplant recipients and their risk factors, healthcare providers can be more aware of the needs of patients in maintaining health promotion behaviours. © 2011 Blackwell Publishing Ltd.

  12. Two stage fracture of a polyethylene post in a 9-year-old posterior-stabilized knee prosthesis: a case report

    Directory of Open Access Journals (Sweden)

    Congiu Terenzio

    2010-02-01

    Full Text Available Abstract Introduction Several cases of tibial post breakage are reported in the literature. To the best of our knowledge, only three cases of NexGen knee prosthesis (Zimmer, Warsaw, Indiana, USA tibial post failure have been reported. Case presentation In November 1999, a 63-year-old Caucasian woman from Italy with a history of symptomatic left knee osteoarthritis underwent a total knee arthroplasty. In March 2008, while rising from a chair, she felt a sudden pain and instability in her left knee. She reported a fracture of the polyethylene post of the tibial insert. No malposition or malalignment of either the femoral or tibial components were identified. The polyethylene tibial insert was studied under light microscopy and scanning electron microscopy. The fracture was also noted to have occurred without any notable polyethylene wear. Conclusion Scanning electron microscopy revealed two different damage patterns that could be explained with a two-stage rupture of our patient's polyethylene post. This could have been caused by a non-optimal ligamentous balancing during first implant surgery. Her knee probably developed a varus instability that weakened the post, and then a posterior anterior stress finally broke the polyethylene.

  13. Landscape variation in tree regeneration and snag fall drive fuel loads in 24-year old post-fire lodgepole pine forests.

    Science.gov (United States)

    Nelson, Kellen N; Turner, Monica G; Romme, William H; Tinker, Daniel B

    2016-12-01

    Escalating wildfire in subalpine forests with stand-replacing fire regimes is increasing the extent of early-seral forests throughout the western USA. Post-fire succession generates the fuel for future fires, but little is known about fuel loads and their variability in young post-fire stands. We sampled fuel profiles in 24-year-old post-fire lodgepole pine (Pinus contorta var. latifolia) stands (n = 82) that regenerated from the 1988 Yellowstone Fires to answer three questions. (1) How do canopy and surface fuel loads vary within and among young lodgepole pine stands? (2) How do canopy and surface fuels vary with pre- and post-fire lodgepole pine stand structure and environmental conditions? (3) How have surface fuels changed between eight and 24 years post-fire? Fuel complexes varied tremendously across the landscape despite having regenerated from the same fires. Available canopy fuel loads and canopy bulk density averaged 8.5 Mg/ha (range 0.0-46.6) and 0.24 kg/m 3 (range: 0.0-2.3), respectively, meeting or exceeding levels in mature lodgepole pine forests. Total surface-fuel loads averaged 123 Mg/ha (range: 43-207), and 88% was in the 1,000-h fuel class. Litter, 1-h, and 10-h surface fuel loads were lower than reported for mature lodgepole pine forests, and 1,000-h fuel loads were similar or greater. Among-plot variation was greater in canopy fuels than surface fuels, and within-plot variation was greater than among-plot variation for nearly all fuels. Post-fire lodgepole pine density was the strongest positive predictor of canopy and fine surface fuel loads. Pre-fire successional stage was the best predictor of 100-h and 1,000-h fuel loads in the post-fire stands and strongly influenced the size and proportion of sound logs (greater when late successional stands had burned) and rotten logs (greater when early successional stands had burned). Our data suggest that 76% of the young post-fire lodgepole pine forests have 1,000-h fuel loads that exceed levels

  14. Functional evaluation of patients treated with osteochondral allograft transplantation for post-traumatic ankle arthritis: one year follow-up.

    Science.gov (United States)

    Berti, L; Vannini, F; Lullini, G; Caravaggi, P; Leardini, A; Giannini, S

    2013-09-01

    Severe post-traumatic ankle arthritis poses a reconstructive challenge in active patients. Whereas traditional surgical treatments, i.e. arthrodesis and arthroplasty, provide good pain relief, arthrodesis is associated to functional and psychological limitations, and arthroplasty is prone to failure in the active patient. More recently the use of bipolar fresh osteochondral allografts transplantation has been proposed as a promising alternative to the traditional treatments. Preliminary short- and long-term clinical outcomes for this procedure have been reported, but no functional evaluations have been performed to date. The clinical and functional outcomes of a series of 10 patients who underwent allograft transplantation at a mean follow-up of 14 months are reported. Clinical evaluation was performed with the AOFAS score, functional assessment by state-of-the-art gait analysis. The clinical score significantly improved from a median of 54 (range 12-65) pre-op to 76.5 (range 61-86) post-op (p=0.002). No significant changes were observed for the spatial-temporal parameters, but motion at the hip and knee joints during early stance, and the range of motion of the ankle joint in the frontal plane (control: 13.8°±2.9°; pre-op: 10.4°±3.1°, post-op: 12.9°±4.2°; p=0.02) showed significant improvements. EMG signals revealed a good recovery in activation of the biceps femoris. This study showed that osteochondral allograft transplantation improves gait patterns. Although re-evaluation at longer follow-ups is required, this technique may represent the right choice for patients who want to delay the need for more invasive joint reconstruction procedures. Copyright © 2013 Elsevier B.V. All rights reserved.

  15. The helminth community component species of the wood mouse as biological tags of a ten post-fire-year regeneration process in a Mediterranean ecosystem.

    Science.gov (United States)

    Sáez-Durán, Sandra; Debenedetti, Ángela L; Sainz-Elipe, Sandra; Galán-Puchades, M Teresa; Fuentes, Màrius V

    2018-05-10

    Serra Calderona Natural Park, a Mediterranean ecosystem, has been in post-fire regeneration for 10 years. To elucidate which helminth community component species of the wood mouse, Apodemus sylvaticus, can be considered biological tags of this process, the influence of intrinsic (host density; host sex and age) and extrinsic factors (site, year, and period of capture; vegetation recovery) on their prevalence and abundance has been analysed, comparing a burned and an unburned area. A total of 564 wood mice (408 from the burned and 156 from the unburned area), from the 2nd to the10th post-fire year, was included in this helminthoecological study. The results suggest that the area in post-fire regeneration is still more vulnerable to periodic environmental changes than the unburned area as deduced from the analysis of the helminth populations of Pseudocatenotaenia matovi, Skrjabinotaenia lobata, Trichuris muris, Eucoleus bacillatus and Aonchotheca annulosa. The intermediate and definitive host populations presented a greater variability to these environmental changes in the burned area (Taenia parva, P. matovi, S. lobata, A. annulosa, Syphacia stroma and S. frederici). In the regenerating area, some behavioural changes in certain populations determined by the host sex are taking place (T. parva, Helgimosomoides polygyrus and S. frederici). During the last years studied, a greater similarity in the populational development of some component species between both areas can be appreciated (H. polygyrus and S. stroma). The role of the wood mouse and its helminth parasites as biological tags of the post-fire regeneration process in Mediterranean ecosystems has been confirmed.

  16. Assessment of safety and efficacy of lamotrigine over the course of 1-year observation in Japanese patients with bipolar disorder: post-marketing surveillance study report

    Science.gov (United States)

    Terao, Takeshi; Ishida, Atsuko; Kimura, Toshifumi; Yoshida, Mitsuhiro; Hara, Terufumi

    2017-01-01

    Background A post-marketing surveillance (PMS) study was conducted with a 1-year observation period to assess the safety and efficacy of lamotrigine in routine clinical practice in patients with bipolar disorder (BD). Patients and methods Central enrollment method was used to recruit patients diagnosed with BD who were being treated for the first time with lamotrigine to prevent the recurrence/relapse of BD mood episodes. Adverse drug reactions (ADRs) and recurrence/relapse were assessed. Improvement of mania and depression was also assessed using the Hamilton’s Rating Scale for Depression (HAM-D) and the Young Mania Rating Scale (YMRS) at treatment initiation, 4–6 months post treatment initiation, and 10–12 months post treatment initiation. Results A total of 237/989 patients (24.0%) reported ADRs, most commonly rash (9.1%), and the incidence of serious ADRs was 3.3% (33/989 patients). Skin disorders occurred in 130 patients (13.1%), mostly within 8 weeks post treatment. A total of 237/703 patients (33.7%) experienced recurrence/relapse of mood episodes. The 25th percentile of the time to recurrence/relapse of mood episodes was 105 days. Remission of depression symptoms (HAM-D ≤7) occurred in 147/697 patients (21.1%) at treatment initiation, rising to 361 patients (67.4%) at 10–12 months post treatment. Remission of manic symptoms (YMRS ≤13) occurred in 615/676 patients (91.0%) at treatment initiation, rising to 500 patients (97.3%) at 10–12 months post treatment. Conclusion The results of this PMS study suggest that lamotrigine is a well-tolerated and effective drug for preventing recurrence/relapse of BD in clinical practice. PMID:28652744

  17. Post-discharge kidney function is associated with subsequent ten-year renal progression risk among survivors of acute kidney injury.

    Science.gov (United States)

    Sawhney, Simon; Marks, Angharad; Fluck, Nick; Levin, Adeera; McLernon, David; Prescott, Gordon; Black, Corri

    2017-08-01

    The extent to which renal progression after acute kidney injury (AKI) arises from an initial step drop in kidney function (incomplete recovery), or from a long-term trajectory of subsequent decline, is unclear. This makes it challenging to plan or time post-discharge follow-up. This study of 14651 hospital survivors in 2003 (1966 with AKI, 12685 no AKI) separates incomplete recovery from subsequent renal decline by using the post-discharge estimated glomerular filtration rate (eGFR) rather than the pre-admission as a new reference point for determining subsequent renal outcomes. Outcomes were sustained 30% renal decline and de novo CKD stage 4, followed from 2003-2013. Death was a competing risk. Overall, death was more common than subsequent renal decline (37.5% vs 11.3%) and CKD stage 4 (4.5%). Overall, 25.7% of AKI patients had non-recovery. Subsequent renal decline was greater after AKI (vs no AKI) (14.8% vs 10.8%). Renal decline after AKI (vs no AKI) was greatest among those with higher post-discharge eGFRs with multivariable hazard ratios of 2.29 (1.88-2.78); 1.50 (1.13-2.00); 0.94 (0.68-1.32) and 0.95 (0.64-1.41) at eGFRs of 60 or more; 45-59; 30-44 and under 30, respectively. The excess risk after AKI persisted over ten years of study, irrespective of AKI severity, or post-episode proteinuria. Thus, even if post-discharge kidney function returns to normal, hospital admission with AKI is associated with increased renal progression that persists for up to ten years. Follow-up plans should avoid false reassurance when eGFR after AKI returns to normal. Copyright © 2017 International Society of Nephrology. Published by Elsevier Inc. All rights reserved.

  18. Rectal carcinoma under 40 years of age: seven-year post-treatment follow-up at a tertiary care hospital in Pakistan

    International Nuclear Information System (INIS)

    Haroon, N.; Khan, S.; Alvi, R.

    2013-01-01

    Objectives: To determine epidemiological characteristics, clinical presentation, histopathological features, and long-term follow-up of patients below 40 years of age with carcinoma rectum. Methods: The retrospective case series comprised all patients presenting with histopathological diagnosis of carcinoma rectum with age 15-40 years at the Aga Khan University Hospital between January 1994 and December 2004. Details regarding patient demographics, pre-operative assessment, management and tumour grade and stage were obtained from a prospectively maintained database. Continuous and categorical variables in the data were analysed. Results: Of the 23 patients in the study, 14 (60.89%) were male and 9 (39.13%) were female. Mean age of the subjects was 31+-5 years. Overall, 22 (95.6%) patients presented with rectal bleeding and 12 (52%) had altered bowel habit. The most common site for the tumour was lower rectum (n=20; 87%) and 13 (56.5%) required abdominoperineal resection. Local recurrence rate was 13% (n=3) and distant metastasis occurred in 2 (8.6%) patients during the seven year follow-up. Two (8.6%) patients died, and both had distant metastasis. Conclusion: Carcinoma rectum is uncommon but an important malignancy in patients aged below 40 years. The clinician should have a high index of suspicion in young patients presenting with bleeding per rectum, altered bowel habit and weight-loss. (author)

  19. Post-term growth and cognitive development at 5 years of age in preterm children: Evidence from a prospective population-based cohort.

    Science.gov (United States)

    Simon, Laure; Nusinovici, Simon; Flamant, Cyril; Cariou, Bertrand; Rouger, Valérie; Gascoin, Géraldine; Darmaun, Dominique; Rozé, Jean-Christophe; Hanf, Matthieu

    2017-01-01

    While the effects of growth from birth to expected term on the subsequent development of preterm children has attracted plentiful attention, less is known about the effects of post-term growth. We aimed to delineate distinct patterns of post-term growth and to determine their association with the cognitive development of preterm children. Data from a prospective population-based cohort of 3,850 surviving infants born at less than 35 weeks of gestational age were used. Growth was assessed as the Body Mass Index (BMI) Z-scores at 3, 9, 18, 24, 36, 48, and 60 months. Cognitive development at five years of age was evaluated by the Global School Adaptation score (GSA). Latent class analysis was implemented to identify distinct growth patterns and logistic regressions based on propensity matching were used to evaluate the relationship between identified growth trajectories and cognitive development. Four patterns of post-term growth were identified: a normal group with a Z-score consistently around zero during childhood (n = 2,469; 64%); a group with an early rapid rise in the BMI Z-score, but only up to 2 years of age (n = 195; 5%); a group with a slow yet steady rise in the BMI Z-score during childhood (n = 510; 13%); and a group with a negative Z-score growth until 3 years of age (n = 676; 18%). The group with a slow yet steady rise in the BMI Z-score was significantly associated with low GSA scores. Our findings indicate heterogeneous post-term growth of preterm children, with potential for association with their cognitive development.

  20. Redfield Energy Approval

    Science.gov (United States)

    This September 19, 2016 letter from EPA approves the petition from Poet Biorefining-Lake Crystal, regarding non-This October 27, 2016 letter from EPA approves the petition from Redfield Energy, LLC, regarding non-grandfathered ethanol produced

  1. Post-Chernobyl incidence of papillary thyroid cancer among Belgian children less than 15 years of age in April 1986: a 30-year surgical experience.

    Science.gov (United States)

    Michel, Luc A; Donckier, Julian; Rosière, Alain; Fervaille, Caroline; Lemaire, Julien; Bertrand, Claude

    2016-04-01

    We raised the question of a possible relationship in Belgium between the occurrence of papillary thyroid carcinoma (PTC) and age of children (Chernobyl nuclear plant accident in April 1986. Referral university centre for endocrine surgery. Thirty-year prospective study of the experience of a surgical team with PTC since the Chernobyl accident, taken out of 2349 patients operated on for any thyroid lesions from April 1986 to April 2015, comparing the incidence of PTC by age groups. Comparison of PTC incidence in patients >15 years (group A) and children Chernobyl and born before April 1986, 2164 were >15 years of age at the time of the nuclear accident (group A) and 175 developed PTC (8.1%) compared to 36 PTC (19.5%) that occurred in 185 children Chernobyl accident. This relationship with age has even been strengthened by the implementation of more sophisticated immunohistochemical biomarkers diagnostic technology since April 2011.

  2. Adjustment of a Population of South African Children of Mothers Living With/and Without HIV Through Three Years Post-Birth.

    Science.gov (United States)

    Rotheram-Borus, Mary Jane; Tomlinson, Mark; Scheffler, Aaron; Harris, Danielle M; Nelson, Sandahl

    2017-06-01

    Mothers living with HIV (MLH) and their children are typically studied to ensure that perinatal HIV transmission is blocked. Yet, HIV impacts MLH and their children lifelong. We examine child outcomes from pregnancy to 3 years post-birth among a peri-urban population of pregnant MLH and mothers without HIV (MWOH). Almost all pregnant women in 12 neighborhoods (98 %; N = 584) in Cape Town, South Africa were recruited and repeatedly assessed within 2 weeks of birth (92 %), at 6 months (88 %), 18 months (84 %), and 3 years post-birth (86 %). There were 186 MLH and 398 MWOH. Controlling for neighborhood and repeated measures, child and maternal outcomes were contrasted over time using longitudinal random effects regression analyses. For measures collected only at 3 years, outcomes were analyzed using multiple regressions. Compared to MWOH, MLH had less income, more informal housing and food insecurity, used alcohol more often during pregnancy, and were more depressed during pregnancy and over time. Only 4.8 % of MLH's children were seropositive; seropositive children were excluded from additional analyses. Children of MLH tended to have significantly lower weights (p rates (8.5 %) and were similar in social and behavioral adjustment, vocabulary, and executive functioning at 3 years post-birth. Despite living in households with fewer resources and having more depressed mothers, only the physical health of children of MLH is compromised, compared to children of MWOH. In township neighborhoods with extreme poverty, social, behavioral, language, and cognitive functioning appear similar over the first three years of life between children of MLH and MWOH.

  3. Histopathological analysis of pre-implantation donor kidney biopsies: association with graft survival and function in one year post-transplantation

    Directory of Open Access Journals (Sweden)

    Karla Lais Pêgas

    2014-04-01

    Full Text Available Introduction: Pre-implantation kidney biopsy is a decision-making tool when considering the use of grafts from deceased donors with expanded criteria, implanting one or two kidneys and comparing this to post-transplantation biopsies. The role of histopathological alterations in kidney compartments as a prognostic factor in graft survival and function has had conflicting results. Objective: This study evaluated the prevalence of chronic alterations in pre-implant biopsies of kidney grafts and the association of findings with graft function and survival in one year post-transplant. Methods: 110 biopsies were analyzed between 2006 and 2009 at Santa Casa de Porto Alegre, including live donors, ideal deceased donors and those with expanded criteria. The score was computed according to criteria suggested by Remuzzi. The glomerular filtration rate (GFR was calculated using the abbreviated MDRD formula. Results: No statistical difference was found in the survival of donors stratified according to Remuzzi criteria. The GFR was significantly associated with the total scores in the groups with mild and moderate alterations, and in the kidney compartments alone, by univariate analysis. The multivariate model found an association with the presence of arteriosclerosis, glomerulosclerosis, acute rejection and delayed graft function. Conclusion: Pre-transplant chronic kidney alterations did not influence the post-transplantation one-year graft survival, but arteriosclerosis and glomerulosclerosis is predictive of a worse GFR. Delayed graft function and acute rejection are independent prognostic factors.

  4. Prevalence and predictors of post-traumatic stress symptoms in adolescent and young adult cancer survivors: a 1-year follow-up study.

    Science.gov (United States)

    Kwak, Minyoung; Zebrack, Brad J; Meeske, Kathleen A; Embry, Leanne; Aguilar, Christine; Block, Rebecca; Hayes-Lattin, Brandon; Li, Yun; Butler, Melissa; Cole, Steven

    2013-08-01

    Post-traumatic stress symptoms (PTSS) have been identified as a meaningful indicator of distress in cancer survivors. Distinct from young adult survivors of childhood cancer, young people diagnosed with cancer as adolescents and young adults (AYAs) face unique psychosocial issues; however, there is little published research of PTSS in the AYA population. This study examines prevalence and predictors of PTSS among AYAs with cancer. As part of a longitudinal study of AYAs with cancer, 151 patients aged 15-39 years completed mailed surveys at 6 and 12 months post-diagnosis. Severity of PTSS was estimated at 6 and 12 months post-diagnosis. Multiple regression analyses were conducted to investigate the predictive effects of socio-demographic and clinical characteristics on changes in PTSS over time. At 6 and 12 months, respectively, 39% and 44% of participants reported moderate to severe levels of PTSS; 29% had PTSS levels suggestive of post-traumatic stress disorder. No significant differences in severity of PTSS between 6 and 12 months were observed. Regression analyses suggested that a greater number of side effects were associated with higher levels of PTSS at 6 months. Currently receiving treatment, having surgical treatment, diagnosis of a cancer type with a 90-100% survival rate, remaining unemployed/not in school, and greater PTSS at 6 months were associated with higher levels of PTSS at 12 months. Post-traumatic stress symptoms were observed as early as 6 months following diagnosis and remained stable at 12-month follow-up. The development of early interventions for reducing distress among AYA patients in treatment is recommended. Copyright © 2012 John Wiley & Sons, Ltd.

  5. Symptom reduction in young people (15 – 30 years) after a brief behavioral intervention for persistent post-concussion symptoms: An uncontrolled study

    DEFF Research Database (Denmark)

    Thastum, Mille; Rask, Charlotte Ulrikka; Næss-Schmidt, Erhard

    2017-01-01

    on principles from cognitive-behavioral therapy and gradual return to activities. The primary treatment objective was to reduce PCS and prevent chronification of symptoms by reducing negative illness perceptions (eg. beliefs that one cannot control the symptoms and that they will persist), and reducing......Background: About 5 – 15 % of patients with concussion experience persistent post-concussion symptoms (PCS) longer than 3 months post-injury. Currently, treatment options are limited, and no evidence-based intervention is available. Recent studies suggest that cognitive and behavioral processes may...... be involved in symptom maintenance. Aim: To explore in an uncontrolled study design: 1) the overall outcome of a newly developed, brief behavioral intervention in young patients (15 – 30 years) with persistent PCS 3 – 6 months after concussion, and 2) the hypothesised mediators, i.e. illness perceptions...

  6. Evolucion de niños post-trasplante hepático luego del primer año de sobrevida Evolution of children one year post liver transplant

    Directory of Open Access Journals (Sweden)

    Miriam Cuarterolo

    2005-10-01

    more than one year of follow up. Between November 1992 and November 2001, 238 patients underwent 264 liver transplantations. A total of 143 patients with more than one year of follow up were included. The median age of patients ± SD was 5.41 years ± 5.26 (r: 0.58-21.7 years. All children received primary immunosuppression with cyclosporine. The indications for liver replacement were: fulminant hepatic failure (n: 50, biliary atresia (n: 38, cirrhosis (n: 37, chronic cholestasis (n: 13 and miscellaneous (n: 5. The indications for liver re-transplantation were: biliary cirrhosis (n: 7, hepatic artery thrombosis (n: 4 and chronic rejection (n: 3. Reduced-size liver allografts were used in73/157 liver transplants, 14 of them were from living-related donors and 11 were split-livers. Patient and graft survival rates were 93% and 86% respectively. Death risk was statistically higher in retransplanted and reduced-size grafted patients. Growth retardation and low bone density were recovered before the first 3 years post-transplant. The incidence of lymphoproliferative disease was 7.69%. De novo hepatitis B was diagnosed in 7 patients (4.8%. Social risk did not affect the outcome of our population. The prevention, detection and early treatment of complications in the long-term follow up contributed to improve the outcome.

  7. Trajectories and associated factors of quality of life, global outcome, and post-concussion symptoms in the first year following mild traumatic brain injury.

    Science.gov (United States)

    Chiang, Chia-Chen; Guo, Su-Er; Huang, Kuo-Chang; Lee, Bih-O; Fan, Jun-Yu

    2016-08-01

    To investigate the associated factors and change trajectories of quality of life (QoL), global outcome, and post-concussion symptoms (PCS) over the first year following mild traumatic brain injury (mTBI). This was a prospective longitudinal study of 100 participants with mTBI from neurosurgical outpatient departments in Chiayi County District Hospitals in Taiwan. The checklist of post-concussion syndromes (CPCS) was used to assess PCS at enrollment and at 1, 3, and 12 months after mTBI; the glasgow outcome scale extended (GOSE), the quality of life after brain injured (QOLIBRI), Chinese version, and the Short Form 36 Health Survey (SF-36), Taiwan version, were used to assess mTBI global outcome and QoL at 1, 3, and 12 months after mTBI. Latent class growth models (LCGMs) indicated the change trajectories of QOLIBRI, PCS SF-36, MCS SF-36, GOSE, and PCS. Classes of trajectory were associated with age ≥40 years, unemployment at 1 month after injury, and educational level ≤12 years. Univariate analysis revealed that employment status at 1 month post-injury was correlated with the trajectories of QOLIBRI, PCS SF-36, MCS SF-36, and GOSE, but not PCS. Employment status was the most crucial associated factor for QoL in individuals with mTBI at the 1-year follow-up. Future studies should explore the benefits of employment on QoL of individuals with mTBI.

  8. Post-licensure safety surveillance for human papillomavirus-16/18-AS04-adjuvanted vaccine: more than 4 years of experience.

    Science.gov (United States)

    Angelo, Maria-Genalin; Zima, Julia; Tavares Da Silva, Fernanda; Baril, Laurence; Arellano, Felix

    2014-05-01

    To summarise post-licensure safety surveillance over more than 4 years of routine use of the human papillomavirus-16/18-AS04-adjuvanted vaccine (HPV-16/18 vaccine: Cervarix®, GlaxoSmithKline, Belgium). We describe global post-licensure passive surveillance data based on routine pharmacovigilance from 18 May 2007 until 17 November 2011 and enhanced surveillance implemented during the 2-year national immunisation programme in the UK (school years 2008-2010). Spontaneous reports from countries worldwide showed a similar pattern for the most frequently reported adverse events after HPV-16/18 vaccination. No patterns or trends were observed for potential immune-mediated diseases after vaccination. Observed incidences of Bell's palsy and confirmed Guillain-Barré syndrome were within the expected range in the general population. Outcomes of pregnancy in women who were inadvertently exposed to HPV-16/18 vaccine during pregnancy, were in line with published reports for similar populations. Enhanced surveillance of adverse events in the UK triggered a review of cases of anaphylaxis, angioedema and syncope reports, leading to an update to the prescribing information. Collaborative partnerships between industry and national regulatory agencies facilitated rapid notification and transfer of safety information, allowing for rapid responses in the event of a safety signal of adverse event of concern. More than 4 years of post-licensure experience may provide confidence to providers and the public about the safety profile of HPV-16/18 vaccine in routine use. The safety profile appears to be consistent with pre-licensure data reporting that HPV-16/18 vaccine has an acceptable benefit-risk profile in adolescent girls and women. © 2014 The Authors. Pharmacoepidemiology and Drug Safety published by John Wiley & Sons, Ltd.

  9. A 10-year study of rendezvous intraoperative endoscopic retrograde cholangiography during cholecystectomy and the risk of post-ERCP pancreatitis.

    Science.gov (United States)

    Noel, Rozh; Enochsson, Lars; Swahn, Fredrik; Löhr, Matthias; Nilsson, Magnus; Permert, Johan; Arnelo, Urban

    2013-07-01

    Rendezvous intraoperative endoscopic retrograde cholangiography (RV-IOERC), also called guidewire-facilitated IOERC, is one of the single-stage options available for managing common bile duct stones (CBDS) during laparoscopic cholecystectomy. The objective of this study is to investigate procedure-related complications in IOERC patients and stone clearance. All patients who underwent IOERC between January 2000 and December 2009 were identified from the local registry of Karolinska University Hospital in Huddinge. Medical charts and ERC reports were studied, and descriptive statistics were obtained. Outcomes were procedure-related complications, especially post-ERCP pancreatitis (PEP), stone clearance, and mortality. 307 patients were identified. In 264 of the patients, the rendezvous cannulation technique was successful (86 %); in the remaining 43 patients, conventional cannulation technique was necessary. In total, PEP occurred in seven patients (2.28 %). One of the PEP patients was in the rendezvous cannulated group (0.37 %), whereas six patients developed PEP in the nonrendezvous group (13.95 %, p < 0.001). The primary stone clearance rate was 88.27 % (271/307). There was no mortality within 90 days in the series. IOERC with RV cannulation technique for management of CBDS during laparoscopic cholecystectomy has a low PEP rate and a high stone clearance rate, making it a safe and feasible method for removing CBDS. However, the technique requires logistics to perform IOERC in the operating theater. The present data suggest that IOERC with RV cannulation is superior to conventional cannulation with respect to risk of PEP.

  10. How long is long-term? reflections based on over 20 years of post-Chernobyl management in Norway

    International Nuclear Information System (INIS)

    Liland, Astrid; Lochard, Jacques; Skuterud, Lavrans

    2009-01-01

    The radiation protection community has only recently started the important work of preparedness for long-term post-accidental management of radioactively contaminated areas, like for instance the EC projects STRATEGY, FARMING and EURANOS and the French authorities' CODIRPA and PAREX programmes. There are, however, different views concerning how long a long-term management might last. Based on the Norwegian and former Soviet Union experience after the Chernobyl accident, it is clear that a nuclear accident can entail decades of necessary management and rehabilitation of living conditions. The time period is dependent on a number of factors, e.g. amount of fallout, type of radionuclides, land use of contaminated area, number and density of people affected and available techniques and resources for implementing countermeasures. This paper discusses the management strategy implemented in Norway after the Chernobyl accident, the need for changing strategy over time and the important involvement of affected groups. Careful planning and reflections should be undertaken before actions are taken in the recovery phase, keeping in mind the possibility of decades with problems.

  11. How long is long-term? reflections based on over 20 years of post-Chernobyl management in Norway

    Energy Technology Data Exchange (ETDEWEB)

    Liland, Astrid [Norwegian Radiation Protection Authority, P.O. Box 55, 1332 Osteras (Norway)], E-mail: astrid.liland@nrpa.no; Lochard, Jacques [CEPN - Nuclear Protection Evaluation Centre, 28 rue de la Redoute, 92260 Fontenay-aux-Roses (France); Skuterud, Lavrans [Norwegian Radiation Protection Authority, P.O. Box 55, 1332 Osteras (Norway); Norwegian Reindeer Husbandry Authority, P.O. Box 121, 7361 Roros (Norway)

    2009-07-15

    The radiation protection community has only recently started the important work of preparedness for long-term post-accidental management of radioactively contaminated areas, like for instance the EC projects STRATEGY, FARMING and EURANOS and the French authorities' CODIRPA and PAREX programmes. There are, however, different views concerning how long a long-term management might last. Based on the Norwegian and former Soviet Union experience after the Chernobyl accident, it is clear that a nuclear accident can entail decades of necessary management and rehabilitation of living conditions. The time period is dependent on a number of factors, e.g. amount of fallout, type of radionuclides, land use of contaminated area, number and density of people affected and available techniques and resources for implementing countermeasures. This paper discusses the management strategy implemented in Norway after the Chernobyl accident, the need for changing strategy over time and the important involvement of affected groups. Careful planning and reflections should be undertaken before actions are taken in the recovery phase, keeping in mind the possibility of decades with problems.

  12. Post-chikungunya chronic inflammatory rheumatism: results from a retrospective follow-up study of 283 adult and child cases in La Virginia, Risaralda, Colombia [version 2; referees: 3 approved

    Directory of Open Access Journals (Sweden)

    Alfonso J. Rodriguez-Morales

    2016-04-01

    Full Text Available Objective: There are limited studies in Latin America regarding the chronic consequences of the Chikungunya virus (CHIK, such as post-CHIK chronic inflammatory rheumatism (pCHIK-CIR. We assessed the largest cohort so far of pCHIK-CIR in Latin America, at the municipality of La Virginia, Risaralda, a new endemic area of CHIK in Colombia. Methods: We conducted a cohort retrospective study in Colombia of 283 patients diagnosed with CHIK that persisted with pCHIK-CIR after a minimum of 6 weeks and up to a maximum of 26.1 weeks. pCHIK cases were identified according to validated criteria via telephone. Results: Of the total CHIK-infected subjects, 152 (53.7% reported persistent rheumatological symptoms (pCHIK-CIR. All of these patients reported joint pains (chronic polyarthralgia, pCHIK-CPA, 49.5% morning stiffness, 40.6% joint edema, and 16.6% joint redness. Of all patients, 19.4% required and attended for care prior to the current study assessment (1.4% consulting rheumatologists. Significant differences in the frequency were observed according to age groups and gender. Patients aged >40 years old required more medical attention (39.5% than those ≤40 years-old (12.1% (RR=4.748, 95%CI 2.550-8.840. Conclusions: According to our results, at least half of the patients with CHIK developed chronic rheumatologic sequelae, and from those with pCHIK-CPA, nearly half presented clinical symptoms consistent with inflammatory forms of the disease. These results support previous estimates obtained from pooled data of studies in La Reunion (France and India and are consistent with the results published previously from other Colombian cohorts in Venadillo (Tolima and Since (Sucre.

  13. Outcomes associated with early post-traumatic osteoarthritis and other negative health consequences 3-10 years following knee joint injury in youth sport.

    Science.gov (United States)

    Whittaker, J L; Woodhouse, L J; Nettel-Aguirre, A; Emery, C A

    2015-07-01

    Post-traumatic osteoarthritis (PTOA) commonly affects the knee joint. Although the risk of PTOA substantially increases post-joint injury, there is little research examining PTOA outcomes early in the period between joint injury and disease onset. Improved understanding of this interval would inform secondary prevention strategies aimed at preventing and/or delaying PTOA progression. This study examines the association between sport-related knee injury and outcomes related to development of PTOA, 3-10 years post-injury. This preliminary analysis of the first year of a historical cohort study includes 100 (15-26 years) individuals. Fifty with a sport-related intra-articular knee injury sustained 3-10 years previously and 50 uninjured age, sex and sport matched controls. The primary outcome was the 'Symptoms' sub-scale of the Knee Osteoarthritis and Injury Outcome Score (KOOS). Secondary outcomes included; the remaining KOOS subscales, body mass index (BMI), hip abductor/adductor and knee extensor/flexor strength, estimated aerobic capacity (VO2max) and performance scores on three dynamic balance tests. Descriptive statistics (mean within-pair difference; 95% Confidence interval (CI) and conditional odds ratio (OR, 95% CI; BMI) were used to compare study groups. Injured participants demonstrated poorer KOOS outcomes [symptoms -9.4 (-13.6, -5.2), pain -4.0 (-6.8, -1.2), quality-of-life -8.0 (-11.0, -5.1), daily living -3.0 (-5.0, -1.1) and sport/recreation -6.9 (-9.9, -3.8)], were 3.75 times (95% CI 1.24, 11.3) more likely to be overweight/obese and had lower triple single leg hop scores compared to controls. No significant group differences existed for remaining balance scores, estimated VO2max, hip or knee strength ratios or side-to-side difference in hip abductor/adductor or quadricep/hamstring strength. This study provides preliminary evidence that youth/young adults following sport-related knee injury report more symptoms and poorer function, and are at

  14. Biosimilars approval process.

    Science.gov (United States)

    Zuñiga, Leyre; Calvo, Begoña

    2010-04-01

    For similar biological medicinal products, the so-called biosimilars, clinical trials are required rather than just the bioequivalence studies required to support the registration of a generic small molecule drug product. The EU Directive 2001/83/EC, as amended, stated that where a biological medicinal product which is similar to a reference biological product, does not meet the conditions in the definition of generic medicinal products the results of appropriate pre-clinical tests or clinical trials relating to these conditions must be provided. The challenge is to determine the exact nature of the non-clinical and clinical programme required to gain regulatory approval. The applicant is encouraged to provide a detailed description of the strategy used to demonstrate the biosimilar and the reference product have similar profiles in terms of quality, safety and efficacy. The extent to which comparability can be proven will have quite an impact on how many non-clinical and clinical studies the biosimilar applicant will be required to conduct. The dossier submitted by the applicant to the EMEA should cover all aspects of the comparability assessment and must include data on possible unwanted immune reactions to the therapeutic protein. Post-marketing pharmacovigilance plans are also expected to be included in the biosimilar dossier. Copyright 2009 Elsevier Inc. All rights reserved.

  15. Military service and military vocational training effects on post-service earnings

    OpenAIRE

    Bolin, Phil Warren

    1980-01-01

    Approved for public release; distribution is unlimited. The influence of military service and military vocational training on post-service earnings was analyzed using the National Longitudinal Survey of young men (14-24 years of age in 1966) . When individuals were classified by their propensity to use training neither military service nor military vocational training was a significant determinant of post-service earnings. A disaggregation of the sample IQ revealed that m...

  16. Secondary health conditions in persons with spinal cord injury : A longitudinal study from one to five years post-discharge

    NARCIS (Netherlands)

    Adriaansen, Jacinthe J. E.; Post, Marcel W. M.; de Groot, Sonja; van Asbeck, Floris W. A.; Stolwijk-Swuste, Janneke M.; Tepper, Marga; Lindeman, Eline

    2013-01-01

    Objective: To assess the occurrence of secondary health conditions and their potential risk factors in persons with spinal cord injury from 1 to 5 years after discharge from initial inpatient rehabilitation. Design: Multicentre longitudinal study. Subjects: A total of 139 wheelchair-dependent

  17. Pre-Post Tornado Effects on Aggressive Children's Psychological and Behavioral Adjustment Through One-Year Postdisaster.

    Science.gov (United States)

    Lochman, John E; Vernberg, Eric; Powell, Nicole P; Boxmeyer, Caroline L; Jarrett, Matthew; McDonald, Kristina; Qu, Lixin; Hendrickson, Michelle; Kassing, Francesca

    2017-01-01

    Using a risk-resilience framework, this study examined how varying levels of exposure to a natural disaster (EF-4 tornado) and children's characteristics (sex; anxiety) influenced the behavioral and psychological adjustment of children who shared a common risk factor predisaster (elevated aggression) prior to exposure through 1-year postdisaster. Participants included 360 children in Grades 4-6 (65% male; 78% African American) and their parents from predominantly low-income households who were already participating in a longitudinal study of indicated prevention effects for externalizing outcomes when the tornado occurred in 2011. Fourth-grade children who were screened for overt aggressive behavior were recruited in 3 annual cohorts (120 per year, beginning in 2009). Parent-rated aggression and internalizing problems were assessed prior to the tornado (Wave 1), within a half-year after the tornado (Wave 2), and at a 1-year follow-up (Wave 3). Children and parents rated their exposure to aspects of tornado-related traumatic experiences at Wave 3. Children displayed less reduction on aggression and internalizing problems if the children had experienced distress after the tornado or fears for their life, in combination with their pre-tornado level of anxiety. Higher levels of children's and parents' exposure to the tornado interacted with children's lower baseline child anxiety to predict less reduction in aggression and internalizing problems 1 year after the tornado. Higher levels of disaster exposure negatively affected at-risk children's level of improvement in aggression and internalizing problems, when life threat (parent- and child-reported) and child-reported distress after the tornado were moderated by baseline anxiety.

  18. Pre-Post Tornado Effects on Aggressive Children’s Psychological and Behavioral Adjustment Through One-Year Postdisaster

    Science.gov (United States)

    Lochman, John E.; Vernberg, Eric; Powell, Nicole P.; Boxmeyer, Caroline L.; Jarrett, Matthew; McDonald, Kristina; Qu, Lixin; Hendrickson, Michelle; Kassing, Francesca

    2017-01-01

    Objective Using a risk-resilience framework, this study examined how varying levels of exposure to a natural disaster (EF-4 tornado) and children’s characteristics (sex; anxiety) influenced the behavioral and psychological adjustment of children who shared a common risk factor predisaster (elevated aggression) prior to exposure through one-year postdisaster. Method Participants included 360 children in 4th–6th grades (65% male; 78% African American) and their parents from predominantly low-income households who were already participating in a longitudinal study of indicated prevention effects for externalizing outcomes when the tornado occurred in 2011. Fourth-grade children who were screened for overt aggressive behavior were recruited in three annual cohorts (120 per year, beginning in 2009). Parent-rated aggression and internalizing problems were assessed prior to the tornado (Wave 1), within a half-year after the tornado (Wave 2), and at a one-year follow-up (Wave 3). Children and parents rated their exposure to aspects of tornado-related traumatic experiences at Wave 3. Results Children displayed less reduction on aggression and internalizing problems if the children had experienced distress after the tornado or fears for their life, in combination with their pre-tornado level of anxiety. Higher levels of children’s and parents’ exposure to the tornado interacted with children’s lower baseline child anxiety to predict less reduction in aggression and internalizing problems one year after the tornado. Conclusion Higher levels of disaster exposure negatively affected at-risk children’s level of improvement in aggression and internalizing problems, when life threat (parent- and child-reported) and child-reported distress after the tornado were moderated by baseline anxiety. PMID:27841691

  19. Understory Bird Communities in Amazonian Rainforest Fragments: Species Turnover through 25 Years Post-Isolation in Recovering Landscapes

    Science.gov (United States)

    Stouffer, Philip C.; Johnson, Erik I.; Bierregaard, Richard O.; Lovejoy, Thomas E.

    2011-01-01

    Inferences about species loss following habitat conversion are typically drawn from short-term surveys, which cannot reconstruct long-term temporal dynamics of extinction and colonization. A long-term view can be critical, however, to determine the stability of communities within fragments. Likewise, landscape dynamics must be considered, as second growth structure and overall forest cover contribute to processes in fragments. Here we examine bird communities in 11 Amazonian rainforest fragments of 1–100 ha, beginning before the fragments were isolated in the 1980s, and continuing through 2007. Using a method that accounts for imperfect detection, we estimated extinction and colonization based on standardized mist-net surveys within discreet time intervals (1–2 preisolation samples and 4–5 post-isolation samples). Between preisolation and 2007, all fragments lost species in an area-dependent fashion, with loss of as few as <10% of preisolation species from 100-ha fragments, but up to 70% in 1-ha fragments. Analysis of individual time intervals revealed that the 2007 result was not due to gradual species loss beginning at isolation; both extinction and colonization occurred in every time interval. In the last two samples, 2000 and 2007, extinction and colonization were approximately balanced. Further, 97 of 101 species netted before isolation were detected in at least one fragment in 2007. Although a small subset of species is extremely vulnerable to fragmentation, and predictably goes extinct in fragments, developing second growth in the matrix around fragments encourages recolonization in our landscapes. Species richness in these fragments now reflects local turnover, not long-term attrition of species. We expect that similar processes could be operating in other fragmented systems that show unexpectedly low extinction. PMID:21731616

  20. Understory bird communities in Amazonian rainforest fragments: species turnover through 25 years post-isolation in recovering landscapes.

    Directory of Open Access Journals (Sweden)

    Philip C Stouffer

    Full Text Available Inferences about species loss following habitat conversion are typically drawn from short-term surveys, which cannot reconstruct long-term temporal dynamics of extinction and colonization. A long-term view can be critical, however, to determine the stability of communities within fragments. Likewise, landscape dynamics must be considered, as second growth structure and overall forest cover contribute to processes in fragments. Here we examine bird communities in 11 Amazonian rainforest fragments of 1-100 ha, beginning before the fragments were isolated in the 1980s, and continuing through 2007. Using a method that accounts for imperfect detection, we estimated extinction and colonization based on standardized mist-net surveys within discreet time intervals (1-2 preisolation samples and 4-5 post-isolation samples. Between preisolation and 2007, all fragments lost species in an area-dependent fashion, with loss of as few as <10% of preisolation species from 100-ha fragments, but up to 70% in 1-ha fragments. Analysis of individual time intervals revealed that the 2007 result was not due to gradual species loss beginning at isolation; both extinction and colonization occurred in every time interval. In the last two samples, 2000 and 2007, extinction and colonization were approximately balanced. Further, 97 of 101 species netted before isolation were detected in at least one fragment in 2007. Although a small subset of species is extremely vulnerable to fragmentation, and predictably goes extinct in fragments, developing second growth in the matrix around fragments encourages recolonization in our landscapes. Species richness in these fragments now reflects local turnover, not long-term attrition of species. We expect that similar processes could be operating in other fragmented systems that show unexpectedly low extinction.

  1. Feelings of being disabled as a prognostic factor for mortality in men and women post-PCI up to 12years.

    Science.gov (United States)

    Bergmann, Michael J; Utens, Elisabeth M W J; de Jager, Tom A J; Radhoe, Sumant P; Daemen, Joost; Lenzen, Mattie J; van Domburg, Ron T; Dulfer, Karolijn

    2017-12-15

    It remains unclear whether feelings of being disabled are a relevant psychological factor that determines long term outcome after percutaneous coronary intervention (PCI). Therefore, we evaluated 'feelings of being disabled' as an independent risk factor for mortality 12years post-PCI. The study population comprised a consecutive series of CAD patients (n=845) treated with PCI as part of the Taxus-Stent Evaluated At Rotterdam Cardiology Hospital (T-SEARCH) registry. Of these patients n=646 (age 63years, 75% male) completed the subscale 'feelings of being disabled' of the Heart Patients Psychological Questionnaire (HPPQ), within the first month after PCI. At 12year follow-up, n=209 patients (32%) died. Of the 162 females n=73 (45%) experienced high feelings of being disabled (High-FOBD) and of the 484 males, n=134 (28%) reported high-FOBD. Patients with high feelings of being disabled had a two-fold increased risk of mortality at 12-year follow-up (HR=1.86, 95% CI=1.41-2.45). After adjusting, high feelings of being disabled remained a predictor of 12-year mortality (HR=2.53, 95% CI=1.30-4.90). This study confirms that psychosocial variables like feelings of being disabled influence cardiac morbidity and mortality. Furthermore, there is no difference in mortality between men and women with high feelings of being disabled 12years post-PCI. It is important that clinicians are aware that PCI-patients who feel disabled have a less favorable survival and that the difference in survival is even greater for women who feel disabled. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  2. Predicting renal graft failure by sCD30 levels and de novo HLA antibodies at 1year post-transplantation.

    Science.gov (United States)

    Wang, Dong; Wu, Guojun; Chen, Jinhua; Yu, Ziqiang; Wu, Weizhen; Yang, Shunliang; Tan, Jianming

    2012-06-01

    HLA antibodies and sCD30 levels were detected in the serum sampled from 620 renal graft recipients at 1 year post-transplantation, which were followed up for 5 years. Six-year graft and patient survivals were 81.6% and 91.0%. HLA antibodies were detected in 45 recipients (7.3%), of whom there were 14 cases with class I antibodies, 26 cases with class II, and 5 cases with both class I and II. Much more graft loss was record in recipients with HLA antibodies than those without antibodies (60% vs. 15.1%, psCD30 levels were recorded in recipients suffering graft loss than the others (73.9±48.8 U/mL vs. 37.3±14.6 U/mL, psCD30 levels, recipients with low sCD30 levels (sCD30 on graft survival was not only independent but also additive. Therefore, post-transplantation monitoring of HLA antibodies and sCD30 levels is necessary and recipients with elevated sCD30 level and/or de novo HLA antibody should be paid more attention in order to achieve better graft survival. Copyright © 2012 Elsevier B.V. All rights reserved.

  3. Post-traumatic Left Ventricular Aneurysm with Massive Hemopericardium in a Child Presenting 3 Years After a Fall

    Directory of Open Access Journals (Sweden)

    Wei-Ting Lai

    2013-12-01

    Full Text Available A 7-year-old boy developed a left ventricular aneurysm with massive hemopericardium 3 years ago due to a fall from a fourth-floor window. He had mild neurological sequelae including cranial nerve III palsy and abnormal electroencephalography findings at that time. He had no chest pain until recently when he presented with chest tightness and abdominal pain for 2 days prior to admission. Chest X-ray showed marked cardiomegaly. Echocardiography revealed massive pericardial effusion and a large left ventricular aneurysm. The massive hemopericardium was surgically drained, and the aneurysm was resected under cardiopulmonary bypass. He was discharged uneventfully 1 week after operation. Because symptoms and signs can vary in patients with ventricular aneurysm, we strongly suggest a close clinical follow-up, preferably with chest X-ray or echocardiography, for patients experiencing a blunt chest trauma.

  4. Evaluation of Trends in Foreign Trade Development in the Post-Communist Countries of Europe in the Years 2000–2012 Following their Accession to the EU

    Directory of Open Access Journals (Sweden)

    Cieślik Ewa

    2016-12-01

    Full Text Available This paper seeks to analyse directions in foreign trade in the post-communist countries of Europe over the years 2000-2012 in the context of changes observed in other EU states. It was assumed that changes in the directions of foreign trade in post-communist states would be similar to those noted in Western Europe. On the basis of data derived from the OECD, EUROSTAT and OECD-WTO we show that the trading rules used by the old EU-15 adopted by those countries have brought them measurable benefits. As a result, the post-communist economies have become similar to those of the EU-15. Considering the structure of their trade and links with the EU-15, it is apparent that they have become the main trading and investment partners for the European Union. Hence, their integration with the EU structures made their development faster, but also made them more sensitive to industrial and demand shocks coming from the eurozone. It is predicted that the present model is not going to change, especially in the context of the participation in production networks.

  5. The great refit of the EDF nuclear fleet and post-Fukushima actions. An ambition to extend to 50 or 60 years the exploitation of reactors

    International Nuclear Information System (INIS)

    Tonnac, Alain de; Perves, Jean-Pierre

    2014-01-01

    The great refit of the EDF nuclear fleet aims at extending the service lifetime of nuclear reactors. If the extension to 40 years is well undertaken, an extension to 50 or 60 years could only be approved after a return on experience of the Fukushima accident and possible additional requests made by the ASN in reference to facilities ageing. The authors first recall some elements related to the Fukushima accident and outline the fact that the possibility of such a strong tsunami had not been taken in to account by the operator (as it had been for a neighbouring nuclear power station, Onagawa). They also highlight the differences between Japan and France in terms of organisation of the nuclear industry. They also outline technical differences in the design of power stations. Thus, the first lessons learned from the accident seem to support French options. They discuss the evolutions which however are planned for the French nuclear stations after the Fukushima accident. Then, the authors present the great refit and the issue of the extension of the service lifetime of the EDF nuclear fleet. This project is presented as a major challenge for EDF, and implies a management of expenses. They outline the good level of French energy production with respect to greenhouse gas emissions, and briefly discuss the issue of competitiveness for renewable energies

  6. A 35-year-old woman presenting with an unusual post-traumatic leiomyoma of the nipple: a case report.

    Science.gov (United States)

    Pavlidis, Leonidas; Vakirlis, Efstratios; Spyropoulou, Georgia-Alexandra; Pramateftakis, Manousos Georgios; Dionyssiou, Dimitris; Demiri, Efterpi

    2013-02-19

    Leiomyoma of the mammary papilla is one of the most uncommon nipple tumors with only 50 cases reported in the literature until now. To the best of our knowledge we present the first report of a nipple leiomyoma that originated from a traumatic abrasion caused by breastfeeding. A 35-year-old healthy Caucasian female with a cauliflower-like tender and pink nodular mass that was approximately 10mm in diameter presented to our out-patients department. The patient suggested that the mass originated from a traumatic abrasion caused by breastfeeding three years ago and it has been slowly growing ever since.An excision biopsy was performed. The histological and immunohistochemical examination confirmed the diagnosis of leiomyoma. There were no postoperative complications or any sign of local recurrence four years postoperatively. Leiomyoma of the mammary papilla is a rare benign neoplasm that usually appears as a solid tender nodule. Differential diagnosis comprises breast carcinoma, leiomyosarcoma and myoid hamartoma. The recommended treatment is complete excision of the tumor with histologically confirmed tumor-free margins otherwise recurrence is possible. A detailed history of the patient's disease can reveal the original etiology. This is an original case report that will have particular interest to plastic surgeons, dermatologists, and pathologists. The pathogenetic mechanism was trauma of the nipple. According to our review of the literature this particular information has never been reported and we think that it may advance our knowledge of this very infrequent tumor.

  7. Commentary: An Introduction to Leadership Self-Assessment at the Society of Neurological Surgeons Post-Graduate Year 1 Boot Camp: Observations and Commentary.

    Science.gov (United States)

    Hunt, Matthew A; Heilman, Carl B; Shutran, Max; Wu, Julian K

    2017-03-01

    Recent trends in graduate medical education have emphasized the mastery of nontechnical skills, especially leadership, for neurosurgical trainees. Accordingly, we introduced leadership development and self-awareness training to interns attending the Society of Neurological Surgeons Post-Graduate Year 1 Boot Camp in the Northeast (New England/New York/New Jersey) region in 2015. Feedback about the session was collected from interns. While neurosurgical interns conveyed a desire to receive more information on improving their leadership skills, most indicated that guidance seemed to be lacking in this critical area. We discuss some of the professional development needs uncovered during this process. Copyright © 2017 by the Congress of Neurological Surgeons.

  8. 38 CFR 21.9765 - Program of education approval.

    Science.gov (United States)

    2010-07-01

    ... education offered by an institution of higher learning if that program of education is approved under 38 U.S... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Program of education... (CONTINUED) VOCATIONAL REHABILITATION AND EDUCATION Post-9/11 GI Bill Approval of Programs of Education § 21...

  9. Dabrafenib Plus Trametinib Approved for Melanoma, Thyroid Cancer

    Science.gov (United States)

    FDA recently approved the combination of dabrafenib (Taflinar) and trametinib (Mekinist) to treat some patients with melanoma and anaplastic thyroid cancer whose tumors have a mutation in the BRAF gene. As this Cancer Currents blog post explains, this is the first treatment approved specifically for anaplastic thyroid

  10. The incidence of post-transplant cancer among kidney transplant recipients is associated with the level of tacrolimus exposure during the first year after transplantation.

    Science.gov (United States)

    Lichtenberg, Shelly; Rahamimov, Ruth; Green, Hefziba; Fox, Benjamin D; Mor, Eytan; Gafter, Uzi; Chagnac, Avry; Rozen-Zvi, Benaya

    2017-07-01

    Immunosuppressive therapy plays a major role in the development of post-transplant cancer. In this nested case-control study of kidney transplant recipients (KTRs), we investigated whether the incidence of post-transplant cancer is associated with the level of tacrolimus exposure over time. We screened the Rabin Medical Center database for adults who received kidney transplants between 2001 and 2014 and developed post-transplant cancer (excluding basal and squamous cell skin cancers). They were matched against KTRs without cancer. All patients received a maintenance immunosuppressive treatment with tacrolimus, mycophenolate mofetil and corticosteroids. The degree of exposure to tacrolimus was estimated as the time-weighted average (tTWA) value of tacrolimus blood levels. The tTWA was calculated as the area under the curve divided by time at 1, 6, and 12 months after transplantation and at time of cancer diagnosis. Thirty-two cases were matched against 64 controls. tTWA values above 11 ng/mL at 6 and 12 months after transplantation were associated with odds ratio (OR) of 3.1 (95% CI 1.1-9) and 11.7 (95% CI = 1.3-106), respectively, for post-transplant cancer; and with OR of 5.2 (95% CI 1.3-20.5) and 14.1 (95% CI = 1.5-134.3), respectively, for cancer diagnosed more than 3 years after transplantation. Exposure to a tacrolimus time-weighted average level above 11 ng/mL at 6 or 12 months after kidney transplantation is associated with an increased risk of developing cancer.

  11. Brain-Only Metastases Seen on FDG PET as First Relapse of Papillary Thyroid Carcinoma Two Years Post-Thyroidectomy.

    Science.gov (United States)

    Naddaf, Sleiman Y; Syed, Ghulam Mustafa Shah; Hadb, Abdulrahman; Al-Thaqfi, Saif

    2016-09-01

    We report a case of a 60-year-old man diagnosed with papillary thyroid cancer who had a relapse seen only in the brain at FDG PET on standard images. Total thyroidectomy was performed in July 2013 after initial diagnosis. Patient received I ablation in December 2013, followed by external beam radiotherapy to the neck. In September 2015, the patient presented with neurological symptoms. Brain MRI showed multiple brain metastases later confirmed on histopathology. An FDG PET/CT scan was performed to evaluate the whole body in November 2015. Multiple hypermetabolic lesions were identified in the brain with no other lesion up to mid thighs.

  12. Differential movement patterns of juvenile Tengmalms owls (Aegolius funereus during the post-fledging dependence period in two years with contrasting prey abundance.

    Directory of Open Access Journals (Sweden)

    Marek Kouba

    Full Text Available Fledgling behaviour and movement patterns throughout the post-fledging dependence period (PFDP, especially in relation to changing environmental conditions, have been rarely studied, despite the fact that this period is recognized as of crucial significance in terms of high mortality of juveniles. The PFDP can extend over quite a protracted period, particularly in birds of prey, and a knowledge of the movement patterns of individuals is fundamental for understanding mechanisms underlying survival, habitat use and dispersion. We radiotracked 39 fledglings of the Tengmalm's owl (Aegolius funereus in two years with different availability of prey: 2010 (n = 29 and 2011 (n = 10 and obtained 1455 daily locations. Fledglings reached independence on average in 45 days after fledging in 2010 (n = 22 and 57 days in 2011 (n = 6. Within years, the most important measures influencing the distance moved from the nest box were age of fledglings and number of surviving siblings present. Individual home range size and duration of PFDP in particular were dependent on maximal number of siblings seen outside the nest box. In the season with low prey availability fledglings were observed at greater distances from the nest box than in the year with higher prey availability (mean distance: 350 m in 2010 and 650 m in 2011 and occupied larger home ranges (mean: 30.3 ha in 2010 and 57.7 ha in 2011. The main factor causing these differences between years was probably the different availability of prey in these two years, affecting breeding success and post-fledging survivorship of the Tengmalm's owls.

  13. A 27,000 year record of Red Sea Outflow: Implication for timing of post-glacial monsoon intensification

    Science.gov (United States)

    Naqvi, Wajih A.; Fairbanks, Richard G.

    We reconstruct here the history of the Red Sea Outflow (RSO) over the past 27,000 years from an AMS 14C-dated high-resolution δ13C record of benthic foraminifera from the inner Gulf of Aden assuming the dominance of circulation over productivity in regulating benthic δ13C. The results reveal that, following a period of suppressed RSO due to shallow sill 24,000-18,000 yr BP, the Red Sea was vigorously flushed for ˜2,000 years before a major monsoon intensification caused the cessation of deep water formation from 15,500 to 7,300 yr BP. It appears that the monsoon intensification did lag behind insolation until 15,500 yr BP. Between 15,500 and the present, however, there was no lag in conflict with the previous reports, implying a negligible dampening effect of continental albedo during this period. However, since our analysis is confined to a single depth horizon and our record is sensitive to sea level, it has some limitations as an indicator of monsoon intensity.

  14. Worldwide Evaluations of Quinoa: Preliminary Results from Post International Year of Quinoa FAO Projects in Nine Countries.

    Science.gov (United States)

    Bazile, Didier; Pulvento, Cataldo; Verniau, Alexis; Al-Nusairi, Mohammad S; Ba, Djibi; Breidy, Joelle; Hassan, Layth; Mohammed, Maarouf I; Mambetov, Omurbek; Otambekova, Munira; Sepahvand, Niaz Ali; Shams, Amr; Souici, Djamel; Miri, Khaled; Padulosi, Stefano

    2016-01-01

    Chenopodium quinoa Willd., a high quality grain crop, is resistant to abiotic stresses (drought, cold, and salt) and offers an optimal source of protein. Quinoa represents a symbol of crop genetic diversity across the Andean region. In recent years, this crop has undergone a major expansion outside its countries of origin. The activities carried out within the framework of the International Year of Quinoa provided a great contribution to raise awareness on the multiple benefits of quinoa as well as to its wider cultivation at the global level. FAO is actively involved in promoting and evaluating the cultivation of quinoa in 26 countries outside the Andean region with the aim to strengthen food and nutrition security. The main goal of this research is to evaluate the adaptability of selected quinoa genotypes under different environments outside the Andean region. This paper presents the preliminary results from nine countries. Field evaluations were conducted during 2013/2014 and 2014/2015 in Asia (Kyrgyzstan and Tajikistan), and the Near East and North African countries (Algeria, Egypt, Iraq, Iran, Lebanon, Mauritania, and Yemen). In each country, the trials were carried out in different locations that globally represent the diversity of 19 agrarian systems under different agro-ecological conditions. Twenty-one genotypes of quinoa were tested using the same experimental protocol in all locations consisting in a randomized complete block design (RCBD) with three replicates. Some genotypes showed higher yields and the Q18 and Q12 landraces displayed greater adaptation than others to new environmental conditions. The Q21 and Q26 landraces were evaluated with stable and satisfactory levels of yield (>1 t.ha(-1)) in each of the different trial sites. This production stability is of considerable importance especially under climate change uncertainty. While these results suggest that this Andean crop is able to grow in many different environments, social, and cultural

  15. Worldwide Evaluations of Quinoa: Preliminary Results from Post International Year of Quinoa FAO Projects in Nine Countries

    Science.gov (United States)

    Bazile, Didier; Pulvento, Cataldo; Verniau, Alexis; Al-Nusairi, Mohammad S.; Ba, Djibi; Breidy, Joelle; Hassan, Layth; Mohammed, Maarouf I.; Mambetov, Omurbek; Otambekova, Munira; Sepahvand, Niaz Ali; Shams, Amr; Souici, Djamel; Miri, Khaled; Padulosi, Stefano

    2016-01-01

    Chenopodium quinoa Willd., a high quality grain crop, is resistant to abiotic stresses (drought, cold, and salt) and offers an optimal source of protein. Quinoa represents a symbol of crop genetic diversity across the Andean region. In recent years, this crop has undergone a major expansion outside its countries of origin. The activities carried out within the framework of the International Year of Quinoa provided a great contribution to raise awareness on the multiple benefits of quinoa as well as to its wider cultivation at the global level. FAO is actively involved in promoting and evaluating the cultivation of quinoa in 26 countries outside the Andean region with the aim to strengthen food and nutrition security. The main goal of this research is to evaluate the adaptability of selected quinoa genotypes under different environments outside the Andean region. This paper presents the preliminary results from nine countries. Field evaluations were conducted during 2013/2014 and 2014/2015 in Asia (Kyrgyzstan and Tajikistan), and the Near East and North African countries (Algeria, Egypt, Iraq, Iran, Lebanon, Mauritania, and Yemen). In each country, the trials were carried out in different locations that globally represent the diversity of 19 agrarian systems under different agro-ecological conditions. Twenty-one genotypes of quinoa were tested using the same experimental protocol in all locations consisting in a randomized complete block design (RCBD) with three replicates. Some genotypes showed higher yields and the Q18 and Q12 landraces displayed greater adaptation than others to new environmental conditions. The Q21 and Q26 landraces were evaluated with stable and satisfactory levels of yield (>1 t.ha−1) in each of the different trial sites. This production stability is of considerable importance especially under climate change uncertainty. While these results suggest that this Andean crop is able to grow in many different environments, social, and cultural

  16. Sexual and reproductive health and rights in the sustainable development goals and the post-2015 development agenda: less than a year to go.

    Science.gov (United States)

    Haslegrave, Marianne

    2014-11-01

    Since the International Conference on Population and Development (ICPD) in Cairo in 1994 there have been significant achievements in moving towards the goal of sexual and reproductive health and rights. Yet there have also been disappointments, as demonstrated in the Millennium Development Goals, even though in 2007 a target on reproductive health was added. Most recently, the 20-year review of the implementation of the ICPD Programme of Action, ICPD Beyond 2014, has taken place, which has moved forward the sexual and reproductive health and rights agenda. But, the main arena for future negotiations has changed and the UN is in the process of negotiating the post-2015 development agenda and the sustainable development goals (SDGs). This paper assesses what has been taking place since 2013 and provides information as to how the process for the post-2015 development agenda and the SDGs are likely to move forward. An understanding of what has been achieved, the processes as they are now proceeding and their future development are important for moving towards the ultimate goal of achieving sexual and reproductive health and rights in the next 15 years. Copyright © 2014 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

  17. Association between maternal depressive symptoms in the early post-natal period and responsiveness in feeding at child age 2 years.

    Science.gov (United States)

    Mallan, Kimberley M; Daniels, Lynne A; Wilson, Jacinda L; Jansen, Elena; Nicholson, Jan M

    2015-10-01

    Maternal depression is a known risk factor for poor outcomes for children. Pathways to these poor outcomes relate to reduced maternal responsiveness or sensitivity to the child. Impaired responsiveness potentially impacts the feeding relationship and thus may be a risk factor for inappropriate feeding practices. The aim of this study was to examine the longitudinal relationships between self-reported maternal post-natal depressive symptoms at child age 4 months and feeding practices at child age 2 years in a community sample. Participants were Australian first-time mothers allocated to the control group of the NOURISH randomized controlled trial when infants were 4 months old. Complete data from 211 mothers (of 346 allocated) followed up when their children were 2 years of age (51% girls) were available for analysis. The relationship between Edinburgh Postnatal Depression Scale (EPDS) score (child age 4 months) and child feeding practices (child age 2 years) was tested using hierarchical linear regression analysis adjusted for maternal and child characteristics. Higher EPDS score was associated with less responsive feeding practices at child age 2 years: greater pressure [β = 0.18, 95% confidence interval (CI): 0.04-0.32, P = 0.01], restriction (β = 0.14, 95% CI: 0.001-0.28, P = 0.05), instrumental (β = 0.14, 95% CI: 0.005-0.27, P = 0.04) and emotional (β = 0.15, 95% CI: 0.01-0.29, P = 0.03) feeding practices (ΔR(2) values: 0.02-0.03, P responsiveness in child feeding. These findings suggest that the provision of support to mothers experiencing some levels of depressive symptomatology in the early post-natal period may improve responsiveness in the child feeding relationship. © 2014 John Wiley & Sons Ltd.

  18. Three-Year Pre-Post Analysis of EBP Integration in a Magnet-Designated Community Hospital.

    Science.gov (United States)

    Warren, Joan Insalaco; Montgomery, Kathryn Lothschuetz; Friedmann, Erika

    2016-02-01

    Adoption of evidence-based practices (EBP) by registered nurses (RNs) and nurse leaders continues to be a challenge. Although multiple strategies and substantial resources are being invested to advance nursing practice based on evidence, little is known about the long-term impact of these interventions. This study was undertaken to assess nurse leaders' and clinical RNs' beliefs to use EBP, perceptions about organizational readiness for EBP, and frequency of implementing EBP following implementation of multifaceted interventions to achieve and maintain Magnet designation. This retrospective descriptive study compared data from two previously administered online surveys (2008 and 2012) at a mid-Atlantic Magnet-designated community hospital. Clinical RNs' self-reported attitudes toward EBP were more positive (2008: M = 53.85, standard error of the mean [SEM] = 0.65; 2012: M = 57.07,SEM = 0.58), as well as their perceptions of organizational readiness (2008: M = 50.72, SEM = 1.20; 2012: M = 81.09, SEM = 0.98), between the two survey years. Contrarily, although nurse leader scores were significantly higher for beliefs (2008: M = 61.15, SEM = 1.23; 2012: M = 60.60., SEM = 0.96), readiness (2008: M = 61.28, SEM = 2.16; 2012: M = 85.18, SEM = 1.64), and implementation (2008: M = 21.35, SEM = 1.72; 2012: M = 19.08, SEM = 1.43) little change was observed in the nurse leader scores between the two survey years compared with clinical RNs. Results from this study suggest that the multifaceted interventions have had a positive impact on clinical RNs' beliefs and readiness for EBP, but not for nurse leaders. Albeit low, self-reported implementation of EBP by RNs and nurse leaders has been sustained, but has not improved. Leaders must see their role as not only facilitators of EBP but also as active participants practicing EBP. Actively engaging leaders in EBP by serving on interprofessional EBP teams and role modeling these behaviors to staff is critical to EBP implementation

  19. A Survey of Psychological, Motivational, Family and Perceptions of Physics Education Factors that Explain 15-Year-Old Students' Aspirations to Study Physics in Post-Compulsory English Schools

    Science.gov (United States)

    Mujtaba, Tamjid; Reiss, Michael J.

    2014-01-01

    This paper investigates the factors that influence 15-year-old students' intentions to study physics post-16, when it is no longer compulsory. The analysis is based on the year 10 (age, 15 years) responses of 5,034 students from 137 England schools as learners of physics during the academic year 2008-2009. Factor analyses uncovered a range of…

  20. Duration of post-vaccination immunity to yellow fever in volunteers eight years after a dose-response study.

    Science.gov (United States)

    de Menezes Martins, Reinaldo; Maia, Maria de Lourdes S; de Lima, Sheila Maria Barbosa; de Noronha, Tatiana Guimarães; Xavier, Janaina Reis; Camacho, Luiz Antonio Bastos; de Albuquerque, Elizabeth Maciel; Farias, Roberto Henrique Guedes; da Matta de Castro, Thalita; Homma, Akira

    2018-06-27

    In 2009, Bio-Manguinhos conducted a dose-response study with the yellow fever vaccine, administering the vaccine in the usual mean dose of 27,476 IU (full dose, reference) and in tapered doses (10,447 IU, 3013 IU, 587 IU, 158 IU, and 31 IU) by the usual subcutaneous route and usual volume (0.5 mL). Tapered doses were obtained by dilution in the manufacturer's laboratory, and the test batches presented industrial quality. Doses down to 587 IU showed similar immunogenicity to the full dose (27,476, reference), while the 158 IU and 31 IU doses displayed lower immunogenicity. Seropositivity was maintained at 10 months, except in the group that received the 31 IU dose. The current study aims to determine whether yellow fever seropositivity was maintained eight years after YF vaccination in non-revaccinated individuals. According to the current study's results, seropositivity was maintained in 85% of 318 participants and was similar across groups. The findings support the use of the yellow fever vaccine in fractional doses during outbreaks, but each fractional dose should have at least 587 IU. This study also supports the minimum dose required by WHO, 1000 IU. Clinicaltrials.gov NCT 03338231. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

  1. Gestational glucose intolerance modifies the association between magnesium and glycemic variables in mothers and daughters 15 years post-partum.

    Science.gov (United States)

    Del Gobbo, Liana C; Song, Yiqing; Elin, Ronald J; Meltzer, Sara J; Egeland, Grace M

    2012-07-01

    Gestational diabetes mellitus (GDM) and low magnesium (Mg) intake and status are associated with an increased risk of type 2 diabetes. However, Mg homeostasis may be modified by GDM. We sought to determine if a history of GDM prospectively modifies associations between Mg and glycemic variables in mothers and their offspring. Plasma and dietary Mg, anthropometric, lifestyle and glycemic variables were assessed in mothers affected by GDM during 1989-1990, a comparative group of normoglycemic women, pregnant during the same time period, and the 15-year-old, nondiabetic daughters of affected and unaffected pregnancies (n = 332). Multivariate regression analyses evaluated the cross-sectional association between plasma and dietary Mg with glycemic variables in mothers and daughters. Plasma Mg was lower in mothers with a history of GDM in comparison to control mothers after adjustment for current type 2 diabetes, race and body mass index (0.90 ± 0.01 versus 0.96 ± 0.01 mmol/L; p = 0.002). Plasma Mg was significantly associated with insulin sensitivity and was inversely associated with fasting insulin in GDM mothers only (pmothers and offspring with a history of GDM.

  2. Barriers to the success of an electronic pharmacovigilance reporting system in Kenya: an evaluation three years post implementation.

    Science.gov (United States)

    Agoro, Oscar O; Kibira, Sarah W; Freeman, Jenny V; Fraser, Hamish S F

    2018-06-01

    Electronic pharmacovigilance reporting systems are being implemented in many developing countries in an effort to improve reporting rates. This study sought to establish the factors that acted as barriers to the success of an electronic pharmacovigilance reporting system in Kenya 3 years after its implementation. Factors that could act as barriers to using electronic reporting systems were identified in a review of literature and then used to develop a survey questionnaire that was administered to pharmacists working in government hospitals in 6 counties in Kenya. The survey was completed by 103 out of the 115 targeted pharmacists (89.5%) and included free-text comments. The key factors identified as barriers were: unavailable, unreliable, or expensive Internet access; challenges associated with a hybrid system of paper and electronic reporting tools; and system usability issues. Coordination challenges at the national pharmacovigilance center and changes in the structure of health management in the country also had an impact on the success of the electronic reporting system. Different personal, organizational, infrastructural, and reporting system factors affect the success of electronic reporting systems in different ways, depending on the context. Context-specific formative evaluations are useful in establishing the performance of electronic reporting systems to identify problems and ensure that they achieve the desired objectives. While several factors hindered the optimal use of the electronic pharmacovigilance reporting system in Kenya, all were considered modifiable. Effort should be directed toward tackling the identified issues in order to facilitate use and improve pharmacovigilance reporting rates.

  3. Post-angioplasty far infrared radiation therapy improves 1-year angioplasty-free hemodialysis access patency of recurrent obstructive lesions.

    Science.gov (United States)

    Lai, C-C; Fang, H-C; Mar, G-Y; Liou, J-C; Tseng, C-J; Liu, C-P

    2013-12-01

    To explore the role of far infrared (FIR) radiation therapy for hemodialysis (HD) access maintenance after percutaneous transluminal angioplasties (PTA). This was a prospective observational study. Eligible patients were those who received repeated PTA with the last PTA successfully performed within 1 week before the study enrollments. Consecutively enrolled patients undergoing successful HD treatments after PTA were randomly assigned to the FIR-radiated group or control group without radiation. FIR-radiated therapy meaning 40-minute radiation at the major lesion site or anastomosed site three times a week was continued until an end-point defined as dysfunction-driven re-PTA or the study end was reached. Of 216 participants analyzed, including 97 with arteriovenous grafts (AVG) (49 FIR-radiated participants and 48 control participants) and 119 with arteriovenous fistulas (AVF) (69 FIR-radiated participants and 50 control participants), the FIR-radiated therapy compared with free-radiated usual therapy significantly enhanced PTA-unassisted patency at 1 year in the AVG subgroup (16.3% vs. 2.1%; p radiated therapy improves PTA-unassisted patency in patients with AVG who have undergone previous PTA. Copyright © 2013 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

  4. Cytogenic follow-up studies in six radiation accident victims 16 and 17 years post-exposure

    International Nuclear Information System (INIS)

    Littlefield, L.G.; Joiner, E.E.

    1978-01-01

    Detailed cytogenetic evaluations were recently conducted in cultured lymphocytes from six men accidentally exposed to fission neutron and gamma radiation in 1958 (dose range 22.8-365 rads). Two-day lymphocyte cultures stimulated with phytohaemagglutinin (PHA) and seven-day cultures stimulated with pokeweed mitogen (PWM) were initiated on all six men for routine microscopic and karyotypic analysis. PHA-stimulated cultures from the two men with the highest exposures were also evaluated using Giemsa-banding procedures. Approximately 9% of the metaphases in the PHA cultures and 11% of the metaphases in the PWM cultures were found to have residual radiation-induced aberrations (symmetrical and asymmetrical exchanges and deletions). In both the PHA and PWM cultures the highest frequencies of lesions were observed in preparations from three men with the highest radiation exposures. Among the abnormal metaphases from the various PHA cultures five possible clones were identified (two or more cells having apparently identical lesions) whereas no stemlines were detected in the PWM cultures. The frequency of stable lesions in 92 banded metaphases from the two men with the highest exposures did not differ significantly from the frequency of lesions detected in 300 metaphases evaluated with routine staining and karyotypic procedures. These data suggest that radiation-damaged lymphocytes responsive to mitogenic stimulation by PHA and PWM may survive for many years following exposure, that the frequency of lymphocytes with persistent aberrations can be roughly correlated with dose, and that in some instances cells bearing 'stable' radiation-induced lesions may propagate in vivo. The findings also show that banding procedures, compared with routine microscopic and karyotypic methods, do not significantly improve the rate of detection of symmetrical lesions in lymphocytes from irradiated persons

  5. Humoral and cell-mediated immunity to pandemic H1N1 influenza in a Canadian cohort one year post-pandemic: implications for vaccination.

    Directory of Open Access Journals (Sweden)

    Lisa E Wagar

    Full Text Available We evaluated a cohort of Canadian donors for T cell and antibody responses against influenza A/California/7/2009 (pH1N1 at 8-10 months after the 2nd pandemic wave by flow cytometry and microneutralization assays. Memory CD8 T cell responses to pH1N1 were detectable in 58% (61/105 of donors. These responses were largely due to cross-reactive CD8 T cell epitopes as, for those donors tested, similar recall responses were obtained to A/California 2009 and A/PR8 1934 H1N1 Hviruses. Longitudinal analysis of a single infected individual showed only a small and transient increase in neutralizing antibody levels, but a robust CD8 T cell response that rose rapidly post symptom onset, peaking at 3 weeks, followed by a gradual decline to the baseline levels seen in a seroprevalence cohort post-pandemic. The magnitude of the influenza-specific CD8 T cell memory response at one year post-pandemic was similar in cases and controls as well as in vaccinated and unvaccinated donors, suggesting that any T cell boosting from infection was transient. Pandemic H1-specific antibodies were only detectable in approximately half of vaccinated donors. However, those who were vaccinated within a few months following infection had the highest persisting antibody titers, suggesting that vaccination shortly after influenza infection can boost or sustain antibody levels. For the most part the circulating influenza-specific T cell and serum antibody levels in the population at one year post-pandemic were not different between cases and controls, suggesting that natural infection does not lead to higher long term T cell and antibody responses in donors with pre-existing immunity to influenza. However, based on the responses of one longitudinal donor, it is possible for a small population of pre-existing cross-reactive memory CD8 T cells to expand rapidly following infection and this response may aid in viral clearance and contribute to a lessening of disease severity.

  6. Time trends in the thesis work by post-graduate students of Community Medicine: A record based descriptive study of 40 years

    Directory of Open Access Journals (Sweden)

    M M Nagargoje

    2015-03-01

    Full Text Available Background: Thesis work conducted by post-graduate students of Community Medicine is critically appraised by not only their examiners but also by many other public health experts and researchers. Issues related to the repetition of work and quality of thesis work is raised by various authors. Objective: To assess the time trend in the thesis work done by post-graduate students of Community Medicine. Material and methods: This is a record based descriptive observational study conducted in the department of Community Medicine of S. N. Medical College, Agra (Uttar Pradesh. Data from all the 66 theses which were submitted by the Post Graduate students of our department till date was collected and assessed systematically. Result: Most preferred areas of research were MCH/Family Planning (28.79% and Programme/Service evaluation (22.73%. 77.27% of theses were community based, 36.37% were done exclusively in a rural area, 24.24% of theses had children/adolescent as their study subjects and 28.79% were conducted exclusively among females. A knowledge, attitude and practice (KAP or Knowledge, attitude, behavior and practice (KABP study was part of many theses but exclusive KAP/KABP study was done only in 12.12% of theses. A purposive or convenience sampling was done in only 18.33% of theses, 86.67% were cross-sectional in design and median sample size was 450 participants per thesis. In comparison to the theses done upto the year 2000, theses thereafter were more often based in an urban area and less often done in an exclusive rural area (p=0.0003 and all KAP/KABP studies were done after the year 2000 (p=0.004. Conclusion: There is no repetition or excessive use of KAP/KABP studies in the theses done by post-graduate students of the department of Community Medicine, S. N. Medical College, Agra

  7. Anti-infective medicine quality: analysis of basic product quality by approval status and country of manufacture

    Directory of Open Access Journals (Sweden)

    Bate R

    2012-07-01

    Full Text Available Roger Bate,1 Lorraine Mooney,2 Kimberly Hess,3 Julissa Milligan,1 Amir Attaran41American Enterprise Institute, Washington DC, USA; 2Africa Fighting Malaria, London, UK; 3Africa Fighting Malaria, Washington DC, USA; 4Faculty of Law and Medicine, University of Ottawa, Ottawa, CanadaBackground: Some medicines for sale in developing countries are approved by a stringent regulatory authority (SRA or the World Health Organization (WHO prequalification program; many of these are global brands. This study ascertains whether medicines approved by SRAs or the WHO perform better in simple quality tests than those that have not been approved by either.Methods: Over the past 4 years, 2652 essential drugs (products to treat malaria, tuberculosis, and bacterial infections were procured by covert shoppers from eleven African cities and eight cities in a variety of mid-income nations. All samples were assessed using the Global Pharma Health Fund eV Minilab® protocol to identify whether they were substandard, degraded, or counterfeit.Results: The failure rate among SRA-approved products was 1.01%, among WHO-approved products was 6.80%, and 13.01% among products that were not approved by either. African cities had a greater proportion of SRA- or WHO-approved products (31.50% than Indian cities (26.57%, but they also experienced a higher failure rate (14.21% than Indian cities (7.83%. The remainder of cities tested had both the highest proportion of approved products at 34.46% and the lowest failure rate at 2.70%. Products made in Africa had the highest failure rate at 25.77%, followed by Chinese products at 15.74%, Indian products at 3.70%, and European/US products, which failed least often, at 1.70%. Most worrying is that 17.65% of Chinese products approved by the WHO failed.Conclusion: The results strongly indicate that approval by either an SRA or the WHO is correlated with higher medicine quality at a statistically significant level. The comparatively high

  8. What do you want to be in ten years? - Advising meteorology students in the post-Twister era

    Science.gov (United States)

    Snow, J. T.; Hempe, M.

    2012-12-01

    "What do you want to be in ten years?' This is a question we ask our students, freshmen and transfer, when they first arrive in the College student services center. Often the answer is "I don't know. I just want to be in meteorology." This response leads to a discussion of career opportunities in meteorology and related fields, including what might be called faux-careers, such as professional storm chasing and weather tour operations. (Students often have been misled by what they have seen in television shows.) Many students arrive on our doorstep with their heart set on a degree in meteorology, but lack knowledge of what the field is about or how challenging a meteorology degree program really is. We find ourselves spending a great deal of time convincing students that they need to explore the real opportunities in meteorology and related fields, which are many. Fortunately, because of the concentration of University and federal weather organizations in the National Weather Center and private sector weather companies in adjacent buildings, we are able to show concrete examples of real careers by means of tours, job shadowing, and introductions to alumni employed in these organizations. Also, as the students' progress in their studies, they discover the many opportunities for undergraduate employment, research experiences, and internships in these same organizations, through which they gain an appreciation for what constitutes a real career in modern meteorology. Further, many of today's careers in meteorology require a broad, global perspective. Unfortunately, many meteorology students have not traveled widely, but again have only seen what the media provides about distant lands and peoples. Accordingly, we encourage our undergraduate students to take advantage of our unique opportunities for overseas experiences in meteorology. Through arrangements with the met programs at the University of Reading (England), Monash University (Australia), and University of

  9. Post-Closure Report for Closed Resource Conservation and Recovery Act Corrective Action Units, Nevada National Security Site, Nevada, for Fiscal Year 2014

    Energy Technology Data Exchange (ETDEWEB)

    Silvas, Alissa J. [Nevada Field Office, Las Vegas, NV (United States)

    2015-01-01

    This report serves as the combined annual report for post-closure activities for several Corrective Action Units (CAUs). The locations of the sites are shown in Figure 1. This report covers fiscal year 2014 (October 2013–September 2014). The post-closure requirements for these sites are described in Resource Conservation and Recovery Act Permit Number NEV HW0101 and summarized in each CAU-specific section in Section 1.0 of this report. The results of the inspections, a summary of maintenance activities, and an evaluation of monitoring data are presented in this report. Site inspections are conducted semiannually at CAUs 90 and 91 and quarterly at CAUs 92, 110, 111, and 112. Additional inspections are conducted at CAU 92 if precipitation occurs in excess of 0.50 inches (in.) in a 24-hour period and at CAU 111 if precipitation occurs in excess of 1.0 in. in a 24-hour period. Inspections include an evaluation of the condition of the units, including covers, fences, signs, gates, and locks. In addition to visual inspections, soil moisture monitoring, vegetation evaluations, and subsidence surveys are conducted at CAU 110. At CAU 111, soil moisture monitoring, vegetation evaluations, subsidence surveys, direct radiation monitoring, air monitoring, radon flux monitoring, and groundwater monitoring are conducted. The results of the vegetation surveys and an analysis of the soil moisture monitoring data at CAU 110 are presented in this report. Results of additional monitoring at CAU 111 are documented annually in the Nevada National Security Site Waste Management Monitoring Report Area 3 and Area 5 Radioactive Waste Management Sites and in the Nevada National Security Site Data Report: Groundwater Monitoring Program Area 5 Radioactive Waste Management Site, which will be prepared in approximately June 2015. All required inspections, maintenance, and monitoring were conducted in accordance with the post-closure requirements of the permit. It is recommended to continue

  10. Post-Traumatic Stress Symptoms and Burnout Among Medical Rescue Workers 4 Years After the Great East Japan Earthquake: A Longitudinal Study.

    Science.gov (United States)

    Kawashima, Yuzuru; Nishi, Daisuke; Noguchi, Hiroko; Usuki, Masato; Yamashita, Akihiro; Koido, Yuichi; Okubo, Yoshiro; Matsuoka, Yutaka J

    2016-12-01

    This study aimed to evaluate factors associated with post-traumatic stress disorder (PTSD) symptoms and burnout 4 years after the Great East Japan Earthquake among medical rescue workers in Disaster Medical Assistance Teams (DMATs). We examined participants' background characteristics, prior health condition, rescue work experiences, and the Peritraumatic Distress Inventory (PDI) score at 1 month after the earthquake. Current psychological condition was assessed by the Impact of Event Scale-Revised and Maslach Burnout Inventory administered 4 years after the earthquake. By applying univariate and multivariate linear regression analyses, we assessed the relative value of the PDI and other baseline variables for PTSD symptoms and burnout at 4 years after the earthquake. We obtained baseline data from 254 participants during April 2 to 22, 2011. Of the 254 participants, 188 (74.0%) completed the follow-up assessment. PDI score 1 month after the earthquake was associated with symptoms of PTSD (β=0.35, Pburnout (β=0.21, PStress before deployment was a related factor for burnout 4 years after the earthquake in these medical rescue workers (β=2.61, Pstress prior to deployment (Disaster Med Public Health Preparedness. 2016;10:848-853).

  11. Resilience, post-traumatic growth, and work engagement among health care professionals after the Great East Japan Earthquake: A 4-year prospective follow-up study.

    Science.gov (United States)

    Nishi, Daisuke; Kawashima, Yuzuru; Noguchi, Hiroko; Usuki, Masato; Yamashita, Akihiro; Koido, Yuichi; Matsuoka, Yutaka J

    2016-07-22

    Although attention has been paid to post-traumatic stress disorder (PTSD) among health care professionals after disasters, the impact of traumatic events on their work has not been elucidated. The aim of this study was to examine whether disaster-related distress, resilience, and post-traumatic growth (PTG) affect work engagement among health care professionals who had been deployed to the areas affected by the Great East Japan Earthquake that occurred on March 11, 2011. We recruited disaster medical assistance team members who were engaged in rescue activities after the earthquake. The short version of the Resilience Scale (RS-14) and Peritraumatic Distress Inventory (PDI) were administered one month after the earthquake, and the short form of Posttraumatic Growth Inventory (SF-PTGI) and Utrecht Work Engagement Scale (UWES) were administered four years after the earthquake. Work engagement is composed of vigor, dedication, and absorption. Regression analyses were used to examine the relationship of UWES with RS-14, PDI, and SF-PTGI. We obtained baseline data of 254 participants in April 2011, and 191 (75.2%) completed the follow-up assessment between December 2014 and March 2015. The results showed that RS-14 predicted vigor, dedication, and absorption; in addition, SF-PTGI was positively related with these three parameters (pwork engagement among health care professionals after disasters. These findings could be useful for establishing a support system after rescue activities during a large-scale disaster and for managing work-related stress among health care professionals.

  12. Physiotherapy and physical functioning post-stroke: exercise habits and functioning 4 years later? Long-term follow-up after a 1-year long-term intervention period: a randomized controlled trial.

    Science.gov (United States)

    Langhammer, Birgitta; Lindmark, Birgitta; Stanghelle, Johan K

    2014-01-01

    Physical activity is mandatory if patients are to remain healthy and independent after stroke. Maintenance of motor function, tone, grip strength, balance, mobility, gait, independence in personal and instrumental activities of daily living, health-related quality-of-life and an active lifestyle 4 years post-stroke. A prospective randomized controlled trial. Four years post-stroke, 37 of the 75 participating persons were eligible for follow-up; 19 (54.3%) from the intensive exercise group and 18 (45%) from the regular exercise group. Both groups were performing equally well with no significant differences in total scores on the BI (p = 0.3), MAS (p = 0.4), BBS (p = 0.1), TUG (p = 0.08), 6MWT (p = 0.1), bilateral grip strength (affected hand, p = 0.8; non-affected hand, p = 0.9) nor in the items of NHP (p > 0.005). Independence in performing the IADL was 40%, while 60% had help from relatives or community-based services. This longitudinal study shows that persons with stroke in two groups with different exercise regimes during the first year after stroke did not differ in long-term outcomes. Both groups maintained function and had a relatively active life style 4 years after the acute incident. The results underline the importance of follow-up testing and encouragement to exercise, to motivate and sustain physical activity patterns, to maintain physical function, not only in the acute but also in the chronic phase of stroke.

  13. 29 CFR 1952.10 - Requirements for approval of State posters.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 9 2010-07-01 2010-07-01 false Requirements for approval of State posters. 1952.10 Section... and Conditions § 1952.10 Requirements for approval of State posters. (a)(1) In order to inform..., States with approved plans shall develop and require employers to post a State poster meeting the...

  14. [Revival after Ebola: multidisciplinary assessment at 1 year, prospect and follow-up study of surviving patients from Ebola in Guinea (PostEboGui cohort)].

    Science.gov (United States)

    Msellati, P; Touré, A; Sow, M S; Cécé, K; Taverne, B; Desclaux, A; Barry, M; Etard, J-F; Delaporte, E

    2016-10-01

    Ebola virus disease (EVD) epidemic that spread in West Africa from the end of 2013 to early 2016 has reached more people than all past epidemics. Beyond care management of acute phase ill patients and measures for the control of the epidemic, the outcome of Ebola survivors became an important question as their number increased and raised new issues. A multidisciplinary prospective cohort of survivors in Guinea has been launched by IRD UMI 233 and Donka National Hospital, Conakry, Guinea, to assess the long-term clinical, psychological, sociological, immunological, and viral outcomes potentially related to EVD. This paper describes PostEboGui Programme, constraints and changes to the initial proposal, participants, first results, and new issues, 1 year after its start, in a descriptive and critical view. We started also to work on ethical aspects in the context of epidemics and of mass interventions with a risk of overinvestigation of patients.

  15. New paths in post-graduate medical training in general practice - 8 years of experience with the pilot project Verbundweiterbildungplus Baden-Württemberg.

    Science.gov (United States)

    Schwill, Simon; Magez, Julia; Joos, Stefanie; Steinhäuser, Jost; Ledig, Thomas; Rubik, Aline; Niebling, Wilhelm; Szecsenyi, Joachim; Flum, Elisabeth

    2017-01-01

    training, these physicians viewed the exchange of information and experiences with other physicians as very positive and important. In 185 seminars lasting 90 minutes each, the seminar program has presently covered 250 out of 320 units in the competency-based curriculum for general medicine. A total of 281 trainers have been trained in 13 train-the-trainer courses and have rated this course on average with 1.36 on a six-point Likert scale. Above all, the trainers emphasized the exchange of information and experiences with other trainers as very positive. In 2013 the DEGAM concept for its Verbundweiterbildung plus program was developed based on that of the VWB plus BW. Since 2008 over 40 articles on the topic of post-graduate medical education have been published. Conclusion: The steadily increasing number of participants over the years demonstrates that the VWB plus BW is relevant for recent medical graduates and contributes to the attractiveness of general practice. The consistently excellent evaluations of the training program and the train-the-trainer course affirm the focus on the needs of the target groups. The post-graduate VWB plus BW program advances structured, competency-based and quality-oriented specialist training and fosters professional sharing between physicians - something that could also be relevant for other fields. The increasing numbers of participating physicians and specialists in general practice in Baden-Württemberg lead to the conclusion that the VWB plus BW program positively influences the number of general practitioners.

  16. New paths in post-graduate medical training in general practice – 8 years of experience with the pilot project Verbundweiterbildung Baden-Württemberg

    Directory of Open Access Journals (Sweden)

    Schwill, Simon

    2017-11-01

    training, these physicians viewed the exchange of information and experiences with other physicians as very positive and important. In 185 seminars lasting 90 minutes each, the seminar program has presently covered 250 out of 320 units in the competency-based curriculum for general medicine. A total of 281 trainers have been trained in 13 train-the-trainer courses and have rated this course on average with 1.36 on a six-point Likert scale. Above all, the trainers emphasized the exchange of information and experiences with other trainers as very positive. In 2013 the DEGAM concept for its Verbundweiterbildung program was developed based on that of the VWB BW. Since 2008 over 40 articles on the topic of post-graduate medical education have been published.Conclusion: The steadily increasing number of participants over the years demonstrates that the VWB BW is relevant for recent medical graduates and contributes to the attractiveness of general practice. The consistently excellent evaluations of the training program and the train-the-trainer course affirm the focus on the needs of the target groups. The post-graduate VWB BW program advances structured, competency-based and quality-oriented specialist training and fosters professional sharing between physicians – something that could also be relevant for other fields. The increasing numbers of participating physicians and specialists in general practice in Baden-Württemberg lead to the conclusion that the VWB BW program positively influences the number of general practitioners.

  17. 2011 Joplin, Missouri Tornado Experience, Mental Health Reactions, and Service Utilization: Cross-Sectional Assessments at Approximately 6 Months and 2.5 Years Post-Event.

    Science.gov (United States)

    Houston, J Brian; Spialek, Matthew L; Stevens, Jordan; First, Jennifer; Mieseler, Vicky L; Pfefferbaum, Betty

    2015-10-26

    Introduction. On May 22, 2011 the deadliest tornado in the United States since 1947 struck Joplin, Missouri killing 161 people, injuring approximately 1,150 individuals, and causing approximately $2.8 billion in economic losses. Methods. This study examined the mental health effects of this event through a random digit dialing sample (N = 380) of Joplin adults at approximately 6 months post-disaster (Survey 1) and a purposive convenience sample (N = 438) of Joplin adults at approximately 2.5 years post-disaster (Survey 2). For both surveys we assessed tornado experience, posttraumatic stress, depression, mental health service utilization, and sociodemographics. For Survey 2 we also assessed social support and parent report of child strengths and difficulties. Results. Probable PTSD relevance was 12.63% at Survey 1 and 26.74% at Survey 2, while current depression prevalence was 20.82% at Survey 1 and 13.33% at Survey 2. Less education and more tornado experience was generally related to greater likelihood of experiencing probable PTSD and current depression for both surveys. Men and younger participants were more likely to report current depression at Survey 1. Low levels of social support (assessed only at Survey 2) were related to more probable PTSD and current depression. For both surveys, we observed low rates of mental health service utilization, and these rates were also low for participants reporting probable PTSD and current depression. At Survey 2 we assessed parent report of child (ages 4 to 17) strengths and difficulties and found that child difficulties were more frequent for younger children (ages 4 to 10) than older children (ages 11 to 17), and that parents reporting probable PTSD reported a greater frequency of children with borderline or abnormal difficulties. Discussion. Overall our results indicate that long-term (multi-year) community disaster mental health monitoring, assessment, referral, outreach, and services are needed following a major

  18. Maternal insulin resistance, triglycerides and cord blood insulin in relation to post-natal weight trajectories and body composition in the offspring up to 2 years.

    Science.gov (United States)

    Brunner, S; Schmid, D; Hüttinger, K; Much, D; Heimberg, E; Sedlmeier, E-M; Brüderl, M; Kratzsch, J; Bader, B L; Amann-Gassner, U; Hauner, H

    2013-12-01

    The intrauterine metabolic environment might have a programming effect on offspring body composition. We aimed to explore associations of maternal variables of glucose and lipid metabolism during pregnancy, as well as cord blood insulin, with infant growth and body composition up to 2 years post-partum. Data of pregnant women and their infants came from a randomized controlled trial designed to investigate the impact of nutritional fatty acids on adipose tissue development in the offspring. Of the 208 pregnant women enrolled, 118 infants were examined at 2 years. In the present analysis, maternal fasting plasma insulin, homeostasis model assessment of insulin resistance and serum triglycerides measured during pregnancy, as well as insulin in umbilical cord plasma, were related to infant growth and body composition assessed by skinfold thickness measurements and abdominal ultrasonography up to 2 years of age. Maternal homeostasis model assessment of insulin resistance at the 32nd week of gestation was significantly inversely associated with infant lean body mass at birth, whereas the change in serum triglycerides during pregnancy was positively associated with ponderal index at 4 months, but not at later time points. Cord plasma insulin correlated positively with birthweight and neonatal fat mass and was inversely associated with body weight gain up to 2 years after multiple adjustments. Subsequent stratification by gender revealed that this relationship with weight gain was stronger, and significant only in girls. Cord blood insulin is inversely associated with subsequent infant weight gain up to 2 years and this seems to be more pronounced in girls. © 2013 The Authors. Diabetic Medicine © 2013 Diabetes UK.

  19. Intravenous immunoglobulin treatment of the post-polio syndrome: sustained effects on quality of life variables and cytokine expression after one year follow up

    Directory of Open Access Journals (Sweden)

    Gonzalez Henrik

    2012-07-01

    Full Text Available Abstract Background Expression of inflammatory cytokines in cerebrospinal fluid (CSF has led to the hypothesis of intrathecal chronic inflammation to explain the denervation observed in post-polio syndrome (PPS. It has been shown that therapy with intravenous immunoglobulin (IVIG improves physical performance and dampens down the inflammatory process at 6 months in PPS patients. We here examined the effects of IVIG on cytokine expression and clinical outcome one year after IVIG treatment. Methods From a previous study with 135 PPS patients included, 41 patients were further evaluated before un-blinding for one year (21 placebo and 20 treated with IVIG, Xepol® 50 mg/ml, and were assessed for clinical variables by performing the Short Form-36 survey (SF-36 questionnaire assessment, the 6 minute walk distance test (6MWT and registering pain level by Visual Analogue Scale (VAS after IVIG treatment. A separate cohort of 37 PPS patients went through lumbar puncture (LP at baseline and 20 patients, treated with IVIG, repeated the LP one year later. Thirty patients affected with other neurological diseases (OND were used as control group. Inflammatory cytokines TNF, TGFβ, IFNγ, IL-23, IL-13 and IL-10 were measured in blood cells and CSF cells with RT-PCR. Results Scores of the physical components of SF-36 were significantly higher at the one year follow up time-point in the IVIG-treated patients when compared to baseline as well as to the control subjects. Pain VAS score and 6MWT improved significantly in the IVIG-treated patients when compared with baseline Relative expression of TNF and IFN-γ in both PBMCs and CSF from PPS patients were increased compared to OND subjects at baseline (p  Conclusions IVIG has effects on relevant QoL variables and inflammatory cytokines up to one year in patients with PPS. This gives a basis for scheduling IVIG in upcoming trials with this therapy.

  20. Trends in global approvals of biotech crops (1992–2014)

    Science.gov (United States)

    Aldemita, Rhodora R; Reaño, Ian Mari E; Solis, Renando O; Hautea, Randy A

    2015-01-01

    ABSTRACT With the increasing number of genetically modified (GM) events, traits, and crops that are developed to benefit the global population, approval of these technologies for food, feed, cultivation and import in each country may vary depending on needs, demand and trade interest. ISAAA established a GMO Approval Database to document global approvals of biotech crops. GM event name, crops, traits, developer, year of approval for cultivation, food/feed, import, and relevant dossiers were sourced from credible government regulatory websites and biosafety clearinghouses. This paper investigates the trends in GM approvals for food, feed and cultivation based on the number of approving countries, GM crops, events, and traits in the last 23 y (1992–2014), rationale for approval, factors influencing approvals, and their implications in GM crop adoption. Results show that in 2014, there was an accumulative increase in the number of countries granting approvals at 29 (79% developing countries) for commercial cultivation and 31 (70% developing countries) for food and 19 (80% developing developing) for feed; 2012 had the highest number of approving countries and cultivation approvals; 2011 had the highest number of country approvals for feed, and 2014 for food approvals. Herbicide tolerance trait had the highest events approved, followed by insect tolerance traits. Approvals for food product quality increased in the second decade. Maize had the highest number of events approved (single and stacked traits), and stacked traits product gradually increased which is already 30% of the total trait approvals. These results may indicate understanding and acceptance of countries to enhance regulatory capability to be able to benefit from GM crop commercialization. Hence, the paper provided information on the trends on the growth of the GM crop industry in the last 23 y which may be vital in predicting future GM crops and traits. PMID:26039675

  1. Trends in global approvals of biotech crops (1992-2014).

    Science.gov (United States)

    Aldemita, Rhodora R; Reaño, Ian Mari E; Solis, Renando O; Hautea, Randy A

    2015-01-01

    With the increasing number of genetically modified (GM) events, traits, and crops that are developed to benefit the global population, approval of these technologies for food, feed, cultivation and import in each country may vary depending on needs, demand and trade interest. ISAAA established a GMO Approval Database to document global approvals of biotech crops. GM event name, crops, traits, developer, year of approval for cultivation, food/feed, import, and relevant dossiers were sourced from credible government regulatory websites and biosafety clearinghouses. This paper investigates the trends in GM approvals for food, feed and cultivation based on the number of approving countries, GM crops, events, and traits in the last 23 y (1992-2014), rationale for approval, factors influencing approvals, and their implications in GM crop adoption. Results show that in 2014, there was an accumulative increase in the number of countries granting approvals at 29 (79% developing countries) for commercial cultivation and 31 (70% developing countries) for food and 19 (80% developing developing) for feed; 2012 had the highest number of approving countries and cultivation approvals; 2011 had the highest number of country approvals for feed, and 2014 for food approvals. Herbicide tolerance trait had the highest events approved, followed by insect tolerance traits. Approvals for food product quality increased in the second decade. Maize had the highest number of events approved (single and stacked traits), and stacked traits product gradually increased which is already 30% of the total trait approvals. These results may indicate understanding and acceptance of countries to enhance regulatory capability to be able to benefit from GM crop commercialization. Hence, the paper provided information on the trends on the growth of the GM crop industry in the last 23 y which may be vital in predicting future GM crops and traits.

  2. Drugs Approved for Thyroid Cancer

    Science.gov (United States)

    ... Ask about Your Treatment Research Drugs Approved for Thyroid Cancer This page lists cancer drugs approved by the ... that are not listed here. Drugs Approved for Thyroid Cancer Cabozantinib-S-Malate Caprelsa (Vandetanib) Cometriq (Cabozantinib-S-Malate) Doxorubicin ...

  3. Drugs Approved for Breast Cancer

    Science.gov (United States)

    ... Ask about Your Treatment Research Drugs Approved for Breast Cancer This page lists cancer drugs approved by the ... are not listed here. Drugs Approved to Prevent Breast Cancer Evista (Raloxifene Hydrochloride) Raloxifene Hydrochloride Tamoxifen Citrate Drugs ...

  4. Summary of Research through Phase II/Year 2 of Initially Approved 3 Phase/3 Year Project - Establishing the Relationship between Fracture-Related Dolomite and Primary Rock Fabric on the Distribution of Reservoirs in the Michigan Basin

    Energy Technology Data Exchange (ETDEWEB)

    G. Grammer

    2007-09-30

    This final scientific/technical report covers the first 2 years (Phases I and II of an originally planned 3 Year/3 Phase program). The project was focused on evaluating the relationship between fracture-related dolomite and dolomite constrained by primary rock fabric in the 3 most prolific reservoir intervals in the Michigan Basin. The characterization of select dolomite reservoirs was the major focus of our efforts in Phases I and II of the project. Structural mapping and log analysis in the Dundee (Devonian) and Trenton/Black River (Ordovician) suggest a close spatial relationship among gross dolomite distribution and regional-scale, wrench fault-related NW-SE and NE-SW structural trends. A high temperature origin for much of the dolomite in these 2 studied intervals (based upon fluid inclusion homogenization temperatures and stable isotopic analyses,) coupled with persistent association of this dolomite in reservoirs coincident with wrench fault-related features, is strong evidence for these reservoirs being influenced by hydrothermal dolomitization. In the Niagaran (Silurian), there is a general trend of increasing dolomitization shelfward, with limestone predominant in more basinward positions. A major finding is that facies types, when analyzed at a detailed level, are directly related to reservoir porosity and permeability in these dolomites which increases the predictability of reservoir quality in these units. This pattern is consistent with our original hypothesis of primary facies control on dolomitization and resulting reservoir quality at some level. The identification of distinct and predictable vertical stacking patterns within a hierarchical sequence and cycle framework provides a high degree of confidence at this point that the results should be exportable throughout the basin. Much of the data synthesis and modeling for the project was scheduled to be part of Year 3/Phase III, but the discontinuation of funding after Year 2 precluded those efforts

  5. Effects of recurrent violence on post-traumatic stress disorder and severe distress in conflict-affected Timor-Leste: a 6-year longitudinal study.

    Science.gov (United States)

    Silove, Derrick; Liddell, Belinda; Rees, Susan; Chey, Tien; Nickerson, Angela; Tam, Natalino; Zwi, Anthony B; Brooks, Robert; Sila, Lazaro Lelan; Steel, Zachary

    2014-05-01

    Little is known about the effect of recurrent episodes of communal violence on mental health in countries recovering from mass conflict. We report results of a 6-year longitudinal study in post-conflict Timor-Leste assessing changes in mental health after a period of communal violence. We assessed 1022 adults (600 from a rural village, 422 from an urban district) exposed to mass conflict during the Indonesian occupation after independence in 2004, and again in 2010-11, following a period of internal conflict. We took a census of all adults living at the two sites. The survey included measures of post-traumatic stress disorder, severe distress, traumatic events, poverty, ongoing conflict, and injustice. 1247 (80%) of 1554 invited adults participated in the baseline survey. 1038 (89% of those eligible) were followed up. The analysis included 1022 people who had sufficient data at baseline and follow-up. The prevalence of post-traumatic stress disorder increased from 23 of 1022 (2.3%) in 2004, to 171 of 1022 (16.7%) in 2010. The prevalence of severe distress also increased, from 57 of 1022 (5.6%) in 2004, to 162 of 1022 (15.9%) in 2010. Both these outcomes were associated with disability at follow-up. Having post-traumatic stress at follow-up was associated with being a woman (odds ratio [OR] 1.63, 95% CI 1.14-2.32), experience of human rights trauma (OR 1.25, 95% CI 1.07-1.47), or exposure to murder (OR 1.71, 95% CI 1.38-2.10) during the Indonesian occupation (1975-99), human rights trauma during the period of internal violence in 2006-07 (OR 1.46, 95% CI 1.04-2.03), and ongoing family or community conflict (OR 1.80, 95% CI 1.15-2.80) or preoccupations with injustice for two or three historical periods (OR 4.06, 2.63-6.28). Severe distress at follow-up was associated with health stress (OR 1.47, 1.14-1.90), exposure to murder (OR 1.57, 1.27-1.95), and natural disaster (OR 1.65, 1.03-2.64) during the Indonesian occupation, conflict-related trauma during the internal

  6. Posterior corneal surface differences between non-laser in situ keratomileusis (LASIK) and 10-year post-LASIK myopic eyes.

    Science.gov (United States)

    Dai, Ma-Li; Wang, Qin-Mei; Lin, Zu-Shun; Yu, Ye; Huang, Jin-Hai; Savini, Giacomo; Zhang, Jia; Wang, Ling; Xu, Chen-Chen

    2018-03-01

    To evaluate the posterior corneal surface differences between non-laser in situ keratomileusis (LASIK) and 10-year post-LASIK myopic eyes. The study included 130 eyes from 65 patients, who were treated with myopic LASIK 10 years ago. In addition, 130 eyes from 65 unoperated myopic patients of matching present age and preoperative refraction were divided into control group. Data on the posterior corneal surface and anterior chamber were obtained from Pentacam software and compared between the groups. Postoperative visual acuity (VA) and refractive error were also analysed. The mean preoperative spherical equivalent (SE) was -6.99 ± 1.78 dioptre (D) in the LASIK group. Ten years after surgery, the mean SE was -0.45 ± 1.22 D, the efficacy index was 0.98, and the safety index was 1.01. The posterior corneal elevations of the LASIK group at 2 mm corneal diameter were significantly lower than those of the control group. However, posterior corneal elevations at 6 mm corneal diameter were higher in the LASIK group than the controls (p LASIK group than in controls. Meanwhile, the anterior chamber volumes (ACV) were smaller in the LASIK group than in the control group. Our results demonstrated that the posterior corneal surface tends to show signs of central flattening and peripheral steepening 10 years after myopic LASIK surgery compared to that of non-operated myopic eyes. © 2017 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  7. Post-Closure Report for Closed Resource Conservation and Recovery Act Corrective Action Units, Nevada National Security Site, Nevada for Fiscal Year 2011 (October 2010-September 2011)

    International Nuclear Information System (INIS)

    2012-01-01

    This report serves as the combined annual report for post-closure activities for the following closed Corrective Action Units (CAUs): (1) CAU 90, Area 2 Bitcutter Containment; (2) CAU 91, Area 3 U-3fi Injection Well; (3) CAU 92, Area 6 Decon Pond Facility; (4) CAU 110, Area 3 WMD U-3ax/bl Crater; and (5) CAU 112, Area 23 Hazardous Waste Trenches. This report covers fiscal year 2011 (October 2010-September 2011). The post-closure requirements for these sites are described in Resource Conservation and Recovery Act Permit Number NEV HW0101 and summarized in each CAU-specific section in Section 1.0 of this report. Site inspections are conducted semiannually at CAUs 90 and 91 and quarterly at CAUs 92, 110, and 112. Additional inspections are conducted at CAU 92 if precipitation occurs in excess of 0.50 inches in a 24-hour period. Inspections include an evaluation of the condition of the units and identification of any deficiencies that may compromise the integrity of the units. The condition of covers, fencing, signs, gates, and locks is documented. In addition, soil moisture monitoring and subsidence surveys are conducted at CAU 110. The results of the inspections, summary of maintenance activities, results of vegetations surveys, and analysis of monitoring data are presented in this report. Copies of the inspection checklists are included as Appendix A. Field notes completed during each inspection are included in Appendix B. Photographs taken during the inspections are included in Appendix C. It is recommended to continue semiannual inspections at CAUs 90 and 91; quarterly inspections at CAUs 92, 110, and 112; and additional inspections at CAU 92 if precipitation occurs in excess of 0.50 inches in a 24-hour period. At CAU 92, it is recommended to remove the wave barriers, as they have not proven to be necessary to protect the cover. At CAU 110, it is recommended to continue annual vegetation monitoring and soil moisture monitoring, and to reduce the frequency of

  8. The prevalence of pain and disability one year post fracture of the distal radius in a UK population: A cross sectional survey

    Directory of Open Access Journals (Sweden)

    Leonardi-Bee Jo

    2008-09-01

    Full Text Available Abstract Background A fracture of the distal radius is a commonly occurring fracture and accounts for a third of all fractures in the elderly. Thus far, one year estimates of pain and disability following a fracture of the distal radius have been reported on Canadian populations. The primary aim of this study is to investigate the prevalence of pain and disability in a UK population one year post fracture of the distal radius. Methods A cross-sectional survey was undertaken, of all subjects suffering a fracture of the distal radius between October 2005 and February 2006 in Nottingham, UK. Primary outcomes used were the VAS for pain and the DASH for disability. Prevalence of pain and disability were calculated and odds ratios presented for associations between demographics, pain and disability. Results 93/264 (35% subjects responded to the questionnaire. 6 subjects did not fulfill the inclusion criteria and were excluded from further analysis. 11% of subjects reported moderate to very severe pain. 16% of subjects reported moderate to very severe disability. Statistically significant associations were found between pain medication usage for the wrist fracture and moderate to very severe pain (OR 11.20, 95% CI 2.05 – 61.23. Moderate to very severe disability was associated with older age (OR 6.53, 95%CI 1.65 – 25.90 and pain medication usage for the wrist fracture (OR 4.75, 95% CI 1.38 – 16.37. Working was associated with a reduction in risk of moderate to very severe disability (OR 0.14, 95% CI 0.03 – 0.67. Conclusion This study demonstrates that there are a small proportion of patients who are still suffering moderate to very severe pain and disability one year post fracture of the distal radius. The study also demonstrates that there are significant associations between characteristics of the patients and the level of pain and disability. This highlights the need for further research into the most appropriate management of these patients

  9. Long-term post-marketing surveillance of mizoribine for the treatment of lupus nephritis: Safety and efficacy during a 3-year follow-up

    Directory of Open Access Journals (Sweden)

    Nobuyuki Yagi

    2014-05-01

    Full Text Available Objective: To determine the safety and efficacy of long-term use of mizoribine by undertaking a 3-year post-marketing surveillance study. Methods: Subjects were all lupus nephritis patients newly treated with mizoribine between 1 October 2003 and 30 September 2005 at contracted study sites. Results: Mizoribine was administered to 881 lupus nephritis patients in the safety analysis set consisting of 946 patients recruited from 281 contracted study sites after satisfying the eligibility criteria. There were 301 events of adverse drug reactions that were observed in 196 (20.7% of the 946 subjects. There were 34 events of serious adverse drug reactions in 31 patients (3.2%. No deterioration in hematological and biochemical test values was observed, but immunological testing showed significant improvements in C3, CH50, and anti-DNA antibody titers. The negative rate of proteinuria also increased over time. The median steroid dosage was 15 mg/day at the commencement of treatment, but was reduced to 10 mg/day at 12 months and 8 mg/day at 36 months. Conclusion: The findings of the 3-year long-term drug use surveillance study indicated that mizoribine can be used over the long term with relatively few adverse drug reactions, suggesting its suitability for use in maintenance drug therapy.

  10. Epidemiological study on life-expectancy and mortality of persons employed in the Joachimthal uranium mines during the post-war years

    International Nuclear Information System (INIS)

    Walter, H.U.

    1982-01-01

    A group of 477 former prisoners of war and internees who were forced to work in the Joachimthal uranium mines underground or in ore dressing and partially in isotope research during the post-war years, was statistically studied concerning the causes of their deaths in dependence from exposure to Rn and Rn daughters at that time. Death causes were registered and the acquired data were evaluated using an EDP facility. Studies focussed on multiple occurrence of radiation-induced neoplasias which were possibly triggered by exposure to Rn or Rn daughters, particularly those of the respiratory tract. The death causes of the uranium miners studied were compared with the mortality of an analogous age group from the population of Bavaria covering the years 1960, 1971 and 1979. This showed a markedly increased rate for all neoplasias that had occurred, as well as for the other death causes. It is not possible to make a statement on the influence of smoking as a 'co-factor' since there are no reliable data on possible smoking habits available. Concerning pulmonary and bronchial cascinomas, for instance, a neoplasia rate increased by a factor of 3.3 was found. The effect of prisonership as a 'co-factor' cannot be determined beyond doubt; however, acquired data suggest that it had a strong positive influence on cancer incidence. (orig./MG) [de

  11. Post-Closure Inspection and Monitoring Report for Corrective Action Unit 417: Central Nevada Test Area Surface, Hot Creek Valley, Nevada, for Calendar Year 2007

    Energy Technology Data Exchange (ETDEWEB)

    None

    2008-09-01

    This report presents data collected during the annual post-closure site inspection conducted at the Central Nevada Test Area Surface Corrective Action Unit (CAU) 417 in May 2007. The annual post-closure site inspection included inspections of the UC-1, UC-3, and UC-4 sites in accordance with the Post-Closure Monitoring Plan provided in the CAU 417 Closure Report (NNSA/NV 2001). The annual inspection conducted at the UC-1 Central Mud Pit (CMP) indicated the site and soil cover were in good condition. No new cracks or fractures were observed in the soil cover during the annual inspection. A crack on the west portion of the cover was observed during the last quarterly inspection in December 2006. This crack was filled with bentonite as part of the maintenance activities conducted in February 2007 and will be monitored during subsequent annual inspections. The vegetation on the soil cover was adequate but showing signs of the area's ongoing drought. No issues were identified with the CMP fence, gate, or subsidence monuments. New DOE Office of Legacy Management signs with updated emergency phone numbers were installed as part of this annual inspection, no issues were identified with the warning signs and monuments at the other two UC-1 locations. The annual subsidence survey was conducted at UC-1 CMP and UC-4 Mud Pit C as part of the maintenance activities conducted in February 2007. The results of the subsidence surveys indicate that the covers are performing as expected, and no unusual subsidence was observed. A vegetation survey of the UC-1 CMP cover and adjacent areas was conducted as part of the annual inspection in May 2007. The vegetation survey indicated that revegetation continues to be successful, although stressed due to the area's prevailing drought conditions. The vegetation should continue to be monitored to document any changes in the plant community and to identify conditions that could potentially require remedial action to maintain a viable

  12. 5 year radar-based rainfall statistics: disturbances analysis and development of a post-correction scheme for the German radar composite

    Science.gov (United States)

    Wagner, A.; Seltmann, J.; Kunstmann, H.

    2015-02-01

    A radar-based rainfall statistic demands high quality data that provide realistic precipitation amounts in space and time. Instead of correcting single radar images, we developed a post-correction scheme for long-term composite radar data that corrects corrupted areas, but preserves the original precipitation patterns. The post-correction scheme is based on a 5 year statistical analysis of radar composite data and its constituents. The accumulation of radar images reveals artificial effects that are not visible in the individual radar images. Some of them are already inherent to single radar data such as the effect of increasing beam height, beam blockage or clutter remnants. More artificial effects are introduced in the process of compositing such as sharp gradients at the boundaries of overlapping areas due to different beam heights and resolution. The cause of these disturbances, their behaviour with respect to reflectivity level, season or altitude is analysed based on time-series of two radar products: the single radar reflectivity product PX for each of the 16 radar systems of the German Meteorological Service (DWD) for the time span 2000 to 2006 and the radar composite product RX of DWD from 2005 through to 2009. These statistics result in additional quality information on radar data that is not available elsewhere. The resulting robust characteristics of disturbances, e.g. the dependency of the frequencies of occurrence of radar reflectivities on beam height, are then used as a basis for the post-correction algorithm. The scheme comprises corrections for shading effects and speckles, such as clutter remnants or overfiltering, as well as for systematic differences in frequencies of occurrence of radar reflectivities between the near and the far ranges of individual radar sites. An adjustment to rain gauges is also included. Applying this correction, the Root-Mean-Square-Error for the comparison of radar derived annual rain amounts with rain gauge data

  13. Poet Marion Approval

    Science.gov (United States)

    This update August 9, 2016 letter from EPA approves, with modifications, the petition from Poet Biorefining-North Manchester, LLC, regarding non-grandfathered ethanol produced through a dry mill process, qualifying under the Clean Air Act for renewable

  14. Poet Portland Approval

    Science.gov (United States)

    This update August 9, 2016 letter from EPA approves the petition, with modifications, from Poet Biorefining-Portland, LLC, regarding non-grandfathered ethanol produced through a dry mill process, qualifying under the Clean Air Act for renewable fuel

  15. Poet North Manchester Approval

    Science.gov (United States)

    This update August 9, 2016 letter from EPA approves, with modifications, the petition from Poet Biorefining-North Manchester, LLC, regarding non-grandfathered ethanol produced through a dry mill process, qualifying under the Clean Air Act for renewable

  16. Poet Alexandria Approval

    Science.gov (United States)

    This update August 9, 2016 letter from EPA approves, with modifications, the petition from Poet Biorefining-Alexandria, LLC, regarding non-grandfathered ethanol produced through a dry mill process, qualifying under the Clean Air Act for renewable fuel

  17. Poet Laddonia Approval

    Science.gov (United States)

    This update Auugust 9, 2016 letter from EPA approves with modifications, the petition from Poet Biorefining Laddonia, Poet Laddonia Facility, regarding non-grandfathered ethanol produced through a dry mill process, qualifying under the Clean Air Act f

  18. Drugs Approved for Neuroblastoma

    Science.gov (United States)

    This page lists cancer drugs approved by the Food and Drug Administration (FDA) for neuroblastoma. The list includes generic names and brand names. The drug names link to NCI's Cancer Drug Information summaries.

  19. Drugs Approved for Leukemia

    Science.gov (United States)

    This page lists cancer drugs approved by the FDA for use in leukemia. The drug names link to NCI's Cancer Drug Information summaries. The list includes generic names, brand names, and common drug combinations, which are shown in capital letters.

  20. Drugs Approved for Retinoblastoma

    Science.gov (United States)

    This page lists cancer drugs approved by the Food and Drug Administration (FDA) for retinoblastoma. The list includes generic names and brand names. The drug names link to NCI’s Cancer Drug Information summaries.

  1. Premarket Approvals (PMA)

    Data.gov (United States)

    U.S. Department of Health & Human Services — Premarket approval by FDA is the required process of scientific review to ensure the safety and effectiveness of all devices classified as Class III devices. An...

  2. Post-Wisconsinan Chemical Weathering Rates and Trajectories From a 13,400-Year Sediment Core Record of Lead Isotopic Ratios in Maine

    Science.gov (United States)

    Perry, R. H.; Norton, S. A.; Koons, P. O.; Handley, M.

    2008-12-01

    Lead isotopic ratios recorded in a 5.3-m 13.4-ka 14C-dated lake sediment core from Sargent Mountain Pond, Maine (USA) are interpreted as an archive of post-glacial chemical weathering. Early weathering yielded highly radiogenic sediment from the preferential release of U and Th decay products (206Pb, 207Pb, and 208Pb) from accessory mineral phases in the catchment's predominantly-granitic till and bedrock relative to non-radiogenic 204Pb from the more abundant primary minerals. Values for 207Pb/206Pb in the sediment increased rapidly from 0.799 to 0.814 in the catchment's first 4,000 years of post-Wisconsinan weathering, and thereafter increased only slightly to just prior to the 19th century. Values for 208Pb/204Pb, 207Pb/204Pb, and 206Pb/204Pb decline over the same time-scale, as a result of decreasing radiogenic Pb being released from catchment weathering. Our results are consistent with: (1) the published interpretation of Pb isotopic variation in ferromanganese ocean crusts as a reflection of continental-scale glacial-interglacial chemical weathering cycles, (2) bench-scale whole-rock weathering experiments, and (3) soil chronosequence Pb isotope dissolution experiments and bridge the gap between short-term, mineral-scale experiments and long-term, ocean sediment records. We establish a time-scale for depletion of accessory minerals, and loss of their Pb isotopic signature at one catchment, and document the concurrent shift to slower primary mineral-controlled chemical weathering after deglaciation.

  3. ["They are enjoying their first holiday ever"--working with the elderly, from the post-war years up to the early 1970s].

    Science.gov (United States)

    Matron, Kristina

    2014-01-01

    While, in the post-war years and into the 1950s, the building of old people's and care homes and the allocation of home places in those homes was seen as the main task of municipal care institutions for the elderly in Frankfurt am Main, in the decade that followed their main task shifted towards increasing the possibilities of providing care in people's own homes, delaying the move into old people's homes and breaking through the loneliness that elderly people were presumed to experience. Supported by the state, community housing was provided with flats for elderly people and with carers to look after their needs. The "warm rooms" of the post-war period changed into clubs, where members met and received guidance. In the late 1960s the clubs were extended into day-care centres, offering a range of consultation services, organized day trips and recreational holidays for the elderly. It was hoped that "meals-on-wheels" in combination with age-appropriate living conditions would delay the move into a home. But these plans were not adequately developed in the 1960s and often it was not clear who would pay the bills. The same was true of outpatient medical care which had traditionally been the task of community nurses, but was now increasingly carried out by local authority carers, who also provided household assistance. This kind of care could only ever be given for a limited period of time and, while it was able to delay the move into an old people's home, it could not replace it.

  4. DSM-IV post-traumatic stress disorder among World Trade Center responders 11-13 years after the disaster of 11 September 2001 (9/11).

    Science.gov (United States)

    Bromet, E J; Hobbs, M J; Clouston, S A P; Gonzalez, A; Kotov, R; Luft, B J

    2016-03-01

    Post-traumatic symptomatology is one of the signature effects of the pernicious exposures endured by responders to the World Trade Center (WTC) disaster of 11 September 2001 (9/11), but the long-term extent of diagnosed Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) post-traumatic stress disorder (PTSD) and its impact on quality of life are unknown. This study examines the extent of DSM-IV PTSD 11-13 years after the disaster in WTC responders, its symptom profiles and trajectories, and associations of active, remitted and partial PTSD with exposures, physical health and psychosocial well-being. Master's-level psychologists administered sections of the Structured Clinical Interview for DSM-IV and the Range of Impaired Functioning Tool to 3231 responders monitored at the Stony Brook University World Trade Center Health Program. The PTSD Checklist (PCL) and current medical symptoms were obtained at each visit. In all, 9.7% had current, 7.9% remitted, and 5.9% partial WTC-PTSD. Among those with active PTSD, avoidance and hyperarousal symptoms were most commonly, and flashbacks least commonly, reported. Trajectories of symptom severity across monitoring visits showed a modestly increasing slope for active and decelerating slope for remitted PTSD. WTC exposures, especially death and human remains, were strongly associated with PTSD. After adjusting for exposure and critical risk factors, including hazardous drinking and co-morbid depression, PTSD was strongly associated with health and well-being, especially dissatisfaction with life. This is the first study to demonstrate the extent and correlates of long-term DSM-IV PTSD among responders. Although most proved resilient, there remains a sizable subgroup in need of continued treatment in the second decade after 9/11.

  5. The World Nuclear Industry Status Report 2010-2011. Nuclear Power in a Post-Fukushima World. 25 years after the Chernobyl accident

    International Nuclear Information System (INIS)

    Schneider, Mycle; Froggatt, Antony; Thomas, Steve; Hazemann, Julie; Mastny, Lisa

    2011-04-01

    , leading to a capacity increase of 5 GW, 18 additional reactors would have to be finished and started up prior to 2015. This corresponds to one new grid connection every three months, with an additional 191 units (175 GW) over the following decade-one every 19 days. Achievement of this 2015 target is simply impossible given existing constraints on the manufacturing of key reactor components-aside from any post-Fukushima effect. As a result, even if the installed capacity level could be maintained, the number of operating reactors will decline over the coming years unless lifetime extensions beyond 40 years become the widespread standard. The scenario of generalized lifetime extensions is getting less likely after Fukushima, as many questions regarding safety upgrades, maintenance costs, and other issues would need to be more carefully addressed. With extremely long lead times of 10 years and more, it will be practically impossible to maintain, let alone increase, the number of operating nuclear power plants over the next 20 years. The flagship EPR project at Olkiluoto in Finland, managed by the largest nuclear builder in the world, AREVA NP, has turned into a financial fiasco. The project is four years behind schedule and at least 90 percent over budget, reaching a total cost estimate of euro 5.7 billion ($8.3 billion) or close to euro 3,500 ($5,000) per kilowatt. The dramatic post-Fukushima situation adds to the international economic crisis and is exacerbating many of the problems that proponents of nuclear energy are facing. If there was no obvious sign that the international nuclear industry could eventually turn empirically evident downward trend into a promising future, the Fukushima disaster is likely to accelerate the decline

  6. The influence of repeated abutment changes on peri-implant tissue stability: 3-year post-loading results from a multicentre randomised controlled trial.

    Science.gov (United States)

    Bressan, Eriberto; Grusovin, Maria Gabriella; D'Avenia, Ferdinando; Neumann, Konrad; Sbricoli, Luca; Luongo, Giuseppe; Esposito, Marco

    because of ceramic and implant fracture, respectively, in the repeated disconnection group vs one provisional prosthesis from the definitive abutment group due to frequent debondings (difference = 15%; CI 95%: 2%, 28%; P = 0.060). Five patients from the definitive abutment group and four patients from the repeated disconnection group were affected by complications (difference = 4%; CI 95%: -11%, 20%; P = 0.725). PES scores assessed at 3 years post-loading were 11.7 (standard deviation = 1.8) mm for the definitive abutment group and 11.3 (1.5) mm for the repeated abutment changes group (difference = 0.4; CI 95%: -0.4, 1.2; P = 0.315). However, there was a difference of 0.26 out of a maximum score of 2 in favour of the definitive abutment group for soft tissue contour only. Buccal recessions at 3 years post-loading amounted to -0.1 (0.8) mm for the definitive abutment group and -0.1 (1.2) mm for the repeated abutment changes group (it was actually a soft tissue gain; difference = 0.01 mm CI 95%: -0.48, 0.50; P = 0.965). All patients declared being very satisfied or satisfied with the function and aesthetics of the prostheses and said they would undergo the same procedure again, with the exception of one patient from the repeated disconnection group who was uncertain regarding function. Mean peri-implant marginal bone loss 3 years after loading was 0.07 (0.18) mm for the definitive abutment group and 0.50 (0.93) mm for the repeated abutment changes group (difference = 0.43 mm; CI 95%: 0.13, 0.74; P = 0.007). The height of keratinised mucosa at 3 years post-loading was 2.8 (1.3) mm for the definitive abutment group and 2.8 (1.6) mm for the repeated abutment changes group (difference = 0.03; CI 95%: -0.67, 0.73; P = .926). Up to 3 years after initial loading there were no statistically significant differences between the two procedures, with the exception of 0.4 mm more marginal bone loss at implants subjected to three abutment disconnections. There were no significantly

  7. Parents of children diagnosed with cancer: work situation and sick leave, a five-year post end-of-treatment or a child's death follow-up study.

    Science.gov (United States)

    Wikman, Anna; Hovén, Emma; Cernvall, Martin; Ljungman, Gustaf; Ljungman, Lisa; von Essen, Louise

    Cancer in a child is associated with a significant impact on parental employment. We assessed the proportions of parents of survivors and bereaved parents working and reporting sick leave five years after end of successful treatment (ST)/child's death (T7) compared with one year after end of ST/child's death (T6) and the association between partial post-traumatic stress disorder (PTSD) and work situation and sick leave at T7. Participants and procedure: The sample included 152 parents of survivors (77 mothers, 75 fathers) and 42 bereaved parents (22 mothers, 20 fathers) of children diagnosed with cancer in Sweden. The proportions of parents working or reporting sick leave did not differ among mothers and fathers of survivors (92% vs. 96% working, 20% vs. 18% on sick leave) or among bereaved mothers and fathers (91% vs. 90% working, 14% vs. 20% on sick leave) at T7. There was no change from T6 to T7 in the proportion of fathers working (fathers of survivors 91% vs. 96%, bereaved fathers 95% vs. 90%). Although more mothers of survivors (92% vs. 82%) and bereaved mothers (91% vs. 77%) worked at T7 than at T6, this increase was not significant. Fewer bereaved mothers reported sick leave at T7 than at T6 (14% vs. 59%, p leave at T7 than at T6 (fathers of survivors 18% vs. 8%, bereaved fathers 20% vs. 15%), this was not significant. Partial PTSD was not associated with parents' work situation or sick leave at T7. Results suggest little adverse effect on work situation and sick leave among parents of survivors and bereaved parents five years after end of ST/child's death from cancer. However, the pattern of change observed differed between parents, which could potentially indicate possible delayed consequences for fathers not captured in the present paper.

  8. The impact of postpartum post-traumatic stress disorder symptoms on child development: a population-based, 2-year follow-up study.

    Science.gov (United States)

    Garthus-Niegel, S; Ayers, S; Martini, J; von Soest, T; Eberhard-Gran, M

    2017-01-01

    Against the background of very limited evidence, the present study aimed to prospectively examine the impact of maternal postpartum post-traumatic stress disorder (PTSD) symptoms on four important areas of child development, i.e. gross motor, fine motor, communication and social-emotional development. This study is part of the large, population-based Akershus Birth Cohort. Data from the hospital's birth record as well as questionnaire data from 8 weeks and 2 years postpartum were used (n = 1472). The domains of child development that were significantly correlated with PTSD symptoms were entered into regression analyses. Interaction analyses were run to test whether the influence of postpartum PTSD symptoms on child development was moderated by child sex or infant temperament. Postpartum PTSD symptoms had a prospective relationship with poor child social-emotional development 2 years later. This relationship remained significant even when adjusting for confounders such as maternal depression and anxiety or infant temperament. Both child sex and infant temperament moderated the association between maternal PTSD symptoms and child social-emotional development, i.e. with increasing maternal PTSD symptom load, boys and children with a difficult temperament were shown to have comparatively higher levels of social-emotional problems. Examining four different domains of child development, we found a prospective impact of postpartum PTSD symptoms on children's social-emotional development at 2 years of age. Our findings suggest that both boys and children with an early difficult temperament may be particularly susceptible to the adverse impact of postpartum PTSD symptoms. Additional studies are needed to further investigate the mechanisms at work.

  9. Five years results after intrafamilial kidney post-transplant in a case of familial hypomagnesemia due to a claudin-19 mutation

    Directory of Open Access Journals (Sweden)

    Jorge Reis Almeida

    2014-09-01

    Full Text Available Introduction: Familial Hypomagnesaemia with hypercalciuria and nephrocalcinosis, with severe ocular impairment secondary to claudin-19 mutation, is a rare recessive autossomic disorder. Its spectrum includes renal Mg2+ wasting, medullary nephrocalcinosis and progressive chronic renal failure in young people. Objective: To report a case of kidney transplantation father to daughter in a familial occurrence of severe bilateral nephrocalcinosis associated with ocular impairment in a non-consanguineous Brazilian family, in which two daughters had nephrocalcinosis and severe retinopathy. Methods: The index case, a 19 years-old female, had long-lasting past medical history of recurrent urinary tract infections, and the abdominal X-ray revealed bilateral multiple renal calcifications as well as ureteral lithiasis, and she was under haemodialysis. She had the diagnosis of retinitis pigmentosa in the early neonatal period. The other daughter (13 years-old had also nephrocalcinosis with preserved kidney function, retinopathy with severe visual impairment, and in addition, she exhibited hypomagnesaemia = 0.5 mg/dL and hypercalciuria. The other family members (mother, father and son had no clinical disease manifestation. Mutation analysis at claudin-19 revealed two heterozygous missense mutations (P28L and G20D in both affected daughters. The other family members exhibited mutant monoallelic status. In despite of that, the index case underwent intrafamilial living donor kidney transplantation (father. Conclusion: In conclusion, the disease was characterized by an autosomal recessive compound heterozygous status and, after five years of donation the renal graft function remained stable without recurrence of metabolic disturbances or nephrocalcinosis. Besides, donor single kidney Mg2+ and Ca2+ homeostasis associated to monoallelic status did not affect the safety and the usual living donor post-transplant clinical course.

  10. Acceptance and Use of Mobile Technology for Health Self-Monitoring in Lung Transplant Recipients during the First Year Post-Transplantation.

    Science.gov (United States)

    Jiang, Yun; Sereika, Susan M; Dabbs, Annette DeVito; Handler, Steven M; Schlenk, Elizabeth A

    2016-01-01

    To describe lung transplant recipients (LTRs') acceptance and use of mobile technology for health self-monitoring during the first year post-transplantation, and explore correlates of the use of technology in the 0 to 2, >2 to ≤6, >6 to ≤12, and 0 to 12 months. Secondary analysis of data from 96 LTR assigned to use Pocket PATH(®), a smartphone application, for daily health self-monitoring in a randomized controlled trial. Use of Pocket PATH was categorized as low, moderate, and high use. Proportional odds models for ordinal logistic regression were employed to explore correlates of use of technology. LTR reported high acceptance of Pocket PATH at baseline. However, acceptance was not associated with actual use over the 12 months (p=0.45~0.96). Actual use decreased across time intervals (ptechnology training (p=0.02) in the first 2 months. Higher use from >2 to ≤6 months was associated with greater satisfaction with technology training (OR=3.37, p=0.01) and shorter length of hospital stay (OR=0.98, p=0.02). Higher use from >6 to ≤12 months was associated with older age (OR=1.05, p=0.02), lower psychological distress (OR=0.43, p=0.02), and better physical functioning (OR=1.09, p=0.01). Higher use over 12 months was also associated with older age (OR=1.05, p=0.007), better physical functioning (OR=1.13, p=0.001), and greater satisfaction with technology training (OR=3.05, p=0.02). Correlates were different for short- and long-term use of mobile technology for health self-monitoring in the first year post-transplantation. It is important to follow up with LTR with longer hospital stay, poor physical functioning, and psychological distress, providing ongoing education to improve their long-term use of technology for health self-monitoring.

  11. Effect of Safety Issues with HIV Drugs on the Approval Process of Other Drugs in the Same Class An Analysis of European Public Assessment Reports : an analysis of European public assessment reports

    NARCIS (Netherlands)

    Arnardottir, Arna H.; Haaijer-Ruskamp, Flora M.; Straus, Sabine M. J.; de Graeff, Pieter A.; Mol, Peter G. M.

    2011-01-01

    Background: Knowledge on the safety of new medicines is limited at the time of market entry. Nearly half of all drugs used to treat HIV registered in the EU required >= 1 Direct Healthcare Professional Communication (DHPC) in the past 10 years for safety issues identified post-approval. Objective:

  12. Ten Year Operating Test Results and Post-Test Analysis of a 1/10 Segment Stirling Sodium Heat Pipe, Phase III

    Science.gov (United States)

    Rosenfeld, John, H; Minnerly, Kenneth, G; Dyson, Christopher, M.

    2012-01-01

    High-temperature heat pipes are being evaluated for use in energy conversion applications such as fuel cells, gas turbine re-combustors, Stirling cycle heat sources; and with the resurgence of space nuclear power both as reactor heat removal elements and as radiator elements. Long operating life and reliable performance are critical requirements for these applications. Accordingly, long-term materials compatibility is being evaluated through the use of high-temperature life test heat pipes. Thermacore, Inc., has carried out a sodium heat pipe 10-year life test to establish long-term operating reliability. Sodium heat pipes have demonstrated favorable materials compatibility and heat transport characteristics at high operating temperatures in air over long time periods. A representative one-tenth segment Stirling Space Power Converter heat pipe with an Inconel 718 envelope and a stainless steel screen wick has operated for over 87,000 hr (10 yr) at nearly 700 C. These life test results have demonstrated the potential for high-temperature heat pipes to serve as reliable energy conversion system components for power applications that require long operating lifetime with high reliability. Detailed design specifications, operating history, and post-test analysis of the heat pipe and sodium working fluid are described.

  13. Post-Transplant Lymphoproliferative Disorder (PTLD) Manifesting in the Oral Cavity of a 13-Year-Old Liver Transplant Recipient (LTx).

    Science.gov (United States)

    Krasuska-Sławińska, Ewa; Minko-Chojnowska, Izabela; Pawłowska, Joanna; Dembowska-Bagińska, Bożenna; Pronicki, Maciej; Olczak-Kowalczyk, Dorota

    2015-08-18

    BACKGROUND Post-transplant lymphoproliferative disorder (PTLD) is a potential complication of solid organ or bone marrow transplants. The main PTLD risk factors are: the Epstein-Barr virus (EBV), transplant type, and use of immunosuppressants. It mainly consists of an uncontrolled growth of lymphocytes in transplant recipients under chronic immunosuppressive therapy. About 85% of PTLDs are EBV-containing B-cell proliferations; 14% are T-cell proliferations, of which only 40% contain EBV; and the remaining 1% is NK-cell or plasmocyte proliferations. PTLD may present various clinical manifestations, from non-specific mononucleosis-like syndrome to graft or other organ damage resulting from pathologic lymphocyte infiltration. PTLD may manifest in the oral cavity. CASE REPORT The objective of this study was to present the case of a 13-year-old female living-donor liver transplant recipient, resulting from biliary cirrhosis caused by congenital biliary atresia, with exophytic fibrous lesions on buccal mucosa and tongue. Exophytic and hyperplastic lesion of oral mucosa were removed and histopathological examination revealed polymorphic PTLD. The patient underwent 6 cycles of CHOP chemotherapy and all the oral lesions regressed completely. CONCLUSIONS All oral pathological lesions in organ transplant recipients need to be surgically removed and histopathologically examined because they present an increased risk of neoplastic transformations such as PTLD.

  14. POST CLOSURE INSPECTION AND MONITORING REPORT FOR CORRECTIVE ACTION UNIT 417: CENTRAL NEVADA TEST AREA - SURFACE, HOT CREEK VALLEY, NEVADA, FOR CALENDAR YEAR 2004

    Energy Technology Data Exchange (ETDEWEB)

    BECHTEL NEVADA; NNSA NEVADA SITE OFFICE

    2005-04-01

    This post-closure inspection and monitoring report has been prepared according to the stipulations laid out in the Closure Report (CR) for Corrective Action Unit (CAU) 417, Central Nevada Test Area (CNTA)--Surface (U.S. Department of Energy, National Nuclear Security Administration Nevada Operations Office [NNSA/NV], 2001), and the Federal Facility Agreement and Consent Order (FFACO, 1996). This report provides an analysis and summary of site inspections, subsidence surveys, meteorological information, and soil moisture monitoring data for CAU 417, which is located in Hot Creek Valley, Nye County, Nevada. This report covers Calendar Year 2004. Inspections at CAU 417 are conducted quarterly to document the physical condition of the UC-1, UC-3, and UC-4 soil covers, monuments, signs, fencing, and use restricted areas. The physical condition of fencing, monuments, and signs is noted, and any unusual conditions that could impact the integrity of the covers are reported. The objective of the soil moisture monitoring program is to monitor the stability of soil moisture conditions within the upper 1.2 meters (m) (4 feet [ft]) of the UC-1 Central Mud Pit (CMP) cover and detect changes that may be indicative of moisture movement exceeding the cover design performance expectations.

  15. Prevalence of post-traumatic stress disorder and depression in two groups of children one year after the January 2010 earthquake in Haiti.

    Science.gov (United States)

    Blanc, Judite; Bui, Eric; Mouchenik, Yoram; Derivois, Daniel; Birmes, Philippe

    2015-02-01

    More than 500 studies were conducted in Haiti following the January 12 of 2010 earthquake, yet few of them assessed mental health of the population. To our knowledge, none targeted the effectiveness of various methods used to treat survivors, whether adults or children Our study aimed to assess one year after the disaster, the effect of a specific psycho-social support offered to relocated children in Port-au-Prince compared with a control group. The two groups were homogeneous in the intensity of the peritraumatic distress they experienced. We were unable to show a significant difference between both in the average scores for PTSD, nor for depression, nor in three out of the four sub-scales of the Child Behavior Check-List. In case children, 68% and 40.9%, respectively, and 50% and 20.5% of the control group, reported severe levels of the symptoms of PTSD and depression. These surprising results can be explained by the absence of equivalence in the two groups from a socio-demographic point of view and because subjects were not randomly selected in the recruitment process. This study has not made it possible to indicate the effectiveness of a specific psycho-social support offered to children in the aftermath of the disaster. On the other hand, the sample illustrates the high prevalence (more than 50% for PTSD) of severe post-traumatic stress in this group of school-age children, one year after the earthquake. These results indicate that serious attention should be paid to the mental health aspects in reconstruction program for the country. Copyright © 2014 Elsevier B.V. All rights reserved.

  16. Safety and efficacy of canagliflozin in elderly patients with type 2 diabetes mellitus: a 1-year post-marketing surveillance in Japan.

    Science.gov (United States)

    Goda, Maki; Yamakura, Tomoko; Sasaki, Kazuyo; Tajima, Takumi; Ueno, Makoto

    2018-02-01

    To evaluate the safety and efficacy of canagliflozin in elderly patients with type 2 diabetes mellitus (T2DM) in clinical settings. The authors conducted a 1-year post-marketing surveillance (PMS) of canagliflozin in almost all the elderly patients (≥65 years old) with T2DM who began taking canagliflozin during the first 3 months after its launch in Japan. The main outcomes included the incidences of adverse drug reactions (ADRs), serious ADRs, and the changes of laboratory tests as well as efficacy variables. An ADR was reported in 9.09% (125 of 1375 patients) in the safety analysis set. The main ADRs were dehydration, constipation, thirst, pollakiuria, dizziness, cystitis, eczema, pruritus, and rash. The incidence of serious ADRs was 1.02% (14 patients), which included urinary tract infection, dehydration, hypoglycemia, and cerebral infarction (two patients each). ADRs of special interest that had been reported in clinical trials of SGLT2 inhibitors, such as hypoglycemia, volume depletion-related events, genital/urinary tract infection, polyuria/pollakiuria, and ketone body increased were also observed in this PMS. The safety profiles were similar to the results of a previous clinical study of canagliflozin, and new safety concerns were not identified in this survey. The mean change in HbA1c was -0.77% after 12 months of treatment in the efficacy analysis set. In this PMS, the safety and efficacy profiles of canagliflozin in elderly patients with T2DM were obtained in the clinical settings in Japan and the drug was well tolerated and effective in improving glycemic control.

  17. The longitudinal interplay between negative and positive symptom trajectories in patients under antipsychotic treatment: a post hoc analysis of data from a randomized, 1-year pragmatic trial.

    Science.gov (United States)

    Chen, Lei; Johnston, Joseph A; Kinon, Bruce J; Stauffer, Virginia; Succop, Paul; Marques, Tiago R; Ascher-Svanum, Haya

    2013-11-28

    Schizophrenia is a highly heterogeneous disorder with positive and negative symptoms being characteristic manifestations of the disease. While these two symptom domains are usually construed as distinct and orthogonal, little is known about the longitudinal pattern of negative symptoms and their linkage with the positive symptoms. This study assessed the temporal interplay between these two symptom domains and evaluated whether the improvements in these symptoms were inversely correlated or independent with each other. This post hoc analysis used data from a multicenter, randomized, open-label, 1-year pragmatic trial of patients with schizophrenia spectrum disorder who were treated with first- and second-generation antipsychotics in the usual clinical settings. Data from all treatment groups were pooled resulting in 399 patients with complete data on both the negative and positive subscale scores from the Positive and Negative Syndrome Scale (PANSS). Individual-based growth mixture modeling combined with interplay matrix was used to identify the latent trajectory patterns in terms of both the negative and positive symptoms. Pearson correlation coefficients were calculated to examine the relationship between the changes of these two symptom domains within each combined trajectory pattern. We identified four distinct negative symptom trajectories and three positive symptom trajectories. The trajectory matrix formed 11 combined trajectory patterns, which evidenced that negative and positive symptom trajectories moved generally in parallel. Correlation coefficients for changes in negative and positive symptom subscale scores were positive and statistically significant (P negative and positive symptoms (n = 70, 18%), (2) mild and sustained improvement in negative and positive symptoms (n = 237, 59%), and (3) no improvement in either negative or positive symptoms (n = 82, 21%). This study of symptom trajectories over 1 year shows that changes in negative

  18. Prevalence of unexplained anaemia in Inuit men and Inuit post-menopausal women in Northern Labrador: International Polar Year Inuit Health Survey.

    Science.gov (United States)

    Jamieson, Jennifer A; Weiler, Hope A; Kuhnlein, Harriet V; Egeland, Grace M

    2016-06-27

    To identify correlates of hemoglobin (Hb) and anaemia unexplained by iron deficiency (UA) in Canadian Inuit adults. A cross-sectional survey assessed diet, demographic information, anthropometry, fasting Hb, ferritin, soluble transferrin receptor (on a subset), high-sensitivity C-reactive protein (hs-CRP) in serum, red blood cell (RBC) fatty acid composition, blood lead, and antibodies to Helicobacter pylori in non-pregnant, Inuit adults (n = 2550), ≥18 years of age from randomly selected households in 36 Inuit communities in Inuvialuit Settlement Region, Nunavut Territory and Nunatsiavut of Northern Labrador, Canada. Hb concentrations were lower and UA prevalence higher in Inuit men after 50 years of age. Rate of anaemia was constant among Inuit women but changed from primarily iron deficiency anaemia pre-menopause, to primarily UA in post-menopause. Low education levels and hs-CRP were associated with increased risk of UA. For Inuit men, % RBC eicosapentaenoic acid (EPA) and elevated blood lead were also associated with increased risk of UA. Frequency of traditional food intake was positively associated with Hb. Age patterns and regional variation of anaemia suggest that ethnicity-related physiological differences cannot explain anaemia prevalence for Inuit. High RBC EPA status, inflammation and infections, and lower education levels may contribute to the prevalence of anaemia in this population, which is not related to iron status. Thus, traditional lifestyle may protect Inuit from nutritional anaemia but contribute to lower Hb through environmental exposures. The clinical significance of UA for older Inuit adults requires further investigation, as the prevalence represents a moderate public health problem.

  19. Vedolizumab: first global approval.

    Science.gov (United States)

    Poole, Raewyn M

    2014-07-01

    Vedolizumab [Entyvio(®) (US, Europe)], a humanized monoclonal antibody α4β7 integrin receptor antagonist, has been developed by Millennium Pharmaceuticals (d/b/a Takeda Pharmaceuticals International) for the treatment of ulcerative colitis and Crohn's disease. Vedolizumab has received its first global approval for the treatment of ulcerative colitis and Crohn's disease in the US, for use in adult patients with moderate-to-severe disease who have had an inadequate response, loss of response or intolerance to one or more standard therapies (corticosteroids, immunomodulators or tumour necrosis factor-α inhibitor) or demonstrated dependence on corticosteroids. Vedolizumab has since been approved for ulcerative colitis and Crohn's disease in the EU, Norway, Iceland and Liechtenstein. This article summarizes the milestones in the development of vedolizumab leading to its first approval for the treatment of ulcerative colitis and Crohn's disease.

  20. Radiological Medical Device Innovation: Approvals via the Premarket Approval Pathway From 2000 to 2015.

    Science.gov (United States)

    Ghobadi, Comeron W; Hayman, Emily L; Finkle, Joshua H; Walter, Jessica R; Xu, Shuai

    2017-01-01

    The aim of this study was to critically assess the clinical evidence leading to radiologic medical device approvals via the premarket approval pathway from 2000 to 2015. This study used the publically available FDA premarket database for radiologic device approvals over the past 15 years (September 1, 2000, to August 31, 2015). Approval characteristics were collected for each device, and statistical analysis was performed on the data for each pivotal trial. Additionally, methodological quality of the pivotal trial was determined using the Quality Assessment of Diagnostic Accuracy Studies tool. Twenty-three class III radiologic device approvals were identified, with breast imaging accounting for 16 (70%) and computer-aided detection software accounting for 9 (39%) approvals. The median premarket approval time was 475 days (range, 180-1,116). Twenty-one devices were approved on the basis of multireader, multicenter studies, one on the basis of a randomized controlled trial, and one on the basis of a preclinical technical equivalence trial. The median number of patients per pivotal trial was 201 (range, 25-3,946). Twenty-six of the 34 pivotal trials (76%) had at least one methodologic bias. Breast imaging devices had a greater number of patients per pivotal trial (P = .009) and more prospective studies. With regard to all modalities, increased time to device approval correlated with weaker trial quality (r = 0.600, P assessing diagnostic technologies. Given that radiologic devices play a key role in modern medicine, further efforts should be made to increase transparency of clinical data leading to approval. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  1. Quality of life and physical activity in long-term (≥5 years post-diagnosis) colorectal cancer survivors - systematic review.

    Science.gov (United States)

    Eyl, Ruth Elisa; Xie, Kun; Koch-Gallenkamp, Lena; Brenner, Hermann; Arndt, Volker

    2018-06-01

    Due to the increasing number of long-term (≥5 years post diagnosis) colorectal cancer survivors, long-term quality of life of these patients is highly relevant. Several studies have reported a positive association between physical activity and quality of life in colorectal cancer survivors, however, so far no systematic review has been published which focuses on long-term colorectal cancer survivors. A systematic review was conducted using the databases PubMed, Web of Science, PsychINFO, and CINAHL. Studies which investigated associations between physical activity and quality of life in long-term colorectal cancer survivors were included. Ten articles based on seven studies were identified. Long-term colorectal cancer survivors who were physically active reported better quality of life than long-term survivors who were not physically active. Both, moderate to vigorous physical activity and lower levels like light physical activity were associated with higher quality of life. Most studies assessed the association between physical activity and quality of life cross-sectionally but one prospective study which measured physical activity and quality of life at three different points in time also found associations between physical activity and quality of life. The association between physical activity and quality of life seemed to be stronger among women than among men. The findings of this systematic review support an association between physical activity and quality of life in long-term colorectal cancer survivors. However, the evidence is limited as most studies were based on cross-sectional and observational design.

  2. Effects of dwarf mistletoe on stand structure of lodgepole pine forests 21-28 years post-mountain pine beetle epidemic in central Oregon.

    Directory of Open Access Journals (Sweden)

    Michelle C Agne

    Full Text Available Lodgepole pine (Pinus contorta forests are widely distributed throughout North America and are subject to mountain pine beetle (Dendroctonus ponderosae epidemics, which have caused mortality over millions of hectares of mature trees in recent decades. Mountain pine beetle is known to influence stand structure, and has the ability to impact many forest processes. Dwarf mistletoe (Arceuthobium americanum also influences stand structure and occurs frequently in post-mountain pine beetle epidemic lodgepole pine forests. Few studies have incorporated both disturbances simultaneously although they co-occur frequently on the landscape. The aim of this study is to investigate the stand structure of lodgepole pine forests 21-28 years after a mountain pine beetle epidemic with varying levels of dwarf mistletoe infection in the Deschutes National Forest in central Oregon. We compared stand density, stand basal area, canopy volume, proportion of the stand in dominant/codominant, intermediate, and suppressed cohorts, average height and average diameter of each cohort, across the range of dwarf mistletoe ratings to address differences in stand structure. We found strong evidence of a decrease in canopy volume, suppressed cohort height, and dominant/codominant cohort diameter with increasing stand-level dwarf mistletoe rating. There was strong evidence that as dwarf mistletoe rating increases, proportion of the stand in the dominant/codominant cohort decreases while proportion of the stand in the suppressed cohort increases. Structural differences associated with variable dwarf mistletoe severity create heterogeneity in this forest type and may have a significant influence on stand productivity and the resistance and resilience of these stands to future biotic and abiotic disturbances. Our findings show that it is imperative to incorporate dwarf mistletoe when studying stand productivity and ecosystem recovery processes in lodgepole pine forests because of its

  3. Effects of dwarf mistletoe on stand structure of lodgepole pine forests 21-28 years post-mountain pine beetle epidemic in central Oregon.

    Science.gov (United States)

    Agne, Michelle C; Shaw, David C; Woolley, Travis J; Queijeiro-Bolaños, Mónica E

    2014-01-01

    Lodgepole pine (Pinus contorta) forests are widely distributed throughout North America and are subject to mountain pine beetle (Dendroctonus ponderosae) epidemics, which have caused mortality over millions of hectares of mature trees in recent decades. Mountain pine beetle is known to influence stand structure, and has the ability to impact many forest processes. Dwarf mistletoe (Arceuthobium americanum) also influences stand structure and occurs frequently in post-mountain pine beetle epidemic lodgepole pine forests. Few studies have incorporated both disturbances simultaneously although they co-occur frequently on the landscape. The aim of this study is to investigate the stand structure of lodgepole pine forests 21-28 years after a mountain pine beetle epidemic with varying levels of dwarf mistletoe infection in the Deschutes National Forest in central Oregon. We compared stand density, stand basal area, canopy volume, proportion of the stand in dominant/codominant, intermediate, and suppressed cohorts, average height and average diameter of each cohort, across the range of dwarf mistletoe ratings to address differences in stand structure. We found strong evidence of a decrease in canopy volume, suppressed cohort height, and dominant/codominant cohort diameter with increasing stand-level dwarf mistletoe rating. There was strong evidence that as dwarf mistletoe rating increases, proportion of the stand in the dominant/codominant cohort decreases while proportion of the stand in the suppressed cohort increases. Structural differences associated with variable dwarf mistletoe severity create heterogeneity in this forest type and may have a significant influence on stand productivity and the resistance and resilience of these stands to future biotic and abiotic disturbances. Our findings show that it is imperative to incorporate dwarf mistletoe when studying stand productivity and ecosystem recovery processes in lodgepole pine forests because of its potential to

  4. CORN, LP Goldfield Approval

    Science.gov (United States)

    This November 19, 2015 letter from EPA approves the petition from CORN, LP, Goldfield facility, regarding non-grandfathered ethanol produced through a dry mill process, qualifying under the Clean Air Act for renewable fuel (D-code 6) RINs under the RFS pro

  5. Poet Fostoria Approval

    Science.gov (United States)

    This August 9, 2016 letter from EPA approves, with modifications, the petition from Poet Biorefining-Fostoria, LLC, regarding non-grandfathered ethanol produced through a dry mill process, qualifying under the Clean Air Act for renewable fuel (D-code 6)

  6. Poet Lake Crystal Approval

    Science.gov (United States)

    This September 19, 2016 letter from EPA approves the petition from Poet Biorefining-Lake Crystal, regarding non-grandfathered ethanol produced through a dry mill process, qualifying under the Clean Air Act for renewable fuel (D-code 6) RINs under the RFS

  7. Poet Leipsic Approval

    Science.gov (United States)

    This August 9, 2016 letter from EPA approves,wtih modifications, the petition from Poet Biorefining-Leipsic, LLC, regarding non-grandfathered ethanol produced through a dry mill process, qualifying under the Clean Air Act for renewable fuel (D-code 6) RINs

  8. Drugs Approved for Rhabdomyosarcoma

    Science.gov (United States)

    This page lists cancer drugs approved by the Food and Drug Administration (FDA) for rhabdomyosarcoma. The list includes generic names and brand names. The drug names link to NCI's Cancer Drug Information summaries. There may be drugs used in rhabdomyosarcoma that are not listed here.

  9. Assessment of the effectiveness of the post-Fukushima food monitoring campaign in the first year after the nuclear accident: A hypothesis

    International Nuclear Information System (INIS)

    Steinhauser, Georg

    2016-01-01

    The purpose of this study was to assess whether or not the food monitoring campaign after the Fukushima nuclear accident has been successful in reducing the number of above-limit-food from reaching the consumers. The hypothesis of this study is that the fraction of “post-market” food can be used for this purpose, when the post-market fraction in the above-limit (p′) items is compared to the post-market fraction in the entity of food items (p) that have been screened for radionuclides ("1"3"4Cs and "1"3"7Cs). Indeed the post-market fraction in most vegetarian produce decreased significantly in the above-limit food items (p′/p   1), indicating a much lower effectiveness of the monitoring action for beef. The author speculates that, by following the governmental monitoring manual (which gives “meat” only second priority), the sudden exceedances caught the monitoring agencies unprepared and triggered a much higher density monitoring of beef with the delay of several weeks. Even then, many above limit items reached the market (mainly because the monitoring during this period had focused on the post-market). Therefore, it is likely that some above-limit beef has been consumed by the public. For other meat products, the fraction of post-market samples was very low, which does not allow for the validation of the effectiveness of the monitoring campaign. Overall, the monitoring seemed to have been more effective for vegetarian produce than for meat. - Highlights: • The fraction of post-market food above the regulatory indicates the effectiveness of the monitoring campaign. • Monitoring of vegetables has been more effective than of meat. • Beef had the highest fraction of exceedances in the post-market fraction.

  10. Post-operative delirium is an independent predictor of 30-day hospital readmission after spine surgery in the elderly (≥65years old): A study of 453 consecutive elderly spine surgery patients.

    Science.gov (United States)

    Elsamadicy, Aladine A; Wang, Timothy Y; Back, Adam G; Lydon, Emily; Reddy, Gireesh B; Karikari, Isaac O; Gottfried, Oren N

    2017-07-01

    In the last decade, costs of U.S. healthcare expenditures have been soaring, with billions of dollars spent on hospital readmissions. Identifying causes and risk factors can reduce soaring readmission rates and help lower healthcare costs. The aim of this is to determine if post-operative delirium in the elderly is an independent risk factor for 30-day hospital readmission after spine surgery. The medical records of 453 consecutive elderly (≥65years old) patients undergoing spine surgery at Duke University Medical Center from 2008 to 2010 were reviewed. We identified 17 (3.75%) patients who experienced post-operative delirium according to DSM-V criteria. Patient demographics, comorbidities, and post-operative complication rates were collected for each patient. Elderly patients experiencing post-operative delirium had an increased length of hospital stay (10.47days vs. 5.70days, p=0.009). Complication rates were similar between the cohorts with the post-operative delirium patients having increased UTI and superficial surgical site infections. In total, 12.14% of patients were re-admitted within 30-days of discharge, with post-operative delirium patients experiencing approximately a 4-fold increase in 30-day readmission rates (Delirium: 41.18% vs. No Delirium: 11.01%, p=0.002). In a multivariate logistic regression analysis, post-operative delirium is an independent predictor of 30-day readmission after spine surgery in the elderly (p=0.03). Elderly patients experiencing post-operative delirium after spine surgery is an independent risk factor for unplanned readmission within 30-days of discharge. Preventable measures and early awareness of post-operative delirium in the elderly may help reduce readmission rates. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. ACL-reconstructed and ACL-deficient individuals show differentiated trunk, hip, and knee kinematics during vertical hops more than 20 years post-injury.

    Science.gov (United States)

    Markström, Jonas L; Tengman, Eva; Häger, Charlotte K

    2018-02-01

    Little is known regarding movement strategies in the long term following injury of the anterior cruciate ligament (ACL), and even less about comparisons of reconstructed and deficient knees in relation to healthy controls. The present purpose was to compare trunk, hip, and knee kinematics during a one-leg vertical hop (VH) ~20 years post-ACL injury between persons treated with surgery and physiotherapy (ACL R ), solely physiotherapy (ACL PT ), and controls (CTRL). Between-leg kinematic differences within groups were also investigated. Sixty-six persons who suffered unilateral ACL injury on average 23 ± 2 years ago (32 ACL R , 34 ACL PT ) and 33 controls performed the VH. Peak trunk, hip, and knee angles during Take-off and Landing phases recorded with a 3D motion capture system were analysed with multivariate statistics. Significant group effects during both Take-off and Landing were found, with ACL PT differing from CTRL in Take-off with a combination of less knee flexion and knee internal rotation, and from both ACL R and CTRL in Landing with less hip and knee flexion, knee internal rotation, and greater hip adduction. ACL R also presented different kinematics to ACL PT and CTRL in Take-off with a combination of greater trunk flexion, hip flexion, hip internal rotation, and less knee abduction, and in Landing with greater trunk flexion and hip internal rotation. Further, different kinematics and hop height were found between legs within groups in both Take-off and Landing for both ACL groups, but not for CTRL. Different kinematics for the injured leg for both ACL groups compared to CTRL and between treatment groups, as well as between legs within treatment groups, indicate long-term consequences of injury. Compensatory mechanisms for knee protection seem to prevail over time irrespective of initial treatment, possibly increasing the risk of re-injury and triggering the development of osteoarthritis. Detailed investigation of movement strategies during the VH

  12. Comparison of the variability of the annual rates of change in FEV1 determined from serial measurements of the pre- versus post-bronchodilator FEV1 over 5 years in mild to moderate COPD: Results of the lung health study

    Directory of Open Access Journals (Sweden)

    Tashkin Donald P

    2012-08-01

    Full Text Available Abstract Background The impact of interventions on the progressive course of COPD is currently assessed by the slope of the annual decline in FEV1 determined from serial measurements of the post-, in preference to the pre-, bronchodilator FEV1. We therefore compared the yearly slope and the variability of the slope of the pre- versus the post-bronchodilator FEV1 in men and women with mild to moderate COPD who participated in the 5-year Lung Health Study (LHS. Methods Data were analyzed from 4484 of the 5887 LHS participants who had measurements of pre- and post-bronchodilator FEV1 at baseline (screening visit 2 and all five annual visits. The annual rate of decline in FEV1 (±SE measured pre- and post-bronchodilator from the first to the fifth annual visit was estimated separately using a random coefficient model adjusted for relevant covariates. Analyses were performed separately within each of the three randomized intervention groups. In addition, individual rates of decline in pre- and post-bronchodilator FEV1 were also determined for each participant. Furthermore, sample sizes were estimated for determining the significance of differences in slopes of decline between different interventions using pre- versus post-bronchodilator measurements. Results Within each intervention group, mean adjusted and unadjusted slope estimates were slightly higher for the pre- than the post-bronchodilator FEV1 (range of differences 2.6-5.2 ml/yr and the standard errors around these estimates were only minimally higher for the pre- versus the post-bronchodilator FEV1 (range 0.05-0.11 ml/yr. Conversely, the standard deviations of the mean FEV1 determined at each annual visit were consistently slightly higher (range of differences 0.011 to 0.035 L for the post- compared to the pre-bronchodilator FEV1. Within each group, the proportion of individual participants with a statistically significant slope was similar (varying by only 1.4 to 2.7% comparing the estimates

  13. REPRESENTATION OF JAPANESE POST-COLONIAL EXPERIENCE IN THE YEAR OF 1942-1945 BASED ON PRAMOEDYA ANANTA TOER’S NOVEL “PERBURUAN”

    Directory of Open Access Journals (Sweden)

    Rifqia Kartika Ningrum

    2017-09-01

    Full Text Available This article is aimed to describe post-colonial forms which represented by the figures in the Pramoedya Ananta Toer’s novel Perburuan. This novel portrays about a character named Hardo who fought Japanese colonialism together with his two friends, Dipo and Karmin. However, their plan was failed to be implemented. It was making Hardo a Japanese fugitive. This novel is about the history of Japanese colonialism in Indonesia. Therefore, this novel can be studied with post-colonial theory. Type of this research is descriptive qualitative research using post-colonial approach. Researchers gathered the data by searching data in the novel that has relevance to the three formulations of the post-colonial theory that have been found. These three formulations include resistance, betrayal, and character’s self-doubt (ambivalence. The technique used in this article is content analysis. The research steps were determined the data source, collection the data, classification the data, and data analysis. Data analysis technique used was Miles and Huberman model that consists of data reduction, data presentation, and drawing conclusions. Through the representation of characters in the novel found the forms of resistance, betrayal, and characteristic’s self-doubts as forms of post-colonial representation.

  14. Does the effect of one-day simulation team training in obstetric emergencies decline within one year? A post-hoc analysis of a multicentre cluster randomised controlled trial

    NARCIS (Netherlands)

    van de Ven, J.; Fransen, A F; Schuit, E.; van Runnard Heimel, P.J.; Mol, Ben W.; Oei, Swan G.

    2017-01-01

    Does the effect of one-day simulation team training in obstetric emergencies decline within one year? A post-hoc analysis of a multicentre cluster randomised controlled trial. J van de Ven, AF Fransen, E Schuit, PJ van Runnard Heimel, BW Mol, SG Oei Objective To investigate whether the effect of a

  15. Innovating by developing new uses of already-approved drugs: trends in the marketing approval of supplemental indications.

    Science.gov (United States)

    DiMasi, Joseph A

    2013-06-01

    approval-phase time during the study period for applications that received a standard review rating from the FDA was substantially shorter for supplements compared to original uses, but the differences for applications that received a priority review rating from the FDA were negligible. Development of and regulatory approval for new uses of already-approved drugs and biologics is an important source of innovation by biopharmaceutical firms. Despite rising development costs, the output of new-use approvals has remained stable in recent years, driven largely by the pursuit of new pediatric indications. FDA approval-phase times have generally declined substantially for all types of applications since the mid-1990s following legislation that provided a new source of income for the agency. However, while the resources needed to review supplemental applications are likely lower in general than for original-use approvals, the approval-phase times for important new uses are no lower than for important original-use applications. Copyright © 2013 Elsevier HS Journals, Inc. All rights reserved.

  16. Learning and memory performance in breast cancer survivors 2 to 6 years post-treatment: the role of encoding versus forgetting.

    Science.gov (United States)

    Root, James C; Andreotti, Charissa; Tsu, Loretta; Ellmore, Timothy M; Ahles, Tim A

    2016-06-01

    Our previous retrospective analysis of clinically referred breast cancer survivors' performance on learning and memory measures found a primary weakness in initial encoding of information into working memory with intact retention and recall of this same information at a delay. This suggests that survivors may misinterpret cognitive lapses as being due to forgetting when, in actuality, they were not able to properly encode this information at the time of initial exposure. Our objective in this study was to replicate and extend this pattern of performance to a research sample to increase the generalizability of this finding in a sample in which subjects were not clinically referred for cognitive issues. We contrasted learning and memory performance between breast cancer survivors on endocrine therapy 2 to 6 years post-treatment with age- and education-matched healthy controls. We then stratified lower- and higher-performing breast cancer survivors to examine specific patterns of learning and memory performance. Contrasts were generated for four aggregate visual and verbal memory variables from the California Verbal Learning Test-2 (CVLT-2) and the Brown Location Test (BLT): Single-trial Learning: Trial 1 performance, Multiple-trial Learning: Trial 5 performance, Delayed Recall: Long-delay Recall performance, and Memory Errors: False-positive errors. As predicted, breast cancer survivors' performance as a whole was significantly lower on Single-trial Learning than the healthy control group but exhibited no significant difference in Delayed Recall. In the secondary analysis contrasting lower- and higher-performing survivors on cognitive measures, the same pattern of lower Single-trial Learning performance was exhibited in both groups, with the additional finding of significantly weaker Multiple-trial Learning performance in the lower-performing breast cancer group and intact Delayed Recall performance in both groups. As with our earlier finding of weaker initial

  17. No post-no core approach to restore severely damaged posterior teeth: An up to 10-year retrospective study of documented endocrown cases.

    Science.gov (United States)

    Belleflamme, Marcia M; Geerts, Sabine O; Louwette, Marie M; Grenade, Charlotte F; Vanheusden, Alain J; Mainjot, Amélie K

    2017-08-01

    The objectives of the present study were to (1) retrospectively evaluate documented cases of ceramic and composite endocrowns performed using immediate dentin sealing (IDS); (2) correlate failures with clinical parameters such as tooth preparation characteristics and occlusal parameters. 99 documented cases of endocrowns were evaluated after a mean observation period of 44.7±34.6months. A classification of restorations was established in function of the level of damage of residual tooth tissues after preparation, from 1 to 3. Evaluation was performed according to FDI criteria and endodontic outcomes were analyzed. Occlusal risk factors were examined and fractographic analysis was performed in case of fracture. 48.4% of patients were shown to present occlusal risk factors. 75.8% of restorations were Class 3 endocrowns. 56.6% were performed on molars, 41.4% on premolars and 2.0% on canines. 84.8% were performed in lithium-disilicate glass-ceramic and 12.1% in Polymer-Infiltrated Ceramic Network (PICN) material. The survival and success rates of endocrowns were 99.0% and 89.9% respectively, while the 10-year Kaplan-Meier estimated survival and success rates were 98.8% and 54.9% respectively. Ten failures were detected: periodontal disease (n=3), endocrown debonding (n=2), minor chipping (n=2), caries recurrence (n=2) and major fractures (n=1). Due to the reduced amount of failures, no statistical correlation could be established with clinical parameters. Endocrowns were shown to constitute a reliable approach to restore severely damaged molars and premolars, even in the presence of extensive coronal tissue loss or occlusal risk factors, such as bruxism or unfavorable occlusal relationships. Practitioners should consider the endocrown instead of the post and core approach to restore severely damaged non-vital posterior teeth. This minimally invasive solution reduces the risk of catastrophic failures and is easily performed. The use of IDS procedure and lithium

  18. Economic Burden of Herpes Zoster and Post-Herpetic Neuralgia in Adults 60 Years of Age or Older: Results from a Prospective, Physician Practice-Based Cohort Study in Kushiro, Japan.

    Science.gov (United States)

    Nakamura, Hiroyuki; Mizukami, Akiko; Adachi, Koichi; Matthews, Sean; Holl, Katsiaryna; Asano, Kazuhiro; Watanabe, Akihiro; Adachi, Riri; Kiuchi, Mariko; Kobayashi, Keiju; Sato, Keiko; Matsuki, Taizo; Kaise, Toshihiko; Curran, Desmond

    2017-12-01

    Herpes zoster has a high incidence rate among people aged ≥ 60 years and can lead to serious complications such as post-herpetic neuralgia. There are currently no data on the economic burden of herpes zoster and post-herpetic neuralgia in Japan, and the objective of this study was to address this gap. A total of 412 patients aged ≥ 60 years diagnosed with herpes zoster were recruited. Demographic, clinical, and healthcare resource utilization data on patients with herpes zoster or post-herpetic neuralgia collected via case report forms were used to estimate direct medical cost. Data obtained from a questionnaire survey among patients with herpes zoster/post-herpetic neuralgia were used to estimate transportation cost and productivity loss. The mean number of outpatient visits was 5.7. Prescription medications were the main cost driver accounting for 60% of the direct medical cost. The mean direct medical and total herpes zoster-related costs per patient were ¥43,925 and ¥57,112, respectively, and were higher in patients with post-herpetic neuralgia than in those with herpes zoster without complications. Direct medical cost represented 77%, productivity loss 19%, and transportation cost 4% of the total. This is the first study of the economic burden of herpes zoster and post-herpetic neuralgia in Japan and it demonstrated substantial direct medical cost as a result of the multiple outpatient visits and prescription medications required. These findings provide baseline data for possible future economic evaluations of new herpes zoster/post-herpetic neuralgia interventions. This cost analysis is part of a prospective, physician practice-based cohort study conducted between June 2013 and February 2015 in Kushiro, Japan (Clinicaltrials.gov identifier NCT01873365, registered on 6 June, 2013).

  19. Linaclotide: first global approval.

    Science.gov (United States)

    McWilliams, Vanessa; Whiteside, Glenn; McKeage, Kate

    2012-11-12

    Linaclotide is a once-daily, orally administered, first-in-class agonist of guanylate cyclase-C that is minimally absorbed. It is being developed to treat gastrointestinal disorders by Ironwood Pharmaceuticals and its partners, Forest Laboratories (North America), Almirall (Europe) and Astellas Pharma (Asia-Pacific). Linaclotide has received its first global approval in the US for the treatment of constipation-predominant irritable bowel syndrome (IBS-C) and chronic idiopathic constipation (CIC), and a marketing submission has been filed in the EU for IBS-C. This article summarizes the milestones in the development of linaclotide leading to this first approval for IBS-C and CIC. This profile has been extracted and modified from the Adis R&D Insight drug pipeline database. Adis R&D Insight tracks drug development worldwide through the entire development process, from discovery, through pre-clinical and clinical studies to market launch.

  20. Neratinib: First Global Approval.

    Science.gov (United States)

    Deeks, Emma D

    2017-10-01

    Neratinib (Nerlynx™) is an oral, irreversible inhibitor of the human epidermal growth factor receptors HER1 (EGFR), HER2 and HER4. The drug originally arose from research by Wyeth (now Pfizer) and is now being developed by Puma Biotechnology primarily for the treatment of HER2-positive (HER+) breast cancer. Neratinib is approved in the USA for the extended adjuvant treatment of patients with HER2+ early-stage breast cancer who have been previously treated with a trastuzumab-based adjuvant regimen, and is in the preregistration phase for this indication in the EU. Neratinib, as monotherapy and/or combination therapy, is also in phase 3 development for metastatic breast cancer and in phase 1/2 development for advanced breast cancer and other solid tumours, including non-small cell lung cancer, colorectal cancer and glioblastoma. This article summarizes the milestones in the development of neratinib leading to this first approval for breast cancer.

  1. Post-Polio Syndrome

    Science.gov (United States)

    ... You are here Home » Disorders » All Disorders Post-Polio Syndrome Information Page Post-Polio Syndrome Information Page What research is being done? ... behavior of motor neurons many years after a polio attack. Others are looking at the mechanisms of ...

  2. Cognitive Impairment, Vulnerability, and Mortality Post Ischemic Stroke: A Five-Year Follow-Up of the Action on Secondary Prevention Interventions and Rehabilitation in Stroke (ASPIRE-S) Cohort.

    Science.gov (United States)

    Gaynor, Eva; Rohde, Daniela; Large, Margaret; Mellon, Lisa; Hall, Patricia; Brewer, Linda; Conway, Orla; Hickey, Anne; Bennett, Kathleen; Dolan, Eamon; Callaly, Elizabeth; Williams, David

    2018-05-23

    The aim of this study was to examine predictors of mortality in patients 5 years after ischemic stroke, focusing on cognitive impairment, vulnerability, and vascular risk factors assessed at 6 months post stroke. Patients from the Action on Secondary Prevention Interventions and Rehabilitation in Stroke (ASPIRE-S) cohort were followed up 5 years post ischemic stroke. Vascular risk factors, cognitive impairment, and vulnerability were assessed at 6 months post stroke. Cognitive impairment was assessed using a cutoff score lower than 26 on the Montreal Cognitive Assessment (MoCA). Vulnerability was defined as a score of 3 or higher on the Vulnerable Elders Scale (VES). Mortality and date of death were ascertained using hospital records, death notifications, and contact with general practitioners. Predictors of mortality were explored using multivariate Cox proportional hazards models. Adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) are presented. Sixty-three of 256 patients (24.6%) assessed at 6 months post stroke had died within 5 years. Cognitive impairment (HR [95% CI]: 2.19 [1.42-3.39]), vulnerability (HR [95% CI]: 5.23 [2.92-9.36]), atrial fibrillation (AF) (HR [95% CI]: 2.31 [1.80-2.96]), and dyslipidemia (HR [95% CI]: 1.90 [1.10-3.27]) were associated with increased risk of 5-year mortality. Vulnerability, cognitive impairment, AF, and dyslipidemia at 6 months were associated with increased risks of mortality 5 years post ischemic stroke. Identification and management of these risk factors should be emphasized in poststroke care. Copyright © 2018 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  3. Bariatric surgery in patients with bipolar spectrum disorders: Selection factors, post-operative visit attendance, and weight outcomes

    Science.gov (United States)

    Friedman, Kelli E.; Applegate, Katherine; Portenier, Dana; McVay, Megan

    2017-01-01

    Background As many of 3% of bariatric surgery candidates are diagnosed with a bipolar spectrum disorder. Objectives 1) To describe differences between patients with bipolar spectrum disorders who are approved and not approved for surgery by the mental health evaluator. 2) To examine surgical outcomes of patients with bipolar spectrum disorders. Setting Academic medical center, United States. Methods A retrospective record review was conducted of consecutive patients who applied for bariatric surgery between 2004 and 2009. Patients diagnosed with bipolar spectrum disorders who were approved for surgery (n=42) were compared with patients with a bipolar spectrum disorder who were not approved (n=31) and to matched control surgical patients without a bipolar spectrum diagnosis (n=29) on a variety of characteristics and surgical outcomes. Results Of bariatric surgery candidates diagnosed with a bipolar spectrum disorder who applied for surgery, 57% were approved by the psychologist and 48% ultimately had surgery. Patients with a bipolar spectrum disorder who were approved for surgery were less likely to have had a previous psychiatric hospitalizations than those who were not approved for surgery. Bariatric surgery patients diagnosed with a bipolar spectrum disorder were less likely to attend follow-up care appointments 2 or more years post-surgery compared to matched patients without bipolar disorder. Among patients with available data, those with a bipolar spectrum disorder and matched patients had similar weight loss at 12 months (n=21 for bipolar, n=24 for matched controls) and at 2 or more years (mean=51 months; n=11 for bipolar, n=20 for matched controls). Conclusions Patients diagnosed with a bipolar spectrum disorder have a high rate of delay/denial for bariatric surgery based on the psychosocial evaluation and are less likely to attend medical follow-up care 2 or more years post-surgery. Carefully screened patients with bipolar disorder who engage in long

  4. Angiosarcoma arising in the non-operated, sclerosing breast after primary irradiation, surviving 6 years post-resection: A case report and review of the Japanese literature

    Directory of Open Access Journals (Sweden)

    Takaaki Ito

    2016-01-01

    Conclusion: Angiosarcoma may occur in the non-operated breast, post irradiation. The potential difficulties of diagnosing angiosarcoma against background fibrosis should be kept in mind. Initial radical surgery currently represents the only effective treatment for improving survival in these patients.

  5. Post-Closure Report for Closed Resource Conservation and Recovery Act Corrective Action Units, Nevada National Security Site, Nevada, for fiscal year 2013 (October 2012 - September 2013)

    International Nuclear Information System (INIS)

    2014-01-01

    This report serves as the combined annual report for post-closure activities for the following closed Corrective Action Units (CAUs): CAU 90, Area 2 Bitcutter Containment; CAU 91, Area 3 U-3fi Injection Well; CAU 92, Area 6 Decon Pond Facility; CAU 110, Area 3 WMD U-3ax/bl Crater; CAU 111, Area 5 WMD Retired Mixed Waste Pits; and, CAU 112, Area 23 Hazardous Waste Trenches

  6. Post-Closure Report for Closed Resource Conservation and Recovery Act Corrective Action Units, Nevada National Security Site, Nevada for fiscal year 2013 (October 2012 - September 2013)

    Energy Technology Data Exchange (ETDEWEB)

    None, None

    2014-01-31

    This report serves as the combined annual report for post-closure activities for the following closed Corrective Action Units (CAUs): CAU 90, Area 2 Bitcutter Containment; CAU 91, Area 3 U-3fi Injection Well; CAU 92, Area 6 Decon Pond Facility; CAU 110, Area 3 WMD U-3ax/bl Crater; CAU 111, Area 5 WMD Retired Mixed Waste Pits; and, CAU 112, Area 23 Hazardous Waste Trenches.

  7. Driving forces of main landscape change processes from past 200 years in Central Europe - differences between old democratic and post-socialist countries

    Directory of Open Access Journals (Sweden)

    Skokanová Hana

    2016-03-01

    Full Text Available The article compares and points out differences in driving forces of four main landscape change processes that shaped post-socialist countries and old democratic countries of Central Europe during the last two centuries. Studying landscape change processes and corresponding driving forces helps in understanding patterns of present landscape and can help among others in better prediction of future landscape change trends. Here, the presented results are based on review of scientific articles published in peer-reviewed journals between 2000 and 2014. Driving forces affecting these processes were grouped into four categories. Economic forces drove mainly agricultural intensification; agricultural land abandonment and urbanisation and were pronounced especially in the second half of the 20th century and at the beginning of the 21st century. Technological driving forces affected agricultural intensification especially in the 19th century and the second half of the 20th century while cultural driving forces had the biggest impact on urbanisation at the beginning of the 21st century. Political driving forces affected agricultural intensification, urbanisation as well as agricultural land abandonment and were pronounced mainly during the second half of the 20th century in the post-socialist countries. Political forces in the form of subsidies drove agricultural extensification at the beginning of the 21st century. The drivers for the agricultural intensification as well as urbanisation seem to be similar for both old democratic and post-socialist countries. In contrast, agricultural land abandonment in the old democratic countries was driven by technological, cultural and economic driving forces while in the post-socialist countries the political driving forces were mainly responsible. Changes in systems for subsidies and changes in the agricultural commodity markets are also responsible for different frequencies and rates of extensification of

  8. Post-ERCP infection and its epidemiological and clinical characteristics in a large Chinese tertiary hospital: a 4-year surveillance study

    Directory of Open Access Journals (Sweden)

    Mingmei Du

    2017-12-01

    Full Text Available Abstract Background Endoscopic retrograde cholangiopancreatography (ERCP is widely performed as a treatment for biliary and pancreatic illness in China; however, there are few data available regarding post-ERCP infections. This study aimed to describe the overall incidence of post-ERCP infections and the epidemiological characteristics of infected patients in a large tertiary-care hospital in China. Methods Real-time surveillance was performed from 2012 through 2015 to identify all healthcare-associated infections (HAIs that occurred after ERCP, using an automatic system. All HAIs (e.g., cholangtitis, bacteremia were identified by infection control practitioners and doctors. Inpatient data were automatically collected by the surveillance system. Results A total of 1743 ERCP operations were included in the study, among these, 132 (7.57% HAIs were identified. ERCP postoperative infections occurred following different surgical procedures, with infection rates ranging from 3.58 to 13.51%. The most prevalent HAI was biliary tract infection (4.02%, followed by transient bacteremia (1.14%. Overall, 62 cases of bacteremia occurred following ERCP surgery and 34 (54.84% cases occurred on the day of the operation or 1-day post-surgery. The most prevalent isolates detected during bacteremia were Enterococcus faecium (12/58 and Escherichia coli (11/58. A large proportion (72.73% of the E. coli isolates and all of the E. faecium isolates were resistant to ciprofloxacin. In addition, only 37.50% of the E. coli isolates were susceptible to ceftriaxone. Conclusions The high incidence of post-ERCP infection and the prevalence of drug resistance suggests that employing second generation cephalosporin or ceftriaxone as the antibiotic of choice for prophylaxis before ERCP, as recommended by the Chinese clinical application of antibacterial drugs guidelines, may not be effective.

  9. Supercollider: Footprint approved

    International Nuclear Information System (INIS)

    Anon.

    1990-01-01

    With the 'footprint' - the precise location of the 87-kilometre US Superconducting Supercollider, SSC, and its ancillary buildings - now approved, teams of specialists commissioned by the State of Texas swing into action to procure the 17,000 acres (69 million square metres) of land covered by the project. With the SSC Laboratory in Ellis County and the US Department of Energy (DoE, the overseeing government agency) both hiring manpower for this project to collide 20 TeV (20,000 GeV) proton beams before the end of the century, the host State of Texas is providing a helping hand

  10. La Poste

    CERN Multimedia

    2004-01-01

    http://www.cern.ch/cern50/ The French Post Office has issued ten commemorative envelopes bearing original images depicting CERN and its history. This special fiftieth anniversary collector's edition will be available on the French Post Office (« La Poste ») stand at the Open Day on 16 October, in the CMS experiment hall at Cessy. Information for collectors: a pictorial postmark and date stamp have been specially designed and produced for the occasion with the assistance of CERN's graphics team. Sending a philatelic souvenir is a great way to commemorate the Open Day, so La Poste will be setting up a large post-box for that very purpose next to its stand. A perfect way to send images of CERN all around the world...

  11. Effectiveness of Eye Movement Desensitization and Reprocessing(EMDR to Reduce the Severity of Symptoms of Post-Traumatic Stress Disorder and Stuttering With Psychological Origin(Case Study in Child with Four Years Old

    Directory of Open Access Journals (Sweden)

    Azam Hashemian Moghadam

    2017-02-01

    Full Text Available Abstract Background: The present research aimed to measure the effectiveness of Eye Movement Desensitization and Reprocessing (EMDR on reducing the severity of symptoms of post-traumatic Stress Disorder (PTSD and Stuttering in a four-year-old child post-traumatic stress disorder in children is one of the disorders relating to trauma and stressful factors, also, stutterring or word fluency disorder is a nerve growth disorder. Materials and Methods: This research design was conducted as a case study with a multiple baseline design. Participant in this research was a four-year- old child with Diagnostic Posttraumatic Stress Disorder and Psychogenic Stuttering. He had been placed under the intervention with EMDR at Shahid Birjand Counseling Center. The instruments used for this research included demographic researcher-made questionnaire, the third edition of stuttering severity test, the scale of parents’ report of post-traumatic Symptoms and child’s report of posttraumatic Symptoms. Data analysis was done through graphic and descriptive analysis. The data was collected as base line and during the treatment as well as after the treatment and follow-up (in terms of 3 and 24 months. Results: Means percentage improvement (MPI to reducing the severity of post-traumatic symptoms was achieved as %74.66 and it was %56.06 for reduction of the severity of stuttering and they continued to maintain in the follow-up period. Conclusion: Results showed that EMDR method had affected on reduction of the severity of post-traumatic stress disorder symptoms and stuttering intensity.

  12. POST CLOSURE INSPECTION AND MONITORING REPORT FOR CORRECTIVE ACTION UNIT 417: CENTRAL NEVADA TEST AREA - SURFACE, HOT CREEK VALLEY, NEVADA; FOR CALENDAR YEAR 2005

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2006-04-01

    Corrective Action Unit (CAU) 417, Central Nevada Test Area - Surface, is located in Hot Creek Valley in northern Nye County, Nevada, and consists of three areas commonly referred to as UC-1, UC-3, and UC-4. CAU 417 consists of 34 Corrective Action Sites (CASs) which were closed in 2000 (U. S. Department of Energy, National Nuclear Security Administration Nevada Operations Office, 2001). Three CASs at UC-1 were closed in place with administrative controls. At CAS 58-09-01, Central Mud Pit (CMP), a vegetated soil cover was constructed over the mud pit. At the remaining two sites CAS 58-09-02, Mud Pit and 58-09-05, Mud Pits (3), aboveground monuments and warning signs were installed to mark the CAS boundaries. Three CASs at UC-3 were closed in place with administrative controls. Aboveground monuments and warning signs were installed to mark the site boundaries at CAS 58-09-06, Mud Pits (5), CAS 58-25-01, Spill and CAS 58-10-01, Shaker Pad Area. Two CASs that consist of five sites at UC-4 were closed in place with administrative controls. At CAS 58-09-03, Mud Pits 9, an engineered soil cover was constructed over Mud Pit C. At the remaining three sites in CAS 58-09-03 and at CAS 58-10-05, Shaker Pad Area, aboveground monuments and warning signs were installed to mark the site boundaries. The remaining 26 CASs at CAU 417 were either clean-closed or closed by taking no further action. Quarterly post-closure inspections are performed at the CASs that were closed in place at UC-I, UC-3, and UC-4. During calendar year 2005, site inspections were performed on March 15, June 16, September 22, and December 7. The inspections conducted at the UC-1 CMP documented that the site was in good condition and continued to show integrity of the cover unit. No new cracks or fractures were observed until the December inspection. A crack on the west portion of the cover showed evidence of lateral expansion; however, it is not at an actionable level. The crack will be sealed by filling with

  13. The bizzare phenomenon of smokers' paradox in the immediate outcome post acute myocardial infarction: an insight into the Malaysian National Cardiovascular Database-Acute Coronary Syndrome (NCVD-ACS) registry year 2006-2013.

    Science.gov (United States)

    Venkatason, Padmaa; Salleh, Norsabihin Mohd; Zubairi, Yong; Hafidz, Imran; Ahmad, Wan Azman Wan; Han, Sim Kui; Zuhdi, Ahmad Syadi Mahmood

    2016-01-01

    'Smoker's paradox' is a controversial phenomenon of an unexpected favourable outcome of smokers post acute myocardial infarction. There are conflicting evidences from the literature so far. We investigate for the existence of this phenomenon in our post acute myocardial infarction patients. We analysed 12,442 active smokers and 10,666 never-smokers diagnosed with STEMI and NSTEMI from the Malaysian National Cardiovascular Database-Acute Coronary Syndrome (NCVD-ACS) year 2006-2013 from 18 hospitals across Malaysia. Comparisons in the baseline characteristics, clinical presentation, in-hospital treatment and short term clinical outcome were made between the two groups. To compare the clinical outcome, an extensive multivariate adjustment was made to estimate the allcause mortality risk ratios for both groups. The active smokers were younger (smokers 53.7 years vs non-smokers 62.3 years P smokers and intravenous thrombolysis was the main reperfusion therapy in both groups. Smokers had a higher rate of in-hsopital coronary revascularisation in NSTEMI group (21.6 % smokers vs 16.7 % non-smokers P non-smokers in the STEMI group. Multivariate adjusted mortality risk ratios showed significantly lower mortality risks of smokers at both in-hospital (RR 0.510 [95 % CI 0.442-0.613]) and 30-day post discharge (RR 0.534 [95 % CI 0.437-0.621]). Smoking seems to be associated with a favourable outcome post myocardial infarction. The phenomenon of 'smoker's paradox' is in fact a reality in our patients population. The definitive explanation for this unexpected protective effect of smoking remains unclear.

  14. I Wish I Had (Not) Taken a Gap-Year? The Psychological and Attainment Outcomes of Different Post-School Pathways

    Science.gov (United States)

    Parker, Philip D.; Thoemmes, Felix; Duineveld, Jasper J.; Salmela-Aro, Katariina

    2015-01-01

    Existing gap-year research indicates a number of benefits of a gap-year at the end of school and before university enrollment. Life span theory of control, however, suggests that direct goal investment, rather than delay, at developmental transitions is associated with more adaptive outcomes. Comparing these perspectives, the authors undertook 2…

  15. Infection status and risk factors associated with urinary schistosomiasis among school-going children in the Ndumo area of uMkhanyakude district in KwaZulu-Natal, South Africa two years post-treatment.

    Science.gov (United States)

    Kabuyaya, Muhubiri; Chimbari, Moses John; Mukaratirwa, Samson

    2018-04-18

    To assess the efficacy of praziquantel of infected children with Schistosoma haematobium over a 2year period in the Ndumo area of uMkhanyakude district, South Africa. This cohort study enrolled 173 school-going children in September 2017 that participated in a baseline survey conducted in 2015 in the Ndumo area. Questionnaire interviews were conducted to collect information on the risk factors related to transmission of schistosomiasis and filtration technique was performed to detect Schistosoma haematobium eggs in urine. Infection intensity was classified as light and heavy. A Chi square test was performed to assess association between variables with 95% confidence interval and p-value=0.05 was considered significant. Of the 173 participants screened two years post-treatment, 10 were infected and six were new infection cases while 4 were re-infections. The intensity of infection decreased significantly (P value=0.001) in the follow-up survey compare to the baseline survey. However, no significant difference was found among the risk factors of schistosomiasis 2 years later. The prevalence of S. haematobium decreased significantly in the cohort 2 years post praziquantel treatment during persistent drought in the area. Risk factors which were significantly associated with schistosomiasis at baseline were not two years following treatment. Copyright © 2018. Published by Elsevier Ltd.

  16. Spatiotemporal exposome dynamics of soil lead and children's blood lead pre- and ten years post-Hurricane Katrina: Lead and other metals on public and private properties in the city of New Orleans, Louisiana, U.S.A.

    Science.gov (United States)

    Mielke, Howard W; Gonzales, Christopher R; Powell, Eric T; Mielke, Paul W

    2017-05-01

    Anthropogenic re-distribution of lead (Pb) principally through its use in gasoline additives and lead-based paints have transformed the urban exposome. This unique study tracks urban-scale soil Pb (SPb) and blood Pb (BPb) responses of children living in public and private communities in New Orleans before and ten years after Hurricane Katrina (29 August 2005). To compare and evaluate associations of pre- and ten years post-Katrina SPb and children's BPb on public and private residential census tracts in the core and outer areas of New Orleans, and to examine correlations between SPb and nine other soil metals. The Louisiana Healthy Housing and Childhood Lead Poisoning Prevention Program BPb (µg/dL) data from pre- (2000-2005) and post-Katrina (2010-2015) for ≤6-year-old children. Data from public and adjacent private residential census tracts within core and outer areas are stratified from a database that includes 916 and 922 SPb and 13,379 and 4830 BPb results, respectively, from pre- and post-Katrina New Orleans. Statistical analyses utilize Multi-Response Permutation Procedure and Spearman's Rho Correlation. Pre- to Post-Katrina median SPb decreases in public and private core census tracts were from 285 to 55mg/kg and 710-291mg/kg, respectively. In public and private outer census tracts the median SPb decreased from 109 to 56mg/kg and 88-55mg/kg. Children's BPb percent ≥5µg/dL on public and private core areas pre-Katrina was 63.2% and 67.5%, and declined post-Katrina to 7.6% and 20.2%, respectively. BPb decreases also occurred in outer areas. Soil Pb is strongly correlated with other metals. Post-Katrina re-building of public housing plus landscaping amends the exposome and reduces children's BPb. Most importantly, Hurricane Katrina revealed that decreasing the toxicants in the soil exposome is an effective intervention for decreasing children's BPb. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. I wish I had (not) taken a gap-year? The psychological and attainment outcomes of different post-school pathways.

    Science.gov (United States)

    Parker, Philip D; Thoemmes, Felix; Duineveld, Jasper J; Salmela-Aro, Katariina

    2015-03-01

    Existing gap-year research indicates a number of benefits of a gap-year at the end of school and before university enrollment. Life span theory of control, however, suggests that direct goal investment, rather than delay, at developmental transitions is associated with more adaptive outcomes. Comparing these perspectives, the authors undertook 2 studies: 1 in Finland (N = 384, waves = 3) and 1 in Australia (N = 2,259, waves = 5) both with an initial time wave in the last year of high school. The authors explored the effects of a gap-year on both psychological and attainment outcomes using an extensive propensity score matching technique. The Finnish study found no difference in growth in goal commitment, effort, expectations of attainment and strain, or in actual university enrollment in those planning to enter university directly versus those who plan to take a gap-year. The Australian study found no difference in growth in outlooks for the future and career prospects, and life satisfaction between gap-year youth and direct university entrants. However, the study did find that gap-year students were more likely to drop out of a university degree. Implication for theory and practice are discussed. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

  18. The Evolution of Approval Services.

    Science.gov (United States)

    Warzala, Martin

    1994-01-01

    Describes major developments in book approval plans used by academic libraries for acquisition and for information dissemination and document distribution services based on approval-like concepts. Topics addressed include publishers; marketing; the impact of library automation; value-added services; the economic climate; the influence of…

  19. Number of patients studied prior to approval of new medicines

    DEFF Research Database (Denmark)

    Duijnhoven, Ruben G; Straus, Sabine M J M; Raine, June M

    2013-01-01

    length of time), whereas 67 (79.8%) of the medicines met the criteria for 12-mo patient exposure (at least 100 participants studied for 12 mo). CONCLUSIONS: For medicines intended for chronic use, the number of patients studied before marketing is insufficient to evaluate safety and long-term efficacy....... Both safety and efficacy require continued study after approval. New epidemiologic tools and legislative actions necessitate a review of the requirements for the number of patients studied prior to approval, particularly for chronic use, and adequate use of post-marketing studies. Please see later...

  20. Electronic Approval of Invoices (AEF)

    CERN Document Server

    2004-01-01

    With a view to the simplification of administrative procedures, AS and FI Departments have completed the second phase of the new procedure for the electronic approval of invoices via the EDH application. The aim of this new procedure is to rationalise the invoice approval process, notably by eliminating paper copies from the approval circuit. This will simplify the processing of invoices and facilitate their timely settlement, while at the same time maintaining a high level of security. Phase II includes handling the electronic approval process of invoices whose amounts do not correspond exactly to those of the associated orders. In such cases, budgetary approval is required for the entire invoiced amount. Further information can be obtained at : http://ais.cern.ch/projs/AEF/help/F_help.htm Phase II of the procedure will be introduced gradually with effect from April 2004. Finance Department, Accounts Payable Section Tel: 72295 Organisation and Procedures Tel: 75885 Information Technologies Department,...

  1. Post-Closure Report for Closed Resource Conservation and Recovery Act Corrective Action Units, Nevada National Security Site, Nevada: For Fiscal Year 2015 (October 2014–September 2015), Revision 0

    Energy Technology Data Exchange (ETDEWEB)

    Matthews, Patrick [Navarro, Las Vegas, NV (United States)

    2016-03-01

    This report serves as the combined annual report for post-closure activities for the following closed corrective action units (CAUs); CAU 90, Area 2 Bitcutter Containment; CAU 91, Area 3 U-3fi Injection Well; CAU 92, Area 6 Decon Pond Facility; CAU 110, Area 3 WMD U-3ax/bl Crater; CAU 111, Area 5 WMD Retired Mixed Waste Pits; and CAU 112, Area 23 Hazardous Waste Trenches. This report covers fiscal year 2015 (October 2014 through September 2015). The post-closure requirements for these sites are described in Resource Conservation and Recovery Act Permit Number NEV HW0101 and are summarized in each CAU-specific section in Section 1.0 of this report. The results of the inspections, a summary of maintenance activities, and an evaluation of monitoring data are presented in this report.

  2. Post-Closure Report for Closed Resource Conservation and Recovery Act Corrective Action Units, Nevada National Security Site, Nevada: For Fiscal Year 2015 (October 2014-September 2015), Revision 0

    International Nuclear Information System (INIS)

    Matthews, Patrick

    2016-01-01

    This report serves as the combined annual report for post-closure activities for the following closed corrective action units (CAUs); CAU 90, Area 2 Bitcutter Containment; CAU 91, Area 3 U-3fi Injection Well; CAU 92, Area 6 Decon Pond Facility; CAU 110, Area 3 WMD U-3ax/bl Crater; CAU 111, Area 5 WMD Retired Mixed Waste Pits; and CAU 112, Area 23 Hazardous Waste Trenches. This report covers fiscal year 2015 (October 2014 through September 2015). The post-closure requirements for these sites are described in Resource Conservation and Recovery Act Permit Number NEV HW0101 and are summarized in each CAU-specific section in Section 1.0 of this report. The results of the inspections, a summary of maintenance activities, and an evaluation of monitoring data are presented in this report.

  3. Fiscal Year 2015 Budget

    Data.gov (United States)

    Montgomery County of Maryland — This dataset includes the Fiscal Year 2015 Council-approved operating budget for Montgomery County. The dataset does not include revenues and detailed agency budget...

  4. EBV-positive B cell cerebral lymphoma 12 years after sex-mismatched kidney transplantation: post-transplant lymphoproliferative disorder or donor-derived lymphoma?

    LENUS (Irish Health Repository)

    Phelan, Paul J

    2010-06-01

    We present a follow-up case report of possible transmission of lymphoma 12 years after deceased-donor renal transplantation from a male donor who was found at autopsy to have had an occult lymphoma. The female recipient underwent prompt transplant nephrectomy. However, 12 years later, she presented with cerebral B cell lymphoma. A donor origin for the cerebral lymphoma was supported by in situ hybridization demonstration of a Y chromosome in the lymphoma. There was a dramatic resolution of the cerebral lesions with tapering of immunosuppression and introduction of rituximab treatment. The finding of a Y chromosome in the cerebral lymphoma does not exclude a host contribution to lymphoma development.

  5. High-affinity human leucocyte antigen class I binding variola-derived peptides induce CD4(+) T cell responses more than 30 years post-vaccinia virus vaccination

    DEFF Research Database (Denmark)

    Wang, M.; Tang, Sheila Tuyet; Lund, Ole

    2009-01-01

    Interferon-gamma secreting T lymphocytes against pox virus-derived synthetic 9-mer peptides were tested by enzyme-linked immunospot in peripheral blood of individuals vaccinated with vaccinia virus more than 30 years ago. The peptides were characterized biochemically as high-affinity human leucoc...

  6. An Ode to Stuart Hall's "The Supply of Demand": The Case of Post-Secondary Education in Ontario Fifty Years Later

    Science.gov (United States)

    FitzGerald Murphy, Maggie

    2016-01-01

    Despite the fact that over fifty years have passed since its publication, Stuart Hall's article "The Supply of Demand" (1960), is remarkably relevant today. The central message that society must not be blinded by "prosperity" such that it no longer envisions and demands a better world is especially pertinent in light of the…

  7. Post-Closure Report for Closed Resource Conservation and Recovery Act Corrective Action Units, Nevada National Security Site, Nevada: For Calendar Year 2016, Revision 0

    Energy Technology Data Exchange (ETDEWEB)

    Matthews, Patrick [Navarro, Las Vegas, NV (United States)

    2017-03-01

    This report covers the reporting period calendar year 2016 and the fourth quarter of 2015 (October 2015 through December 2016). This change to the reporting periods (i.e., fiscal to calendar) is to gain efficiencies during report development and to better align with other environmental report schedules.

  8. Post-marketing surveillance study of the long-term use of mizoribine for the treatment of lupus nephritis: 2-Year results.

    Science.gov (United States)

    Takeuchi, Tsutomu; Okada, Kenya; Yoshida, Hisao; Yagi, Nobuyuki

    2018-01-01

    To understand the status of mizoribine use in patients with lupus nephritis (LN) and to collect safety- and efficacy-related data on 2-year treatment with mizoribine. A continuous survey was conducted between March 2010 and July 2015. The analysis set included 559 patients (mean age 39.5 years, females 82.6%, mean duration of systemic lupus erythematosus (SLE) 8.4 years, mean duration of LN 5.9 years). Renal function was satisfactory for 6 months, but worsened from 12 months, with significant worsening at 24 months. By the ACR 2006 remission criteria (eGFR >60), at 24 months, 26.5% of patients achieved complete remission, and 63.3% achieved complete or partial remission. The urine protein to creatinine ratio decreased significantly. The SLE Disease Activity Index 2000 score decreased significantly at 12 and 24 months. Overall, 98 (17.5%) patients experienced 124 adverse drug reactions (ADRs); 3.6% experienced serious ADRs. Mizoribine was used with a steroid in 99.3% and an immunosuppressant in 51.2%; tacrolimus was used in 43.8%. The oral steroid dosage decreased from baseline to 24 months. The incidence of ADRs was not significantly different with concomitant tacrolimus use. The results suggest that long-term mizoribine is safe and effective, even when used with tacrolimus.

  9. Drugs Approved for Kidney (Renal Cell) Cancer

    Science.gov (United States)

    ... Your Treatment Research Drugs Approved for Kidney (Renal Cell) Cancer This page lists cancer drugs approved by the ... not listed here. Drugs Approved for Kidney (Renal Cell) Cancer Afinitor (Everolimus) Aldesleukin Avastin (Bevacizumab) Axitinib Bevacizumab Cabometyx ( ...

  10. Post-glacial dispersal patterns of Northern pike inferred from an 8800 year old pike (Esox cf. lucius) skull from interior Alaska

    Science.gov (United States)

    Wooller, Matthew J.; Gaglioti, Benjamin; Fulton, Tara L.; Lopez, Andres; Shapiro, Beth

    2015-07-01

    The biogeography of freshwater fish species during and after late-Pleistocene glaciations relate to how these species are genetically organized today, and the management of these often disjunct populations. Debate exists concerning the biogeography and routes of dispersal for Northern pike (Esox lucius) after the last glaciation. A hypothesis to account for the relatively low modern genetic diversity for E. lucius is post-glacial radiation from refugia, including lakes from within the un-glaciated portions of eastern Beringia. We report the remains of a Northern pike (E. cf. lucius) skull, including bones, teeth, bone collagen and ancient DNA. The remains were preserved at a depth of between 440 and 446 cm in a 670 cm long core of sediment from Quartz Lake, which initiated at ˜11,200 cal yr BP in interior Alaska. A calibrated accelerator mass spectrometer (AMS) radiocarbon age of the collagen extracted from the preserved bones indicated that the organism was dated to 8820 cal yr BP and is bracketed by AMS values from analyses of terrestrial plant macrofossils, avoiding any potential aquatic reservoir effect that could have influenced the radiocarbon age of the bones. Scanning electron microscope images of the specimen show the hinged tooth anatomy typically of E. lucius. Molar C:N (3.5, 1σ = 0.1) value of the collagen from the specimen indicated well-preserved collagen and its mean stable nitrogen isotope value is consistent with the known predatory feeding ecology of E. lucius. Ancient DNA in the bones showed that the specimen was identical to modern E. lucius. Our record of E. lucius from interior Alaska is consistent with a biogeographic scenario involving rapid dispersal of this species from glacial refugia in the northern hemisphere after the last glaciation.

  11. Surgical Treatment of Periodontal Intrabony Defects with Calcium Sulphate in Combination with Beta-Tricalcium Phosphate: Clinical Observations Two Years Post-Surgery

    Directory of Open Access Journals (Sweden)

    Sujith Sukumar

    2011-01-01

    Full Text Available The study was designed to evaluate the clinical outcome of a composite material, beta-tricalcium phosphate in combination with calcium sulphate, in the treatment of periodontal intrabony defects. The combination of these materials is believed to aid in guided tissue regeneration owing to their properties. A total of 47 teeth with intrabony defects in 26 periodontitis patients were treated with Fortoss® Vital (Biocomposites, Staffordshire, UK. Clinical parameters were evaluated which included changes in probing depth, clinical attachment level/loss and gingival recession at the baseline and 2 years postoperatively. The mean differences in measurements between the baseline and 2 years postoperatively were a reduction of 2.07±1.14 mm (p=0.000 in case of probing depth and a gain of 1.93±1.36 mm (p=0.000 in clinical attachment level; but an increase of 0.14±0.73 mm (p=0.571 in gingival recession. The study results show that the treatment with a combination of beta tricalcium phosphate and calcium sulphate led to a significantly favorable clinical improvement in periodontal intrabony defects 2 years after the surgery.

  12. Spatially quantifying and attributing 17 years of land cover change to examine post-agricultural forest transition in Hawai`i

    Science.gov (United States)

    Lucas, M.; Trauernicht, C.; Carlson, K. M.; Miura, T.; Giambelluca, T. W.; Chen, Q.

    2017-12-01

    results directly link land management history to land cover outcomes using an innovative approach to quantify change. It is also the first study to quantify forest transition dynamics in Hawaii and points to the need for similar assessments in post-agricultural landscapes on other oceanic islands.

  13. 48 CFR 750.7105 - Approving authorities.

    Science.gov (United States)

    2010-10-01

    ... CONTRACT MANAGEMENT EXTRAORDINARY CONTRACTUAL ACTIONS Extraordinary Contractual Actions To Protect Foreign Policy Interests of the United States 750.7105 Approving authorities. All authority to approve actions...

  14. Intensified pharmaceutical care is improving immunosuppressive medication adherence in kidney transplant recipients during the first post-transplant year: a quasi-experimental study.

    Science.gov (United States)

    Joost, Robert; Dörje, Frank; Schwitulla, Judith; Eckardt, Kai-Uwe; Hugo, Christian

    2014-08-01

    Medication adherence is critical for transplant patients because the consequences of non-adherence can result in allograft loss and may be life threatening. A prospective study with 74 renal transplant recipients using a sequential control group design was performed to investigate the impact of a pharmaceutical intensified care programme led by a clinical pharmacist on daily drug adherence during the first year after renal transplantation. Thirty-nine patients of the control group received the already established standardized drug and transplant training, while 35 patients of the intensified care group (ICG) received additional inpatient and outpatient pharmaceutical care and counselling by a dedicated clinical pharmacist. Applied interventions were clustered and classified using the behaviour change technique taxonomy according to Michie. Adherence to immunosuppressive drug therapy was monitored up to 1 year using a medication event monitoring system, pill count (PC), drug holiday (DH) occurrence, Morisky questionnaire and self-report. Sixty-seven patients (35 of the standard care and 32 of the ICG) were analysed. Implementation of DA was significantly (P = 0.014) improved in patients of the ICG (91%) compared with SCG (75%) during the first year after transplantion. Daily adherence measures were already improved within 30-40 days after start of intensified patient care and continued throughout the study period. Intensified care patients also showed significantly better results for taking adherence (P = 0.006), PC (P = 0.008) and DHs (P = 0.001). The additional, intensified pharmaceutical care improved patients' medication adherence remarkably, suggesting that the applied additional care programme has the potential to improve outcomes after organ transplantation. © The Author 2014. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.

  15. Post traumatic painful shoulder – a delayed clinical feature of upper lobe lung cancer in a 74 year-old male. - case report -

    Directory of Open Access Journals (Sweden)

    Oana-Cristina Arghir

    2014-02-01

    Full Text Available A 74 year old Caucasian man, presents with a 6 week history of right sided chest pain including traumatic related painful right shoulder. Shoulder minor contusion was diagnosed and partial managed by symptomatic treatment associated to rehabilitation. The pain was initially eased with nonsteroidal anti-inflammatory drug (NSAID use and finally changed worsening. He has evidence of moderate COPD on spirometry and has been commenced on inhalers. An invasive primitive adenocarcinoma lung cancer was confirmed by chest CT scan and lymphnode biopsy through mediastinoscopy

  16. Post-traumatic nonunion of the clavicle in a 4-year-old boy and the importance of vitamin D level testing.

    Science.gov (United States)

    Duplantier, Neil L; Waldron, Sean

    2016-01-01

    Clavicle fractures in children are common and usually go on to achieve solid union with closed treatment. A limited number of pediatric clavicle fracture nonunion cases have been reported in the literature, none of which were directly associated with hypovitaminosis D. We report the youngest case to our knowledge in a 4-year-old vitamin D-deficient male with a 6-month-old right midshaft clavicle fracture nonunion that was treated successfully with vitamin D supplementation, followed by open reduction and internal fixation with autologus iliac crest bone grafting.

  17. Mumps virus encephalomyelitis in a 19-year old male patient with an undefined severe combined immunodeficiency post-haematopoietic bone marrow transplantation: a rare fatal complication.

    Science.gov (United States)

    Eyre, Toby A; Pelosi, Emanuela; McQuaid, Stephen; Richardson, Deborah; Newman, Joan; Hill, Kate; Veys, Paul; Davies, Graham; Orchard, Kim H

    2013-06-01

    We describe a rare case of fatal mumps encephalomyelitis occurring in 19-year old male following matched unrelated donor peripheral blood haematopoietic stem cell transplantation (HSCT). The indication for HSCT was for an undefined form of severe combined immunodeficiency (SCID). Molecular typing of the mumps viral RNA isolated from neural tissue indicated that the infection was acquired at the time of a mumps outbreak in England and Wales that occurred between 2004 and 2006. This case highlights the importance of considering mumps in the differential diagnosis of central nervous system infection in highly immunosuppressed patients. Copyright © 2013 Elsevier B.V. All rights reserved.

  18. Monitoring post

    DEFF Research Database (Denmark)

    Hansen, Pelle Guldborg; Jespersen, Andreas Maaløe

    2013-01-01

    This blog reports on the rumour that White House considers establishing a nudge unit similar to the UK Behavioural Insights Team. Given The Nudging Networks purpose and the work of the iNudgeYou-team this post is updated continuously to follow the US debate as it unfolds. Which issues are raised...

  19. Drugs Approved for Esophageal Cancer

    Science.gov (United States)

    This page lists cancer drugs approved by the Food and Drug Administration (FDA) for esophageal cancer. The list includes generic names and brand names. The drug names link to NCI's Cancer Drug Information summaries.

  20. Drugs Approved for Liver Cancer

    Science.gov (United States)

    This page lists cancer drugs approved by the Food and Drug Administration (FDA) for liver cancer. The list includes generic names and brand names. The drug names link to NCI’s Cancer Drug Information summaries.

  1. Drugs Approved for Kaposi Sarcoma

    Science.gov (United States)

    This page lists cancer drugs approved by the Food and Drug Administration (FDA) for Kaposi sarcoma. The list includes generic names and brand names. The drug names link to NCI's Cancer Drug Information summaries.

  2. Drugs Approved for Pancreatic Cancer

    Science.gov (United States)

    This page lists cancer drugs approved by the Food and Drug Administration (FDA) for pancreatic cancer. The list includes generic names, brand names, and common drug combinations, which are shown in capital letters.

  3. Drugs Approved for Vaginal Cancer

    Science.gov (United States)

    This page lists cancer drugs approved by the Food and Drug Administration (FDA) to prevent vaginal cancer. The list includes generic names and brand names. The drug names link to NCI’s Cancer Drug Information summaries.

  4. Drugs Approved for Skin Cancer

    Science.gov (United States)

    This page lists cancer drugs approved by the Food and Drug Administration (FDA) for skin cancer. The list includes generic names and brand names. The drug names link to NCI's Cancer Drug Information summaries.

  5. Drugs Approved for Vulvar Cancer

    Science.gov (United States)

    This page lists cancer drugs approved by the Food and Drug Administration (FDA) for vulvar cancer. The list includes generic names and brand names. The drug names link to NCI's Cancer Drug Information summaries.

  6. Drugs Approved for Wilms Tumor

    Science.gov (United States)

    This page lists cancer drugs approved by the Food and Drug Administration (FDA) for Wilms tumor and other childhood kidney cancers. The list includes generic names and brand names. The drug names link to NCI's Cancer Drug Information summaries.

  7. Drugs Approved for Lung Cancer

    Science.gov (United States)

    This page lists cancer drugs approved by the Food and Drug Administration (FDA) for lung cancer. The list includes generic names, brand names, and common drug combinations, which are shown in capital letters.

  8. Drugs Approved for Bone Cancer

    Science.gov (United States)

    This page lists cancer drugs approved by the Food and Drug Administration (FDA) for bone cancer. The list includes generic names and brand names. The drug names link to NCI's Cancer Drug Information summaries.

  9. Drugs Approved for Malignant Mesothelioma

    Science.gov (United States)

    This page lists cancer drugs approved by the Food and Drug Administration (FDA) for malignant mesothelioma. The list includes generic names and brand names. The drug names link to NCI's Cancer Drug Information summaries.

  10. Drugs Approved for Penile Cancer

    Science.gov (United States)

    This page lists cancer drugs approved by the Food and Drug Administration (FDA) for penile cancer. The list includes generic names and brand names. The drug names link to NCI’s Cancer Drug Information summaries.

  11. Drugs Approved for Bladder Cancer

    Science.gov (United States)

    This page lists cancer drugs approved by the Food and Drug Administration (FDA) for bladder cancer. The list includes generic names, brand names, and common drug combinations, which are shown in capital letters.

  12. Drugs Approved for Endometrial Cancer

    Science.gov (United States)

    This page lists cancer drugs approved by the Food and Drug Administration (FDA) for endometrial cancer. The list includes generic names and brand names. The drug names link to NCI's Cancer Drug Information summaries.

  13. Is It Really FDA Approved?

    Science.gov (United States)

    ... satisfaction before companies can market them in interstate commerce. Some examples of biologics that require approval are ... it means the agency has determined that the benefits of the product outweigh the known risks for ...

  14. Electronic Voucher Approval - Financial Management

    Data.gov (United States)

    US Agency for International Development — This process provides a workflow and eSignature capability which allows the CFO to router vouchers for review and electronic signature approval to COTRs in AIDW. It...

  15. Guidance for package approvals in the United Kingdom

    International Nuclear Information System (INIS)

    Morgan-Warren, E.J.

    2004-01-01

    Approval is required under the transport regulations for a wide range of package designs and operations, and applications for competent authority approval and validation are received from many sources, both in the UK and overseas. To assist package designers and applicants for approval, and to promote consistency in applications and their assessment, the UK Department for Transport issues guidance on the interpretation of the transport regulations and the requirements of an application for approval and its supporting safety case. The general guidance document, known as the Guide to an Application for UK Competent Authority Approval of Radioactive Material in Transport, has been issued for many years and updated to encompass the provisions of each successive edition of the IAEA transport regulations. The guide has been referred to in a number of international fora, including PATRAM, and was cited as a 'good practice' in the report of the IAEA TRANSAS appraisal of the UK in 2002. Specialist guides include the Guide to the Suitability of Elastomeric Seal Materials, which is the subject of a separate paper in this conference, and the Guide to the Approval of Freight Containers as Types IP-2 and IP-3 Packages. This paper discusses the guidance material and summarises the administrative and technical information required in support of applications for approval of package designs, special form and low-dispersible radioactive materials, shipments, special arrangements, modifications and validations. (author)

  16. Report of the evaluation by the Ad Hoc Review Committee on Materials Science Research. Ex-post evaluation in fiscal year 2003

    International Nuclear Information System (INIS)

    2004-06-01

    The Research Evaluation Committee, which consisted of 13 members from outside of the Japan Atomic Energy Research Institute (JAERI), set up an Ad Hoc Review Committee on Materials Science Research in accordance with the Fundamental Guideline for the Evaluation of Research and Development (R and D) at JAERI' and its subsidiary regulations in order to evaluate the adequacy of the R and D results achieved for five years until Fiscal Year 2002 at Department of Materials Science in Tokai Research Establishment of JAERI. The Ad Hoc Review Committee consisted of eight specialists from outside of JAERI. The Ad Hoc Review Committee conducted its activities from October 2003 to February 2004. The evaluation was performed on the basis of the materials submitted in advance and of the oral presentations made at the Ad Hoc Review Committee meeting which was held on November 14, 2003, in line with the items, viewpoints, and criteria for the evaluation specified by the Research Evaluation Committee. The result of the evaluation by the Ad Hoc Review Committee was submitted to the Research Evaluation Committee, and was judged to be appropriate at its meeting held on March 8, 2004. This report describes the result of the evaluation by the Ad Hoc Review Committee on Materials Science Research. (author)

  17. Ten Years of Complete Remission of Pulmonary Metastasis after Post-Cystectomy Palliative Cisplatin-Gemcitabine Chemotherapy with Gefitinib for Muscle Invasive Bladder Cancer: A Case Report.

    Science.gov (United States)

    Fahmy, Omar; Scharpf, Marcus; Schubert, Tina; Feyerabend, Susan; Stenzl, Arnulf; Schwentner, Christian; Fend, Falko; Gakis, Georgios

    2016-01-01

    Muscle-invasive bladder cancer (MIBC) is considered one of the most lethal malignancies with high metastatic potential. Usually, metastatic bladder cancer carries worse prognosis with a median survival rate of approximately 6 months, which can be prolonged for up to 14 months with palliative systemic chemotherapy. We present the case of a 61-year-old male patient diagnosed with localized MIBC 10 years ago. He underwent nerve-sparing radical cystectomy with ileal neobladder, but developed pulmonary metastatic disease 7 months postoperatively. Six cycles of gemcitabine/cisplatin combination chemotherapy with an addition of gefitinib as daily oral medication were administered within a randomized phase II clinical trial; this resulted in complete remission of the pulmonary metastases. Until now, the patient is still on gefitinib daily without any side effects. Although, the addition of gefitinib to standard systemic chemotherapy has not been shown to improve the survival in metastatic urothelial cancer, this case represents a very pleasant albeit uncommon long-term outcome. © 2016 S. Karger AG, Basel.

  18. Survival analysis, long-term outcomes, and percentage of recovery up to 8 years post-infection among the Houston West Nile virus cohort.

    Directory of Open Access Journals (Sweden)

    Kristy O Murray

    Full Text Available In 2012, we witnessed a resurgence of West Nile virus (WNV in the United States, with the largest outbreak of human cases reported since 2003. WNV is now endemic and will continue to produce epidemics over time, therefore defining the long-term consequences of WNV infection is critical. Over a period of eight years, we prospectively followed a cohort of 157 WNV-infected subjects in the Houston metropolitan area to observe recovery over time and define the long-term clinical outcomes. We used survival analysis techniques to determine percentage of recovery over time and the effects of demographic and co-morbid conditions on recovery. We found that 40% of study participants continued to experience symptoms related to their WNV infection up to 8 years later. Having a clinical presentation of encephalitis and being over age 50 were significantly associated with prolonged or poor recovery over time. Since the health and economic impact as a result of prolonged recovery, continued morbidity, and related disability is likely substantial in those infected with WNV, future research should be aimed at developing effective vaccines to prevent illness and novel therapeutics to minimize morbidity, mortality, and long-term complications from infection.

  19. Job resumption status, hindering factors, and interpersonal relationship within post-heart transplant 1 to 4 years as perceived by heart transplant recipients in Taiwan: a between-method triangulation study.

    Science.gov (United States)

    Tseng, P H; Wang, S S; Chang, C L; Shih, F J

    2010-12-01

    This project examined heart transplant (HT) recipients' perspectives of (a) the changes in their working competence (WC), status for job resumption and related factors at 1- to 2-year, 2- to 3-year, and 3- to 4-year stages; and (b) impacts of HT on interpersonal relationships (IPR). We used a between-method triangulation (including qualitative and quantitative data) design. Quantitative data were collected using the Vertical Visual Analogue Scale and Taiwan's version of the World Health Organization Health-Related Quality-of-Life (HRQoL) questionnaire. Six qualitative semistructured questions were further applied to explore social and environmental domains. The Fifty subjects (86% males and 14% females) had an age range from 20 to 70 years old (mean, 47.68 years). Their post-HT time ranged from 1 to 4.1 years with 42%, 42%, and 16% at 1- to 2-, 2- to 3-, or 3- to 4-years post-HT, respectively. Within 6 months, 10% of administration or restaurant staff, and police resumed their jobs. At 6 to 12 months, 8% of administration, quality control, and design and planning staff resumed their jobs. At 12 months, 14% of educators, insurance personnel, managers, informatics engineers, and ironworkers resumed their jobs. Hindering factors to returning to work included (a) physical (ie, lack of energy, second heart attack, recurrence of rejection, physical discomforts of dizziness, memory lapses/lack of concentration or bone pain from osteoporosis); (b) psychological (ie, lack of confidence, worries about discrimination, being different, maladaptation); and (c) environmental (inadequate job opportunities due to poor socioeconomic conditions). Additionally, 34% reported worse IPR after HT due to diet limitations, slower pacing, less contacts with friends, and changes in personality. Reflections on both the meaning and value of life caused 10% to report better IPR with a better personality and positive mindset. By the end of the first postoperative year, the mean score of HRQoL in

  20. Evidences of safety and tolerability of the zoledronic acid 5 mg yearly in the post-menopausal osteoporosis: the HORIZON project

    Directory of Open Access Journals (Sweden)

    F. Bertoldo

    2011-06-01

    Full Text Available Bisphosphonates are the most commonly prescribed medications for the treatment of osteoporosis. Despite evidence supporting the anti-fracture efficacy of aminobisphosphonates approximately 50% of patients do not follow their prescribed treatment regimen and/or discontinue treatment within the first year. Poor compliance is associated with negative outcomes, including increased fracture risk. Tolerability and safety are among the causes of poor compliance. Intravenous bisphosphonates avoids the gastrointestinal intolerance and the complex dosing instruction of the oral route ensuring full compliance which may provide improved efficacy. However, there are some concerns regarding potent intravenous bisphosphonates as zoledronic acid with respect to tolerability, mainly the acute phase response and to safety, mainly a theoretical risk of over suppression of bone turnover, renal toxicity and osteonecrosis of the jaw. In the HORIZON study, 152 patients on active treatment (82 or placebo (70 underwent to a bone biopsy after double tetracycline labeling. Bone biopsies (iliac crest were obtained at the final visit at month 36, 1 year after the last infusion. The biopsies were analyzed by histomorphometry on bone sections and by micro-CT (μCT analysis. 143 biopsies (76 zoledronic acid, 67 placebo had at least one μCT parameter measured and 111 were available for quantitative histomorphometry (59 zoledronic acid, 52 placebo. Micro-CT analysis of bone structure revealed higher trabecular bone volume (BV/TV, decreased trabecular separation (Tb.Sp, and a strong trend towards improvement in connectivity density in biopsies obtained from patients treated with zoledronic acid, indicating preservation of trabecular bone structure with respect to placebo. Histomorphometric analysis obtained from patients treated with zoledronic acid exhibited reduction of bone turnover, as suggested by decreased activation frequency (Ac.F by 63%, mineralizing surface (MS

  1. Identifying cytokine predictors of cognitive functioning in breast cancer survivors up to 10 years post chemotherapy using machine learning.

    Science.gov (United States)

    Henneghan, Ashley M; Palesh, Oxana; Harrison, Michelle; Kesler, Shelli R

    2018-07-15

    The purpose of this study is to explore 13 cytokine predictors of chemotherapy-related cognitive impairment (CRCI) in breast cancer survivors (BCS) 6 months to 10 years after chemotherapy completion using a multivariate, non-parametric approach. Cross sectional data collection included completion of a survey, cognitive testing, and non-fasting blood from 66 participants. Data were analyzed using random forest regression to identify the most significant predictors for each of the cognitive test scores. A different cytokine profile predicted each cognitive test. Adjusted R 2 for each model ranged from 0.71-0.77 (p's < 9.50 -10 ). The relationships between all the cytokine predictors and cognitive test scores were non-linear. Our findings are unique to the field of CRCI and suggest non-linear cytokine specificity to neural networks underlying cognitive functions assessed in this study. Copyright © 2018 Elsevier B.V. All rights reserved.

  2. A healthcare utilization cost comparison between employees receiving a worksite mindfulness or a diet/exercise lifestyle intervention to matched controls 5 years post intervention.

    Science.gov (United States)

    Klatt, Maryanna D; Sieck, Cynthia; Gascon, Gregg; Malarkey, William; Huerta, Timothy

    2016-08-01

    To compare healthcare costs and utilization among participants in a study of two active lifestyle interventions implemented in the workplace and designed to foster awareness of and attention to health with a propensity score matched control group. We retrospectively compared changes in healthcare (HC) utilization among participants in the mindfulness intervention (n=84) and the diet/exercise intervention (n=86) to a retrospectively matched control group (n=258) drawn for this study. The control group was matched from the non-participant population on age, gender, relative risk score, and HC expenditures in the 9 month preceding the study. Measures included number of primary care visits, number and cost of pharmacy prescriptions, number of hospital admissions, and overall healthcare costs tracked for 5 years after the intervention. Significantly fewer primary care visits (porganization health cost savings that such programs can generate. Copyright © 2016 Elsevier Ltd. All rights reserved.

  3. [Approval of ISO/IEC 17025 and quality control of laboratory testing].

    Science.gov (United States)

    Yamamoto, Shigeki; Asakura, Hiroshi; Machii, Kenji; Igimi, Shizunobu

    2010-01-01

    First section of Division of Biomedical Food Research, National Institute of Health Sciences (NIHS) was approved by ISO/IEC 17025 as a laboratory having an appropriate laboratory testing technique. NIHS is the first national laboratory approved by ISO/IEC 17025. NIHS has also been accepted the appropriate technique and facility for the BSL3 level pathogens by ISO/IEC 17025. NIHS is necessary to take an external audit almost every year. This approval is renewed every 4 years.

  4. Healthy Aging 5 Years After a Period of Daily Supplementation With Antioxidant Nutrients: A Post Hoc Analysis of the French Randomized Trial SU.VI.MAX.

    Science.gov (United States)

    Assmann, Karen E; Andreeva, Valentina A; Jeandel, Claude; Hercberg, Serge; Galan, Pilar; Kesse-Guyot, Emmanuelle

    2015-10-15

    This study's objective was to investigate healthy aging in older French adults 5 years after a period of daily nutritional-dose supplementation with antioxidant nutrients. The study was based on the double-blind, randomized trial, Supplementation with Antioxidant Vitamins and Minerals (SU.VI.MAX) Study (1994-2002) and the SU.VI.MAX 2 Follow-up Study (2007-2009). During 1994-2002, participants received a daily combination of vitamin C (120 mg), β-carotene (6 mg), vitamin E (30 mg), selenium (100 µg), and zinc (20 mg) or placebo. Healthy aging was assessed in 2007-2009 by using multiple criteria, including the absence of major chronic disease and good physical and cognitive functioning. Data from a subsample of the SU.VI.MAX 2 cohort, initially free of major chronic disease, with a mean age of 65.3 years in 2007-2009 (n = 3,966), were used to calculate relative risks. Supplementation was associated with a greater healthy aging probability among men (relative risk = 1.16, 95% confidence interval: 1.04, 1.29) but not among women (relative risk = 0.98, 95% confidence interval: 0.86, 1.11) or all participants (relative risk = 1.07, 95% confidence interval: 0.99, 1.16). Moreover, exploratory subgroup analyses indicated effect modification by initial serum concentrations of zinc and vitamin C. In conclusion, an adequate supply of antioxidant nutrients (equivalent to quantities provided by a balanced diet rich in fruits and vegetables) may have a beneficial role for healthy aging. © The Author 2015. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  5. Does behaviour modification affect post-stroke risk factor control? Three-year follow-up of a randomized controlled trial.

    Science.gov (United States)

    McManus, Julie Ann; Craig, Alison; McAlpine, Christine; Langhorne, Peter; Ellis, Graham

    2009-02-01

    Little is known about the long-term effectiveness after stroke of interventions for behaviour modification and ensuring concordance with therapies. We describe a follow-up study of a previous randomized controlled trial of a brief period of behaviour modification. The aim of this study was to determine outcomes three years after the initial intervention. Survivors of the original cohort were contacted and asked to attend for follow-up interview, within a geriatric day hospital. This study was carried out in the Geriatric Day Hospital at Stobhill Hospital, Balornock Road, Glasgow. Details of risk factor control, including blood pressure, cholesterol levels and diabetic control, were assessed. Questionnaires used in the initial study were repeated including the Geriatric Depression Scale score, Euroqol Perceived Health Status and Stroke Services Satisfaction Questionnaire. Primary outcome was collective risk factor control. Clinical outcomes including recurrent cerebrovascular events, medication persistence and perceived health status were also recorded. Mean length of follow-up was 3.6 years (SD 0.43). Of the 205 patients enrolled in the initial study, 102 patients attended for repeat interview(49 intervention/53 control). There were no significant differences in the percentage of controlled risk factors between groups (intervention 51.7% versus control 55.9%, P = 0.53). Similarities were observed in the number of recurrent clinical events and medication persistence between groups. No overall difference was observed in perceived health status, satisfaction with care or depression scores. Brief intervention with respect to behaviour modification and risk factor control does not appear to have any long-term benefit. These results must be cautiously interpreted in light of the small study number and further research is required.

  6. [Can epidemiological factors affect the 2-year outcomes after surgery for degenerative lumbar disease in terms of quality of life, disability and post-surgical pain?].

    Science.gov (United States)

    Lozano-Álvarez, C; Pérez-Prieto, D; Saló-Bru, G; Molina, A; Lladó, A; Cáceres, E; Ramírez, M

    2014-01-01

    To evaluate the influence of epidemiological factors on the outcomes of surgery for degenerative lumbar disease in terms of quality of life, disability and chronic pain. A total of 263 patients who received surgery for degenerative lumbar disease (2005-2008) were included in the study. The epidemiological data collected were age, gender, employment status, and co-morbidity. The SF-36, Oswestry Disability Index (ODI), Core Outcomes Measures Index (COMI), and VAS score for lumbar and sciatic pain were measure before and 2 years after surgery. The correlation between epidemiological data and questionnaire results, as well as any independent prognostic factors, were assessed in the data analysis. The mean age of the patients was 54.0 years (22-86), and 131 were female (49.8%). There were 42 (16%) lost to follow-up. Statistically significant correlations (P<.05) were observed between age, gender, co-morbidity, permanent sick leave, and pre-operative pain with changes in the ODI, COMI, physical and SF-36 mental scales, and lumbar and sciatic VAS. Linear regression analysis showed permanent sick leave and age as predictive factors of disability (β=14.146; 95% CI: 9.09 - 29.58; P<.01 and β=0.334; 95% CI: 0.40 - 0.98, P<.05, respectively), and change in quality of life (β=-8.568; 95% CI: -14.88 - -2.26; p<.01 and β=-0.228, IC 95% CI: -0.40 - -0.06, P<.05, respectively). Based on our findings, age and permanent sick leave have to be considered as negative epidemiologic predictive factors of the outcome of degenerative lumbar disease surgery. Copyright © 2012 SECOT. Published by Elsevier Espana. All rights reserved.

  7. Trauma-focused cognitive behaviour therapy versus treatment as usual for post traumatic stress disorder (PTSD) in young children aged 3 to 8 years: study protocol for a randomised controlled trial.

    Science.gov (United States)

    Dalgleish, Tim; Goodall, Benjamin; Chadwick, Isobel; Werner-Seidler, Aliza; McKinnon, Anna; Morant, Nicola; Schweizer, Susanne; Panesar, Inderpal; Humphrey, Ayla; Watson, Peter; Lafortune, Louise; Smith, Patrick; Meiser-Stedman, Richard

    2015-03-25

    Following horrific or life-threatening events approximately 10 to 15% of young children develop post traumatic stress disorder (PTSD). The symptoms of this disorder are distressing - nightmares, flashbacks, anger outbursts and disturbed play. These symptoms cause major disruption to a child's functioning and, if left untreated, can persist for many years. As yet, there are no established empirically-validated treatments for PTSD in young children. Trauma-focused cognitive behaviour therapy (TF-CBT) is a psychological intervention that is effective in treating the disorder in older children (8 to 12 years), adolescents and adults. This study examines TF-CBT adapted for children aged between 3 and 8 years. This protocol describes a two-arm exploratory randomised controlled trial comparing TF-CBT to treatment as usual (TAU) in children aged 3 to 8 years with a principal diagnosis of PTSD following a single-event discrete trauma. Using a half-crossover design, 44 participants will be randomly allocated to receive the intervention or to receive TAU. Those allocated to TAU will be offered TF-CBT at the end of the 'treatment' period (approximately 12 weeks) if still indicated. The primary outcome is PTSD diagnosis according to DSM-5 criteria for children 6 years and younger at post-treatment. Secondary outcomes include effects on co-morbid diagnoses and changes in emotion and trauma symptoms at each of the follow-up points (post-treatment, 3-months, 12-months). Additionally, broader efficacy will be considered with regard to treatment feasibility, acceptability and service utilisation. The key targets of the intervention are trauma memory, the interpretation of the meaning of the event, and the management of symptoms. This is the first European trial to examine the efficacy of TF-CBT in alleviating PTSD in very young children. As well as providing much-needed data on the utility of the intervention, this exploratory trial will also allow us to gather important information

  8. Multi-scale 46-year remote sensing change detection of diamond mining and land cover in a conflict and post-conflict setting

    Science.gov (United States)

    Dewitt, Jessica D.; Chirico, Peter G.; Bergstresser, Sarah E.; Warner, Timothy A.

    2017-01-01

    The town of Tortiya was created in the rural northern region of Côte d′Ivoire in the late 1940s to house workers for a new diamond mine. Nearly three decades later, the closure of the industrial-scale diamond mine in 1975 did not diminish the importance of diamond profits to the region's economy, and resulted in the growth of artisanal and small-scale diamond mining (ASM) within the abandoned industrial-scale mining concession. In the early 2000s, the violent conflict that arose in Côte d′Ivoire highlighted the importance of ASM land use to the local economy, but also brought about international concerns that diamond profits were being used to fund the rebellion. In recent years, cashew plantations have expanded exponentially in the region, diversifying economic activity, but also creating the potential for conflict between diamond mining and agricultural land uses. As the government looks to address the future of Tortiya and this potential conflict, a detailed spatio-temporal understanding of the changes in these two land uses over time may assist in informing policymaking. Remotely sensed imagery presents an objective and detailed spatial record of land use/land cover (LULC), and change detection methods can provide quantitative insight regarding regional land cover trends. However, the vastly different scales of ASM and cashew orchards present a unique challenge to comprehensive understanding of land use change in the region. In this study, moderate-scale categories of LULC, including cashew orchards, uncultivated forest, urban space, mining/ bare, and mixed vegetation, were produced through supervised classification of Landsat multispectral imagery from 1984, 1991, 2000, 2007, and 2014. The fine-scale ASM land use was identified through manual interpretation of annually acquired high resolution satellite imagery. Corona imagery was also integrated into the study to extend the temporal duration of the remote sensing record back to the period of industrial

  9. Accelerated approval of oncology products: the food and drug administration experience.

    Science.gov (United States)

    Johnson, John R; Ning, Yang-Min; Farrell, Ann; Justice, Robert; Keegan, Patricia; Pazdur, Richard

    2011-04-20

    We reviewed the regulatory history of the accelerated approval process and the US Food and Drug Administration (FDA) experience with accelerated approval of oncology products from its initiation in December 11, 1992, to July 1, 2010. The accelerated approval regulations allowed accelerated approval of products to treat serious or life-threatening diseases based on surrogate endpoints that are reasonably likely to predict clinical benefit. Failure to complete postapproval trials to confirm clinical benefit with due diligence could result in removal of the accelerated approval indication from the market. From December 11, 1992, to July 1, 2010, the FDA granted accelerated approval to 35 oncology products for 47 new indications. Clinical benefit was confirmed in postapproval trials for 26 of the 47 new indications, resulting in conversion to regular approval. The median time between accelerated approval and regular approval of oncology products was 3.9 years (range = 0.8-12.6 years) and the mean time was 4.7 years, representing a substantial time savings in terms of earlier availability of drugs to cancer patients. Three new indications did not show clinical benefit when confirmatory postapproval trials were completed and were subsequently removed from the market or had restricted distribution plans implemented. Confirmatory trials were not completed for 14 new indications. The five longest intervals from receipt of accelerated approval to July 1, 2010, without completion of trials to confirm clinical benefit were 10.5, 6.4, 5.5, 5.5, and 4.7 years. The five longest intervals between accelerated approval and successful conversion to regular approval were 12.6, 9.7, 8.1, 7.5, and 7.4 years. Trials to confirm clinical benefit should be part of the drug development plan and should be in progress at the time of an application seeking accelerated approval to prevent an ineffective drug from remaining on the market for an unacceptable time.

  10. The Twenty-Year Trajectory of Suicidal Activity among Post-Hospital Psychiatric Men and Women with Mood Disorders and Schizophrenia

    Science.gov (United States)

    Kaplan, Kalman J.; Harrow, Martin; Clews, Kelsey

    2016-01-01

    The Chicago Follow-up Study has followed the course of severe mental illness among psychiatric patients for over 20 years after their index hospitalization. Among these patients are 97 schizophrenia patients, 45 patients with schizoaffective disorders, 102 patients with unipolar nonpsychotic depression, and 53 patients with a bipolar disorder. Maximum suicidal activity (suicidal ideation, suicidal attempts and suicide completions) generally declines over the three time periods (early, middle, and late follow-ups) following discharge from the acute psychiatric hospitalization for both males and females across diagnostic categories with two exceptions: female schizophrenia patients and female bipolar patients. A weighted mean suicidal activity score tended to decrease across follow-ups for male patients in the schizophrenia, schizoaffective and depressive diagnostic groups with an uneven trend in this direction for the male bipolars. No such pattern emerges for our female patients except for female depressives. Males’ suicidal activity seems more triggered by psychotic symptoms and potential chronic disability while females’ suicidal activity seems more triggered by affective symptoms. PMID:26881891

  11. Teaching Post-Pornography

    Directory of Open Access Journals (Sweden)

    Tim Gregory

    2018-04-01

    Full Text Available This article introduces the term ‘post-pornography’, drawing on diverse texts from the last three decades. We propose that ‘post-pornography’ expands Porn Studies beyond its focus on explicit representations of sex. First, we outline the history of post-pornography as a concept that emerged in the sex-positive, anti-censorship and queer/feminist moment in the United States in the 1980s and 1990s and has subsequently been taken up by a diverse group of artists, activists and scholars to describe practices that both reference and attempt to move beyond pornography. We define post-pornography as characterised by three aspects—the denaturalising of sex, the de-centring of the spectator and the recognition of media and technology as inseparable from sex. We examine the history of Porn Studies in the university, including in our own faculty at UNSW Art & Design, and the singular influence of Linda Williams in defining its place and setting out its pedagogical methods. We propose post-pornography as a framework that can confront prevailing assumptions about sex and sexuality that underpin Porn Studies and its critique of pornography, and outline a set of concepts that have emerged from the development of the second- and third-year art theory course Post-Pornographic Bodies.

  12. Radiation requirements for uranium project approvals

    International Nuclear Information System (INIS)

    Hondros, J.

    2014-01-01

    Uranium mining projects in Australia must receive approval under both state and national laws based on a wide ranging impact assessment of the project. The process may take a number of years and involves multiple levels and parts of government and public consultation and scrutiny. The impact assessment is broad and usually covers; environmental, social, health, public safety and economic aspects. Information provided in the approvals documentation needs to be presented in a credible and understandable manner for all audiences. This means making complex information simpler, while making sure that it maintains its technical integrity. Poorly communicated information, which is overly complex, overly simplified or incomplete, can result in significant delays to the project approval which can potentially impact on project timelines. For uranium projects, along with other projects involving radioactive materials, such as minerals sands and rare earths, radiation and its impacts usually draw a disproportionate amount of both government and public scrutiny compared to other potential impacts and risks. It is therefore of key importance that radiation assessments are properly performed and results clearly presented and communicated with sufficient detail for stakeholders to make informed decisions. It is also important to ensure that the radiation risk is presented in perspective with other risks of the project. This presentation outlines a structure for a radiation impact assessment based on experience from a number of projects in Australia. The structure aims to be clear and simple and ensure the right balance between scientific fact, digestible information and demonstrable competence. (author)

  13. An application by Centra Gas Manitoba Inc. for an order of the Manitoba Public Utilities Board approving: Rates for the sale of natural gas and the provision of transportation services, to be effective with respect to all gas consumed on and after January 1, 1994; determination of a year-end rate base, rate of return and revenue requirement based on a 1993 test year including new gas supply arrangements; confirmation of interim ex parte order 113/93 related to franchise agreements with the rural municipality of Elton and the rural municipality of Grey; and other related matters

    Energy Technology Data Exchange (ETDEWEB)

    1994-01-28

    Centra Gas Manitoba, a gas utility, applied before the Manitoba Public Utilities Board for an order approving a year-end rate base, rate of return, cost of service, and revenue requirement based on a 1993 test year and increased rates to be effective in 1994. A hearing was held to consider matters related to Centra's application, and views of intervenors at the hearings, the utility, and the Board are summarized along with the Board decision. Issues considered at the hearings include year-end net plant values, computer expenditures, working capital allowance, capital structure and risk, cost adjustments, gas sales and cost of gas, operating and maintenance expenses, financial expenses, cost allocation, rate design, and other matters including service policies. The revenue requirement increase approved was $30.4 million, which included a $24.8 million increase in the commodity cost of gas. The allowed overall rate of return was 10.17%. 2 figs., 33 tabs.

  14. Ex-post assessment of China's industrial energy efficiency policies during the 11th Five-Year Plan

    International Nuclear Information System (INIS)

    Yu, Yuqing; Wang, Xiao; Li, Huimin; Qi, Ye; Tamura, Kentaro

    2015-01-01

    China implemented a package of policies during the 11th Five-Year Plan (2006–2010) to improve industrial energy efficiency. This assessment provides a methodology that establishes a causal relationship between policy implementation and energy conservation effects. To enhance the confidence in the research findings, this assessment applies two distinctive and independent approaches: one top-down and the other bottom-up. This assessment finds that industrial energy efficiency policies collectively achieved energy savings of 322 Mtce (9.4 EJ) against the baseline scenario. This accounted for 59% of the sector's total energy savings from 2006 to 2010. The remaining energy savings were realised through autonomous technology improvement (33%) and sector-level structural shift (8%). Correspondingly, cumulative avoided CO 2 emissions realised through energy efficiency policies amounted to 760 million tons. This assessment concludes that industrial energy efficiency policies were effective in realising energy conservation targets, but energy conservation effects were not achieved in a cost-effective way. Command and control measures were dominantly implemented, with economic incentives and informational measures taking a complementary role; while market based instruments did not play an important role. As China is planning on implementing a nationwide emissions trading scheme, special attention needs to be paid to policy interaction and coordination. - Highlights: • EE policies applied in the industry sector achieved energy savings of 322 Mtce. • Energy saving realized through EE policies accounted for 59% of the sector's total. • Avoided CO 2 emissions realized by EE policies amounted to 760 million tons. • Autonomous technology improvement accounted for 33% of the sector's total energy savings. • Sector-level structural shift accounted for the remaining 8% energy savings

  15. Research Review: Changes in the prevalence and symptom severity of child post-traumatic stress disorder in the year following trauma - a meta-analytic study.

    Science.gov (United States)

    Hiller, Rachel M; Meiser-Stedman, Richard; Fearon, Pasco; Lobo, Sarah; McKinnon, Anna; Fraser, Abigail; Halligan, Sarah L

    2016-08-01

    Understanding the natural course of child and adolescent posttraumatic stress disorder (PTSD) has significant implications for the identification of, and intervention for, at-risk youth. We used a meta-analytic approach to examine longitudinal changes in youth PTSD prevalence and symptoms over the first 12 months posttrauma. We conducted a systematic review to identify longitudinal studies of PTSD in young people (5-18 years old), excluding treatment trials. The search yielded 27 peer-reviewed studies and one unpublished dataset for analysis of pooled prevalence estimates, relative prevalence reduction and standardised mean symptom change. Key moderators were also explored, including age, proportion of boys in the sample, initial prevalence of PTSD and PTSD measurement type. Analyses demonstrated moderate declines in PTSD prevalence and symptom severity over the first 3-6 months posttrauma. From 1 to 6 months posttrauma, the prevalence of PTSD reduced by approximately 50%. Symptoms also showed moderate decline, particularly across the first 3 months posttrauma. There was little evidence of further change in prevalence or symptom severity after 6 months, suggesting that it is unlikely a child would lose a PTSD diagnosis without intervention beyond this point. The current findings provide key information about the likelihood of posttrauma recovery in the absence of intervention and have important implications for our understanding of child and adolescent PTSD. Results are discussed with reference to the timing of PTSD screening and the potential role of early interventions. Findings particularly highlight the importance of future research to develop our understanding of what factors prevent the action of normal recovery from the 'acute' posttrauma period. © 2016 The Authors. Journal of Child Psychology and Psychiatry published by John Wiley & Sons Ltd on behalf of Association for Child and Adolescent Mental Health.

  16. [25 Years After Re-Unification of Germany: An Overview on Eastern German Psychiatry. Part 1: Post-War Era, Pavlovization, Psychopharmacological Era and Social Psychiatric Reform Movement].

    Science.gov (United States)

    Steinberg, H

    2016-04-01

    This is the first of a 2-part study on the history of psychiatry in Eastern Germany, i. e. the Soviet Occupied Zone and later German Democratic Republic. It mainly covers the years post World War II up until the beginning of the 1970s. The first post-war years were determined by the new power holders' attempts to overcome National Socialist (Nazi) heritage and to re-organize mental health and care in general. The doctrine of a strict denazifization in East Germany must, however, be regarded as a myth. Promoted by centralized organization, there was an increase in communist party-ideological influence and harassment as well as aligning scientific views and research with Soviet paradigms (Pavlovization) during the 1950s and early 1960s. This, however, led to an enormous rise in exodus of skilled labor to West Germany, which in turn further increased the notorious lack of staff. After the erection of the inner-German wall, this problem was mitigated, yet never fully solved over the 40 years of the existence of the GDR. Despite adverse conditions, East German psychiatrists made major original contributions to the development of psychiatry in general, at least up until the 1960s. Academic psychiatry was mainly based on biological concepts that were further promoted by new somatic and psychopharmacological therapeutic options. In the 1960s, social psychiatric reformist forces emerged, primarily in the large psychiatric hospitals. The improvements achieved by these forces, however, were not implemented on a nation-wide scale, but mainly restricted to one particular or several institutions. © Georg Thieme Verlag KG Stuttgart · New York.

  17. 42 CFR 8.13 - Revocation of accreditation and accreditation body approval.

    Science.gov (United States)

    2010-10-01

    ... GENERAL PROVISIONS CERTIFICATION OF OPIOID TREATMENT PROGRAMS Certification and Treatment Standards § 8.13... period of 1 year after the date of withdrawal of approval of the accreditation body, unless SAMHSA.... (2) Within 1 year from the date of withdrawal of approval of an accreditation body, or within any...

  18. Post petroleum

    International Nuclear Information System (INIS)

    Urry, John

    2014-01-01

    In this original book-object, John Urry describes a world conditioned by an all-oil system. Our movement, possessions, and even our social relationships are entirely dependent on this rapidly-depleting energy source. He shows that the 20. century created the illusion of a future that, today, proves untenable, even in the medium term. While everyone's attention is still focused on just how long this reprieve will last, John Urry shifts the debate, asking the much more fundamental question: 'What happens next?' What would a world without oil look like? How would our lives as producers and consumers play out in a world deprived of this resource? In spite of growing awareness of the depletion of oil reserves, these questions remain unanswered. That is why the author alerts us to the need to prepare for post-oil now, and asks: without political awareness, how can our societies radically reinvent their relationship to energy and movement? John Urry thus imagines what will become of 'disconnected' societies in the form of four 'post-oil' scenarios, and calls us to action. His work is of particular importance to the Mobile Lives Forum, which aims to imagine good mobile lives for the future and prepare for the mobility transition. This text is transcript of a lecture given by John Urry to the Mobile Lives Forum's Scientific Steering Committee. Table of contents: 1 - Illusion: Understanding the energization of a social phenomenon; The birth of a new socio-technical system; United states: founders of an all-energy society; The emergence of an oil-based civilisation; Increasing difficulties in the use of oil; The role of oil in the current economic crisis; Can oil-dependency be deleted?; 2 - 4 scenarios: The Magic bullet future; digital lives; Unplugging: a post-car society; Warlordism in a world of shortages; 3 - Conclusion

  19. SUSPICIOUS POST

    CERN Multimedia

    Relations with the Host States Service

    2001-01-01

    If you receive a suspicious letter or package in the post, please do not open it and contact the Fire Brigade Tel. 74444. They will contact the CERN Medical Service. This is especially important in today's current situation with regard to the Anthrax scare. For further information, the Permanent Mission of Switzerland to the International Organisations in Geneva recommends the following web sites:   http://www.admin.ch/ch/f/cf/brennpunkt/03.html http://www.who.int/emc-documents/zoonoses/whoemczdi986c.html

  20. 9 CFR 130.11 - User fees for inspecting and approving import/export facilities and establishments.

    Science.gov (United States)

    2010-01-01

    ... hourly user fee rate in § 130.30(2) applies to biosecurity level two laboratories. (b) [Reserved] [65 FR... approval) Per year $537.00 $553.00 $570.00 $587.00 $604.00 Inspection for approval of biosecurity level three labs (all inspections related to approving the laboratory for handling one defined set of...

  1. Electronic Approval of Invoices (AEF)

    CERN Multimedia

    2003-01-01

    With a view to the simplification of administrative procedures, AS and FI Divisions have drawn up a new procedure for the electronic approval of invoices via the EDH application. The aim of this new procedure is to rationalise the invoice approval process, notably by eliminating paper copies from the approval circuit. This will simplify the processing of invoices and facilitate their timely settlement, while at the same time maintaining a high level of security. This new procedure, in its current phase, will be gradually implemented from 1 November 2003 onwards. For clarification and further information, please see: http://ais.cern.ch/projs/AEF/help/help.htm . Finance Division, Accounts Payable Tel.: 7.22.95

  2. Calendar Year 2007 Resource Conservation and Recovery Act Annual Monitoring Report for the U.S. Department of Energy Y-12 National Security Complex, Oak Ridge, Tennessee - RCRA Post-Closure Permit Nos. TNHW-113, TNHW-116, and TNHW-128

    Energy Technology Data Exchange (ETDEWEB)

    Elvado Environmental

    2008-02-01

    This report contains groundwater quality monitoring data obtained during calendar year (CY) 2007 at the following hazardous waste treatment, storage, and disposal (TSD) units located at the US Department of Energy (DOE) Y-12 National Security Complex (hereafter referenced as Y-12) in Oak Ridge, Tennessee; this S-3 Site, Oil Landfarm, Bear Creek Burial Grounds/Walk-In Pits (BCBG/WIP), Eastern S-3 Site Plume, Chestnut Ridge Security Pits (CRSP), Chestnut Ridge Sediment Disposal Baste (CRSDB), few Hollow Quarry (KHQ), and East Chestnut Ridge Waste Pile (ECRWP). Hit monitoring data were obtained in accordance with the applicable Resource Conservation and Recovery Act of 1976 (RCRA) hazardous waste post-closure permit (PCP). The Tennessee Department of Environment and Conservation (TDEC) - Division of Solid Waste Management issued the PCPs to define the requirements for RCRA post-closure inspection, maintenance, and groundwater monitoring at the specified TSD units located within the Bear Creek Hydrogeologic Regime (PCP no. TNHW-116), Upper East Fork Poplar Creek Hydrogeologic Regime (PCP no. TNHW-113), and Chestnut Ridge Hydrogeologic Regime (PCP no. TNHW-128). Each PCP requires the Submittal of an annual RCRA groundwater monitoring report containing the groundwater sampling information and analytical results obtained at each applicable TSD unit during the preceding CY, along with an evaluation of groundwater low rates and directions and the analytical results for specified RCRA groundwater target compounds; this report is the RCRA annual groundwater monitoring report for CY 2007. The RCRA post-closure groundwater monitoring requirements specified in the above-referenced PCP for the Chestnut Ridge Regime replace those defined in the previous PCP (permit no. TNHW-088), which expired on September 18, 2005, but remained effective until the TDEC issued the new PCP in September 2006. The new PCP defines site-specific groundwater sampling and analysis requirements for the

  3. Post-Baccalaureate Fellowship Program.

    Science.gov (United States)

    Cadbury, Jr., William E.

    The Post-Baccalaureate Fellowship Program provides an opportunity for students who went to college with inferior preparation to supplement their education by studying for 1 year at an academically demanding liberal arts college before entering graduate or professional school. The post-baccalaureate fellows take regular courses in a program that is…

  4. Data handling and post-reconstruction analysis at next generation experiments

    International Nuclear Information System (INIS)

    Fischler, M.; Lammel, S.

    1995-11-01

    A new generation of experiments in high energy physics is approaching. With the approval of the LHC at CERN and the revised Main Injector project at Fermilab, high statistics experiments will start operation within 5 to 10 years. With luminosities Up to 10 34 /cm 2 /sec and several hundred thousand readout channels, data most likely cannot be handled and analysed using traditional HEP approaches. The CAP group at Fermilab is investigating different approaches to data handling and organization for post-reconstruction analysis. We discuss the approaches considered, their strengths and weaknesses, integration with hierarchical storage, and sharing of primary data resources

  5. Combination Protocol of Low-Frequency rTMS and Intensive Occupational Therapy for Post-stroke Upper Limb Hemiparesis: a 6-year Experience of More Than 1700 Japanese Patients.

    Science.gov (United States)

    Kakuda, Wataru; Abo, Masahiro; Sasanuma, Jinichi; Shimizu, Masato; Okamoto, Takatsugu; Kimura, Chikou; Kakita, Kiyohito; Hara, Hiroyoshi

    2016-06-01

    Several years ago, we proposed a combination protocol of repetitive transcranial magnetic stimulation (rTMS) and intensive occupational therapy (OT) for upper limb hemiparesis after stroke. Subsequently, the number of patients treated with the protocol has increased in Japan. We aimed to present the latest data on our proposed combination protocol for post-stroke upper limb hemiparesis as a result of a multi-institutional study. After confirming that a patient met the inclusion criteria for the protocol, they were scheduled to receive the 15-day inpatient protocol. In the protocol, two sessions of 20-min rTMS and 120-min occupational therapy were provided daily, except for Sundays and the days of admission/discharge. Motor function of the affected upper limb was evaluated by the Fugl-Meyer assessment (FMA) and Wolf motor function test (WMFT) at admission/discharge and at 4 weeks after discharge if possible. A total of 1725 post-stroke patients were studied (mean age at admission 61.4 ± 13.0 years). The scheduled 15-day protocol was completed by all patients. At discharge, the increase in FMA score, shortening in performance time of WMFT, and increase in functional ability scale (FAS) score of WMFT were significant (FMA score 46.8 ± 12.2 to 50.9 ± 11.4 points, p hemiparesis after stroke, although its efficacy should be confirmed in a randomized controlled study.

  6. esophageal carcinoma complicating achalasia, 25 years post

    African Journals Online (AJOL)

    mine

    Some degree of stasis usually persists despite adequate treatment and relief of symptoms. Complications or recurrent symptoms include dysphagia, esophageal reflux, stricture and carcinoma. 5. This case report suggests that long term surveillance of the patient with achalasia is essential even after successful treatment.

  7. Changes in the total Oswestry Index and its ten items in females and males pre- and post-surgery for lumbar disc herniation: a 1-year follow-up

    Science.gov (United States)

    Kautiainen, Hannu; Järvenpää, Salme; Arkela-Kautiainen, Marja; Ylinen, Jari

    2006-01-01

    To study the characteristics and changes in the total Oswestry Disability Index (ODI) and in its ten component items in female and male patients pre- and post-surgery for lumbar disc herniation. Ninety-eight patients [mean (SD) age 43 (13), 61% males] undergoing lumbar disc herniation surgery were selected for this clinical 12-month follow-up. Subjective disability and back and leg pain were assessed by ODI version 1.0 and the visual analog scale. Pre-operatively females had a significantly higher mean (SD) total ODI [59(3)] than males [51(2)] (P = 0.030). Females were more disabled in the walking, sex life, social life and travelling items of the ODI compared to males. The total Oswestry decreased by 38 (95% CI − 44 to − 31) in females and by 34 (− 39 to − 30) in males at the 1-year follow-up. Most of the improvement (88% in females and 80% in males) occurred during the first 6 weeks; thereafter the changes were minor. In males the changes were greatest in pain, social life and travelling and in females in walking, social life and travelling. Internal consistency value of ODI was 0.88 (95% CI 0.82–0.91). Item analysis of the ODI showed that all the items except pain had high corrected item correlation. As recovery following lumbar disc surgery occurred to a great extent during the first 6 weeks, the early post-operative outcome appears to be quite a reliable indicator of the overall post-operative outcome over the 1-year follow-up. The ODI proved to capture a wide range of disability in these lumbar disc surgery patients, thereby supporting the future use of the index. The “pain intensity” component, which collects data on the use of painkillers in version 1.0 of the ODI did not support the item structure of the index in this study. The use of ODI version 2.0 might remove this problem. PMID:16912888

  8. Posting system

    International Nuclear Information System (INIS)

    Hackney, S.

    1983-01-01

    A system for posting hazardous materials into and out of an enclosure, such as a glovebox, through a port in a wall of the enclosure. The port is normally closed by a door which cooperates with a removable end closure, on a container or the like when the latter is presented to and secured at the port. The container is secured in position at the port by means of a rotatable coupling ring. A single interlock ensures that the door cannot be opened in the absence of a container at the port and also that the container cannot be removed from the port when the door is open. In place of the container, a glove secured to a rigid sleeve may be used to enable the operator to perform a work function within the glovebox. (author)

  9. Posting system

    International Nuclear Information System (INIS)

    Jones, E.L.

    1983-01-01

    A posting system for the movement of equipment, such as a manipulator, into and out of an enclosure e.g. a cell or glovebox, for toxic or radioactive materials has the manipulator arranged within a collapsible bellows-like container with an end of the container cooperating with a port entry to the enclosure. The collapsible container isolates the manipulator from the environment outside the enclosure and allows the manipulator to enter and leave the contaminated enclosure without breach of the containment. A particular construction of cell for use with radioactive material is described, having a thick wall of shielding material such as concrete provided with a door normally closed by a Pb shutter and having a cylindrical gamma shield block located over the shutter on the exterior of the wall. (author)

  10. Drugs Approved for Cervical Cancer

    Science.gov (United States)

    This page lists cancer drugs approved by the Food and Drug Administration (FDA) for cervical cancer. The list includes generic names, brand names, and common drug combinations, which are shown in capital letters. The drug names link to NCI's Cancer Drug Information summaries.

  11. Drugs Approved for Multiple Myeloma

    Science.gov (United States)

    This page lists cancer drugs approved by the Food and Drug Administration (FDA) for multiple myeloma and other plasma cell neoplasms. The list includes generic names, brand names, and common drug combinations, which are shown in capital letters. The drug names link to NCI's Cancer Drug Information summaries.

  12. Drugs Approved for Testicular Cancer

    Science.gov (United States)

    This page lists cancer drugs approved by the Food and Drug Administration (FDA) for testicular cancer. The list includes generic names, brand names, and common drug combinations, which are shown in capital letters. The drug names link to NCI's Cancer Drug Information summaries.

  13. Drugs Approved for Hodgkin Lymphoma

    Science.gov (United States)

    This page lists cancer drugs approved by the Food and Drug Administration (FDA) for Hodgkin lymphoma. The list includes generic names, brand names, and common drug combinations, which are shown in capital letters. The drug names link to NCI's Cancer Drug Information summaries.

  14. Drugs Approved for Myeloproliferative Neoplasms

    Science.gov (United States)

    This page lists cancer drugs approved by the Food and Drug Administration (FDA) for myeloproliferative neoplasms. The list includes generic names, brand names, and common drug combinations, which are shown in capital letters. The drug names link to NCI's Cancer Drug Information summaries.

  15. Implementing the access and waiting time standard for early intervention in psychosis in the United Kingdom: An evaluation of referrals and post-assessment outcomes over the first year of operation.

    Science.gov (United States)

    Adamson, Vidyah; Barrass, Emma; McConville, Stephen; Irikok, Chantelle; Taylor, Kim; Pitt, Steve; Van Duyn, Rob; Bennett, Susan; Jackson, Lisa; Carroll, Jon; Andrews, Mark; Parker, Ann; Wright, Caroline; Greathead, Katie; Price, David

    2018-03-26

    Improving timely access to evidence-based treatment for people aged 14-65 years experiencing a first episode psychosis (FEP) or an at-risk mental state (ARMS) for psychosis is a national priority within the United Kingdom. An early intervention in psychosis (EIP) access and waiting time standard has been set which has extended the age range and acceptance criteria for services. This descriptive evaluation reports upon the referrals and access to treatment times within an EIP service over the first year of operating in line with the access and waiting time standard. Patient pathways and post-assessment status are also described. The service received 406 referrals, of which 88% (n = 357) were assessed. The mean length of time to treatment was 1.5 weeks, with 88% being seen within 2 weeks. Of those who engaged in an assessment, 34% (n = 138) were identified as ARMS cases and 30% (n = 123) were identified as FEP. Over 35 year olds accounted for 22% (n = 80) of the total accepted cases. The findings indicate clinical and operational issues, which will need careful consideration in the future planning of services. The high number of ARMS cases highlights the importance of clear treatment pathways and targeted interventions and may suggest a need to commission distinct ARMS services. The number of people who met the extended age and service acceptance criteria may suggest a need to adapt or redesign clinical services to meet the age-specific needs of over 35 year olds and those with an ARMS. It is unclear how changes to the remit of EIP services will impact upon future clinical outcomes. © 2018 John Wiley & Sons Australia, Ltd.

  16. Does emergency department use and post-visit physician care cluster geographically and temporally for adolescents who self-harm? A population-based 9-year retrospective cohort study from Alberta, Canada.

    Science.gov (United States)

    Rosychuk, Rhonda J; Johnson, David W; Urichuk, Liana; Dong, Kathryn; Newton, Amanda S

    2016-07-11

    Clustering of adolescent self-harming behaviours in the context of health care utilization has not been studied. We identified geographic areas with higher numbers of adolescents who (1) presented to an emergency department (ED) for self-harm, and (2) were without a physician follow-up visit for mental health within 14 days post-ED visit. We extracted a population-based cohort of adolescents aged 15-17 years (n = 3,927) with ED visits during 2002-2011 in Alberta, Canada. We defined the case as an individual with one or more ED presentations for self-harm in the fiscal year of the analysis. Crude case rates were calculated and clusters were identified using a spatial scan. The rates decreased over time for ED visits for self-harm (differences: girls -199.6/100,000; p self-harm (differences: girls -108.3/100,000; p self-harm (relative risks [RRs]: 1.58 for cluster 1, 3.54 for cluster 2) and were without a 14-day physician follow-up (RRs: 1.78 for cluster 1, 4.17 for cluster 2). In 2010/2011, clusters in the North, Edmonton, and Central zones were identified for adolescents with and without a follow-up visit within 14 days following an ED visit for self-harm (p self-harm and rates of adolescents without a 14-day physician follow-up visit following emergency care for self-harm decreased during the study period. The space-time clusters identified the areas and years where visits to the ED by adolescents for self-harm were statistically higher than expected. These clusters can be used to identify locations where adolescents are potentially not receiving follow-up and the mental health support needed after emergency-based care. The 2010/2011 geographic cluster suggests that the northern part of the province still has elevated numbers of adolescents visiting the ED for self-harm. Prospective research is needed to determine outcomes associated with adolescents who receive physician follow-up following ED-based care for self-harm compared to those who do not.

  17. Development of a fresh cadaver model for instruction of ultrasound-guided breast biopsy during the surgery clerkship: pre-test and post-test results among third-year medical students.

    Science.gov (United States)

    McCrary, Hilary C; Krate, Jonida; Savilo, Christine E; Tran, Melissa H; Ho, Hang T; Adamas-Rappaport, William J; Viscusi, Rebecca K

    2016-11-01

    The aim of our study was to determine if a fresh cadaver model is a viable method for teaching ultrasound (US)-guided breast biopsy of palpable breast lesions. Third-year medical students were assessed both preinstruction and postinstruction on their ability to perform US-guided needle aspiration or biopsy of artificially created masses using a 10-item checklist. Forty-one third-year medical students completed the cadaver laboratory as part of the surgery clerkship. Eight items on the checklist were found to be significantly different between pre-testing and post-testing. The mean preinstruction score was 2.4, whereas the mean postinstruction score was 7.10 (P cadaver models have been widely used in medical education. However, there are few fresh cadaver models that provide instruction on procedures done in the outpatient setting. Our model was found to be an effective method for the instruction of US-guided breast biopsy among medical students. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Patient-Centered Drug Approval: The Role of Patient Advocacy in the Drug Approval Process.

    Science.gov (United States)

    Mattingly, T Joseph; Simoni-Wastila, Linda

    2017-10-01

    Recent approval of eteplirsen for Duchenne muscular dystrophy (DMD), a rare disease with few treatment alternatives, has reignited the debate over the U.S. drug approval process. The evolution of legal and regulatory restrictions to the marketing and sale of pharmaceuticals has spanned more than a century, and throughout this history, patient advocacy has played a significant role. Scientific evidence from clinical trials serves as the foundation for drug approval, but the patient voice has become increasingly influential. Although the gold standard for establishing safety and efficacy through randomized controlled trials has been in place for more than 50 years, it poses several limitations for rare disorders where patient recruitment for traditional clinical trials is a major barrier. Organized efforts by patient advocacy groups to help patients with rare diseases access investigational therapy have had a legislative and regulatory effect. After approval by the FDA, patient access to therapy may still be limited by cost. A managed care organization (MCO) with the fiduciary responsibility of managing the health of a population must weigh coverage decisions for costly therapies with questionable effectiveness against alternatives within the constraint of a finite budget. Even when the FDA deems a drug safe and effective, an MCO may determine that the drug should only be made available at a tier level where out-of-pocket costs are still too high for many patients. This limitation of availability may be due to cost, other treatment alternatives, or outcomes from existing clinical evidence. However, if the MCO makes a costly new treatment for a rare disease readily available, it may temporarily satisfy a small contingency at the cost of all of its members. This article examines the risks and benefits of patient-centered drug approval and the potential economic effect of patient-centered drug approval on population health. There is no funding to disclose. Mattingly

  19. Irradiation as an alternative post harvest treatment

    Energy Technology Data Exchange (ETDEWEB)

    Satin, M. [Agricultural Industries and Post-harvest Management Service, FAO, Rome (Italy); Loaharanu, P. [Head, Food Preservation Section, Joint FAO/ IAEA Division of Nuclear Techniques in Food and Agriculture, Wagramerstr. 5, A-1400, Vienna (Austria)

    1997-12-31

    This current world population has significantly added to the pressures placed upon our finite resources and our resulting ability to feed ourselves. In order to cope with current and future demands, the two established lines of action, that is, reduced population growth and expansion of agricultural production, must be supplemented with the parallel activity of reducing food losses during and after harvest. For developing countries in particular, enormous post-harvest losses result from spillage, contamination, pests and physiological deterioration during storage. Studies in these countries indicate that post-harvest losses are enormous and amount to tens of millions of tons per year valued at billions of dollars. Programs to reduce post-harvest losses, if applied properly, can result in realistic yield increases between 10 and 30%, which can be directly converted into increased consumption for humans. Post-harvest losses vary greatly and are a function of the crop variety, pest combinations in the environment, climate, the system of harvesting, storage, handling, marketing, and even the social and cultural environment. Pests are among the most criticals of these factors. Because of the disastrous potential consequences of such pests, quarantine regulations prohibit the entrance of plants or products which might hide the unwanted pest from countries where it is known to exist. Quarantine treatments are can be chemical, physical or ionizing radiation treatment. Numerous investigations on the use of ionizing radiation for the disinfestation of fresh plant materials indicate that rather low dosages will control fruit-fly problems, thus making it well suited for quarantine treatment. The effectiveness of the irradiation as a broad spectrum quarantine treatment of fresh fruits and vegetables was recognized by the several plant protection organizations around the world. Currently, some 40 countries have approved one or more irradiated food items or groups of food

  20. Irradiation as an alternative post harvest treatment

    Energy Technology Data Exchange (ETDEWEB)

    Satin, M [Agricultural Industries and Post-harvest Management Service, FAO, Rome (Italy); Loaharanu, P [Head, Food Preservation Section, Joint FAO/ IAEA Division of Nuclear Techniques in Food and Agriculture, Wagramerstr. 5, A-1400, Vienna (Austria)

    1998-12-31

    This current world population has significantly added to the pressures placed upon our finite resources and our resulting ability to feed ourselves. In order to cope with current and future demands, the two established lines of action, that is, reduced population growth and expansion of agricultural production, must be supplemented with the parallel activity of reducing food losses during and after harvest. For developing countries in particular, enormous post-harvest losses result from spillage, contamination, pests and physiological deterioration during storage. Studies in these countries indicate that post-harvest losses are enormous and amount to tens of millions of tons per year valued at billions of dollars. Programs to reduce post-harvest losses, if applied properly, can result in realistic yield increases between 10 and 30%, which can be directly converted into increased consumption for humans. Post-harvest losses vary greatly and are a function of the crop variety, pest combinations in the environment, climate, the system of harvesting, storage, handling, marketing, and even the social and cultural environment. Pests are among the most criticals of these factors. Because of the disastrous potential consequences of such pests, quarantine regulations prohibit the entrance of plants or products which might hide the unwanted pest from countries where it is known to exist. Quarantine treatments are can be chemical, physical or ionizing radiation treatment. Numerous investigations on the use of ionizing radiation for the disinfestation of fresh plant materials indicate that rather low dosages will control fruit-fly problems, thus making it well suited for quarantine treatment. The effectiveness of the irradiation as a broad spectrum quarantine treatment of fresh fruits and vegetables was recognized by the several plant protection organizations around the world. Currently, some 40 countries have approved one or more irradiated food items or groups of food

  1. Irradiation as an alternative post harvest treatment

    International Nuclear Information System (INIS)

    Satin, M.; Loaharanu, P.

    1997-01-01

    This current world population has significantly added to the pressures placed upon our finite resources and our resulting ability to feed ourselves. In order to cope with current and future demands, the two established lines of action, that is, reduced population growth and expansion of agricultural production, must be supplemented with the parallel activity of reducing food losses during and after harvest. For developing countries in particular, enormous post-harvest losses result from spillage, contamination, pests and physiological deterioration during storage. Studies in these countries indicate that post-harvest losses are enormous and amount to tens of millions of tons per year valued at billions of dollars. Programs to reduce post-harvest losses, if applied properly, can result in realistic yield increases between 10 and 30%, which can be directly converted into increased consumption for humans. Post-harvest losses vary greatly and are a function of the crop variety, pest combinations in the environment, climate, the system of harvesting, storage, handling, marketing, and even the social and cultural environment. Pests are among the most criticals of these factors. Because of the disastrous potential consequences of such pests, quarantine regulations prohibit the entrance of plants or products which might hide the unwanted pest from countries where it is known to exist. Quarantine treatments are can be chemical, physical or ionizing radiation treatment. Numerous investigations on the use of ionizing radiation for the disinfestation of fresh plant materials indicate that rather low dosages will control fruit-fly problems, thus making it well suited for quarantine treatment. The effectiveness of the irradiation as a broad spectrum quarantine treatment of fresh fruits and vegetables was recognized by the several plant protection organizations around the world. Currently, some 40 countries have approved one or more irradiated food items or groups of food

  2. Incidence and classification of neointimal proliferation and in-stent restenosis in post-stenting patients at 1-year interval: Findings from non-invasive coronary computed tomography angiography

    Energy Technology Data Exchange (ETDEWEB)

    Xu, Nan, E-mail: southmuch@hotmail.com [Department of Radiology, East Hospital, Tongji University School of Medicine, No. 150, Jimo Road, Shanghai 200120 (China); Zhang, Jiayin, E-mail: andrewssmu@msn.com [Department of Radiology, Shanghai Jiao Tong University Affiliated Sixth People' s Hospital, No. 600, Yishan Road, Shanghai 200233 (China); Li, Minghua, E-mail: drliminghua@gmail.com [Department of Radiology, Shanghai Jiao Tong University Affiliated Sixth People' s Hospital, No. 600, Yishan Road, Shanghai 200233 (China); Pan, Jingwei, E-mail: drpanjingwei@gmail.com [Department of Cardiology, Shanghai Jiao Tong University Affiliated Sixth People' s Hospital, No. 600, Yishan Road, Shanghai 200233 (China); Lu, Zhigang, E-mail: drluzhigang@gmail.com [Department of Cardiology, Shanghai Jiao Tong University Affiliated Sixth People' s Hospital, No. 600, Yishan Road, Shanghai 200233 (China)

    2014-10-15

    Highlights: • The incidence of silent in-stent restenosis at 1-year as revealed by CT is 7.6%. • The incidence of neointimal proliferation at 1-year as revealed by CT is 12.6%. • Diabetes are associated with higher incidence of neointimal proliferation. - Abstract: Objectives: To evaluate the incidence of coronary in-stent restenosis (ISR) and neointimal proliferation by coronary CT angiography (CCTA) at 1-year follow-up in asymptomatic patients. Methods: 234 patients (mean age: 67 ± 10.2 years, range 39–88 years, 180 males and 54 females) with 379 stents were prospectively enrolled in this study. Binary ISR was classified by CCTA into 4 types using Mehran classification. Neointimal proliferation was similarly classified into focal and diffuse types. All patients with CCTA-revealed ISR or neointimal proliferation underwent further invasive coronary angiography (ICA) for validation. Fisher's exact test was used for comparison. Results: ICA revealed patent stents with neointimal proliferation in 39 patients (16.7%, 39/234) and binary ISR in 23 patients (9.8%, 23/234). Lesion-based analysis showed 12 type I ISR lesions, 4 type II ISR lesions, 1 type III ISR lesion and 7 type IV ISR lesions. Among cases with neointimal proliferation, 27 lesions were classified as focal type whereas 13 lesions were classified as diffuse type. Patients with diabetes mellitus were associated with higher incidence of CCTA-revealed neointimal proliferation (21/77 vs. 18/157, p = 0.002) as well as ISR (12/77 vs. 11/157, p = 0.038), compared to patients without diabetes. CCTA was found to have good diagnostic performance for neointimal proliferation and ISR detection as well as classification, with an overall accuracy of 84.4% (54/64). Conclusions: Silent ISR as well as neointimal proliferation is not uncommon findings in asymptomatic post-stenting patients at 1-year interval, as revealed by CCTA. Patients with diabetes are prone to have higher incidence of neointimal

  3. FDA-approved small-molecule kinase inhibitors

    DEFF Research Database (Denmark)

    Wu, Peng; Nielsen, Thomas E.; Clausen, Mads Hartvig

    2015-01-01

    Kinases have emerged as one of the most intensivelypursued targets in current pharmacological research,especially for cancer, due to their critical roles in cellularsignaling. To date, the US FDA has approved 28 smallmoleculekinase inhibitors, half of which were approvedin the past 3 years. While...

  4. The Cost of Delaying Approval of Golden Rice

    NARCIS (Netherlands)

    Wesseler, J.H.H.; Kaplan, S.; Zilberman, D.

    2014-01-01

    More than 250,000 children go blind every year because of Vitamin A deficiency. Vitamin A intake can be enhanced by consuming Golden Rice—a genetically engineered variety of rice. It was available for commercialization in 2002, but approval has been delayed. We estimate that this delay has resulted

  5. Timelines of translational science: From technology initiation to FDA approval.

    Directory of Open Access Journals (Sweden)

    Laura M McNamee

    Full Text Available While timelines for clinical development have been extensively studied, there is little data on the broader path from initiation of research on novel drug targets, to approval of drugs based on this research. We examined timelines of translational science for 138 drugs and biologicals approved by the FDA from 2010-2014 using an analytical model of technology maturation. Research on targets for 102 products exhibited a characteristic (S-curve maturation pattern with exponential growth between statistically defined technology initiation and established points. The median initiation was 1974, with a median of 25 years to the established point, 28 years to first clinical trials, and 36 years to FDA approval. No products were approved before the established point, and development timelines were significantly longer when the clinical trials began before this point (11.5 vs 8.5 years, p<0.0005. Technological maturation represents the longest stage of translation, and significantly impacts the efficiency of drug development.

  6. Post LS1 schedule

    CERN Document Server

    Lamont, M

    2014-01-01

    The scheduling limits for a typical long year taking into account technical stops, machine development, spe- cial physics runs are presented. An attempt is then made to outline a ten year post LS1 schedule taking into account the disparate requirements outlined in the previous talks in this session. The demands on the planned long shutdowns and the impact of these demands on their proposed length will be discussed. The option of using ion running as a pre-shutdown cool-down period will be addressed.

  7. Post-irradiation diarrhea

    International Nuclear Information System (INIS)

    Meerwaldt, J.H.

    1984-01-01

    In radiotherapy of pelvic cancers, the X-ray dose to be delivered to the tumour is limited by the tolerance of healthy surrounding tissue. In recent years, a number of serious complications of irradiation of pelvic organs were encountered. Modern radiotherapy necessitates the acceptance of a calculated risk of complications in order to achieve a better cure rate. To calculate these risks, one has to know the radiation dose-effect relationship of normal tissues. Of the normal tissues most at risk when treating pelvic tumours only the bowel is studied. In the literature regarding post-irradiation bowel complications, severe and mild complications are often mixed. In the present investigation the author concentrated on the group of patients with relatively mild symptoms. He studied the incidence and course of post-irradiation diarrhea in 196 patients treated for carcinoma of the uterine cervix or endometrium. The aims of the present study were: 1) to determine the incidence, course and prognostic significance of post-irradiation diarrhea; 2) to assess the influence of radiotherapy factors; 3) to study the relation of bile acid metabolism to post-irradiation diarrhea; 4) to investigate whether local factors (reservoir function) were primarily responsible. (Auth.)

  8. 40 CFR 145.31 - Approval process.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 22 2010-07-01 2010-07-01 false Approval process. 145.31 Section 145.31 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS (CONTINUED) STATE UIC PROGRAM REQUIREMENTS Program Approval, Revision and Withdrawal § 145.31 Approval process. (a...

  9. 40 CFR 123.61 - Approval process.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 21 2010-07-01 2010-07-01 false Approval process. 123.61 Section 123... REQUIREMENTS Program Approval, Revision, and Withdrawal § 123.61 Approval process. (a) After determining that a...; and (6) Briefly outline the fundamental aspects of the State's proposed program, and the process for...

  10. 7 CFR 1710.406 - Loan approval.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 11 2010-01-01 2010-01-01 false Loan approval. 1710.406 Section 1710.406 Agriculture... GENERAL AND PRE-LOAN POLICIES AND PROCEDURES COMMON TO ELECTRIC LOANS AND GUARANTEES Application Requirements and Procedures for Loans § 1710.406 Loan approval. (a) A loan is approved when the Administrator...

  11. 40 CFR 52.1772 - Approval status.

    Science.gov (United States)

    2010-07-01

    ...) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS (CONTINUED) North Carolina § 52.1772 Approval status. (a) With the exceptions set forth in this subpart, the Administrator approves North Carolina's plans for... CTGs issued by the previous January. (b) New Source review permits issued pursuant to section 173 of...

  12. 40 CFR 52.2122 - Approval status.

    Science.gov (United States)

    2010-07-01

    ... sources covered by CTGs issued by the previous January. (b) EPA disapproved South Carolina's generic...) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS (CONTINUED) South Carolina § 52.2122 Approval status. (a) With the exceptions set forth in this subpart, the Administrator approves South Carolina's plans for...

  13. 40 CFR 52.1323 - Approval status.

    Science.gov (United States)

    2010-07-01

    ... on January 16, 1979 (44 FR 3274) are met. (b) The Administrator approves Rule 10 CSR 10-2.290 as.... (c) The Administrator approves Rule 10 CSR 10-2.230 as identified under § 52.1320, paragraph (c)(70... SIP would be the emission limits stated in the rule. (d) The Administrator approves Rule 10 CSR 10-5...

  14. 9 CFR 147.52 - Approved tests.

    Science.gov (United States)

    2010-01-01

    ... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Approved tests. 147.52 Section 147.52 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE... Approved Tests § 147.52 Approved tests. (a) The procedures for the bacteriological examination of poultry...

  15. Auditing the process of ethics approval for Master's degrees at a ...

    African Journals Online (AJOL)

    Objective. This study audited the process of ethics approval for Master's research at the Nelson R Mandela School of Medicine, Durban, KwaZulu-Natal, South Africa. Methods. After obtaining the appropriate ethical approval, all the correspondence surrounding each Master's proposal for the year 2010 was reviewed.

  16. Does the effect of one-day simulation team training in obstetric emergencies decline within one year? A post-hoc analysis of a multicentre cluster randomised controlled trial.

    Science.gov (United States)

    van de Ven, J; Fransen, A F; Schuit, E; van Runnard Heimel, P J; Mol, B W; Oei, S G

    2017-09-01

    Does the effect of one-day simulation team training in obstetric emergencies decline within one year? A post-hoc analysis of a multicentre cluster randomised controlled trial. J van de Ven, AF Fransen, E Schuit, PJ van Runnard Heimel, BW Mol, SG Oei OBJECTIVE: To investigate whether the effect of a one-day simulation-based obstetric team training on patient outcome changes over time. Post-hoc analysis of a multicentre, open, randomised controlled trial that evaluated team training in obstetrics (TOSTI study).We studied women with a singleton pregnancy beyond 24 weeks of gestation in 24 obstetric units. Included obstetric units were randomised to either a one-day, multi-professional simulation-based team training focusing on crew resource management in a medical simulation centre (12 units) or to no team training (12 units). We assessed whether outcomes differed between both groups in each of the first four quarters following the team training and compared the effect of team training over quarters. Primary outcome was a composite outcome of low Apgar score, severe postpartum haemorrhage, trauma due to shoulder dystocia, eclampsia and hypoxic-ischemic encephalopathy. During a one year period after the team training the rate of obstetric complications, both on the composite level and the individual component level, did not differ between any of the quarters. For trauma due to shoulder dystocia team training led to a significant decrease in the first quarter (0.06% versus 0.26%, OR 0.19, 95% CI 0.03 to 0.98) but in the subsequent quarters no significant reductions were observed. Similar results were found for invasive treatment for severe postpartum haemorrhage where a significant increase was only seen in the first quarter (0.4% versus 0.03%, OR 19, 95% CI 2.5-147), and not thereafter. The beneficial effect of a one-day, simulation-based, multiprofessional, obstetric team training seems to decline after three months. If team training is further evaluated or

  17. Inventory information approval system certification and flexible spending account purchases.

    Science.gov (United States)

    Shuey, Brandon; Williams, La Vonn A

    2010-01-01

    There is no question that 2009 was a year of change within the pharmacy industry. Several new requirements were implemented, including the need for an Inventory Information Approval System for accepting flexible spending or health reimbursement account cords. Some pharmacies relied on the 90% exemption rule, which is discussed within this article, or an alternative method to avoid the expense of a point of sale. However, with flexible spending or health reimbursement account card participation expected to reach 85% in 2010, now bay be the time for compounding pharmacists to weigh the pros and cons of Inventory Information Approval System certification.

  18. 38 CFR 17.65 - Approvals and provisional approvals of community residential care facilities.

    Science.gov (United States)

    2010-07-01

    ... approvals of community residential care facilities. 17.65 Section 17.65 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Community Residential Care § 17.65 Approvals and provisional approvals of community residential care facilities. (a) An approval of a facility meeting all of...

  19. Post-acquisition data processing for the screening of transformation products of different organic contaminants. Two-year monitoring of river water using LC-ESI-QTOF-MS and GCxGC-EI-TOF-MS.

    Science.gov (United States)

    López, S Herrera; Ulaszewska, M M; Hernando, M D; Martínez Bueno, M J; Gómez, M J; Fernández-Alba, A R

    2014-11-01

    This study describes a comprehensive strategy for detecting and elucidating the chemical structures of expected and unexpected transformation products (TPs) from chemicals found in river water and effluent wastewater samples, using liquid chromatography coupled to electrospray ionization quadrupole-time-of-flight mass spectrometer (LC-ESI-QTOF-MS), with post-acquisition data processing and an automated search using an in-house database. The efficacy of the mass defect filtering (MDF) approach to screen metabolites from common biotransformation pathways was tested, and it was shown to be sufficiently sensitive and applicable for detecting metabolites in environmental samples. Four omeprazole metabolites and two venlafaxine metabolites were identified in river water samples. This paper reports the analytical results obtained during 2 years of monitoring, carried out at eight sampling points along the Henares River (Spain). Multiresidue monitoring, for targeted analysis, includes a group of 122 chemicals, amongst which are pharmaceuticals, personal care products, pesticides and PAHs. For this purpose, two analytical methods were used based on direct injection with a LC-ESI-QTOF-MS system and stir bar sorptive extraction (SBSE) with bi-dimensional gas chromatography coupled with a time-of-flight spectrometer (GCxGC-EI-TOF-MS).

  20. 46 CFR 169.849 - Posting placards containing instructions for launching and inflating inflatable liferafts.

    Science.gov (United States)

    2010-10-01

    ... Inspections § 169.849 Posting placards containing instructions for launching and inflating inflatable... accessible to the ship's company and guests approved placards containing instructions for launching and... determined by the Officer in Charge, Marine Inspection. ...