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5 Other Domains6%
Distribution within Medical Sciences
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Dermatology4%
Oncology & Radiotherapy3%
66 Other Subdomains62%

Kinds of Long-term

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    • Selected Abstracts

    The Ecological Future of the North American Bison: Conceiving Long-Term, Large-Scale Conservation of Wildlife

    CONSERVATION BIOLOGY, Issue 2 2008
    ERIC W. SANDERSON
    Bison bison; conservación de especies; Declaración de Vermejo; metas de conservación; representación ecológica Abstract:,Many wide-ranging mammal species have experienced significant declines over the last 200 years; restoring these species will require long-term, large-scale recovery efforts. We highlight 5 attributes of a recent range-wide vision-setting exercise for ecological recovery of the North American bison (Bison bison) that are broadly applicable to other species and restoration targets. The result of the exercise, the "Vermejo Statement" on bison restoration, is explicitly (1) large scale, (2) long term, (3) inclusive, (4) fulfilling of different values, and (5) ambitious. It reads, in part, "Over the next century, the ecological recovery of the North American bison will occur when multiple large herds move freely across extensive landscapes within all major habitats of their historic range, interacting in ecologically significant ways with the fullest possible set of other native species, and inspiring, sustaining and connecting human cultures." We refined the vision into a scorecard that illustrates how individual bison herds can contribute to the vision. We also developed a set of maps and analyzed the current and potential future distributions of bison on the basis of expert assessment. Although more than 500,000 bison exist in North America today, we estimated they occupy <1% of their historical range and in no place express the full range of ecological and social values of previous times. By formulating an inclusive, affirmative, and specific vision through consultation with a wide range of stakeholders, we hope to provide a foundation for conservation of bison, and other wide-ranging species, over the next 100 years. Resumen:,Muchas especies de mamíferos de distribución amplia han experimentado declinaciones significativas durante los últimos 200 años; la restauración de estas especies requerirá esfuerzos de recuperación a largo plazo y a gran escala. Resaltamos 5 atributos de un reciente ejercicio de gran visión para la recuperación ecológica del bisonte de Norte América (Bison bison) que son aplicables en lo general a otras especies y objetivos de restauración. El resultado del ejercicio, la "Declaración de Vermejo", explícitamente es (1) de gran escala, (2) de largo plazo, (3) incluyente, (4) satisfactor de valores diferentes y (5) ambicioso. En parte, establece que "En el próximo siglo, la recuperación ecológica del Bisonte de Norte América ocurrirá cuando múltiples manadas se desplacen libremente en los extensos paisajes de todos los hábitats importantes en su rango de distribución histórica, interactúen de manera significativa ecológicamente con el conjunto más completo de otras especies nativas e inspiren, sostengan y conecten culturas humanas." Refinamos esta visión en una tarjeta de puntuación que ilustra cómo las manadas de bisonte individuales pueden contribuir a la visión. También desarrollamos un conjunto de mapas y analizamos las distribuciones actuales y potencialmente futuras del bisonte con base en la evaluación de expertos. Aunque actualmente existen más de 500,000 bisontes en Norte América, estimamos que ocupan <1% de su distribución histórica y no expresan el rango completo de valores ecológicos y culturales de otros tiempos. Mediante la formulación de una visión incluyente, afirmativa y específica basada en la consulta a una amplia gama de interesados, esperamos proporcionar un fundamento para la conservación del bisonte, y otras especies de distribución amplia, para los próximos 100 años. [source]

    Long-Term, Open-Label Safety Study of Oral Almotriptan 12.5 mg for the Acute Treatment of Migraine in Adolescents

    HEADACHE, Issue 5 2010
    Frank Berenson MD
    (Headache 2010;50:795-807) Objectives., This study evaluated the long-term safety of oral almotriptan 12.5 mg for the treatment of multiple migraine episodes in adolescents over a 12-month period. Efficacy outcomes were assessed as a secondary objective. Methods., Adolescent migraineurs aged 12-17 years were enrolled in this 12-month, open-label study (Study ID CR002827). Patients were instructed to record their assessments on paper headache records whenever they experienced a migraine headache that they treated with study medication. Safety was assessed descriptively and assessments included adverse event (AE) recording, change in laboratory values, vital signs, and electrocardiogram parameters. Efficacy outcomes were assessed descriptively and outcomes included rates for 2- and 24-hour pain relief and sustained pain relief, 2- and 24-hour pain-free and sustained pain-free, and presence of migraine-associated symptoms of photophobia, phonophobia, nausea and vomiting. Results., Overall, 67.1% of patients reported ,1 AE over the course of the trial, 7.6% had an AE judged by the study investigator to be related to treatment with almotriptan, 2.4% discontinued because of an AE, and 1.9% reported serious AEs. The most commonly reported treatment-related AEs (occurring in ,1% of patients) were nausea (1.4%) and somnolence (1.4%). Pain relief responses for treated migraines of moderate or severe intensity at baseline were 61.7% and 68.6%, at 2 and 24 hours, respectively; the sustained pain relief rate was 55.5%. Pain-free responses were reported for 40.5% of all treated migraines at 2 hours and 65.9% of treated migraines at 24 hours; the sustained pain-free rate was 38.4%. The proportion of migraines that achieved the pain relief, sustained pain relief, pain-free and sustained pain-free endpoints were similar in the 12- to 14-year and 15- to 17-year age groups. Treating with almotriptan 12.5 mg when headache pain was mild was associated with higher rates of pain relief and pain-free at 2 and 24 hours, and sustained pain relief and sustained pain-free, compared with treatment initiated when pain was severe. Conclusions., Almotriptan 12.5 mg was well tolerated in this adolescent population over a 12-month period. No unexpected safety or tolerability concerns were revealed over the course of this study. The results are consistent with almotriptan 12.5 mg being effective for the acute treatment of pain and symptoms associated with migraine in both younger and older adolescents. [source]

    Long-Term Results of Heart Transplantation for End-Stage Valvular Heart Disease

    JOURNAL OF CARDIAC SURGERY, Issue 5 2009
    D.Sc., F.I.C.S., M.P.H., M.Sc., Ph.D., Yanto Sandy Tjang M.D.
    However, the outcomes of heart transplantation for patients with end-stage valvular heart disease are less well reported. This is a substantial group of patients, many of whom have had previous cardiac surgery. They therefore may be considered a subgroup with a poor prognosis. This study reports on the outcomes of heart transplantation for patients with end-stage valvular heart disease. Patients and methods: From March 1989 to December 2004, 75 consecutive adult heart transplantations were performed for end-stage valvular heart disease. Clinical characteristics were retrieved from a computerized database. Results: The early mortality risk in heart transplantation for end-stage valvular heart disease was 13%, compared to 8% for other indications (p = 0.12). The main causes of early death were rejection (20%) and right ventricular failure (20%). The total follow-up time was 415 patient-years. During the follow-up, another 23 patients died (55/1000 patient-years of late mortality rate), mostly due to infection (43%) and multiorgan failure (22%). Multivariable analysis demonstrated that increased waiting time to heart transplantation correlated with increased survival (HR = 0.998, p = 0.04). The survival at 1, 5, 10, and 15 years was 70%, 64%, 56%, and 46% compared to 78%, 68%, 53%, and 41% for other indications, respectively (p = 0.5). Conclusion: The outcomes of heart transplantation for patients with end-stage valvular heart disease are similar to those for other patients. Apparently, the longer the waiting time to heart transplantation the better the outcome becomes. [source]

    Long-Term Results of Cardiac Transplantation

    JOURNAL OF CARDIAC SURGERY, Issue 3 2003
    Alberto Juffe M.D.
    From April 1991 to December 2000, 345 patients underwent heart transplantation at the Juan Canalejo Hospital. The mean age of recipients was54.5 ± 11.4 years; 286 (83%) were male patients. Idiopathic (52.2%) and ischemic (34.9%) end-stage cardiomyopathy were the main causes leading to transplantation. Ninety-four patients had undergone a previous heart operation. The mean left ventricular ejection fraction was22.8 ± 11.4. Forty patients (11.5%) were transplanted in urgent (status I) condition. The mean time spent on the waiting list was 35.9 days. In-hospital mortality was 10.6% and 24% for transplantations performed on an elective and urgent basis, respectively. Operative (30-day), one-year and six-year survival was 87.2%, 81.3% and 64%, respectively. In terms of actuarial survival, there were no significant differences with regard to the recipient's age, sex, previous cardiac surgery, and the etiology of the end-stage cardiomyopathy. The six-year actuarial survival for recipients receiving hearts from female donors was 59% compared with 72% for male donors(p = 0.05). There has been a low incidence of rejection, as well as cardiac graft vasculopathy. Actuarial survival at six years was 66% for patients transplantated on an elective basis compared with 57% for patients transplanted on an urgent basis(p = 0.04). The aim of the study was to evaluate long-term results for patients who underwent orthotopic heart transplantation. In our experience, status I is associated with a higher mortality.(J Card Surg 2003;18:183-189) [source]

    Flow-Reversal Device for Cerebral Protection During Carotid Artery Stenting,Acute and Long-Term Results

    JOURNAL OF INTERVENTIONAL CARDIOLOGY, Issue 1 2006
    KASJA RABE M.D.
    Objective: Several types of cerebral (embolic) protection devices have been used in patients undergoing carotid stenting. This study assessed results achieved with a flow-reversal system. Method: Carotid stenting was performed in 56 patients (mean age, 68 ± 9 years). The mean percentage of stenosis was 77%± 10%. During the procedure, cerebral protection was achieved by means of balloon occlusion of the common and external carotid artery with use of a Parodi Anti-Emboli System. The patients' neurologic status was assessed during the intervention; at discharge; 1, 6, and 12 months after the procedure; and yearly thereafter. Results: The procedure was technically successful in all cases. One patient had a minor stroke 6 hours after the intervention. No major strokes, deaths, or myocardial infarctions occurred. During long-term follow-up (to 40 months), 2 patients died of a secondary complication after intracerebral bleeding and stroke and 1 died as a result of ventricular fibrillation. Restenosis did not exceed 50% of vessel diameter in any patient. Conclusions: The acute results indicate that proximal occlusion and flow reversal for cerebral protection during carotid stenting is a safe and effective method. The low restenosis and complication rate during long-term follow-up is in accordance with other series of carotid angioplasty and shows that the occlusion balloons do not cause any long-term side effects. [source]

    Mechanical Behavior and Failure Analysis of Prosthetic Retaining Screws after Long-Term Use In Vivo.

    JOURNAL OF PROSTHODONTICS, Issue 3 2008
    Microhardness Analysis, Part 2: Metallurgical
    Abstract Purpose: This study involved testing and analyzing multiple retrieved prosthetic retaining screws after long-term use in vivo to: (1) detect manufacturing defects that could affect in-service behavior; (2) characterize the microstructure and alloy composition; and (3) further characterize the wear mechanism of the screw threads. Materials and Methods: Two new (control) screws from Nobel Biocare (NB) and 18 used (in service 18,120 months) retaining screws [12 from NB and 6 from Sterngold (SG)] were: (1) metallographically examined by light microscopy and scanning electron microscopy (SEM) to determine the microstructure; (2) analyzed by energy dispersive X-ray (EDX) microanalysis to determine the qualitative and semiquantitative average alloy and individual phase compositions; and (3) tested for Vickers microhardness. Results: Examination of polished longitudinal sections of the screws using light microscopy revealed a significant defect in only one Group 4 screw. No significant defects in any other screws were observed. The defect was considered a "seam" originating as a "hot tear" during original casting solidification of the alloy. Additionally, the examination of longitudinal sections of the screws revealed a uniform homogeneous microstructure in some groups, while in other groups the sections exhibited rows of second phase particles. The screws for some groups demonstrated severe deformation of the lower threads and the bottom part of the screw leading to the formation of crevices and grooves. Some NB screws were comprised of Au-based alloy with Pt, Cu, and Ag as alloy elements, while others (Groups 4 and 19) were Pd-based with Ga, Cu, and Au alloy elements. The microstructure was homogeneous with fine or equiaxed grains for all groups except Group 4, which appeared inhomogeneous with anomalous grains. SG screws demonstrated a typical dendritic structure and were Au-based alloy with Cu and Ag alloy elements. There were differences in the microhardness of gold alloy screws from NB and SG as well as palladium alloy screws from NB. Conclusions: Significant differences within NB retaining screws and between NB and SG screws were found for microstructure, major alloy constituents, and microhardness. [source]

    Long-Term Results of a Phase III Randomized Trial of Postoperative Radiotherapy With or Without Carboplatin in Patients With High-Risk Head and Neck Cancer

    THE LARYNGOSCOPE, Issue 3 2008
    Athanassios Argiris MD
    Abstract Background: The role of postoperative radiotherapy and carboplatin in squamous cell carcinoma of the head and neck (SCCHN) has not been established. Methods: Patients with macroscopically resected stage III/IV SCCHN with high-risk pathologic features (,3 lymph nodes, extracapsular extension, perineural or angiolymphatic invasion, or involved margins) were randomized to receive postoperative radiotherapy alone (arm A) or the same radiotherapy plus carboplatin 100 mg/m2 intravenously once weekly during radiation (arm B). The primary endpoint was 2-year disease-free survival. Results: Seventy-six patients were randomized, of whom 72 were eligible and analyzable (36 in each arm). The study was prematurely closed because of slow accrual. With a median follow-up of 5.3 years, the disease-free survival at 2 and 5 years was 71% and 53% in arm B versus 58% (P = .27) and 49% (P = .72) in arm A. The overall survival at 2 and 5 years was 74% and 47% in arm B versus 51% (P = .04) and 41% (P = .61) in arm A. Serious toxicities were infrequent in both arms. Conclusions: We could not demonstrate a benefit with the addition of carboplatin to postoperative radiotherapy, possibly because of insufficient sample size. [source]

    Long-Term Results of Provox ActiValve, Solving the Problem of Frequent Candida- and "Underpressure"-Related Voice Prosthesis Replacements

    THE LARYNGOSCOPE, Issue 2 2008
    Jessica Soolsma MSc
    Abstract Objectives: To assess the long-term results of the Provox ActiValve, a prosthesis for voice rehabilitation after total laryngectomy that was designed to lessen the need for frequent replacements caused by Candida and "underpressure." Patients and Methods: Retrospective assessment of device lifetime, indications for replacement, voice quality, and maintenance issues, measured by a structured trial specific questionnaire, in a cohort of 42 laryngectomized patients, experiencing a short Provox2 device lifetime (median, 21 days). Results: The median device lifetime of Provox ActiValve, replaced for leakage through the device and those still in situ at the date of data collection (N = 32), was 337 days (mean 376 days): a statistically significant 16-fold increase compared to the Provox2 prosthesis (P < .001). In 10 patients, replacement was fistula-related (median after 86 days): esophageal pouch (N = 4), fistula granulation (N = 3), extrusion of the device (N = 2), and periprosthetic leakage (N = 1). Eighty-six percent of the patients used a special lubricant to diminish "stickiness" of the valve. Provox ActiValve was preferred by 90% of the patients who completed the trial-specific questionnaire. Conclusions: For patients requiring frequent device-related replacements, Provox ActiValve, also long-term, provides a true solution and thereby is a valuable addition to prosthetic voice rehabilitation. [source]

    Long-Term Results after Endoscopic Sinus Surgery Involving Frontal Recess Dissection

    THE LARYNGOSCOPE, Issue 4 2006
    Michael Friedman MD
    Abstract Objective: To assess long-term follow-up on a cohort of patients who underwent endoscopic frontal sinus surgery with identification and preservation of the natural frontal outflow tract. Study Design and Settings: Retrospective chart review, telephone interview, and endoscopic evaluation on a previously studied cohort of patients at a university affiliated medical center. Results: Two hundred patients who underwent endoscopic frontal sinus surgery were previously studied and reported after short-term (mean = 12.2 mo) follow-up. One hundred fifty-two (76%) patients were available for long-term (mean 72.3 mo) follow-up and assessment of subjective symptoms. Fifty-seven of 152 (37.5%) patients also had nasal endoscopy for evaluation of objective findings. The percentage of patients responding to telephone interview reporting overall improvement after surgery was 92.4%. Endoscopic assessment revealed patency of the frontal sinus in 67.6% of the patients after initial surgery. Thirteen additional patients had patent sinuses after revision procedures, bringing overall patency rate to 71.1%. We found statistically significant correlation of asthma and smoking and poor subjective and objective outcome. Conclusion: Long-term assessment of subjective and objective findings in our previously reported cohort of patients who underwent frontal sinus surgery indicates that the frontal sinus, similar to any other sinus, can be successfully treated surgically by preserving the natural frontal sinus outflow tract. [source]

    Long-Term Results of Endonasal Sinus Surgery in Sinonasal Papillomas

    THE LARYNGOSCOPE, Issue 9 2003
    Marcel Kraft MD
    Abstract Objective To assess the value of endonasal sinus surgery in the management of sinonasal papillomas. Study Design Retrospective study including 43 patients operated on for sinonasal papilloma in a long-term follow-up. Methods In 26 cases (60%) an endonasal approach, in eight cases (19%) an external approach, and in four cases (9%) a combined procedure was performed to remove these tumors. Five septal lesions (12%) were resected under direct vision. The original sections and charts of all patients were reviewed to assess clinical data. Follow-up information was available for 42 of our patients (98%) with a mean follow-up of 62 months. Results Histologic examination revealed 34 cases of inverted papilloma (79%), five cases of exophytic papilloma (12%), and four cases of columnar cell papilloma (9%). Malignancy occurred in 4 of 43 patients (9%), and recurrences developed in 8 of 42 patients (19%). Two of these recurrences happened after endoscopic sinus surgery (two inverted papillomas), three after lateral rhinotomy (three inverted papillomas), one after a combined procedure (one inverted papilloma), and two after simple resection (two exophytic papilloma). Conclusions In keeping with our experience, the endonasal endoscopic approach, often in combination with a medial maxillectomy, is favored for the treatment of sinonasal papilloma because of a lower recurrence rate and a better cosmetic result. In some larger tumors and lesions in difficult locations, better visualization can be obtained by a combined external and endonasal approach. [source]

    MEDAL (Multinational Etoricoxib and Diclonfenac Arthritis Long-Term)

    CLINICAL CARDIOLOGY, Issue 1 2007
    Article first published online: 29 JAN 200
    No abstract is available for this article. [source]

    Long-term coping in childhood cancer survivors,influence of illness, treatment and demographic factors

    ACTA PAEDIATRICA, Issue 1 2000
    PJ Moe
    No abstract is available for this article. [source]

    The Conservation Relevance of Epidemiological Research into Carnivore Viral Diseases in the Serengeti

    CONSERVATION BIOLOGY, Issue 3 2007
    SARAH CLEAVELAND
    conservación de carnívoros; investigación epidemiológica; moquillo; rabia; Serengeti Abstract:,Recent outbreaks of rabies and canine distemper in wildlife populations of the Serengeti show that infectious disease constitutes a significant cause of mortality that can result in regional extirpation of endangered species even within large, well-protected areas. Nevertheless, effective management of an infectious disease depends critically on understanding the epidemiological dynamics of the causative pathogen. Pathogens with short infection cycles cannot persist in small populations in the absence of a more permanent reservoir of infection. Development of appropriate interventions requires detailed data on transmission pathways between reservoirs and wildlife populations of conservation concern. Relevant data can be derived from long-term population monitoring, epidemic and case-surveillance patterns, genetic analyses of rapidly evolving pathogens, serological surveys, and intervention studies. We examined studies of carnivore diseases in the Serengeti. Epidemiological research contributes to wildlife conservation policy in terms of management of endangered populations and the integration of wildlife conservation with public health interventions. Long-term, integrative, cross-species research is essential for formulation of effective policy for disease control and optimization of ecosystem health. Resumen:,Brotes recientes de rabia y moquillo en poblaciones silvestres del Serengeti muestran que las enfermedades infecciosas constituyen una causa significativa de mortandad que puede resultar en la extirpación regional de especies en peligro, aun en áreas extensas bien protegidas. Sin embargo, el manejo efectivo de una enfermedad infecciosa depende críticamente del entendimiento de la dinámica epidemiológica del patógeno. Los patógenos con ciclo infeccioso corto no pueden persistir en poblaciones pequeñas en ausencia de un reservorio de la infección más permanente. El desarrollo de intervenciones adecuadas requiere de datos detallados de las vías de transmisión entre reservorios y poblaciones de vida silvestre de preocupación para la conservación. Se pueden derivar datos importantes del monitoreo de poblaciones a largo plazo, de patrones de epidemias y de estudios de caso, del análisis genético de patógenos que evolucionan rápidamente, de muestreos sexológicos y de estudios de intervención. Examinamos estudios de enfermedades de carnívoros en el Serengeti. La investigación epidemiológica contribuye a las políticas de conservación de vida silvestre en términos de la gestión de poblaciones en peligro y de la integración de la conservación con intervenciones de salud pública. La investigación a largo plazo e integradora es esencial para la formulación de políticas efectivas para el control de enfermedades y la optimización de la salud del ecosistema. [source]

    The treatment of CIN: what are the risks?

    CYTOPATHOLOGY, Issue 3 2009
    W. Prendiville
    The treatment of squamous cervical intraepithelial neoplasia is to remove or destroy the transformation zone (TZ). It is likely that no method of treatment is superior to another if it is performed properly and the limited available evidence supports this view. The significant advantages of excision (simplicity, cost, outpatient procedure, histological examination of the entire TZ) mean that treatment thresholds may have lowered over the last decade. Long-term pregnancy-related morbidity associated with excision has been reported recently. The evidence would suggest that this increase equates to a genuine increase in serious adverse outcome for cone biopsy but not large loop excision of the transformation zone (LLETZ). The available data also point to an increase in both incomplete excision and premature labour associated with the excision of large endocervical TZs. The clinical implications arising from this are firstly that women with large type 2 and 3 TZs need appropriate counselling before treatment and that the threshold for treating young women with mild abnormalities needs review. [source]

    Long-term landscape evolution: linking tectonics and surface processes

    EARTH SURFACE PROCESSES AND LANDFORMS, Issue 3 2007
    Paul Bishop
    Abstract Research in landscape evolution over millions to tens of millions of years slowed considerably in the mid-20th century, when Davisian and other approaches to geomorphology were replaced by functional, morphometric and ultimately process-based approaches. Hack's scheme of dynamic equilibrium in landscape evolution was perhaps the major theoretical contribution to long-term landscape evolution between the 1950s and about 1990, but it essentially ,looked back' to Davis for its springboard to a viewpoint contrary to that of Davis, as did less widely known schemes, such as Crickmay's hypothesis of unequal activity. Since about 1990, the field of long-term landscape evolution has blossomed again, stimulated by the plate tectonics revolution and its re-forging of the link between tectonics and topography, and by the development of numerical models that explore the links between tectonic processes and surface processes. This numerical modelling of landscape evolution has been built around formulation of bedrock river processes and slope processes, and has mostly focused on high-elevation passive continental margins and convergent zones; these models now routinely include flexural and denudational isostasy. Major breakthroughs in analytical and geochronological techniques have been of profound relevance to all of the above. Low-temperature thermochronology, and in particular apatite fission track analysis and (U,Th)/He analysis in apatite, have enabled rates of rock uplift and denudational exhumation from relatively shallow crustal depths (up to about 4 km) to be determined directly from, in effect, rock hand specimens. In a few situations, (U,Th)/He analysis has been used to determine the antiquity of major, long-wavelength topography. Cosmogenic isotope analysis has enabled the determination of the ,ages' of bedrock and sedimentary surfaces, and/or the rates of denudation of these surfaces. These latter advances represent in some ways a ,holy grail' in geomorphology in that they enable determination of ,dates and rates' of geomorphological processes directly from rock surfaces. The increasing availability of analytical techniques such as cosmogenic isotope analysis should mean that much larger data sets become possible and lead to more sophisticated analyses, such as probability density functions (PDFs) of cosmogenic ages and even of cosmogenic isotope concentrations (CICs). PDFs of isotope concentrations must be a function of catchment area geomorphology (including tectonics) and it is at least theoretically possible to infer aspects of source area geomorphology and geomorphological processes from PDFs of CICs in sediments (,detrital CICs'). Thus it may be possible to use PDFs of detrital CICs in basin sediments as a tool to infer aspects of the sediments' source area geomorphology and tectonics, complementing the standard sedimentological textural and compositional approaches to such issues. One of the most stimulating of recent conceptual advances has followed the considerations of the relationships between tectonics, climate and surface processes and especially the recognition of the importance of denudational isostasy in driving rock uplift (i.e. in driving tectonics and crustal processes). Attention has been focused very directly on surface processes and on the ways in which they may ,drive' rock uplift and thus even influence sub-surface crustal conditions, such as pressure and temperature. Consequently, the broader geoscience communities are looking to geomorphologists to provide more detailed information on rates and processes of bedrock channel incision, as well as on catchment responses to such bedrock channel processes. More sophisticated numerical models of processes in bedrock channels and on their flanking hillslopes are required. In current numerical models of long-term evolution of hillslopes and interfluves, for example, the simple dependency on slope of both the fluvial and hillslope components of these models means that a Davisian-type of landscape evolution characterized by slope lowering is inevitably ,confirmed' by the models. In numerical modelling, the next advances will require better parameterized algorithms for hillslope processes, and more sophisticated formulations of bedrock channel incision processes, incorporating, for example, the effects of sediment shielding of the bed. Such increasing sophistication must be matched by careful assessment and testing of model outputs using pre-established criteria and tests. Confirmation by these more sophisticated Davisian-type numerical models of slope lowering under conditions of tectonic stability (no active rock uplift), and of constant slope angle and steady-state landscape under conditions of ongoing rock uplift, will indicate that the Davis and Hack models are not mutually exclusive. A Hack-type model (or a variant of it, incorporating slope adjustment to rock strength rather than to regolith strength) will apply to active settings where there is sufficient stream power and/or sediment flux for channels to incise at the rate of rock uplift. Post-orogenic settings of decreased (or zero) active rock uplift would be characterized by a Davisian scheme of declining slope angles and non-steady-state (or transient) landscapes. Such post-orogenic landscapes deserve much more attention than they have received of late, not least because the intriguing questions they pose about the preservation of ancient landscapes were hinted at in passing in the 1960s and have recently re-surfaced. As we begin to ask again some of the grand questions that lay at the heart of geomorphology in its earliest days, large-scale geomorphology is on the threshold of another ,golden' era to match that of the first half of the 20th century, when cyclical approaches underpinned virtually all geomorphological work. Copyright © 2007 John Wiley & Sons, Ltd. [source]

    Geological controls on the formation of alluvial meanders and floodplain wetlands: the example of the Klip River, eastern Free State, South Africa

    EARTH SURFACE PROCESSES AND LANDFORMS, Issue 8 2002
    S. Tooth
    Abstract Floodplain wetlands are common features of rivers in southern Africa, but they have been little studied from a geological or geomorphological perspective. Study of the upper Klip River, eastern Free State, South Africa, indicates strong geological controls on the formation of alluvial meanders and associated floodplain wetlands. Along this river, pronounced and abrupt changes in valley width are strongly linked to lithological variations. Where weakly cemented sandstone crops out, the Klip has laterally eroded bedrock and carved valleys up to 1500 m wide. In these valleys, the river meanders (sinuosity up to ,1·75) on moderate gradients (<0·001) within extensive floodplains marked by numerous oxbow lakes, backswamps and abandoned channels, many of which host substantial wetlands. In contrast, where highly resistant dolerite crops out, lateral erosion of bedrock is restricted, with the Klip tending instead to erode vertically along joints or fractures. Here, valleys are narrower (<200 m), channel-bed gradients are steeper (>0·003), the river follows a much straighter course (sinuosity ,1·10,1·34), and floodplains are restricted in width. Long-term landscape development in the Klip and numerous similar catchments depends on the interaction between fluvial processes in the sandstone and dolerite valleys. In the sandstone valleys, vertical erosion rates are controlled by erosion rates of the more resistant dolerites downstream. Hence, in the short- to medium-term (decades to tens of thousands of years), lateral erosion dominates over vertical erosion, with the river concomitantly planing sandstone in the channel floor and reworking floodplain sediments. The thickness of alluvial fill in the sandstone valleys is limited (<4 m), but the resultant meanders are naturally dynamic, with processes such as point bar deposition, cutoff formation and channel avulsion resulting in an assemblage of fluvial landforms. In the longer term (greater than tens of thousands of years), however, vertical erosion will occur in the sandstone valleys as the downstream dolerites are lowered by erosion, resulting in channel incision, floodplain abandonment, and desiccation of the wetlands. Identification of the geological controls on meander and wetland formation provides information vital for the design of effective management guidelines for these ecologically rich habitats, and also contributes to a better understanding of rivers that are intermediate between fully alluvial and fully bedrock. Copyright © 2002 John Wiley & Sons, Ltd. [source]

    Commentary on Blanken et al. (2010): Long-term heroin-assisted treatment,some more questions and answers

    ADDICTION, Issue 2 2010
    NICHOLAS LINTZERIS
    No abstract is available for this article. [source]

    Long-term corrosion-induced copper runoff from natural and artificial patina and its environmental impact,

    ENVIRONMENTAL TOXICOLOGY & CHEMISTRY, Issue 3 2006
    Sofia Bertling
    Abstract The overall objective of this paper is to present an extensive set of data for corrosion-induced copper dispersion and its environmental interaction with solid surfaces in the near vicinity of buildings. Copper dispersion is discussed in terms of total copper flows, copper speciation and bioavailability at the immediate release situation, and its changes during transport from source to recipient. Presented results are based on extensive field exposures (eight years) at an urban site, laboratory investigations of the runoff process, published field data, generated predictive site-specific runoff rate models, and reactivity investigations toward various natural and manmade surfaces, such as those in soil, limestone, and concrete. Emphasis is placed on the interaction of copper-containing runoff water with different soil systems through long-term laboratory column investigations. The fate of copper is discussed in terms of copper retention, copper chemical speciation, breakthrough capacities, and future mobilization based on changes in copper concentrations in the percolate water, computer modeling using the Windermere Humic Aqueous Model, and sequential extractions. The results illustrate that, for scenarios where copper comes in extensive contact with solid surfaces, such as soil and limestone, a large fraction of released copper is retained already in the immediate vicinity of the building. In all, both the total copper concentration in runoff water and its bioavailable part undergo a significant and rapid reduction. [source]

    Trends in water quality and discharge confound long-term warming effects on river macroinvertebrates

    FRESHWATER BIOLOGY, Issue 2 2009
    ISABELLE DURANCE
    Summary 1.,Climate-change effects on rivers and streams might interact with other pressures, such as pollution, but long-term investigations are scarce. We assessed trends among macroinvertebrates in 50 southern English streams in relation to temperature, discharge and water quality over 18 years (1989,2007). 2.,Long-term records, coupled with estimates from inter-site calibrations of 3,4 years, showed that mean stream temperatures in the study area had increased by 2.1,2.9 °C in winter and 1.1,1.5 °C in summer over the 26 year period from 1980 to 2006, with trends in winter strongest. 3.,While invertebrate assemblages in surface-fed streams were constant, those in chalk-streams changed significantly during 1989,2007. Invertebrate trends correlated significantly with temperature, but effects were spurious because (i) assemblages gained taxa typical of faster flow or well-oxygenated conditions, contrary to expectations from warming; (ii) more invertebrate families increased in abundance than declined and (iii) concomitant changes in water quality (e.g. declining orthophosphate, ammonia and biochemical oxygen demand), or at some sites changes in discharge, explained more variation in invertebrate abundance and composition than did temperature. 4.,These patterns were reconfirmed in both group- and site-specific analyses. 5.,We conclude that recent winter-biased warming in southern English chalk-streams has been insufficient to affect invertebrates negatively over a period of improving water quality. This implies that positive management can minimize some climate-change impacts on stream ecosystems. Chalk-stream invertebrates are sensitive, nevertheless, to variations in discharge, and detectable changes could occur if climate change alters flow pattern. 6.,Because climatic trends now characterize many inter-annual time-series, we caution other investigators to examine whether putative effects on ecological systems are real or linked spuriously to other causes of change. [source]

    Comparison of Pb Purification by Anion-Exchange Resin Methods and Assessment of Long-Term Reproducibility of Th/U/Pb Ratio Measurements by Quadrupole ICP-MS

    GEOSTANDARDS & GEOANALYTICAL RESEARCH, Issue 2 2009
    Balz S. Kamber
    échange d'anions; purification de Pb; élimination de matrice A comparison between HBr-HCl and HBr-HNO3 based anion chemistry is presented to test the efficiency of Pb purification in the preparation of samples for isotope ratio measurement by ICP-MS. It was found that the small advantages in yield and blank offered by the HNO3 -based method were more than compensated by the more effective matrix removal of the HCl-based method. Apart from very zinc rich matrices (e.g., sphalerite), a careful single pass purification using HBr and HCl removed more than 99.9% of the matrix. In preparation for the isotope ratio analysis, a small (2,5% m/v) liquid sample aliquot was analysed to determine U, Th and Pb concentrations by solution quadrupole ICP-MS. This allowed accurate prediction of the expected ion signal and permitted optimal spiking with Tl, if desired, for mass bias correction. Long-term results for international rock reference materials showed reproducibilities of better than 1% (Th/U) and 1.5% (U/Pb). For most geological applications, such analyses obviate the need for isotope dilution concentration measurements. Les échantillons dont on veut mesurer la composition isotopique de Pb par ICP-MS sont préparés par élution sur résines anioniques. Une comparaison a été effectuée entre la chimie utilisant HBr-HCl et celle utilisant HBr-HNO3, pour vérifier leurs efficacités respectives. On montre que le léger avantage présenté par HNO3 pour ce qui concerne la qualité des blancs et le rendement était plus que compensé par la bien meilleure élimination de la matrice effectuée par la méthode utilisant HCl. A l'exception des matrices très riches en zinc (par ex sphalérite) une seule purification soigneuse avec HBr et HCl éliminait plus de 99.9% de la matrice. Pour préparer l'analyse isotopique, un petit volume (2,5% m/v) était prélevé afin d'analyser les concentrations en U, Th et Pb par ICP-MS à quadrupôle. Ceci permettait de prédire de façon précise l'intensité du signal espérée et d'optimiser la quantité de solution de spike de Tl à mettre si on souhaite corriger ainsi le biais de masse. Les résultats sur le long terme obtenus sur des roches, matériaux de référence internationale, ont montré des reproductibilités meilleures que 1% (Th/U) et 1.5% (U/Pb). Pour la plupart des applications, des analyses de cette qualité suppriment le besoin de mesures de concentrations par dilution isotopique. [source]

    Increasing ocean temperatures allow tropical fishes to survive overwinter in temperate waters

    GLOBAL CHANGE BIOLOGY, Issue 2 2010
    WILL F. FIGUEIRA
    Abstract The southeast coast of Australia is a global hotspot for increasing ocean temperatures due to climate change. The temperate incursion of the East Australian Current (EAC) is increasing, affording increased connectivity with the Great Barrier Reef. The survival of tropically sourced juveniles over the winter is a significant stumbling block to poleward range shifts of marine organisms in this region. Here we examine the dependence of overwintering on winter severity and prewinter recruitment for eight species of juvenile coral reef fishes which are carried into temperate SE Australia (30,37 °S) by the EAC during the austral summer. The probability of persistence was most strongly influenced by average winter temperature and there was no effect of recruitment strength. Long-term (138 years) data indicate that winter water temperatures throughout this region are increasing at a rate above the global average and predictions indicate a further warming of >2 °C by the end of the century. Rising ocean temperatures are resulting in a higher frequency of winter temperatures above survival thresholds. Current warming trajectories predict 100% of winters will be survivable by at least five of the study species as far south as Sydney (34 °S) by 2080. The implications for range expansions of these and other species of coral reef fish are discussed. [source]

    Squamous cell carcinoma arising in the skin of a deltopectoral flap 27 years after pharyngeal reconstruction,

    HEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 1 2002
    Tim A. Iseli MBBS
    Abstract Background Development of a second primary squamous cell carcinoma in the skin of a flap used for pharyngeal reconstruction is rare. Methods A case of squamous cell carcinoma is presented arising in a deltopectoral flap used to reconstruct the hypopharynx 27 years after total laryngectomy. Three previous reports found on review of the literature are summarized. Results A second primary squamous cell carcinoma may arise in the skin of a myocutaneous flap in the absence of any obvious risk factors. Conclusion We suspect that long-term exposure of the skin of the flap lining the pharynx to saliva may have been a significant factor in the development of this malignancy. Long-term follow up and awareness of this complication is required for patients with soft tissue reconstruction of the oral cavity and pharynx. © 2002 John Wiley & Sons, Inc. Head Neck 24: 87,90, 2002. [source]

    Long-term Follow up of Helicobacter pylori IgG Serology After Eradication and Reinfection Rate of H. pylori in South Korea

    HELICOBACTER, Issue 4 2008
    Jung Hoon Lee
    Abstract Background: Serology is widely used for epidemiologic research of Helicobacter pylori. However, there is limited information on the long-term follow up of H. pylori titers after eradication. In addition, it is presumed that the reinfection rate decreases as the H. pylori infection rate decreases. The aim of this study was to investigate the long-term follow up of H. pylori IgG, and to evaluate the reinfection rate of H. pylori in Korea. Methods: Among 247 patients, who were enrolled during 2003,07, 185 patients with invasive H. pylori test positive received proton pump inhibitor-based triple therapy, and follow-up H. pylori testing, including histology, CLOtest, culture, and serology, were evaluated 2, 10, and 18 months after H. pylori eradication. Results: The initial H. pylori IgG optical density (OD450nm), 2.06, gradually decreased to 0.63 (67% reduction) at 18 months after H. pylori eradication. The seroreversion rate was 5, 10, and 45% at 2, 10, and 18 months after H. pylori eradication, respectively. The recrudescence of H. pylori was 3.49%, and the annual reinfection rate was 2.94% per year. H. pylori IgG titers abruptly increased in cases with recrudescence and reinfection, and correlated with the results of the invasive H. pylori tests. Conclusion: The results of this study showed that H. pylori IgG serology could be used for the determination of reinfection of H. pylori, but not for the diagnosis of H. pylori eradication. The reinfection rate of H. pylori, in Korea, was found to be very low, 2.94% per year. [source]

    Long-term outcome (35 years) of hepatitis C after acquisition of infection through mini transfusions of blood given at birth

    HEPATOLOGY, Issue 1 2004
    Maria Antonietta Casiraghi
    Long-term follow up studies of hepatitis C virus (HCV) infection rarely exceed 20,25 yr. We studied the outcome of HCV infection in 35-yr-old adults infected at birth (1968) through mini transfusions of blood. A retrospective-prospective study was carried out. The cohort included 31 individuals who were given mini blood transfusions (21,30 ml) collected from a donor subsequently revealed to be HCV infected. At enrollment (1998), 18 of 31 (58.1%) recipients had anti-HCV antibody and 16 (88.9%) of them were HCV-RNA positive. All viremic recipients and the infectious donor had the same genotype 1b. Sequence analysis of E1/E2 and NS5b regions, coupled with phylogenetic analysis, indicated that HCV isolates from donor/recipients were linked. Eleven of the 16 viremic recipients gave consent to liver biopsy. Nine had no fibrosis or mild portal fibrosis and 2 had either discrete (Ishak's staging 3) or marked (Ishak's staging 4) fibrosis. During the prospective follow-up period (1998,2003), 2 patients were given therapy, one of whom achieved sustained clinical and virologic response. A second biopsy, performed in 5 patients at a 5 yr interval, revealed no substantial modifications in 4 cases and progression from absence of fibrosis to mild portal fibrosis in the fifth. In conclusion, taking into account the limited study sample, these findings suggest that HCV infection acquired early in life shows a slow progression and mild outcome during the first 35 yr of infection. (HEPATOLOGY 2004;39:90,96.) [source]

    Complex HBV populations with mutations in core promoter, C gene, and pre-S region are associated with development of cirrhosis in long-term renal transplant recipients

    HEPATOLOGY, Issue 2 2002
    Petra Preikschat
    Long-term immunosuppressed renal transplant recipients with chronic hepatitis B virus (HBV) infection often develop liver cirrhosis (LC) and end-stage liver disease (ESLD). This study investigated accumulation and persistence of specific HBV mutants in relation to the clinical course in these patients (n = 38; mean follow-up, 3.5 years). HBV was analyzed longitudinally via length polymorphism of polymerase chain reaction (PCR) fragments (median, 6.5 serum samples per patient) as well as by cloning and partial sequencing of 346 full-length HBV genomes. Fourteen patients (group 1) developed LC or died from ESLD, whereas 24 patients (group 2) showed no evidence of LC during follow-up. Development of LC and ESLD was associated with persistence of HBV mutant populations characterized by deletions/insertions in core promoter plus deletions in the C gene and/or deletions in the pre-S region (86% of group 1 vs. 17% of group 2; P < .0001). HBV without these mutations or with core promoter mutations alone were predominantly found in group 2 (14% of group 1 vs. 75% of group 2). In patients infected with core promoter mutants, the additional appearance and persistence of deletions in the C gene and/or the pre-S region were accompanied or followed by development of LC and ESLD. The mutations were distributed on individual genomes in various combinations, leading to a high complexity of the virus population. In conclusion, these data suggest that accumulation and persistence of specific HBV populations characterized by mutations in 3 subgenomic regions play a role in pathogenesis of LC and ESLD in long-term renal transplant recipients. [source]

    Long-term (18-year) changes in sulphate concentrations in two Ontario headwater lakes and their inflows in response to decreasing deposition and climate variations

    HYDROLOGICAL PROCESSES, Issue 14 2004
    M. C. Eimers
    Abstract Sulphate concentrations in two headwater lakes and their major inflows were evaluated over an 18 year period (1980,81 to 1997,98) during which time sulphate bulk deposition declined by approximately 40%. The two lake catchments represent either end of the spectrum of acid sensitivity in the Muskoka,Haliburton region of Ontario. Between 1980 and 1998, sulphate concentrations in Harp and Plastic Lakes decreased, but the decrease was much less than expected (28% and 21% respectively) given the magnitude of change in deposition. Sulphate export in streams draining into the lakes greatly exceeded sulphate input to catchments in most years, which quantitatively explains the response of lake-sulphate concentration. Furthermore, temporal patterns in mean annual sulphate concentrations in streams were similar, and appeared to be related to climate factors. Specifically, catchment export of sulphate was greater and stream-sulphate concentrations were higher in years that had warm, dry summers, i.e. when streamflow in many catchments ceased for up to several weeks. Increased sulphate export from catchments resulted in higher sulphate concentrations in lakes, but the response of lake sulphate was not as immediate or dramatic as the response of stream sulphate to changes in catchment dryness. Factors that affect sulphate retention or export in catchments exert a strong influence on sulphate concentrations in lakes and streams and need to be considered when evaluating the response of surface water chemistry to changes in sulphate deposition. Copyright © 2004 John Wiley & Sons, Ltd. [source]

    Temporal variability of phytoplankton in a salt wedge estuary, the Swan,Canning Estuary, Western Australia

    HYDROLOGICAL PROCESSES, Issue 13 2001
    Peter A. Thompson
    Abstract The temporal cycles of variation in salinity, temperature and river flow in the Swan,Canning Estuary plus rainfall in the vicinity are examined. A ,normal' pattern is defined for rainfall and river flow based on long-term median monthly values from available historical data. Long-term monthly median rainfall and median monthly river flow were highly correlated. Deviations from the ,normal' patterns of rainfall and river flow are documented. Three years of detailed data on the temporal distribution of the algal biomass and phytoplankton community composition from the Swan,Canning Estuary are presented and discussed. Significant interannual variability in the phytoplankton biomass was observed with 1996 having a significantly lower median chlorophyll a concentration than 1995 or 1997. Different years also had pronounced differences in the timing, persistence and occurrence of algal blooms. Links with, and between, rainfall, river flow, nutrient concentrations and phytoplankton biomass are made by careful examination of the temporal patterns. Deviations from the proposed ,normal' temporal pattern of physical and chemical environmental factors relevant to the growth of phytoplankton biomass are assessed. Deviations from ,normal' rainfall and river flow, depending upon their timing and intensity, appear to be associated with occurrence of algal blooms. For example, the lack of a dinoflagellate bloom in December 1996 or January 1997 appears to be associated with a wetter than normal spring. Based upon the observed data, published reports and basic principles of algal ecology a set of predicted responses to variation in the major environmental variables (rainfall and river flow) are tabulated. The tabulated predictions are proposed as a useful tool for resource managers. Copyright © 2001 John Wiley & Sons, Ltd. [source]

    Retaliatory discourse: the politics of attack and withdrawal

    INTERNATIONAL JOURNAL OF APPLIED PSYCHOANALYTIC STUDIES, Issue 2 2006
    Lynne Layton
    Abstract Long-term and recent sociopolitical trends in the USA pull for narcissistic ways of fashioning the self and relating to others. Discourses that sustain a split between capacities for autonomy and capacities for attachment, and discourses that sustain a split between individuals and their social surround elicit omnipotent and/or submissive modes of narcissistic relating. An increasingly vulnerable and socially abandoned population, conditioned to be ashamed of its vulnerabilities and dependency, finds itself subject to discourses that pull for various splits between "us" and "them." This situation is a breeding ground for a politics of attack, or a politics of hostile withdrawal, or both. Neoconservatism fosters a politics of attack, and liberalism fosters a politics of withdrawal. Drawing on the psychoanalytic concept of "thirdness," the paper concludes that only discourses and institutions that foster interdependence, containment of vulnerability, and the bringing together of relational and autonomous capacities can counter retaliatory politics. Copyright © 2006 John Wiley & Sons, Ltd. [source]

    Problems in evaluating regional and local trends in temperature: an example from eastern Colorado, USA

    INTERNATIONAL JOURNAL OF CLIMATOLOGY, Issue 4 2002
    R. A. Pielke SR
    Abstract We evaluated long-term trends in average maximum and minimum temperatures, threshold temperatures, and growing season in eastern Colorado, USA, to explore the potential shortcomings of many climate-change studies that either: (1) generalize regional patterns from single stations, single seasons, or a few parameters over short duration from averaging dissimilar stations; or (2) generalize an average regional pattern from coarse-scale general circulation models. Based on 11 weather stations, some trends were weakly regionally consistent with previous studies of night-time temperature warming. Long-term (80 + years) mean minimum temperatures increased significantly (P < 0.2) in about half the stations in winter, spring, and autumn and six stations had significant decreases in the number of days per year with temperatures , , 17.8 °C (,0 °F). However, spatial and temporal variation in the direction of change was enormous for all the other weather parameters tested, and, in the majority of tests, few stations showed significant trends (even at P < 0.2). In summer, four stations had significant increases and three stations had significant decreases in minimum temperatures, producing a strongly mixed regional signal. Trends in maximum temperature varied seasonally and geographically, as did trends in threshold temperature days ,32.2 °C (,90 °F) or days ,37.8 °C (,100 °F). There was evidence of a sub-regional cooling in autumn's maximum temperatures, with five stations showing significant decreasing trends. There were many geographic anomalies where neighbouring weather stations differed greatly in the magnitude of change or where they had significant and opposite trends. We conclude that sub-regional spatial and seasonal variation cannot be ignored when evaluating the direction and magnitude of climate change. It is unlikely that one or a few weather stations are representative of regional climate trends, and equally unlikely that regionally projected climate change from coarse-scale general circulation models will accurately portray trends at sub-regional scales. However, the assessment of a group of stations for consistent more qualitative trends (such as the number of days less than ,17.8 °C, such as we found) provides a reasonably robust procedure to evaluate climate trends and variability. Copyright © 2002 Royal Meteorological Society [source]

    Long-term results of endoureterotomy using a holmium laser

    INTERNATIONAL JOURNAL OF UROLOGY, Issue 9 2007
    Hastuki Hibi
    Abstract: The long-term results of endoureterotomy using a holmium laser in cases of benign ureteral stricture, uretero-pelvic junction obstruction (UPJ-O) and ureteroenteric stricture were evaluated. Twenty procedures were carried out in 18 patients. Strictures were incised with a holmium laser using a fiber passed through the ureteroscope. Sixteen of the 20 procedures (80%) were successful at average follow-up of 60.5 months (range, 46,74). Stricture recurred in four cases. All failures occurred within 18 months. Although stricture length was not correlated with recurrence, all failures, with the exception of a single UPJ-O, involved middle ureteral strictures. Endoureterotomy using a holmium laser affords favorable results with respect to long-term patency. This procedure is recommended as a satisfactory therapeutic option for the initial management of patients presenting with ureteral stricture. [source]