433 research outputs found
Treatment of cancer with cryochemotherapy
Cryosurgery employs freezing to destroy solid tumours. However, frozen cells can survive and cause cancer recurrence. Bleomycin, an anticancer drug with a huge intrinsic cytotoxicity is normally not very effective because it is nonpermeant. We report that freezing facilitates bleomycin penetration into cells making it toxic to cryosurgery surviving cells at concentrations that are non-toxic systemically
VA residential substance use disorder treatment program providersâ perceptions of facilitators and barriers to performance on pre-admission processes
Abstract Background In the U.S. Department of Veterans Affairs (VA), residential treatment programs are an important part of the continuum of care for patients with a substance use disorder (SUD). However, a limited number of program-specific measures to identify quality gaps in SUD residential programs exist. This study aimed to: (1) Develop metrics for two pre-admission processes: Wait Time and Engagement While Waiting, and (2) Interview program management and staff about program structures and processes that may contribute to performance on these metrics. The first aim sought to supplement the VAâs existing facility-level performance metrics with SUD program-level metrics in order to identify high-value targets for quality improvement. The second aim recognized that not all key processes are reflected in the administrative data, and even when they are, new insight may be gained from viewing these data in the context of day-to-day clinical practice. Methods VA administrative data from fiscal year 2012 were used to calculate pre-admission metrics for 97 programs (63 SUD Residential Rehabilitation Treatment Programs (SUD RRTPs); 34 Mental Health Residential Rehabilitation Treatment Programs (MH RRTPs) with a SUD track). Interviews were then conducted with management and front-line staff to learn what factors may have contributed to high or low performance, relative to the national average for their program type. We hypothesized that speaking directly to residential program staff may reveal innovative practices, areas for improvement, and factors that may explain system-wide variability in performance. Results Average wait time for admission was 16Â days (SUD RRTPs: 17Â days; MH RRTPs with a SUD track: 11Â days), with 60% of Veterans waiting longer than 7Â days. For these Veterans, engagement while waiting occurred in an average of 54% of the waiting weeks (range 3â100% across programs). Fifty-nine interviews representing 44 programs revealed factors perceived to potentially impact performance in these domains. Efficient screening processes, effective patient flow, and available beds were perceived to facilitate shorter wait times, while lack of beds, poor staffing levels, and lengths of stay of existing patients were thought to lengthen wait times. Accessible outpatient services, strong patient outreach, and strong encouragement of pre-admission outpatient treatment emerged as facilitators of engagement while waiting; poor staffing levels, socioeconomic barriers, and low patient motivation were viewed as barriers. Conclusions Metrics for pre-admission processes can be helpful for monitoring residential SUD treatment programs. Interviewing program management and staff about drivers of performance metrics can play a complementary role by identifying innovative and other strong practices, as well as high-value targets for quality improvement. Key facilitators of high-performing facilities may offer programs with lower performance useful strategies to improve specific pre-admission processes
Avaliação sorolĂłgica, clĂnica e epidemiolĂłgica da toxocarĂase em ĂĄreas urbanas do sul do Brasil
Toxocariasis is a worldwide public-health problem that poses major risks to children who may accidentally ingest embryonated eggs of Toxocara. The objectives of this study were to investigate the occurrence of anti-Toxocara spp. antibodies in children and adolescents and the variables that may be involved, as well as environmental contamination by Toxocara spp. eggs, in urban recreation areas of north central mesoregion, ParanĂĄ State, Brazil. From June 2005 to March 2007. a total of 376 blood samples were collected by the Public Health Service from children and adolescents one to 12 years old, of both genders. Samples were analyzed by the indirect ELISA method for detection of anti-Toxocara antibodies. Serum samples were previously absorbed with Ascaris suum antigens, and considered positive with a reagent reactivity index >;1. Soil samples from all of the public squares and schools located in the four evaluated municipalities that had sand surfaces (n = 19) or lawns (n = 15) were analyzed. Of the 376 serum samples, 194 (51.6%) were positive. The seroprevalence rate was substantially higher among children aging one to five years (p = 0.001) and six to eight years (p = 0.022). The clinical signs and symptoms investigated did not show a statistical difference between seropositive and seronegative individuals (p >; 0.05). In 76.5% of the investigated recreation places, eggs of Toxocara were detected in at least one of the five collected samples. Recreation areas from public schools were 2.8 times more contaminated than from public squares. It is important to institute educational programs to inform families and educators, as well as to improve sanitary control of animals and cleaning of the areas intended for recreation in order to prevent toxocariasis.A toxocarĂase Ă© um problema de saĂșde pĂșblica mundial, com maior risco para crianças que podem, acidentalmente, ingerir ovos embrionados de Toxocara spp.. Os objetivos deste estudo foram avaliar a ocorrĂȘncia de anticorpos anti-Toxocara spp. em crianças e adolecentes e as variĂĄveis que podem estar envolvidas, bem como a contaminação ambiental por ovos de Toxocara spp., em locais de recreação, em ĂĄreas urbanas da mesorregiĂŁo norte central, ParanĂĄ, Brasil. De junho de 2005 a março de 2007 foram coletadas 376 amostras de sangue de crianças e adolescentes de um a doze anos, de ambos os sexos, atendidas pelo Sistema Ănico de SaĂșde. As amostras foram analisadas pelo mĂ©todo de ELISA indireto para detecção de IgG anti-Toxocara e previamente absorvidas com antĂgeno de Ascaris suum. Foram consideradas reagentes as amostras com Ăndice de reatividade >; 1. A anĂĄlise das amostras de areias (n = 19) e gramados (n = 15) de cada municĂpio foi realizada em todas as praças e escolas pĂșblicas. Das 376 amostras de soro, 194 (51,6%) foram positivas. A taxa de soroprevalĂȘncia foi substancialmente mais elevada entre as crianças na faixa etĂĄria de atĂ© um a cinco (p = 0.001) e de seis a oito anos de idade (p = 0,022). Os sinais e sintomas clĂnicos investigados nĂŁo mostraram diferenças estatĂsticas entre soropositivos e soronegativos (p >; 0,05). Em 76,5% dos locais de recreação investigados, ovos de Toxocara foram detectados em pelo menos uma das cinco amostras. Os locais de recreação das escolas pĂșblicas estavam 2,8 vezes mais contaminados do que as praças. Ă importante a realização de programas educativos junto Ă s famĂlias e educadores, o controle sanitĂĄrio de animais e a higienização dos locais destinados Ă recreação para prevenção da toxocarĂase
Measurement of the cross-section ratio sigma_{psi(2S)}/sigma_{J/psi(1S)} in deep inelastic exclusive ep scattering at HERA
The exclusive deep inelastic electroproduction of and
at an centre-of-mass energy of 317 GeV has been studied with the ZEUS
detector at HERA in the kinematic range GeV,
GeV and GeV, where is the photon virtuality, is the
photon-proton centre-of-mass energy and is the squared four-momentum
transfer at the proton vertex. The data for GeV were taken in
the HERA I running period and correspond to an integrated luminosity of 114
pb. The data for GeV are from both HERA I and HERA II
periods and correspond to an integrated luminosity of 468 pb. The decay
modes analysed were and for the
and for the . The cross-section ratio
has been measured as a function of
and . The results are compared to predictions of QCD-inspired
models of exclusive vector-meson production.Comment: 24 pages, 8 figure
Measurement of neutral current e+/-p cross sections at high Bjorken x with the ZEUS detector
The neutral current e+/-p cross section has been measured up to values of
Bjorken x of approximately 1 with the ZEUS detector at HERA using an integrated
luminosity of 187 inv. pb of e-p and 142 inv. pb of e+p collisions at sqrt(s) =
318GeV. Differential cross sections in x and Q2, the exchanged boson
virtuality, are presented for Q2 geq 725GeV2. An improved reconstruction method
and greatly increased amount of data allows a finer binning in the high-x
region of the neutral current cross section and leads to a measurement with
much improved precision compared to a similar earlier analysis. The
measurements are compared to Standard Model expectations based on a variety of
recent parton distribution functions.Comment: 39 pages, 9 figure
High-E_T dijet photoproduction at HERA
The cross section for high-E_T dijet production in photoproduction has been
measured with the ZEUS detector at HERA using an integrated luminosity of 81.8
pb-1. The events were required to have a virtuality of the incoming photon,
Q^2, of less than 1 GeV^2 and a photon-proton centre-of-mass energy in the
range 142 < W < 293 GeV. Events were selected if at least two jets satisfied
the transverse-energy requirements of E_T(jet1) > 20 GeV and E_T(jet2) > 15 GeV
and pseudorapidity requirements of -1 < eta(jet1,2) < 3, with at least one of
the jets satisfying -1 < eta(jet) < 2.5. The measurements show sensitivity to
the parton distributions in the photon and proton and effects beyond
next-to-leading order in QCD. Hence these data can be used to constrain further
the parton densities in the proton and photon.Comment: 36 pages, 13 figures, 20 tables, including minor revisions from
referees. Accepted by Phys. Rev.
Inclusive jet cross sections and dijet correlations in photoproduction at HERA
Inclusive jet cross sections in photoproduction for events containing a
meson have been measured with the ZEUS detector at HERA using an integrated
luminosity of . The events were required to have a
virtuality of the incoming photon, , of less than 1 GeV, and a
photon-proton centre-of-mass energy in the range . The measurements are compared with next-to-leading-order (NLO) QCD
calculations. Good agreement is found with the NLO calculations over most of
the measured kinematic region. Requiring a second jet in the event allowed a
more detailed comparison with QCD calculations. The measured dijet cross
sections are also compared to Monte Carlo (MC) models which incorporate
leading-order matrix elements followed by parton showers and hadronisation. The
NLO QCD predictions are in general agreement with the data although differences
have been isolated to regions where contributions from higher orders are
expected to be significant. The MC models give a better description than the
NLO predictions of the shape of the measured cross sections.Comment: 43 pages, 12 figures, charm jets ZEU
Measurement of (anti)deuteron and (anti)proton production in DIS at HERA
The first observation of (anti)deuterons in deep inelastic scattering at HERA
has been made with the ZEUS detector at a centre-of-mass energy of 300--318 GeV
using an integrated luminosity of 120 pb-1. The measurement was performed in
the central rapidity region for transverse momentum per unit of mass in the
range 0.3<p_T/M<0.7. The particle rates have been extracted and interpreted in
terms of the coalescence model. The (anti)deuteron production yield is smaller
than the (anti)proton yield by approximately three orders of magnitude,
consistent with the world measurements.Comment: 26 pages, 9 figures, 5 tables, submitted to Nucl. Phys.
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