Trends of Obesity in 10-Years of Follow-up among Tehranian Children and Adolescents: Tehran Lipid and Glucose Study (TLGS)

Background: We aimed to investigate the trend of childhood obesity in Tehranian population during a median follow-up of 10 years. Methods: Within a prospective cohort study, using data collected from Tehran Lipid and Glucose Study (TLGS), 1406 participants, aged 3-11 yr were selected and monitored in 4 phases: phase I (1999-2001), phase II (2002–2005), phase III (2006–2008) and phase IV (2009–2011). Results: Total prevalence of obesity in children increased from 5.5% to 9.4% from phase I to IV. Performing GEE (Generalized Estimating Equation) analysis, relative risk of obesity was calculated, comparing each phase to its previous phase: phase II in reference to phase I (RR=1.06, CI=1.04-1.08), phase III in reference to phase II (RR=1.01, CI=1.00-1.03) and phase IV in reference to phase III (RR=0.96, CI=0.94-0.98). Between group difference was significant in all subgroups (age, gender, parental obesity) except parental education. Test of interaction for effect of time was insignificant in all subgroups except for the age group. For children younger than 7 yr old at phase I, trend of obesity throughout the study was higher compared to those with 7 yr of age and older at phase I. Conclusion: During a decade of follow-up, trend of obesity was rising in this Tehranian children in both genders, especially in younger children. Any preventive interventions for stopping this trend should focus on early stages of childhood.

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Holmium-166 (166Ho)-DOTMP Skeletal Targeted Radiotherapy (STR™) with Melphalan and Autologous Peripheral Stem Cell Transplant (PBSCT) for Multiple Myeloma (MM).

Blood ◽

10.1182/blood.v104.11.922.922 ◽

2004 ◽

Vol 104 (11) ◽

pp. 922-922 ◽

Cited By ~ 2

Author(s):

Mark Goodman ◽

William I. Bensinger ◽

Sergio Giralt ◽

Donna Salzman ◽

Katherine L. Ruffner ◽

...

Keyword(s):

Phase I ◽

Phase Ii ◽

Hemorrhagic Cystitis ◽

Conditioning Regimen ◽

Complete Response ◽

Phase Iii ◽

High Dose ◽

Cell Transplant ◽

Red Marrow

Abstract Background: 166Ho-DOTMP is a beta-emitting radiophosphonate that localizes specifically to the bone surfaces and can deliver high dose radiation both to the bone and bone marrow. Follow-up data from 3 clinical trials with STR as conditioning for patients with MM undergoing autologous PBSCT are presented. Methods: In 2 Phase I/II dose-escalation trials, 83 patients received a dose of 166Ho-DOTMP STR calculated to deliver 20, 30, or 40 Gy to the red marrow; 82 pts received melphalan (140 or 200 mg/m2) ± 8 Gy TBI (n=25), followed by PBSCT. As of June, 2004, 77 subjects have been followed for at least 48 months. In a separate Phase II dosimetry trial, 12 patients received two 30 mCi tracer doses of 166Ho-DOTMP STR to determine the reproducibility of biodistribution and pharmacokinetics (PK). All pts received a 25 Gy therapy dose with concurrent IV hydration and continuous bladder irrigation, followed by 200 mg/m2 melphalan and PBSCT. These patients have been followed for at least 18 months. Results: Up to 2.3 Ci/m2, 166Ho-DOTMP STR was given in the Phase I/II trials; 29/83 (35%) patients achieved complete response (CR) and overall response rate (CR + PR) was 64% (7 pts not evaluable). The Kaplan-Meier estimate of median survival is 5.2 years for all 83 patients. In patients who are at least 4 years post transplant who achieved a CR, the survival is 74% (n=27). In patients who achieved less than a CR at least 4 years ago, the survival is 34% (n=44). Dose-related radiation-induced kidney toxicity presented in some patients more than 6 months post-therapy. The dose of 166Ho-DOTMP STR in the Phase II dosimetry trial was 550 to 860 mCi/m2, 166Ho-DOTMP. Currently, 18 months of follow-up reveals no occurrence of hemorrhagic cystitis or > Grade 2 elevated creatinine. A CR rate of 17% with an overall survival of 92%, was observed. In 10 patients who received 166Ho-DOTMP STR 750 mCi/m2 ± 10% in the Phase I/II trial, the CR rate was 40%, and the 4-year survival was 70%. Monitoring for safety and duration of response is ongoing in all 3 trials. Conclusion: Follow-up from the Phase I/II trials confirms that 166Ho-DOTMP STR provides favorable efficacy and safety as part of the conditioning regimen for patients with MM undergoing PBSCT. A Phase III, randomized multicenter study is now open to enrollment, comparing the safety and efficacy of 166Ho-DOTMP STR plus melphalan to melphalan alone as conditioning for PBSCT in subjects with primary refractory MM who have failed to respond to induction therapy, including high-dose dexamethasone, and are within 18 months of diagnosis.

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Hemispheric Brain Dominance and Mathematics Performance of Western Visayas College of Science and Technology Students – Phase IV

Proceedings Journal of Interdisciplinary Research ◽

10.21016/irrc.2015.ma21wf38o ◽

2015 ◽

Vol 2 ◽

pp. 111-119 ◽

Cited By ~ 1

Author(s):

Belinda M. Go ◽

Doly Joy C. Celindro

Keyword(s):

Phase I ◽

Phase Ii ◽

Mathematics Performance ◽

Phase Iii ◽

Brain Dominance ◽

Brain Hemisphere ◽

Bachelor Of Science ◽

Left Brain ◽

Right Brain ◽

Phase Iv

This is the last phase of a four-year study which aimed to determine the significance of the difference in the mathematics (math) performance of the participants when grouped according to their hemispheric dominance (HD). The study was anchored in the Split-Brain or Lateralization Theory of Roger Wolcott Sperry which states that the brain is divided into two hemispheres, the left, and the right hemisphere. The participants were eighty-eight (88) fourth-year college students from the courses of Bachelor of Science in Mathematics (BSM), Bachelor of Science in Education major in Mathematics (BSEd), Bachelor of Science in Electrical Engineering (BSEE), Bachelor of Science in Electronics and Communication Engineering (BSECE), and Bachelor of Science in Mechanical Engineering major in Automotive Engineering (BSMEAE) at Western Visayas College of Science and Technology SY 2014-2015. The participants’ HD was determined by the use of a researcher-made 46-item Hemispheric Brain Dominance Test while their mathematics performance was based on their Math classes average final grades. The statistical tools used were the mean, standard deviation, Mann-Whitney, Kruskal-Wallis, and Post hoc tests. The hypothesis was set at the 0.05 alpha level. As an entire group, the left brain was the dominant brain hemisphere among the participants from phase I to phase IV. When the participants were grouped according to program in phase I, the BSM, BSEd, and BSMEAE was left-brain dominant while the BSEE participants were right-brain dominant. The BSECE had an equal number of left-brained and right-brained participants. In phase II, the dominant brain hemisphere was the left brain. Only the BSEE participants were right-brain dominant. In phase III, the dominant brain hemisphere was the left brain, except for the BSMEAE where there was an equal number of left-brained and right-brained participants. In phase IV, all participants from the different programs were left-brained. Only the BSEE participants were right-brain dominant. As an entire group, phase I and II participants had “fair” mathematics performance; phase III had “good” mathematics performance, and phase IV had “very good” mathematics performance. When the participants who were right-brained were grouped according to mathematics performance, phase I had “conditional” mathematics performance; phase II and III had “fair” mathematics performance; and phase IV had “good” mathematics performance. Those who were left-brain dominant had “fair” mathematics performance in phase I, “good” mathematics performance in phase II and III, and “very good” mathematics performance in phase IV. In all phases of the study, significant differences existed in the level of mathematics performance when the participants were grouped according to their hemispheric brain dominance. The “left-brained” performed better in mathematics than the “right-brained”. There was a significant decrease in the enrolment of participants who were right-brain dominant because they shifted to other courses or they transferred to other schools. In phases, I, II and III, significant differences existed in the level of mathematics performance when the participants were grouped according to their program. There is no significant difference in the hemispheric brain dominance of the participants when grouped according to the phase of the study. This implies that the slight changes in the hemispheric brain dominance of the participants were not significant in the last four years.

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The four phases of esophageal bolus transit defined by high-resolution impedance manometry and fluoroscopy

AJP Gastrointestinal and Liver Physiology ◽

10.1152/ajpgi.00148.2014 ◽

2014 ◽

Vol 307 (4) ◽

pp. G437-G444 ◽

Cited By ~ 30

Author(s):

Zhiyue Lin ◽

Brandon Yim ◽

Andrew Gawron ◽

Hala Imam ◽

Peter J. Kahrilas ◽

...

Keyword(s):

High Resolution ◽

Phase I ◽

Phase Ii ◽

Intrathoracic Pressure ◽

Phase Iii ◽

Esophageal Disease ◽

Esophageal Wall ◽

Slow Increase ◽

Bolus Transit ◽

Phase Iv

We aimed to model esophageal bolus transit based on esophageal pressure topography (EPT) landmarks, concurrent intrabolus pressure (IBP), and esophageal diameter as defined with fluoroscopy. Ten healthy subjects were studied with high-resolution impedance manometry and videofluoroscopy. Data from four 5-ml barium swallows (2 upright, 2 supine) in each subject were analyzed. EPT landmarks were utilized to divide bolus transit into four phases: phase I, upper esophageal sphincter (UES) opening; phase II, UES closure to the transition zone (TZ); phase III, TZ to contractile deceleration point (CDP); and phase IV, CDP to completion of bolus emptying. IBP and esophageal diameter were analyzed to define functional differences among phases. IBP exhibited distinct changes during the four phases of bolus transit. Phase I was associated with filling via passive dilatation of the esophagus and IBP reflective of intrathoracic pressure. Phase II was associated with auxotonic relaxation and compartmentalization of the bolus distal to the TZ. During phase III, IBP exhibited a slow increase with loss of volume related to peristalsis (auxotonic contraction) and passive dilatation in the distal esophagus. Phase IV was associated with the highest IBP and exhibited isometric contraction during periods of nonemptying and auxotonic contraction during emptying. IBP may be used as a marker of esophageal wall state during the four phases of esophageal bolus transit. Thus abnormalities in IBP may identify subtypes of esophageal disease attributable to abnormal distensibility or neuromuscular dysfunction.

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Praxisempfehlungen für psychologische Interventionen in der neurologischen Rehabilitation: Multiple Sklerose, Idiopathisches Parkinson-Syndrom und Schlaganfall

Zeitschrift für Neuropsychologie ◽

10.1024/1016-264x/a000248 ◽

2019 ◽

Vol 30 (1) ◽

pp. 45-47 ◽

Cited By ~ 1

Author(s):

Hanna Kampling ◽

Jutta Küst ◽

Niels Allert ◽

Christian Dettmers ◽

Oskar Mittag

Keyword(s):

Phase I ◽

Phase Ii ◽

Multiple Sklerose ◽

Phase Iii ◽

Interdisziplinäre Behandlung ◽

Neurologische Rehabilitation ◽

Psychologische Interventionen ◽

Diagnostik Und Therapie ◽

Diagnostik Therapie ◽

Phase Iv

Zusammenfassung. Hintergrund: Patienten mit neurologischen Erkrankungen sehen sich mit einer Vielzahl motorischer und nicht-motorischer Problemlagen konfrontiert, die eine umfassende interdisziplinäre Behandlung erfordern. Hier greift die neurologische Rehabilitation. Psychologisch fundierte Interventionen bilden dabei einen wesentlichen Baustein der multimodalen und interdisziplinären Behandlung. In der klinischen Praxis fällt es jedoch oft schwer, aus der Vielzahl von Leitlinien zu ganz bestimmten Störungsaspekten konkrete Informationen für die Behandlung zu gewinnen und auf den Einzelfall anzuwenden. Vor diesem Hintergrund wurden im Rahmen zweier Projekte evidenzbasierte Praxisempfehlungen für psychologische Interventionen in der neurologischen Rehabilitation entwickelt, die das gesamte interdisziplinäre Team darin unterstützen sollen, auf den Patienten individuell zugeschnittene Einzelfallentscheidungen treffen zu können. Methode: In Phase I des Entwicklungsprozesses wurde zunächst eine systematische Literaturrecherche (Schritt 1) und parallel eine bundesweite Befragung aller neurologischen Rehabilitationseinrichtungen hinsichtlich ihrer strukturellen und prozeduralen Gegebenheiten (Schritt 2) durchgeführt. In Phase II diskutierte und konsentierte ein interdisziplinäres Expertengremium die in Phase I erarbeitete erste Version der Praxisempfehlungen (Schritt 3). Ziel von Phase III war der Einbezug von Klinikern und Patienten, daher wurde die erste Version als Konsultationsfassung deutschlandweit an die leitenden Psychologinnen/Psychologen und Ärztinnen/Ärzte aller neurologischen Rehabilitationseinrichtungen versandt (Schritt 4) und in indikationsspezifischen Fokusgruppen mit Patienten diskutiert (Schritt 5). Rückmeldungen und Anmerkungen wurden abschließend in Phase IV mit dem Expertengremium abgestimmt und die Praxisempfehlungen final konsentiert (Schritt 6). Nachdem zunächst die Praxisempfehlungen für Patienten nach Schlaganfall entwickelt wurden, konnten in einem Folgeprojekt die Indikationsbereiche Multiple Sklerose und Idiopathisches Parkinson-Syndrom nach analogem Vorgehen in die Praxisempfehlungen Schlaganfall integriert werden. Ergebnisse: Inhaltlich unterscheiden die Praxisempfehlungen für die drei Indikationsbereiche zwei Hauptkomplexe: 1) Die Allgemeinen Vorbemerkungen einschließlich der strukturellen Rahmenbedingungen und Prozessanforderungen sowie 2) Empfehlungen zu Diagnostik und Therapie. Letztere unterteilen sich weiter in die Teile A bis E, welche 34 für die neurologische Rehabilitation relevante Aspekte abdecken und z. T. weiter unterteilt sind in Empfehlungen zu Diagnostik, Therapie, Nachsorge sowie Anmerkungen, sodass insgesamt 191 verschiedene Empfehlungsbereiche vorliegen. Adressiert werden in den Teilen A bis E die Problemlagen in den Bereichen „Partizipation – Übergeordnete Ziele der Rehabilitation“ (Teil A), „Kognition“ (Teil B), „Affektivität und Verhalten“ (Teil C), „Risikofaktoren“ (Teil D) sowie „Spezifische Aspekte und Spezielle Problemlagen“ (Teil E). Mit einer durchschnittlichen Zustimmung von jeweils 97 % (Range Schlaganfall: 88–100 %; Range Multiple Sklerose/Idiopathisches Parkinson-Syndrom: 91–100 %) wurden die Praxisempfehlungen von leitenden Psychologen und Ärzten (= Schritt 4) weit akzeptiert. Diskussion: Damit umfassen die „Praxisempfehlungen für psychologische Interventionen in der neurologischen Rehabilitation: Multiple Sklerose, Idiopathisches Parkinson-Syndrom und Schlaganfall“ detaillierte, evidenzbasierte und gleichzeitig breit konsentierte Empfehlungen, die individualisierte Einzelfallentscheidungen im gesamten interdisziplinären Team unterstützen können.

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Effect of Practicing Health Behaviors on Unmet Needs among Patients with Chronic Diseases: A Longitudinal Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18157977 ◽

2021 ◽

Vol 18 (15) ◽

pp. 7977

Author(s):

Bich-Na Jang ◽

Hwi-Jun Kim ◽

Bo-Ram Kim ◽

Seon-Yeong Woo ◽

Woo-Jin Lee ◽

...

Keyword(s):

Health Behaviors ◽

Chronic Diseases ◽

Unmet Needs ◽

Estimating Equation ◽

Correlated Data ◽

Equation Analysis ◽

Using Data ◽

High Risk Drinking ◽

The Impact

With the growing prevalence of chronic diseases, the proportion of unmet needs is increasing. In this study, we investigated the effect of practicing health behaviors on unmet needs among patients with chronic diseases, using data from the Korea Health Panel Survey conducted between 2014–2017. Participants (n = 4069) aged 19 or older, with at least one chronic disease (hypertension, diabetes mellitus, dyslipidemia, or arthrosis) and with existing follow up data were selected. Health behaviors combined three variables: not presently smoking, not belonging to high-risk drinking group, and indulging in moderate- or high-intensity exercise. Those who met all three criteria were classified as the practicing health behaviors group. Generalized Estimating Equation analysis was performed to consider correlated data within a subject. Of the participants, 23.9% practiced health behaviors. Participants who did not practice health behaviors were significantly more likely to have unmet needs compared with those who did (OR: 1.24, 95% CI: 1.10–1.39). Further research would be needed to verify the impact of practicing health behavior on unmet needs.

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Demonstration of a correlation between young leaves, apex and young bunches specific to a young grapevine cutting in the first period of its development

OENO One ◽

10.20870/oeno-one.2001.35.3.1700 ◽

2001 ◽

Vol 35 (3) ◽

pp. 117

Author(s):

Jean-Claude Fournioux

Keyword(s):

Phase I ◽

Phase Ii ◽

Inhibitory Effect ◽

Phase Iii ◽

Apical Bud ◽

Terminal Bud ◽

Young Leaves ◽

Hardwood Cutting ◽

In The Beginning ◽

Phase Iv

The development of hardwood cutting of grapevine comprise 4 succesive phases. Phase I: first period of shoot extension. Phase II: characterized by a slow growth due to a very low activity of the terminal bud. Phase III: reactivation of the growth consecutive to a resumption of the apical activity. Phase IV: when the growth becomes maximal.The objective of this work has been to identify the cause of the slowdown of the activity of apical bud during the phase II.In a first experiment, we have compared the effects of three modes of defoliation applied from the beginning of the phase II on the apical activity: total defoliation, defoliation to have two adult leaves at the base of the shoot and defoliation to have two young leaves near the apex. The results of this experiment showed that only treatments depriving the shoot of young leaves induced an activation of the plastochronic activity. So, it appeared that young leaves exercises an inhibitory effect on the apex. The same experiment has been carried out during the phase IV of cuttings development, when the apical activity was maximal. In this condition, no treatments modified the apical activity. This suggests that the inhibition of the apex by young leaves is specifie to the phase II of the develop¬ ment of a grapevine cutting. In a third experiment, we have demonstrated that the foliar inhibition persisted during the all period of the laminart growth. Cytokinins are probably implied in this competition because exogenous applications of these growth regulators during the phase II produced a stimulation of the activity of apical bud. Results of a last experiment showed that, in cuttings prerooted before budburst, the apical activity was not decreased after the phase I. In other words, in this condition, the growth of the shoot was regular without phase II. We explain this resuit as follows. The roots preformed on the cuttings produced cytokinins in sufficient quantity for provide for needs of both foliar growth and apical activity.In previous studies, MULLINS showed that abortion of the young bunches on cuttings of grapevine was due to an inhibition by deficiency in cytokinins exercised by young leaves.The present work reveales the existence of an exactly similar correlation between the young leaves and the apex. So, in the beginning of the development of a grapevine cutting, young leaves, apical bud and young bunches are implied in a common correlative process which results on the one hand from a small availability of cytokinins due to the lack of roots and, on the other hand from a more efficient sink effect towards the cytokinins for the young leaves than for the apex and young bunches.

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Outcomes for Step-Wise Implementation of a Human Papillomavirus Testing–Based Cervical Screen-and-Treat Program in El Salvador

JCO Global Oncology ◽

10.1200/go.20.00206 ◽

2020 ◽

pp. 1519-1530

Author(s):

Karla Alfaro ◽

Mauricio Maza ◽

Juan C. Felix ◽

Julia C. Gage ◽

Philip E. Castle ◽

...

Keyword(s):

Human Papillomavirus ◽

Public Sector ◽

Phase I ◽

El Salvador ◽

Phase Ii ◽

Cervical Cancer Prevention ◽

Phase Iii ◽

Hpv Testing ◽

Screening Guidelines

PURPOSE The Cervical Cancer Prevention in El Salvador (CAPE) project is a public-sector intervention introducing lower-cost human papillomavirus (HPV) testing in all four departments of the Paracentral region that screened a total of 28,015 women. After demonstrating success of an HPV screen-and-treat (S&T) algorithm over colposcopy management in the first two phases, the third phase scaled up the S&T strategy. We present results from phase III and evaluate S&T components across the entire project. METHODS During phase III, 17,965 women age 30-59 years underwent HPV testing. HPV-positive women were asked to return and, if eligible, received gas-based cryotherapy. We compare loss to follow-up and time intervals between S&T steps across the three phases. RESULTS There were no differences in HPV positivity across phases (phase I, 11.9%; phase II, 11.4%; phase III, 12.3%; P = .173). Although most HPV-positive women completed indicated follow-up procedures within 6 months in phases I (93.3%, 111 of 119) and II (92.3%, 429 of 465), this proportion declined to 74.9% (1,659 of 2,214; P < .001) in phase III. Mean days between testing and delivery of results to patients increased over program phases (phase I, 23.2 days; phase II, 46.7 days; phase III, 99.8 days; P < .001). CONCLUSION A public-sector implementation of an HPV-based S&T algorithm was successfully scaled up in El Salvador, albeit with losses in efficiency. After CAPE, the Ministry of Health changed its screening guidelines and procured additional tests to expand the program.

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Blood Supply Management Amidst COVID -19 Pandemic

10.21203/rs.3.rs-1023136/v1 ◽

2022 ◽

Author(s):

KIRTI DEVGAN ◽

Subrat Gupta ◽

VIJAY SHARMA

Keyword(s):

Phase I ◽

Blood Supply ◽

Phase Ii ◽

Whole Blood ◽

Blood Donation ◽

Supply Management ◽

Phase Iii ◽

Mass Gatherings ◽

Second Wave ◽

Phase Iv

Abstract AIMS AND OBJECTIVES: The mandatory lockdown restrictions and curtailment strategies towards mass gatherings imposed by the government amid the COVID-19 outbreak, the organization of the voluntary blood donation camps were suspended and in house donations were limited leading to scarcity of blood With this we intend to assess the effect of this mass lockdown on our blood supply management in four phases [phase-I prior to the outbreak] ,phase-II[during the outbreak], Phase-III: The declining phase [Oct20-Feb21] and Phase IV: The second wave [March21-may21] MATERIALS AND METHOD : This is a retrospective study of twenty months of a blood bank supplying to a 1200 bedded multi-specialty Tertiary Care Academic Hospital in Lucknow. The study was divided into four phases namely: • Phase-I: Pre-pandemic phase [Oct’19 to Feb’20] • Phase-II: The full-blown pandemic phase [Mar 20-Sep 20] • Phase-III: The declining phase [Oct20-Feb21] • Phase IV: The second wave [March21-may21] Details of the blood units collected both in-house as well as in the VBDC’s were used for the study. The date of collection, expiry and date of issue for each packed red blood cell [PRBC] units were noted. The components prepared from the whole blood was also noted. The average In-house donations were tabulated. The various components issued month wise was also noted. The supply of Convalescent plasma in all the three phases was tabulate RESULT: The average whole blood collection pre pandemic was 1103 units (55%), 768units (51%) in pandemic phase, 1219units (61%) in declining phase and only 692units (21%) in second wave of the pandemic. In Phase I 27 VBDC collected 1153 units (58%) and in Phase III 8 VBDC collected 236units(12%) Due to restrictions in mass gatherings and lockdown enforced, the whole blood collections from Phase II and Phase IV was 93units (6.5%) and 76units (2.2%) only. In Phase I, the average In House Donation was 33.6%, In Phase II it was12%, In Phase III was 5.75% and lastly in Phase IV was 5.4% The PRBC issued on an average in the four phases was 59%, 48%, 55% and 26% respectively. Similarly the FFP issued in Phase I , II, III and IV was 62%,34%,58% and 20%. Lastly the RDP issued was 15%, 13%, 19% and 4.5% in all the various phases. CONCLUSION: Our study concluded that COVID 19 pandemic had a negative impact on total number of In-house donations, voluntary blood donation camps, blood stock inventory and transfusion recipients along with taking a major toll on health and safety of our blood bank staff as well. With little insight of the disease and everyday learning, by motivating more voluntary donors and health care workers the efficient chain of blood supply and demand can be maintained as the virus is to stay with us for a long time.

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Structure–property correlation over five phases and four transitions in Pb5Al3F19

Acta Crystallographica Section B Structural Science ◽

10.1107/s0108768103011509 ◽

2003 ◽

Vol 59 (5) ◽

pp. 557-574 ◽

Cited By ~ 8

Author(s):

S. C. Abrahams ◽

J. Ravez ◽

H. Ritter ◽

J. Ihringer

Keyword(s):

Phase I ◽

Phase Ii ◽

Thermal Hysteresis ◽

Ambient Pressure ◽

Entropy Change ◽

Phase Iii ◽

Mode Analysis ◽

First Order ◽

Five Phases ◽

Phase Iv

The calorimetric and dielectric properties of Pb5Al3F19 in the five phases stable under ambient pressure are correlated with structure for fuller characterization of each phase. The first-order transition between ferroelectric phase V and antiferroelectric phase IV at T V,IV = 260 (5) K exhibits a thermal hysteresis of 135 (5) K on heating, with a maximum atomic displacement Δ(xyz)max = 1.21 (6) Å; the transition from phase IV to ferroelastic phase III at 315 (5) K is also first order but with a thermal hysteresis of 10 (5) K and Δ(xyz)max = 0.92 (7) Å; that from phase III to paraelastic phase II at 360 (5) K is second order without hysteresis and has Δ(xyz)max = 0.69 (4) Å; and the transition from phase II to paraelectric phase I at 670 (5) K is second or higher order, with Δ(xyz)max = 0.7 (4) Å. The measured entropy change ΔS at T V,IV agrees well with ΔS as derived from the increased configurational energy by Stirling's approximation. For all other phase transitions, 0.5 ≥ ΔS > 0 J mol−1 K−1 is consistent with an entropy change caused primarily by the changes in the vibrational energy. The structure of phase III is determined both by group theoretical/normal mode analysis and by consideration of the structures of phases II, IV and V reported previously; refinement is by simultaneous Rietveld analysis of the X-ray and neutron diffraction powder profiles. The structure of prototypic phase I is predicted on the basis of the atomic arrangement in phases II, III, IV and V. The introduction of 3d electrons into the Pb5Al3F19 lattice disturbs the structural equilibrium, the addition of 0.04% Cr3+ causing significant changes in atomic positions and increasing T IV,III by ∼15 K. Substitution of Al3+ by 20% or more Cr3+ eliminates the potential minima that otherwise stabilize phases IV, III and II.

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Bewegungstherapie und körperliche Aktivität bei Patienten mit Herzinsuffizienz

Praxis ◽

10.1024/1661-8157/a003050 ◽

2018 ◽

Vol 107 (17-18) ◽

pp. 951-958 ◽

Cited By ~ 1

Author(s):

Matthias Wilhelm

Keyword(s):

Phase I ◽

Phase Ii ◽

Körperliche Aktivität ◽

Phase Iii

Zusammenfassung. Herzinsuffizienz ist ein klinisches Syndrom mit unterschiedlichen Ätiologien und Phänotypen. Die überwachte Bewegungstherapie und individuelle körperliche Aktivität ist bei allen Formen eine Klasse-IA-Empfehlung in aktuellen Leitlinien. Eine Bewegungstherapie kann unmittelbar nach Stabilisierung einer akuten Herzinsuffizienz im Spital begonnen werden (Phase I). Sie kann nach Entlassung in einem stationären oder ambulanten Präventions- und Rehabilitationsprogramm fortgesetzt werden (Phase II). Typische Elemente sind Ausdauer-, Kraft- und Atemtraining. Die Kosten werden von der Krankenversicherung für drei bis sechs Monate übernommen. In erfahrenen Zentren können auch Patienten mit implantierten Defibrillatoren oder linksventrikulären Unterstützungssystemen trainieren. Wichtiges Ziel der Phase II ist neben muskulärer Rekonditionierung auch die Steigerung der Gesundheitskompetenz, um die Langzeit-Adhärenz bezüglich körperlicher Aktivität zu verbessern. In Phase III bieten Herzgruppen Unterstützung.

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