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Sample records for proctalgia fugax mid-term

  1. Amaurosis fugax associated with congenital vascular defect

    PubMed Central

    Giltner, John W; Thomas, Edward R; Rundell, William K

    2016-01-01

    A 68-year-old female with no significant past medical history presented with loss of vision in the lower half of her left eye that lasted <5 minutes. No abnormalities were found on ocular or physical exam. Computed tomography angiography and carotid ultrasound were performed, which confirmed the diagnosis as amaurosis fugax with two abnormalities leading to the transient retinal vessel occlusion. First, it was found that the patient has a congenital vascular anomaly, which consisted most notably of a right-sided aortic arch. This vascular anomaly also consisted of abnormal branching of the left subclavian and common carotid arteries, predisposing the patient to turbulent blood flow and increased risk of the formation of an atherosclerotic plaque at the origin of the common carotid artery. This is an abnormal location for a plaque leading to amaurosis fugax compared to the most common location at the carotid bifurcation. Endarterectomy was not performed because of the difficult location of the plaque and tortuosity of the vessel. Rather, medical intervention with antiplatelet and lipid-lowering therapy was initiated to lower the risk of future retinal or cerebral thromboembolic events. PMID:27445507

  2. LYRA Mid-Term Periodicities

    NASA Astrophysics Data System (ADS)

    Wauters, L.; Dominique, M.; Dammasch, I. E.

    2016-08-01

    The spectra of the PROBA2/LYRA data, similarly to every other solar time series, show predominant periodicities that can be of solar or instrumental origin. In this article, we compare the main periodicities characterizing the LYRA spectrum to those found in the sunspot number, in the 10.7 cm flux, in an X-ray flare index, and in the sunspot area evolution. We focused on the 2010 to 2014 time range, for which the LYRA data are available, although we also briefly address the evolution of the main periodicities in the longer range. The mid-term periodicities at {˜} 28, {˜} 44, {˜} 54, {˜} 59, {˜} 100, {˜} 110, and {˜} 150 days appear as highly significant in several analyzed datasets. The consistency of distinct periodicities between datasets provides characteristics for the global Sun. This consistency also strengthens the reliability of LYRA data.

  3. Amaurosis fugax

    MedlinePlus

    ... pressure. If you have diabetes, heart disease, or hardening of the arteries, your LDL "bad" cholesterol should ... Elsevier Saunders; 2012:chap 14. Read More Diabetes Hardening of the arteries High blood cholesterol levels High ...

  4. Amaurosis fugax

    MedlinePlus

    ... vision loss may be followed by more serious nervous system symptoms. These symptoms can be similar to those ... Tests include a complete eye and nervous system exam. The doctor ... to listen to the carotid arteries in your neck. In some cases, ...

  5. A financial indicator for mid-term tendencies

    NASA Astrophysics Data System (ADS)

    Leonel Caetano, Marco Antonio; Yoneyama, Takashi

    2007-11-01

    This work proposes an heuristic indicator for mid-term tendencies of stock prices based on non-linear dynamic equations combined with a graphical method inspired on cell morphology analysis. The model consists of ordinary differential equations with parameters that are fitted by means of the actual data history of stock prices using Extended Kalman Filter. The model structures are to be chosen so as to adequately represent the specific microeconomic condition, such as oligopoly with leader and follower, economic clusters, firms producing complementary products and others. The equations are solved numerically and the trajectories in the phase plane are associated with cell membranes. In an analogy with the increase in the cell volume when its internal pressure rises, the new financial indicator expresses the increase of the stress in a stock market by means of expanding phase portraits.

  6. Female sex pheromones of two Japanese saturniid species, Rhodinia fugax and Loepa sakaei: identification, synthesis, and field evaluation.

    PubMed

    Yan, Qi; Kanegae, Akiko; Miyachi, Takashi; Naka, Hideshi; Tatsuta, Haruki; Ando, Tetsu

    2015-01-01

    While 11 species in the family Saturniidae are found in Japan, no sex pheromones of the native species had been investigated previously. We collected larvae of Rhodinia fugax in Nagano and Tottori Prefecture, and of Loepa sakaei in Okinawa Prefecture, and extracted sex pheromones of these two species from virgin female moths. In gas chromatography-electroantennogram detection (GC-EAD) analyses, male antennae of each species responded to one component in the respective pheromone extracts of conspecific females. Chemical analyses of the extracts by GC/mass spectrometry revealed that the EAD-active compounds of R. fugax and L. sakaei were a hexadecadienal and a tetradecadienyl acetate, respectively. The two species belong to the subfamily Saturniinae, and the mass spectra of both were similar to that of the 6,11-hexadecadienyl acetate identified from Antheraea polyphemus, classified in the same subfamily, suggesting the same 6,11-dienyl structure for the C16 aldehyde and a 4,9-dienyl structure for the C14 acetate. Based on this assumption, four geometrical isomers of each dienyl compound were stereoselectively synthesized via acetylene intermediates, compared to the natural products, and tested in the field. Male catches confirmed the pheromone structures of the two Japanese saturniid species as (6E,11Z)-6,11-hexadecadienal for R. fugax and (4E,9Z)-4,9-tetradecadienyl acetate for L. sakaei. The compounds have a characteristic 1,6-dienyl motif common to the pheromones of Saturniinae species. PMID:25533776

  7. Mid-Term Probabilistic Forecast of Oil Spill Trajectories

    NASA Astrophysics Data System (ADS)

    Castanedo, S.; Abascal, A. J.; Cardenas, M.; Medina, R.; Guanche, Y.; Mendez, F. J.; Camus, P.

    2012-12-01

    There is increasing concern about the threat posed by oil spills to the coastal environment. This is reflected in the promulgation of various national and international standards among which are those that require companies whose activities involves oil spill risk, to have oil pollution emergency plans or similar arrangements for responding promptly and effectively to oil pollution incidents. Operational oceanography systems (OOS) that provide decision makers with oil spill trajectory forecasting, have demonstrated their usefulness in recent accidents (Castanedo et al., 2006). In recent years, many national and regional OOS have been setup focusing on short-term oil spill forecast (up to 5 days). However, recent accidental marine oil spills (Prestige in Spain, Deep Horizon in Gulf of Mexico) have revealed the importance of having larger prediction horizons (up to 15 days) in regional-scale areas. In this work, we have developed a methodology to provide probabilistic oil spill forecast based on numerical modelling and statistical methods. The main components of this approach are: (1) Use of high resolution long-term (1948-2009) historical hourly data bases of wind, wind-induced currents and astronomical tide currents obtained using state-of-the-art numerical models; (2) classification of representative wind field patterns (n=100) using clustering techniques based on PCA and K-means algorithms (Camus et al., 2011); (3) determination of the cluster occurrence probability and the stochastic matrix (matrix of transition of probability or Markov matrix), p_ij, (probability of moving from a cluster "i" to a cluster "j" in one time step); (4) Initial state for mid-term simulations is obtained from available wind forecast using nearest-neighbors analog method; (5) 15-days Stochastic Markov Chain simulations (m=1000) are launched; (6) Corresponding oil spill trajectories are carried out by TESEO Lagrangian transport model (Abascal et al., 2009); (7) probability maps are

  8. Teaching about the 2010 Mid-Term Election Using the Internet

    ERIC Educational Resources Information Center

    Risinger, C. Frederick

    2010-01-01

    Mid-term elections, particularly in a president's first term, can be as significant as presidential elections. They can determine whether or not a president and his party can fulfill promises and achieve goals that they set for the nation when elected. In this article, the author recommends websites that can help guide students in understanding…

  9. Nextgen Technologies for Mid-Term and Far-Term Air Traffic Control Operations

    NASA Technical Reports Server (NTRS)

    Prevot, Thomas

    2009-01-01

    This paper describes technologies for mid-term and far-term air traffic control operations in the Next Generation Air Transportation System (NextGen). The technologies were developed and evaluated with human-in-the-loop simulations in the Airspace Operations Laboratory (AOL) at the NASA Ames Research Center. The simulations were funded by several research focus areas within NASA's Airspace Systems program and some were co-funded by the FAA's Air Traffic Organization for Planning, Research and Technology.

  10. Conversion arthroplasty of the hip: mid-term results are good.

    PubMed

    Zahar, Akos; Cross, Michael B; Lakatos, Tamas; Lakatos, Jozsef; Major, Balint; Kendoff, Daniel; Szendröi, Miklos

    2015-01-01

    The historical mid-term results of conversion total hip arthroplasty (THA) are acceptable; however, the complication rates are high. In total, 39 patients (45 hips) from 2 institutions underwent conversion THA from 1993-2006 and were retrospectively evaluated. The mean age was 48.3 years, the mean follow-up time was 8.7 years, and the mean duration arthrodesis prior to conversion THA was 18.2 years. The outcomes included operative time, blood loss, leg-length discrepancy (LLD), thigh circumference, Harris Hip Score (HHS), complications, and radiographic evaluation. A total of 34 THAs were cemented, and 11 were uncemented. The mean operative time was 102 minutes, and the mean blood loss was 1019 ml. The mean HHS improved from 32.4 to 82.5 (p<0.01). The mean LLD decreased from 4.2 to 1.1 cm, while the thigh circumference increased by a mean of 1.6 cm. Complications included: a positive Trendelenburg gait (6), early haematoma that required surgical evacuation (5), dislocation (2), deep infection (1), and early aseptic loosening of the components (2). In conclusion, the functional results of the conversion THA using predominantly cemented components are good at mid-term follow-up; although the complication rates remain higher than a standard primary THA, aseptic loosening rates of the cemented components is low at mid-term follow-up. PMID:26351116

  11. Short- and Mid-term Effects of Irreversible Electroporation on Normal Renal Tissue: An Animal Model

    SciTech Connect

    Wendler, J. J. Porsch, M.; Huehne, S.; Baumunk, D.; Buhtz, P.; Fischbach, F.; Pech, M.; Mahnkopf, D.; Kropf, S.; Roessner, A.; Ricke, J.; Schostak, M.; Liehr, U.-B.

    2013-04-15

    Irreversible electroporation (IRE) is a novel nonthermal tissue ablation technique by high current application leading to apoptosis without affecting extracellular matrix. Previous results of renal IRE shall be supplemented by functional MRI and differentiated histological analysis of renal parenchyma in a chronic treatment setting. Three swine were treated with two to three multifocal percutaneous IRE of the right kidney. MRI was performed before, 30 min (immediate-term), 7 days (short-term), and 28 days (mid-term) after IRE. A statistical analysis of the lesion surrounded renal parenchyma intensities was made to analyze functional differences depending on renal part, side and posttreatment time. Histological follow-up of cortex and medulla was performed after 28 days. A total of eight ablations were created. MRI showed no collateral damage of surrounded tissue. The highest visual contrast between lesions and normal parenchyma was obtained by T2-HR-SPIR-TSE-w sequence of DCE-MRI. Ablation zones showed inhomogeneous necroses with small perifocal edema in the short-term and sharp delimitable scars in the mid-term. MRI showed no significant differences between adjoined renal parenchyma around ablations and parenchyma of untreated kidney. Histological analysis demonstrated complete destruction of cortical glomeruli and tubules, while collecting ducts, renal calyxes, and pelvis of medulla were preserved. Adjoined kidney parenchyma around IRE lesions showed no qualitative differences to normal parenchyma of untreated kidney. This porcine IRE study reveals a multifocal renal ablation, while protecting surrounded renal parenchyma and collecting system over a mid-term period. That offers prevention of renal function ablating centrally located or multifocal renal masses.

  12. The Mid-term Forecast Method of Solar Radiation Index {F}_{10.7}

    NASA Astrophysics Data System (ADS)

    Wang, H. B.; Xiong, J. N.; Zhao, C. Y.

    2014-07-01

    In the low earth orbit satellite's orbit computation, the solar radiation index F_{10.7} is an important parameter, which is usually used to describe the solar activity's effect on the thermosphere density and the orbit perturbation. So the accuracy of index F_{10.7} will affect the precision of orbit prediction. In this paper, based on the characteristics of the solar 27-day short-term activity, we bring up a forecast method of F_{10.7} which can use the historical indices of the past 135 days to predict the solar radiation indices in the next 54 days. That is to say, the method is able to forecast the variations of solar radiation for about two rotation-cycles in the future. In this paper, we compare this method with those widely-used methods. The detail results are as follows: (1) This paper's method is observably better than the traditional triangle function method; (2) In the short-term forecast (7 days) , this paper's method is little better than the method developed by Space Weather Prediction Center in America, since the root mean square could be reduced by about 19% when using this paper's method; (3) In the mid-termforecast (2 7 days), the accuracy of this paper's method is almost equal to the 54-order self-regression method which is used widely in our country. However, fewer parameters and observation data are needed in this paper's method, leading to the more convenient application in orbit computation. Moreover, on the 54th day the correlation coefficient between the prediction and actual index is still greater than 0.92, implying that the method can keep stable in mid-term forecast. All in all, the advantage of this paper's method is that it could use fewer historical indices to predict the mid-term solar radiation independent of extra solar real-time observation, and it is very helpful to the orbit short- and mid-term predictions in some space flight missions.

  13. Mid-term Stability of Novel Mica-based Compressive Seals for Solid Oxide Fuel Cells

    SciTech Connect

    Chou, Y S.; Stevenson, Jeffry W.

    2003-04-10

    A novel mica-based hybrid compressive seal was examined the stability at elevated temperatures under the compressive stress. The hybrid mica compressive seals were composed of the Muscovite mica and two compliant inter-layers and were reported earlier to have ultra-low leak rates at 800 C. In this paper, we examined the mid-term ({approx}350-700 hours) stability of the mica-based compressive seals with three different inter-layers: a low melting borosilicate glass, a glass ceramics, and a metallic material. The 800 C leak test results showed excellent stability for the three different inter-layers in air at a compressive stress of 100 psi that the leak rates remained almost unchanged during the test. Microstructure characterization of the interface showed very limited interfacial reaction or glass penetration at the 8YSZ substrate interface. The results clearly demonstrate the applicability of the mica-based compressive seals for solid oxide fuel cells.

  14. A mid-term analysis of progress toward international biodiversity targets.

    PubMed

    Tittensor, Derek P; Walpole, Matt; Hill, Samantha L L; Boyce, Daniel G; Britten, Gregory L; Burgess, Neil D; Butchart, Stuart H M; Leadley, Paul W; Regan, Eugenie C; Alkemade, Rob; Baumung, Roswitha; Bellard, Céline; Bouwman, Lex; Bowles-Newark, Nadine J; Chenery, Anna M; Cheung, William W L; Christensen, Villy; Cooper, H David; Crowther, Annabel R; Dixon, Matthew J R; Galli, Alessandro; Gaveau, Valérie; Gregory, Richard D; Gutierrez, Nicolas L; Hirsch, Tim L; Höft, Robert; Januchowski-Hartley, Stephanie R; Karmann, Marion; Krug, Cornelia B; Leverington, Fiona J; Loh, Jonathan; Lojenga, Rik Kutsch; Malsch, Kelly; Marques, Alexandra; Morgan, David H W; Mumby, Peter J; Newbold, Tim; Noonan-Mooney, Kieran; Pagad, Shyama N; Parks, Bradley C; Pereira, Henrique M; Robertson, Tim; Rondinini, Carlo; Santini, Luca; Scharlemann, Jörn P W; Schindler, Stefan; Sumaila, U Rashid; Teh, Louise S L; van Kolck, Jennifer; Visconti, Piero; Ye, Yimin

    2014-10-10

    In 2010, the international community, under the auspices of the Convention on Biological Diversity, agreed on 20 biodiversity-related "Aichi Targets" to be achieved within a decade. We provide a comprehensive mid-term assessment of progress toward these global targets using 55 indicator data sets. We projected indicator trends to 2020 using an adaptive statistical framework that incorporated the specific properties of individual time series. On current trajectories, results suggest that despite accelerating policy and management responses to the biodiversity crisis, the impacts of these efforts are unlikely to be reflected in improved trends in the state of biodiversity by 2020. We highlight areas of societal endeavor requiring additional efforts to achieve the Aichi Targets, and provide a baseline against which to assess future progress. PMID:25278504

  15. Comparative Study of Cryostripping and Endovenous Laser Therapy for Varicose Veins: Mid-Term Results

    PubMed Central

    Lee, Kwang Hyoung; Chung, Jae Ho; Kim, Kwang Taik; Lee, Sung Ho; Son, Ho Sung; Jung, Jae Seung; Kim, Hee Jung; Lee, Seung Hun

    2015-01-01

    Background Conventional stripping is considered to be the standard procedure for great saphenous vein (GSV) varicosities, but many other alternative treatments such as cryostripping, endovenous laser therapy (EVLT), radio-frequency ablation, and ultrasound-guided foam sclerotherapy have been developed. Among them, both cryostripping and laser therapy have been reported to be less traumatic, with lower rates of complications and recurrences when compared to conventional stripping. To compare the efficacy of these treatments, we have analyzed and compared the mid-term clinical outcomes of cryostripping and EVLT. Methods Patients diagnosed with varicose veins of the GSV and treated with cryostripping or laser therapy between September 2008 and April 2013 were enrolled in this study. Duplex ultrasonography was used for the diagnosis and evaluation of varicosity and reflux, and the clinical-etiology-anatomy-pathophysiology classification was used to measure the clinical severity. The symptoms, Venous Clinical Severity Score (VCSS), recurrence rates, and complication rates of the cryostripping and laser therapy groups were analyzed and compared. Results A total of 68 patients were enrolled in this study. 32 patients were treated with cryostripping, and 36 patients were treated with laser therapy. The median follow-up period was 29.6 months. Recurrence was noted in three patients from the cryostripping group and in two patients from the EVLT group. There was no difference in the VCSS score, operative time, duration of hospital stay, and complication rate between the cryostripping group and the EVLT group. Conclusion The mid-term clinical outcomes of cryostripping were not inferior to those of EVLT. Further, considering its cost-effectiveness, cryostripping seems to be a safe and feasible method for the treatment of varicose veins. PMID:26509128

  16. Mid-term Results of Revision Total Hip Arthroplasty Using Modular Cementless Femoral Stems

    PubMed Central

    Jang, Hyung-Gyu; Min, Byung-Woo; Ye, Hee-Uk; Lim, Kyung-Hwan

    2015-01-01

    Purpose The purpose of this study was to evaluate the clinical and radiological results of revision total hip arthroplasty using modular distal fixation stems for proximal femoral deficiency. Materials and Methods Forty-five patients (47 hips) were analyzed more than 24 months after revision total hip arthroplasty that used modular distal fixation stems and was performed between 2006 and 2012. There were proximal femoral defects in all cases. Preoperative femoral defect classification revealed Paprosky type II in 31 cases, type IIIA in 7, and type IIIB in 9. The mean duration of follow-up was 53.4 (25-100) months. We evaluated the Harris hip score (HHS), walking ability according to Koval as clinical parameters, stem stability, and stem position change as radiographic parameters. Kaplan-Meier survival analysis was performed. Results The average HHS improved form 39.5 points to 91.3 points and walking ability also improved in most cases; all patients had stable fixation of the femoral stem. Postoperative complications included 5 cases of infection and 2 cases of dislocation. The survival rate with the end point of re-revision surgery due to infection or dislocation was 86% after 8-year follow-up. Conclusion Cementless revision total hip arthroplasty using modular femoral stems is useful because the stems can be stably fixed on the diaphyseal portion of the femur, which has relatively good bone quality at mid-term follow-up. PMID:27536616

  17. Progress and Achievements at the Mid Term Stage of the Dragon 3 Programme

    NASA Astrophysics Data System (ADS)

    Desnos, Yves-Louis; Li, Zengyuan; Zmuda, Andy; Gao, Zhihai

    2014-11-01

    The Dragon Programme is a joint undertaking between ESA and the Ministry of Science and Technology (MOST) of China and the National Remote Sensing Center of China (NRSCC). Its purpose is to encourage increased exploitation of ESA and Chinese space resources within China as well as stimulate increased scientific cooperation in the field of Earth Observation (EO) science and applications between China and Europe. Since 2004, this pioneering programme has become a model for scientific and technological cooperation between China and Europe. By successfully encouraging joint research using ESA, Third Party Missions and Chinese EO data across a range of thematic areas, Dragon continues to deliver outstanding scientific results. The programme has successfully completed two phases, Dragon 1 from 2004 to 2008, Dragon 2 from 2008 to 2012. The third phase of Dragon was started in 2012 and will be completed in 2016. The Dragon 3 project teams are led by leading EO scientists and young scientists are also engaged on the projects. Advanced training in land, ocean and atmospheric applications is a feature of the programme and a course on land and one course on ocean applications have been successfully held in 2012 and 2013 in China. Here-in provided is an overview of the results, reporting and training activities at the mid-term stage of the programme.

  18. Mid-term clinical results of a modern convertible total elbow arthroplasty.

    PubMed

    Wagener, M L; de Vos, M J; Hannink, G; van der Pluijm, M; Verdonschot, N; Eygendaal, D

    2015-05-01

    Unlinked, linked and convertible total elbow arthroplasties (TEAs) are currently available. This study is the first to report the clinical results of the convertible Latitude TEA. This was a retrospective study of a consecutive cohort of 63 patients (69 primary TEAs) with a mean age of 60 years (23 to 87). Between 2006 and 2008 a total of 19 men and 50 women underwent surgery. The mean follow-up was 43 months (8 to 84). The range of movement, function and pain all improved six months post-operatively and either continued to improve slightly or reached a plateau thereafter. The complication rate is similar to that reported for other TEA systems. No loosening was seen. Remarkable is the disengagement of the radial head component in 13 TEAs (31%) with a radial head component implanted. Implantation of both the linked and the unlinked versions of the Latitude TEA results in improvement of function and decreased pain, and shows high patient satisfaction at mid-term follow-up. PMID:25922464

  19. Image-guided percutaneous microwave ablation of small renal tumours: short- and mid-term outcomes

    PubMed Central

    Genson, Pierre-Yves; Mourey, Eric; Moulin, Morgan; Favelier, Sylvain; Di Marco, Lucy; Chevallier, Olivier; Cercueil, Jean-Pierre; Krausé, Denis; Cormier, Luc

    2015-01-01

    Background The purpose is to assess the short- and mid-term outcomes of microwave ablation (MWA) of small renal tumours in selected patients. Methods From August 2012 to February 2015, 29 renal tumours in 23 patients (17 male, 6 female, mean age 75 years) were treated by percutaneous MWA under imaging guidance. The tumours were 1-4.7 cm in diameter (mean size, 2.7 cm). Therapeutic effects were assessed at follow-up with magnetic resonance imaging (MRI). All patients were followed up for 2-25 months (mean, 12.2 months) to observe the therapeutic effects and complications. Changes in renal function at day 1 after treatment were statistically analyzed using the Student paired t-test or the paired Wilcoxon test. Results Technical success was achieved in all cases. One severe bleeding complication post-procedure occurred leading to death. No other unexpected side effects were observed after the MWA procedures. Clinical effectiveness was 100%. None of the patients showed recurrence on MRI imaging follow-up. No significant changes in renal function were noted after treatment (P=0.57). Conclusions Our preliminary study demonstrates that the use of MWA for the treatment of small renal tumours can be applied as safely and efficiently as other ablative techniques in selected patients not eligible for surgery. PMID:26682134

  20. Hip resurfacing arthroplasty: mid-term results in 486 cases and current indication in our institution.

    PubMed

    Ribas, Manuel; Cardenas, Carlomagno; Astarita, Emanuele; Moya, Esther; Bellotti, Vittorio

    2014-01-01

    In the previous decade, metal-on-metal hip resurfacing has been considered an attractive option and theoretically advantageous over conventional total hip arthroplasty, especially in young active patients. Different authors have reported favourable mid-term clinical and functional results with acceptable survival rates. Proper indication and planning, as accurate technical execution have been advocated to be crucial elements for success.Concerns regarding serum metal ion levels and possible clinical implications have led in the last years to a decline in the use of metal-on-metal hip resurfacing and metal-on-metal bearings in general.The aim of this study is to present the results of our first 486 cases of hybrid hip resurfacing arthroplasties with a second generation cementing technique, and to describe our current restricted indication of this type of prosthesis, in the light of recent findings in the literature about the possible complications related to metallosis or improper patient selection. Global survivorship of our series was 97.9% at a mean follow-up of 7.2 years.In the second season of our experience the indication is restrictive. The candidate for a resurfacing hip replacement is a young and active male patient, with good bone quality, that has been made aware of the risks and benefits of this type of prosthesis. PMID:24970031

  1. The Avon Patellofemoral Joint Replacement: Mid-Term Prospective Results from an Independent Centre

    PubMed Central

    Akhbari, Pouya; Malak, Tamer; East, Debra; Miles, Kim; Butler-Manuel, P. Adrian

    2015-01-01

    Background Approximately 10% of patients with osteoarthritis (OA) of the knee have unicompartmental OA confined to the patellofemoral joint (PFJ). The main surgical options are total knee replacement (TKR) and PFJ replacement (PFJR). PFJR has a number of advantages over TKR, including being less invasive, preserving the unaffected parts of the knee, allowing faster recovery and better range of motion and function. We report our prospective mid-term results of the Avon PFJR for established isolated PFJ arthritis in 61 consecutive procedures. Methods Sixty-one Avon PFJRs were performed in 57 patients. The outcome measures were the new Oxford knee score (OKS), Hungerford and Kenna score (HKS), and Crosby Insall knee scores. Only patients with severe isolated PFJ OA were included. The diagnosis was based on a combination of clinical, radiological and, where available, arthroscopic findings. Results Mean follow-up was 5.09 years (range, 12 to 124 years). There were 2 revisions in the first 5 years. The median HKS score was 80 (interquartile range, 70 to 95) and the mean OKS was 31.8 (± standard deviation, 8.7) at 5 years. These were significantly better (p < 0.001) than the preoperative scores. Conclusions The Avon prosthesis gives good functional outcomes in the medium term and survives well. Our data support other studies in the literature and is the largest independent prospective study to date. PMID:26217462

  2. On Mid-Term Periodicities in Sunspot Groups and Flare Index

    NASA Astrophysics Data System (ADS)

    Mendoza, Blanca; Velasco-Herrera, Víctor Manuel

    2011-07-01

    In this work we study the mid-term periodicities (MTPs), between 1 and 2 years, of the sunspot groups and the flare index (FI), by separating the data into hemispheres and spectral bands (SBs) according to the most significant periodicities presented by these phenomena. We found that the MTP of sunspot groups has a diminished power during the Modern Minimum and an increased power during the Modern Maximum, with the exception of cycle 20. For flares, the MTP has a diminished power during the low activity cycle 20, and an increased power during cycles 21 and 22. Therefore, for both sunspot groups and FI, cycle 20 shows a very diminished power followed by the active and higher-power cycles 21 and 22; cycle 23 shows a weaker power than cycles 21 and 22. It is uncertain whether MTP can be a precursor of a long-term minimum of solar activity or not, as has been previously suggested. Also, there is no one-to-one correlation between the cycle intensity and the importance of MTP. Concerning the quasi-biennial periodicities and the theory of two kinds of dynamos, we notice the tendency that higher-power cycles mean weaker coupling in the model. Concerning the hemispheric north-south asymmetry, for sunspot groups the southern hemisphere dominates in most of the SBs, while for FI the northern hemisphere dominates for all the SBs. Additionally, the time lag found between the two hemispheres indicates that the degrees of coupling in the photosphere for sunspot groups and in the corona for flares are between moderate and strong. Finally, the modulation shown by the MTP time series suggests that these periodicities are the product of chaotic quasi-periodic processes and not of stochastic processes.

  3. Functional annulus remodelling using a prosthetic ring in tricuspid aortic valve repair: mid-term results†

    PubMed Central

    Fattouch, Khalil; Castrovinci, Sebastiano; Murana, Giacomo; Nasso, Giuseppe; Guccione, Francesco; Dioguardi, Pietro; Salardino, Massimo; Bianco, Giuseppe; Speziale, Giuseppe

    2014-01-01

    OBJECTIVES The functional aortic valve annulus (FAVA) is a complex unit with proximal (aorto-ventricular junction) and distal (sinotubular junction) components. The aim of our study was to evaluate the impact of the total FAVA remodelling, using a prosthetic ring, on mid-term clinical and echocardiographic results after aortic valve repair. METHODS Since February 2003, 250 patients with tricuspid aortic valve insufficiency (AI) underwent aortic valve repair. FAVA dilatation was treated by prosthetic ring in 52 patients, by isolated subcommissural plasty in 62, by subcommissural plasty plus ascending aortic replacement in 57 and by David's reimplantation procedure in 79. Survival rate and freedom from recurrent AI greater than or equal to moderate were evaluated by Kaplan–Meier. RESULTS Overall late survival was 90.4%. Late cardiac-related deaths occurred in 15 patients. At follow-up, 36 (16%) patients had recurrent AI greater than or equal to moderate because of cusp reprolapse and/or FAVA redilatation. Freedom from recurrent AI was significantly higher for patients who underwent David's procedure or FAVA remodelling by prosthetic ring than those who underwent isolated subcommissural plasty (P < 0.01) or subcommissural plasty plus ascending aortic replacement (P = 0.02). There was no statistical difference between David's procedure and prosthetic ring annuloplasty (P = 0.26). CONCLUSION FAVA remodelling using a prosthetic ring is a safe procedure in aortic valve repair surgery thanks to long-term annulus stabilization and it is a pliable alternative to David's procedure in selected patients. This technique may be used in all patients with slight root dilatation to avoid aggressive root reimplantation. We also recommended total FAVA annuloplasty in all patients who underwent aortic valve repair to improve long-term repair results. PMID:24065345

  4. Mid- term results of stryker® scorpio plus mobile bearing total knee arthroplasty

    PubMed Central

    2012-01-01

    Background The mobile bearing knee system was introduced to lessen contact stress on the articular bearing surface and reduce polyethylene wear. The purpose of the current study was to investigate the mid-term results of patients undergoing total knee arthroplasties (TKAs) using Scorpio Plus Mobile Bearing Knee System (Stryker, Mahwah, NJ), and compare the outcomes between patients with osteoarthritis and osteonecrosis (OA·ON group) and patients with rheumatoid arthritis (RA group). Methods Eight males and 58 females were followed up for a period of 4.4- 7.6 years from June 1, 2003 to December 31, 2005. There were 53 knees with osteoarthritis, 17 knees with rheumatoid arthritis, and 6 knees with osteonecrosis. Clinical and radiographic follow- up was done using The Japanese Orthopedic Association knee rating score (JOA score) and Knee Society Total Knee Arthroplasty Roentgenographic Evaluation and Scoring System. Results With regard to the JOA score, there was significant improvement in both groups. The postoperative range of motion was between 0.8°and 116.8° in OA·ON group, and between 0.0° and 113.7° in RA group. There were no significant differences with the radiographic evaluation between two groups. Spontaneous dislocation of a polyethylene insert occurred in one patient, and deep infection was occurred in one patient. Conclusion There was significant improvement with regard to the clinical and radiographic results of patients undergoing TKAs using the model. The risk of polyethylene insert dislocation related to the mobile bearing TKA is a cause for concern. PMID:23075162

  5. Early and Mid-term Outcomes in Female Patients Undergoing Isolated Conventional Coronary Surgery

    PubMed Central

    Erguneş, Kazim; Yilik, Levent; Yetkin, Ufuk; Lafcı, Banu; Bayrak, Serdar; Ozpak, Berkan; Gurbuz, Ali

    2014-01-01

    Introduction: Several observational studies comparing outcomes between female and male patients after coronary artery bypass grafting (CABG) have shown that operative mortality rate is higher among female patients than in male patients. However, some conflicting studies report that early mortality among female patients is equivalent to that among male patients. We investigated predictive factors of morbidity, mortality and survival in female patients undergoing isolated conventional CABG. Methods: Between January 2002 and December 2009, 1657 patients underwent isolated conventional CABG in our clinic. 21.8% (n=361) of patients were female and 78.2% (n=1296) males. Results: Advanced age (P<0.0001), hypertension (P<0.0001), diabetes (P<0.0001), and hyperlipidemia (P<0.0001) were the independent predictive factors among female patients. Mean in-hospital mortality rates were 5.8% and 3.2%; for females and males, respectively (P=0.029). Prolonged ventilatory support (P=0.009) and postoperative atrial fibrillation (P=0.049) were the independent predictive factors of in-hospital mortality in female patients. Cardiopulmonary bypass time (P=0.041), prolonged ventilatory support (P<0.0001), and postoperative atrial fibrillation (P=0.031) were the independent predictive factors of in-hospital mortality in male patients. Mean follow-up was 47.51±25.06 months and 48.42±25.21 months among female and male patients (P=0.820). In follow-up, mortality rate was 6.1% (n=22) among female patients and 4.6% (n=60) among male patients (P=0.272). Left internal thoracic artery (LITA) usage (P=0.001) was the independent predictive factor of survival in female patients. Conclusion: In-hospital mortality rate was higher in female patients. Length of ICU and hospital stay, and mid-term survival was similar between female and male patients. PMID:25031826

  6. Short and mid-term effects of different biochar additions on soil GHG fluxes

    NASA Astrophysics Data System (ADS)

    Maier, Regine; Soja, Gerhard; Friesl-Hanl, Wolfgang; Dunst, Gerald; Kitzler, Barbara

    2015-04-01

    The application of biochar (BC) to soils may have a positive influence on physico-chemical soil properties and the mitigation of greenhouse gas (GHG) emissions. Furthermore, biochar contributes to a long-term soil carbon sequestration. The aim of this study is to explore short and mid-term effects (one day up to six months) of different BC-compost applications on soil GHG emissions, particularly CO2, CH4, N2O and NOx. In addition, compounds of the nitrogen cycle like NH4+, NO3- and the microbial biomass nitrogen (Nmic) were measured. For this purpose a field experiment in Kaindorf (Styria/Austria, gleyic Cambisol, loamy, 376 m.a.s.l.) with 16 plots and four different treatments was conducted. K = no BC-compost mixture but fertilized (NH4SO4) corresponding to T3 in 2013; T1 = 1 % BC-compost mixture, no addition of N in 2013 and 2014; T2 = 0.5 % BC-compost mixture, + 175 kg N ha-1 in 2013 and 2014; T3 = 1% BC-compost mixture, + 350 kg N ha-1 in 2013. Nitrogen was added as (NH4)2SO4 directly to the freshly produced biochar before mixing it with compost. Greenhouse gas fluxes (CO2, CH4, N2O) were measured monthly from closed chambers in the field over a period of six months, starting 30 days before BC application and ended shortly before harvesting in September. For the analysis of nitric oxide (NO) fluxes intact soil cylinders were taken from each plot and incubated at the laboratory at ambient air temperature. Mineral N contents were measured by the extraction with KCl-solution and the microbial biomass with chloroform-fumigation extraction (CFE). Biochar application to our agricultural soil showed no reduction potential of NO emissions, but N2O fluxes were significantly lower at T1 and T3 compared to treatment K. Gaseous N fluxes of the pure BC-compost mixture and the additional N fertilization with (NH4)2SO4 led to enormous gaseous N losses in form of N2O and NO. However, after application to the soil, fluxes were only higher for a short time period. We suggest

  7. Short- and Mid-Term Effects of Violent Victimization on Delinquency: A Multilevel Growth-Curve Modeling Approach.

    PubMed

    Kim, Young S; Lo, Celia C

    2016-10-01

    The present study investigates how adolescents' experiences of violent victimization exert short- and mid-term effects on their involvement in delinquency. The study compares and contrasts delinquency trajectories of youths whose experiences of violent victimization differ. A multilevel growth-curve modeling approach is applied to analyze data from five waves of the National Youth Survey. The results show that, although delinquency involvement increases as youths experience violent victimization, delinquency trajectories differ with the type of violent victimization, specifically, parental versus non-parental victimization. Violent victimization by parents produced a sharp initial decline in delinquency (short-term effect) followed by a rapid acceleration (mid-term effect). In turn, non-parental violence showed a stable trend over time. The findings have important implications for prevention and treatment services. PMID:25888502

  8. Mid-term evaluation of the NRECA (National Rural Electric Cooperative Association) Central America Rural Electrification Support Program (CARES)

    SciTech Connect

    Perlack, R.D. ); Jones, H.G. ); Garcia, A. III . Dept. of Agricultural Engineering); Flores, E. , Guatemala City )

    1990-09-01

    Oak Ridge National Laboratory was requested by the Regional Office for Central America and Panama to conduct a mid-term evaluation of the Cares Project, which is being implemented by the National Rural Electric Cooperative Association. This evaluation was conducted over a three week period by a four person team. Overall, the project has had numerous successes and is highly valued by local counterpart utilities and USAID Missions. Notwithstanding the significant results of the project, changes can be made in certain operating procedures and in the direction of some programmatic activities that can lead to an even more effective project.

  9. Percutaneous Transluminal Angioplasty of Hepatic Artery Stenosis in Patients After Orthotopic Liver Transplantation: Mid-term Results

    SciTech Connect

    Jarmila, Lastovickova Jan, Peregrin

    2011-12-15

    Purpose: This study was designed to present our experience with percutaneous treatment of hepatic artery stenosis in orthotopic liver transplant patients and to evaluate the efficacy, technical outcomes, and mid-term clinical results of the procedure. Methods: Twenty-two percutaneous transluminal angioplasties (PTAs) were performed in 19 liver transplant recipients at our institution between 1998 and 2010. Stents were placed into the hepatic/celiac artery in 16 PTAs, but balloon dilatation alone was performed in 6 because of the anatomical condition of the vessel. PTA/stenting was indicated in 17 patients because of elevated liver enzymes; 2 patients were asymptomatic. The objective of treating stenosis was prevention of long-term complications, including thrombosis. Results: Technical success was achieved in all patients. There was only one complication: dissection of the treated artery without any subsequent adverse effects. In all patients, elevated liver enzyme levels improved after treatment. No restenosis was observed in any patient during a mean follow-up of 2.6 years (1 month to 5.5 years). Conclusions: Percutaneous angioplasty/stent placement is a safe method for the treatment of hepatic artery stenosis after orthotopic liver transplantation, with a high technical success rate and promising mid-term results.

  10. CT-Guided Radiofrequency Ablation of T1a Renal Cell Carcinoma in Korea: Mid-Term Outcomes

    PubMed Central

    Kim, Hae Jin; Park, Jung Jae; Kim, Chan Kyo

    2016-01-01

    Objective To evaluate the mid-term outcomes of percutaneous radiofrequency ablation (RFA) treatment in patients with small (< 4 cm) renal cell carcinoma (RCC) in Korea. Materials and Methods Between 2010 and 2015, 51 patients (40 men and 11 women; median age, 57 years) with biopsyproven 51 RCC were treated using CT-guided RFA. All patients were clinically staged T1aN0M0 prior to RFA. The median tumor size and follow-up period were 2.1 cm (range, 1.0–3.9 cm) and 26 months (4–60 months), respectively. Local tumor progression, distant metastasis, primary and secondary effectiveness rates, and major complication rates were recorded. Estimated glomerular filtration rates (GFRs) between pre-RFA and last follow-up were compared using paired t tests. The 2-year recurrence-free survival rate was calculated using Kaplan-Meier survival analysis. Results Of the 51 patients, 2 (3.9%) experienced local tumor progression, and 1 (2.0%) had lymph node metastasis after the first RFA session. Primary and secondary effectiveness rates were 96.1% (49/51) and 100% (1/1), respectively. Only 1 patient experienced a major complication (uretero-pelvic stricture) after the second RFA session for treating a local tumor progression, and the major complication rate was 1.9% (1/52). The median pre-RFA and last follow-up GFRs were 87.1 mL/ min/1.73 m2 (14.2–142.7 mL/min/1.73 m2) and 72.0 mL/min/1.73 m2 (7.2–112.6 mL/min/1.73 m2), respectively (p < 0.0001). The 2-year recurrence-free survival rate was 96.0%. Conclusion CT-guided RFA is a safe and effective treatment in Korean patients with T1a RCC because of excellent mid-term outcomes. PMID:27587966

  11. Mid-term survivorship and clinical outcomes of cobalt-chrome and oxidized zirconium on highly crosslinked polyethylene

    PubMed Central

    Petis, Stephen M.; Vasarhelyi, Edward M.; Lanting, Brent A.; Howard, James L.; Naudie, Douglas D.R.; Somerville, Lyndsay E.; McCalden, Richard W.

    2016-01-01

    Background The choice of bearing articulation for total hip arthroplasty in younger patients is amenable to debate. We compared mid-term patient-reported outcomes and survivorship across 2 different bearing articulations in a young patient cohort. Methods We reviewed patients with cobalt-chrome or oxidized zirconium on highly crosslinked polyethylene who were followed prospectively between 2004 and 2012. Kaplan–Meier analysis was used to determine predicted cumulative survivorship at 5 years with all-cause and aseptic revisions as the outcome. We compared patient-reported outcomes, including the Harris hip score (HHS), Western Ontario and McMaster University Osteoarthritis Index (WOMAC) and Short-form 12 (SF-12) scores. Results A total of 622 patients were followed during the study period. Mean follow-up was 8.2 (range 2.0–10.6) years for cobalt-chrome and 7.8 (range 2.1–10.7) years for oxidized zirconium. Mean age was 54.9 ± 10.6 years for cobalt-chrome and 54.8 ± 10.7 years for oxidized zirconium. Implant survivorship was 96.0% (95% confidence interval [CI] 94.9%–97.1%) for cobalt-chrome and 98.7% (95% CI 98.0%–99.4%) for oxidized zirconium on highly crosslinked polyethylene for all-cause revisions, and 97.2% (95% CI 96.2%–98.2%) for cobalt-chrome and 99.0% (95% CI 98.4%–99.6%) for oxidized zirconium for aseptic revisions. An age-, sex- and diagnosis-matched comparison of the HHS, WOMAC and SF-12 scores demonstrated no significant changes in clinical outcomes across the groups. Conclusion Both bearing surface couples demonstrated excellent mid-term survivorship and outcomes in young patient cohorts. Future analyses on wear and costs are warranted to elicit differences between the groups at long-term follow-up. PMID:26812409

  12. Transhepatic Balloon Dilatation of Early Biliary Strictures in Pediatric Liver Transplantation: Successful Initial and Mid-Term Outcome

    SciTech Connect

    Belenky, Alexander; Mor, Eytan; Bartal, Gabriel; Atar, Eli; Shapiro, Riki; Bar-Nathan, Nathan; Bachar, Gil N.

    2004-09-15

    Purpose: To evaluate the initial and mid-term outcomes of transhepatic balloon dilatation for the treatment of early biliary strictures in lateral left-segment liver transplants in young children.Methods: Between April 1997 and May 2001, seven children aged 9 months to 6 years with nine benign strictures in left-segment liver grafts were treated percutaneously. Sessions of two or three dilations were performed three or four times at average intervals of 10-20 days. In each session, the biliary stenoses were gradually dilated using balloons of 3-7 mm. Follow-up ranged from 12 to 54 months (mean 27 months, median 12 months). Clinical success was defined as resolution of the stenosis, normalization of liver enzymes and lack of clinical symptoms. Results: Technical success was achieved in all nine strictures. Hemobilia occurred in one patient and was successfully treated. On follow-up, all patients had complete clinical recovery with normalization of liver function and imaging of patent bile ducts. Conclusion: Balloon dilatation is an effective and relatively safe method for the treatment of early biliary strictures in left-segment liver transplantation in young children. We recommend this approach as the initial treatment for early strictures. Metal stents or surgery should be reserved for patients with late appearance of strictures or failure of balloon dilatation.

  13. Preparedness actions towards seismic risk mitigation for the general public in Martinique, French Lesser Antilles: a mid-term appraisal

    NASA Astrophysics Data System (ADS)

    Audru, J. C.; Vernier, J. L.; Capdeville, B.; Salindre, J. J.; Mouly, É.

    2013-08-01

    Martinique is a French island in the Lesser Antilles, with a high seismic hazard. In 2006, Martinican stakeholders involved in seismic safety formed the "Réplik" working group ("Aftershock" in French), the first of its kind in this region. This paper addresses a mid-term appraisal of the first seismic awareness campaign organised by Réplik from 2006 to 2011, and how it has modified, or not, local earthquake and tsunami preparedness. Despite efforts from Réplik to assess its efficiency through surveys, a growing gap is noted between the observed awareness and the actual preparedness of the public. As usual, gender, age, educational level, then boredom and saturation contribute to this discrepancy; strong cultural items may also influence the perception of actions. To remain efficient and respond to the public's expectations, Réplik must redirect its actions towards a cultural congruence of information: consideration of religion and local beliefs, comprehensive messages on TV and radio, use of the Creole language, participatory experiences and drills, and a little science. With this, the Réplik stakeholders can hope to increase Martinicans' involvement into the preparedness process, to cope quickly with a strong earthquake and this know-how can be shared with other seismically active islands in the Caribbean.

  14. Mid-term Clinical Results and Patient Satisfaction After Uterine Artery Embolization in Women with Symptomatic Uterine Fibroids

    SciTech Connect

    Smeets, Albert J.; Lohle, Paul N. M. Vervest, Harry A. M.; Boekkooi, P. Focco; Lampmann, Leo E.H.

    2006-04-15

    Purpose. To evaluate the mid-term clinical results and patient satisfaction following uterine artery embolization (UAE) in women with symptomatic fibroids. Methods. Between August 1998 and December 2002, 135 patients had UAE for symptomatic uterine fibroids. All patients were asked to fill in a questionnaire. Questions were aimed at changes in bleeding, pain, and bulk-related symptoms. Symptoms after UAE were scored as disappeared, improved, unchanged or worsened. Adverse events were noted, such as vaginal dryness and discharge, menopausal complaints or fibroid expulsion. Patient satisfaction after UAE was assessed. Patient satisfaction of women embolized with polyvinyl alcohol (PVA) particles was compared with satisfaction of women embolized with calibrated microspheres. Results. The questionnaire was returned by 110 of 135 women (81%) at a median time interval of 14 months following UAE. In 10 women additional embolization or hysterectomy had been performed. Of the 110 responders, 86 (78%) were satisfied with the result of UAE. The proportion of satisfied women was higher in the group embolized with calibrated microspheres than in women embolized with PVA, although this difference was not statistically significant (p = 0.053). Conclusion. UAE in women with symptomatic uterine fibroids leads to improvement of symptoms and patient satisfaction is good in the vast majority after a median follow-up period of 14 months.

  15. Early- and mid-term outcomes after transcatheter aortic valve implantation. Data from a single-center registry

    PubMed Central

    Bagienski, Maciej; Dziewierz, Artur; Rzeszutko, Lukasz; Sorysz, Danuta; Trebacz, Jaroslaw; Sobczynski, Robert; Tomala, Marek; Stapor, Maciej; Gackowski, Andrzej; Dudek, Dariusz

    2016-01-01

    Introduction Transcatheter aortic valve implantation (TAVI) is a less invasive treatment option for elderly, high-risk patients with symptomatic severe aortic stenosis (AS) than aortic valve replacement. More importantly, TAVI improves survival and quality of life as compared to medical treatment in inoperable patients. Aim To assess early- and mid-term clinical outcomes after TAVI. Material and methods All consecutive high-risk patients with severe symptomatic AS undergoing TAVI from November 2008 to August 2014 were enrolled. The clinical and procedural characteristics, as well as clinical outcomes including mortality during 12-month follow-up, were assessed. Results A total of 101 consecutive patients underwent TAVI for native aortic valve stenosis (100%). Patients were elderly, with a median age of 81.0 (76.0–84.0) years, 60.4% were female and 83.2% presented with NYHA III/IV. Median baseline EuroSCORE I and STS scores were 14.0 (10.0–22.5)% and 12.0 (5.0–24.0)%, respectively. The main periprocedural and in-hospital complications were minor vascular complications, bleeding requiring blood transfusions, and the need for a permanent pacemaker. In-hospital, 30-day, 6-month and 12-month mortality rates were 6.9%, 10.9%, 15.8% and 17.8%, respectively. Conclusions A mortality rate of < 20% after 12 months seems acceptable given the high-risk population enrolled. PMID:27279871

  16. Mid-term results of Ponseti management for an idiopathic congenital clubfoot at a single center in Vietnam.

    PubMed

    Vo, Nam Q D; Huynh, Nhi M

    2016-05-01

    Despite the increasing popularity of the Ponseti method for the treatment of idiopathic congenital clubfeet, the relapse rate and sequela after the initial correction of manipulating and casting remain high. This study presents a scale to evaluate the relapse and identify the factors correlated with the relapse and latest follow-up mid-term results. A total of 101 children (newborn to 12 months), 142 idiopathic congenital clubfeet, were recruited for this study following treatment with the Ponseti method at the Hospital for Traumatology and Orthopaedics (Ho Chi Minh City, Vietnam) with a follow-up period of a minimum of 2 years. The clubfeet were then classified and evaluated during casting, for initial correction, and for relapse according to Diméglio's score. Next, the latest follow-up results were evaluated according to Richards' classification. The initial correction was successful in 95.8% (perfect: 74.0%, acceptable: 21.8%); 6.6% developed relapses and relapse-related factors were the initial correction and bracing program. The latest follow-up results are good in 74.7%, fair in 22.5%, and poor in 2.8%, and correlated with the age of presentation and the follow-up period in both univariate and multivariate analysis. On the basis of a precise evaluation of the relapse, this study indicates that the initial correction classified by the author on the basis of Diméglio's score and bracing compliance affect relapse. In addition, early treatment after birth and continuous long-term follow-up to appropriately manage the sequelae are essential to obtain the latest follow-up results as expected. PMID:26709996

  17. Short to Mid-Term Term Surgical Outcome Study with Posterior Only Approach on Tuberculous Spondylodiscitis in an Elderly Population

    PubMed Central

    Kothari, Manish; Tikoo, Agnivesh; Nene, Abhay

    2016-01-01

    Study Design Retrospective study. Purpose To study short to mid-term outcome of surgically managed elderly patients of tuberculous spondylodiscitis with posterior only approach in terms of decision making and challenges in treatment, choice of implants and outcomes. Overview of Literature Tuberculous spondylodiscitis in the elderly is increasing due to longer survival rates. It presents with varied clinical manifestations needing surgical management. Management in tuberculous spondylodiscitis has been scarcely reported in the elderly, with a paucity of data on the choice of implants and approach. Methods Sixteen patients (five males, 11 females) older than 70-years-of-age culture and/or histopathology proven tuberculous spondylodiscitis were included in the study. All patients were operated using a single posterior approach. Pedicle screw with rods (PS/rods) or spinal loop with sublaminar wires (SL/SLW) were used for fixation. Clinical and surgical details were recorded. Sagittal correction achieved postoperatively and loss of correction at follow-up were noted. Results The mean age was 73.6 years (range, 70 to 80 years). The mean follow up was 44.5 months (range, 24 to 84 months). The mean immediate postoperative correction of sagittal deformity was 11.3 degrees; this correction was lost by a mean of 3.1 degrees at last follow-up. All 10 patients with deficit showed neurological recovery and all but one of the seven non-walkers were capable of independent ambulation at follow-up. Patients with SL/SLW and PS/rods had similar radiological outcome at final follow up. Conclusions Operative management gives satisfactory results in elderly patients with tuberculous spondylodiscitis. The posterior approach provides adequate exposure for decompression and rigid fixation, providing satisfactory clinical and radiological outcomes. SSL/SLW and pedicle screw rod construct both give similar radiological results if used appropriately in patients. PMID:27114766

  18. Mid-term results of tricuspid annuloplasty using the MC3 ring for secondary tricuspid valve regurgitation.

    PubMed

    Yoda, Masataka; Tanabe, Hiroaki; Kadoma, Yoshitaka; Suma, Hisayoshi

    2011-07-01

    We investigated mid-term outcomes after ring annuloplasty with the MC3 ring and aimed to identify factors associated with recurrent tricuspid regurgitation (TR). From October 2006 to October 2010, 136 patients (male:female 80:56, with a mean age 64.7±11.8 years) underwent tricuspid valve (TV) annuloplasty for functional TR. The indications for TV annuloplasty were (1) severe TR, or (2) mild or moderate TR with pulmonary hypertension (systolic pulmonary artery pressure >50 mmHg) or tricuspid annular (TA) dilatation, in patients undergoing mitral valve (MV) surgery. The average follow-up period was 1.5±0.8 years. The overall survival rates were 97.1±0.15%, 93.4 ± 0.02% and 90.7 ± 0.28% at three months, one year and four years, respectively. Freedom from recurrent moderate TR was 98.5±0.01, 95.6 ± 0.17% and 90.6 ± 0.03% at three months, one year and four years, respectively. Multivariate analysis revealed that residual TR was significantly associated with preoperative severe TR, left ventricular end-diastolic dimension >70 mm, right ventricular dimension >40 mm, dilated cardiomyopathy (DCM) and left ventriculoplasty. This MC3 ring corrects TR effectively, and provided good results. We must point out, however, that additional or alternative surgical options should still be considered for high-risk of repair failure, such as those with DCM or high pulmonary hypertension. PMID:21454311

  19. Devising an Indicator to Detect Mid-Term Abortions in Dairy Cattle: A First Step Towards Syndromic Surveillance of Abortive Diseases

    PubMed Central

    Bronner, Anne; Morignat, Eric; Hénaux, Viviane; Madouasse, Aurélien; Gay, Emilie; Calavas, Didier

    2015-01-01

    Bovine abortion surveillance is essential for human and animal health because it plays an important role in the early warning of several diseases. Due to the limited sensitivity of traditional surveillance systems, there is a growing interest for the development of syndromic surveillance. Our objective was to assess whether, routinely collected, artificial insemination (AI) data could be used, as part of a syndromic surveillance system, to devise an indicator of mid-term abortions in dairy cattle herds in France. A mid-term abortion incidence rate (MAIR) was computed as the ratio of the number of mid-term abortions to the number of female-weeks at risk. A mid-term abortion was defined as a return-to-service (i.e. a new AI) taking place 90 to 180 days after the previous AI. Weekly variations in the MAIR in heifers and parous cows were modeled with a time-dependent Poisson model at the département level (French administrative division) during the period of 2004 to 2010. The usefulness of monitoring this indicator to detect a disease-related increase in mid-term abortions was evaluated using data from the 2007–2008 episode of bluetongue serotype 8 (BT8) in France. An increase in the MAIR was identified in heifers and parous cows in 47% (n = 24) and 71% (n = 39) of the départements. On average, the weekly MAIR among heifers increased by 3.8% (min-max: 0.02–57.9%) when the mean number of BT8 cases that occurred in the previous 8 to 13 weeks increased by one. The weekly MAIR among parous cows increased by 1.4% (0.01–8.5%) when the mean number of BT8 cases occurring in the previous 6 to 12 weeks increased by one. These results underline the potential of the MAIR to identify an increase in mid-term abortions and suggest that it is a good candidate for the implementation of a syndromic surveillance system for bovine abortions. PMID:25746469

  20. Impact of severe left ventricular dysfunction on mid-term mortality in elderly patients undergoing transcatheter aortic valve implantation

    PubMed Central

    Ferrante, Giuseppe; Presbitero, Patrizia; Pagnotta, Paolo; Sonia Petronio, Anna; Brambilla, Nedy; De Marco, Federico; Fiorina, Claudia; Giannini, Cristina; D'Ascenzo, Fabrizio; Klugmann, Silvio; Rossi, Marco L; Ettori, Federica; Bedogni, Francesco; Testa, Luca

    2016-01-01

    Background Whether patients with reduced left ventricular function present worse outcome after transcatheter aortic valve implantation (TAVI) is controversial. The aim of this study was to assess the impact of baseline severe impairment of left ventricular ejection fraction (LVEF) on mortality after TAVI. Methods Six-hundred-forty-nine patients with aortic stenosis underwent TAVI with the CoreValve system (92.8%) or the Edwards SAPIEN valve system (7.2%). Baseline LVEF was measured by the echocardiographic Simpson method. The impact of LVEF ≤ 30% on mortality was assessed by Cox regression. Results Patients with LVEF ≤ 30% (n = 63), as compared to those with LVEF > 30% (n = 586), had a higher prevalence of NHYA class > 2 (P < 0.001) and presented with a higher Euroscore (P < 0.001). Procedural success was similar in both groups (98.4% vs. 97.2%, P = 1). After a median follow-up of 436 days (25th–75th percentile, 357–737 days), all-cause mortality [23.8% vs. 23.7%, P = 0.87, hazard ratios (HR): 0.96, 95% confidence intervals (CI): 0.56–1.63] and cardiac mortality (19.1% vs. 17.6%, P = 0.89, HR: 1.04, 95% CI: 0.57–1.90) were similar in patients with LVEF ≤ 30% as compared to those with LVEF > 30%. Thirty-day all-cause mortality was not significantly different between the two groups (11.1% vs. 6.3%, P = 0.14, HR: 1.81, 95% CI: 0.81–4.06). Patients with LVEF ≤ 30% had a trend toward higher risk of 30-day cardiac mortality (11.1% vs. 5.3%; P = 0.06, HR: 2.16, 95% CI: 0.95–4.90), which disappeared after multivariable adjustment (P = 0.22). Conclusions Baseline severe impairment of LVEF is not a predictor of increased short-term and mid-term mortality after TAVI. Selected patients with severe impairment of left ventricular function should not be denied TAVI. PMID:27403137

  1. Mid term monitoring of heavy metals content in soils of Mediterranean coastal wetlands. La Albufera de Valencia Natural Park, Spain

    NASA Astrophysics Data System (ADS)

    Pascual-Aguilar, Juan Antonio; Andreu, Vicente; Gimeno-García, Eugenia

    2014-05-01

    Coastal wetlands, in general, and Mediterranean ones, in particular, suffer from differente anthropogenic pressures that may affect their intrinsic environmental and ecological functions. Most, if not all, Mediterranean wetlands are not natural spaces were preservation of habitat and wildlife is the only management policy achieved, bur rather their terriroty is a combination of land units with different activities and influences, such as farming, environmental protection and connectivities with urban and industrial areas. Therefore, the need of periodical monitoring is required whenever pressures and environmental health of wetlands is assessed, particularly of those processes that affect the interconnection of environmental compartiments involving water, soils and biota. In agro-ecological protected wetlands soils play and important role because they are potential sources of pollutants due to farming practices. In this case, presence of heavy metals in soils is and indicator of both environmental health and anthtopogenic direct (farming activities) and indirect (neighbour urban areas) pressures. In this work a mid term (17 year) monitoring of seven heavy metals (Cd, Co, Cr, Cu, Pb, Ni and Zn) in soils of coastal Mediterranean wetlands (La Albufera Natural Park, Spain) are analyzed. Two monitoring campaings were achieved in 1991 and 2008. In both cases the same 20 points were visited which were distributed in the natural park according two four different sectors of potential anthropogenic pressure and land use. At each point two soil samples were collected at differente depths (0 to 20 cm and 20 to 40 cm). The selected metals were analyzed to determine its total and extractable fractions by treatment with EDTA. Atomic Absorption Spectrometry, using graphite furnace when necessary, was used for the determination of metals. In general, there is a reduction of metal contents in the study area in both dates. The trend of metals according to average concentration (mg

  2. COST Action TU1208 "Civil Engineering Applications of Ground Penetrating Radar:" ongoing research activities and mid-term results

    NASA Astrophysics Data System (ADS)

    Pajewski, Lara; Benedetto, Andrea; Loizos, Andreas; Slob, Evert; Tosti, Fabio

    2015-04-01

    This work aims at presenting the ongoing activities and mid-term results of the COST (European COoperation in Science and Technology) Action TU1208 'Civil Engineering Applications of Ground Penetrating Radar.' Almost three hundreds experts are participating to the Action, from 28 COST Countries (Austria, Belgium, Croatia, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Ireland, Italy, Latvia, Malta, Macedonia, The Netherlands, Norway, Poland, Portugal, Romania, Serbia, Slovakia, Slovenia, Spain, Sweden, Switzerland, Turkey, United Kingdom), and from Albania, Armenia, Australia, Egypt, Hong Kong, Jordan, Israel, Philippines, Russia, Rwanda, Ukraine, and United States of America. In September 2014, TU1208 has been praised among the running Actions as 'COST Success Story' ('The Cities of Tomorrow: The Challenges of Horizon 2020,' September 17-19, 2014, Torino, IT - A COST strategic workshop on the development and needs of the European cities). The principal goal of the COST Action TU1208 is to exchange and increase scientific-technical knowledge and experience of GPR techniques in civil engineering, whilst simultaneously promoting throughout Europe the effective use of this safe and non-destructive technique in the monitoring of infrastructures and structures. Moreover, the Action is oriented to the following specific objectives and expected deliverables: (i) coordinating European scientists to highlight problems, merits and limits of current GPR systems; (ii) developing innovative protocols and guidelines, which will be published in a handbook and constitute a basis for European standards, for an effective GPR application in civil- engineering tasks; safety, economic and financial criteria will be integrated within the protocols; (iii) integrating competences for the improvement and merging of electromagnetic scattering techniques and of data- processing techniques; this will lead to a novel freeware tool for the localization of buried objects

  3. Initial Weight Loss after Restrictive Bariatric Procedures May Predict Mid-Term Weight Maintenance: Results From a 12-Month Pilot Trial

    PubMed Central

    Nikolić, Marko; Kirigin, Lora; Mirošević, Gorana; Ljubičić, Neven; Nikolić, Borka Pezo; Bekavac-Bešlin, Miroslav; Budimir, Ivan; Vrkljan, Milan

    2015-01-01

    Background: Bariatric procedures are effective options for weight loss (WL) in the morbidly obese. However, some patients fail to lose any weight after bariatric surgery, and mid-term weight maintenance is variable. The aim of this study was to investigate whether initial WL could predict mid-term weight maintenance. Methods: Eighty patients were enrolled, of whom 44 were treated with the BioEnterics Intragastric Balloon (BIB), 21 with laparoscopic adjustable gastric lap-banding (LAGB), and 15 with laparoscopic sleeve gastrectomy (LSG). Percentage of body WL and percentage of excess weight loss (EWL) were calculated at baseline and after 1, 3, 6, and 12 months. Successful WL was defined as EWL >20% for patients treated with BIB and >50% for patients treated with LAGB and SG. Results: Success in the 6th and 12th month was achieved in 80% and 58% of patients in the BIB group, 33% and 40% in the LAGB group, and 60% and 73% in the LSG group. In the BIB group, WL in the 1st month correlated positively with WL at the 6th and 12th month, and an initial WL >6.5% best predicted success (sensitivity 50%, specificity 80%). A similar association was observed in the LAGB group at the 6th and 12th month and an initial WL >9.4% best predicted success (sensitivity 90.0%, specificity 81.2%). In patients treated with LSG, WL in the 3rd month correlated positively with EWL at the 6th and 12th month, with a cutoff value of 17% (sensitivity 66.7%, specificity 100%). Conclusions: WL in the 1st month in patients treated with BIB and LAGB and WL in the 3rd month in patients treated with LSG could be used as a prognostic factor to predict mid-term weight maintenance. PMID:26594600

  4. The assessment of treated wastewater quality and the effects of mid-term irrigation on soil physical and chemical properties (case study: Bandargaz-treated wastewater)

    NASA Astrophysics Data System (ADS)

    Kaboosi, Kami

    2016-05-01

    This study was conducted to investigate the characteristics of inflow and outflow wastewater of the Bandargaz wastewater treatment plant on the basis of the data collection of operation period and the samples taken during the study. Also the effects of mid-term use of the wastewater for irrigation (from 2005 to 2013) on soil physical and chemical characteristics were studied. For this purpose, 4 samples were taken from the inflow and outflow wastewater and 25 quality parameters were measured. Also, the four soil samples from a depth of 0-30 cm of two rice field irrigated with wastewater in the beginning and middle of the planting season and two samples from one adjacent rice field irrigated with fresh water were collected and their chemical and physical characteristics were determined. Average of electrical conductivity, total dissolved solids, sodium adsorption ratio, chemical oxygen demand and 5 days biochemical oxygen demand in treated wastewater were 1.35 dS/m, 707 ppm, 0.93, 80 ppm and 40 ppm, respectively. Results showed that although some restrictions exist about chlorine and bicarbonate, the treated wastewater is suitable for irrigation based on national and international standards and criteria. In comparison with fresh water, the mid-term use of wastewater caused a little increase of soil salinity. However, it did not lead to increase of soil salinity beyond rice salinity threshold. Also, there were no restrictions on soil in the aspect of salinity and sodium hazard on the basis of many irrigated soil classifications. In comparison with fresh water, the mid-term use of wastewater caused the increase of total N, absorbable P and absorbable K in soil due to high concentration of those elements in treated wastewater.

  5. Mid-term survival after transcatheter aortic valve implantation: Results with respect to the anesthetic management and to the access route (transfemoral versus transapical)

    PubMed Central

    Gauthier, Caroline; Astarci, Parla; Baele, Philippe; Matta, Amine; Kahn, David; Kefer, Joëlle; Momeni, Mona

    2015-01-01

    Context: Several studies have analyzed the long-term survival after transcatheter aortic valve implantation (TAVI). However, no previous studies have looked at survival beyond 1-year with respect to the type of anesthesia. Aims: The aim was to evaluate the mid-term survival after TAVI with respect to the type of anesthesia (general anesthesia [GA] vs. local anesthesia ± sedation [LASedation]) or the type of procedure (transfemoral [transfem] vs. transapical TAVI) performed. Settings and Design: Retrospective cohort study. Subjects and Methods: This retrospective study included TAVI's between January 2009 and June 2013. Patients were divided into three groups: transfem TAVI under GA, transfem TAVI under LASedation and transapical TAVI. A total of 176 patients were eligible. The following clinical outcomes were evaluated: (1) Mortality, (2) Major cardiovascular complications, (3) Conduction abnormalities and arrhythmias, (4) Acute kidney injury, (5) Aortic regurgitation, (6) Neurologic events, (7) Vascular complications, (8) Pulmonary complications, (9) Bleeding, (10) Infectious complications, (11) Delirium. Statistical Analysis Used: A Kruskal–Wallis test was performed to test significance between the three groups for quantitative variables. Categorical variables were compared using a Chi-square test. Survival was estimated using Kaplan–Meier method. Results: There was no statistically significant difference between the survival of both transfem TAVI's (P = 0.46). The short-term outcome of the transfem TAVI groups was better than the transapical arm, but their mid-term survival did not show any significant difference (P = 0.69 transapical vs. transfem GA; P = 0.07 transapical vs. transfem LASedation). Conclusions: Our results demonstrate that the type of anesthesia and the access route do not influence mid-term survival after TAVI. PMID:26139739

  6. COST Action TU1208 "Civil Engineering Applications of Ground Penetrating Radar:" ongoing research activities and mid-term results

    NASA Astrophysics Data System (ADS)

    Pajewski, Lara; Benedetto, Andrea; Loizos, Andreas; Slob, Evert; Tosti, Fabio

    2015-04-01

    This work aims at presenting the ongoing activities and mid-term results of the COST (European COoperation in Science and Technology) Action TU1208 'Civil Engineering Applications of Ground Penetrating Radar.' Almost three hundreds experts are participating to the Action, from 28 COST Countries (Austria, Belgium, Croatia, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Ireland, Italy, Latvia, Malta, Macedonia, The Netherlands, Norway, Poland, Portugal, Romania, Serbia, Slovakia, Slovenia, Spain, Sweden, Switzerland, Turkey, United Kingdom), and from Albania, Armenia, Australia, Egypt, Hong Kong, Jordan, Israel, Philippines, Russia, Rwanda, Ukraine, and United States of America. In September 2014, TU1208 has been praised among the running Actions as 'COST Success Story' ('The Cities of Tomorrow: The Challenges of Horizon 2020,' September 17-19, 2014, Torino, IT - A COST strategic workshop on the development and needs of the European cities). The principal goal of the COST Action TU1208 is to exchange and increase scientific-technical knowledge and experience of GPR techniques in civil engineering, whilst simultaneously promoting throughout Europe the effective use of this safe and non-destructive technique in the monitoring of infrastructures and structures. Moreover, the Action is oriented to the following specific objectives and expected deliverables: (i) coordinating European scientists to highlight problems, merits and limits of current GPR systems; (ii) developing innovative protocols and guidelines, which will be published in a handbook and constitute a basis for European standards, for an effective GPR application in civil- engineering tasks; safety, economic and financial criteria will be integrated within the protocols; (iii) integrating competences for the improvement and merging of electromagnetic scattering techniques and of data- processing techniques; this will lead to a novel freeware tool for the localization of buried objects

  7. Short-term and mid-term effects of fasting and downset meal pattern on lipid profile in Iranian fasted women.

    PubMed

    Rabiee, Samira; Afghari, Narsis; Rastmanesh, Reza

    2014-06-01

    It is not clear that whether the effects of fasting and downset meal pattern on lipid profile are limited only to Ramadan or do they remain after that month. The cohort study was conducted on 49 women aged 20-45 who worked at Shahid Motahari hospital in Isfahan. They put on groups of 23 consuming downset meal and 26 non-consuming downset meal persons. Serum triglyceride, cholesterol, LDL, and HDL were measured on the 3 days before the beginning, 3 and 30 days after the end of Ramadan. Repeated measure test was used to determine the changes during times and the interaction effects between times and nocturnal eating pattern. This study showed that fasting causes some short-term and mid-term changes in triglyceride and HDL that is mostly attributable to changes in dietary habits during Ramadan, rather than downset meal pattern. PMID:23111814

  8. Mid-term results of 17-mm St. Jude Medical Regent prosthetic valves in elder patients with small aortic annuli: comparison with 19-mm bioprosthetic valves.

    PubMed

    Teshima, Hideki; Ikebuchi, Masahiko; Sano, Toshikazu; Tai, Ryuta; Horio, Naohiro; Irie, Hiroyuki

    2014-09-01

    This study was designed to compare the mid-term outcomes after aortic valve replacement (AVR) between 17-mm mechanical heart valves (MV) and 19-mm bioprosthetic valves (BV) in elderly patients with small aortic annuli. Between 2000 and 2011, 127 consecutive patients (mean age 79 years; 87 % female) underwent AVR for aortic valve stenosis with a small aortic annulus. 19-mm BV (n = 67) was implanted. When the 19-mm BV did not fit the annulus, 17-mm St. Jude Medical Regent prosthetic mechanical valve (n = 60) was used instead of an aortic root-enlargement procedure. The follow-up rate was 94.0 % in the BV group, and 98.5 % in the MV group. No significant differences in survival rate and valve-related complications were found between the 2 groups. In-hospital mortality rates were 1.5 % (n = 1) in the BV group and 5.0 % (n = 3) in the MV group. Late mortality rates were 3.9 % per patient-years (p-y; n = 8) in the BV group, and 6.0 % per p-y (n = 10) in the MV group. Five-year Kaplan-Meier survival rates were 62 % in the BV group, and 72 % in the MV group (log-rank P = 0.280). Freedom from major adverse valve-related stroke and cerebral bleeding events was 92.5 and 98.5 % in the BV group, and 94.7 and 100 % in the MV group. AVR using 17-mm MV in elder patients with small aortic annuli provided equivalent mid-term clinical results to that with 19-mm BV. PMID:24878870

  9. Surgical treatment of morbid obesity: mid-term outcomes of the laparoscopic ileal interposition associated to a sleeve gastrectomy in 120 patients.

    PubMed

    DePaula, Aureo L; Stival, Alessandro R; Halpern, Alfredo; Vencio, Sergio

    2011-05-01

    The aim of this study was to evaluate the mid-term outcomes of the laparoscopic ileal interposition associated to a sleeve gastrectomy (LII-SG) for the treatment of morbid obesity. The procedure was performed in 120 patients: 71 women and 49 men with mean age of 41.4 years. Mean body mass index (BMI) was 43.4 ± 4.2 kg/m². Patients had to meet requirements of the 1991 NIH conference criteria for bariatric operations. Associated comorbidities were observed in all patients, including dyslipidemia in 51.7%, hypertension in 35.8%, type 2 diabetes in 15.8%, degenerative joint disease in 55%, gastroesophageal reflux disease in 36.7%, sleep apnea in 10%, and cardiovascular problems in 5.8%. Mean follow-up was 38.4 ± 10.2 months, range 25.2-61.1. There was no conversion to open surgery nor operative mortality. Early major complications were diagnosed in five patients (4.2%). Postoperatively, 118 patients were evaluated. Late major complications were observed in seven patients (5.9%). Reoperations were performed in six (5.1%). Mean postoperative BMI was 25.7 ± 3.17 kg/m², and 86.4% were no longer obese. Mean %EWL was 84.5 ± 19.5%. Hypertension was resolved in 88.4% of the patients, dyslipidemia in 82.3%, and T2DM in 84.2%. The LII-SG provided an adequate weight loss and resolution of associated diseases during mid-term outcomes evaluation. There was an acceptable morbidity with no operative mortality. It seems that chronic ileal brake activation determined sustained reduced food intake and increased satiety over time. LII-SG could be regularly used as a surgical alternative for the treatment of morbid obesity. PMID:20652440

  10. Anterior Cervical Discectomy and Fusion with Stand-Alone Trabecular Metal Cages as a Surgical Treatment for Cervical Radiculopathy: Mid-Term Outcomes

    PubMed Central

    ElAbed, Khaldoun; Shawky, Ahmad; Ainscow, Donald

    2016-01-01

    Study Design Retrospective case cohort study done between 2002 and 2012. Purpose To assess the mid-term clinical and radiological outcomes of 1-level and 2-level anterior cervical discectomy and fusion (ACDF) with stand-alone trabecular metal cages. Overview of Literature ACDF is the gold standard surgical treatment for cervical degenerative disease. The usual surgical practice is to use an anteriorly placed fusion plate with or without interdiscal cages. Methods Patients between 36 and 64 years of age diagnosed with cervical radiculopathy who underwent ACDF using stand-alone trabecular metal cages with at least 3 years follow-up were included in this study. Recorded clinical outcomes included residual axial neck pain, radicular arm pain, upper extremity weakness, and upper extremity altered sensation. Visual Analogue scores were also recorded. Fusion was assessed by lateral radiographs looking for bone breaching and radiolucent lines around the device at the latest follow-up. Results Ninety patients were included in the study. Fifty-one patients underwent 2-level surgery and 39 patients underwent 1-level surgery. Mean age was 44±10.4 years and mean follow-up time was 4.5±2.6 years. Patients reported excellent or good outcomes (90%), as well as improvements in axial neck pain (80%), radicular arm pain (95%), upper extremity weakness (85%), and upper extremity altered sensation (90%). Most patients (90%) progressed to fusion at the 1-year follow-up. The reoperation rate was 3.6%. There was no reported persistent dysphagia, voice complaints, dural tear, or tracheal or oesophageal perforation in any of the patients. One patient developed a deep methicillin-resistant Staphylococcus aureus infectious infarction of the spinal cord, which was treated with antibiotics. Recovery was complete at the 1-year follow up. Conclusions Mid-term results show that surgical treatment with ACDF with trabecular metal cages is a safe and effective treatment of single and 2-level

  11. Mid-Term Follow-Up of Drug-Eluting Stenting for In-Stent Restenosis: Bare-Metal Stents versus Drug-Eluting Stents

    PubMed Central

    Faramarzi, Negar; Salarifar, Mojtaba; Kassaian, Seyed Ebrahim; Zeinali, Ali Mohammad Haji; Alidoosti, Mohammad; Pourhoseini, Hamidreza; Nematipour, Ebrahim; Mousavi, Mohammad Reza; Goodarzynejad, Hamidreza

    2013-01-01

    Background: Despite major advances in percutaneous coronary intervention (PCI), in-stent restenosis (ISR) remains a therapeutic challenge. We sought to compare the mid-term clinical outcomes after treatment with repeat drug-eluting stent (DES) implantation (“DES sandwich” technique) with DES placement in the bare-metal stent (DES-in-BMS) in a “real world” setting. Methods: We retrospectively identified and analyzed clinical and angiographic data on 194 patients previously treated with the DES who underwent repeat PCI for ISR with a DES or a BMS. ISR was defined, by visual assessment, as a luminal stenosis greater than 50% within the stent or within 5 mm of its edges. We recorded the occurrence of major adverse cardiac events (MACE), defined as cardiac death, non-fatal myocardial infarction, and the need for target vessel revascularization (TVR). Results: Of the 194 study participants, 130 were men (67.0%) and the mean ± SD of age was 57.0 ± 10.4 years, ranging from 37 to 80 years. In-hospital events (death and Q-wave myocardial infarction) occurred at a similar frequency in both groups. Outcomes at twelve months were also similar between the groups with cumulative clinical MACE at one-year follow-up of 9.6% and 11.3% in the DES-in-BMS and the DES-in-DES groups, respectively (p value = 0.702). Although not significant, there was a trend toward a higher TVR rate in the intra-DES ISR group as compared to the intra-BMS ISR group (0.9% BMS vs. 5.2% DES; p value = 0.16). Conclusion: Our study suggests that the outcome of the patients presenting with ISR did not seem to be different between the two groups of DES-in-DES and DES-in-BMS at one-year follow-up, except for a trend toward more frequent TVR in the DES-in-DES group. Repeat DES implantation for DES restenosis could be feasible and safe with a relatively low incidence of MACE at mid-term follow-up. PMID:23646043

  12. Cystatin C as a predictive marker of renal dysfunction and mid-term outcomes following off-pump coronary artery bypass grafting

    PubMed Central

    Lee, Seung Hyun; Youn, Young-Nam; Choo, Hyun Chel; Lee, Sak; Yoo, Kyung-Jong

    2015-01-01

    Objective To determine whether plasma cystatin C and creatinine levels after isolated off-pump coronary artery bypass grafting (OPCAB) are predictive of postoperative renal dysfunction and clinical outcomes. Methods Between January 2008 and December 2013, 1033 who underwent isolated OPCAB were recruited. The patients were divided into three groups according to the preoperative level of cystatin C: low (0.83 mg/L>), mid (0.83–1.13 mg/L) and high (1.13 mg/L<). The endpoints of all-cause mortality and major adverse cerebrovascular and cardiovascular events were compared among three groups using the Kaplan–Meier method. The predictive power of cystatin C was compared with creatinine using receiver operating curves. Results Follow-up was complete in all of the included patients at a mean of 2.9±1.5 years. Within the follow-up period, 9 early (30-day mortality) and 46 late deaths occurred. The 30-day mortality was zero, four (44%), and five (56%) cases in low, mid and high groups, respectively (p=0.03). The cut-off value of cystatin C for renal dysfunction prediction was approximately 1.04 (mg/L, p<0.001), and cystatin C showed greater predictive power than creatinine for renal dysfunction (area under the curve=0.73 vs 0.65; p=0.01). One-year and five-year overall survival in low, mid and high groups were 99.2%, 98.9% and 94.3%, and 97.9%, 97.3% and 86.3%, respectively (low vs high, p=0.01). Conclusions Cystatin C is a stronger predictor of postoperative renal dysfunction than serum creatinine, and its level is directly correlated with mid-term OPCAB adverse results. PMID:26215986

  13. Ultrasound-guided radiofrequency ablation for cT1a renal masses in poor surgical candidates: mid-term, single-center outcomes

    PubMed Central

    Zachos, Ioannis; Dimitropoulos, Konstantinos; Karatzas, Anastasios; Samarinas, Michael; Petsiti, Argiro; Tassoudis, Vassilios; Tzortzis, Vassilios

    2016-01-01

    Objectives: Surgical management of small renal masses can be challenging in frail patients and thus modalities such as radiofrequency ablation (RFA) have emerged as valid alternative options. The aim of the current study was to present mid-term oncological and functional results on a series of patients with cT1a renal cell carcinomas (RCCs) who were unfit for surgery and underwent RFA using ultrasound guidance under local anesthesia. Methods: Data from patients fulfilling the study selection criteria were retrospectively collected. RENAL nephrometry score was used for tumor description. Parametric tests were used for data analysis and survival curves were estimated using the Kaplan–Meier method. Results: Overall, 32 patients (mean±standard deviation age, 72.4 ± 7.6 years) with biopsy-proven RCCs (tumor size, 23.75 ± 10.44 mm and RENAL score, 5.28 ± 1.33) underwent 32 RFA sessions. Twenty-seven patients (84.4%) had low complexity masses and five patients had masses of intermediate complexity (15.6%) according to RENAL score categorization. Over a follow-up period of 22.1 ± 13.7 months, one case of primary treatment failure was recognized (primary technical success 97.0%), and overall, three patients were diagnosed with residual disease (primary technique effectiveness 90.6%). No major complications occurred during the postprocedure 90-day follow up, while no difference was found in serum creatinine and estimated glomerular filtration rate pre and post procedure. Patients with intermediate-complexity renal lesions had shorter time to recurrence in comparison to low-complexity masses (p = 0.002). All patients were alive at the time of study data analysis without diagnosed metastases. Conclusions: Percutaneous RFA of small RCCs using ultrasound-based guidance under local anesthesia can be an effective alternative method for managing patients who are unfit for surgery.

  14. Effects of arthroscopic-assisted surgery on irreducible developmental dislocation of hip by mid-term follow-up: An observational study.

    PubMed

    Xu, Hui-Fa; Yan, Ya-Bo; Xu, Chao; Li, Tian-Qing; Zhao, Tian-Feng; Liu, Ning; Huang, Lu-Yu; Zhang, Chun-Li; Lei, Wei

    2016-08-01

    The purpose of this study was to investigate the indications, surgical technique, and the clinical effects of arthroscopic-assisted treatment of irreducible developmental dislocation of the hip by mid-term follow-up. Arthroscopic-assisted surgeries were performed on 40 children (52 hips) between January 2005 and December 2009. Anterior and antero-superior greater trochanter portals were used in these treatments. Spica cast and abduction splint were applied for 3 months postoperatively. The follow-up was conducted on every 3 months postoperatively. During 12-month follow-up, a secondary treatment such as acetabuloplasty and/or femoral osteotomy (shortening, varus, and derotation) was applied if the acetabular angle was greater than 25°. The pelvic acetabular angle, Mckay and Severin score were evaluated every 6 months in all children. With 36 to 96 months (average 71 months) follow-up, 35 children (44 hips) were successfully followed up with complete case data while 5 children unsuccessfully. According to Tönnis classification, there were 5 grade 1 hips, 14 grade 2 hips, 14 grade 3 hips, 11 grade 4 hips, in which 3 children (4 hips) were failed in arthroscopic reduction and femoral head avascular necrosis occurred in 2 children (4 hips). According to Mckay standard, the good rate is 100%. According to Severin standard, the good rate is 84.1%. Arthroscopic assisted treatment is an effective way of reduction of the irreducible hip. Compared with the open reduction, arthroscopic treatment combined with acetabuloplasty and/or femoral osteotomy has advantages of less trauma and better function preservation. PMID:27537595

  15. Mid-Term Patency in Radial Artery and Saphenous Vein After Coronary Artery Bypass Grafting in Asymptomatic Patients Using 128-Slice CT Coronary Angiography

    PubMed Central

    Sadeghpour, Ali; Pouraliakbar, Hamidreza; Azarfarin, Rasoul; Alizadeh Ghavidel, Alireza; Zavareian, Somayeh; Amirahmadi, Ali

    2015-01-01

    Background: Patency of the revascularization conduit is an essential predictor of long-standing survival after coronary artery bypass grafting. Objectives: We have conducted this study to compare the mid-term patency rates of radial artery (RA), left internal thoracic artery (LITA) and also saphenous vein (SV) grafts in asymptomatic patients following coronary artery bypass graft surgery (CABG) undergoing total IV anesthesia. Patients and Methods: In this study, 30 three-vessel disease patients with 104 RA, LITA, and SV grafts used concomitantly for primary isolated non-emergent CABG surgery were assessed. The primary end point was CT angiographic graft patency rate. After 53.5 (24-97) months’ follow-up, graft patency was assessed using 128-slice CT coronary angiography. Logistic regression analysis was used to detect the independent predictors of graft failure. Results: A total of 104 grafts, including 30 LITA, 44 SV, and 30 RA grafts, were studied. Cumulative graft patency rates were 93.3% in LITA, 83.3% in RA, and 70.5% in SV grafts. Statistically significant difference was found between the LITA and the SV graft patency rates (P = 0.019), whereas the difference between the RA conduit patency and the LITA or SV graft patency rates did not have any statistical significance (P = 0.424 and P = 0.273, respectively). Independent predictors of RA grafts occlusion were native coronary stenosis < 70% and female gender. Conclusions: In our patients, the RA grafts had an acceptable patency rate in 2 to 5 years’ follow-up. Although the SV grafts had a relatively higher patency rate than RA grafts in our asymptomatic patients, the patency rates in RA and SV grafts were close to each other. The RA graft function was poor in the patients with a higher number of risk factors and in the females. PMID:25789243

  16. [Coxitis fugax. The role of diagnostic imaging].

    PubMed

    de Pellegrin, M; Fracassetti, D; Ciampi, P

    1997-10-01

    Between 1990 and 1996, 129 children (mean age 4.8 years) with hip pain were examined consecutively. In group I (n = 100, mean age 4.14 +/- 2.2), transient synovitis of the hip was diagnosed; group II (n = 29, mean age 7.3 +/- 2.1) showed the following diagnoses: Perthes' disease (n = 12), early slipped capital femoral epiphysis (n = 5), Meyer's dysplasia (n = 2), septic arthritis of the hip (n = 2), osteomyelitis of the acetabulum (n = 1), abscess of the psoas (n = 1), chondromatosis of the hip joint (n = 1), Ewing's sarcoma of the os pubis (n = 1), hip dysplasia (n = 1). Three patients who had synovitis developed Perthes' disease and were assigned to group II. The efficiency of ultrasound, scintigraphy and MRI as diagnostic tools was tested in the examination of painful hip. A capsular distension was present in 73 cases and showed a significant statistical difference (t-test, P < 0.001) in group I between affected and unaffected hips. There were no differences in the measurements of the epiphyseal and metaphyseal width in group I between the affected and the nonaffected side (t-test, P = 0.91, P = 0.57) and between the first sonographic evaluation at presentation and at the follow-up (t-test, P = 0.053, P = 0.75). MRI was performed, because of persistent joint effusion, in 10 cases in group I, and Perthes' disease was excluded. In group II the use of an MRI allowed the diagnosis in 89% of the cases. Sonographic examination, together with X-ray examination and serological testing, represent the first choices in the evaluation of a painful hip at presentation and in the follow-up of transient synovitis. MRI should always be performed when abnormalities are present at the clinical and sonographic examination, and when the X-ray does not allow a clear diagnosis. PMID:9446093

  17. Use of a New Hybrid Heparin-Bonded Nitinol Ring Stent in the Popliteal Artery: Procedural and Mid-term Clinical and Anatomical Outcomes

    SciTech Connect

    Parthipun, Aneeta; Diamantopoulos, Athanasios; Kitrou, Panagiotis; Padayachee, Soundrie; Karunanithy, Narayan; Ahmed, Irfan; Zayed, Hany; Katsanos, Konstantinos E-mail: katsanos@med.upatras.gr

    2015-08-15

    PurposeTo report the immediate and mid-term clinical and anatomical outcomes of a novel, hybrid, heparin-bonded, nitinol ring stent (TIGRIS; Gore Medical) when used for the treatment of lesions located in the popliteal artery.Materials and MethodsThis was a prospective single-centre registry. Patients eligible for inclusion were individuals suffering from symptomatic popliteal arterial occlusive disease (Rutherford–Becker stage 3–6; P1–P3 segments) and treated with placement of the TIGRIS stent(s). Patients were prospectively scheduled for clinical review and duplex ultrasound follow-up after 6 and 12 months. Outcome measures included immediate technical success, primary vessel patency, in-stent binary restenosis (evaluable by Duplex at 50 % threshold; PSVR > 2.0), freedom from target lesion revascularization (TLR) and amputation-free survival (AFS) estimated by Kaplan–Meier (K–M) survival analysis. Cox proportional-hazards regression analysis was also performed to adjust for confounders and search for independent predictors of outcomes.ResultsFrom August 2012 to March 2014, a total of 54 popliteal TIGRIS stents were implanted in 50 limbs of 48 patients (27 men and 21 women; mean age 76.0 ± 1.7 years). Median Rutherford–Becker stage was five at baseline and 37/50 (74.0 %) were chronic total occlusions. Technical success was achieved in all cases (100 %). Stented lesion length was 114.2 ± 36.9 mm (range 6–20 cm). Median follow-up was 11.8 ± 0.8 months. After 12 months, primary patency of the TIGRIS stent was 69.5 ± 10.2 % with an 86.1 ± 5.9 % freedom from TLR and 87 ± 5.0 % AFS (K–M estimates).ConclusionThe TIGRIS hybrid heparin-bonded nitinol ring stent is a safe and effective endovascular option for complex occlusive disease of the popliteal artery.

  18. Seismic hazard models for the central Apennines constrained by GPS and InSAR: mid-term review results of the ESA Pathfinder project CHARMING

    NASA Astrophysics Data System (ADS)

    Merryman Boncori, John Peter; Pezzo, Giuseppe; Visini, Francesco; Carafa, Michele; Devoti, Roberto; Atzori, Simone; Kastelic, Vanja; Berardino, Paolo; Fornaro, Gianfranco; Riguzzi, Federica; Pietrantonio, Grazia; d'Amico, Vera; Meletti, Carlo; Salvi, Stefano

    2015-04-01

    The contribution of space geodetic techniques to earthquake rate estimation, and thus seismic hazard modelling, has been recognized since two decades and made possible in more recent years by the increased availability and accuracy of geodetic measurements. We present the mid-term review results of a feasibility study named "Constraining Seismic Hazard Models with InSAR and GPS (CHARMING)", funded by the European Space Agency's (ESA) Support to Science Element (STSE) Pathfinders 2013 project. The area of interest considered at this stage of the project comprises a 200 km x 200 km area, covering the Abruzzi region (central Italy). In a later stage this area shall be extended to comprise a large portion of central and southern Italy, including most of the highest strain regions identified by recent studies. We present the interseismic velocities derived by ~60 permanent GPS stations and measurements derived from coast-to-coast strips of Synthetic Aperture Radar imagery from the ERS-1/2 AMI, ENVISAT ASAR and ALOS PALSAR sensors. The latter are processed with the Intermittent Small Baseline Subset (ISBAS) techniques, which greatly improves the measurement coverage compared to previous studies. Corrections are applied concerning tropospheric propagation errors, using ENVISAT MERIS precipitable water vapour maps and ERA-Interim numerical weather model parameters, as well as for the recently discovered oscillator drift of the ENVISAT ASAR sensor. Finally, measurements from individual SAR tracks are calibrated using GPS to ensure a common reference frame. For a set of composite seismogenic sources extracted from the DISS v.3.1.1 catalogue (Database of Italian Seismogenic Sources), we use the kinematic finite element NeoKinema model to derive long term average velocity fields and slip rates. We then derive earthquake rates, i.e. the number of earthquakes in a given time period above an established magnitude threshold, following the Seismic Hazard Inferred From Tectonics

  19. Common Anorectal Disorders

    PubMed Central

    Foxx-Orenstein, Amy E.; Umar, Sarah B.; Crowell, Michael D.

    2014-01-01

    Anorectal disorders result in many visits to healthcare specialists. These disorders include benign conditions such as hemorrhoids to more serious conditions such as malignancy; thus, it is important for the clinician to be familiar with these disorders as well as know how to conduct an appropriate history and physical examination. This article reviews the most common anorectal disorders, including hemorrhoids, anal fissures, fecal incontinence, proctalgia fugax, excessive perineal descent, and pruritus ani, and provides guidelines on comprehensive evaluation and management. PMID:24987313

  20. Poor mid-term survival of the low-carbide metal-on-metal Zweymüller-plus total hip arthroplasty system: a concise follow-up, at a minimum of ten years, of a previous report*.

    PubMed

    Repantis, Thomas; Vitsas, Vasilis; Korovessis, Panagiotis

    2013-03-20

    Between 1994 and 1999, 217 metal-on-metal total hip arthroplasties with a low-carbide bearing surface were performed with use of the cementless Zweymüller SL-Plus stem and the Bicon-Plus threaded cup in 194 consecutive patients. After a minimum follow-up of ten years, 181 living patients (203 hips) were available for evaluation. The revision rate after an average of twelve years was 18% (thirty-six hips in thirty-six patients were revised). The main reason for revision was aseptic loosening of one or both components. The probability of survival of the stem at fifteen years was 77% (95% confidence interval [CI], 65% to 86%). The probability of survival of the cup was 80% (95% CI, 62% to 90%). These high failure rates at mid-term follow-up led us to abandon the use of low-carbide metal-on-metal total hip arthroplasty components. PMID:23515994

  1. Sequential Vein Bypass Grafting is Not Associated with an Increase of Either In-hospital or Mid-term Adverse Events in Off-pump Coronary Artery Bypass Grafting

    PubMed Central

    Xiao, Fucheng; Wang, Jian; Wu, Hengchao; Sun, Hansong

    2015-01-01

    Background: The impact of sequential vein bypass grafting on clinical outcomes is less known in off-pump coronary artery bypass grafting (CABG). We aimed to evaluate the effects of sequential vein bypass grafting on clinical outcomes in off-pump CABG. Methods: From October 2009 to September 2013 at the Fuwai Hospital, 127 patients with at least one sequential venous graft were matched with 127 patients of individual venous grafts only, using propensity score matching method to obtain risk-adjusted outcome comparison. In-hospital measurement was composite outcome of in-hospital death, myocardial infarction (MI), stroke, requirement for intra-aortic ballon pump (IABP) assistance and prolonged ventilation. Major adverse cardiac events (MACEs: Death, MI or repeat revascularization) and angina recurrence were considered as mid-term endpoints. Results: No significant difference was observed among the groups in baseline characteristics. Intraoperative mean blood flow per vein graft was 40.4 ml in individual venous grafts groups versus 59.5 ml in sequential venous grafts groups (P < 0.001). There were no differences between individual and sequential venous grafts groups with regard to composite outcome of in-hospital mortality, MI, stroke, IABP assistance and prolonged ventilation (11.0% vs. 14.2%, P = 0.45). Individual in-hospital measurement also did not differ significantly between the two groups. At about four years follow-up, the survival estimates free from MACEs (92.5% vs. 97.3%, P = 0.36) and survival rates free of angina recurrence (80.9% vs. 85.5%, P = 0.48) were similar among individual and sequential venous grafts groups with a mean follow-up of 22.5 months. In the Cox regression analysis, sequential vein bypass grafting was not identified as an independent predictor of both MACEs and angina recurrence. Conclusions: Compared to individual vein bypass grafting, sequential vein bypass grafting was not associated with an increase of either in-hospital or mid-term

  2. The Present, Mid-Term, and Long-Term Supply Curves for Tellurium; and Updates in the Results from NREL's CdTe PV Module Manufacturing Cost Model (Presentation)

    SciTech Connect

    Woodhouse, M.; Goodrich, A.; Redlinger, M.; Lokanc, M.; Eggert, R.

    2013-09-01

    For those PV technologies that rely upon Te, In, and Ga, first-order observations and calculations hint that there may be resource constraints that could inhibit their successful deployment at a SunShot level. These are only first-order approximations, however, and the possibility for an expansion in global Te, In, and Ga supplies needs to be considered in the event that there are upward revisions in their demand and prices.In this study, we examine the current, mid-term, and long-term prospects of Tellurium (Te) for use in PV. We find that the current global supply base of Te would support <10 GW of annual traditional CdTe PV manufacturing production. But as for the possibility that the supply base for Te might be expanded, after compiling several preliminary cumulative availability curves we find that there may be significant upside potential in the supply base for this element - principally vis a vis increasing demand and higher prices. Primarily by reducing the Tellurium intensity in manufacturing and by increasing the recovery efficiency of Te in Cu refining processes, we calculate that it may prove affordable to PV manufacturers to expand the supply base for Te such that 100 GW, or greater, of annual CdTe PV production is possible in the 2030 - 2050 timeframe.

  3. Provenance of alluvial fan deposits to constrain the mid-term offsets along a strike-slip active fault: the Elsinore fault in the Coyote Mountains, Imperial Valley, California.

    NASA Astrophysics Data System (ADS)

    Masana, Eulalia; Stepancikova, Petra; Rockwell, Thomas

    2013-04-01

    The lateral variation in rates along a fault and its constancy along time is a matter of discussion. To give light to this discussion, short, mid and long term offset distribution along a fault is needed. Many studies analyze the short-term offset distribution along a strike-slip fault that can be obtained by the analysis of offset features imprinted in the morphology of the near-fault area. We present an example on how to obtain the mid- to long-term offset values based on the composition of alluvial fans that are offset by the fault. The study area is on the southern tip of the Elsinore fault, which controls the mountain front of the Coyote Mountains (California). The Elsinore-Laguna Salada fault is part of the San Andreas fault (SAF) system, extending 250 km from the Los Angeles Basin southeastward into the Gulf of California, in Mexico. The slip-rate on the southern Elsinore fault is believed to be moderate based on recent InSAR observations, although a recent study near Fossil Canyon (southern Coyote Mountains) suggests a rate in the range of 1-2 mm/yr. For this study we processed the airborne LiDAR dataset (EarthScope Southern & Eastern California, SoCal) to map short to mid-term alluvial offsets. We reprocessed the point clouds to produce DEMs with 0.5m and 0.25m grids and we varied the insolation angles to illuminate the various fault strands and the offset features. We identified numerous offset features, such as rills, channel bars, channel walls, alluvial fans, beheaded channels and small erosional basins that varied in displacement from 1 to 350 m. For the mid- to long-term offsets of the alluvial fans we benefited from the diverse petrological composition of their sources. Moreover, we recognized that older alluvium, which is offset by greater amounts, is in some cases buried beneath younger alluvial fan deposits and separated by buried soils. To determine the source canyon of various alluvial elements, we quantified the clast assemblage of each source

  4. Predicting Mid-Term Grades for Science Students at Perkinston.

    ERIC Educational Resources Information Center

    Mann, Noel R.

    In order to reduce the 35-40% dropout/failure rate in chemistry classes at the Perkinston Campus of Mississippi Gulf Coast Junior College, this study sought predictors which would provide early identification of students in need of special or additional help. Using regression analysis, data accumulated from the achievement records of students over…

  5. MESSENGER at Mercury: A mid-term report

    NASA Astrophysics Data System (ADS)

    Bedini, Peter D.; Solomon, Sean C.; Finnegan, Eric J.; Calloway, Andrew B.; Ensor, Susan L.; McNutt, Ralph L.; Anderson, Brian J.; Prockter, Louise M.

    2012-12-01

    After almost 5 years in development and more than 6 and a half years in cruise toward its destination, NASA's MErcury Surface, Space ENvironment, GEochemistry, and Ranging (MESSENGER) spacecraft finally entered orbit about Mercury on 18 March 2011, initiating a 1-year, focused investigation of the innermost planet. Operating from a highly eccentric orbit designed to keep the spacecraft safe and to facilitate the required observations, MESSENGER is using its payload of seven instruments and the spacecraft's radio-frequency telecommunications system to characterize the planet's interior, surface, atmosphere, and magnetosphere. The demands of the many measurements needed to meet the program objectives, coupled with the constraints associated with spacecraft safety and the orbital geometry, led to the adoption of an automated science-planning tool to optimize science data collection. The tool was used to design the entire year of observations prior to orbit insertion and has the capability of regenerating the plan quickly in response to anomalies in flight (e.g., spacecraft safe-mode demotions) or on the ground (e.g., missed Deep Space Network tracks). Because one Earth year spans two Mercury solar days, there are two opportunities in the course of MESSENGER's science data-collection campaign to observe any specific location on the planet with a given viewing geometry. To take advantage of this schedule, the science plan was divided into two parts. During the first solar day, priority was given to producing global map products. The second day will be used to focus on specific targets and to recover observations missed during the first half of the year. Also, complementary observations can be made in the second day that, when paired with results from the first day, form a stereo map. Although only midway through the orbital operations phase of the mission, MESSENGER had, at the end of the first Mercury solar day, already viewed the entire surface of the planet once and produced global monochrome and multispectral maps. The spacecraft's orbit has completed two local-time rotations and three rotations in longitude, allowing spatial characterization of the planet's magnetic field, development of an elevation model from northern hemisphere altimetry, and global abundance estimates for major elements. After more than 350 orbits, more than 80 Gbit of compressed data have been collected, including more than 50,000 images. Calibrated data from the first 2 months in orbit have been delivered to NASA's Planetary Data System for dissemination to the science community.

  6. Mid-term experience with valved bovine jugular vein conduits.

    PubMed

    Pawelec-Wojtalik, Malgorzata; Mrówczyński, Wojciech; Wodziński, Andrzej; Wojtalik, Michal; Henschke, Jacek; Sharma, Girish K

    2005-12-01

    From June 1999 to January 2004, 43 children underwent implantation of a valved bovine jugular vein conduit and correction of complex congenital heart defects. Median age was 1.98 years (range, 11 days - 13.3 years). There were 7 early deaths (16.3%) unrelated to conduit failure or thrombosis. Median follow-up of 36 survivors was 24 months (range, 1-48 months, quartile range, 12-48 months), total follow-up was 78 patient-years. There were 3 late deaths (8.3%) due to infection, pulmonary thromboembolism, and sudden cardiac arrest after re-operation to repair a right ventricular outflow tract aneurysm. There were 2 conduit explantations due to dysfunction and suspected endocarditis. Three patients underwent balloon dilatation of distal stenoses. The mean peak gradient through the pulmonary anastomosis was 15 mm Hg (range, 3-42 mm Hg) among patients free from re-intervention. No severe valve regurgitation was observed. Freedom from re-intervention was 72% at 48 months. This conduit remains a good alternative to homografts. Causes of distal stenosis must be clarified, guidelines for prophylactic anticoagulation must be created, and the role of percutaneous balloon dilatation established. PMID:16304226

  7. Texasgulf solar cogeneration program. Mid-term topical report

    SciTech Connect

    Not Available

    1981-02-01

    The status of technical activities of the Texasgulf Solar Cogeneration Program at the Comanche Creek Sulfur Mine is described. The program efforts reported focus on preparation of a system specification, selection of a site-specific configuration, conceptual design, and facility performance. Trade-off studies performed to select the site-specific cogeneration facility configuration that would be the basis for the conceptual design efforts are described. Study areas included solar system size, thermal energy storage, and field piping. The conceptual design status is described for the various subsystems of the Comanche Creek cogeneration facility. The subsystems include the collector, receiver, master control, fossil energy, energy storage, superheat boiler, electric power generation, and process heat subsystems. Computer models for insolation and performance are also briefly discussed. Appended is the system specification. (LEW)

  8. The formal Darwinism project: a mid-term report.

    PubMed

    Grafen, A

    2007-07-01

    For 8 years I have been pursuing in print an ambitious and at times highly technical programme of work, the 'Formal Darwinism Project', whose essence is to underpin and formalize the fitness optimization ideas used by behavioural ecologists, using a new kind of argument linking the mathematics of motion and the mathematics of optimization. The value of the project is to give stronger support to current practices, and at the same time sharpening theoretical ideas and suggesting principled resolutions of some untidy areas, for example, how to define fitness. The aim is also to unify existing free-standing theoretical structures, such as inclusive fitness theory, Evolutionary Stable Strategy (ESS) theory and bet-hedging theory. The 40-year-old misunderstanding over the meaning of fitness optimization between mathematicians and biologists is explained. Most of the elements required for a general theory have now been implemented, but not together in the same framework, and 'general time' remains to be developed and integrated with the other elements to produce a final unified theory of neo-Darwinian natural selection. PMID:17584220

  9. Space station needs, attributes and architectural options study. Briefing material, mid-term review

    NASA Technical Reports Server (NTRS)

    1982-01-01

    User mission requirements and their relationship to the current space transportation system are examined as a means of assuring the infusion of corporate ideas and knowledge in the space station program. Specific tasks include developing strategies to develop user consistency; determine DOD implication and requirements; and foster industry involvement in the space station. Mission alternatives; accrued benefits; program options; system attributes and characteristics; and a recommended plan for space station evolution are covered.

  10. Mid-Term Outcomes Following Endovascular Re-Intervention for Iliac Artery In-Stent Restenosis

    PubMed Central

    Javed, Usman; Balwanz, Christopher R.; Armstrong, Ehrin J.; Yeo, Khung-Keong; Singh, Gagan D.; Singh, Satinder; Anderson, David; Westin, Gregory G.; Pevec, William C.; Laird, John R.

    2013-01-01

    Objectives We sought to evaluate the procedural characteristics and clinical outcomes of endovascular repair for iliac artery (IA) in-stent restenosis (ISR). Background An increasing percentage of patients with complex IA occlusive disease are treated with an endovascular approach, but the outcomes of IA-ISR have not been well described. Methods We analyzed all endovascular procedures for treatment of IA-ISR performed at our institution between July 2006–December 2010. The primary outcome was primary patency, defined as <50% stenosis as assessed by clinical examination and duplex ultrasonography (DUS). Results Forty-one lesions in 24 patients who underwent repeated endovascular intervention for treatment of IA-ISR. Most lesions were unilateral and involved the common IA (66%). The mean length of ISR was 30.1 ± 14.1 mm with type I (focal) and II (diffuse) ISR occurring with the greatest frequency (34% and 39%, respectively). All patients underwent balloon angioplasty; adjunctive stenting zwas performed in 27 (66%) of the lesions. Type II ISR lesions more frequently required stenting (13/16 lesions, P = 0.02 compared with other patterns of ISR). Procedural success was 100% with a mean gain of 0.13 in the ankle-brachial index (P = 0.001). The 6-and 12-month primary patency rates were 96% and 82%, respectively. The 12-month primary-assisted patency rate was 90% with clinically driven target lesion revascularization (TLR) in three patients. Conclusions Endovascular treatment of IA-ISR using an approach of balloon angioplasty followed by selective stenting is associated with high-patency rates and low rates of TLR at 1 year. PMID:23613343

  11. Mid-Term Report On 'SMOS CAL/VAL In China'

    NASA Astrophysics Data System (ADS)

    Zhang, Weiguo; Wu, Ji; Liu, Heguang; Liu, Hao; Li, Zengyuan; Kerr, Yann; Desnos, Y.-L.; Hahne, A.; Mecklenburg, S.

    2010-10-01

    Within framework of Dragon-2 programme, collaboration on SMOS Cal/Val is on the track. This paper reviewed SMOS behavior and status which follows the latest progress in the field. By analyzing historical low frequency microwave radiometric observation and ground truth data, it is shown the Taklamakan desert is well suited for calibration of spaceborne microwave sensors such as SMOS MIRAS. The pioneer experiment confirms the assumption in the simulation and defines requirements for further works. Sampling tools for the specified environment as well as an L band ground based radiometer were designed and constructed. Data analysis shows many areas in China are affected by RFI problem. It will be necessary to investigate the problem further in depth both technically and tactically.

  12. Return to sporting activity after Birmingham hip resurfacing arthroplasty: Mid term results

    PubMed Central

    Sandiford, Nemandra; Muirhead-Allwood, SK; Skinner, JA

    2015-01-01

    Background: Hip resurfacing arthroplasty (HRA) is primarily indicated for young, active patients with disabling coxarthrosis who wish to remain active and return to sports after surgery. Relatively few prospective studies have assessed return to sporting activity and impact of gender and age on this. Materials and Methods: Seventy-nine consecutive patients treated with HRA were included. Patients were reviewed clinically and radiologically. Function was assessed using the modified University of California Los Angeles (UCLA) activity score. The Oxford, Harris and WOMAC hip scores were calculated. Results: Average age at the time of surgery was 54.9 years (range 34.5–73.6 years). Average preoperative and postoperative UCLA scores were 4 and 7.6 respectively. Patients were involved in 2 (0–4) sporting activities preoperatively and 2 (0–5) postoperatively. Preoperative and postoperative Oxford Hip Scores, Harris Hip Score and WOMAC scores were 40, 46 and 51 and 16, 94 and 3 respectively (P < 0.0001). Patients returned to sports at an average of 3 months postoperatively. Conclusion: Patients were able to return to sports by 3 months and perform the same number of activities at preoperative intensity. Activity levels are maintained up to the medium term with few complications. PMID:26806965

  13. Mid-term effects of mine soil reclamation by use of aided phytostabilization

    NASA Astrophysics Data System (ADS)

    Zornoza, Raúl; Faz, Ángel; Martínez-Martínez, Silvia; Acosta, Jose Alberto; Gómez, María Dolores; Yanardag, Ibrahim

    2014-05-01

    Abandoned tailing ponds show environmental and human health hazards by the transfer of heavy metals through erosion or leaching. To reduce these hazards, a reclamation strategy has been developed on a tailing pond based on aided phytostabilization. In 2011 marble mud and pig slurry were applied on the tailing pond surface. In spring 2012 thirteen native vegetal species were introduced. During two years (2012-2013) the evolution of different soil properties and the bioavailable fraction of the heavy metals Cd, Pb and Zn has been monitored. Results showed that pH, aggregates stability, organic carbon, nitrogen and cation exchange capacity increased with the application of the amendments and the development of vegetation, while the bioavailable fraction of the heavy metals drastically decreased (90-99%). Thus, the strategy followed resulted positive to reduce the availability of heavy metals, improving soil quality and fertility. These results are promising in areas with extractive activity of carbonated materials, since the generated wastes can be used for reclamation of soils affected with heavy metals, turning a waste into a by-product. Key words: amendments, geochemistry, heavy metals, mining, tailing pond. Acknowledgements: This work has been funded by the European Union LIFE+ project MIPOLARE (LIFE09 ENV/ES/000439).

  14. Mid-term NEAT review: analysing the improvements in hospital ED performance.

    PubMed

    Khanna, Sankalp; Boyle, Justin; Good, Norm; Lind, James

    2014-01-01

    Introduced with a promise to reduce overcrowding in the Emergency Department (ED) and the associated morbidity and mortality linked to bed access difficulties, the National Emergency Access Target (NEAT) is now over halfway through transitionary arrangements towards a target of 90% of patients that visit a hospital ED being admitted or discharged within 4 hours. Facilitation and reward funding has ensured hospitals around the country are remodelling workflows to ensure compliance. Recent reports however show that the majority of hospitals are still far from being able to meet this target. We investigate the NEAT journey of 30 Queensland hospitals over the past two years and compare this performance to a previous study that investigated the 4 hour ED discharge performance of these hospitals at various times of day and under varying occupancy conditions. Our findings reveal that, while most hospitals have made significant improvements to their 4 hour discharge performance in 2013, the underlying flow patterns and periods of poor NEAT compliance remain largely unchanged. The work identifies areas for targeted improvement to inform system redesign and workflow planning. PMID:25087527

  15. Mid term results of total hip arthroplasty using polyethylene-ceramic composite (Sandwich) liner

    PubMed Central

    Wang, Tao; Sun, Jun-Ying; Zha, Guo-Chun; Dong, Sheng-Jie; Zhao, Xi-Jiang

    2016-01-01

    Background: Ceramic-on-ceramic (COC) couplings are an attractive alternative bearing surfaces that have been reported to eliminate or reduce problems related to polyethylene wear debris. However, the material in total hip arthroplasty (THA) remains one of the major concern regarding the risk of fracture. The present study aims at reporting the fracture rate of bearings in a series of COC THAs with the use of a sandwich liner and attempt to detect the relative risk factors, the possible cause and assess the clinical results. Materials and Methods: We retrospectively evaluated 153 patients (163 hips) using the sandwich liner COC THA between 2001 and 2009. Patient assessment was based on demographic factors, including age, weight, gender and body-mass index (BMI). All patients were evaluated clinically and radiographically or using computed tomography viz-a-viz dislocation, osteolysis, periprosthetic fracture, infection, loosening and implant fracture. Results: Three ceramic sandwich liners fracture (1.84%) were observed at an average of 7.3 years’ followup. The factors which were found to be non-significant to the ceramic liner fracture, included age (P = 0.205), weight (P = 0.241), gender (P = 0.553), BMI (P = 0.736), inclination (P = 0.199) and anteversion (P = 0.223). The overall survival was 91.4% at 12-year with revision as the endpoint. Other complications included osteolysis in 4 (2.45%), dislocation in one and periprosthetic fracture in one. In no hip aseptic loosening of the implants was seen. Conclusions: Our experience with the ceramic-polyethylene sandwich liner acetabular component has been disappointing because of the high rate of fracture and osteolyis. We have discontinued the use of this device and recommend the same. PMID:26952027

  16. Mid-term results of a metal-backed glenoid component in total shoulder replacement.

    PubMed

    Castagna, A; Randelli, M; Garofalo, R; Maradei, L; Giardella, A; Borroni, M

    2010-10-01

    Total shoulder replacement is a successful procedure for degenerative or some inflammatory diseases of the shoulder. However, fixation of the glenoid seems to be the main weakness with a high rate of loosening. The results using all-polyethylene components have been better than those using metal-backed components. We describe our experience with 35 consecutive total shoulder replacements using a new metal-backed glenoid component with a mean follow-up of 75.4 months (48 to 154). Our implant differs from others because of its mechanism of fixation. It has a convex metal-backed bone interface and the main stabilising factor is a large hollow central peg. The patients were evaluated with standard radiographs and with the Constant Score, the Simple Shoulder Test and a visual analogue scale. All the scores improved and there was no loosening, no polyethylene-glenoid disassembly and no other implant-related complications. We conclude that a metal-backed glenoid component is a good option in total shoulder replacement with no worse results than of those using a cemented all-polyethylene prosthesis. PMID:20884980

  17. Mid-term evaluation of USAID Sudan Energy Planning and Management Project (650-0059)

    SciTech Connect

    Jones, D.W.; Stovall, J.P.; Raby, J.G.; Younger, D.R.; Pryor, C.A.

    1987-07-01

    The Energy Planning and Management (EPM) Project was designed to increase reliability of the Blue Nile Grid and to bolster the management and operation of the National Electricity Corporation (NEC) and the General Petroleum Corporation (GPC), and to help develop the National Energy Administration (NEA) as a national energy planning institution. Two major successes are already in evidence at NEC at mid-project. The Blue Nile Grid reliability has improved from a low of 74% in 1983 to 94% currently; although the EPM project has not been the only influence, its maintenance activities have been partly responsible for this improvement. Accomplishments of NEA and NEC are described.

  18. What can we expect from near to mid-term direct imaging programs?

    NASA Astrophysics Data System (ADS)

    Boccaletti, A.

    2015-10-01

    Direct imaging for exoplanets has made enormous progress in the last decades owing to the advent of new technologies, efficient algorithms for postprocessing and dedicated observing strategies. A few young giant exoplanets were detected with the previous generation of instruments (beta Pic b, HS3799bcde, HR95086b ...). While SPHERE and GPI were conceived with this very purpose, we are thus expecting many more discoveries in the next years. SPHERE comes with a series of facilities to characterize the atmosphere of these planets, from the visible to the near IR, with broad band, narrow band filters, and low to medium resolution spectroscopy as well. It is also a fabulous instrument to study circumstellar disks both intensity and polarimetry in order to establish the link between planets and their environments. A large survey of 600 targets on a 5 years baseline has been started. The next space telescope, JWST equipped with MIRI and NIRCAM will extend the ability to characterize young giants in the mid IR. NO doubt we will learn more about their atmospheres. Finally, by the next decade, very large apertures will become available on the ground. Extremely Large Telescope will have general first light instruments (MICADO, HARMONI), but some programs to image and characterize young giant planets around very distant stars (>100pc) will be feasible. For much ambitious goal, detecting telluric planets and studying their atmosphere, two paths are now considered either from space (WFIRST AFTA-C is good candidate) and from the Ground with SPHERE-like instruments on ELTs. A review of achievments and perspectives in the context of direct imaging will be presented.

  19. Phase 3 study of selected tether applications in space, mid-term review

    NASA Technical Reports Server (NTRS)

    1986-01-01

    Topics addressed include: guidelines for the Space Transportation System (STS) payload deployer design; mini-orbital maneuvering vehicle (MOMV) design: shuttle tether deployer systems (STEDS); cost modeling; tethered platform analysis; fuel savings analysis; and STEDS control simulation.

  20. Mid-Term Outcome of Mechanical Pulmonary Valve Prostheses: The Importance of Anticoagulation

    PubMed Central

    Sadeghpour, Anita; Kyavar, Majid; Javani, Bahareh; Bakhshandeh, Hooman; Maleki, Majid; Khajali, Zahra; Subrahmanyan, Lakshman

    2014-01-01

    Introduction: Pulmonary valve replacement (PVR) is being performed more commonly late after the correction of tetralogy of Fallot. Most valves are replaced with an allograft or xenograft, although reoperations are a common theme. Mechanical prostheses have a less favorable reputation due to the necessity of lifelong anticoagulation therapy and higher risk of thrombosis, but they are also less likely to require reoperation. There is a paucity of data on the use of prosthetic valves in the pulmonary position. We report the midterm outcomes of 38 cases of PVR with mechanical prostheses. Methods: One hundred twenty two patients who underwent PVR were studied. Thirty-eight patients, mean age 25 ± 8.4 years underwent PVR with mechanical prostheses based on the right ventricular function and the preferences of the patients and physicians. Median age of prosthesis was 1 year (range 3 months to 5 years). Results: Seven (18%) patients had malfunctioning pulmonary prostheses and two patients underwent redo PVR. Mean International Normalized Ratio (INR) in these seven patients was 2.1±0.8. Fibrinolytic therapy was tried and five of them responded to it well. There was no significant association between the severity of right ventricular dysfunction, patient’s age, prostheses valve size and age of the prosthesis in the patients with prosthesis malfunction. Conclusion: PVR with mechanical prostheses can be performed with promising midterm outcomes. Thrombosis on mechanical pulmonary valve prostheses remains a serious complication, but most prosthesis malfunction respond to fibrinolytic therapy, underscoring the need for adequate anticoagulation therapy. PMID:25320663

  1. Mid-term outcomes of primary constrained condylar knee arthroplasty for severe knee deformity.

    PubMed

    Feng, Xiao-Bo; Yang, Cao; Fu, De-Hao; Ye, Shu-Nan; Liu, Xian-Zhe; Chen, Zhe; Rai, Saroj; Yang, Shu-Hua

    2016-04-01

    This study aimed to examine the clinical and radiographic outcomes of primary total knee arthroplasy (TKA) with use of NexGen® Legacy® Constrained Condylar Knee (CCK) prosthesis for severe knee deformity. Clinical data of 46 patients (48 knees in total, aged 61 years on average) with severe knee deformity who underwent TKA with NexGen® Legacy® CCK prosthesis between December 2007 and February 2012 were retrospectively analyzed. There were 34 knees with severe valgus with incompetent medial collateral ligament, 11 knees with severe flexion contracture with inability to achieve knee balancing in flexion and extension by posterior soft tissue release, 2 knees with Charcot arthritis with severe varus and bone loss, and 1 with traumatic osteoarthritis with severe varus and ligamentous instability. The mean duration of follow-up was 71 months (range 40-90 months). The New Knee Society scoring (NKSS) system and the Hospital for Special Surgery (HSS) score were used to evaluate the functional and clinical outcomes. Visual Analogue Scale (VAS) was used for pain measurement and Knee Society criteria for evaluation of radiological images. The results showed that, in the total 48 knees, 1 case of loosening due to short-stem tibial component at 3 months post-operatively underwent revision. The 6-year prosthesis survival rate in this cohort was 97.9%. There was no component infection occurring within 6 years. Significant post-operative improvements were found in NKSS and HSS scores. Patient satisfaction was significantly increased. Pain score was decreased significantly. Total functional score was improved from 31.46±11.43 to 86.42±8.87, range of motion (ROM) from 42.42°±23.57° to 95.31°±23.45° and the flexion contracture from 5.31°±7.87° to 0.92°±1.80°. Preoperative radiographic study showed excessive valgus (≥7°) in 37 knees, and varus deformity in 3 knees. Post-operative femorotibial alignment was valgus 3.88°±1.76° in 48 knees. Antero/posterior (A/P) view of X-ray films showed 4 radiolucent lines (RLL) in 48 tibial components. It was concluded that TKA with CCK is effective for the treatment of the severe unstable knee that cannot be balanced by soft tissue. PMID:27072968

  2. Pure Laparoscopic Radical Cystectomy with Ileal Conduit: A Single Surgeon's Mid-Term Outcomes

    PubMed Central

    Park, Bumsoo; Jeong, Byong Chang; Jeon, Seong Soo; Lee, Hyun Moo; Choi, Han Yong

    2013-01-01

    Purpose The use of laparoscopic radical cystectomy (LRC) for muscle-invasive bladder cancer is not yet widespread because of the technical difficulties of the procedure and the lengthy operating time. In this study, we report a single surgeon's experience with LRC. Materials and Methods Thirty patients (25 men and 5 women) with bladder cancer underwent LRC and ileal conduit by a single surgeon between November 2007 and May 2011. An extracorporeal urinary diversion was performed through 5-6 cm midline incision for specimen extraction. Results The median operating time and estimated blood loss were 527.5 minutes and 275 mL, respectively. There was no conversion to open surgery. The median time to oral intake and postoperative hospital stay were 5 days and 12 days, respectively. The rates of immediate, early postoperative and late postoperative complication were 3.3%, 20% and 20%, respectively. With 16 months of median follow-up, the overall and recurrence-free survival rates were 70% and 56.7%, respectively. Conclusion LRC is feasible for the management of invasive bladder cancer and, with appropriate patient selection, can be a good alternative to open or robot-assisted radical cystectomy in the era of robot-assisted surgery. PMID:23709426

  3. U.S. Natural Gas Markets: Mid-Term Prospects for Natural Gas Supply

    EIA Publications

    2001-01-01

    This service report describes the recent behavior of natural gas markets with respect to natural gas prices, their potential future behavior, the potential future supply contribution of liquefied natural gas and increased access to federally restricted resources, and the need for improved natural gas data.

  4. Mid-term functional outcome after the internal fixation of distal radius fractures

    PubMed Central

    2012-01-01

    Background Distal radius fracture is a common injury with a variety of operative and non-operative management options. There remains debate as to the optimal treatment for a given patient and fracture. Despite the popularity of volar locking plate fixation, there are few large cohort or long term follow up studies to justify this modality. Our aim was to report the functional outcome of a large number of patients at a significant follow up time after fixation of their distal radius with a volar locking plate. Methods 180 patients with 183 fractures and a mean age of 62.4 years were followed up retrospectively at a mean of 30 months (Standard deviation = 10.4). Functional assessment was performed using the Disabilities of the Arm, Shoulder and Hand (DASH) and modified MAYO wrist scores. Statistical analysis was performed to identify possible variables affecting outcome and radiographs were assessed to determine time to fracture union. Results The median DASH score was 2.3 and median MAYO score was 90 for the whole group. Overall, 133 patients (74%) had a good or excellent DASH and MAYO score. Statistical analysis showed that no specific variable including gender, age, fracture type, post-operative immobilisation or surgeon grade significantly affected outcome. Complications occurred in 27 patients (15%) and in 11 patients were major (6%). Conclusion This single centre large population series demonstrates good to excellent results in the majority of patients after volar locking plate fixation of the distal radius, with complication rates comparable to other non-operative and operative treatment modalities. On this basis we recommend this mode of fixation for distal radius fractures requiting operative intervention. PMID:22280557

  5. Coronary artery bypass surgery without cardiopulmonary bypass: short- and mid-term results.

    PubMed

    Mishra, Y; Mehta, Y; Kohli, V M; Kohli, V; Mairal, M; Mishra, A; Bapna, R K; Trehan, N

    1997-01-01

    From March 1994 to April 1997, 433 patients had undergone coronary artery bypass grafting without cardiopulmonary bypass in our institute. Sixty-eight patients had various organ dysfunctions and/or aortic atheroma or calcification and were regarded as high risk for cardiopulmonary bypass. In 277 patients surgery was performed through midline sternotomy, while in 156 minithoracotomy approach was used. In 361 patients single coronary artery bypass grafting was done, and in 72 two-coronary arteries were bypassed. In 63 patients who had graftable vessels in anterior wall and diffusely diseased ungraftable vessels in posterolateral and/or inferior wall, transmyocardial laser revascularisation was also done along with coronary artery bypass grafting to achieve complete myocardial revascularisation. Nine patients in this series were also subjected to simultaneous carotid endarterectomy along with myocardial revascularisation. In two patients complementary percutaneous transluminal coronary angioplasty of left circumflex coronary artery was done five days after minithoracotomy and left internal mammary artery to left anterior descending coronary artery bypass grafting. Forty-two cases were extubated in operating room. Average blood loss was 260 ml. Six patients were reexplored for postoperative bleeding. Seven patients had perioperative myocardial infarction. One developed neurological complication. Hospital mortality was 2.3 percent (10/433 cases) and four deaths were due to malignant ventricular arrhythmias. Nine patients developed chest wound complications. Average hospital stay after operation was six days, 423 patients were discharged from hospital and all of them were asymptomatic. During three years follow-up (range 3 to 38 months) there were three known cardiac deaths. Ninety percent (391) patients reported to the follow-up clinic and 91 percent of them were angina-free. In patients who were subjected to transmyocardial laser revascularisation along with coronary artery bypass grafting, myocardial perfusion scan showed a step-wise improvement in reversible ischemia. The perfusion index increased from 52 percent at three months to 90 percent at 12 months. We conclude that coronary artery bypass grafting without cardiopulmonary bypass can be done with relatively low mortality, more so in a group of patients in whom cardiopulmonary bypass poses a high risk. Transmyocardial laser revascularisation is a suitable means to provide complete myocardial revascularisation along with coronary artery bypass surgery in patients who have graftable vessels in anterior wall and ungraftable vessels in posterolateral and inferior walls. PMID:9505019

  6. Opium Consumption and Mid-Term Outcome of Percutaneous Coronary Intervention in Men

    PubMed Central

    Sharafi, Ahmad; Pour Hosseini, Hamid Reza; Jalali, Arash; Salarifar, Mojtaba; Nematipour, Ebrahim; Shojanasab, Mohsen; Aghajani, Hassan; Amirzadegan, Alireza; Nozari, Younes; Alidoosti, Mohamad; Zeinali, Alimohammad Haji; Kassaian, Seyed Ebrahim

    2014-01-01

    Abstract Background: Controversy persists over the potential benefits/harms of opium consumption in coronary heart disease. This study investigated the association between 12 months’ major adverse cardiac events (MACE) and pre-procedural opium consumption among patients undergoing percutaneous coronary intervention (PCI). Methods: Retrospectively, 1545 consecutive men who underwent PCI between 21st June 2009 and 20th June 2010 at Tehran Heart Center and were registered in the PCI Databank were entered into this cohort study. The occurrence of MACE, defined as cardiac death, non-fatal myocardial infarction, and need for target vessel revascularization (TVR) or target lesion revascularization (TLR), was compared between two groups of opium consumers and non-consumers in 350 (22.7%) patients. Results: Sixty-four (0.86%) patients expired within 12 months. After adjustment for potential confounders, analysis revealed that opium consumption had no significant relationship with 12 months’ MACE [11(3.1%) vs. 53(4.4%); p value = 0.286, among opium users vs. non users, respectively].Furthermore, the different components of MACE, including target vessel revascularization, target lesion revascularization, coronary artery bypass graft, and non-fatal myocardial infarction, were not significantly related to opium use. Conclusion: Pre-procedural opium usage in patients undergoing PCI was not associated with 12 months’ MACE. PMID:25870628

  7. Early and Mid-Term Outcome of Pediatric Congenital Mitral Valve Surgery

    PubMed Central

    Baghaei, Ramin; Tabib, Avisa; Jalili, Farshad; Totonchi, Ziae; Mahdavi, Mohammad; Ghadrdoost, Behshid

    2015-01-01

    Background: Congenital lesions of the mitral valve are relatively rare and are associated with a wide spectrum of cardiac malformations. The surgical management of congenital mitral valve malformations has been a great challenge. Objectives: The aim of this study was to evaluate the early and intermediate-term outcome of congenital mitral valve (MV) surgery in children and to identify the predictors for poor postoperative outcomes and death. Patients and Methods: In this retrospective study, 100 consecutive patients with congenital MV disease undergoing mitral valve surgery were reviewed in 60-month follow-up (mean, 42.4 ± 16.4 months) during 2008 - 2013. Twenty-six patients (26%) were under one-year old. The mean age and weight of the patients were 41.63 ± 38.18 months and 11.92 ± 6.12 kg, respectively. The predominant lesion of the mitral valve was MV stenosis (MS group) seen in 21% and MR (MR group) seen in 79% of the patients. All patients underwent preoperative two-dimensional echocardiography and then every six months after surgery Results: Significant improvement in degree of MR was noted in all patients with MR during postoperative and follow-up period in both patients with or without atrioventricular septal defect (AVSD) (P = 0.045 in patients with AVSD and P = 0.008 in patients without AVSD). Decreasing trend of mean gradient (MG) in MS group was statistically significant (P = 0.005). In patients with MR, the mean pulmonary artery pressure (PAP) had improved postoperatively (P < 0.001). Although PAP in patients with MV stenosis was reduced, this reduction was not statistically significant (P = 0.17). In-hospital mortality was 7%. Multivariate analysis demonstrated that age (P < 0.001), weight (P < 0.001), and pulmonary stenosis (P = 0.03) are strong predictors for mortality. Based on the echocardiography report at the day of discharge from hospital, surgical results were optimal (up to moderate degree for MR group and up to mild degree for MS group) in 85.7% of patients with MS and in 76.6% of patients with MR. Age (P = 0.002) and weight (P = 0.003) of patients are strong predictors for surgical success in multivariate analysis. Conclusions: Surgical repair of the congenital MV disease yields acceptable early and intermediate-term satisfactory valve function and good survival at intermediate-term follow-up. Strong predictors for poor surgical outcome and death were age smaller than 1 year, weight smaller or equal than 6 kg, and associated cardiac anomalies such as pulmonary stenosis. PMID:26446282

  8. Mid-Term Outcomes in Patients Implanted with Cardiac Resynchronization Therapy

    PubMed Central

    Lee, Sung Ho; Park, Seung-Jung; Kim, June Soo; Shin, Dae-Hee; Cho, Dae Kyoung

    2014-01-01

    We applied cardiac resynchronization therapy (CRT) for desynchronized heart failure patients. We evaluated clinical outcomes including morbidity, mortality, and echocardiographic parameters in 47 patients with implanted CRT in Korea from October 2005 to May 2013. The combined outcomes of hospitalization from heart failure, heart transplantation and death were the primary end point. Median follow-up period was 17.5 months. The primary outcomes listed above occurred in 10 (21.3%) patients. Two patients (4.3%) died after CRT and 8 (17%) patients were hospitalized for recurrent heart failure. Among patients hospitalized for heart failure, 2 (4.3%) patients underwent heart transplantation. The overall free rate of heart failure requiring hospitalization was 90.1% (95% CI, 0.81-0.99) over one year and 69.4% (95% CI, 0.47-0.91) over 3 yr. We observed improvement of the New York Heart Association classification (3.1±0.5 to 1.7±0.4), decreases in QRS duration (169.1 to 146.9 ms), decreases in left ventricular (LV) end-diastolic (255.0 to 220.1 mL) and end-systolic (194.4 to 159.4 mL) volume and increases in LV ejection fraction (22.5% to 31.1%) at 6 months after CRT. CRT improved symptoms and echocardiographic parameters in a relatively short period, resulting in low mortality and a decrease in hospitalization due to heart failure. PMID:25469065

  9. The Mid-Term Changes of Pulmonary Function Tests After Phrenic Nerve Transfer

    PubMed Central

    Yavari, Masoud; Hassanpour, Seyed Esmail; Khodayari, Mohammad

    2016-01-01

    Background: In the restoration of elbow flexion, the phrenic nerve has proven to be a good donor, but considering the role of the phrenic nerve in respiratory function, we cannot disregard the potential dangers of this method. Objectives: In the current study, we reviewed the results of pulmonary function tests (PFT) in four patients who underwent phrenic nerve transfer. Patients and Methods: We reviewed the results of serial spirometry tests, which were performed before and after phrenic nerve transfer surgery. Results: All patients regained Biceps power to M3 strength or above. None of our patients experienced pulmonary problems or respiratory complaints, but a significant reduction of spirometric parameters occurred after surgery. Conclusions: This study highlights the close link between the role of the phrenic nerve and pulmonary function, such that the use of this nerve as a transfer donor leads to spirometric impairments. PMID:27148498

  10. Mid-Term Results of Terrain Measurements in the Dragon-3 Program

    NASA Astrophysics Data System (ADS)

    Liao, Mingsheng; Zhang, Lu; Balz, Timo; Li, Deren

    2014-11-01

    In the project 10569 under the theme “Terrain Measurement” within the ESA-MOST Dragon-3 program, our research focused on topographic mapping and deformation measurements with SAR data acquired by ESA missions as well as third party missions. SAR data was used to map topography in mountainous area using interferometry and stereoscopy. Deformations due to slow landslide movements and urban ground subsidence were measured by PSI and offset tracking techniques. In this paper an overview of the studies undertaken is given and the achievements are summarized.

  11. Mid-Term Status of the Forest Dragon III: Data Collection and Regional Aboveground Biomass Estimation

    NASA Astrophysics Data System (ADS)

    Pang, Yong; Li, Zengyuan; Liu, Luxia; Lu, Hao; Jia, Wen; Liu, Qingwang; Tian, Xin; Zhang, Ruiying; Shmullius, Christiana

    2014-11-01

    In the 1st two years of Forest Dragon 3 project, Chinese groups engaged in following activities: 1) field measurements and airborne campaigns for forest map validation, 2) regional forest aboveground biomass (AGB) estimation algorithm development and map generation. The AGB estimation by fusion multisensor fusion was investigated. Two campaigns consist of in-situ observation, airborne flight and spaceborne measurements were designed and implemented in the Heilongjiang Province and Yunnan Province of China. The Heilongjiang Province is located in Northeast China and has typical temperate forest. The Yunnan Province is located in Southwest China and contains multiple forest types including tropical forest. By using these observation data from different scales, multi-source satellite data were used to estimate spatial explicit AGB for Da Xinganling study area.

  12. Mid Term Progress Report: Desertification Assessment and Monitoring in China Based on Remote Sensing

    NASA Astrophysics Data System (ADS)

    Gao, Zhihai; del Barrio, Gabriel; Li, Xiaosong; Wang, Bengyu; Puigdefabregas, Juan; Sanjuan, Maria E.; Bai, Lina; Wu, Junjun; Sun, Bin; Li, Changlong

    2014-11-01

    The objective of Dragon 3 Project 10367 is the development of techniques research for desertification assessment and monitoring in China using remote sensing data in combination with climate and environmental-related data. The main achievements acquired since2012could be summarized as follows: (1)Photosynthetic vegetation(PV)and non-photosynthetic vegetation(NPV)fraction were retrieved separately through utilizing Auto Monte Carlo Unmixing technique (AutoMCU), based on BJ-1 data and field measured spectral library. (2) The accuracy of sandy land classification was as high as81.52%when the object-oriented method and Support Vector Machine (SVM) classifiers were used. (3) A new Monthly net primary productivity (NPP)dataset from 2002 to 2010 for the whole China were established with Envisat-MERIS fraction of absorbed photosynthetically active radiation (FPAR) data. (4) The 2dRUE proved to be a good indicator for land degradation, based on which, land degradation status in the general potential extent of desertification in China(PEDC) was assessed preliminarily.

  13. Mid-term outcome of opening-wedge high tibial osteotomy for varus arthritic knees.

    PubMed

    Haviv, Barak; Bronak, Shlomo; Thein, Ran; Kidron, Amos; Thein, Rafael

    2012-02-01

    Gonarthrosis in the relatively young and active population causes major daily discomfort and disability. If the arthritic process is mainly limited to the medial compartment, the axis of a varus knee can be realigned laterally with high tibial osteotomy to unload the medial compartment and allow some cartilage regeneration and pain relief. This study describes the outcomes of patients who underwent opening-wedge high tibial osteotomies using Puddu plate (Arthrex, Naples, Florida) fixation. Eighteen patients (22 knees) with genu varum and medial compartment osteoarthritis were followed-up for an average of 6.3±2.3 years after high tibial osteotomy with Puddu plate fixation and iliac crest allograft. Clinical outcome was assessed by the Oxford Knee Score and subjective satisfaction rating. Pre- and postoperative radiographs were evaluated for tibiofemoral angle, Insall-Salvati index, and Kellgren-Lawrence Grading Scale for osteoarthritis. Mean patient age at surgery was 44±13.7 years, and mean body mass index was 29.1±4.7 kg/m(2). At last follow-up, mean Oxford Knee Score improved from 22.4±13.5 to 37.2±13.7 (P=.002). Average subjective satisfaction rate at last follow-up was 8±3. The measured tibiofemoral angle was corrected to an average genu valgum of 3.3°±4.8° (P=.001). No patient showed severe postoperative osteoarthritis (ie, Kellgren-Lawrence grade 4) at last follow-up. All radiographs showed full incorporation of the bone grafts. At the end of the study, 2 patients underwent total knee replacement. Opening-wedge high tibial valgus osteotomy with Puddu plate fixation can be a reliable procedure for the treatment of medial-compartment osteoarthritis of the knee associated with varus deformity. PMID:22310405

  14. Lost Opportunities: The Civil Rights Record of the Bush Administration Mid-Term.

    ERIC Educational Resources Information Center

    Liss, Susan M., Ed.; Taylor, William L., Ed.

    This study of the civil rights policies and practices of the Bush Administration reviews the first 2 years of that administration's actions, presents recommendations for the future, and offers a series of working papers prepared by experts in the civil rights field. Part 1 of two major parts presents the actual report of the Citizen's Commission…

  15. Primary rotating-hinge total knee arthroplasty: good outcomes at mid-term follow-up.

    PubMed

    Kowalczewski, Jacek; Marczak, Dariusz; Synder, Marek; Sibiński, Marcin

    2014-06-01

    We evaluated the clinical and radiologic outcomes of primary knee replacements using a rotating-hinge knee prosthesis in 12 knees with a minimum follow-up of 10 years. Indications for the operation included gross joint destruction, significant axial deformities and contracture with a dysfunctional medial collateral ligament in all cases. The patients' WOMAC and Knee Society scores improved, and the use of mobility aids decreased. No loosening of implants was observed. Nonprogressive radiolucent lines were identified around three tibial components. Three patients required marginal wound excision with resuturing and thereafter healed uneventfully. With significant improvement in function, pain and range of motion, the rotating-hinge knee prosthesis can be used as a salvage device in patients with medial collateral ligament deficiency, contracture, and gross joint destruction. PMID:24418767

  16. Short- and Mid-Term Changes in Lung Function after Bilateral Pulmonary Metastasectomy.

    PubMed

    Welter, Stefan; Cheufou, Danjouma; Zahin, Mahmood; Kampe, Sandra; Darwiche, Kaid; Weinreich, Gerhard; Stamatis, Georgios

    2016-03-01

    Introduction The resection of pulmonary metastases is associated with a loss of lung function. The amount of functional impairment after bilateral metastasectomy remains unclear. Because only around 35% of those patients may expect long-term survival, it is important to preserve enough pulmonary function for an adequate quality of life. This analysis of 31 bilaterally operated patients was performed to describe the amount of pulmonary function loss. Methods This is a post-hoc subanalysis and comparison of a population that was published before. All pulmonary metastasectomies were performed through an anteroaxillary thoracotomy in all patients. Resections were performed with staplers, electrocautery, or laser. All patients had pulmonary function tests (PFTs) preoperative and after 3 months at the follow-up visit, including spirometry, diffusing capacity of lung for carbon monoxide (Dlco) and blood gases. Of the 31 bilaterally operated cases, 15 had additional PFTs after each staged operation before discharge from hospital. Results Altogether, 271 nodules (median 7, mean 8.2) were removed from the 31 patients with a lobectomy in 2, a segmentectomy in 8, and multiple wedge resections in 21 patients, with this being the largest resection. The mean loss of pulmonary function at follow-up visit was forced vital capacity (FVC) - 15.2%, total lung capacity (TLC) - 13.8%, forced expiratory volume in 1 second (FEV1) - 16.3%, and Dlco - 10.3%, all of which were significant (p = < 0.001). The 15 patients with PFTs after each operation showed a stepwise decrease of volume parameters and Dlco with deepest values after the second surgery of around - -40% from preoperative values. At this time, Po 2 was also significantly reduced by 10 mm Hg (p = 0.01). Comparing the bilateral group with 86 patients after unilateral metastasectomy, we found significantly more nodules removed in the bilateral group (8.2 vs. 3.1; p < 0.001) and that the loss of volume parameters was twice that of the unilateral group after metastasectomy. Dlco impairment did not differ between the groups (- 10.3 vs. - 9.5%; p = 0.868) after 3 months. Conclusion Midterm pulmonary function impairment after bilateral pulmonary metastasectomy is 15% of spirometry values and 10% of Dlco. Reduction of spirometry values is almost twice compared with the group after unilateral surgery. Early functional loss after the second intervention causes FVC, TLC, and FEV1 reduction of around 40% and is associated with lower Po 2 (- 10 mm Hg). Therefore, bilateral metastasectomy can be offered to patients who do not have greater pulmonary limitations. PMID:25068776

  17. Mid-term patency of the inverted left internal thoracic artery conduit.

    PubMed

    Nezic, Dusko G; Bojovic, Zeljko R; Milicic, Miroslav D; Antonic, Zelimir D; Boricic, Mladen I; Micovic, Slobodan V

    2014-11-01

    In order to expand the revascularization of the left anterior descending coronary artery, we have applied the inverted left internal thoracic artery (left internal thoracic artery [LITA] transected near its origin, thus supplied by retrograde flow from superior epigastric and musculophrenic arteries) in carefully selected cases (four patients). The 64-slice multidetector row computed tomographic scans performed postoperatively (range, 6 to 40 days), as well as the scans performed in the follow-up period (range, 18 to 35 months) showed preserved inverted LITA conduits with thrombolysis in myocardial infarction (TIMI) 3 flow in all patients. PMID:25100203

  18. Mid-term results of Copeland shoulder cementless surface replacement arthroplasty from an independent centre

    PubMed Central

    Modi, Chetan S; Drew, Stephen J; Turner, Stephen M

    2014-01-01

    Background The present study reports our experience of Copeland shoulder cementless surface replacement arthroplasty (CSRA) and whether glenoid microfracture influences the progression of glenoid erosion. Methods One-hundred-and-twelve CSRAs were performed in 101 patients between 2002 and 2007. Eighty-three patients were alive at the median follow-up time of 72 months (range 9 to 121 months; interquartile range 46 to 93 months). Assessment included an Oxford shoulder score (OSS), patient satisfaction score and plain radiographs. Results The mean (range) OSS was 27 (7 to 48) and 64 of 73 (87.7%) patients were ‘very satisfied’ or ‘satisfied’ with their shoulder. Twenty-three (20.5%) shoulders had over 2 mm of glenoid erosion. Microfracture was performed in 43 of 112 shoulders (38.4%) and did not influence the progression of glenoid erosion. Further surgery was performed in 27 (24.1%) shoulders, including 15 revisions, eight arthrolyses and four subacromial decompressions. Revision to total shoulder arthroplasty was performed in 14 : 10 for glenoid erosion; one each for loosening, periprosthetic fracture, deep infection, and chronic pain. One was revised to reverse arthroplasty for chronic pain. Conclusions CSRA performed in an independent centre reproduces the functional outcomes reported by the designer. Glenoid erosion, however, was a common occurrence and the main cause of revision – microfracture did not influence its progression.

  19. Anococcygeal Raphe Revisited: A Histological Study Using Mid-Term Human Fetuses and Elderly Cadavers

    PubMed Central

    Arakawa, Takashi; Abe, Hiroshi; Abe, Shinichi; Cho, Baik Hwan; Murakami, Gen; Sugihara, Kenichi

    2012-01-01

    Purpose We recently demonstrated the morphology of the anococcygeal ligament. As the anococcygeal ligament and raphe are often confused, the concept of the anococcygeal raphe needs to be re-examined from the perspective of fetal development, as well as in terms of adult morphology. Materials and Methods We examined the horizontal sections of 15 fetuses as well as adult histology. From cadavers, we obtained an almost cubic tissue mass containing the dorsal wall of the anorectum, the coccyx and the covering skin. Most sections were stained with hematoxylin and eosin or Masson-trichrome solution. Results The adult ligament contained both smooth and striated muscle fibers. A similar band-like structure was seen in fetuses, containing: 1) smooth muscle fibers originating from the longitudinal muscle coat of the anal canal and 2) striated muscle fibers from the external anal sphincter (EAS). However, in fetuses, the levator ani muscle did not attach to either the band or the coccyx. Along and around the anococcygeal ligament, we did not find any aponeurotic tissue with transversely oriented fibers connecting bilateral levator ani slings. Instead, in adults, a fibrous tissue mass was located at a gap between bilateral levator ani slings; this site corresponded to the dorsal side of the ligament and the EAS in the immediately deep side of the natal skin cleft. Conclusion We hypothesize that a classically described raphe corresponds to the specific subcutaneous tissue on the superficial or dorsal side of the anococcygeal ligament. PMID:22665356

  20. Global Immunization Vision and Strategy (GIVS): a mid-term analysis of progress in 50 countries.

    PubMed

    Kamara, Lidija; Lydon, Patrick; Bilous, Julian; Vandelaer, Jos; Eggers, Rudi; Gacic-Dobo, Marta; Meaney, William; Okwo-Bele, Jean-Marie

    2013-01-01

    Within the overall framework set out in the Global Immunization Vision and Strategy (GIVS) for the period 2006-2015, over 70 countries had developed comprehensive Multi-Year Plans (cMYPs) by 2008, outlining their plans for implementing the GIVS strategies and for attaining the GIVS Goals at the midpoint in 2010 or earlier. These goals are to: (1) reach ≥90% and ≥80% vaccination coverage at national and district level, respectively; and (2) reduce measles-related mortality by 90% compared with the 2000 level. Fifty cMYPs were analysed along the four strategic areas of the GIVS: (1) protecting more people in a changing world; (2) introducing new vaccines and technologies; (3) integrating immunization, other health interventions and surveillance in the health system context; and (4) immunizing in the context of global interdependence. By 2010, all 50 countries planned to have introduced hepatitis B (HepB) vaccine, 48 the Haemophilus influenzae type B (Hib) vaccine and only a few countries had firm plans to introduce pneumococcal or rotavirus vaccines. Countries seem to be inadequately prepared in terms of cold-chain requirements to deal with the expected increases in storage that will be required for vaccines, and in making provisions to establish a corresponding surveillance system for planned new vaccine introductions. Immunization contacts are used to deliver other health interventions, especially in the countries in the World Health Organization (WHO) Africa Region. The cost for the planned immunization activities will double to U$27 per infant, of which U$5 per infant is the expected shortfall. Global Alliance for Vaccines and Immunization (GAVI) funding is becoming the largest contributor to immunization programmes. PMID:22411879

  1. [Surgery for incomplete atrioventricular canal. Mid-term follow-up apropos of 128 patients].

    PubMed

    Houyel, L; Petit, J; Langlois, J; Nottin, R; Planche, C; Binet, J P

    1988-04-01

    Among 128 consecutive patients operated upon between 1972 and 1984 at the Marie-Lannelongue Surgical Centre for incomplete persistent atrioventricular canal, 102 could be followed up for periods ranging from 18 months to 11 years. Of the 23 patients lost sight of, 19 were foreigners. One patient died during the first postoperative month and two died during the following five months; there was no death thereafter. One patient developed complete atrioventricular block immediately after surgery. At the end of the follow-up period, three patients had been reoperated upon for disinsertion of the patch on the ostium primum associated in one case with massive mitral regurgitation; two complete atrioventricular blocks requiring permanent pacing had occurred some time after surgery; five patients had presented with late atrial dysrhythmia, and only six patients had signs of heart failure primarily due to residual mitral regurgitation. At radiography, the cardiothoracic ratio was reduced in 74 p. 100 of the cases from 0.60 +/- 0.08 to 0.53 +/- 0.05 (p less than 0.001), and the earlier the operation had been performed, the greater the reduction in cardiothoracic ratio (p less than 0.05). A mitral regurgitation murmur was observed in 72 p. 100 of patients immediately after surgery and in 82 p. 100 of patients at the end of the follow-up period. The murmur was usually weak (79 p. 100) with a tendency to remain stable (44 p. 100) or to increase in intensity (43 p. 100, but reoperation was necessary in only one case.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:3136711

  2. [Immediate and mid-term results of surgery of aortic valve stenosis in the newborn infant].

    PubMed

    Losay, J; Touchot-Koné, A; Bruniaux, J; Serraf, A; Lacour-Gayet, F; Planché, C; Binet, J P

    1992-05-01

    Between January 1980 and June 1990, 47 consecutive neonates with severe aortic stenosis underwent surgical aortic commissurotomy at Marie-Lannelongue Hospital. The average age at operation was 5 days. Other cardiac abnormalities were present in 27 children and left ventricular fibroelastosis in 11 children. Closed heart aortic valvotomy via the apex of the left ventricle was performed in 26 patients and open heart commissurotomy in 21 patients. Immediate per- or postoperative death was observed in 14 cases (29.8%). Six patients died after open heart valvulotomy (29%) and 8 after closed heart valvulotomy (31%). The mortality was higher in children with a critical preoperative status: 60% versus 22% (p less than 0.05); in cases with an associated cardiac malformation: 45% versus 6% (p less than 0.01) or fibroelastosis: 91% versus 11% (p less than 0.001). None of the patients was lost to follow-up which lasted an average of 47 +/- 41 months. Ten secondary deaths were observed, of which 4 were sudden, 4 after reoperation and 2 due to mitral stenosis with pulmonary hypertension. The overall one year survival was 57% (IC 70%: 40-64); the 5 year survival was 46% (IC 70%; 30-60). Reoperation was necessary in 12 children. Survival without reoperation at 1 and 5 years was 49% (IC 70%: 41-56) and 43% (IC 70%: 29-59) respectively. At the last follow-up examination, 97% of the 23 survivors had good left ventricular function; the systolic pressure gradient was less than 50 mmHg in two thirds of patients and aortic regurgitation was minimal or absent in three quarters of patients. In critical aortic stenosis in neonates, surgery is associated with a high immediate and secondary mortality. The results at medium term in the survivors are good with respect to symptoms, left ventricular function and obstruction to left ventricular ejection. PMID:1530395

  3. Diurnal and twenty-four hour patterning of human diseases: acute and chronic common and uncommon medical conditions.

    PubMed

    Smolensky, Michael H; Portaluppi, Francesco; Manfredini, Roberto; Hermida, Ramon C; Tiseo, Ruana; Sackett-Lundeen, Linda L; Haus, Erhard L

    2015-06-01

    The symptom intensity and mortality of human diseases, conditions, and syndromes exhibit diurnal or 24 h patterning, e.g., skin: atopic dermatitis, urticaria, psoriasis, and palmar hyperhidrosis; gastrointestinal: esophageal reflux, peptic ulcer (including perforation and hemorrhage), cyclic vomiting syndrome, biliary colic, hepatic variceal hemorrhage, and proctalgia fugax; infection: susceptibility, fever, and mortality; neural: frontal, parietal, temporal, and occipital lobe seizures, Parkinson's and Alzheimer's disease, hereditary progressive dystonia, and pain (cancer, post-surgical, diabetic neuropathic and foot ulcer, tooth caries, burning mouth and temporomandibular syndromes, fibromyalgia, sciatica, intervertebral vacuum phenomenon, multiple sclerosis muscle spasm, and migraine, tension, cluster, hypnic, and paroxysmal hemicranial headache); renal: colic and nocturnal enuresis and polyuria; ocular: bulbar conjunctival redness, keratoconjunctivitis sicca, intraocular pressure and anterior ischemic optic neuropathy, and recurrent corneal erosion syndrome; psychiatric/behavioral: major and seasonal affective depressive disorders, bipolar disorder, parasuicide and suicide, dementia-associated agitation, and addictive alcohol, tobacco, and heroin cravings and withdrawal phenomena; plus autoimmune and musculoskeletal: rheumatoid arthritis, osteoarthritis, axial spondylarthritis, gout, Sjögren's syndrome, and systemic lupus erythematosus. Knowledge of these and other 24 h patterns of human pathophysiology informs research of their underlying circadian and other endogenous mechanisms, external temporal triggers, and more effective patient care entailing clinical chronopreventive and chronotherapeutic strategies. PMID:25129839

  4. Proctalgia and colorectal stricture as the result of a 2-year transit of a retained rectal chicken bone: a case presentation and review of the literature.

    PubMed

    Elmoghrabi, Adel; Mohamed, Mohamed; Wong, Kristoffer; McCann, Michael

    2016-01-01

    We report a case of a 70-year-old woman who presented with progressively increasing intensity of lower abdominal, pelvic and rectal pain of 3-day duration. She had similar symptoms intermittently over the preceding 2 years. CT of the abdomen and pelvis revealed the presence of a 3.8×0.4 cm linear foreign body in the colorectal region. History obtained from relatives recalled inadvertent ingestion of a chicken bone 2 years prior to presentation. Trials of foreign body retrieval, both manually and via rigid and flexible sigmoidoscopy, however, were unsuccessful due to the presence of obstruction by a circumferential rectal stricture. Consequently, an exploratory laparotomy was performed, with segmental resection of 17 cm of rectum and distal sigmoid. Dissection of the strictured segment revealed the presence of a chicken bone. The patient had an uneventful postoperative course, was discharged and is to continue following up on an outpatient basis. PMID:27325671

  5. Mid-term quasi-periodicities in the CaII-K plage index of the Sun and their implications

    NASA Astrophysics Data System (ADS)

    Chowdhury, Partha; Gokhale, M. H.; Singh, Jagdev; Moon, Y.-J.

    2016-02-01

    We present results of the fast Fourier transform (FFT), the MEM analysis, and the wavelet analysis (WA), of the temporal variation of the monthly disk integrated "CaII-K plage-area and enhanced network (EN) area" hereafter called `plage index' derived by Tlatov et al. (2009), from spectro-heliograms taken in Ca II K line at Kodaikanal Observatory, from February 1907 to April, 1998, In the range {>}3 months and < decade, the Fourier transform power spectra reveal solar cycle periodicity {˜}122 months, its sub-harmonic ˜61 months, two short quasi-periodicities ({>}2 and <4 months), and nine `intermediate-range' quasi-periodicities (≳ 4 mo and <11 yr), in the variation of the plage index. The quasi-periodicities include Rieger, Rieger type and quasi-biennial. The presence of quasi-periodicities and the mean values of the periods are confirmed by the maximum entropy method (MEM). The temporal spans of the quasi-periodicities during different solar cycles are determined from the complex Morlet-wavelet analyses. The Rieger quasi-periodicity (150-160 days) appeared during cycle 21 and cycle 22. Each of the quasi-periodicities in the studied range lies close to one or more planetary periodicities (orbital, or spring tidal, or heliocentric conjunction frequency). We discuss possible interpretations of our results, and those of similar results obtained earlier by other authors, towards understanding the mechanisms of excitation of various quasi-periodicities detected in solar variability parameters.

  6. Is the tantalum Strecker stent suitable for TIPS creation? short- and mid-term results in 20 consecutive patients

    SciTech Connect

    Ugolotti, Ugo; Larini, Pietro; Marcato, Carla; Saccani, Andrea; Puccianti, Franca; Pedretti, Giovanni

    1997-01-15

    Purpose. To assess the suitability of tantalum Strecker stents for transjugular intrahepatic portosystemic shunt (TIPS) creation. Methods. TIPS was performed with Strecker balloon-expandable stents in the first 20 patients of our series. A total of 26 prostheses were utilized (average 1.3 per patient). Results. Immediate technical success was achieved in all 20 cases. Nine patients (45%) died during follow-up. The overall average follow-up period was 18.9 months; the 11 survivors were followed for a mean period of 29.8 months. In 4 patients (20%) the stent dislodged towards the hepatic vein during withdrawal of the balloon catheter, and difficulties in recatheterizing the shunt for routine control portal phlebography were frequently encountered. Rebleeding occurred in 5 cases and aggravation of pre-existing encephalopathy occurred in 2 cases. Shunt occlusions or stenosis required further intervention in 4 and 9 patients, respectively. Conclusion. In our opinion the tantalum Strecker stent is not particularly suitable for TIPS. Although it has evident advantages, such as high radiopacity and minimal shortening after deployment, the tendency of the device to dislodge and the difficulty in recatheterization during portal phlebography were important drawbacks. Furthermore, the atraumatic ends of the device did not seem to reduce shunt-related complications, which were comparable to those occurring with other types of stent.

  7. Mid-term study of bone remodeling after femoral cemented stem implantation: comparison between DXA and finite element simulation.

    PubMed

    Herrera, Antonio; Rebollo, Sarai; Ibarz, Elena; Mateo, Jesús; Gabarre, Sergio; Gracia, Luis

    2014-01-01

    This five-year prospective study was designed to investigate periprosthetic bone remodeling associated with two cemented stem models, ABG-II (Stryker) and VerSys (Zimmer), randomly implanted in patients older than 75 years. The sample consisted of 64 cases (32, ABG-II; 32, VerSys). Inclusion criterion was diagnosis of osteoarthritis recommended for cemented total hip arthroplasty. Besides clinical study, Finite Element (FE) simulation was used to analyze biomechanical changes caused by hip arthroplasty. Bone Mineral Density (BMD) measurements showed a progressive increase in bone mass throughout the entire follow-up period for both stems, well correlated with FE results except in Gruen zones 4, 5, 6 for ABG-II and in zones 4, 5 for VerSys, denoting that remodeling in those zones does not depend on mechanical factors but rather on biological or physiological ones. PMID:23725926

  8. Does Previous Hip Surgery Effect the Outcome of Tönnis Triple Periacetabular Osteotomy? Mid-Term Results

    PubMed Central

    Konya, Mehmet Nuri; Aydın, Bahattin Kerem; Yıldırım, Timur; Sofu, Hakan; Gürsu, Sarper

    2016-01-01

    Abstract Hip dysplasia (HD) is 1 of the major reasons of coxarthrosis. The goal of the treatment of HD by Tönnis triple pelvic osteotomy (TPAO) is to improve the function of hip joint while relieving pain, delaying and possibly preventing end-stage arthritis. The aim of this study is to compare the clinical and radiological results of TPAO to determine if previous surgery has a negative effect on TPAO. Patients operated with TPAO between 2005 and 2010, included in this study. Patients divided into 2 groups: primary acetabular dysplasia (PAD) and residual acetabular dysplasia (RAD). Prepostoperatively, hip range of motion, Harris hip score (HHS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) hip score, visual analog scores (VAS), impingement tests, and also the presence of Trendelenburg sign (TS) were investigated for clinical evaluation. For radiological analysis pre–postoperative, anterior–posterior (AP) pelvis and faux profile radiographs were used. Acetabular index, lateral center edge (LCE) angle, and Sharp angles were measured by AP pelvis; anterior center edge (ACE) angle were measured by faux profile radiography. All the clinical and radiological data of the groups were analyzed separately for the pre–postoperative scores also the amount of improvement in all parameters were analyzed. SPSS20 (SPSS Inc., Chicago, IL) was used for statistical analysis. Wilcoxon test, McNemar test, paired t tests, and Mann–Whitney U tests were used to compare the groups. P < 0.05 were defined as statistically significant. Study included 27 patients: 17 patients were in PAD and 10 patients were in RAD. The mean follow-up period was 6.2 years (5.2–10.3 years). In all patients, the radiological and the clinical outcomes were better after TPAO except the flexion of the hip parameter. When the patient groups were evaluated as pre–postoperatively, more statistically significant parameters were found in the PAD group when compared with RAD group. Extension, impingement, TS, VAS, HHS, WOMAC score parameters in clinical outcome and LCE, ACE, Sharp angle, coverage ratio in radiological results were significantly better in PAD group postoperatively but in RAD group; only extension, VAS, HHS, and WOMAC parameters were clinically and LCE and Coverage ratio were significantly different compared with the preoperative measurements. The change of the parameters that used for the evaluation of clinical and radiological results did not show a significant difference between groups. Our data suggest that TPAO can be performed on patients with HD for both groups. Although there were fewer parameters which changed significantly after TPAO in RAD patients; the improvement of radiological and clinical results was similar for groups. Further long-term follow-up studies with large number of patients are needed to determine the proper results of TPAO. PMID:26962829

  9. Partnership Development Fund: Keep America Working Project. West Hills Community College Mid-Term and Final Report.

    ERIC Educational Resources Information Center

    West Hills Community Coll., Coalinga, CA.

    With funding from the Keep America Working Project, the West Hills Community College (WHCC) District initiated efforts to establish a rural vocational/technical education curriculum partnership between the college and the major unified school districts in its service area. The project focused on improving the competencies of high-risk students,…

  10. Treating epiphora in adults with the Wilhelm plastic nasolacrimal stent: mid-term results of a prospective study.

    PubMed

    Ciampi, Juan J; Lanciego, Carlos; Navarro, Sofia; Cuena, Rafael; Velasco, Javier; Perea, Miguel; García-García, Lorenzo

    2011-02-01

    The objective of the present study was to evaluate, in a prospective, single-center study, the effectiveness of the Wilhelm-type stent used in interventional radiology for the management of epiphora. Patients (n = 104; mean age 64 [range 25–88]; 33 male and 71 female) with severe epiphora had the stents inserted (135 stents in 115 eyes) to treat obstruction of the nasolacrimal system. The etiology of the obstruction was idiopathic in 83 cases, chronic dacryocystitis in 31, cases and postsurgical status in 1 case. The overall technical success rate of stent placement was near 94%. Resolution of epiphora was complete in 105 cases and partial in 3 cases. During a mean 13-month follow-up (range 1 week to 28 months), the median duration of primary patency was 11 months, and the percentage of patency at 6 months was 60.8%, at 1 year was 39.6%, and at 2 years was 25%. Stents malfunctioned in 54 cases, and all were easily withdrawn except in 1 case. Of these 27 cases, patency recovered spontaneously in 9 and by way of a second stent in 18. Secondary patency was 50%. Factors presdisposing to lower primary patency are inflammatory etiology and location of the obstruction. The benefit of stent deployment is clear with respect to the resolution of epiphora in candidate patients for percutaneous treatment. Technical and/or design improvements would be welcomed. PMID:20390276

  11. Mid-term clinical results of total hip arthroplasty using a Wagner standard cup for dysplastic hip

    PubMed Central

    Maezawa, Katsuhiko; Nozawa, Masahiko; Yuasa, Takahito; Aritomi, Kentaro; Ogawa, Seiki; Maruyama, Yuichiro; Kaneko, Kazuo

    2014-01-01

    Background The outcome of cementless total hip arthroplasty depends on many factors. We must not forget fundamental things those are design of outer surface of the component, that leads bone ingrowth into the prosthesis, better initial stability, and better insertional techniques. The purpose of this study was to review our experience with metal-on-metal total hip arthroplasty with a Wagner standard cup for patients who had acetabular dysplasia. Patients and methods Fifty-four patients with 55 hips underwent primary metal-on-metal total hip arthroplasty (Metasul prosthesis) with a Wagner standard cup (44–48 mm in outer diameter) and were followed for a minimum of 10 years. All patients received the same type of cementless femoral component (Natural hip stem) and femoral head (28 mm in diameter). Results Seventeen of the 55 Wagner standard cups (30.9%) showed aseptic loosening over a mean period of 3.6 years after surgery, and there were no bone anchors on the outer surface of the 16 retrieved cups. Conclusion From our experience, the small Wagner standard cup does not achieve sufficient osteointegration and we do not recommend the use of this cup, especially for patients with acetabular dysplasia and/or those with a small stature. PMID:25561751

  12. Coping Power Adapted as Universal Prevention Program: Mid Term Effects on Children's Behavioral Difficulties and Academic Grades.

    PubMed

    Muratori, Pietro; Bertacchi, Iacopo; Giuli, Consuelo; Nocentini, Annalaura; Ruglioni, Laura; Lochman, John E

    2016-08-01

    Aggressive behaviors in schools have the potential to cause serious harm to students' emotional and social well-being and to limit their ability to achieve their full academic potential. Prevention programs developed to reduce children's aggressive behaviors in school settings can provide interventions at a universal or targeted level. The main aim of our randomized control study was to examine the efficacy of Coping Power, adapted as a universal prevention program, in reducing children's behavioral problems and improving school grades. Nine classes participated (184 students, mean age 91 months) from two elementary state schools in Tuscany, Italy. Study findings showed a significant reduction in behavioral problems and an improvement in school grades for the intervention classes relative to the control classes. This study suggests the Coping Power program can be delivered in school settings at both universal and targeted prevention levels, and that in this multi-tiered prevention model, teachers, educators and school psychologists can learn a set of intervention skills which can be delivered with flexibility, thus reducing some of the complexity and costs of schools using multiple interventions. PMID:27129573

  13. Mid-term evaluation of USAID (US Agency for International Development) Sudan Energy Planning and Management Project (650-0059)

    SciTech Connect

    Jones, D.W.; Stovall, J.P.; Raby, J.G.; Younger, D.R.; Pryor, C.A.

    1988-06-01

    In 1984, the United States Agency for International Development's mission in Sudan implemented the Energy Planning and Management Project to strengthen several key institutions in the energy sector of Sudan. One component of the project focused on improving management, billing and collection, pricing, purchasing and stores, and vehicle operation and maintenance in the National Electricity Corporation. The other major component was devoted to strengthening the capability of the National Energy Administration to conduct national energy planning studies, including the analysis of energy issues and policies and the recommendation of policies. Originally the planned date for the midterm evaluation of this project was early 1986, but because political turmoil and other events impeded implementation of the project, that evaluation was only conducted in January and February 1987. ORNL, at the request of the Sudan Mission and the office of Energy of AID, fielded a team in January 1987 to evaluate the progress of the project to that date and make recommendations for the remainder of the project's implementation. This study reports the findings and recommendations of the evaluation team regarding the Sudan Energy Management and Planning Project. 84 refs., 2 figs., 6 tabs.

  14. Mid-term clinical results of medial meniscus repair with the meniscus arrow in the unstable knee.

    PubMed

    Koukoulias, Nikolaos; Papastergiou, Stergios; Kazakos, Konstantinos; Poulios, Georgios; Parisis, Konstantinos

    2007-02-01

    The medial meniscus is a secondary stabilizer to anterior tibial translation and provides significant stability, especially in an ACL-deficient knee. The purpose of this study is to evaluate the clinical outcome of medial meniscus repair in the unstable knee. Between 1997 and 2002, 11 patients, with a mean age of 25.8 years (range 15-39 years), underwent all-inside medial meniscus repair, using the Meniscus Arrow, for unstable medial meniscus tear in ACL-deficient knees. For various reasons none of these patients underwent ACL reconstruction. The average follow-up was 73 months (range 52-91 months). There were three failures (27.3%) defined as the need for reoperation and partial meniscectomy. The mean Tegner activity score decreased from 6.75 (pretrauma) to 4.5 (postoperatively). The average Lysholm and subjective IKDC scores were 83 and 77.4, respectively. Two patients were graded as B (nearly normal) and six as C (abnormal), according to the IKDC knee evaluation form. KT-2000 arthrometry demonstrated that sagittal knee laxity was more than 5 mm in all knees (side to side difference). MRI demonstrated grade three signal alterations at the repair site of meniscus in three patients and signs of cartilage damage in two patients. All patients were asymptomatic during daily activities but seven out of eight reported pain or effusion after sports. Medial meniscus repair in the ACL-deficient knee is not contraindicated. The need of reducing the level of physical activity is essential. PMID:16967201

  15. Does Previous Hip Surgery Effect the Outcome of Tönnis Triple Periacetabular Osteotomy? Mid-Term Results.

    PubMed

    Konya, Mehmet Nuri; Aydn, Bahattin Kerem; Yldrm, Timur; Sofu, Hakan; Gürsu, Sarper

    2016-03-01

    Hip dysplasia (HD) is 1 of the major reasons of coxarthrosis. The goal of the treatment of HD by Tönnis triple pelvic osteotomy (TPAO) is to improve the function of hip joint while relieving pain, delaying and possibly preventing end-stage arthritis. The aim of this study is to compare the clinical and radiological results of TPAO to determine if previous surgery has a negative effect on TPAO.Patients operated with TPAO between 2005 and 2010, included in this study. Patients divided into 2 groups: primary acetabular dysplasia (PAD) and residual acetabular dysplasia (RAD). Prepostoperatively, hip range of motion, Harris hip score (HHS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) hip score, visual analog scores (VAS), impingement tests, and also the presence of Trendelenburg sign (TS) were investigated for clinical evaluation. For radiological analysis pre-postoperative, anterior-posterior (AP) pelvis and faux profile radiographs were used. Acetabular index, lateral center edge (LCE) angle, and Sharp angles were measured by AP pelvis; anterior center edge (ACE) angle were measured by faux profile radiography. All the clinical and radiological data of the groups were analyzed separately for the pre-postoperative scores also the amount of improvement in all parameters were analyzed.SPSS20 (SPSS Inc., Chicago, IL) was used for statistical analysis. Wilcoxon test, McNemar test, paired t tests, and Mann-Whitney U tests were used to compare the groups. P < 0.05 were defined as statistically significant.Study included 27 patients: 17 patients were in PAD and 10 patients were in RAD. The mean follow-up period was 6.2 years (5.2-10.3 years). In all patients, the radiological and the clinical outcomes were better after TPAO except the flexion of the hip parameter. When the patient groups were evaluated as pre-postoperatively, more statistically significant parameters were found in the PAD group when compared with RAD group. Extension, impingement, TS, VAS, HHS, WOMAC score parameters in clinical outcome and LCE, ACE, Sharp angle, coverage ratio in radiological results were significantly better in PAD group postoperatively but in RAD group; only extension, VAS, HHS, and WOMAC parameters were clinically and LCE and Coverage ratio were significantly different compared with the preoperative measurements. The change of the parameters that used for the evaluation of clinical and radiological results did not show a significant difference between groups.Our data suggest that TPAO can be performed on patients with HD for both groups. Although there were fewer parameters which changed significantly after TPAO in RAD patients; the improvement of radiological and clinical results was similar for groups. Further long-term follow-up studies with large number of patients are needed to determine the proper results of TPAO. PMID:26962829

  16. Morphologic and Clinical Outcome of Intracranial Aneurysms after Treatment Using Flow Diverter Devices: Mid-Term Follow-Up

    PubMed Central

    Breu, Anna-Katharina; Hauser, Till-Karsten; Ebner, Florian H.; Bischof, Felix; Ernemann, Ulrike; Seeger, Achim

    2016-01-01

    Flow diverters (FDs) are designed for the endovascular treatment of complex intracranial aneurysm configurations. From February 2009 to March 2013 28 patients (22 females, 6 males) were treated with FD; mean age was 57 years. Data, including aneurysm features, clinical presentation, history of previous bleeding, treatment, and follow-up results, are presented. Early postinterventional neurological deficits (transient: n = 3/enduring: n = 1) appeared in 4/28 patients (14%), and early improvement of neurological symptoms was observed in 7 patients with previous restriction of cranial nerve function. The overall occlusion rate was 20/26 (77%; 59% after 3 months). 77% achieved best results according to O'Kelly-Marotta score grade D with no contrast material filling (70% of those after 3 months). In 4/6 patients who did not achieve grade D, proximal and/or distal stent overlapping ≥5 mm was not guaranteed sufficiently. During follow-up we did not detect any aneurysm recurrence or haemorrhage. In-stent stenosis emerged as the most frequent complication (4/27; 15%) followed by 2 cases of vascular obliteration (AICA/VA). In conclusion endovascular reconstruction using a FD represents a modern and effective treatment in those aneurysms that are not suitable for conventional interventional or surgical treatment. The appearance of severe complications was rare. PMID:27006830

  17. THE POTENTIAL MID-TERM ROLE OF NUCLEAR POWER IN THE UNITED STATES: A SCENARIO ANALYSIS USING MARKAL

    EPA Science Inventory

    With all nations facing enormous challenges related to energy security, sustainability and environmental quality, nuclear power is likely to play an increasingly important role in the future. In particular, the life-cycle emissions of criteria pollutants and greenhouse gases (GHG...

  18. Evaluation of proximal femoral locking plate in unstable extracapsular proximal femoral fractures: Surgical technique & mid term follow up results☆

    PubMed Central

    Kumar, Nishikant; Kataria, Himanshu; Yadav, Chandrashekhar; Gadagoli, Bharath S.; Raj, Rishi

    2014-01-01

    Background Stable trochanteric femur fractures can be treated successfully with conventional implants such as sliding hip screw, cephalomedullary nails, angular blade plates. However comminuted and unstable inter or subtrochanteric fractures with or without osteoporosis are challenging & prone to complications. The PF-LCP is a new implant that allows angular stability by creating fixed angle block for treatment of complex, comminuted proximal femoral fractures. Method We reviewed 30 patients with unstable inter or subtrochanteric fractures, which were stabilized with PF-LCP. Mean age of patient was 65 years, and average operative time was 80 min. Patients were followed up for a period of 3 years (June 2010–June 2013). Patients were examined regularly at 3 weekly interval for signs of union (radiological & clinical), varus collapse (neck-shaft angle), limb shortening, and hardware failure. Result All patients showed signs of union at an average of 9 weeks (8–10 weeks), with minimum varus collapse (<10°), & no limb shortening and hardware failure. Results were analysed using IOWA (Larson) hip scoring. Average IOWA hip score was 77.5. Conclusion PF-LCP represents a feasible alternative for treatment of unstable inter- or subtrochanteric fractures. PMID:25983487

  19. Looking Forward with LIFE: Literacy Initiative for Empowerment. Global LIFE Mid-Term Evaluation Report 2006-2011

    ERIC Educational Resources Information Center

    Hanemann, Ulrike

    2012-01-01

    The United Nations Educational, Scientific and Cultural Organization (UNESCO) launched the Literacy Initiative for Empowerment (2006-2015)--LIFE--to tackle the literacy challenge. This is a collaborative effort to accelerate literacy efforts in thirty five of the world's most challenged countries and thereby to unlock progress to reach all of the…

  20. Mid-term results of laparoscopic sleeve gastrectomy and Roux-en-Y gastric bypass in adolescent patients.

    PubMed

    Cozacov, Yaniv; Roy, Mayank; Moon, Savannah; Marin, Pablo; Lo Menzo, Emanuele; Szomstein, Samuel; Rosenthal, Raul

    2014-05-01

    The prevalence and severity of obesity in children and adolescents has been increasing in recent years at an unprecedented rate. Morbidly obese children will almost certainly develop severe comorbidities as they progress to adulthood, and bariatric surgery may provide the only alternative for achieving a healthy weight. The aim of this study was to assess the long-term outcomes and safety of laparoscopic sleeve gastrectomy (LSG) and Roux-en-Y gastric bypass (RYGB) as new treatment modalities for morbidly obese adolescents. We conducted a retrospective review of a prospectively collected database of all adolescent patients who underwent LSG and RYGB under IRB protocol at the Bariatric and Metabolic Institute in Cleveland Clinic Florida between 2002 and 2011. Patients were also contacted by phone, adhering to HIPAA regulations, and were asked to answer a survey. Eighteen adolescents had a bariatric procedure performed at this institution. The mean age was 17.5 years, the average weight was 293.1 lbs, and the average BMI was 47.2 kg/m2. The mean follow-up period consisted of 55.2 months. The postoperative weight at 55 months follow-up was 188.4 lbs and average BMI was 30.1 kg/m2. Fifteen of the patients were available for follow-up. Thirteen out of 16 (81%) comorbidities in patients available for follow-up were in remission following rapid weight loss. The long-term follow-up and perioperative morbidity shown in this study suggest that LSG and LRYGB appear to be safe and effective operations in morbidly obese adolescents. PMID:24390732

  1. Endovascular Repair of Abdominal Aortic Aneurysms: Analysis of Aneurysm Volumetric Changes at Mid-Term Follow-Up

    SciTech Connect

    Bargellini, Irene Cioni, Roberto; Petruzzi, Pasquale; Pratali, Alessandro; Napoli, Vinicio; Vignali, Claudio; Ferrari, Mauro; Bartolozzi, Carlo

    2005-05-15

    Purpose. To evaluate the volumetric changes in abdominal aortic aneurysms (AAA) after endovascular AAA repair (EVAR) in 24 months of follow-up. Methods. We evaluated the volume modifications in 63 consecutive patients after EVAR. All patients underwent strict duplex ultrasound and computed tomography angiography (CTA) follow-up; when complications were suspected, digital subtraction angiography was also performed. CTA datasets at 1, 6, 12, and 24 months were post-processed through semiautomatic segmentation, to isolate the aneurysmal sac and calculate its volume. Maximum transverse diameters (Dmax) were also obtained in the true axial plane, Presence and type of endoleak (EL) were recorded. A statistical analysis was performed to assess the degree of volume change, correlation with diameter modifications, and significance of the volume increase with respect to ELs. Results. Mean reconstruction time was 7 min. Mean volume reduction rates were 6.5%, 8%, and 9.6% at 6, 12, and 24 months follow-up, respectively. Mean Dmax reduction rates were 4.2%, 6.7%, and 12%; correlation with volumes was poor (r = 0.73-0.81). ELs were found in 19 patients and were more frequent (p = 0.04) in patients with higher preprocedural Dmax, The accuracies of volume changes in predicting ELs ranged between 74.6% and 84.1% and were higher than those of Dmax modifications. The strongest independent predictor of EL was a volume change at 6 months {<=}0.3% (p = 0.005), although 6 of 19 (32%) patients with EL showed no significant AAA enlargement, whereas in 6 of 44 (14%) patients without EL the aneurysm enlarged. Conclusion. The lack of volume decrease in the aneurysm of at least 0.3% at 6 months follow-up indicates the need for closer surveillance, and has a higher predictive accuracy for an endoleak than Dmax.

  2. Mid-Term Results After Endovascular Stent-Grafting of Descending Aortic Aneurysms in High-Risk Patients

    SciTech Connect

    Brandt, Michael Walluscheck, Knut P.; Jahnke, Thomas; Attmann, Tim; Heller, Martin; Cremer, Jochen; Mueller-Huelsbeck, Stefan

    2006-10-15

    Purpose. To analyze our experience with endovascular stent-grafting of descending aortic aneurysms in high-risk patients. Methods. Nineteen patients underwent endovascular stent-graft repair of descending aortic aneurysms using the Talent Stent Graft System (Medtronic). All patients were considered high-risk for open surgical repair due to their age, requirement for emergency surgery, and comorbidities. Computed tomography and/or MR tomography were performed at 3, 6 and 12 months postoperatively and thereafter every 12 months. Results. Secondary technical success was 100%. Thirty-day mortality was 5%. Incidence of postoperative stroke and paraplegia were 5% each. One patient required a second stent-graft due to a type I endoleak during the same hospital stay (primary technical success 95%). All patients have been followed for a median of 20 months. No migration, wire fractures or endoleak appeared during follow-up. Conclusion. Endovascular stent-grafting had a low 30-day mortality and morbidity in high-risk patients. One patient developed an aortoesophageal fistula 40 days after stent implantation. Stent-graft repair is a valuable supplement to surgical therapy in high-risk patients.

  3. Treating Epiphora in Adults With the Wilhelm Plastic Nasolacrimal Stent: Mid-Term Results of a Prospective Study

    SciTech Connect

    Ciampi, Juan J. Lanciego, Carlos; Navarro, Sofia; Cuena, Rafael; Velasco, Javier; Perea, Miguel; Garcia-Garcia, Lorenzo

    2011-02-15

    The objective of the present study was to evaluate, in a prospective, single-center study, the effectiveness of the Wilhelm-type stent used in interventional radiology for the management of epiphora. Patients (n = 104; mean age 64 [range 25-88]; 33 male and 71 female) with severe epiphora had the stents inserted (135 stents in 115 eyes) to treat obstruction of the nasolacrimal system. The etiology of the obstruction was idiopathic in 83 cases, chronic dacryocystitis in 31, cases and postsurgical status in 1 case. The overall technical success rate of stent placement was near 94%. Resolution of epiphora was complete in 105 cases and partial in 3 cases. During a mean 13-month follow-up (range 1 week to 28 months), the median duration of primary patency was 11 months, and the percentage of patency at 6 months was 60.8%, at 1 year was 39.6%, and at 2 years was 25%. Stents malfunctioned in 54 cases, and all were easily withdrawn except in 1 case. Of these 27 cases, patency recovered spontaneously in 9 and by way of a second stent in 18. Secondary patency was 50%. Factors presdisposing to lower primary patency are inflammatory etiology and location of the obstruction. The benefit of stent deployment is clear with respect to the resolution of epiphora in candidate patients for percutaneous treatment. Technical and/or design improvements would be welcomed.

  4. Percutaneous peripheral rotational ablation using the Rotablator: immediate and mid term results. Single center experience concerning 146 lesions treated.

    PubMed

    Henry, M; Amor, M; Ethevenot, G; Henry, I

    1993-09-01

    In order to assess the role of percutaneous peripheral rotational ablation using Rotablator (PPRA), 95 symptomatic patients (58 M, 37 F, m. age: 77 +/- 1 y) (r: 50-90 y) having 146 peripheral vascular lesions (PVL) were treated by PPRA. 59% were below the knee and 41% above. The runoff status (n of distal leg art. involved) was as follows: 3:52 pts, 2:23 pts, 1:14 pts, 0:6 pts. The femoral lesions were significantly longer than those at other sites (5.27 +/- 0.43 vs 2.97 +/- 0.3 cm) (p < 0.001). The mean length was 3.73 +/- 0.26 cm (r: 1-20 cm). Complementary PTA was significantly (p < 0.001) more frequent in femoro-popliteal (32 PTA/48 Fem, 5 PTA/12 Pop) than in distal leg lesions (10/86.). RESULTS. After PPRA alone (99 PVL) the stenosis % decreased from 81 +/- 0.75 to 18 +/- 1.1. The residual stenosis was greater at femoral (26 +/- 2.3%) than at distal leg level (16 +/- 1.2%) (p < 0.01). Complementary PTA (47 PVL) lowered residual stenosis from 44% to 13%. 52 complications (spasm, perforation, dissection, distal emboli, no reflow, others) were cured in 47 PVL. Thus our primary technical success per PVL was 97% and per pt 95%. The mean follow-up period was 11 +/- 1 mths (r: 1-37 m). Among 78 pts having a follow-up period > or = 4 mths, 74 pts representing 115 treated PVL underwent an angiography control (2 deaths, 2 lost for follow-up). 87 lesions (76%) showed no restenosis and 28 lesions (34%) showed restenosis of 83 +/- 2.4% (r: 50-100%). The restenosis rate was higher in femoral (12/21: 36%) than in distal (15/58: 21%) or popliteal arteries (1/8: 12%). Restenosis was more frequent for PVL > or = 7 cm (67% vs 16%) (p < 0.001) at all sites. This result together with the complication rate would seem to indicate that lesions > or = 6.7 cm would be a limitation for PPRA. CONCLUSIONS. In our experience Percutaneous Peripheral Rotational Ablation has taken a pre-eminent position in the treatment of distal leg arteries. Our results lead us to broaden its indications to complex vascular lesions. The possibility of runoff treatment should allow an improvement in the long-term patency of PTA and bypass grafts. PMID:8151165

  5. Information Requirements for Supervisory Air Traffic Controllers in Support of a Mid-Term Wake Vortex Departure System

    NASA Technical Reports Server (NTRS)

    Lohr, Gary W.; Williams, Daniel M.; Trujillo, Anna C.; Johnson, Edward J.; Domino, David A.

    2008-01-01

    A concept focusing on wind dependent departure operations has been developed the current version of this concept is called the Wake Turbulence Mitigation for Departures (WTMD). This concept takes advantage the fact that cross winds of sufficient velocity blow wakes generated by "heavy" and B757 category aircraft on the downwind runway away from the upwind runway. Supervisory Air Traffic Controllers would be responsible for authorization of the Procedure. An investigation of the information requirements necessary to for Supervisors to approve monitor and terminate the Procedure was conducted. Results clearly indicated that the requisite information is currently available in air traffic control towers and that additional information was not required.

  6. Cutting Balloon Angioplasty Versus Standard Balloon Angioplasty for Failing Infra-inguinal Vein Grafts: Comparative Study of Short- and Mid-Term Primary Patency Rates

    SciTech Connect

    Vikram, Raghunandan; Ross, Rose A.; Bhat, Rajesh; Griffiths, Gareth D.; Stonebridge, Peter A.; Houston, J. Graeme; Chakraverty, S.

    2007-07-15

    Purpose. To evaluate the results of a recent change in practice in our institution using cutting balloon angioplasty instead of standard balloon angioplasty as the primary treatment for failing infra-inguinal vein bypass grafts. Methods. In this nonrandomized cohort study with a historical control, failing infra-inguinal vein grafts were identified at duplex surveillance or clinical examination. Patients had confirmatory arteriography and balloon angioplasty at the same attendance. Interventions proximal or distal to the graft itself and prosthetic grafts were not included. Patients were entered into a duplex graft surveillance program. Initial assessment of technical success was duplex or improvement 4-6 weeks after the primary angioplasty. Results. Twenty-seven consecutive patients were treated with standard balloon angioplasty, then 11 consecutive patients were treated with cutting balloon angioplasty. Initial technical success was 74% for the standard balloon versus 82% for the cutting balloon. The primary patency rate at 6 months was 16/26 (62%) for standard balloon angioplasty and 8/10 (80%) for cutting balloon angioplasty (p = 0.44). The primary patency rate at 12 months was 9/25 (36%) for standard balloon angioplasty and 5/10 (50%) for cutting balloon angioplasty (p = 0.47). Conclusion. The use of cutting balloons for primary angioplasty of infra-inguinal vein grafts offers no definite advantage over standard balloon angioplasty in this institution or compared with patency rates after standard balloon angioplasty reported elsewhere. Larger multicenter studies would be required to demonstrate whether there was any real difference between the two techniques.

  7. New Challenges: The Civil Rights Record of the Clinton Administration Mid-Term. Report of the Citizens' Commission on Civil Rights.

    ERIC Educational Resources Information Center

    Yu, Corrine M., Ed.; Taylor, William L., Ed.

    This report is the work of the Citizens' Commission on Civil Rights, a bipartisan group of former federal officials with responsibility for equal opportunity. Part 1 contains three chapters: (1) "Introduction"; (2) "Executive Summary and Review"; and (3) "Recommendations of the Commission." Part 2 contains the following working papers: (4)…

  8. Total Hip Arthroplasty Using Modular Trabecular Metal Acetabular Components for Failed Treatment of Acetabular Fractures: A Mid-term Follow-up Study

    PubMed Central

    Huang, De-Yong; Zhang, Liang; Zhou, Yi-Xin; Zhang, Chun-Yu; Xu, Hui; Huang, Yong

    2016-01-01

    Background: Porous-coated cups have been widely used in acetabular reconstruction after failed treatment of acetabular fractures, and good results have been reported with the use of these cups; however, the durability and functionality of modular trabecular metal (TM) acetabular components in acetabular reconstruction after failed treatment of acetabular fractures remain unclear. This study aimed to examine the radiographic and clinical outcomes associated with the use of modular TM acetabular components for failed treatment of acetabular fractures to assess the durability and functionality of these components in acetabular reconstruction after failed treatment of acetabular fractures. Methods: A total of 41 patients (41 hips) underwent total hip arthroplasty (THA) using modular TM acetabular components for failed treatment of acetabular fractures at our hospital between January 2007 and December 2012. Among these patients, two were lost to follow-up. Therefore, 39 patients (39 hips) were finally included in this study. The Harris hip score before and after the surgery, satisfaction level of the patients, and radiographic results were assessed. Results: The mean Harris hip score increased from 34 (range, 8–52) before surgery to 91 (range, 22–100) at the latest follow-up examination (P < 0.001). The results were excellent for 28 hips, good for six, fair for three, and poor for two. Among the 39 patients, 25 (64%) and 10 (26%) were very satisfied and somewhat satisfied, respectively. All cups were found to be fully incorporated, and no evidence of cup migration or periacetabular osteolysis was noted. Conclusions: Despite the technically demanding nature of the procedure, THA using modular TM acetabular components showed good durability and functionality and may be an effective reconstruction option for failed treatment of acetabular fractures. PMID:27064033

  9. Uncemented total hip arthroplasty in osteoarthritis of hip secondary to low and high dislocated hips: A mid-term follow-up study

    PubMed Central

    Munigangaiah, Sudarshan; O’Dwyer, Sinead; Masterson, Eric

    2016-01-01

    Background: Performing successful total hip replacement (THR) in dysplastic, subluxed, and dislocated hip is a challenging task. Here, we assessed midterm clinical and radiological outcomes of uncemented total hip arthroplasty in osteoarthritis (OA) of hip secondary to Hartofilakidis low and high-dislocated hips with a mean follow-up of 8.8 years. Materials and Methods: A retrospective study of prospectively collected data was designed involving all consecutive patients who underwent uncemented THR for OA of hip secondary to developmental dysplasia of the hip and Grade II or Grade III Hartofilakidis classification. Results: Thirty-two patients underwent 45 THR, with 23 Grade II (low dislocation) and 22 Grade III (high-dislocation) of Hartofilakidis classification. Thirteen patients had bilateral hip replacements, 19 patients had unilateral THR. There was highly statistically significant difference between preoperative and postoperative HHS and SF-36v2™ at each follow-up. Survivorship of original implant was 98.88% at a mean follow-up of 8.8 years. The mean improvement in leg length in this series was 3.6 cm (1.8-4.5, 95% confidence interval). No sciatic nerve or femoral nerve palsies were observed. Conclusions: Uncemented THR provides better function and quality of life. However, longer follow-up studies are needed to assess survivorship of uncemented THR in Hartofilakidis low and high-dislocations. PMID:27433063

  10. Different Mid-Term Prognostic Predictors of Major Adverse Events in Diabetic and Nondiabetic Peripheral Artery Disease Presenting With Critical Limb Ischemia.

    PubMed

    Liang, Kae-Woei; Kuo, Hsun-Nan; Lee, Wen-Lieng; Liu, Tsun-Jui; Lin, Wei-Wen; Tsao, Chen-Rong; Ting, Chih-Tai; Wang, Kuo-Yang

    2016-03-01

    We compared midterm prognostic predictors of peripheral artery disease (PAD) with or without diabetes mellitus (DM) presenting with critical lower limb ischemia (CLI). A total of 172 patients with PAD (109 DM; 63 non-DM) were enrolled. The major adverse events (MAEs) were death or amputation. The diabetic group had a higher MAE rate (39% vs 22%, P = .042) with a mean follow-up duration of 30 ± 19 months. In a multivariate binary logistic regression analysis, revascularization (odds ratio = 0.289, P = .006) and higher serum cholesterol (odds ratio=0.988, P = .027) predicted a lower MAE rate in the DM group. In contrast, the presence of severe chronic kidney disease (stage 4 or 5, odds ratio = 5.238, P = .025) was a positive predictor of MAEs in the nondiabetic group. In conclusion, the prognostic predictors of MAE in diabetic and nondiabetic patients with PAD and CLI were different. PMID:23389094

  11. Does Family Make a Difference? Mid-Term Effects of a School/Home-Based Intervention Program to Enhance Reading Motivation

    ERIC Educational Resources Information Center

    Villiger, Caroline; Niggli, Alois; Wandeler, Christian; Kutzelmann, Sabine

    2012-01-01

    This study examined the effects of a school/home-based intervention program designed to enhance the reading motivation and comprehension of Swiss fourth graders (N = 713). In order to identify the specific contribution of the home environment, the program was implemented in one group "without" (N = 244) and in one group "with" (N = 225) parental…

  12. Osteochondritis dissecans of the elbow: excellent mid-term follow-up results in teenage athletes treated by arthroscopic debridement and microfracture

    PubMed Central

    Bojanić, Ivan; Smoljanović, Tomislav; Dokuzović, Stjepan

    2012-01-01

    Aim To extend the microfracture procedure, which has been proven successful on osteochondritis dissecans (OCD) lesions in the knee and ankle, to OCD lesions in the elbow. Methods Nine young patients were treated by arthroscopic debridement and microfracture by a single surgeon. The average age at operation was 15.0 years (median 15; range 12-19). The average length of the follow-up was 5.3 years (median 5; range 2-9). The follow-up included physical examination and patient interview with elbow function scoring. Success of treatment was determined according to pre-operative and follow-up Mayo Elbow Performance Index scores and the patients’ return to sports. Results Eight patients scored excellent results on the follow-up and 1 scored a good result. Four out of 9 patients were able to increase their training intensity, 2 returned to the same level of activity, 2 changed sports (due to reasons unrelated to the health of their elbow), and 1 left professional sports and started training only recreationally. No patients stopped participating in sports altogether. Conclusions We advocate arthroscopic microfracturing, followed by a strict rehabilitation regime, as a highly effective treatment for OCD of the humeral capitellum. PMID:22351577

  13. Project 5322 Mid-Term Report: Key Eco-Hydrological Parameters Retrieval And Land Data Assimilation System Development In A Typical Inland River Basin Of Chinas Arid Region

    NASA Astrophysics Data System (ADS)

    Faivre, R.; Colin, J.; Menenti, M.; Lindenbergh, R.; Van Den Bergh, L.; Yu, H.; Jia, L.; Xin, L.

    2010-10-01

    Improving the understanding and the monitoring of high elevation regions hydrology is of major relevance from both societal and environmental points of view for many Asian countries, in particular in terms of flood and drought, but also in terms of food security in a chang- ing environment. Satellite and airborne remote sensing technologies are of utmost for such a challenge. Exist- ing imaging spectro-radiometers, radars, microwave ra- diometers and backscatter LIDAR provide a very com- prehensive suite of measurements over a wide rage of wavelengths, time frequencies and spatial resolu- tions. It is however needed to devise new algorithms to convert these radiometric measurements into useful eco-hydrological quantitative parameters for hydrologi- cal modeling and water management. The DRAGON II project entitled Key Eco-Hydrological Parameters Re- trieval and Land Data Assimilation System Development in a Typical Inland River Basin of Chinas Arid Region (ID 5322) aims at improving the monitoring, understand- ing, and predictability of hydrological and ecological pro- cesses at catchment scale, and promote the applicability of quantitative remote sensing in watershed science. Ex- isting Earth Observation platforms provided by the Euro- pean Space Agency as well as prototype airborne systems developed in China - ENVISAT/AATSR, ALOS/PRISM and PALSAR, Airborne LIDAR - are used and combined to retrieve advanced land surface physical properties over high elevation arid regions of China. The existing syn- ergies between this project, the CEOP-AEGIS project (FP7) and the WATER project (CAS) provide incentives for innovative studies. The investigations presented in the following report focus on the development of advanced and innovative methodologies and algorithms to monitor both the state and the trend of key eco-hydrological vari- ables: 3D vegetation properties, land surface evaporation, glacier mass balance and drought indicators.

  14. [Epstein-Barr virus-associated hemophagocytic syndrome during mid-term pregnancy successfully treated with combined methylprednisolone and intravenous immunoglobulin].

    PubMed

    Mihara, H; Kato, Y; Tokura, Y; Hattori, Y; Sato, A; Kobayashi, H; Imamura, A; Daimaru, O; Miwa, H; Nitta, M

    1999-12-01

    A 32-year-old woman in the 16th week of pregnancy was admitted to our hospital because of high fever. Laboratory findings disclosed pancytopenia and extremely elevated serum LDH and ferritin levels. Coagulation tests showed disseminated intravascular coagulation. Serum soluble interleukin-2 receptor, tumor necrosis factor-alpha, and interleukin-6 levels were high, but serum interferon-gamma was below the detectable limit. Reactive Epstein-Barr virus (EBV) infection was diagnosed on the basis of a high titer of IgG antibodies to the EBV capsid antigen and early antigen. EBV was demonstrated in the peripheral blood and bone marrow cells by polymerase chain reaction. Mature histiocytosis and hemophagocytosis were detected in the bone marrow. A diagnosis of EBV-associated hemophagocytic syndrome (EBV-AHS) was made. Neither prednisolone (PSL 30 mg/day, P.O.) nor methylprednisolone (m-PSL) pulse therapy (1,000 mg/day for 3 days) induced a response. Thereafter, treatment with m-PSL pulse therapy (1,000 mg/day for 3 days) and i.v. administrations of high-dose immunoglobulin (20 g/day for 3 days) in combination with acyclovir (750 mg/day) and gabexate mesilate (2 g/day) induced remission of the disease. Maintenance therapy consisted of PSL (5 mg/day, P.O.) and camostat mesilate (600 mg/day, P.O.). The patient delivered a healthy male infant in the 35th week of pregnancy via natural birth. Reports of pregnant women with EBV-AHS are rare, and the choice of therapy has not yet been established. The present case study suggested the above combination treatment is useful and safe, and capable of changing the fulminant course of EBV-AHS during pregnancy without the use of anticancer drugs. PMID:10658479

  15. The Value of Pre- and Post-Stenting Fractional Flow Reserve for Predicting Mid-Term Stent Restenosis Following Percutaneous Coronary Intervention (PCI)

    PubMed Central

    Rai, Alireza; Bahremand, Mostafa; Saidi, Mohammad Reza; Jalili, Zahra; Salehi, Nahid; Assareh, Marzieeh; Abarghoei, Gholamreza Amini; Kazerani, Hashem

    2016-01-01

    Measuring fractional flow reserve (FFR) in percutaneous coronary intervention (PCI) has predictive value for PCI outcome. We decided to examine the utility of pre- and post-stenting FFR as a predictor of 6-month stent restenosis as well as MACE (major adverse cardiac events). Pre- and post-stenting FFR values were measured for 60 PCI patients. Within 6 months after stenting, all patients were followed for assessment of cardiac MACE including myocardial infarction, unstable angina, or positive exercise test. Stent restenosis was also assessed. Cut-off values for pre- and post-stenting FFR measurements were considered respectively as 0.65 and 0.92. Stent restenosis was detected in 4 patients (6.6%). All 4 patients (100%) with restenosis had pre-stenting FFR of < 0.65, while only 26 of 56 patients without restenosis (46.4%) had pre-stenting FFR value of < 0.65 (P = 0.039). Mean pre-stenting FFR in patients with restenosis was significantly lower than in those without restenosis (0.25 ± 0.01 vs. 0.53 ± 0.03, P = 0.022). Although stent restenosis was higher in patients with post-stenting FFR of < 0.92 (2 cases, 9.5%) than in those with FFR value of ≥ 0.92 (2 cases, 5.1%), the difference was not statistically (P = 0.510). Pre-stenting FFR, the use of longer stents, and history of diabetes mellitus can predict stent restenosis, but the value of post-stenting FFR for predicting restenosis was not explicit.

  16. Prevalence of autism spectrum disorders among children (1-10 years of age) – Findings of a mid-term report from Northwest India

    PubMed Central

    Raina, SK; Kashyap, V; Bhardwaj, AK; Kumar, D; Chander, V

    2015-01-01

    Background: India is the second most populous country of the world. A large portion of the population of this country is below 20 years of age but still there is a paucity of information about the prevalence and incidence of many developmental disorders. This study was planned to estimate the prevalence of autism spectrum disorders (ASDs) in the selected areas (tribal, rural, and urban) of a northern state of India, Himachal Pradesh. Methods: A cross-sectional two-phase study was conducted covering all the children in the range of 1-10 years of age. Phase one included screening of all the children in the age group of 1-10 years, with the help of an indigenous assessment tool for autism. The sociodemographic profile of the participants was also recorded during phase one. Phase two involved the clinical evaluation of individuals who were suspected of autism on screening. Results: The results show a prevalence rate of 0.9/1000. The highest prevalence rate was observed in the rural area. Conclusions: Socioeconomic status (SES) may be one of the fundamental indicators for ASDs in India. PMID:26440394

  17. Class III Mid-Term Project, "Increasing Heavy Oil Reserves in the Wilmington Oil Field Through Advanced Reservoir Characterization and Thermal Production Technologies"

    SciTech Connect

    Scott Hara

    2007-03-31

    The overall objective of this project was to increase heavy oil reserves in slope and basin clastic (SBC) reservoirs through the application of advanced reservoir characterization and thermal production technologies. The project involved improving thermal recovery techniques in the Tar Zone of Fault Blocks II-A and V (Tar II-A and Tar V) of the Wilmington Field in Los Angeles County, near Long Beach, California. A primary objective has been to transfer technology that can be applied in other heavy oil formations of the Wilmington Field and other SBC reservoirs, including those under waterflood. The first budget period addressed several producibility problems in the Tar II-A and Tar V thermal recovery operations that are common in SBC reservoirs. A few of the advanced technologies developed include a three-dimensional (3-D) deterministic geologic model, a 3-D deterministic thermal reservoir simulation model to aid in reservoir management and subsequent post-steamflood development work, and a detailed study on the geochemical interactions between the steam and the formation rocks and fluids. State of the art operational work included drilling and performing a pilot steam injection and production project via four new horizontal wells (2 producers and 2 injectors), implementing a hot water alternating steam (WAS) drive pilot in the existing steamflood area to improve thermal efficiency, installing a 2400-foot insulated, subsurface harbor channel crossing to supply steam to an island location, testing a novel alkaline steam completion technique to control well sanding problems, and starting on an advanced reservoir management system through computer-aided access to production and geologic data to integrate reservoir characterization, engineering, monitoring, and evaluation. The second budget period phase (BP2) continued to implement state-of-the-art operational work to optimize thermal recovery processes, improve well drilling and completion practices, and evaluate the geomechanical characteristics of the producing formations. The objectives were to further improve reservoir characterization of the heterogeneous turbidite sands, test the proficiency of the three-dimensional geologic and thermal reservoir simulation models, identify the high permeability thief zones to reduce water breakthrough and cycling, and analyze the nonuniform distribution of the remaining oil in place. This work resulted in the redevelopment of the Tar II-A and Tar V post-steamflood projects by drilling several new wells and converting idle wells to improve injection sweep efficiency and more effectively drain the remaining oil reserves. Reservoir management work included reducing water cuts, maintaining or increasing oil production, and evaluating and minimizing further thermal-related formation compaction. The BP2 project utilized all the tools and knowledge gained throughout the DOE project to maximize recovery of the oil in place.

  18. Real time test of the long-range aftershock algorithm as a tool for mid-term earthquake prediction in Southern California

    NASA Astrophysics Data System (ADS)

    Prozorov, A. G.; Schreider, S. Yu.

    1990-04-01

    Result of the algorithm of earthquake prediction, published in 1982, is examined in this paper. The algorithm is based on the hypothesis of long-range interaction between strong and moderate earthquakes in a region. It has been applied to the prediction of earthquakes with M≥6.4 in Southern California for the time interval 1932 1979. The retrospective results were as follows: 9 out of 10 strong earthquakes were predicted with average spatial accuracy of 58 km and average delay time (the time interval between a strong earthquake and its best precursor) 9.4 years varying from 0.8 to 27.9 years. During the time interval following the period studied in that publication, namely in 1980 1988, four earthquakes occurred in the region which had a magnitude of M≥6.4 at least in one of the catalogs: Caltech or NOAA. Three earthquakes—Coalinga of May, 1983, Chalfant Valley of July, 1985 and Superstition Hills of November, 1987—were successfully predicted by the published algorithm. The missed event is a couple of two Mammoth Lake earthquakes of May, 1980 which we consider as one event due to their time-space closeness. This event occurred near the northern boundary of the region, and it also would have been predicted if we had moved the northern boundary from 38°N to the 39°N; the precision of the prediction in this case would be 30 km. The average area declared by the algorithm as the area of increased probability of strong earthquake, e.g., the area within 111-km distance of all long-range aftershocks currently present on the map of the region during 1980 1988 is equal to 47% of the total area of the region if the latter is measured in accordance with the density distribution of earthquakes in California, approximated by the catalog of earthquakes with M≥5. In geometrical terms it is approximately equal to 17% of the total area. Thus the result of the real time test shows a 1.6 times increase of the occurrence of C-events in the alarmed area relative to the normal rate of seismicity. Due to the small size of the sample, it is of course, beyond the statistically significant value. We adjust the parameters of the algorithm in accordance with the new material and publish them here for further real-time testing.

  19. An emerging view of the crust and mantle of tectonic North America from EMScope: a mid- term progress review of Earthscope's magnetotelluric program

    NASA Astrophysics Data System (ADS)

    Schultz, A.; Bedrosian, P.; Evans, R.; Egbert, G.; Kelbert, A.; Mickus, K.; Livelybrooks, D.; Park, S.; Patro, P.; Peery, T.; Wannamaker, P.; Unsworth, M.; Weiss, C.; Woodward, B.

    2008-12-01

    EMScope, the MT component of the Earthscope project has completed its final year of infrastructure construction, and its third annual campaign of regional magnetotelluric array operations in the western USA. Seven semi-permanent "backbone" MT observatories have been installed in California, Oregon, Montana, New Mexico, Minnesota, Missouri and Virginia, designed through installation in 2 m deep, insulated underground vaults and with long, buried electric dipole detectors using stable electrodes, to provide extremely long-period magnetotelluric data meant to provide a set of regional, deep structural "anchor points" penetrating into the mid-mantle, in which a series of denser and more uniform regional, transportable MT networks can be tied. A total of 160 "transportable array" MT stations have been occupied in Oregon, Washington, Idaho, northernmost-California, and Montana. These were located on a 70 km quasi-regular grid, with coverage of Cascadia, parts of the Basin and Range, the Rockies and the Snake River Plain, the zone above a putative mantle plume that is hypothesized to serve as the magma source for both the Yellowstone supervolcano and a chain of volcanic features extending westward into Oregon. It is anticipated that in 2009 the transportable array will sweep eastward through the Yellowstone region, following which a set of regional transects at sites of special geodynamic interest will be staged. The transportable array stations are typically occupied for three weeks, providing MT response functions extending from 2-10,000 s or in cases as great as 20,000 s period. These stations are anchored at longer periods (extending as close to 100,000 s periods as possible) by the network of 7 backbone stations, to be operated continuously for up to five years. We present an initial set of 3-d inverse models from the EMScope data sets There is substantial coherence between the resulting 3-d conductivity model and the known boundaries of major physiographic provinces, as well as seismically delineated mid-to-lower crustal and upper mantle features. A combination of telemetry from backbone stations and frequent batch transmission of data from the transportable array field sites, followed by rapid data quality control procedures and generation of MT response functions provides a data set of use to all interested researchers. All EMScope data are made available freely through the IRIS Data Management Center or via the EMScope data portal. For transportable array sites these data are available typically within two weeks of acquisition.

  20. Forest Canopy Height Models from SAR Data: Mid-Term Report of the Dragon 3 Project (Id. 10667) and the Dragon 3 Young Scientist Project

    NASA Astrophysics Data System (ADS)

    Karjalainen, Mika; Huang, Guoman; Karila, Kirsi; Lu, Lijun; Vastaranta, Mikko

    2014-11-01

    Recent experiences with Airborne Laser Scanning and digital stereo-photogrammetry data have revealed that precise forest biomass estimations can be obtained using these techniques. The basis of the high biomass estimation accuracy is the ability to measure the forest canopy height and density accurately. The objective of the Dragon3 forest resources research project is to study the use of satellite based 3D measurement techniques for mapping forest canopy height, biomass and biomass change by combining satellite data with terrestrial measurements and airborne remote sensing data. In this paper, preliminary results of canopy height models created from TanDEM-X INSAR data are shown. Also, results from the airborne CASMSAR system to measure forest canopy height from P- and X-band INSAR are presented.

  1. Clinical and Radiographic Mid-Term Outcomes After Total Shoulder Replacement: A Retrospective Study Protocol Including 400 Anatomical and Reverse Prosthetic Implants

    PubMed Central

    Merolla, Giovanni; Tartarone, Antonio; Porcellini, Giuseppe

    2016-01-01

    Objectives: To obtain outcomes data on anatomical and reverse total shoulder arthroplasty by analysis of clinical scores and standard radiographs. Subject selection and enrollment: 400 consecutive series of patients replaced with anatomical and reverse total shoulder arthroplasty (minimum 3 years follow-up). Study Design: retrospective monocenter. Preoperative assessment: Demographics, clinical scores (Constant-Murley) as available, shoulder X-ray (AP, outlet and axillary views) . Last follow-up: Postoperative radiographhs and clinical scores. Adverse events and complications to be reported as occurred since implantation. Statistical analysis: Data collected will be summarized and analyzed for statistical significance. PMID:27326389

  2. EU-FP7-iMARS: analysis of Mars multi-resolution images using auto-coregistration, data mining and crowd source techniques: A Mid-term Report

    NASA Astrophysics Data System (ADS)

    Muller, J.-P.; Yershov, V.; Sidiropoulos, P.; Gwinner, K.; Willner, K.; Fanara, L.; Waelisch, M.; van Gasselt, S.; Walter, S.; Ivanov, A.; Cantini, F.; Morley, J. G.; Sprinks, J.; Giordano, M.; Wardlaw, J.; Kim, J.-R.; Chen, W.-T.; Houghton, R.; Bamford, S.

    2015-10-01

    Understanding the role of different solid surface formation processes within our Solar System is one of the fundamental goals of planetary science research. There has been a revolution in planetary surface observations over the last 8 years, especially in 3D imaging of surface shape (down to resolutions of 10s of cms) and subsequent terrain correction of imagery from orbiting spacecraft. This has led to the potential to be able to overlay different epochs back to the mid-1970s. Within iMars, a processing system has been developed to generate 3D Digital Terrain Models (DTMs) and corresponding OrthoRectified Images (ORIs) fully automatically from NASA MRO HiRISE and CTX stereo-pairs which are coregistered to corresponding HRSC ORI/DTMs. In parallel, iMars has developed a fully automated processing chain for co-registering level-1 (EDR) images from all previous NASA orbital missions to these HRSC ORIs and in the case of HiRISE these are further co-registered to previously co-registered CTX-to-HRSC ORIs. Examples will be shown of these multi-resolution ORIs and the application of different data mining algorithms to change detection using these co-registered images. iMars has recently launched a citizen science experiment to evaluate best practices for future citizen scientist validation of such data mining processed results. An example of the iMars website will be shown along with an embedded Version 0 prototype of a webGIS based on OGC standards.

  3. A deeper look at the response of oxygenated and non oxygenated VOC to mid-term drought over the seasonal cycle: the case study of a drought-resistant species

    NASA Astrophysics Data System (ADS)

    Saunier, Amelie; Ormeño Lafuente, Elena; Wortham, Henri; Temime-Roussel, Brice; Fernandez, Catherine

    2015-04-01

    At the end of this century, climatic models plan an intensification of summer drought in the Mediterranean area due to a 30% rain reduction and a temperature rise of 3.4 °C. Plants respond to drought by modifying their primary (growth) and their secondary metabolism, the later being partly represented by volatile organic compound (VOC) emissions, such as terpenes. With drought, oxygenated and non oxygenated terpene emissions have been observed to increase, decrease or remain unchanged according to drought severity and vegetal model. By contrast, the response of non-terpenic oxygenated compounds to drought has been poorly studied. The aim of this study is to determine the potential impact of a two-year drought period on the full screen of VOC released by Q. pubescens, with a focus on both isoprene and methanol, issued from plant anabolism , and the numerous highly volatile oxygenated VOC, issued from plant catabolism (i.e. issued from oxidation of isoprene or methanol). A 70 years-old Downy oak forest (Quercus pubescens), highly resistant to drought stress, was selected as model ecosystem since it is well widespread in Southern France occupying 321 000 ha. Downy oak also represents the major source of isoprene emissions in the Mediterranean area and, unlike the other major Quercus sp. of the region (i.e. Quercus ilex, a monoterpene emitter) the impact of watering withholding over years has never been tackled. The study was performed at the experimental platform of O3HP (Oak Observatory at Observatoire de Haute Provence) in Southern France which is equipped with both a rain exclusion (by 30 %) and a rain addition structure (simulating the rainiest years of the region), allowing for comparison with naturally watered trees. Using dynamic enclosure chambers at the branch level and PTR-MS-Q-ToF, we screened the anabolic VOC (isoprene, methanol) and the catabolic VOC (e.g. methacrolein, methyl vinyl ketone, C6 aldehydes and carboxylic acids) of trees located under the three watering treatments during the three seasons of the vegetation period (spring, summer and autumn). Concomitantly, water stress was characterized by monitoring the ecophysiological plant parameters such as predawn leaf water potential, photosynthesis, stomatal conductance as well as VOCanabolic/VOCCcatabolic ratios indicators of oxidation within the cell. Differences among the three watering treatments were slight or absent depending on the season and the compound. This response was attributed to Downy Oak resistance to rain exclusion as reflected by the maintenance of the photosynthetic machinery activity and leaf water levels.

  4. Pseudotumour incidence, cobalt levels and clinical outcome after large head metal-on-metal and conventional metal-on-polyethylene total hip arthroplasty: mid-term results of a randomised controlled trial.

    PubMed

    van der Veen, H C; Reininga, I H F; Zijlstra, W P; Boomsma, M F; Bulstra, S K; van Raay, J J A M

    2015-11-01

    We compared the incidence of pseudotumours after large head metal-on-metal (MoM) total hip arthroplasty (THA) with that after conventional metal-on-polyethylene (MoP) THA and assessed the predisposing factors to pseudotumour formation. From a previous randomised controlled trial which compared large head (38 mm to 60 mm) cementless MoM THA with conventional head (28 mm) cementless MoP THA, 93 patients (96 THAs: 41 MoM (21 males, 20 females, mean age of 64 years, standard deviation (sd) 4) and 55 MoP (25 males, 30 females, mean age of 65 years, sd 5) were recruited after a mean follow-up of 50 months (36 to 64). The incidence of pseudotumours, measured using a standardised CT protocol was 22 (53.7%) after MoM THA and 12 (21.8%) after MoP THA. Women with a MoM THA were more likely to develop a pseudotumour than those with a MoP THA (15 vs 7, odds ratio (OR) = 13.4, p < 0.001). There was a similar incidence of pseudotumours in men with MoM THAs and those with MoP THAs (7 vs 5, OR = 2.1, p = 0.30). Elevated cobalt levels (≥ 5 microgram/L) were only associated with pseudotumours in women with a MoM THA. There was no difference in mean Oxford and Harris hip scores between patients with a pseudotumour and those without. Contrary to popular belief, pseudotumours occur frequently around MoP THAs. Women with a MoM THA and an elevated cobalt level are at greatest risk. In this study, pseudotumours had no effect on the functional outcome after either large head MoM or conventional MoP THA. PMID:26530649

  5. Influence of developing ligaments on the muscles in contact with them: a study of the annular ligament of the radius and the sacrospinous ligament in mid-term human fetuses

    PubMed Central

    Kim, Ji Hyun; Rodriguez-Vazquez, Jose Francisco; Murakami, Gen; Fukuzawa, Yoshitaka; Asamoto, Ken; Nakano, Takashi

    2013-01-01

    The supinator muscle originates from the annular ligament of the radius, and the muscle fibers and ligament take a similar winding course. Likewise, the coccygeus muscle and the sacrospinous ligament are attached together, and show a similar fiber orientation. During dissection of adult cadavers for our educational curriculum, we had the impression that these ligaments grow in combination with degeneration of parts of the muscles. In histological sections of 25 human fetuses at 10-32 weeks of gestation, we found that the proximal parts of the supinator muscle were embedded in collagenous tissue when the developing annular ligament of the radius joined the thick intermuscular connecting band extending between the extensor carpi radialis and anconeus muscles at 18-22 weeks of gestation, and the anterior parts of the coccygeus muscle were surrounded by collagenous tissue when the intramuscular tendon became the sacrospinous ligament at 28-32 weeks. Parts of these two muscles each seemed to provide a mold for the ligament, and finally became involved with it. This may be the first report to indicate that a growing ligament has potential to injure parts of the "mother muscle," and that this process may be involved in the initial development of the ligament. PMID:23869262

  6. Comparison of minimally invasive surgery with standard open surgery for vertebral thoracic metastases causing acute myelopathy in patients with short- or mid-term life expectancy: surgical technique and early clinical results.

    PubMed

    Miscusi, Massimo; Polli, Filippo Maria; Forcato, Stefano; Ricciardi, Luca; Frati, Alessandro; Cimatti, Marco; De Martino, Luca; Ramieri, Alessandro; Raco, Antonino

    2015-05-01

    OBJECT Spinal metastasis is common in patients with cancer. About 70% of symptomatic lesions are found in the thoracic region of the spine, and cord compression presents as the initial symptom in 5%-10% of patients. Minimally invasive spine surgery (MISS) has recently been advocated as a useful approach for spinal metastases, with the aim of decreasing the morbidity associated with more traditional open spine surgery; furthermore, the recovery time is reduced after MISS, such that postoperative chemotherapy and radiotherapy can begin sooner. METHODS Two series of oncological patients, who presented with acute myelopathy due to vertebral thoracic metastases, were compared in this study. Patients with complete paraplegia for more than 24 hours and with a modified Bauer score greater than 2 were excluded from the study. The first group (n = 23) comprised patients who were prospectively enrolled from May 2010 to September 2013, and who were treated with minimally invasive laminotomy/laminectomy and percutaneous stabilization. The second group (n = 19) comprised patients from whom data were retrospectively collected before May 2010, and who had been treated with laminectomy and stabilization with traditional open surgery. Patient groups were similar regarding general characteristics and neurological impairment. Results were analyzed in terms of neurological recovery (American Spinal Injury Association grade), complications, pain relief (visual analog scale), and quality of life (European Organisation for Research and Treatment of Cancer [EORTC] QLQ-C30 and EORTC QLQ-BM22 scales) at the 30-day follow-up. Operation time, postoperative duration of bed rest, duration of hospitalization, intraoperative blood loss, and the need and length of postoperative opioid administration were also evaluated. RESULTS There were no significant differences between the 2 groups in terms of neurological recovery and complications. Nevertheless, the MISS group showed a clear and significant improvement in terms of blood loss, operation time, and bed rest length, which is associated with a more rapid functional recovery and discharge from the hospital. Postoperative pain and the need for opioid administration were also significantly less pronounced in the MISS group. Results from the EORTC QLQ-C30 and QLQ-BM22 scales showed a more pronounced improvement in quality of life at follow-up in the MISS group. CONCLUSIONS In the authors' opinion, MISS techniques should be considered the first choice for the treatment for patients with spinal metastasis and myelopathy. MISS is as safe and effective for spinal cord decompression and spine fixation as traditional surgery, and it also reduces the impact of surgery in critical patients. However, further studies are needed to confirm these findings. PMID:25723122

  7. Cost-effectiveness of initial stress cardiovascular MR, stress SPECT or stress echocardiography as a gate-keeper test, compared with upfront invasive coronary angiography in the investigation and management of patients with stable chest pain: mid-term outcomes from the CECaT randomised controlled trial

    PubMed Central

    Thom, Howard; West, Nicholas E J; Hughes, Vikki; Dyer, Matthew; Buxton, Martin; Sharples, Linda D; Jackson, Christopher H; Crean, Andrew M

    2014-01-01

    Objectives To compare outcomes and cost-effectiveness of various initial imaging strategies in the management of stable chest pain in a long-term prospective randomised trial. Setting Regional cardiothoracic referral centre in the east of England. Participants 898 patients (69% man) entered the study with 869 alive at 2 years of follow-up. Patients were included if they presented for assessment of stable chest pain with a positive exercise test and no prior history of ischaemic heart disease. Exclusion criteria were recent infarction, unstable symptoms or any contraindication to stress MRI. Primary outcome measures The primary outcomes of this follow-up study were survival up to a minimum of 2 years post-treatment, quality-adjusted survival and cost-utility of each strategy. Results 898 patients were randomised. Compared with angiography, mortality was marginally higher in the groups randomised to cardiac MR (HR 2.6, 95% CI 1.1 to 6.2), but similar in the single photon emission CT-methoxyisobutylisonitrile (SPECT-MIBI; HR 1.0, 95% CI 0.4 to 2.9) and ECHO groups (HR 1.6, 95% CI 0.6 to 4.0). Although SPECT-MIBI was marginally superior to other non-invasive tests there were no other significant differences between the groups in mortality, quality-adjusted survival or costs. Conclusions Non-invasive cardiac imaging can be used safely as the initial diagnostic test to diagnose coronary artery disease without adverse effects on patient outcomes or increased costs, relative to angiography. These results should be interpreted in the context of recent advances in imaging technology. Trial registration ISRCTN 47108462, UKCRN 3696. PMID:24508847

  8. White Paper on School-Lunch Nutrition.

    ERIC Educational Resources Information Center

    Center for Science in the Public Interest, Washington, DC.

    Recommendations are made on how school lunch programs can provide better nutrition and promote healthier eating habits. Recommendations consist of goals with both short-term and mid-term objectives. The short-term objectives should be implemented over the next 2 to 4 years; the mid-term objectives should be implemented by the year 2000 or sooner…

  9. Visual impairment.

    PubMed

    Ellenberger, Carl

    2016-01-01

    This chapter can guide the use of imaging in the evaluation of common visual syndromes: transient visual disturbance, including migraine and amaurosis fugax; acute optic neuropathy complicating multiple sclerosis, neuromyelitis optica spectrum disorder, Leber hereditary optic neuropathy, and Susac syndrome; papilledema and pseudotumor cerebri syndrome; cerebral disturbances of vision, including posterior cerebral arterial occlusion, posterior reversible encephalopathy, hemianopia after anterior temporal lobe resection, posterior cortical atrophy, and conversion blindness. Finally, practical efforts in visual rehabilitation by sensory substitution for blind patients can improve their lives and disclose new information about the brain. PMID:27430448

  10. Cutting Balloon Angioplasty of Bilateral Renal Artery Stenosis Due to Takayasu Arteritis in a 5-Year-Old Child with Midterm Follow-Up

    SciTech Connect

    Gumus, Burcak Cevik, Halime; Vuran, Can; Omay, Oguz; Kocyigit, Ozgen Ilgaz; Turkoz, Riza

    2010-04-15

    The aim of this report is to demonstrate the successful endovascular treatment of bilateral renal artery stenosis due to Takayasu arteritis by cutting balloon angioplasty in a 5-year-old child with mid-term follow-up.

  11. Advanced batteries for electric vehicle applications: Nontechnical summary

    NASA Astrophysics Data System (ADS)

    Henriksen, G. L.

    This paper provides an overview of the performance characteristics of the most prominent batteries under development for electric vehicles (EV's) and compares these characteristics to the USABC Mid-Term and Long-Term criteria, as well as to typical vehicle-related battery requirements. Most of the battery performance information was obtained from independent tests, conducted using simulated driving power profiles, for DOE and EPRI at Argonne National Laboratory. The EV batteries are categorized as near-term, mid-term, and long-term technologies based on their relative development status, as well as our estimate of their potential availability as commercial EV batteries. Also, the performance capabilities generally increase in going from the near-term to the mid-term and on to the long-term technologies. To date, the USABC has chosen to fund a few selected mid-term and long-term battery technologies.

  12. Hyperbaric oxygen in the treatment of radiation-induced optic neuropathy

    SciTech Connect

    Guy, J.; Schatz, N.J.

    1986-08-01

    Four patients with radiation-induced optic neuropathies were treated with hyperbaric oxygen. They had received radiation therapy for treatment of pituitary tumors, reticulum cell sarcoma, and meningioma. Two presented with amaurosis fugax before the onset of unilateral visual loss and began hyperbaria within 72 hours after development of unilateral optic neuropathy. Both had return of visual function to baseline levels. The others initiated treatment two to six weeks after visual loss occurred in the second eye and had no significant improvement of vision. Treatment consisted of daily administration of 100% oxygen under 2.8 atmospheres of pressure for 14-28 days. There were no medical complications of hyperbaria. While hyperbaric oxygen is effective in the treatment of radiation-induced optic neuropathy, it must be instituted within several days of deterioration in vision for restoration of baseline function.

  13. [Immediate and remote results of surgical treatment of patients presenting with pathological tortuosity of internal carotid arteries and accompanying ocular ischaemic syndrome].

    PubMed

    Gavrilenko, A V; Kuklin, A V; Kisileva, T N; Abramian, A V; Omarzhanova, I I

    2013-01-01

    The article deals with the data concerning the efficacy of reconstructive operations and conservative treatment in patients presenting with pathological tortuosity of internal carotid arteries. The study included a total of 63 patients. The diagnostic algorithm was as follows: studying the haemodynamics of the internal carotid arteries, assessing the neurological status, and the methods of examining the eye. The patients were subdivided into two groups: Group One consisted of operated on patients (n=37) and Group Two comprising patients treated conservatively (n=26). The patients according to the neurological status were subdivided as follows: an asymptomatic course in 25 (39.7%) patients, transitory ischaemic attacks in 18 (28.6%) patients, dyscirculatory encephalopathy in 12 (19 %) patients, and stroke in 8 (12.7%) patients. Ophthalmological symptomatology was predominantly manifested by fits of amaurosis fugax in 19 (30.2%) patients and processes of maculodystrophy in 49 (77.8 %) patients. We assessed the immediate (day 30) and remote (1 year) results of conservative and surgical treatment. Group One patients demonstrated cessation of the amaurosis fugax attacks, improvement of the acuity of vision by 0.1 and more, enlargement of the borders of the field of vision, disappearance of scotomas, as well as arrest of the processes of maculodystrophy. Patients with transitory ischaemic attacks and dyscirculatory encephalopathy changed to the category of asymptomatic patients. In Group Two patients the dynamics of the neurological status was negative and the patients continued to experience fits of amaurosis fugas. The dynamics of the opthalmological symptomatology was weakly pronounced. PMID:24429568

  14. The requirements for batteries for electric vehicles

    NASA Technical Reports Server (NTRS)

    Schwartz, H. J.

    1976-01-01

    Analysis of automobile use patterns shows that the battery requirements for an urban car can be met by mid-term battery technology. The far-term technology potentially offers greater range but does not proportionately increase the usefulness of the vehicle. This suggests that emphasis should be shifted toward more modest energy density goals, if such a shift would ease technical problems and allow the use of lower cost materials and construction methods. A technology diffusion model indicates that the impact of the mid-term batteries by the year 2000 would be greater than that of the far-term batteries because of their earlier introduction and nearly equal market potential. From the standpoint of maximizing both the cumulative impact and the benefits derived in the year 2000, however, a strategy of early introduction of near-term and mid-term cars followed by the far-term vehicle would produce the optimum results.

  15. Altering Test Environments for Reducing Test Anxiety and for Improving Academic Performance.

    ERIC Educational Resources Information Center

    Bushnell, Don D.

    To test the effects of altering situational variables in stressful examinations on high test anxious and low test anxious undergraduates, mid-terms and final examinations were administered in two environmental settings: large lecture halls and small language laboratories. Mean test scores for high test anxious students in the language labs were…

  16. EFA Mid-Decade Assessment Meeting Report. Annual EFA Coordinators Meeting/EFA Mid-Decade Assessment Planning Meeting (7th, Bangkok, Thailand, October 24-29, 2005)

    ERIC Educational Resources Information Center

    Tung, Ko-Chih

    2006-01-01

    Six Education For All (EFA) goals were agreed to in the World Education Forum in Dakar, Senegal in 2000. Since then, UNESCO Bangkok, UNICEF and the Regional Thematic Working Group on EFA have been jointly assisting countries in conducting assessment of progress and gaps towards the EFA goals and mid-term review of policies and reforms. In October…

  17. Energy Frontier Research Center, Center for Materials Science of Nuclear Fuels

    SciTech Connect

    Todd R. Allen

    2011-12-01

    This is a document required by Basic Energy Sciences as part of a mid-term review, in the third year of the five-year award period and is intended to provide a critical assessment of the Center for Materials Science of Nuclear Fuels (strategic vision, scientific plans and progress, and technical accomplishments).

  18. Enhancing Student Performance through Cooperative Learning in Physical Sciences

    ERIC Educational Resources Information Center

    Gupta, Madan L.

    2004-01-01

    Students in a physical sciences course were introduced to cooperative learning at the University of Queensland, Gatton Campus. Groups of four to five students worked together in tutorial and practical sessions. Mid-term and practical examinations were abolished and 40% of total marks were allocated to the cooperative learning activities. A peer-…

  19. Maintenance Crisis vs Solutions.

    ERIC Educational Resources Information Center

    Haggard, Susie

    Industrial maintenance in Northeast Georgia is facing an acute crisis. Contributing factors are economic development that is depleting the work force, aging of the population, downsizing of the military, and lack of technical school graduates. Solutions to the crisis fall into three categories: short-term, mid-term, and long-term. For short-term…

  20. Metacognitive Monitoring in University Classes: Anticipating a Graded vs. a Pass-Fail Test Affects Monitoring Accuracy

    ERIC Educational Resources Information Center

    Barenberg, Jonathan; Dutke, Stephan

    2013-01-01

    Three field studies tested the hypothesis that anticipating a graded test as opposed to a pass-fail test enhances metacognitive monitoring. Participants were teacher candidates who completed a mid-term and a final test in psychology courses. Each participant chose whether the result of the final test should be evaluated with one of five grades or…

  1. A Descriptive Study of Community College Students Coping with Examination Stress.

    ERIC Educational Resources Information Center

    Grina, Michaele Erin

    In previous research students' reactions to examinations from a cognitive-process perspective have been based on a singular study of university college students. The purpose of this study was to describe and predict students' reactions to a community college mid-term examination, based on a cognitively-oriented, process-centered theory of stress…

  2. Top Tips for Buying Telecommunication Services.

    ERIC Educational Resources Information Center

    Linder, Jeff

    2001-01-01

    Examines top regulatory issues and other unique issues resulting from this regulatory overlay when negotiating for corporate telecom services. Issues cover such topics as tariffs, rate negotiation, exclusivity provisions, revenue commitments, mid-term negotiations, service-level agreements, and dispute resolution. (GR)

  3. English Teaching in South Africa: Languages, Literacies and Politics.

    ERIC Educational Resources Information Center

    Farrell, Lesley; Homer, David; Patterson, Annette

    1998-01-01

    Uses three addresses given at a mid-term International Federation for the Teaching of English at the University of Witwatersrand to outline workplace realities for South African teachers. Summarizes the addresses which deal with (1) the role of intellectuals in Africa; (2) the problems of school and social reconstruction; and (3) the political…

  4. Incorporating Multiple-Choice Questions into an AACSB Assurance of Learning Process: A Course-Embedded Assessment Application to an Introductory Finance Course

    ERIC Educational Resources Information Center

    Santos, Michael R.; Hu, Aidong; Jordan, Douglas

    2014-01-01

    The authors offer a classification technique to make a quantitative skills rubric more operational, with the groupings of multiple-choice questions to match the student learning levels in knowledge, calculation, quantitative reasoning, and analysis. The authors applied this classification technique to the mid-term exams of an introductory finance…

  5. Evaluating Knowledge, Attitudinal, and Behavioral Change Effects from a Multinational HIV/AIDS Education Program for Youth

    ERIC Educational Resources Information Center

    Hardre, Patricia L.; Garcia, Fe; Apamo, Peter; Mutheu, Lucy; Ndege, Monica; Bois, Iderle

    2010-01-01

    This project tracked the mid-term evaluation processes, practices, and products of a multinational program to reduce at-risk behaviors for HIV/AIDS among children in Kenya, Tanzania, and Haiti. It focused on participant and community perceptions; program effectiveness in promoting abstinence and monogamy decisions; and factors supporting ongoing…

  6. New Technology Trends in Education: Seven Years of Forecasts and Convergence

    ERIC Educational Resources Information Center

    Martin, Sergio; Diaz, Gabriel; Sancristobal, Elio; Gil, Rosario; Castro, Manuel; Peire, Juan

    2011-01-01

    Each year since 2004, a new Horizon Report has been released. Each edition attempts to forecast the most promising technologies likely to impact on education along three horizons: the short term (the year of the report), the mid-term (the next 2 years) and the long term (the next 4 years). This paper analyzes the evolution of technology trends…

  7. Development of PCK for Novice and Experienced University Physics Instructors: A Case Study

    ERIC Educational Resources Information Center

    Jang, Syh-Jong; Tsai, Meng-Fang; Chen, Ho-Yuan

    2013-01-01

    The current study assessed and compared university students' perceptions' of a novice and an experienced physics instructor's Pedagogical Content Knowledge (PCK). Two college physics instructors and 116 students voluntarily participated in this study. The research model comprised three workshops, mid-term and final evaluations and…

  8. Atomic clock using coherent population trapping in a cesium cell: frequency stability and limitations

    NASA Astrophysics Data System (ADS)

    Mejri, Sinda; Tricot, Francois; Danet, Jean-Marie; Yun, Peter; De Clercq, Emeric; Guerandel, Stephane

    2016-06-01

    Toward the next generation of compact devices, atomic clocks based on coherent population trapping (CPT) offer a very interesting alternative. We present a review of our studies on the short and mid term stability of a compact high performance atomic clock based on CPT in view of portable applications.

  9. 76 FR 199 - Self-Regulatory Organizations; NYSE Arca, Inc.; Order Granting Approval of Proposed Rule Change...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-03

    ... Relating to the Listing and Trading of the ProShares VIX Short-Term Futures ETF and the ProShares VIX Mid... and trade shares (``Shares'') of the ProShares VIX Short-Term Futures ETF and the ProShares VIX Mid-Term Futures ETF (``Funds'') of the ProShares Trust II (``Trust'') under NYSE Arca Equities Rule...

  10. Academic Policy.

    ERIC Educational Resources Information Center

    Chicago City Colleges, IL.

    This statement outlines the academic policies of the City Colleges of Chicago. Part I outlines the Institution's academic standards, covering: (1) student class attendance; (2) the grading system; (3) mid-term grades; (4) the use of non-grade designations; i.e., administrative initiated withdrawal, auditor, no-show withdrawal, incomplete, and…

  11. Simultaneous surgery of the aortic valve and sternal osteomyelitis.

    PubMed

    Urbanski, Paul P; Lindemann, Yvonne; Babin-Ebell, Jörg; Fröhner, Steffen; Diegeler, Anno

    2009-09-01

    A 64-year-old man was referred for aortic valve replacement due to severe stenosis. He also suffered chronic sternal osteomyelitis with skin fistula subsequent to radiation therapy. Both pathologies were approached simultaneously by sternal resection, omental plasty, and valve replacement, which led to favorable primary and mid-term result. PMID:19699936

  12. Developing Mobile Learning Practices through Teacher Education: Outcomes of the MLEARN Pilot

    ERIC Educational Resources Information Center

    Passey, Don; Zozimo, Joana

    2016-01-01

    Purpose: This paper explores the context, development and outcomes of a cross-European in-service training programme, developing mobile learning practices in school classrooms--MLEARN--in The Netherlands, England, Greece and Italy. This paper focuses on: contextual backgrounds; a training needs analysis; and initial, mid-term and final outcomes…

  13. National Electric Sector Cybersecurity Organization Resource (NESCOR)

    SciTech Connect

    None, None

    2014-06-30

    The goal of the National Electric Sector Cybersecurity Organization Resource (NESCOR) project was to address cyber security issues for the electric sector, particularly in the near and mid-term. The following table identifies the strategies from the DOE Roadmap to Achieve Energy Delivery Systems Cybersecurity published in September 2011 that are applicable to the NESCOR project.

  14. Cyclic Nucleotide-Gated Channels, Calmodulin, Adenylyl Cyclase, and Calcium/Calmodulin-Dependent Protein Kinase II Are Required for Late, but Not Early, Long-Term Memory Formation in the Honeybee

    ERIC Educational Resources Information Center

    Matsumoto, Yukihisa; Sandoz, Jean-Christophe; Devaud, Jean-Marc; Lormant, Flore; Mizunami, Makoto; Giurfa, Martin

    2014-01-01

    Memory is a dynamic process that allows encoding, storage, and retrieval of information acquired through individual experience. In the honeybee "Apis mellifera," olfactory conditioning of the proboscis extension response (PER) has shown that besides short-term memory (STM) and mid-term memory (MTM), two phases of long-term memory (LTM)…

  15. FY 1979 Unit Cost Analysis for the Public Community Colleges of Illinois.

    ERIC Educational Resources Information Center

    Illinois Community Coll. Board, Springfield.

    A unit cost analysis for fiscal year (FY) 1979 was conducted by the Illinois Community College Board using mid-term enrollment data and uniform accounting information from each of the state's 51 community colleges. Unit costs for instructional areas were determined at three incremental levels: (1) net instructional cost (NIC), which includes…

  16. Teacher-Student Cooperative Learning in the Freshman Writing Course.

    ERIC Educational Resources Information Center

    Ney, James W.

    This study examined the effectiveness of a cooperative learning model for the teaching of Freshman English at the college level. The model involved student presentations based on assigned readings from the texts, nine compositions and daily quizzes on the reading material, and peer grading of the daily quizzes as well as mid-term and final exams,…

  17. Evolutionary Theories of Detection

    SciTech Connect

    Fitch, J P

    2005-04-29

    Current, mid-term and long range technologies for detection of pathogens and toxins are briefly described in the context of performance metrics and operational scenarios. Predictive (evolutionary) and speculative (revolutionary) assessments are given with trade-offs identified, where possible, among competing performance goals.

  18. Course Syllabus: Minds and Robots.

    ERIC Educational Resources Information Center

    Goldman, Steven L.

    1985-01-01

    Describes and outlines the general syllabus of a philosophy course entitled, "Minds and Robots." Lists the assigned readings and explains the issues addressed in the 14-week course. Essay questions that are used for the mid-term and final exams are also included. (ML)

  19. Academic Comparison of Athletes and Non-Athletes in a Rural High School.

    ERIC Educational Resources Information Center

    Zaugg, Holt

    1998-01-01

    Compares academic performance, behavior, and commitment of basketball and volleyball athletes and nonathletes in a rural Canadian high school. Compares mid-term and final grades in each school discipline, disciplinary visits to administrators, and misbehavior demerits. Estimates athletes' mean weekly time commitment in each sport. Athletes matched…

  20. The Effect of Context and Input Conditions on Oral and Written Development: A Study Abroad Perspective

    ERIC Educational Resources Information Center

    Perez-Vidal, Carmen; Juan-Garau, Maria

    2011-01-01

    This article aims at describing and explaining the effects of a period of Study Abroad spent in the target language country (SA) on foreign language development. Such effects are analysed in the short- and mid-term and in contrast with the impact of a period of formal instruction (FI) previously spent in the home country (AH). It is hypothesised…

  1. Self-Directed Writing: Giving Voice to Student Writers

    ERIC Educational Resources Information Center

    Lovejoy, Kim Brian

    2009-01-01

    Self-directed writing is an opportunity for teachers to write with their students, and it is writing that ultimately ends up in the student's portfolio at mid-term and end of term. It is one component of a structured writing class in which students also do other writing assignments. It is important for teachers to communicate their expectations of…

  2. Differential Prognostic Impacts of Diabetes over Time Course after Acute Myocardial Infarction

    PubMed Central

    Kim, Hack-Lyoung; Kang, Si-Hyuck; Yoon, Chang-Hwan; Cho, Young-Seok; Youn, Tae-Jin; Cho, Goo-Yeong; Chae, In-Ho; Kim, Hyo-Soo; Chae, Shung-Chull; Cho, Myeong-Chan; Kim, Young-Jo; Kim, Ju Han; Ahn, Youngkeun; Jeong, Myung Ho

    2013-01-01

    This study was performed to evaluate the effects of diabetes on short- and mid-term clinical outcomes in patients with acute myocardial infarction (AMI). Between October 2005 and December 2009, a total of 22,347 patients with AMI from a nationwide registry was analyzed. At the time point of the day 30 after AMI onset, landmark analyses were performed for the development of major adverse cardiovascular events (MACEs), including death, re-infarction and revascularization. In this cohort, 6,131 patients (27.4%) had diabetes. Short-term MACEs, which occurred within 30 days of AMI onset, were observed in 1,364 patients (6.1%). Among the 30-day survivors (n = 21,604), mid-term MACEs, which occurred between 31 and 365 days after AMI onset, were observed in 1,181 patients (5.4%). After adjustment for potential confounders, diabetes was an independent predictor of mid-term MACEs (HR, 1.25; 95% CI, 1.08-1.45; P = 0.002), but not of short-term MACEs (HR: 1.16; 95% CI: 0.93-1.44; P = 0.167). Diabetes is a poor prognostic factor for mid-term clinical outcomes but not for short-term outcomes in AMI patients. Careful monitoring and intensive care should be considered in diabetic patients, especially following the acute stage of AMI. PMID:24339704

  3. Resilience and Learning: A Conspectus for Environmental Education

    ERIC Educational Resources Information Center

    Lundholm, Cecilia; Plummer, Ryan

    2010-01-01

    There has been an increasing interest in how environmental education contributes to sustainability dating from the 1977 UNESCO conference in Tbilisi to the current Decade of Education for Sustainable Development, which in 2009, reached mid term. There is also a growing interest and concern in the complexity, uncertainty and changing nature of…

  4. Color Doppler and pulse wave assessment of flow in anomalous origin of left coronary artery from pulmonary artery: Pre- and post-surgery

    PubMed Central

    Bhalgat, Parag S.; Naik, Abhijeet V.; Salvi, Prasanna R.; Joshi, Suresh V.

    2016-01-01

    Changes in left coronary artery flow pattern in anomalous left coronary from pulmonary artery can provide valuable insight into pathology and natural history of disease. We wish to discuss a case with pre and post operative left coronary flow pattern with mid term follow up. PMID:27212862

  5. Defensive platform size and survivability. [Platform survivability

    SciTech Connect

    Canavan, Gregory H.

    1988-06-01

    This report discusses the survivability of space platforms, concentrating on space based kinetic energy interceptors. It evaluates the efficacy of hardening, maneuver, self-defense, and deception in extending the survivability of platforms of varying sizes to expected threats, concluding that they should be adequate in the near and mid terms.

  6. Bevacizumab, Capecitabine, Amifostine, and Preoperative Hypofractionated Accelerated Radiotherapy (HypoArc) for Rectal Cancer: A Phase II Study

    SciTech Connect

    Koukourakis, Michael I.; Tsoutsou, Pelagia; Chloropoulou, Pelagia A.; Manolas, Kostantinos; Sivridis, Efthimios

    2011-06-01

    Purpose: Bevacizumab has established therapeutic activity in patients with metastatic colorectal cancer, and anti-vascular endothelial growth factor therapy enhances the activity of radiotherapy in experimental models. We assessed the feasibility and efficacy of preoperative radiochemotherapy combined with bevacizumab in patients with rectal cancer. Methods and Materials: Nineteen patients with radiologic T3 and/or N+ rectal carcinoma were treated with preoperative conformal hypofractionated accelerated radiotherapy (3.4 Gy in 10 consecutive fractions) supported with amifostine (500-1,000 mg daily), capecitabine (600 mg/m{sup 2} twice daily, 5 days per week), and bevacizumab (5 mg/kg every 2 weeks for 2 cycles). Surgery followed 6 weeks after the end of radiotherapy. A cohort of 14 sequential patients treated with the same regimen without bevacizumab was available for comparison. Results: Grade 2 or 3 diarrhea was noted in 7 of 19 patients (36.8%), which was statistically worse than patients receiving the same regimen without bevacizumab (p = 0.01). A higher incidence of Grade 2 or 3 proctalgia was also noted (21.1%) (p = 0.03). Bladder and skin toxicity was negligible. All toxicities regressed completely within 2 weeks after the end of therapy. Pathologic complete and partial response was noted in 7 of 19 cases (36.8%) and 8 of 19 cases (42.1%). Within a median follow-up of 21 months, none of the patients has had late complications develop and only 1 of 18 evaluable cases (5.5%) has had locoregional relapse. Conclusions: Bevacizumab can be safely combined with hypofractionated radiotherapy and capecitabine as a preoperative radiochemotherapy regimen for patients with rectal cancer. The high pathologic complete response rates urges the testing of bevacizumab in randomized studies.

  7. Identifying Functional Requirements for Flexible Airspace Management Concept Using Human-In-The-Loop Simulations

    NASA Technical Reports Server (NTRS)

    Lee, Paul U.; Bender, Kim; Pagan, Danielle

    2011-01-01

    Flexible Airspace Management (FAM) is a mid- term Next Generation Air Transportation System (NextGen) concept that allows dynamic changes to airspace configurations to meet the changes in the traffic demand. A series of human-in-the-loop (HITL) studies have identified procedures and decision support requirements needed to implement FAM. This paper outlines a suggested FAM procedure and associated decision support functionality based on these HITL studies. A description of both the tools used to support the HITLs and the planned NextGen technologies available in the mid-term are presented and compared. The mid-term implementation of several NextGen capabilities, specifically, upgrades to the Traffic Management Unit (TMU), the initial release of an en route automation system, the deployment of a digital data communication system, a more flexible voice communications network, and the introduction of a tool envisioned to manage and coordinate networked ground systems can support the implementation of the FAM concept. Because of the variability in the overall deployment schedule of the mid-term NextGen capabilities, the dependency of the individual NextGen capabilities are examined to determine their impact on a mid-term implementation of FAM. A cursory review of the different technologies suggests that new functionality slated for the new en route automation system is a critical enabling technology for FAM, as well as the functionality to manage and coordinate networked ground systems. Upgrades to the TMU are less critical but important nonetheless for FAM to be fully realized. Flexible voice communications network and digital data communication system could allow more flexible FAM operations but they are not as essential.

  8. [Hypercoagulable workup in ophthalmology. When and what].

    PubMed

    Muñoz-Negrete, F J; Casas-Lleras, P; Pérez-López, M; Rebolleda, G

    2009-07-01

    Most ophthalmologic disorders secondary to hypercoagulabe state are due to the confluence of congenital and adquired factors. A systematic workup is mandatory. Most of congenital coagulation disorders cause venous trombosis and are inherited autosomal dominantly. In order of frequency these are factor V Leiden mutation (activated protein C resistance), G20210A mutation of the prothrombin gen and protein C, protein S, and antithrombin III deficiencies. Sickle cell anemia can determine arerial and venous thrombosis. In relation with arterial occlusion, the markers most frequently involved are homcysteine fasting levels and the markers of antiphospholipid antibody syndrome. Both of them can also determine venous thrombosis. Several acquired factors can lead to hypoercoagulable state, especially hyperhomocysteinemia, antiphospholipid antibody syndrome, hepatic disease, alcohol and tobacco intake, oral contraceptives, immobilization, surgeries and malignancies. In central venous occlusion is only necessary to rule out hyperhomocysteinemia and antiphospholipid antibody syndrome in young patients without known risk factors. In central artery occlusion, hypercoagulable workup is only recommended for patients less than 50 years-old with unknown emboli source. In this cases protein C, protein S, and antithrombin III deficiencies, homocystein, sickle cell disease and antiphospholipid antibody syndrome will ruled out. In non arteritic ischemic optic neuropathy hypercoagulable work up is not necessary. In amaurosis fugax without known emboli source, it is recommended to rule out etiologies of arterial occlusion, especially antithrombin III deficiencies, homocystein, sickle cell disease and antiphospholipid antibody syndrome. PMID:19658050

  9. Noninvasive evaluation of the extracranial carotid arteries in patients with cerebrovascular events and atrial fibrillations.

    PubMed

    Weinberger, J; Rothlauf, E; Materese, E; Halperin, J

    1988-08-01

    Noninvasive carotid artery testing was performed in 73 patients with nonvalvular atrial fibrillation who were referred because of symptoms or signs of cerebrovascular disease. Thromboembolism related to atrial fibrillation without valvular heart disease was the probable source of cerebral ischemia in 25 (80%) of 31 patients with stroke and coexisting atherosclerotic disease at the carotid artery bifurcation in six (20%). Nonvalvular atrial fibrillation was the probable source of symptoms in nine (70%) of 13 of patients with transient cerebral ischemia, while coexisting carotid artery disease was present in four (30%). Nonvalvular atrial fibrillation accounted for the symptoms in four of five patients with amaurosis fugax, with atherosclerotic carotid artery disease present in one. The remaining 24 patients had nonhemispheric symptoms of cerebrovascular disease, including vertebrobasilar insufficiency, dizziness, and syncope, and only one had a carotid lesion. A significantly higher proportion of patients with focal hemispheric symptoms had coexisting carotid disease than patients with nonfocal symptoms had, suggesting that atherosclerotic cerebrovascular disease contributes to stroke in patients with nonvalvular atrial fibrillation. Noninvasive carotid artery testing may be helpful in identifying atherosclerotic lesions at the carotid artery bifurcation in patients with atrial fibrillation and cerebrovascular disease, because different therapeutic modalities may be appropriate when two potential sources of cerebral ischemia are present. PMID:3041939

  10. Digital cameras with designs inspired by the arthropod eye.

    PubMed

    Song, Young Min; Xie, Yizhu; Malyarchuk, Viktor; Xiao, Jianliang; Jung, Inhwa; Choi, Ki-Joong; Liu, Zhuangjian; Park, Hyunsung; Lu, Chaofeng; Kim, Rak-Hwan; Li, Rui; Crozier, Kenneth B; Huang, Yonggang; Rogers, John A

    2013-05-01

    In arthropods, evolution has created a remarkably sophisticated class of imaging systems, with a wide-angle field of view, low aberrations, high acuity to motion and an infinite depth of field. A challenge in building digital cameras with the hemispherical, compound apposition layouts of arthropod eyes is that essential design requirements cannot be met with existing planar sensor technologies or conventional optics. Here we present materials, mechanics and integration schemes that afford scalable pathways to working, arthropod-inspired cameras with nearly full hemispherical shapes (about 160 degrees). Their surfaces are densely populated by imaging elements (artificial ommatidia), which are comparable in number (180) to those of the eyes of fire ants (Solenopsis fugax) and bark beetles (Hylastes nigrinus). The devices combine elastomeric compound optical elements with deformable arrays of thin silicon photodetectors into integrated sheets that can be elastically transformed from the planar geometries in which they are fabricated to hemispherical shapes for integration into apposition cameras. Our imaging results and quantitative ray-tracing-based simulations illustrate key features of operation. These general strategies seem to be applicable to other compound eye devices, such as those inspired by moths and lacewings (refracting superposition eyes), lobster and shrimp (reflecting superposition eyes), and houseflies (neural superposition eyes). PMID:23636401

  11. Venous Thromboembolism and Cerebrovascular Events in Patients with Giant Cell Arteritis: A Population-Based Retrospective Cohort Study

    PubMed Central

    Crowson, Cynthia S.; Makol, Ashima; Ytterberg, Steven R.; Saitta, Antonino; Salvarani, Carlo; Matteson, Eric L.; Warrington, Kenneth J.

    2016-01-01

    Objective To investigate the incidence of venous thromboembolism (VTE) and cerebrovascular events in a community-based incidence cohort of patients with giant cell arteritis (GCA) compared to the general population. Methods A population-based inception cohort of patients with incident GCA between January 1, 1950 and December 31, 2009 in Olmsted County, Minnesota and a cohort of non-GCA subjects from the same population were assembled and followed until December 31, 2013. Confirmed VTE and cerebrovascular events were identified through direct medical record review. Results The study population included 244 patients with GCA with a mean ± SD age at diagnosis of 76.2 ± 8.2 years (79% women) and an average length of follow-up of 10.2 ± 6.8 years. Compared to non-GCA subjects of similar age and sex, patients diagnosed with GCA had a higher incidence (%) of amaurosis fugax (cumulative incidence ± SE: 2.1 ± 0.9 versus 0, respectively; p = 0.014) but similar rates of stroke, transient ischemic attack (TIA), and VTE. Among patients with GCA, neither baseline characteristics nor laboratory parameters at diagnosis reliably predicted risk of VTE or cerebrovascular events. Conclusion In this population-based study, the incidence of VTE, stroke and TIA was similar in patients with GCA compared to non-GCA subjects. PMID:26901431

  12. [Differential diagnosis of pediatric hip pain in MR tomography].

    PubMed

    Glas, K; Obletter, N; Staudt, F; Scheuerer, K

    1991-01-01

    The efficiency of spin echo tomography in the differential diagnosis of hip joint pain in children in comparison with other imaging methods was tested in 115 spin echo tomography examinations of 68 patients. By means of the different modes available it was possible to determine joint effusion, necrosed areas and the formation of abscesses with great accuracy. In the case of Legg-Calve-Perthes disease the MRT is especially in the early diagnosis superior to the other Methods, already in the early stage a classification in the four Catterall groups was possible. Furthermore the "head at risk" signs, except the gage-sign, were better to describe by BRI than by conventional x-rays. The MRT allows an exacter staging and a better observation of the course of disease, especially the beginning of the revitalisation of the femora epiphysis in earlier and clearer visible than in other imaging methods. Further diseases like epiphysial dysplasie, specific and unspecific coxitis and slipped capital femora epiphysis were also investigated. We regard spin echo examination in the differential diagnosis of hip pain in children indicated by the following criteria: 1. with over six weeks uncertain differential diagnosis of coxitis fugax and Legg-Calve-Perthes disease 2. with Legg-Calve-Perthes disease in the early stage for therapy option 3. with TBC- and non-TBC-coxitis as a therapy attend and diagnostic measure. PMID:1829298

  13. Computerized texture analysis of carotid plaque ultrasonic images can identify unstable plaques associated with ipsilateral neurological symptoms.

    PubMed

    Kakkos, Stavros K; Nicolaides, Andrew N; Kyriacou, Efthyvoulos; Daskalopoulou, Stella S; Sabetai, Michael M; Pattichis, Constantinos S; Geroulakos, George; Griffin, Maura B; Thomas, Dafydd

    2011-05-01

    We estimated the value of objective, computerized texture analysis of ultrasonic images in distinguishing carotid plaques associated with neurological ipsilateral symptoms (amaurosis fugax [AmF; n = 30], transient ischemic attack [TIA; n = 52], and stroke [n = 55]) from asymptomatic plaques (n = 51). We performed 3 case-control studies (1/symptom with asymptomatic plaques as control). On logistic regression, AmF was independently associated with severity of stenosis, percentage of pixels with gray levels 0 to 10 (PPCS1; measure of echolucency), and spatial gray level dependence matrices (SGLDM) information measure of correlation (IMC-1; texture); TIAs with PPCS1 (echolucency), SGLDM correlation, and skewness (both texture); and stroke with PPCS1, SGLDM correlation, and percentage of pixels with gray levels 11 to 20 (PPCS2; echolucency). The area under the curve of the regression-derived predicted probability for AmF, TIA, and stroke was 0.92, 0.82, and 0.85, respectively (all P < .001). Texture analysis can identify carotid plaques associated with a neurological event, improving the diagnostic value of echolucency measures. Texture analyses could be applied to natural history studies. PMID:21474467

  14. Spontaneous internal carotid dissection in a 38-year-old woman: a case report.

    PubMed

    Abed, Kareem; Misra, Amit; Vankawala, Viren

    2015-01-01

    This case report describes a patient found to have amaurosis fugax as a result of non-traumatic internal carotid dissection. Monocular blindness can be due to multiple causes including keratitis, acute glaucoma, vitreous hemorrhage, uveitis, retinal vascular occlusion, retinal detachment, optic neuropathy, trauma, or vascular malformations. In the setting of headache, neck pain, and an otherwise normal ophthalmic examination, this case report highlights the importance of recognizing transient ischemic attack and carotid artery dissection in the differential diagnosis. To further clarify the diagnosis, carotid ultrasound may aid diagnosis as was seen in this case, where decreased internal carotid artery velocities were found and subsequent CT angiography of the neck confirmed a diagnosis of carotid dissection. If a dissection is present, progression of symptoms may indicate impending cerebral infarction and warrant immediate attention. Antiplatelet therapy is the first-line treatment with anticoagulation, thrombolysis, and surgery reserved for cases of recurrent, progressive symptomatic episodes. Surgical options include endovascular repair such as angioplasty, stent placement, embolization, surgical revascularization, and bypass. PMID:26486115

  15. The requirements for batteries for electric vehicles

    NASA Technical Reports Server (NTRS)

    Schwartz, H. J.

    1976-01-01

    The paper reassesses the role of electric vehicles in the modern transportation system and their potential impact on oil consumption. Three major factors determining the size of this impact are discussed: the market potential, the date of introduction, and the rate of consumer acceptance. The strategy of selecting the battery type for an urban car to introduce in coming years is analyzed. The results of the analysis suggest that the research and development emphasis should be placed on near- and mid-term battery technology. From the standpoint of maximizing both the cumulative impact and the benefits derived in the year 2000, however, a strategy of early introduction of near-term and mid-term cars followed by the far-term vehicles seems to produce the optimum result.

  16. Techno-economic analysis of corn stover fungal fermentation to ethanol

    SciTech Connect

    Meyer, Pimphan; Tews, Iva J.; Magnuson, Jon K.; Karagiosis, Sue A.; Jones, Susanne B.

    2013-11-01

    This techno-economic analysis assesses the process economics of ethanol production from lignocellulosic feedstock by fungi in order to identify promising opportunities and the research needed to achieve them. Based on literature derived data, four different ethanologen strains are considered in this study: native and recombinant Saccharomyces cerevisiae, the natural pentose-fermenting yeast, Pichia stipitis and the filamentous fungus Fusarium oxysporum. Organism performance and technology readiness are split into three groups: near-term (<5 years), mid-term (5-10 years) and long-term (>10 years) process deployment. Processes classified as near-term could reasonably be developed in this shorter time frame, as suggested by recent literature. Mid-term technology process models are based on lab-scale experimental data, and yields near the theoretical limit are used to estimate long-term technology goals. Further research and economic evaluation on the integrated production of chemicals and fuels in biorefineries are recommended.

  17. Frequency stability of maser oscillators operated with cavity Q. [hydrogen and rubidium masers

    NASA Technical Reports Server (NTRS)

    Tetu, M.; Tremblay, P.; Lesage, P.; Petit, P.; Audoin, C.

    1982-01-01

    The short term frequency stability of masers equipped with an external feedback loop to increase the cavity quality factor was studied. The frequency stability of a hydrogen and a rubidium maser were measured and compared with theoretical evaluation. It is shown that the frequency stability passes through an optimum when the cavity Q is varied. Long term fluctuations are discussed and the optimum mid term frequency stability achievably by small size active and passive H-masers is considered.

  18. Classroom Life

    ERIC Educational Resources Information Center

    Miller, Karl

    2014-01-01

    In this reflective piece, Karl Miller looks down the lens at an ancient world, once his own. He does so with the help of a memoir, "Rebecca's Vest," which he published much later, in the mid-1990s: a mid-term report in which he describes how he became a reader and about what he read. With the end of the term approaching, he offers a…

  19. Socialization and Participation: A Research Agenda for the 21st Century.

    ERIC Educational Resources Information Center

    Gans, Curtis B.

    If one counts both the mid-term and presidential elections, the United States has had the lowest voter turnout of any democracy in the world. In the 1986 election, only 16.6% of the eligible 18-24 year olds voted, and although final census surveys for that year are not yet published, it is unlikely that the turnout for that age group would have…

  20. Materials issues in USABC-sponsored battery technologies

    NASA Astrophysics Data System (ADS)

    Smaga, J. A.

    1995-01-01

    Battery goals for electric vehicles are doubled range and acceleration, performance, life, and total cost comparable to internal-combustion cars. Sponsored battery technologies face both technical and materials challenges to meet these goals. The materials issues for both the mid-term and long-term batteries are the focus of this paper. The expected demand for battery materials in the future is estimated.

  1. How to Awaken an Appreciation for the Value of Practicing Learning Skills in an Environment of Poverty, Theft, Destruction and Violent Behavior

    ERIC Educational Resources Information Center

    Fish, James C.

    2011-01-01

    A first-year teacher thrust mid-term into a mixed-grade geometry class in a tough high school struggles to sort out what works and does not work to engage the 120 students in meaningful learning. The students are largely from low-income urban families and demonstrate a broad range of abilities and motivation. The purpose of this study is to…

  2. Climate observing system studies: An element of the NASA Climate Research Program: Workshop report

    NASA Technical Reports Server (NTRS)

    1980-01-01

    Plans for NASA's efforts in climatology were discussed. Targets for a comprehensive observing system for the early 1990's were considered. A program to provide useful data in the near and mid-term, and a program to provide for a feasibility assessment of instruments and methods for the development of a long-term system were discussed. Climate parameters that cannot be measured from space were identified. Long-term calibration, intercomparison, standards, and ground truth were discussed.

  3. Support of a pathway to a hydrogen future

    SciTech Connect

    Hoffman, A.R.

    1997-12-31

    This paper consists of viewgraphs which outline the content of the presentation. Subjects addressed include: hydrogen research program vision; electricity industry restructuring -- opportunities and challenges for hydrogen; transportation sector -- opportunities for hydrogen; near-term and mid-term opportunities for hydrogen; and hydrogen production technologies from water. It is concluded that the global climate change challenge is the potential driver for the development of hydrogen systems.

  4. [Nasal endometriosis: apropos of 1 case].

    PubMed

    Laghzaoui, O; Laghzaoui, M

    2001-12-01

    The nasal mucosa is an exceptional localization for endometriosis. We report a case observed in a woman who developed nasal tumefaction associated with epistaxis that had followed a cyclic repetitive pattern since puberty. Surgical excision of the nasal nodule confirmed the diagnosis of endometriosis. Local and general evaluated identified other localizations. Outcome has been favorable at short and mid term. Endometriosis is a frequent condition although extra-pelvic localizations are uncommon. The nasal localization is highly exceptional. PMID:11917731

  5. ACUTE RETINAL ARTERIAL OCCLUSIVE DISORDERS

    PubMed Central

    Hayreh, Sohan Singh

    2011-01-01

    The initial section deals with basic sciences; among the various topics briefly discussed are the anatomical features of ophthalmic, central retinal and cilioretinal arteries which may play a role in acute retinal arterial ischemic disorders. Crucial information required in the management of central retinal artery occlusion (CRAO) is the length of time the retina can survive following that. An experimental study shows that CRAO for 97 minutes produces no detectable permanent retinal damage but there is a progressive ischemic damage thereafter, and by 4 hours the retina has suffered irreversible damage. In the clinical section, I discuss at length various controversies on acute retinal arterial ischemic disorders. Classification of acute retinal arterial ischemic disorders These are of 4 types: CRAO, branch retinal artery occlusion (BRAO), cotton wools spots and amaurosis fugax. Both CRAO and BRAO further comprise multiple clinical entities. Contrary to the universal belief, pathogenetically, clinically and for management, CRAO is not one clinical entity but 4 distinct clinical entities – non-arteritic CRAO, non-arteritic CRAO with cilioretinal artery sparing, arteritic CRAO associated with giant cell arteritis (GCA) and transient non-arteritic CRAO. Similarly, BRAO comprises permanent BRAO, transient BRAO and cilioretinal artery occlusion (CLRAO), and the latter further consists of 3 distinct clinical entities - non-arteritic CLRAO alone, non-arteritic CLRAO associated with central retinal vein occlusion and arteritic CLRAO associated with GCA. Understanding these classifications is essential to comprehend fully various aspects of these disorders. Central retinal artery occlusion The pathogeneses, clinical features and management of the various types of CRAO are discussed in detail. Contrary to the prevalent belief, spontaneous improvement in both visual acuity and visual fields does occur, mainly during the first 7 days. The incidence of spontaneous visual

  6. Hemodynamic and metabolic effects of cerebral revascularization.

    PubMed

    Leblanc, R; Tyler, J L; Mohr, G; Meyer, E; Diksic, M; Yamamoto, L; Taylor, L; Gauthier, S; Hakim, A

    1987-04-01

    Pre- and postoperative positron emission tomography (PET) was performed in six patients undergoing extracranial to intracranial bypass procedures for the treatment of symptomatic extracranial carotid occlusion. The six patients were all men, aged 52 to 68 years. Their symptoms included transient ischemic attacks (five cases), amaurosis fugax (two cases), and completed stroke with good recovery (one case). Positron emission tomography was performed within 4 weeks prior to surgery and between 3 to 6 months postoperatively, using oxygen-15-labeled CO, O2, and CO2 and fluorine-18-labeled fluorodeoxyglucose. Cerebral blood flow (CBF), cerebral blood volume (CBV), cerebral metabolic rates for oxygen and glucose (CMRO2 and CMRGlu), and the oxygen extraction fraction (OEF) were measured in both hemispheres. Preoperatively, compared to five elderly control subjects, patients had increased CBV, a decreased CBF/CBV ratio, and decreased CMRO2, indicating reduced cerebral perfusion pressure and depressed oxygen metabolism. The CBF was decreased in only one patient who had bilateral carotid occlusions; the OEF, CMRGlu, and CMRO2/CMRGlu and CMRGlu/CBF ratios were not significantly different from control measurements. All bypasses were patent and all patients were asymptomatic following surgery. Postoperative PET revealed decreased CBV and an increased CBF/CBV ratio, indicating improved hemodynamic function and oxygen hypometabolism. This was associated with increased CMRO2 in two patients in whom the postoperative OEF was also increased. The CMRGlu and CMRGlu/CBF ratio were increased in five patients. Changes in CBF and the CMRO2/CMRGlu ratio were variable. One patient with preoperative progressive mental deterioration, documented by serial neuropsychological testing and decreasing CBF and CMRO2, had improved postoperative CBF and CMRO2 concomitant with improved neuropsychological functioning. It is concluded that symptomatic carotid occlusion is associated with altered

  7. The risk of stroke with occlusion of the internal carotid artery.

    PubMed

    Pierce, G E; Keushkerian, S M; Hermreck, A S; Iliopoulos, J I; Thomas, J H

    1989-01-01

    Reports of all cervicocephalic arteriograms (n = 1836) performed at one institution during a 10-year period were reviewed and the patients were classified into three groups according to the indication for arteriography. Group I included all patients with symptoms or findings compatible with occlusive disease of the carotid or vertebral artery (n = 806). Group II included patients with cerebrovascular symptoms unrelated to carotid or vertebral disease (e.g., patients with subarachnoid hemorrhage) (n = 367). Group III consisted of patients with no evidence of cerebrovascular disease (e.g., patients with primary and metastatic brain tumors) (n = 663). One hundred ten atherosclerotic occlusions of the internal carotid artery (ICA) were found in 106 patients in group I. Fifty-one percent of these patients had a history of stroke before arteriography, 24% had transient ischemic attacks (TIAs) or amaurosis fugax (AF), and 12% had nonhemispheric symptoms. Only 13% (1.7% of group I patients) were without symptoms. Ninety-one percent of the strokes and 75% of the TIAs or AF were ipsilateral to the ICA occlusion. Seventy-six percent of patients with stroke and 80% with ipsilateral TIAs or AF vs only 29% of patients without symptoms had contralateral stenosis of 60% diameter reduction or greater (p less than 0.003). No occlusions of the ICA occurred in groups II or III. Three hundred forty-six patients in groups II and III were more than 60 years of age. Assuming either Poisson or binomial distributions, the incidence of silent ICA occlusion in the population at large older than 60 years was estimated at less than 1% (p less than 0.03). PMID:2911144

  8. Nature and nurture: a case of transcending haematological pre-malignancies in a pair of monozygotic twins adding possible clues on the pathogenesis of B-cell proliferations.

    PubMed

    Hansen, Marcus C; Nyvold, Charlotte G; Roug, Anne S; Kjeldsen, Eigil; Villesen, Palle; Nederby, Line; Hokland, Peter

    2015-05-01

    We describe a comprehensive molecular analysis of a pair of monozygotic twins, who came to our attention when one experienced amaurosis fugax and was diagnosed with JAK2+ polycythaemia vera. He (Twin A) was also found to have an asymptomatic B-cell chronic lymphocytic leukaemia (B-CLL). Although JAK2-, Twin B was subsequently shown to have a benign monoclonal B-cell lymphocytosis (MBL). Flow cytometric and molecular analyses of the B-cell compartments revealed different immunoglobulin light and heavy chain usage in each twin. We hypothesized that whole exome sequencing could help delineating the pattern of germline B-cell disorder susceptibility and reveal somatic mutations potentially contributing to the differential patterns of pre-malignancy. Comparing bone marrow cells and T cells and employing in-house engineered integrative analysis, we found aberrations in Twin A consistent with a myeloid neoplasm, i.e. in TET2, RUNX1, PLCB1 and ELF4. Employing the method for detecting high-ranking variants by extensive annotation and relevance scoring, we also identified shared germline variants in genes of proteins interacting with B-cell receptor signalling mediators and the WNT-pathway, including IRF8, PTPRO, BCL9L, SIT1 and SIRPB1, all with possible implications in B-cell proliferation. Similar patterns of IGHV-gene usage to those demonstrated here have been observed in inherited acute lymphoblastic leukaemia. Collectively, these findings may help in facilitating identification of putative master gene(s) involved in B-cell proliferations in general and MBL and B-CLL in particular. PMID:25752595

  9. Diagnostic ramifications of ocular vascular occlusion as a first thrombotic event associated with factor V Leiden and prothrombin gene heterozygosity

    PubMed Central

    Schockman, Samantha; Glueck, Charles J; Hutchins, Robert K; Patel, Jaykumar; Shah, Parth; Wang, Ping

    2015-01-01

    Aim This study aimed to assess the diagnostic ramifications of vascular occlusion of the ocular vein and artery as a first thrombotic event associated with factor V Leiden (FVL) and/or prothrombin gene (PTG) heterozygosity. Methods Patients with ocular vein (n=191) and artery (n=74) occlusion, free of cardioembolic etiologies, were sequentially referred from vitreoretinal specialists for measurement of thrombophilia-hypofibrinolysis and compared to 110 healthy normal controls. Results Of the 265 patients, 29 (11%; 17 women, 12 men) of all referred ocular vascular occlusion (OVO) cases were found to be heterozygous for FVL and/or PTG, including 16 with FVL, 12 with PTG, and 1 with both. Of the 29 cases, 16 had central retinal vein occlusion (CRVO), 2 branch retinal vein occlusion (BRVO), 5 nonarteritic anterior ischemic optic neuropathy (NA-AION), 3 retinal artery occlusion (RAO), 2 amaurosis fugax (AF), and 1 had both CRVO and RAO. Of the 16 FVL cases, 15 (94%) had OVO as a first thrombotic event without prior deep venous thrombosis (DVT) or pulmonary embolism (PE); 6 (38%) also had other thrombotic events, including recurrent miscarriage, osteonecrosis, ischemic stroke, and/or ischemic colitis; and 5 (31%) had immediate family members with previous venous thromboembolism (VTE). Of the 12 PTG cases, 9 (75%) had OVO as a first thrombotic event, 5 (42%) experienced VTE other than DVT or PE, and 6 (50%) had immediate family members with VTE. In one patient with both FVL and PTG, DVT occurred before BRVO. Of the 17 women with FVL and/or PTG mutations, 7 (41%) experienced ≥1 miscarriage, 6 (35%) were on estrogen therapy, and 1 (6%) was on clomiphene. Conclusion Of the 265 patients with OVO, 29 (11%) had FVL and/or PTG, and 83% of these 29 cases presented with OVO as their first thrombotic event. By diagnosing thrombophilia as an etiology for OVO, the ophthalmologist opens a window to family screening and preventive therapy. PMID:25897198

  10. Next Generation Multi-Scale Quantum Simulation Software for Strongly Correlated Materials

    SciTech Connect

    Jarrell, Mark

    2014-11-18

    The goal of this project was to develop a new formalism for the correlated electron problem, which we call, the Multi Scale Many Body formalism. This report will focus on the work done at the Louisiana State University (LSU) since the mid term report. The LSU group moved from the University of Cincinnati (UC) to LSU in the summer of 2008. In the last full year at UC, only half of the funds were received and it took nearly two years for the funds to be transferred from UC to LSU . This effectively shut down the research at LSU until the transfer was completed in 2011, there were also two no-cost extensions of the grant until August of this year. The grant ended for the other SciDAC partners at Davis and ORNL in 2011. Since the mid term report, the LSU group has published 19 papers [P1-P19] acknowledging this SciDAC, which are listed below. In addition, numerous invited talked acknowledged the SciDAC. Below, we will summarize the work at LSU since the mid-term report and mainly since funding resumed. The projects include the further development of multi-scale methods for correlated systems (1), the study of quantum criticality at finite doping in the Hubbard model (2), the description of a promising new method to study Anderson localization with a million-fold reduction of computational complexity!, the description of other projects (4), and (5) a workshop to close out the project that brought together exascale program developers (Stellar, MPI, OpenMP,...) with applications developers.

  11. Initial Clinical Experience with a New Self-Expanding Nitinol Microstent for the Treatment of Wide-Neck Intracranial Cerebral Aneurysms: The Acandis Acclino Stent

    PubMed Central

    Kabbasch, C; Liebig, T; Faymonville, A; Dorn, F; Mpotsaris, A

    2015-01-01

    BACKGROUND AND PURPOSE The Acclino is a laser-cut closed-cell microstent composed of nitinol. It was developed for stent-assisted coiling of wide-neck intracranial aneurysms. The key feature of the stent is its deployability via low-profile microcatheters with an inner diameter of 0.0165 inch, which are also suited for coil deployment. The objective of this study was to evaluate the safety and feasibility as well as the immediate and mid-term results of this new device. MATERIALS AND METHODS Our database was screened for all Acclino-based stent-assisted intracranial coil embolizations since its introduction to the European market in June 2012. Case files and imaging data were retrospectively analyzed for angiographical and clinical outcome parameters, including immediate and mid-term modified Raymond-Roy aneurysm occlusion classification (RROC) rates and procedural complications. RESULTS Fourteen patients comprising 14 aneurysms (9 unruptured and 5 ruptured) were treated with the Acclino. All except for a dissecting one were wide-neck saccular aneurysms. Immediate complete occlusion (RROC1) was observed in 8/14 cases (57%), a residual neck (RROC2) in 4/14 (29%), and a persistent filling of the dome (RROC 3) in 1/14 cases (7%). An in-stent thrombus formation in one case (7%) was medically resolved without neurological deficit. Follow-up was available in 9/14 cases (64%) after a mean of 137 days (SD ± 50). All followed cases depicted a complete occlusion (RROC1). CONCLUSIONS The Acclino microstent showed a satisfactory safety profile and a promising rate of immediate and mid-term complete aneurysm occlusion for stent-assisted coil embolization in wide-neck intracranial aneurysms, warranting further investigation of the device. PMID:26301024

  12. Nestedness and successional trajectories of macroinvertebrate assemblages in man-made wetlands.

    PubMed

    Ruhí, Albert; Boix, Dani; Gascón, Stéphanie; Sala, Jordi; Quintana, Xavier D

    2013-02-01

    Current successional models, primarily those based on floral succession, propose several distinct trajectories based on the integration of two key hypotheses from succession theory: convergence versus divergence in species composition among successional sites, and progression towards versus deviation from a desired reference state. We applied this framework to faunal succession, including differential colonization between active and passive dispersers, and the nested patterns generated as a consequence of this peculiarity. Nine man-made wetlands located in three different areas, from 0-3 years from wetland creation, were assessed. In addition, 91 wetlands distributed throughout the region were used as references for natural macroinvertebrate communities. We predicted the following: (1) highly nested structures in pioneering assemblages will decrease to lower mid-term values due to a shift from active pioneering taxa to passive disperser ones; (2) passive idiosyncratic taxa will elicit divergent successional trajectories among areas; (3) the divergent trajectories will provoke lower local and higher regional diversity values in the mid-term assemblages than in pioneer assemblages. Our results were largely congruent with hypotheses (1) and (2), diverging from the anticipated patterns only in the case of the temporary wetlands area. However, overall diversity trends based on hypothesis (3) did not follow the expected pattern. The divergent successional trajectories did not compensate for regional biodiversity losses that occurred as a consequence of pioneering colonizer decline over time. Consequently, we suggest reconsidering wetland construction for mitigation purposes within mid-term time frames (≤ 3 years). Wetlands may not offset, within this temporal scenario, regional biodiversity loss because the ecosystem may not support idiosyncratic taxa from natural wetlands. PMID:22965268

  13. Incidence, Predictors and Impact of Severe Periprocedural Bleeding According to VARC-2 Criteria on 1-Year Clinical Outcomes in Patients After Transcatheter Aortic Valve Implantation.

    PubMed

    Kochman, Janusz; Rymuza, Bartosz; Huczek, Zenon; Kołtowski, Łukasz; Ścisło, Piotr; Wilimski, Radosław; Ścibisz, Anna; Stanecka, Paulina; Filipiak, Krzysztof J; Opolski, Grzegorz

    2016-01-01

    There are differences in reporting bleeding complications after transcatheter aortic valve implantation (TAVI), which is a consequence of the lack of consensus for their definition. Furthermore, the amount of data on the impact of peri-procedural bleeding on the mid-term prognosis is still limited. The aim of this study was to investigate the incidence, predictors, and impact of life-threatening and major bleedings as defined by the Valve Academic Research Consortium 2 (VARC-2) in patients after TAVI over the mid-term prognosis.Consecutive patients who underwent TAVI from March 2010 to December 2013 were included. All data were classified according to the VARC-2 criteria. We assessed the incidence and the predictors of serious bleeding events (SBE), defined as life-threatening/disabling (LT/D) or major bleeding, and analyzed their impact on 30-day and 1-year clinical outcome.A total of 129 patients were included (79.1 ± 8.3 years; mean EuroSCORE = 17.8 ± 12.7). The SBE occurred in 25 patients (19.4%), of which 9 (7.0%) had LT/D and 16 (12.4%) had major bleeding. Trans-subclavian (TS) access (OR 4.38, 95% CI 2.13-14.29, P = 0.01) and diabetes (OR 2.93, 95% CI 1.08-7.93, P = 0.03) were identified as independent predictors of SBE. Patients with SBE had higher 30-day mortality (20.0% versus 4.0% P = 0.02) and 1-year mortality (40.0% versus 11.1%, P < 0.002). SBE independently predicted 1-year, all-cause mortality (HR 5.88, 95% CI 1.7319,94, P = 0.005).SBE are frequent after TAVI and are associated with decreased short and mid-term survival. Diabetes and TS access are independent risk factors for SBE. PMID:26673439

  14. Robot-assisted coronary artery bypass grafting improves short-term outcomes compared with minimally invasive direct coronary artery bypass grafting

    PubMed Central

    Gong, Wenhui; Cai, Junfeng; Wang, Zhe; Chen, Anqing; Ye, Xiaofeng; Li, Haiqing

    2016-01-01

    Background Robot-assisted coronary artery bypass grafts (RACAB) utilizing the da Vinci surgical system are increasingly used and allow the surgeon to conveniently harvest internal mammary arteries (IMAs). The aim of this study was to compare the outcomes of off-pump RACAB and minimally invasive direct coronary artery bypass grafting (MIDCAB) in the short and medium term. Methods We performed a retrospective review of 132 patients with single- or multiple-vessel coronary artery disease who underwent minimally invasive off-pump CABG (OPCAB) between May 2009 and May 2014. The patients were divided into two groups based on the surgical approach, MIDCAB and RACAB group. The anastomosis of the left internal mammary artery (LIMA) to the left anterior descending artery (LAD) was performed as regular OPCAB through the incision on the beating heart using regular stabilization devices (Genzyme Corporation). The preoperative, intraoperative, postoperative, and follow-up data, including major adverse cardiac and cerebrovascular events (MACCE), were compared. Results The preoperative data were similar. RACAB significantly shorten the intensive care unit (ICU) stay and postoperative compared with the MIDCAB group (P<0.05). There were 12 (19.7%) patients treated with a two-stage hybrid procedure in the MIDCAB group and 34 (47.9%) patients in the RACAB group (P=0.001). Thirty-day mortality was 1.6% in the MIDCAB group. There were 9 (14.7%) MIDCAB patients and 2 (2.8%) RACAB patients (P=0.013) that developed new arrhythmia. The two groups showed comparable mid-term survival (P=0.246), but the MACCEs were significantly different (P=0.038). Conclusions RACAB may be a valuable alternative for patients requiring single or simple multi-vessel coronary artery bypass grafting (CABG). Although the mid-term mortality outcomes are similar, RACAB improves short-term outcomes and mid-term MACCE-free survival compared with MIDCAB. PMID:27076941

  15. [One complication can mask another: chance discovery of a rare lesion during screening for arthritis of the hip].

    PubMed

    Laumonier, F; Chevalier, J M; Duverne, C; Bouderlique, C; Coupris, L

    1984-01-01

    The authors report the case of a new born baby in whom at the fourth day of life, a severe hypocalcemia was discovered. An umbilical arterial catheterization was performed. The evolution was characterized by a staphylococcic septicemia with hip arthritis and partial immune deficit. The mid term survey of the joint status, allowed the unexpected discovery, during an examination held under general anesthesia, of a probable mycotic aneurysm, by abdominal palpation. The lesion was localized on the right common iliac artery and was successfully treated by resection; arterial continuity was possible without venous patch nor prosthesis. PMID:6547645

  16. An Overview of the VHITAL Program: A Two-Stage Bismuth Fed Very High Specific Impulse Thruster with Anode Layer

    NASA Technical Reports Server (NTRS)

    Sengupta, Anita; Marrese-Reading, Colleen; Capelli, Mark; Scharfe, David; Tverdokhlebov, Sergey; Semenkin, Sasha; Tverdokhlebov, Oleg; Boyd, Ian; Keidar, Michael; Yalin, Azer; Markusic, Tom; Polzin, Kurt

    2005-01-01

    The Very High Isp Thruster with Anode Layer (VHITAL) is a two stage Hall thruster program that is a part of NASA's Prometheus Program in NASA's New Exploration Systems Mission Directorate (ESMD). It is a potentially viable low-cost alternative to ion engines for near-term NEP applications with the growth potential to support mid-term and far-term NEP missions... This paper will present an overview of the thruster fabrication, pre-existing TAL 160 demonstration, feed system development, lifetime assessment, contamination assessment, and mission study activities performed to date.

  17. Electrolysis: Information and Opportunities for Electric Power Utilities

    SciTech Connect

    Kroposki, B.; Levene, J.; Harrison, K.; Sen, P.K.; Novachek, F.

    2006-09-01

    Recent advancements in hydrogen technologies and renewable energy applications show promise for economical near- to mid-term conversion to a hydrogen-based economy. As the use of hydrogen for the electric utility and transportation sectors of the U.S. economy unfolds, electric power utilities need to understand the potential benefits and impacts. This report provides a historical perspective of hydrogen, discusses the process of electrolysis for hydrogen production (especially from solar and wind technologies), and describes the opportunities for electric power utilities.

  18. Blood pressure variability and cardiovascular disease: systematic review and meta-analysis

    PubMed Central

    Wood, Sally; Koshiaris, Constantinos; Law, Kathryn; Glasziou, Paul; McManus, Richard J

    2016-01-01

    Objective To systematically review studies quantifying the associations of long term (clinic), mid-term (home), and short term (ambulatory) variability in blood pressure, independent of mean blood pressure, with cardiovascular disease events and mortality. Data sources Medline, Embase, Cinahl, and Web of Science, searched to 15 February 2016 for full text articles in English. Eligibility criteria for study selection Prospective cohort studies or clinical trials in adults, except those in patients receiving haemodialysis, where the condition may directly impact blood pressure variability. Standardised hazard ratios were extracted and, if there was little risk of confounding, combined using random effects meta-analysis in main analyses. Outcomes included all cause and cardiovascular disease mortality and cardiovascular disease events. Measures of variability included standard deviation, coefficient of variation, variation independent of mean, and average real variability, but not night dipping or day-night variation. Results 41 papers representing 19 observational cohort studies and 17 clinical trial cohorts, comprising 46 separate analyses were identified. Long term variability in blood pressure was studied in 24 papers, mid-term in four, and short-term in 15 (two studied both long term and short term variability). Results from 23 analyses were excluded from main analyses owing to high risks of confounding. Increased long term variability in systolic blood pressure was associated with risk of all cause mortality (hazard ratio 1.15, 95% confidence interval 1.09 to 1.22), cardiovascular disease mortality (1.18, 1.09 to 1.28), cardiovascular disease events (1.18, 1.07 to 1.30), coronary heart disease (1.10, 1.04 to 1.16), and stroke (1.15, 1.04 to 1.27). Increased mid-term and short term variability in daytime systolic blood pressure were also associated with all cause mortality (1.15, 1.06 to 1.26 and 1.10, 1.04 to 1.16, respectively). Conclusions Long term

  19. Simulation investigation of the effects of helicopter hovering dynamics on pilot performance

    NASA Technical Reports Server (NTRS)

    Aponso, Bimal L.; Mitchell, David G.; Hoh, Roger H.

    1987-01-01

    A fixed base simulation has been performed to investigate the handling qualities requirements for the mid-term pitch response of a helicopter at hover and in low-speed flight. Pilot rating results from this simulation were compared with those from previous experiments to develop handling qualities limits on the frequency and damping of the oscillatory mode in the hovering cubic. Pilot performance data obtained during the experiment were used to confirm the pilot rating results. These data show the pilot performance to closely match that predicted by the theory of piloted control. A means of predicting pilot ratings from the open-loop aircraft dynamics is presented.

  20. The `advanced DIR-MCFC development' project, an overview

    NASA Astrophysics Data System (ADS)

    Kortbeek, P. J.; Ottervanger, R.

    An overview is given of the approach and mid-term status of the joint European `Advanced DIR-MCFC Development' project, in which BCN, BG plc, GDF, ECN, Stork, Schelde and Sydkraft co-operate. Hospitals are identified as an attractive initial market for cogeneration direct internal reforming-molten carbonate fuel cell (DIR-MCFC) systems in the size of 400 kWe. Innovative system and stack design concepts are being developed for this application. The `SMARTER' system, based on DIR stacks, combines high electric efficiency and a wide operational window with optimal system simplicity and low cost.

  1. Moderate Patient-Prosthesis Mismatch Has No Negative Effect on Patients’ Functional Status After Aortic Valve Replacement With CarboMedics Prosthesis

    PubMed Central

    Alizadeh-Ghavidel, Alireza; Azarfarin, Rasoul; Alizadehasl, Azin; Sadeghpour-Tabaei, Ali; Totonchi, Ziae

    2016-01-01

    Background: Patient-prosthesis mismatch (PPM) after aortic valve replacement (AVR) is the subject of continuing debate in the cardiac surgery field. Objectives: The aim of this study was to evaluate the frequency and severity of patient-prosthesis mismatch (PPM) and the functional status of patients undergoing aortic valve replacement (AVR) using a CarboMedics prosthesis in the mid-term follow up. Patients and Methods: We retrospectively studied 66 consecutive patients who were referred to AVR with a CarboMedics prosthesis at the Rajaie cardiovascular medical and research center, a university referral hospital in Tehran, Iran. The severity of PPM as well as clinical and echocardiographic parameters and the patients’ New York heat association (NYHA) functional classification status, operative data and postoperative complications, and mortality in a mid-term (4 - 5 months) follow up period was assessed. Severe PPM was defined as the effective orifice area (EOA) indexed to the patient’s body surface area (BSA) < 0.65 cm2/m2 and moderate PPM was defined as the indexed effective orifice area (IEOA) between 0.65 and 0.85 cm2/m2. Results: Of the 66 studied patients, 39 were male and 27 were female. The mean age of the patients was 43 ± 17 with a range of 6 - 76 years. Implanted sizes of the CarboMedics AV prosthesis in 22 patients were 19 and 21 mm, and in 44 patients were 23 and 25 mm. Eleven patients had moderate PPM (IEOA < 0.85 cm2/m2) and 55 of them did not have PPM (IEOA ≥ 0.85 cm2/m2). There were no statistically significant differences between the two groups in the echocardiographic trans-aortic pressure gradients (35.6 ± 19 vs. 23.2 ± 16 mmHg; P = 0.061) and the mean NYHA functional classification (1.10 ± 0.3 vs. 1.01 ± 0.10; P = 0.074) after AVR in the mid-term follow up. Conclusions: Moderate PPM has no negative effect on echocardiographic trans-aortic pressure gradients or the patients’ NYHA functional status after AVR with a Carbo

  2. Dynamic simulation of voltage collapses

    SciTech Connect

    Deuse, J.; Stubbe, M. )

    1993-08-01

    Most of the time the voltage collapse phenomena are studied by means of computer programs designed for the calculation of steady state conditions. But in the real world, the simultaneous occurrences of losses of synchronism, of AVR dynamics or of transformer tap changes call for a full dynamic simulation of voltage phenomena. The present paper shows some examples of dynamic simulations of voltage phenomena using a new general purpose stability program (EUROSTAG), covering in a continuous way the classical fields of transient, mid-term and long-term stability, and also the quasi steady state conditions of a power system.

  3. Isolation and characterization of an abortifacient protein, momorcochin, from root tubers of Momordica cochinchinensis (family cucurbitaceae).

    PubMed

    Yeung, H W; Ng, T B; Wong, N S; Li, W W

    1987-07-01

    A glycoprotein with a molecular weight of 32,000 as estimated by SDS-polyacrylamide gel electrophoresis, and characterized by an abundance of Asp and Glu residues and an absence of Cys residues in its amino acid analysis, was isolated from fresh root tubers of Momordica cochinchinensis using a procedure that involved acetone precipitation, ammonium sulfate precipitation, ion exchange chromatography on DEAE Sepharose CL-6B and gel filtration on Sephadex G-75. The protein was capable of inducing mid-term abortion in mice. The characteristics of this protein were compared and contrasted with those of the abortifacient proteins isolated from other plants of the Cucurbitaceae family. PMID:3667075

  4. In-Space Propulsion Solar Electric Propulsion Program Overview of 2006

    NASA Technical Reports Server (NTRS)

    Baggett, Randy M.; Hulgan, Wendy W.; Dankanich, John W.; Bechtel, Robert T.

    2006-01-01

    The primary source of electric propulsion development throughout NASA is implemented by the In-Space Propulsion Technology Project at the NASA MSFC under the management of the Science Mission Directorate. The Solar Electric Propulsion technology area's objective is to develop near and mid-term SEP technology to enhance or enable mission capture while minimizing risk and cost to the end user. Major activities include developing NASA s Evolutionary Xenon Thruster (NEXT), implementing a Standard Architecture, and developing a long life High Voltage Hall Accelerator (HiVHAC). Lower level investments include advanced feed system development, advanced cathode testing and xenon recovery testing. Progress on current investments and future plans are discussed.

  5. Advanced batteries for electric vehicle applications

    SciTech Connect

    Henriksen, G.L.

    1993-08-01

    A technology assessment is given for electric batteries with potential for use in electric powered vehicles. Parameters considered include: specific energy, specific power, energy density, power density, cycle life, service life, recharge time, and selling price. Near term batteries include: nickel/cadmium and lead-acid batteries. Mid term batteries include: sodium/sulfur, sodium/nickel chloride, nickel/metal hydride, zinc/air, zinc/bromine, and nickel/iron systems. Long term batteries include: lithium/iron disulfide and lithium- polymer systems. Performance and life testing data for these systems are discussed. (GHH)

  6. Outcomes of total cavopulmonary connection for single ventricle palliation

    PubMed Central

    Zou, Minghui; Wang, Yanfei; Cui, Hujun; Ma, Li; Yang, Shengchun; Xia, Yuansheng; Chen, Weidan

    2016-01-01

    Background The aim of this study was to review the early and mid-term outcomes of the total cavopulmonary connection (TCPC) procedure and evaluate risk factors for prolonged pleural effusions. Methods The clinical records of 82 consecutive patients, who underwent a TCPC operation between January 2008 and December 2013, were reviewed for incidence of prolonged pleural effusions, duration of ventilation time and pleural drainage, length of intensive care unit (ICU) stay, and early and mid-term morbidity and mortality. Results The median age at surgery was 3.0 years. The main single ventricle diagnoses included 18 cases of a double-inlet single ventricle, 17 cases of heterotaxy, 16 cases of tricuspid atresia, 4 cases of mitral atresia, 12 cases of unbalanced complete atrioventricular canal (CAVC), 5 cases of double-outlet right ventricle (DORV) combined with ventricular septal defect (VSD) and pulmonary stenosis (PS), 4 cases of transposition of the great arteries (TGA) combined with VSD and PS, 4 cases of corrected transposition of great arteries (cTGA) combined VSD and PS, and 2 cases of criss-cross heart. Preoperative mean pulmonary artery pressure (mPAP) was 13.66±2.21 mmHg with 23.2% (n=19) higher than 15 mmHg. A total of 61 (74.4%) patients underwent a fenestration. The perioperative mortality was 4.9%. The median duration of pleural effusion was 10 days (range, 3−80 days), and prolonged pleural effusions occurred in 16 (19.5%) patients. Multivariable analysis revealed that mPAP >15 mmHg was independently associated with prolonged pleural effusions (OR, 8.33; 95% CI, 2.33−29.74; P=0.001), and creation of a fenestration was associated with decreased odds of effusion (OR, 0.21; 95% CI, 0.06−0.74; P=0.015). Five-year estimated Kaplan-Meier survival of two-stage TCPC was significantly higher than that of one-stage group(96.7% vs. 79.7%, P=0.023). Patients with heterotaxy or obstructed totally anomalous pulmonary venous connection (TAPVC) had significantly

  7. Emerging Community Noise Reduction Approaches

    NASA Technical Reports Server (NTRS)

    Envia, Edmane

    2012-01-01

    An overview of the current NASA research portfolio in the area of aircraft noise reduction is presented. The emphasis of the research described herein is on meeting the aggressive near- and mid-term national goals for reducing aircraft noise emissions, which NASA internal studies have shown to be feasible using noise reduction technologies currently being developed in-house or in partnership with NASA s industry and academic partners. While NASA has an active research effort in airframe noise reduction, this overview focuses on propulsion noise reduction only.

  8. In-Space Propulsion Solar Electric Propulsion Technology Overview

    NASA Astrophysics Data System (ADS)

    Dankanich, John W.

    2006-12-01

    NASA’s In-space Propulsion Technology Project is developing new propulsion technologies that can enable or enhance near and mid-term NASA science missions. The solar electric propulsion technology area has been investing in NASA’s Evolutionary Xenon Thruster (NEXT), the High Voltage Hall Accelerator (HiVHAC), lightweight reliable feed systems, wear testing and thruster modeling. These investments are specifically targeted to increase planetary science payload capability, expand the envelope of planetary science destinations, and significantly reduce the travel times, risk and cost of NASA planetary science missions. Current status and expected capabilities of the solar electric propulsion technologies will be discussed.

  9. Energy data collection as a necessary activity for developing countries

    SciTech Connect

    Loebl, A.S.; Cagle, J.D.

    1980-01-01

    This paper examines the reasons for energy data collection by developing countries and includes an examination of the special requirements of Costa Rica for energy data collection. A primary reason for national data collection is to support the planning function, and this is particularly significant where energy planning and economic development are concerned. Energy data are necessary to support all phases of planning: short-term; mid-term; and long-range and/or strategic planning. These different planning requirements are discussed. Energy data are also necessary to support national management, as well as the economic-development functions. These latter requirements are also discussed briefly.

  10. Analysis of the validity of the coefficient estimates and forecasting properties of the RDFOR (Regional Demand FORcasting) models: A summary report: Validation report

    SciTech Connect

    Kuh, E.; Lahiri, S.; Minkoff, A.; Swartz, S.; Welsch, R.

    1982-11-01

    The Regional Demand FORcasting model (RDFOR) is a simple econometric model currently used by the DOE within the Midterm Energy Forecasting System. Econometric models are often used to provide baseline forecasts of near- to mid-term economic behavior. From the point of view of the policymaker, it is desirable to ascertain as objectively as possible the degree to which these econometric forecasts can be trusted. This paper illustrates, within the context of the industrial and residential sectors of RDFOR, a number of diagnostic tools of general interest which are useful in assessing model reliability.

  11. Activities of the Oil Implementation Task Force, December 1990--February 1991; Contracts for field projects and supporting research on enhanced oil recovery, April--June 1990

    SciTech Connect

    Tiedemann, H.A. )

    1991-03-01

    The Oil Implementation Task Force was appointed to implement the US DOE's new oil research program directed toward increasing domestic oil production by expanded research on near- or mid-term enhanced oil recovery methods. An added priority is to preserve access to reservoirs that have the largest potential for oil recovery, but that are threatened by the large number of wells abandoned each year. This report describes the progress of research activities in the following areas: chemical flooding; gas displacement; thermal recovery; resource assessment; microbial technology; geoscience technology; and environmental technology. (CK)

  12. Upper stage alternatives for the shuttle era

    NASA Technical Reports Server (NTRS)

    1981-01-01

    The status and general characteristics of Space Shuttle upper stages now in use or in development, as well as new vehicle possibilities are examined. Upper stage requirements for both civil and Department of Defense missions, categorized generally into near-term (early and mid-1980's), mid-term (late 1980's to mid-1990's), and far-term (late 1990's and beyond) are discussed. Finally, the technical, schedule and cost impact of alternative ways in which these requirements could be met are examined, and a number of conclusions and recommendations are reached.

  13. Technology Development Plan for the Baseline Detector System of the X-Ray Microcalorimeter Spectrometer (XMS) of the International X-Ray Observatory (IXO)

    NASA Technical Reports Server (NTRS)

    Kilbourne, C. A.; Boriese, W. B.

    2010-01-01

    The primary purpose of this document is to present the technology development plan for the XMS detector system. It covers the current status (including assessment of the Technology Readiness Level, TRL, and a justification of the level assigned), the roadmap to progress to a level between TRL 5 and TRL 6 by the middle of 2012, and an assessment of the associated cost. A secondary purpose of this document is to address the Action Items raised at the XMS Phase-A Study Mid-Term Review that pertain to the detector system (AI #4, #8, and #9).

  14. “DK Crush” Technique for a Tightly Stenosed Conjoined SVG Lesion in a Patient with Acute Coronary Syndrome and Cardiogenic Shock

    PubMed Central

    Chen, Kuan-Ju; Lee, Wen-Lieng; Liu, Tsun-Jui; Chang, Wei-Chun; Wang, Kuo-Yang; Su, Chieh-Shou

    2015-01-01

    Coronary artery bifurcation disease of saphenous venous graft (SVG) is extremely rare. SVG disease remains a challenging lesion to treat because of increased morbidity and mortality with repeated coronary artery bypass graft surgery (CABG), high rates of periprocedural complications, and in-stent restenosis or occlusion requiring repeat revascularization with percutaneous coronary intervention. Herein, we present the first reported case of using the “DK crush” technique to treat an inverted Y-shaped SVG bifurcation disease in a patient with a prior CABG and new-onset acute coronary syndrome. Arising from our treatment, favorable immediate and mid-term angiographic and clinical outcomes were obtained. PMID:27122880

  15. Subtotal resection and omentoplasty of the epidermoid splenic cyst: a case report

    PubMed Central

    Spahija, Gazmend S; Hashani, Shemsedin I; Osmani, Eshref A; Hoxha, Sejdullah A; Hamza, Astrit H; Gashi-Luci, Lumturije H

    2009-01-01

    Introduction Nonparasitic splenic cysts are uncommon clinical entity and because of it, there is no information regarding their optimal surgical treatment. Case presentation A 41-years-old female with incidentally diagnosed nonparasitic splenic cyst which initially was asymptomatic. After two years of follow up, the patient underwent surgery; subtotal cystectomy and omentoplasty as an additional procedure. Postoperative course was uneventful. Conclusion Short and mid term results showed that near total cystectomy with omentoplasty was a safe successful procedure for treatment of epidermoid splenic cyst. PMID:19829799

  16. NEMS industrial module documentation report

    SciTech Connect

    Not Available

    1994-01-01

    The NEMS Industrial Demand Model is a dynamic accounting model, bringing together the disparate industries and uses of energy in those industries, and putting them together in an understandable and cohesive framework. The Industrial Model generates mid-term (up to the year 2010) forecasts of industrial sector energy demand as a component of the NEMS integrated forecasting system. From the NEMS system, the Industrial Model receives fuel prices, employment data, and the value of output of industrial activity. Based on the values of these variables, the Industrial Model passes back to the NEMS system estimates of consumption by fuel types.

  17. Status and development of the calibration programme

    NASA Astrophysics Data System (ADS)

    Doury, Benoit; Nikolova, Svetlana; Marty, Julien; Kramer, Alfred; Zampolli, Mario; Charbit, Maurice

    2015-04-01

    The objective of this poster is to present the status and latest achievements on the calibration of the IMS Seismic, Infrasound and Hydroacoustic stations. This includes PTS progress on scheduled calibration of IMS Seismic stations, the development and testing of a new calibration technique for Infrasound stations using a reference sensor and ambient noise, and related software developments. The poster will also describe PTS development axes and mid-term plan to fulfil the IMS Operational Manuals minimum requirements on the calibration of waveform stations.

  18. The State of the Corona During the Weak Solar Cycle 24: the View from LASCO Images

    NASA Astrophysics Data System (ADS)

    Barlyaeva, T.; Lamy, P.; Llebaria, A.; Boclet, B.

    2016-04-01

    The LASCO-C2 coronagraph onboard SOHO continues its white-light imaging of the corona from 1.5 to 6.0 solar radii, thus allowing investigating the consequences of the weak Solar Cycle 24 on the corona and comparing it to the previous cycle (23). Temporal variations of the global radiance of the corona are presented. We pay particular attention to the mid-term variations which are distinctly different between the two cycles and highlight the similarities and differences. Finally, we rely on our ARTEMIS II catalog of coronal mass ejections (CMEs) to compare their global rates during these two cycles.

  19. Clinical and morphological features of patients who underwent endovascular interventions for lower extremity arterial occlusive diseases

    PubMed Central

    Arslan, Sakir; Yuksel, Isa Oner; Koklu, Erkan; Cagirci, Goksel; Ureyen, Cagin Mustafa; Bayar, Nermin; Kus, Gorkem

    2015-01-01

    Introduction Patients with peripheral arterial disease (PAD) are at increased risk for all-cause mortality and cardiovascular mortality. Aim To present anatomical and morphological characteristics of patients who underwent endovascular stenting with laboratory and our mid-term results. Material and methods One hundred fifty-three patients (mean age: 62.8, 86% male) who underwent percutaneous intervention of lower extremity arteries were included in the study. Demographic characteristics, medical history, physical examination and laboratory findings of patients were analyzed. Patients’ lesions were classified according to the TransAtlantic Inter-Society Consensus (TASC). Clinical outcomes included complications and mortality, 6-minute walking distance, functional class (NYHA) and patency rates. Results Seventy percent of patients had hypertension, 42% were smokers, 78% had coronary artery disease, 20% had coronary artery bypass grafting, 55% had diabetes mellitus and 71% had dyslipidemia. Six patients with diabetes mellitus and poor wound healing despite medical therapy were treated with stenting leading to alleviation of pain and avoidance of amputation. The initial technical success rate of revascularization was 95.6% (153/160). Our mid-term results show that percutaneous procedures in lower extremity arterial diseases can be performed with low complication and high success rates. Patients’ 6-minute walk distance, ankle/brachial index values, functional class and the status of foot ulcers were evaluated. Conclusions Especially in patients with distal vascular disease, poor wound healing and no chance of surgical revascularization, percutaneous endovascular revascularization may provide good blood flow and prevent amputation. PMID:26161103

  20. FY 90 annual research plan

    SciTech Connect

    Not Available

    1990-01-01

    The National Institute for Petroleum and Energy Research (NIPER) was established by the DOE to perform contract research for government and industrial clients. The emphasis of the DOE program is immediate near- and mid-term concerns of domestic oil and gas producibility. Its primary purpose is to improve the fundamental understanding of domestic oil and gas resources and the chemical, physical, and biological phenomena that govern the occurrence and recovery of these resources in addition to their associated environmental issues. The near-term objective of the DOE program is to maintain access to resources presently being produced in domestic oil and gas fields, and to decrease the rate of decline of domestic production. NIPER projects in chemical flooding, gas injection, steam injection, and microbial EOR address near-term concerns of domestic oil production. Further, problems associated with the utilization of heavier fossil feedstocks are being addressed. The mid-term objective of the DOE program is to maximize the recovery efficiency of discovered oil and gas through improved understanding of the resource and to develop advanced extraction and instrumentation techniques. The objective also emphasizes an expanded understanding of the environment. NIPER projects dealing with the quantification of reservoir heterogeneities, pore structure analysis, and fluid flow in porous media are designed to improve extraction technologies. 3 figs., 3 tabs.

  1. Interventional Treatment of Pulmonary Valve Stenosis: A Single Center Experience

    PubMed Central

    Idrizi, Shpend; Milev, Ivan; Zafirovska, Planinka; Tosheski, Goce; Zimbakov, Zan; Ampova-Sokolov, Vilma; Angjuseva, Tanja; Mitrev, Zan

    2015-01-01

    BACKGROUND: Percutaneous pulmonary valvuloplasty is well established treatment of choice in pulmonary valve stenosis. AIM: The aim of our study was to present our experience with the interventional technique, its immediate and mid-term effectiveness as well as its complication rate. MATERIAL AND METHODS: The study included 43 patients, where 33 (74%) of them were children between the age of 1 month and 15 years. RESULTS: The procedure was successful in 38 patients or 90%. Mean peak to peak transvalvular gradient was reduced from 91.2 mmHg (55-150 mmHg) to 39.1 mmHg (20-80 mmHg). Follow- up of patients was between 2 and 13 years and included echocardiographic evaluation of pulmonary valve gradient, right heart dimensions and function as well as assessment of pulmonary regurgitation. We experienced one major complication pericardial effusion in a 5 months old child that required pericardiocenthesis. Six patients (13.9%) required a second intervention. During the follow up period there was significant improvement of right heart function and echocardiography parameters. Mild pulmonary regurgitation was noted in 24 (55%) patients, and four (9%) patients developed moderate regurgitation, without affecting the function of the right ventricle. CONCLUSIONS: Percutaneous pulmonary valvuloplasty is an effective procedure in treatment of pulmonary stenosis with good short and mid-term results. PMID:27275259

  2. Cost and surface optimization of a remote photovoltaic system for two kinds of panels' technologies

    NASA Astrophysics Data System (ADS)

    Avril, S.; Arnaud, G.; Colin, H.; Montignac, F.; Mansilla, C.; Vinard, M.

    2011-10-01

    Stand alone photovoltaic (PV) systems comprise one of the promising electrification solutions to cover the demand of remote consumers, especially when it is coupled with a storage solution that would both increase the productivity of power plants and reduce the areas dedicated to energy production. This short communication presents a multi-objective design of a remote PV system coupled to battery and hydrogen storages systems simultaneously minimizing the total levelized cost and the occupied area, while fulfilling a constraint of consumer satisfaction. For this task, a multi-objective code based on particle swarm optimization has been used to find the best combination of different energy devices. Both short and mid terms based on forecasts assumptions have been investigated. An application for the site of La Nouvelle in the French overseas island of La Réunion is proposed. It points up a strong cost advantage by using Heterojunction with Intrinsic Thin layer (HIT) rather than crystalline silicon (c-Si) cells for the short term. However, the discrimination between these two PV cell technologies is less obvious for the mid term: a strong constraint on the occupied area will promote HIT, whereas a strong constraint on the cost will promote c-Si.

  3. Endovascular Treatment of Descending Thoracic Aortic Aneurysms with the EndoFit Stent-Graft

    SciTech Connect

    Saratzis, N.; Saratzis, Athanasios Melas, N.; Ginis, G.; Lioupis, A.; Lykopoulos, D.; Lazaridis, J.; Kiskinis, Dimitrios

    2007-04-15

    Objective. To evaluate the mid-term feasibility, efficacy, and durability of descending thoracic aortic aneurysm (DTAA) exclusion using the EndoFit device (LeMaitre Vascular). Methods. Twenty-three (23) men (mean age 66 years) with a DTAA were admitted to our department for endovascular repair (21 were ASA III+ and 2 refused open repair) from January 2003 to July 2005. Results. Complete aneurysm exclusion was feasible in all subjects (100% technical success). The median follow-up was 18 months (range 8-40 months). A single stent-graft was used in 6 cases. The deployment of a second stent-graft was required in the remaining 17 patients. All endografts were attached proximally, beyond the left subclavian artery, leaving the aortic arch branches intact. No procedure-related deaths have occurred. A distal type I endoleak was detected in 2 cases on the 1 month follow-up CT scan, and was repaired with reintervention and deployment of an extension graft. A nonfatal acute myocardial infarction occurred in 1 patient in the sixth postoperative month. Graft migration, graft infection, paraplegia, cerebral or distal embolization, renal impairment or any other major complications were not observed. Conclusion. The treatment of DTAAs using the EndoFit stent-graft is technically feasible. Mid-term results in this series are promising.

  4. Effect of Renal Function on Prognosis in Chronic Heart Failure

    PubMed Central

    Löffler, Adrián I.; Cappola, Thomas P.; Fang, James; Hetzel, Scott J.; Kadlec, Andrew; Astor, Brad; Sweitzer, Nancy K.

    2014-01-01

    Renal dysfunction (RD) is associated with increased mortality in heart failure (HF). The aim of this study was to identify whether worsened or improved renal function during mid-term follow-up is associated with worsened outcomes in chronic HF patients. 892 participants from a multicenter cohort study of chronic HF were followed over 3.1±1.9 years of enrollment. Worsened and improved renal function were tested with multivariable models as independent predictors of HF hospitalization and mortality. While 12% of subjects experienced a ≥25% decrease in estimated glomerular filtration rate (eGFR), 17% experienced a ≥25% increase in eGFR, and there was stability of kidney function observed in the cohort as a whole. The quartile with the worst RD at any point in time had increased risk of HF hospitalization and mortality. Worsened eGFR was associated with HF outcomes in the unadjusted (HR=1.71 (95%CI 1.04-2.81), p=0.035), but not the adjusted analysis. Improvement in eGFR was not associated with outcome (p=0.453). In chronic HF, the severity of RD predicts risk of poor outcome better than changes in renal function during mid-term follow-up. This suggests that in patients with appropriately treated chronic HF, worsening renal function in itself does not yield useful prognostic information and may not reflect poor outcome. PMID:25465925

  5. Degradation of Kidney and Psoas Muscle Proteins as Indicators of Post-Mortem Interval in a Rat Model, with Use of Lateral Flow Technology

    PubMed Central

    Lee, Dong-Gi; Yang, Kyeong Eun; Hwang, Jeong Won; Kang, Hwan-Soo; Lee, Seung-Yeul; Choi, Seoyeon; Shin, Joonchul; Jang, Ik-Soon; An, Hyun Joo; Chung, Heesun; Jung, Hyo-Il; Choi, Jong-Soon

    2016-01-01

    We investigated potential protein markers of post-mortem interval (PMI) using rat kidney and psoas muscle. Tissue samples were taken at 12 h intervals for up to 96 h after death by suffocation. Expression levels of eight soluble proteins were analyzed by Western blotting. Degradation patterns of selected proteins were clearly divided into three groups: short-term, mid-term, and long-term PMI markers based on the half maximum intensity of intact protein expression. In kidney, glycogen synthase (GS) and glycogen synthase kinase-3β were degraded completely within 48 h making them short-term PMI markers. AMP-activated protein kinase α, caspase 3 and GS were short-term PMI markers in psoas muscle. Glyceraldehyde 3-phosphate dehydrogenase (GAPDH) was a mid-term PMI marker in both tissues. Expression levels of the typical long-term PMI markers, p53 and β-catenin, were constant for at least 96 h post-mortem in both tissues. The degradation patterns of GS and caspase-3 were verified by immunohistochemistry in both tissues. GAPDH was chosen as a test PMI protein to perform a lateral flow assay (LFA). The presence of recombinant GAPDH was clearly detected in LFA and quantified in a concentration-dependent manner. These results suggest that LFA might be used to estimate PMI at a crime scene. PMID:27552165

  6. Transcatheter Embolisation of Proximal Type 1 Endoleaks Following Endovascular Aneurysm Sealing (EVAS) Using the Nellix Device: Technique and Outcomes

    SciTech Connect

    Ameli-Renani, S. Morgan, R. A.

    2015-10-15

    AimTo evaluate the technical success and mid-term outcomes following transcatheter embolisation of type 1a endoleak after Nellix endovascular aneurysm sealing (EVAS).Materials and MethodsSeven patients (5 men; mean age 83; range 79–90) underwent transcatheter embolisation between July 2013 and August 2014. The average time from EVAS to embolisation was 136 days (range 6–301) and from endoleak diagnosis to embolisation was 20 days (range 2–50). Embolisation was performed with coils and Onyx in six cases and Onyx only in one case. Technical success, imaging and clinical outcomes of embolisation were reviewed. Technical success was defined as elimination of the endoleak on completion angiography and first imaging follow-up. Clinical success was defined as unchanged or decreased aneurysm sac size on subsequent follow-up (average 8 months; range 103–471 days).ResultsAll cases were technically successful. One patient required a second endovascular procedure following Onyx reflux into the Nellix endograft and another patient required surgical closure of a brachial puncture site. All patients are endoleak free with stable sac size on the latest available follow-up imaging.ConclusionIf a type 1 endoleak occurs after EVAS, embolisation using Onyx with or without coils is feasible and effective with high technical success and freedom from endoleak recurrence at mid-term follow-up.

  7. Uterine Fibroid Embolization for Symptomatic Fibroids: Study at a Teaching Hospital in Kenya

    PubMed Central

    Mutai, John Kiprop; Vinayak, Sudhir; Stones, William; Hacking, Nigel; Mariara, Charles

    2015-01-01

    Objective: Characterization of magnetic (MRI) features in women undergoing uterine fibroid embolization (UFE) and identification of clinical correlates in an African population. Materials and Methods: Patients with symptomatic fibroids who are selected to undergo UFE at the hospital formed the study population. The baseline MRI features, baseline symptom score, short-term imaging outcome, and mid-term symptom scores were analyzed for interval changes. Assessment of potential associations between short-term imaging features and mid-term symptom scores was also done. Results: UFE resulted in statistically significant reduction (P < 0.001) of dominant fibroid, uterine volumes, and reduction of symptom severity scores, which were 43.7%, 40.1%, and 37.8%, respectively. Also, 59% of respondents had more than 10 fibroids. The predominant location of the dominant fibroid was intramural. No statistically significant association was found between clinical and radiological outcome. Conclusion: The response of uterine fibroids to embolization in the African population is not different from the findings reported in other studies from the west. The presence of multiple and large fibroids in this study is consistent with the case mix described in other studies of African-American populations. Patient counseling should emphasize the independence of volume reduction and symptom improvement. Though volume changes are of relevance for the radiologist in understanding the evolution of the condition and identifying potential technical treatment failures, it should not be the main basis of evaluation of treatment success. PMID:25883858

  8. Peripheral Applications of Drug-Coated Balloons: Past, Present and Future

    SciTech Connect

    Krokidis, Miltiadis Spiliopoulos, Stavros Katsanos, Konstantinos Sabharwal, Tarun

    2013-04-15

    Drug-coated balloon (DCB) technologies represent the latest and hottest development in the field of endovascular treatment of peripheral arterial disease. Initial experience with paclitaxel-coated balloon use in the femoral artery has demonstrated lower mid-term restenosis and superior mid-term clinical outcomes in terms of improved wound healing and reduced repeat angioplasty rates compared with standard balloon angioplasty. Many companies are presently developing and/or improving DCB catheters and therefore ongoing, technical improvements of the already existing platforms, new drugs, and innovative carriers are expected. The ongoing basic research studies and various multicenter randomized, controlled trials that are currently in progress will offer valuable scientific insights regarding the long-term effectiveness and other crucial issues, such as efficacy in various vascular beds, optimal balloon dosage, and post angioplasty antiplatelet therapy. Future applications of these devices also could include in-stent restenosis, anastomotic stenosis of surgical bypass, and benign stenoses of the central venous system. The authors envision that DCB angioplasty will evolve to a major paradigm shift in the endovascular treatment of occlusive vascular diseases.

  9. Tightly Coupled Inertial Navigation System/Global Positioning System (TCMIG)

    NASA Technical Reports Server (NTRS)

    Watson, Michael D.; Jackson, Kurt (Technical Monitor)

    2002-01-01

    Many NASA applications planned for execution later this decade are seeking high performance, miniaturized, low power Inertial Management Units (IMU). Much research has gone into Micro-Electro-Mechanical System (MEMS) over the past decade as a solution to these needs. While MEMS devices have proven to provide high accuracy acceleration measurements, they have not yet proven to have the accuracy required by many NASA missions in rotational measurements. Therefore, a new solution has been formulated integrating the best of all IMU technologies to address these mid-term needs in the form of a Tightly Coupled Micro Inertial Navigation System (INS)/Global Positioning System (GPS) (TCMIG). The TCMIG consists of an INS and a GPS tightly coupled by a Kalman filter executing on an embedded Field Programmable Gate Array (FPGA) processor. The INS consists of a highly integrated Interferometric Fiber Optic Gyroscope (IFOG) and a MEMS accelerometer. The IFOG utilizes a tightly wound fiber coil to reduce volume and the high level of integration and advanced optical components to reduce power. The MEMS accelerometer utilizes a newly developed deep etch process to increase the proof mass and yield a highly accurate accelerometer. The GPS receiver consists of a low power miniaturized version of the Blackjack receiver. Such an IMU configuration is ideal to meet the mid-term needs of the NASA Science Enterprises and the new launch vehicles being developed for the Space Launch Initiative (SLI).

  10. Rapid Arctic Change: Mapping the Extent of Change on Human Systems

    NASA Astrophysics Data System (ADS)

    Murray, M. S.; Atkinson, D.; Gerlach, C.; Loring, P.

    2008-12-01

    Human system changes tied to the loss of sea ice and other arctic changes are have been observed across the entire range of human activities both in the arctic and elsewhere. The specific nature of a particular impact may be understood within a framework organizing human systems along three dimensions: time, space, and category. Three temporal scales may be recognized: short-term or "reactive" - covering immediate threats to life, mid-term or "proactive" - covering seasonal level concerns, and the planning - covering long-term threats to viability. Similarly, four spatial scales may be recognized: local, regional, national, and international. Among many others, five main categories of response are considered: individual, cultural, regulatory, food systems, political, and scientific. This framework allows us to structure discussion of changes and impacts. From the myriad we have identified three examples that provide snapshots of this spectrum: 1) The Bering Sea fisheries of Unalaska. This is a commercial/subsistence mixed culture/food system strongly impacted by national regulations on a short and mid-term time frame. 2) Impacts on food systems, infrastructure, transportation and economy from the loss of sea ice to in the Alaska Native subsistence community of Shishmaref, and 3) National and international scale changes resulting from increased scientific understanding and media coverage of a changing arctic.