Science.gov

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. 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

  14. 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.

  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. 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

  18. 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

  19. 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

  20. 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.

  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. 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

  3. 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

  4. 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

  5. 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.

  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. 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.

  13. 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.

  14. 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

  15. 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.

  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. 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

  15. 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

  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. 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

  18. 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.

  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. 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.

  5. 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

  6. 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)

  7. 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…

  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. 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

  10. 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.

  11. 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.

  12. 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.

  13. 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

  14. 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

  15. 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

  16. 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.

  17. 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

  18. 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.

  19. 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

  20. 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).

  1. 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

  2. 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

  3. 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

  4. 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.

  5. 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

  6. 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

  7. 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

  8. 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

  9. [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

  10. [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

  11. 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.

  12. 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.

  13. 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.

  14. 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

  15. 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…

  16. 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

  17. 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.

  18. 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

  19. 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

  20. 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

  1. 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

  2. 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

  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 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

  6. 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

  7. 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.

  8. 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

  9. 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

  10. 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

  11. 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...

  12. 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

  13. 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…

  14. 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

  15. 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.

  16. 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.

  17. 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.

  18. 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

  19. 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

  20. 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,…

  1. 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

  2. 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.

  3. 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

  4. 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.

  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. [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

  7. 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.

  8. 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

  9. 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.

  10. 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.

  11. 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)…

  12. 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

  13. 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

  14. 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

  15. 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…

  16. 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

  17. 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.

  18. 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

  19. 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.

  20. 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.

  1. 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.

  2. 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.

  3. 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

  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. 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.

  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. 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…

  16. 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…

  17. 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.

  18. 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...

  19. 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…

  20. 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

  1. 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…

  2. 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…

  3. 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…

  4. 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).

  5. 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-…

  6. 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…

  7. 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…

  8. 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…

  9. 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)

  10. 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…

  11. 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…

  12. 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…

  13. 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…

  14. 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

  15. 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…

  16. 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.

  17. 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

  18. 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.

  19. 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.

  20. 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…

  1. 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,…

  2. 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)…

  3. 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)

  4. 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…

  5. 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…

  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. [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

  9. 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

  10. 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

  11. 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

  12. 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

  13. [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

  14. 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

  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. 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…

  18. 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.

  19. 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…

  20. 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.

  1. [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

  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. 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…

  4. 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.

  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. 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

  7. 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

  8. 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

  9. 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

  10. 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

  11. 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

  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. 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.

  14. 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

  15. 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

  16. 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.

  17. 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.

  18. 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.

  19. 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.

  20. 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)

  1. 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.

  2. 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).

  3. 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

  4. 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.

  5. 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.

  6. 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

  7. 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.

  8. 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

  9. 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.

  10. 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.

  11. 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.

  12. 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

  13. 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.

  14. 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.

  15. “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

  16. 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.

  17. [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

  18. 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)

  19. 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

  20. 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.

  1. 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.

  2. 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

  3. 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

  4. Stability analysis of large electric power systems

    SciTech Connect

    Elwood, D.M.

    1993-01-01

    Modern electric power systems are large and complicated, and, in many regions of the world, the generation and transmission systems are operating near their limits. Ensuring the reliable operation of the power system requires engineers to study the response of the system to various disturbances. The responses to large disturbances are examined by numerically solving the nonlinear differential-algebraic equations describing the power system. The response to small disturbances is typically studied via eigenanalysis. The Electric Power Research Institute (EPRI) recently developed the Extended Transient/Mid-term Stability Program (ETMSP) to study large disturbance stability and the Small Signal Stability Program Package (SSSP) to study small signal stability. The primary objectives of the work described in this report were to (1) explore ways of speeding up ETMSP, especially on mid-term voltage stability problems, (2) explore ways of speeding up the Multi-Area Small-Signal Stability program (MASS), one of the codes in SSSP, and (3) explore ways of increasing the size of problem that can be solved by the Cray version of MASS.

  5. Early assessment of implementing evidence-based brief therapy interventions among secondary service psychiatric therapists.

    PubMed

    Lindholm, Lars H; Koivukangas, Antti; Lassila, Antero; Kampman, Olli

    2015-10-01

    This implementation study was part of the Ostrobothnia Depression Study, in Finland, which covered implementation of motivational interviewing (MI) and behavioral activation (BA) within regional public psychiatric secondary care. It aimed to evaluate the mid-term progress of implementation and related factors. Altogether, 80 therapists had been educated through the implementation program by the point of the mid-term evaluation. Eligible information for evaluation was gathered using two questionnaires (q1, q2) with a one-year interval. A total of 45 of the 80 therapists completed q1, 30 completed q2, and 24 completed both questionnaires. Professional education was the only background factor associated with adopting the interventions (q1: p=0.059, q2: p=0.023), with higher education indicating greater activity. On the basis of trends such as changes in overall usefulness score from q1 to q2, the most involved therapists were slightly more likely to adopt MI/BA. Our experience so far suggests that encouraging staff to begin using new interventions during education is very important. The Consolidated Framework for Implementation Research was found to be a useful tool for constructing the evaluation. PMID:26113263

  6. Phlogopite Mica-based Compressive Seals for Solid Oxide Fuel Cells: Effect of Mica Thickness

    SciTech Connect

    Chou, Y S.; Stevenson, Jeffry W.

    2003-11-24

    Commercially available Phlogopite mica papers of varying thickness, {approx} 0.1 mm, {approx} 0.2 mm, and {approx} 0.5 mm, were evaluated as potential solid oxide fuel cell seal materials. The micas were tested in two forms: plain and hybrid. The hybrid form involved the addition of glass interlayers between the mica and the adjacent components. For each sample, about 30 thermal cycles were conducted and the 800 C leak rates were determined. The results showed an excellent thermal cycle stability of the Phlogopite micas in the hybrid design in that the leak rates remained almost constant after {approx}10 cycles. In addition, the leak rate appeared to increase with increasing mica thickness in the hybrid design, but showed no thickness dependence for mica in the plain design. The Phlogopite micas also showed good mid-term ({approx}500 hrs) stability in both air and reducing environments. Microstructure characterization showed no distinct degradation such as fragmentation and particle formation after thermal cycle and the mid-term stability tests.

  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. 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

  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.

  11. 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.

  12. Echocardiographic assessment of mitral valve morphology and performance after triangular resection of the prolapsing posterior leaflet for degenerative myxomatous disease.

    PubMed

    Chiappini, Bruno; Gregorini, Renato; De Remigis, Franco; Petrella, Licia; Villani, Carmine; Di Pietrantonio, Fabrizio; Pavicevic, Srdan; Mazzola, Alessandro

    2009-08-01

    The gold standard for the surgical treatment of prolapse of the posterior leaflet of the mitral valve (MV) for degenerative myxomatous disease has been represented by the quadrangular resection of the leaflet, according to the Carpentier technique. Since 2006 we performed a triangular resection of the prolapsing leaflet in 20 patients with myxomatous mitral regurgitation (MR). Seventeen patients (85%) underwent the triangular resection of P2; one patient (5%) had a triple scallops triangular resection (P1, P2, P3) and two (10%) a double scallops (P2, P3) resection. In this study, we report the immediate and mid-term clinical and echocardiographic results of a cohort of 20 patients, who underwent this technique. Thirty-day mortality was 0. Acute renal failure occurred in three patients (15%) and they resolved with conservative management. One patient (5%) required re-exploration for bleeding. At the mean follow-up of 13.1+/-4.2 months survival was 95%; one patient died of lymphoma during the follow-up time. All the cases were in New York Heart Association (NYHA) class I. Nineteen survivors underwent transthoracic echocardiography (TTE) (5), or transesophageal echocardiography (TEE) (13), performed by two skilled cardiologists. All patients showed no or trivial MV regurgitation. We believe that triangular resection of posterior MV leaflet (PMVL) provides excellent mid-term results providing the surgeon with a reliable and reproducible surgical option for myxomatous degenerative MV regurgitation. PMID:19414490

  13. 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.

  14. 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.

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

    PubMed

    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

  16. A Systems Approach to Developing an Affordable Space Ground Transportation Architecture using a Commonality Approach

    NASA Technical Reports Server (NTRS)

    Garcia, Jerry L.; McCleskey, Carey M.; Bollo, Timothy R.; Rhodes, Russel E.; Robinson, John W.

    2012-01-01

    This paper presents a structured approach for achieving a compatible Ground System (GS) and Flight System (FS) architecture that is affordable, productive and sustainable. This paper is an extension of the paper titled "Approach to an Affordable and Productive Space Transportation System" by McCleskey et al. This paper integrates systems engineering concepts and operationally efficient propulsion system concepts into a structured framework for achieving GS and FS compatibility in the mid-term and long-term time frames. It also presents a functional and quantitative relationship for assessing system compatibility called the Architecture Complexity Index (ACI). This paper: (1) focuses on systems engineering fundamentals as it applies to improving GS and FS compatibility; (2) establishes mid-term and long-term spaceport goals; (3) presents an overview of transitioning a spaceport to an airport model; (4) establishes a framework for defining a ground system architecture; (5) presents the ACI concept; (6) demonstrates the approach by presenting a comparison of different GS architectures; and (7) presents a discussion on the benefits of using this approach with a focus on commonality.

  17. Transient isolated brainstem symptoms preceding posterior circulation stroke: a population-based study

    PubMed Central

    Paul, Nicola LM; Simoni, Michela; Rothwell, Peter M

    2013-01-01

    Summary Background Transient isolated brainstem symptoms (eg, isolated vertigo, dysarthria, diplopia) are not consistently classified as transient ischaemic attacks (TIAs) and data for prognosis are limited. If some of these transient neurological attacks (TNAs) are due to vertebrobasilar ischaemia, then they should be common during the days and weeks preceding posterior circulation strokes. We aimed to assess the frequency of TNAs before vertebrobasilar ischaemic stroke. Methods We studied all potential ischaemic events during the 90 days preceding an ischaemic stroke in patients ascertained within a prospective, population-based incidence study in Oxfordshire, UK (Oxford Vascular Study; 2002–2010) and compared rates of TNA preceding vertebrobasilar stroke versus carotid stroke. We classified the brainstem symptoms isolated vertigo, vertigo with non-focal symptoms, isolated double vision, transient generalised weakness, and binocular visual disturbance as TNAs in the vertebrobasilar territory; atypical amaurosis fugax and limb-shaking as TNAs in the carotid territory; and isolated slurred speech, migraine variants, transient confusion, and hemisensory tingling symptoms as TNAs in uncertain territory. Findings Of the 1141 patients with ischaemic stroke, vascular territory was categorisable in 1034 (91%) cases, with 275 vertebrobasilar strokes and 759 carotid strokes. Isolated brainstem TNAs were more frequent before a vertebrobasilar stroke (45 of 275 events) than before a carotid stroke (10 of 759; OR 14·7, 95% CI 7·3–29·5, p<0·0001), particularly during the preceding 2 days (22 of 252 before a vertebrobasilar stroke vs two of 751 before a carotid stroke, OR 35·8, 8·4–153·5, p<0·0001). Of all 59 TNAs preceding (median 4 days, IQR 1–30) vertebrobasilar stroke, only five (8%) fulfilled the National Institute of Neurological Disorders and Stroke (NINDS) criteria for TIA. The other 54 cases were isolated vertigo (n=23), non-NINDS binocular visual

  18. Recommended names for pleomorphic genera in Dothideomycetes.

    PubMed

    Rossman, Amy Y; Crous, Pedro W; Hyde, Kevin D; Hawksworth, David L; Aptroot, André; Bezerra, Jose L; Bhat, Jayarama D; Boehm, Eric; Braun, Uwe; Boonmee, Saranyaphat; Camporesi, Erio; Chomnunti, Putarak; Dai, Dong-Qin; D'souza, Melvina J; Dissanayake, Asha; Gareth Jones, E B; Groenewald, Johannes Z; Hernández-Restrepo, Margarita; Hongsanan, Sinang; Jaklitsch, Walter M; Jayawardena, Ruvishika; Jing, Li Wen; Kirk, Paul M; Lawrey, James D; Mapook, Ausana; McKenzie, Eric H C; Monkai, Jutamart; Phillips, Alan J L; Phookamsak, Rungtiwa; Raja, Huzefa A; Seifert, Keith A; Senanayake, Indunil; Slippers, Bernard; Suetrong, Satinee; Taylor, Joanne E; Thambugala, Kasun M; Tian, Qing; Tibpromma, Saowaluck; Wanasinghe, Dhanushka N; Wijayawardene, Nalin N; Wikee, Saowanee; Woudenberg, Joyce H C; Wu, Hai-Xia; Yan, Jiye; Yang, Tao; Zhang, Ying

    2015-12-01

    This paper provides recommendations of one name for use among pleomorphic genera in Dothideomycetes by the Working Group on Dothideomycetes established under the auspices of the International Commission on the Taxonomy of Fungi (ICTF). A number of these generic names are proposed for protection because they do not have priority and/or the generic name selected for use is asexually typified. These include: Acrogenospora over Farlowiella; Alternaria over Allewia, Lewia, and Crivellia; Botryosphaeria over Fusicoccum; Camarosporula over Anthracostroma; Capnodium over Polychaeton; Cladosporium over Davidiella; Corynespora over Corynesporasca; Curvularia over Pseudocochliobolus; Elsinoë over Sphaceloma; Excipulariopsis over Kentingia; Exosporiella over Anomalemma; Exserohilum over Setosphaeria; Gemmamyces over Megaloseptoria; Kellermania over Planistromella; Kirschsteiniothelia over Dendryphiopsis; Lecanosticta over Eruptio; Paranectriella over Araneomyces; Phaeosphaeria over Phaeoseptoria; Phyllosticta over Guignardia; Podonectria over Tetracrium; Polythrincium over Cymadothea; Prosthemium over Pleomassaria; Ramularia over Mycosphaerella; Sphaerellopsis over Eudarluca; Sphaeropsis over Phaeobotryosphaeria; Stemphylium over Pleospora; Teratosphaeria over Kirramyces and Colletogloeopsis; Tetraploa over Tetraplosphaeria; Venturia over Fusicladium and Pollaccia; and Zeloasperisporium over Neomicrothyrium. Twenty new combinations are made: Acrogenospora carmichaeliana (Berk.) Rossman & Crous, Alternaria scrophulariae (Desm.) Rossman & Crous, Pyrenophora catenaria (Drechsler) Rossman & K.D. Hyde, P. dematioidea (Bubák & Wróbl.) Rossman & K.D. Hyde, P. fugax (Wallr.) Rossman & K.D. Hyde, P. nobleae (McKenzie & D. Matthews) Rossman & K.D. Hyde, P. triseptata (Drechsler) Rossman & K.D. Hyde, Schizothyrium cryptogamum (Batzer & Crous) Crous & Batzer, S. cylindricum (G.Y. Sun et al.) Crous & Batzer, S. emperorae (G.Y. Sun & L. Gao) Crous & Batzer, S. inaequale (G.Y. Sun & L

  19. A Possible Effect of Concentrated Oolong Tea Causing Transient Ischemic Attack-Like Symptoms

    PubMed Central

    Layher, John W.; Poling, Jon S.; Ishihara, Mayumi; Azadi, Parastoo; Alvarez-Manilla, Gerardo; Puett, David

    2014-01-01

    Aims Tea (green, oolong, and black) is the second most widely consumed beverage worldwide, second only to water. Aside from a few reported adverse effects, tea, particularly green tea, appears to be beneficial for human health. In the case described herein, a male experienced several transient ischemic attack-like symptoms immediately following the consumption of a cup of high quality oolong tea. A thorough medical evaluation uncovered no evidence of such an attack and leads to the suggestion of a heretofore unreported response to oolong tea. Presentation of Case A 72-year old male with hypertension and atrial fibrillation, who takes valsartan/hydrochlorothiazide to control hypertension and warfarin to reduce the risk of thrombosis and thromboembolism, presented at the emergency room of a local hospital describing several transient ischemic attack-like symptoms immediately after consuming a cup of oolong tea. His symptoms included presyncope, disequilibrium, bilateral hand parathesias, mild dysphasia, and visual problems (but apparently not presbyopia or amaurosis fugax), all of which had disappeared in approximately two hours after drinking the tea. (Mild presyncope was previously noted by the patient when ingesting a strong green tea.) No unusual features emerged from his physical examination, and his blood work was unremarkable except for elevation of his partial thromboplastin time (39 sec) and prothrombin time (22.5 sec), giving an international reference of 2.0, all consistent with the effects of warfarin. A battery of tests by the emergency room physician, a cardiologist, and a neurologist, e.g. electrocardiogram, brain computerized tomography, 2-dimensional transthoracic echocardiogram, brain magnetic resonance imaging, with and without 20 ml Gadolinium, and a magnetic resonance angiogram, confirmed the earlier diagnosis of atrial fibrillation but disclosed no additional malfunction in his heart. His brain showed no evidence of a prior hemorrhage, and his

  20. Restenosis after carotid artery stenting and endarterectomy: a secondary analysis of CREST, a randomised controlled trial

    PubMed Central

    Lal, Brajesh K.; Beach, Kirk W.; Roubin, Gary S.; Lutsep, Helmi L.; Moore, Wesley S.; Malas, Mahmoud B.; Chiu, David; Gonzales, Nicole R.; Burke, J. Lee; Rinaldi, Michael; Elmore, James R.; Weaver, Fred A.; Narins, Craig R.; Foster, Malcolm; Hodgson, Kim J.; Shepard, Alexander D.; Meschia, James F.; Bergelin, Robert O.; Voeks, Jenifer H.; Howard, George; Brott, Thomas G.

    2012-01-01

    Background In the Carotid Revascularization Endarterectomy versus Stenting Trial (CREST), the composite primary endpoint of stroke, myocardial infarction, or death during the periprocedural period or ipsilateral stroke thereafter did not differ between carotid artery stenting and carotid endarterectomy for symptomatic or asymptomatic carotid stenosis. A secondary aim of this randomised trial was to compare the composite endpoint of restenosis or occlusion. Methods Patients with stenosis of the carotid artery who were asymptomatic or had had a transient ischaemic attack, amaurosis fugax, or a minor stroke were eligible for CREST and were enrolled at 117 clinical centres in the USA and Canada between Dec 21, 2000, and July 18, 2008. In this secondary analysis, the main endpoint was a composite of restenosis or occlusion at 2 years. Restenosis and occlusion were assessed by duplex ultrasonography at 1, 6, 12, 24, and 48 months and were defined as a reduction in diameter of the target artery of at least 70%, diagnosed by a peak systolic velocity of at least 3·0 m/s. Studies were done in CREST-certified laboratories and interpreted at the Ultrasound Core Laboratory (University of Washington). The frequency of restenosis was calculated by Kaplan-Meier survival estimates and was compared during a 2-year follow-up period. We used proportional hazards models to assess the association between baseline characteristics and risk of restenosis. Analyses were per protocol. CREST is registered with ClinicalTrials.gov, number NCT00004732. Findings 2191 patients received their assigned treatment within 30 days of randomisation and had eligible ultrasonography (1086 who had carotid artery stenting, 1105 who had carotid endarterectomy). In 2 years, 58 patients who underwent carotid artery stenting (Kaplan-Meier rate 6·0%) and 62 who had carotid endarterectomy (6·3%) had restenosis or occlusion (hazard ratio [HR] 0·90, 95% CI 0·63–1·29; p=0·58). Female sex (1·79, 1·25–2

  1. Role of galectin-3 and plasma B type-natriuretic peptide in predicting prognosis in discharged chronic heart failure patients.

    PubMed

    Feola, Mauro; Testa, Marzia; Leto, Laura; Cardone, Marco; Sola, Mario; Rosso, Gian Luca

    2016-06-01

    Galectin-3 demonstrated to be a robust independent marker of cardiovascular mid-term (18-month) outcome in heart failure (HF) patients. The objective of this study was to analyze the value of a predischarged determination of plasma galectin-3 alone and with plasma brain natriuretic peptide (BNP) in predicting mid-term outcome in frequent-flyers (FF) HF (≥2 hospitalization for HF/year)/dead patients discharged after an acute decompensated HF (ADHF) episode.All FF chronic HF subjects discharged alive after an ADHF were enrolled. All patients underwent a determination of BNP and galectin-3, a 6-minute walk test, and an echocardiogram within 48 hours upon hospital discharge. Death by any cause, cardiac transplantation, and worsening HF requiring readmission to hospital were considered cardiovascular events.Eighty-three patients (67 males, age 73.2 ± 8.6 years old) were analyzed (mean follow-up 11.6 ± 5.2 months; range 4-22 months). During the follow-up 38 events (45.7%) were scheduled: (13 cardiac deaths, 35 rehospitalizations for ADHF). According to medical history, in 33 patients (39.8%) a definition of FF HF patients was performed (range 2-4 hospitalization/year). HF patients who suffered an event (FF or death) demonstrated more impaired ventricular function (P = 0.037), higher plasma BNP (P = 0.005), and Gal-3 at predischarge evaluation (P = 0.027). Choosing adequate cut-off points (BNP ≥ 500 pg/mL and Gal-3 ≥ 17.6 ng/mL), the Kaplan-Meier curves depicted the powerful stratification using BNP + Gal-3 in predicting clinical course at mid-term follow-up (log rank 5.65; P = 0.017).Adding Gal-3 to BNP, a single predischarge strategy testing seemed to obtain a satisfactorily predictive value in alive HF patients discharged after an ADHF episode. PMID:27368017

  2. Ischaemic mitral regurgitation: The effects of ring annuloplasty and suture annuloplasty repair techniques on left ventricular re-remodeling

    PubMed Central

    Aydin, Cemalettin; Kara, Ibrahim; Ay, Yasin; Inan, Bekir; Basel, Halil; Yanartas, Mehmet; Zeybek, Rahmi

    2013-01-01

    Objective: To examine the mid-term results of patients on whom a coronary revascularization as well as a mitral ring and suture annuloplasty have been performed due to coronary artery disease (CAD) and ischaemic mitral regurgitation (IMR). Methodology: Totally 73 patients on whom a revascularization and a mitral valve repair due to CAD and IMR had been performed in our clinic between 2000-2008 were included in the study. Patients were divided into two groups one of which included 38 patients (52.05%) on whom a coronary artery bypass graft (CABG) and a ring annuloplasty on the mitral valve had been performed (Group 1) and the other one 35 patients (47.95%) on whom only suture annuloplasty as well as a CABG had been performed (Group 2). The study was planned retrospectively and study data have been obtained by screening the hospital registries retrospectively. In the mid-term, patients were invited for a check and their intragroup and intergroup echocardiographic parameters and functional capacities were assessed statistically. Results: In pre-operational and post-operational intragroup assessment in terms of echocardiographic findings; although LVEDD, LVESD, EDV, PAP and the degree of recurrent MR have been decreased in both groups, the decrease in LVESD and PAP and the low degree of recurrent MR were statistically significant in Group 1 patients (p=0.047, p=0.023, p=0.01, respectively). When the mid-term intergroup echocardiograpic findings were assessed; PAP and recurrent MR have been determined statistically lower in Group 1 patients (p=0.005, p=0.08, respectively). The length of intensive care unit stay, length of hospitalization and length of detachment from respiratory support were statistically significantly longer in ring annuloplasty performed group (p=0.012, p=0.033, p=0.029, respectively). Conclusions: In moderate to severe IMR patients, a positive contribution can be provided to ventricular remodeling by a ring annuloplasty through a significant decrease

  3. Combined mid- and short-term optimization of multireservoir systems via dynamic programming with function approximators

    NASA Astrophysics Data System (ADS)

    Bottacin-Busolin, Andrea; Wörman, Anders; Zmijewski, Nicholas

    2013-04-01

    A main challenge for the planning and management of water resources is the development of strategies for regulation of multireservoir systems under a complex stochastic environment. The sequential decision problem involving the release of water from multiple reservoirs depends on the stochastic variability of the hydrologic inflows over a spectrum of time scales. An important distinction is made between short-term and mid-term planning: the first is associated with regulation on the hourly scale within the one-week time horizon, whilst the second is associated with the weekly scale within the one-year horizon. Although a variety of optimization methods have been suggested, the achievement of a global optimum in the operation of large-scale systems is hindered by their high dimensional state space and by the stochastic nature of the hydrologic inflows. In this work, operational plans for multireservoir systems are derived via an approximate dynamic programming approach using a policy iteration algorithm. The algorithm is based on an off-line learning process in which policies are evaluated for a number of stochastic inflow scenarios by constructing approximations of their value functions, and the resulting value functions are used iteratively to design new, improved policies. In the mid-term planning phase, inflow scenarios are generated with a periodic autoregressive model that is calibrated against historical inflow data, and the policy iteration algorithm leads to a cyclostationary operating policy. In the short-term planning phase, the mid-term value function is used to calculate the value of a policy at the end of the short-term operating horizon, and synthetic inflow scenarios are generated by perturbing streamflow forecasts with Gaussian noise, following Zhao et al. (Water Resour. Res., 48, W01540, 2012). The variance of the noise is assumed to increase linearly over time and converges to the local variance of the historical time series. A case study is

  4. Role of galectin-3 and plasma B type-natriuretic peptide in predicting prognosis in discharged chronic heart failure patients

    PubMed Central

    Feola, Mauro; Testa, Marzia; Leto, Laura; Cardone, Marco; Sola, Mario; Rosso, Gian Luca

    2016-01-01

    Abstract Galectin-3 demonstrated to be a robust independent marker of cardiovascular mid-term (18-month) outcome in heart failure (HF) patients. The objective of this study was to analyze the value of a predischarged determination of plasma galectin-3 alone and with plasma brain natriuretic peptide (BNP) in predicting mid-term outcome in frequent-flyers (FF) HF (≥2 hospitalization for HF/year)/dead patients discharged after an acute decompensated HF (ADHF) episode. All FF chronic HF subjects discharged alive after an ADHF were enrolled. All patients underwent a determination of BNP and galectin-3, a 6-minute walk test, and an echocardiogram within 48 hours upon hospital discharge. Death by any cause, cardiac transplantation, and worsening HF requiring readmission to hospital were considered cardiovascular events. Eighty-three patients (67 males, age 73.2 ± 8.6 years old) were analyzed (mean follow-up 11.6 ± 5.2 months; range 4–22 months). During the follow-up 38 events (45.7%) were scheduled: (13 cardiac deaths, 35 rehospitalizations for ADHF). According to medical history, in 33 patients (39.8%) a definition of FF HF patients was performed (range 2–4 hospitalization/year). HF patients who suffered an event (FF or death) demonstrated more impaired ventricular function (P = 0.037), higher plasma BNP (P = 0.005), and Gal-3 at predischarge evaluation (P = 0.027). Choosing adequate cut-off points (BNP ≥ 500 pg/mL and Gal-3 ≥ 17.6 ng/mL), the Kaplan–Meier curves depicted the powerful stratification using BNP + Gal-3 in predicting clinical course at mid-term follow-up (log rank 5.65; P = 0.017). Adding Gal-3 to BNP, a single predischarge strategy testing seemed to obtain a satisfactorily predictive value in alive HF patients discharged after an ADHF episode. PMID:27368017

  5. Can Platforms Affect the Safety and Efficacy of Drug-Eluting Stents in the Era of Biodegradable Polymers?: A Meta-Analysis of 34,850 Randomized Individuals

    PubMed Central

    Zhang, Ming-Duo; Li, Xin-He; Nie, Mao-Xiao; Feng, Ting-Ting; Zhao, Xin; Wang, Lu-Ya; Zhao, Quan-Ming

    2016-01-01

    Objective In the era of bare metal stents (BMSs), alloys have been considered to be better materials for stent design than stainless steel. In the era of biodegradable polymer drug-eluting stents (BP-DESs), the safety and efficacy of BP-DESs with different metal platforms (stainless steel or alloys) have not yet been reported, although their polymers are eventually absorbed, and only the metal platforms remain in the body. This study sought to determine the clinical safety and efficacy of BP-DESs with different platforms compared with other stents (other DESs and BMSs). Methods PubMed, Embase and Clinical Trials.gov were searched for randomized controlled trials (RCTs) that compared BP-DESs with other stents. After performing pooled analysis of BP-DESs and other stents, we performed a subgroup analysis using two classification methods: stent platform and follow-up time. The study characteristics, patient characteristics and clinical outcomes were abstracted. Results Forty RCTs (49 studies) comprising 34,850 patients were included. Biodegradable polymer stainless drug-eluting stents (BP-stainless DESs) were superior to the other stents [mainly stainless drug-eluting stents (DESs)] in terms of pooled definite/probable stent thrombosis (ST) (OR [95% CI] = 0.76[0.61–0.95], p = 0.02), long-term definite/probable ST (OR [95% CI] = 0.73[0.57–0.94], p = 0.01), very late definite/probable ST (OR [95% CI] = 0.56[0.33–0.93], p = 0.03) and long-term definite ST. BP-stainless DESs had lower rates of pooled, mid-term and long-term target vessel revascularization (TVR) and target lesion revascularization (TLR) than the other stainless DESs and BMSs. Furthermore, BP-stainless DESs were associated with lower rates of long-term death than other stainless DESs and lower rates of mid-term myocardial infarction than BMSs. However, only the mid-term and long-term TVR rates were superior in BP-alloy DESs compared with the other stents. Conclusion Our results indirectly suggest that

  6. Fenestrated and Chimney Technique for Juxtarenal Aortic Aneurysm: A Systematic Review and Pooled Data Analysis

    PubMed Central

    Li, Yue; Hu, Zhongzhou; Bai, Chujie; Liu, Jie; Zhang, Tao; Ge, Yangyang; Luan, Shaoliang; Guo, Wei

    2016-01-01

    Juxtarenal aortic aneurysms (JAA) account for approximately 15% of abdominal aortic aneurysms. Fenestrated endovascular aneurysm repair (FEVAR) and chimney endovascular aneurysm repair (CH-EVAR) are both effective methods to treat JAAs, but the comparative effectiveness of these treatment modalities is unclear. We searched the PubMed, Medline, Embase, and Cochrane databases to identify English language articles published between January 2005 and September 2013 on management of JAA with fenestrated and chimney techniques to conduct a systematic review to compare outcomes of patients with juxtarenal aortic aneurysm (JAA) treated with the two techniques. We compared nine F-EVAR cohort studies including 542 JAA patients and 8 CH-EVAR cohorts with 158 JAA patients regarding techniques success rates, 30-day mortality, late mortality, endoleak events and secondary intervention rates. The results of this systematic review indicate that both fenestrated and chimney techniques are attractive options for JAAs treatment with encouraging early and mid-term outcomes. PMID:26869488

  7. Application and future of solid foams

    NASA Astrophysics Data System (ADS)

    Bienvenu, Yves

    2014-10-01

    To conclude this series of chapters on solid foam materials, a review of industrial current applications and of mid-term market perspectives centred on manmade foams is given, making reference to natural cellular materials. Although the polymeric foam industrial development overwhelms the rest and finds applications on many market segments, more attention will be paid to the emerging market of inorganic-especially metallic-foams (and cellular materials) and their applications, present or upcoming. It is shown that the final applications of solid foams are primarily linked to transport and the present-day development of the different classes of solid foams is contrasted between functional applications and structural applications. xml:lang="fr"

  8. Mechanically-Deployed Hypersonic Decelerator and Conformal Ablator Technologies for Mars Missions

    NASA Technical Reports Server (NTRS)

    Venkatapathy, Ethiraj; Wercinski, Paul F.; Beck, Robin A. S.; Hamm, Kenneth R.; Yount, Bryan C.; Makino, A.; Smith, B.; Gage, P.; Prabhu, D.

    2012-01-01

    The concept of a mechanically deployable hypersonic decelerator, developed initially for high mass (40 MT) human Mars missions, is currently funded by OCT for technology maturation. The ADEPT (Adaptive, Deployable Entry and Placement Technology) project has broad, game-changing applicability to in situ science missions to Venus, Mars, and the Outer Planets. Combined with maturation of conformal ablator technology (another current OCT investment), the two technologies provide unique low mass mission enabling capabilities otherwise not achievable by current rigid aeroshell or by inflatables. If this abstract is accepted, we will present results that illustrate the mission enabling capabilities of the mechanically deployable architecture for: (1) robotic Mars (Discovery or New Frontiers class) in the near term; (2) alternate approaches to landing MSL-class payloads, without the need for supersonic parachute or lifting entry, in the mid-term; and (3) Heavy mass and human missions to Mars in the long term.

  9. Mechanically-Deployed Hypersonic Decelerator and Conformal Ablator Technologies for Mars Missions

    NASA Technical Reports Server (NTRS)

    Venkatapathy, E.; Wercinski, P.; Prabhu, D.

    2012-01-01

    The concept of a mechanically deployable hypersonic decelerator, developed initially for high mass (approximately 40 MT) human Mars missions, is currently funded by OCT for technology maturation. The ADEPT (Adaptive, Deployable Entry and Placement Technology) project has broad, game-changing applicability to in situ science missions to Venus, Mars, and the Outer Planets. Combined with maturation of conformal ablator technology (another current OCT investment), the two technologies provide unique low-mass mission enabling capabilities otherwise not achievable by current rigid aeroshell or by inflatables. If this abstract is accepted, we will present results that illustrate the mission enabling capabilities of the mechanically deployable architecture for: (1) robotic Mars (Discovery or New Frontiers class) in the near term (2) alternate approaches to landing MSL-class payloads, without the need for supersonic parachute or lifting entry, in the mid-term and (3) Heavy mass and human missions to Mars in the long term.

  10. The application of interferometry to optical astronomical imaging.

    PubMed

    Baldwin, John E; Haniff, Christopher A

    2002-05-15

    In the first part of this review we survey the role optical/infrared interferometry now plays in ground-based astronomy. We discuss in turn the origins of astronomical interferometry, the motivation for its development, the techniques of its implementation, examples of its astronomical significance, and the limitations of the current generation of interferometric arrays. The second part focuses on the prospects for ground-based astronomical imaging interferometry over the near to mid-term (i.e. 10 years) at optical and near-infrared wavelengths. An assessment is made of the astronomical and technical factors which determine the optimal designs for imaging arrays. An analysis based on scientific capability, technical feasibility and cost argues for an array of large numbers of moderate-sized (2 m class) telescopes rather than one comprising a small number of much larger collectors. PMID:12804289

  11. Comparison of Different Materials and Proximal Coatings Used for Femoral Components in One-Stage Bilateral Total Hip Arthroplasty.

    PubMed

    Miyatake, Kazumasa; Jinno, Tetsuya; Koga, Daisuke; Yamauchi, Yuki; Muneta, Takeshi; Okawa, Atsushi

    2015-12-01

    To evaluate the mid-term effects of different materials and coatings used for femoral components, we prospectively performed 21 one-stage bilateral total hip arthroplasties using 2 anatomical stems which have identical geometries, randomized to side. One stem was made of Ti6Al4V alloy and had a hydroxyapatite coating on grit-blasted surface proximally, and the other was made of TMZF™ alloy and had a proximal coating of hydroxyapatite in addition to an arc-deposited titanium surface coating. Although we found extensions of radiopaque lines to the surface of coatings of seven grit-blasted stems whereas we found none in the case of the arc-deposited titanium stems, all hips showed excellent clinical and radiological outcomes as shown by radiographs and bone mineral density at the final follow-up, average 5.5 years postoperatively. PMID:26190568

  12. Final evaluation of USAID (US Agency for International Development) Alternative Energy Sources Project in Ecuador (Project No. 518-0029/Loan No. 518-W-039)

    SciTech Connect

    Maestas, G.; Jones, D.W.; Samuels, G. Jr.; Younger, D.R.

    1987-10-01

    This evaluation concentrated on reviewing the project's original purpose and design; modifications to the design over the project's life; the project's accomplishments and shortcomings; and the record of the project's implementation from the completion of the project's mid-term evaluation in April-May 1984 through June 1986. Goals were to encourage more rational use of energy resources in order to improve Ecuador's ability to meet the energy needs of its population (and) to better address the energy needs of lower income Ecuadorian families, particularly those in rural areas. To achieve these goals, the project was to strengthen INE's (the National Energy Institute, Instituto Nacional de Energia) institutional capacity to affect overall GOE (government of Ecuador) energy planning and the promotion of NCE (nonconventional energy) technologies appropriate to Ecuador.

  13. Midterm Outcomes of the Recently FDA Approved Ceramic on Ceramic Bearing in Total Hip Arthroplasty Patients Under 65 Years of Age.

    PubMed

    Aoude, Ahmed A; Antoniou, John; Epure, Laura M; Huk, Olga L; Zukor, David J; Tanzer, Michael

    2015-08-01

    The present study aimed to evaluate the mid-term results of the fourth generation of ceramic on ceramic (CC) bearing. Demographics, surgical technique, complications, clinical and radiologic outcomes were analyzed in a series of 133 consecutive CC total hip arthroplasties (THAs) with a newest generation CC bearings to determine if these provide safe and well performing bearings. At the last follow-up, there were no cases of ceramic fracture or chipping and no revision surgery necessary for bearing related complication. One hip underwent two staged revision for infection and another underwent revision for dislocation, resulting in an overall 98.5% survival rate at a mean of 6 years. The newest generation of CC bearings provides a reliable and safe bearing in young, active patients undergoing THA. PMID:25869588

  14. [Endovascular repair for an acute traumatic aortic transection: a case report].

    PubMed

    Sanioğlu, Soner; Sahin, Sinan; Aydoğan, Hakki; Barutça, Hakan; Eren, Ergin

    2012-03-01

    A thirty-eight-year-old male patient who suffered from 10th and 11th thoracal vertebrae fractures, paraplegia and acute traumatic aortic transection because of accidental fall was referred to our hospital. Open surgical repair carried a very high risk due to severe coexisting injuries. Transection was treated with 30x100 mm Valiant thoracic endograft, which was deployed just distal to the ostium of the left carotid artery. The patient was transferred to the neurosurgery clinic for treatment of paraplegia after an uneventful recovery. Endovascular repair of acute transection confers substantial advantages in mortality and morbidity compared to surgical repair. However, the long-term durability of thoracic endografts remains unknown. If the long-term results are as satisfactory as the promising mid-term results, this technique may become the gold standard approach for the treatment of acute transection. PMID:22792827

  15. 2nd Generation RLV Risk Definition Program

    NASA Technical Reports Server (NTRS)

    Davis, Robert M.; Stucker, Mark (Technical Monitor)

    2000-01-01

    The 2nd Generation RLV Risk Reduction Mid-Term Report summarizes the status of Kelly Space & Technology's activities during the first two and one half months of the program. This report was presented to the cognoscente Contracting Officer's Technical Representative (COTR) and selected Marshall Space Flight Center staff members on 26 September 2000. The report has been approved and is distributed on CD-ROM (as a PowerPoint file) in accordance with the terms of the subject contract, and contains information and data addressing the following: (1) Launch services demand and requirements; (2) Architecture, alternatives, and requirements; (3) Costs, pricing, and business cases analysis; (4) Commercial financing requirements, plans, and strategy; (5) System engineering processes and derived requirements; and (6) RLV system trade studies and design analysis.

  16. The in vitro immunoregulatory properties of cultured murine trophoblast are not unique to this tissue.

    PubMed Central

    Drake, B L; Rodger, J C

    1985-01-01

    Primary cultures of murine trophoblast (ectoplacental cone and mid-term placenta) and their supernatants were found to inhibit in vitro lymphocyte proliferative responses to concanavalin A (77-87%) and allo-antigen (52-84%). However, cultures and cell-conditioned media from non-trophoblastic tissues (embryonic sac, adult lung and liver, and B16 melanoma line) produced similar results. In all cases, the inhibitory effects were not due to reduced cell viability. Addition of anti-progesterone serum to the ectoplacental cone-lymphocyte co-cultures, at a concentration known to bind the available trophoblast-derived progesterone, did not overcome the observed suppression. The results clearly demonstrate that a range of cultured cell types, and their conditioned media, will suppress immune responses in vitro. We conclude that cultured trophoblast is not an appropriate model for studies of placental immunoregulation. PMID:3159651

  17. Neurosciences research in space - Future directions

    NASA Technical Reports Server (NTRS)

    Sulzman, Frank M.; Wolfe, James W.

    1991-01-01

    In order to gain a better understanding of the effects of long-duration space missions on the central nervous system, near-term research, to take place from 1990-1995, will be directed at investigating the acute effects of microgravity and the 'space adaptation syndrome'. These include experiments scheduled for the Spacelab Life Sciences 1 which is designed to evaluate changes in the visual, vestibular, and proprioceptive systems. An extensive series of experiments, collectively termed Microgravity Vestibular Investigations (MVI), is also planned for the IML-1 mission to be flown in 1992. The IML-2 mission will emphasize behavior and performance, biological rhythms, and further vestibular studies. Mid-term goals, projected to be achieved from 1995-2000, include the use of new technology such as magnetic recording techniques. Long-term goals are also discussed including studies dealing with neuronal plasticity and sensory substitution, augmentation, and robotic telepresence.

  18. A CPT-based Cs vapor cell atomic clock with a short-term fractional frequency stability of 3 x 10-13 τ-1/2

    NASA Astrophysics Data System (ADS)

    Abdel Hafiz, Moustafa; Liu, Xiaochi; Guérandel, Stéphane; De Clercq, Emeric; Boudot, Rodolphe

    2016-06-01

    This article reports on the development and short-term fractional frequency stability of a continuous-regime (CW) Cs vapor cell atomic clock based on coherent population trapping (CPT). The push-pull optical pumping technique is used to increase the number of atoms that participate to the clock transition, yielding a typical CPT resonance contrast of 25% for a CPT linewidth of about 450 Hz. The clock short-term fractional frequency stability is measured to be 3 x 10-13 τ-1/2 up to 100 seconds averaging time, in correct agreement with the signal-to-noise ratio limit. The mid-term frequency stability results are currently mainly limited by laser power effects. The detection of high-contrast narrow Raman-Ramsey fringes is demonstrated with this setup by making the atoms interact with a light pulse sequence.

  19. Model documentation report: Residential sector demand module of the national energy modeling system

    SciTech Connect

    1998-01-01

    This report documents the objectives, analytical approach, and development of the National Energy Modeling System (NEMS) Residential Sector Demand Module. The report catalogues and describes the model assumptions, computational methodology, parameter estimation techniques, and FORTRAN source code. This reference document provides a detailed description for energy analysts, other users, and the public. The NEMS Residential Sector Demand Module is currently used for mid-term forecasting purposes and energy policy analysis over the forecast horizon of 1993 through 2020. The model generates forecasts of energy demand for the residential sector by service, fuel, and Census Division. Policy impacts resulting from new technologies, market incentives, and regulatory changes can be estimated using the module. 26 refs., 6 figs., 5 tabs.

  20. Top pair production at a future e + e - machine in a composite Higgs scenario

    NASA Astrophysics Data System (ADS)

    Barducci, D.; De Curtis, S.; Moretti, S.; Pruna, G. M.

    2015-08-01

    The top quark plays a central role in many New Physics scenarios and in understanding the details of Electro-Weak Symmetry Breaking. In the short- and mid-term future, top-quark studies will mainly be driven by the experiments at the Large Hadron Collider. Exploration of top quarks will, however, be an integral part of particle physics studies at any future facility and an e + e - collider will have a very comprehensive top-quark physics program. We discuss the possibilities of testing NP in the top-quark sector within a composite Higgs scenario through deviations from the Standard Model in top pair production for different Centre-of-Mass energy options of a future e + e - machine. In particular, we focus on precision studies of the top-quark sector at a CM energy ranging from 370 GeV up to 3 TeV.

  1. World Energy Projection System Plus (WEPS ): Global Activity Module

    EIA Publications

    2016-01-01

    The World Energy Projection System Plus (WEPS ) is a comprehensive, mid?term energy forecasting and policy analysis tool used by EIA. WEPS projects energy supply, demand, and prices by country or region, given assumptions about the state of various economies, international energy markets, and energy policies. The Global Activity Module (GLAM) provides projections of economic driver variables for use by the supply, demand, and conversion modules of WEPS . GLAM’s baseline economic projection contains the economic assumptions used in WEPS to help determine energy demand and supply. GLAM can also provide WEPS with alternative economic assumptions representing a range of uncertainty about economic growth. The resulting economic impacts of such assumptions are inputs to the remaining supply and demand modules of WEPS .

  2. [Spanish National Plan for Scientific Research, Development and Innovation 2008-2011: an opportunity for healthcare research].

    PubMed

    Catalá-López, Ferrán; Contreras, Mónica

    2008-01-01

    Research in health sciences is a core element for success in any strategy aiming to improve health in today's society. The search for a safe, effective and efficient healthcare, that guarantees citizens equitable access to health services, has placed evidence-based clinical practice and research in healthcare in the front line. In this context, the Spanish National Plan for Scientific Research, Development and Innovation (R&D&I) 2008-2011 is the programming tool through which objectives and priorities of the national research policy are set in the mid-term. The present document is an approach to the current Spanish National Plan for R&D&I 2008-2011, which also describes current opportunities for developing research in health care within the Spanish National Health System. PMID:18579065

  3. Lateral patellar facetectomy and medial reefing in patients with lateral facet syndrome after patellar-retaining total knee arthroplasty.

    PubMed

    Pagenstert, Geert; Seelhoff, Juliane; Henninger, Heath B; Wirtz, Dieter C; Valderrabano, Victor; Barg, Alexej

    2014-11-01

    We analyzed clinical outcomes of partial lateral patellar facetectomy and medial reefing in patients with lateral patellar facet syndrome with painful patellar-retaining total knee arthroplasty. 34 patients were followed for a mean of 40 months. All 34 patients were matched with those having secondary patellar resurfacing without facetectomy. Both groups experienced significant pain relief and range of motion improvement. The facetectomy group had higher Kujala scores than those in patellar resurfacing group. Patients with facetectomy had significantly less pain postoperatively. There were significant differences in postoperative lateral patellar tilt and congruency angle in both groups. The mid-term results for LPF with medial reefing are promising to resolve pain in patients with lateral patellar facet syndrome in patellar-retaining TKA. Therapeutic level III (retrospective comparative study). PMID:25070901

  4. Degenerative arthritis of pseudoarticulation between the os peroneum and cuboid: a rare cause of lateral foot pain.

    PubMed

    Gökkuş, Kemal; Sagtas, Ergin; Demirci, Erkan; Saylik, Murat; Aydın, Ahmet Turan

    2015-03-01

    The painful os peroneum syndrome is widely recognized. It is often the result of trauma. However degenerative changes between the os peroneum and the articular facet is much rarer and we could only find two other case reports in the literature. This report concerns a middle aged woman with chronic plantar-lateral foot pain and a limp secondary to degenerative changes between the os peroneum and its articular facet with cuboid. The aim of this study is to remind to orthopaedic surgeons about painful os peroneum syndrome and to highlight the rarity of our case. In our case the mid term result of the excision of the os peroneum with painful articulation appear good, providing symptomatic pain relief with little alteration in the function of the foot. PMID:25682421

  5. Bretton Woods Institution Narratives about Inequality and Economic Vulnerability on the Eve of South African Austerity.

    PubMed

    Bond, Patrick

    2015-01-01

    In South Africa, at a time when National Health Insurance should be generously funded (7 years after its approval as public policy by the ruling party), state fiscal austerity appears certain to nip the initiative in the bud. The World Bank and the International Monetary Fund issued separate reports about South Africa in late 2014, following a new finance minister's mid-term budget speech. In justifying austerity, they revealed 2 important conceptual blockages regarding inequality and international financial relations. The resulting political bias in the macroeconomic debate has, in turn, given neoliberal policy advocates intellectual weaponry to impose deeper austerity. In contrast, the rise of a "united front" of labor, community-based, and social movement activists, along with a vigorous left opposition party in Parliament, ensure that one of the world's most visible class struggles ratchets up in intensity in the years ahead. PMID:26077853

  6. Chapter 1.03: Solar Photovoltaics Technology: No Longer an Outlier

    SciTech Connect

    Kazmerski, L. L.

    2012-01-01

    The status and future technology, market, and industry opportunities for solar photovoltaics are examined and discussed. The co-importance of both policy and technology investments for the future markets and competitiveness of this solar approach is emphasized. This paper underscores the technology side, with a comprehensive overview and insights to technical, policy, market, industry and other investments needed to tip photovoltaics to its next level of contribution as a significant clean-energy partner in the world energy economy. The requirement to venture from near-term and evolutionary approaches into disruptive and revolutionary technology pathways is argued for our needs in the mid-term (the next 10-15 years) and the long-term (beyond the first quarter of this century).

  7. Opportunities for Drell-Yan Physics at RHIC

    SciTech Connect

    Aschenauer, E.; Bland, L.; Crawford, H.; Goto, Y.; Eyser, O.; Kang, Z.; Vossen, A.

    2011-05-24

    Drell-Yan (DY) physics gives the unique opportunity to study the parton structure of nucleons in an experimentally and theoretically clean way. With the availability of polarized proton-proton collisions and asymmetric d+Au collisions at the Relativistic Heavy Ion Collider (RHIC), we have the basic (and unique in the world) tools to address several fundamental questions in QCD, including the expected gluon saturation at low partonic momenta and the universality of transverse momentum dependent parton distribution functions. A Drell-Yan program at RHIC is tied closely to the core physics questions of a possible future electron-ion collider, eRHIC. The more than 80 participants of this workshop focused on recent progress in these areas by both theory and experiment, trying to address imminent questions for the near and mid-term future.

  8. Computer Assisted Total Knee Arthroplasty: Does it Make a Difference?

    PubMed Central

    HARITINIAN, Emil G.; PIMPALNERKAR, Ashvin L.

    2013-01-01

    ABSTRACT The longevity of total knee prostheses depends mostly on the correct alignment (frontal, sagittal and axial) of the prosthetic components, soft tissue balancing and restoring the mechanical axis of the lower limb. The use of computer-assisted navigation allows more accurate and reproducible restoration of mechanical axis and component positioning, better results in patients with extra-articular deformities and it has an important role in surgical training. Better alignment should lead to an improved functional outcome and an increased long-term survival of the prosthesis. Several studies have proven an improved function in the short and mid-term but we still lack long-term data regarding functional outcome and longevity of the prostheses. PMID:24371482

  9. Workplan for Catalyzing Collaboration with Amazonian Universities in the Large Scale Biosphere-Atmosphere Experiment in Amazonia (LBA)

    NASA Technical Reports Server (NTRS)

    Brown, I. Foster; Moreira, Adriana

    1997-01-01

    Success of the Large-Scale Biosphere-Atmospheric Experiment in Amazonia (LBA) program depends on several critical factors, the most important being the effective participation of Amazonian researchers and institutions. Without host-county counterparts, particularly in Amazonia, many important studies cannot he undertaken due either to lack of qualified persons or to legal constraints. No less important, the acceptance of the LBA program in Amazonia is also dependent on what LBA can do for improving the scientific expertise in Amazonia. Gaining the active investment of Amazonian scientists in a comprehensive research program is not a trivial task. Potential collaborators are few, particularly where much of the research was to be originally focused - the southern arc of Brazilian Amazonia. The mid-term goals of the LBA Committee on Training and Education are to increase the number of collaborators and to demonstrate that LBA will be of benefit to the region.

  10. Dismantle or Improve ObamaCare? Nurses Must Take Action.

    PubMed

    Gardner, Deborah B

    2014-01-01

    Following the 2014 mid-term elections, what will the next 2 years of Republican leadership do to change the structures still being put into place to meet the goals of the Affordable Care Act (ACA)? Nurses need to be visible by creating partnerships with their new state and federal representatives and by demonstrating collaboration through identified shared values. Nurses must hold all congressional leaders accountable for continuing to improve access to quality and affordable health care, while containing costs and strengthening incentives to provide a client-centered approach to care delivery. As health care reform legislation is a highly charged political battleground, nurses must support legislative changes in the ACA that will strengthen our health care system, not weaken it. PMID:26267964

  11. ECASTAR: Energy Conservation; an Assessment of Systems, Technologies and Requirements

    NASA Technical Reports Server (NTRS)

    1975-01-01

    A methodology for a systems approach display and assessment of the potential for energy conservation actions and the impacts of those actions was presented. The U.S. economy is divided into four sectors: energy industry, industry, residential/commercial and transportation. Each sector is assessed with respect to energy conservation actions and impacts. The four sectors are combined and three strategies for energy conservation actions for the combined sectors are assessed. The three strategies (national energy conservation, electrification and diversification) represent energy conservation actions for the near term (now to 1985), the mid term (1985 to 2000) and the far term (2000 and beyond). The assessment procedure includes input/output analysis to bridge the flows between the sectors, and net economics and net energetics as performance criteria for the conservation actions. Targets of opportunity for large net energy net energy savings and the application of technology to achieve these savings are discussed.

  12. Overview of the Thermal Energy Storage (TES) Program

    NASA Astrophysics Data System (ADS)

    Gurevich, M.

    1981-03-01

    The program promotes energy savings and fuel substitution by developing and helping to commercialize technologies for storing heat or cold, with shot investment payback periods as a cost goal. The sources of energy include industrial and utility waste heat as well as primary sources such as solar, geothermal, nuclear and fossil fuels. The primary source of "cold" for seasonal storage is winter chilled air. The program emphasizes near-term (1980's) approaches to energy conservation and displacement of natural gas and oil. It also provides for development of technologies which will allow use of renewable resources such as solar-thermal energy during the mid-term (1990's) and advanced energy storage and transport techniques for the far-term (beyond 2000).

  13. Focus and Objectives for Effecting Near-Term Improvements to Bipropellant Earth Storable Propulsion Systems

    NASA Astrophysics Data System (ADS)

    Byers, Dave C.

    2006-12-01

    NASA’s In-Space Propulsion Technology (ISPT) Program is investing in Advanced Chemical Propulsion (ACP) technologies with the goal of enhancing propulsion system performance and science exploration mission capability in the nearto mid-term. These investments are currently focused on applying significant incremental technology improvements to state-of-the-art bipropellant propulsion systems for near-term implementation and adoption. Improvements in high temperature materials and processes for thrust chamber assemblies, lightweight composite tanks, and propellant management and delivery systems indicate potential for significantly reducing system mass and significantly increasing propellant performance. The current ACP development strategy and approach will mature technologies that can deliver these improvements while reducing manufacturing costs and increasing system reliability.

  14. Endovascular Treatment of Venous Occlusive Disease

    PubMed Central

    2008-01-01

    Endovascular treatment of acute and chronic iliac vein occlusions has proven to be safe and effective. Recanalization of chronic occlusions with balloon angioplasty and stenting can re-establish normal venous flow in the iliac veins and the IVC and relieve symptoms in the majority of treated patients. CDT with recanalization and stenting of underlying chronically obstructed iliofemoral segments is becoming the treatment of choice for patients with acute iliofemoral thrombosis, as anticoagulation and compression therapy alone are not satisfactory in preventing PTS. The new treatment modalities offer stimulating options for a patient group that is not adequately treated, neither by medical nor open surgical therapy. The substantial effort and additional costs of endovascular treatment appear to be justified by the encouraging mid-term results both for patients with acute and chronic occlusive iliofemoral disease. However, multi-center randomized prospective studies are required to further validate the role of these techniques. PMID:23555345

  15. High tibial osteotomy in varus knees: indications and limits

    PubMed Central

    LOIA, MARCO CORGIAT; VANNI, STEFANIA; ROSSO, FEDERICA; BONASIA, DAVIDE EDOARDO; BRUZZONE, MATTEO; DETTONI, FEDERICO; ROSSI, ROBERTO

    2016-01-01

    Opening wedge high tibial osteotomy (OWHTO) is a surgical procedure that aims to correct the weight-bearing axis of the knee, moving the loads laterally from the medial compartment. Conventional indications for OWHTO are medial compartment osteoarthritis and varus malalignment of the knee; recently OWHTO has been used successfully in the treatment of double and triple varus. OWHTO, in contrast to closing wedge high tibial osteotomy, does not require fibular osteotomy or peroneal nerve dissection, or lead to disruption of the proximal tibiofibular joint and bone stock loss. For these reasons, interest in this procedure has grown in recent years. The aim of this study is to review the literature on OWHTO, considering indications and prognostic factors (body mass index, grade of osteoarthritis, instability, range of movement and age), outcomes at mid-term follow-up, and limits of the procedure (slope modifications, patellar height changes and difficulties in conversion to a total knee arthroplasty). PMID:27602350

  16. Silicon CVD on powders in fluidized bed: Experimental and multifluid Eulerian modelling study

    SciTech Connect

    Cadoret, L.; Reuge, N; Pannala, Sreekanth; Syamlal, M; Coufort, C; Caussat, B

    2007-01-01

    The Computational Fluid Dynamics code MFIX was used for transient simulations of silicon Fluidized Bed Chemical Vapor Deposition (FBCVD) from silane (SiH4) on coarse alumina powders. FBCVD experiments were first performed to obtain a reference database for modelling. Experimental thermal profiles existing along the bed were considered in the model. 3D simulations provide better results than 2D ones and predict silane conversion rate with a mean deviation of 9% compared to experimental values. The model can predict the temporal and spatial evolutions of local void fractions, gas and particle velocities, species gas fractions and silicon deposition rate. We aim at mid term to model FBCVD treatments of submicronic powders in a vibrated reactor since we have performed experiments proving the efficacy of the process to treat submicronic particles.

  17. Isolation of a ribosome-inactivating and abortifacient protein from seeds of Luffa acutangula.

    PubMed

    Yeung, H W; Li, W W; Ng, T B

    1991-07-01

    A glycoprotein with a molecular weight of 28,000 as estimated by SDS-polyacrylamide gel electrophoresis was isolated from seeds of Luffa acutangula using a procedure that involved acetone precipitation, ion exchange chromatography on CM Sepharose CL-6B and gel filtration on Sephadex G-50. In immunodiffusion studies it was found to be immunologically distinct from abortifacient proteins isolated from other members of the Cucurbitaceae family including Momordica charantia, Momordica cochinchinensis, Trichosanthes kirilowii and Trichosanthes cucumeroides. There were some differences in amino acid composition among the proteins although there was a gross similarity. The protein from L. acutangula was capable of inducing mid-term abortion in mice and inhibiting protein synthesis in a cell-free system. PMID:1938101

  18. The Etiology and Arthroscopic Surgical Management of Cam Lesions.

    PubMed

    Werner, Brian C; Gaudiani, Michael A; Ranawat, Anil S

    2016-07-01

    Cam-type deformity of the proximal femur is a relative increase in the discrepancy of the femoral head-neck offset. The etiology is unknown; several conditions have been implicated in the development of abnormal proximal femoral anatomy. Recent evidence suggests that high-impact sports place stress on the immature physis during growth and may play an important role. Imaging is essential in the initial diagnostic workup, characterization of pathology, preoperative planning, and intraoperative decision making. Short-term and mid-term outcomes for arthroscopic osteoplasty of cam lesions for both isolated cam-type deformity and mixed cam-pincer femoroacetabular impingement have been well-described and are favorable. PMID:27343392

  19. KTP laser stapedotomy with a self-crimping, thermal shape memory Nitinol piston: follow-up study reporting intermediate-term hearing.

    PubMed

    Gerlinger, Imre; Bakó, Péter; Piski, Zalán; Révész, Péter; Ráth, Gábor; Karosi, Tamás; Lujber, László

    2014-12-01

    The aim of this study was an evaluation of the mid-term hearing results after the implantation of a self-crimping heat memory Nitinol piston in stapes surgery. The 12-month postoperative results were compared with those at a minimum of 3 years (maximum 6.7, average 4.4 years). The medical records of all 44 patients who underwent surgery with a Nitinol piston for stapes fixation between November 2005 and January 2007 were evaluated retrospectively. The prostheses used in all cases measured either 4.5 or 4.75 × 0.6 mm. We hypothesized that the 12-month postoperative hearing results would be permanent after an average follow-up of 4.4 years. Thirty-two of the 44 consecutive patients were females and 12 were males. Their mean age was 40.4 years (range 27-69). All underwent a 12-month postoperative audiometric evaluation. 38 (30 females, 8 males, average age 45, range 28-77 years) of the 44 were available for mid-term 4.4-year (minimum 3 years, maximum 6.7 years) postoperative audiometric evaluation. The mean air-bone gap (ABG) for the frequencies 0.5, 1, 2 and 3 kHz at the 12-month postoperative follow-up was 11 dB (SD 4.1) and that after an average 4.4-year postoperative evaluation was 6.4 dB (SD 3.6). The mean decrease in ABG after 12 months was 19.5 dB, and that after the average 4.4 years was 21.3 dB. ABG closure within 10 dB was achieved in 77.2 % after 12 months and in 89.5 % after the average 4.4 years. No patient with an ABG > 20 dB was recorded after the average 4.4 years. The mean air conduction threshold at 4 kHz was examined pre and postoperatively so as to indicate any possible inner ear damage. At the 12-month follow-up, the difference between the pre and postoperative values was -2.5 dB, whereas after the average 4.4 years the difference was surprisingly +13 dB. The individual AC improvements were also demonstrated with the use of Amsterdam Hearing Evaluation Plots (AHEPs). The Nitinol prosthesis allowed excellent intraoperative handling and no

  20. Photovoltaics at the Tipping Point: Taking Us from the Evolutionary to the Revolutionary

    SciTech Connect

    Kazmerski, L. L.

    2007-01-01

    We examine the current situation and future technology opportunities for solar photovoltaics (PV), emphasizing the importance of both policy and technology investments for the future markets and competitiveness of this solar approach. We review some examples of policy significantly impacting world markets and discuss the targets of the new U.S. Solar America Initiative. On the technology side, we present insights to technical and other investments needed to tip PV to its next level of contribution as a significant clean-energy partner in the world energy portfolio. The need to venture into disruptive and revolutionary technology pathways is argued for our needs in the mid term (the next 10-15 years) and the long term (beyond the first quarter of this century).

  1. Mortality after percutaneous edge-to-edge mitral valve repair: a contemporary review

    PubMed Central

    de Beenhouwer, Thomas; Swaans, Martin J.; Post, Marco C.; van der Heyden, Jan A. S.; Eefting, Frank D.; Rensing, Benno J. W. M.

    2016-01-01

    Percutaneous edge-to-edge mitral valve (MV) repair is a relatively new treatment option for mitral regurgitation (MR). After the feasibility and safety having been proved in low-surgical-risk patients, the use of this procedure has shifted more to the treatment of high-risk patients. With the absence of randomized controlled trials (RCT) for this particular subgroup, observational studies try to add evidence to the safety aspect of this procedure. These also provide short- and mid-term mortality figures. Several mortality predictors have been identified, which may help the optimal selection of patients who will benefit most from this technique. In this article we provide an overview of the literature about mortality and its predictors in patients treated with the percutaneous edge-to-edge device. PMID:27054105

  2. Three strategies for conservation

    NASA Technical Reports Server (NTRS)

    1975-01-01

    The three strategies considered as energy conservation oriented were given: national energy conservation, electrification, and diversification. The first one applies to the near term period (now-1985), the second one to the mid term (1985-2000), and the third one to the far term (2000- ). The rest of this section was focussed on the near term period. The following proposed actions were considered: (1) roll back the price of newly discovered oil, (2) force conversion of many power plants from gas and oil to coal, (3) freeze gasoline production for three years at 1972 levels, (4) mandate automobile mileage requirements, (5) require industry to improve energy efficiency, and (6) require manufacture of household appliances with greater efficiency. Each of these six actions was described and discussed in more detail.

  3. A critical friend: monitoring and evaluation systems, development cooperation and local government. The case of Tuscany.

    PubMed

    Rossignoli, Serena; Coticchia, Fabrizio; Mezzasalma, Annarosa

    2015-06-01

    The role of monitoring and evaluation (M&E) systems in the field of development cooperation has globally increased in last decades. International and regional organizations, as well as states, local governments and NGOs have largely adopted the tools provided by M&E in order to enhance transparency, effectiveness and efficiency. The paper aims at verifying how and to what extent the implementation of M&E systems has affected the overall quality of international cooperation projects financed by a local government. After a literature review on M&E in development cooperation, the research analyzes the wide range of activities (evaluation ex-ante, mid-term, final, monitoring, consultancy) carried out by the Evaluation Team of the XY in the last eight years in behalf of an Italian local government: the Region of Tuscany. The paper reveals the strategic significance of adopting M&E systems in the medium-long term. PMID:25765621

  4. Alternative energy sources for non-highway transportation: executive summary

    SciTech Connect

    Not Available

    1980-06-01

    A planning study was made for DOE on alternate fuels for non-highway transportation (aircraft, rail, marine, and pipeline). The study provides DOE with a recommendation of what alternate fuels may be of interest to non-highway transportation users from now through 2025 and recommends R and D needed to allow non-petroleum derived fuels to be used in non-highway transportation. In the near term (present-1985), there is unlikely to be any major change in the fuels used in any of the four modes of transportation except that the average quality of the marine fuel is likely to get worse. In the mid-term period (1985-2000), there will be a transition to non-petroleum fuels, based primarily on shale oil derived liquids assuming a shale oil industry is started during this time.

  5. Midterm results of large diameter Biolox forte ceramic head on delta ceramic liner articulation in total hip arthroplasty.

    PubMed

    Kang, Bun-Jung; Ha, Yong-Chan; Hwang, Sun-Chul; Lee, Young-Kyun; Koo, Kyung-Hoi

    2014-12-01

    Seventy-nine patients (94 hips), who underwent cementless alumina-on-alumina total hip arthroplasty (THA) with the use of a 36-mm delta ceramic liner-on-alumina ceramic femoral head, were followed for an average of 6.5years (range, 5-7.7years). All acetabular and femoral components were bone-ingrown and neither pelvic nor femoral osteolysis was identified until the latest follow-up. The survivorship with revision surgery as an endpoint was 97.9% (95% confidence interval=100%-95%). Ceramic related complications such as fracture and squeaking did not occur in any patient. The mid-term results of cementless THA with this type of ceramic articulation are encouraging. PMID:24704123

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

    SciTech Connect

    Meyer, Pimphan A.; 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 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. In addition, filamentous fungi are applied in multi-organism and consolidated process configurations. Organism performance and technology readiness are categorized as near-term (<5 years), mid-term (5-10 years), and long-term (>10 years) process deployment. The results of the analysis suggest that the opportunity for fungal fermentation exists for lignocellulosic ethanol production.

  7. [Tissue engineering and construction of human skin in vitro].

    PubMed

    Arvelo, Francisco

    2007-09-01

    Tissue engineering is the new science that has come to make possible the growth of new organ tissue from small fragments of healthy tissue, thus partially or totally restoring the lost functions of ill tissues or organs, as shown by the achievements made with the culture of skin, cornea or cartilage. Thus far, this new science is able to ensure the recovery of lost functions and, doubtlessly, in a near future will be capable of developing tissues and organs not unlike natural ones. In our laboratory we have began the development of tissue engineering techniques for the successful construction of in vitro skin with the aim at mid term of producing cornea and cartilage. In a first clinical trial, these techniques were applied in the treatment of chronic skin lesions and the advantages and reach of these new tools were demonstrated for the effective solution of problems with would otherwise not be easily solved through the use of conventional treatments. PMID:17853796

  8. High tibial osteotomy in varus knees: indications and limits.

    PubMed

    Loia, Marco Corgiat; Vanni, Stefania; Rosso, Federica; Bonasia, Davide Edoardo; Bruzzone, Matteo; Dettoni, Federico; Rossi, Roberto

    2016-01-01

    Opening wedge high tibial osteotomy (OWHTO) is a surgical procedure that aims to correct the weight-bearing axis of the knee, moving the loads laterally from the medial compartment. Conventional indications for OWHTO are medial compartment osteoarthritis and varus malalignment of the knee; recently OWHTO has been used successfully in the treatment of double and triple varus. OWHTO, in contrast to closing wedge high tibial osteotomy, does not require fibular osteotomy or peroneal nerve dissection, or lead to disruption of the proximal tibiofibular joint and bone stock loss. For these reasons, interest in this procedure has grown in recent years. The aim of this study is to review the literature on OWHTO, considering indications and prognostic factors (body mass index, grade of osteoarthritis, instability, range of movement and age), outcomes at mid-term follow-up, and limits of the procedure (slope modifications, patellar height changes and difficulties in conversion to a total knee arthroplasty). PMID:27602350

  9. The management of bone loss in revision total knee arthroplasty: rebuild, reinforce, and augment.

    PubMed

    Sculco, P K; Abdel, M P; Hanssen, A D; Lewallen, D G

    2016-01-01

    The treatment of bone loss in revision total knee arthroplasty has evolved over the past decade. While the management of small to moderate sized defects has demonstrated good results with a variety of traditional techniques (cement and screws, small metal augments, impaction bone grafting or modular stems), the treatment of severe defects continues to be problematic. The use of a structural allograft has declined in recent years due to an increased failure rate with long-term follow-up and with the introduction of highly porous metal augments that emphasise biological metaphyseal fixation. Recently published mid-term results on the use of tantalum cones in patients with severe bone loss has reaffirmed the success of this treatment strategy. PMID:26733657

  10. STARSEM—A reliable and affordable space transportation system

    NASA Astrophysics Data System (ADS)

    Luciani, Bernard

    2000-03-01

    The launch services industry is facing a tremendous evolution caused by the changes brought to the design of the satellites. The launch industry must cope with the ≪≪ smaller, faster, better ≫> era. This context is the main reason for the creation of the European-Russian joint venture STARSEM promoting the exclusive marketing of the SOYUZ launch services. As a matter of fact, the characteristics of the SOYUZ launch vehicle fit the customers' specific requirements and STARSEM is able to provide all the range of services needed to perform launches complying with requests from satellites operators. For this purpose, STARSEM relies on a completely operational infrastructure in both Samara and Baikonur, from launch vehicles manufacturing up to launch campaigns. This is why leaders in space activities have already chosen STARSEM. Indeed, prospects look promising as short and mid-term challenges are to be taken up by the company.

  11. Supporting analyses and assessments

    SciTech Connect

    Ohi, J.

    1995-09-01

    Supporting analysis and assessments can provide a sound analytic foundation and focus for program planning, evaluation, and coordination, particularly if issues of hydrogen production, distribution, storage, safety, and infrastructure can be analyzed in a comprehensive and systematic manner. The overall purpose of this activity is to coordinate all key analytic tasks-such as technology and market status, opportunities, and trends; environmental costs and benefits; and regulatory constraints and opportunities-within a long-term and systematic analytic foundation for program planning and evaluation. Within this context, the purpose of the project is to help develop and evaluate programmatic pathway options that incorporate near and mid-term strategies to achieve the long-term goals of the Hydrogen Program. In FY 95, NREL will develop a comprehensive effort with industry, state and local agencies, and other federal agencies to identify and evaluate programmatic pathway options to achieve the long-term goals of the Program. Activity to date is reported.

  12. Prosthetic lumbar disc replacement for degenerative disc disease.

    PubMed

    Kulkarni, Arvind G; Diwan, Ashish D

    2005-12-01

    Mechanical articulated device to replace intervertebral disc as a treatment for low back pain secondary to disc degeneration has emerged as a promising tool for selected patients. The potential advantages are prevention of adjacent segment degeneration, maintenance of mobility as well as avoidance of all the complications associated with fusion. The short-term results have been comparable to that of fusion, a few mid-term results have shown mixed outcome, but information on long-term results and performance are not available at present. The rationale for lumbar disc arthroplasty, indications, contraindications, the various artificial devices in the market and the concepts intrinsic to each of them, basic technique of insertion, complications are discussed and a brief summary of our experience with one of the devices is presented. PMID:16565543

  13. Climate indices over the last three decades in Tunisia using Weather Research and Forecasting Model:WRF

    NASA Astrophysics Data System (ADS)

    Deli, Meriem; Mkhinini, Nadia; Sadok Guellouz, Mohamed; Benjabrallah, Sadok

    2016-04-01

    Tunisia is a country situated in the south of the mediterannen basin. This region undergoes direct and indirect effects of climate change. Actually, we notice that summer temperatures have risen during the last decades. Nevertheless research on the tunisian climate are not well developed and are mainly based on observations; short and mid term forecast are not available for the tunisian case. In this context we have studied the climate properties of Tunisia over the last 30 years using Weather Research and Forecasting model WRF. Afterwards we compared our results to the observations that we have obteined on behalf of the National Institute of Meteorology. Results were then used to calculate different climate indices related to the air temperature such as extreme values during a specific period exceeding specific limits (Percentile), warm and cold spell duration and growing season length. We admit that we have created a reliable database for the Tunisian climate.

  14. Treatment of chronic low back pain in patients with spinal deformities using a sagittal re-alignment brace

    PubMed Central

    Weiss, Hans-Rudolf; Werkmann, Mario

    2009-01-01

    Background For adult scoliosis patients with chronic low back pain bracing is initially indicated before spinal surgery is considered. Until recently there has been a lack of research into the effect upon pain reductions in the mid and long-term. Promising results have been documented in short-term studies for the application of a sagittal re-alignment brace in patients with spinal deformities and along with pain; however mid-term and long-term results are not yet available. The purpose of this study is to investigate the mid-term effects of this brace with respect to pain control. Materials and methods 67 patients (58 females and 9 males) with chronic low back pain (> 24 months) and the diagnosis of scoliosis or hyperkyphosis were treated with a sagittal re-alignment brace (physio-logic brace™) between January 2006 and July 2007. The indication for this kind of brace treatment was derived from a positive sagittal re-alignment test (SRT) and the exclusion of successful conservative treatment during the last 24 months. The aim of this type of conservative intervention was to avoid surgery for chronic low back pain. Results The average pain intensity was measured on the Roland and Morris VRS (5 steps) before treatment. This was 3.3 (t1), at the time of brace adjustment it was 2.7 (t2) and after at an average observation time of 18 months it was 2.0 (t3). The differences were highly significant in the Wilcoxon test. Discussion Short-term measurements showed that a significant pain reduction is possible in chronic postural low back pain using a sagittal re-alignment brace inducing lumbar re-lordosation. In a preliminary report at adjustment (t2), highly significant improvements of pain intensity have also been demonstrated. At 6 months of treatment however, no improvement was measured. The improvement of the mid-term effects (18 months) found in this study compared to the preliminary report may be due to the changed approach to compliance: whilst the bracing standard

  15. NextGen Far-Term Concept Exploration for Integrated Gate-to-Gate Trajectory-Based Operations

    NASA Technical Reports Server (NTRS)

    Johnson, Sally C.; Barmore, Bryan E.

    2016-01-01

    NASA is currently conducting concept exploration studies toward the definition of a far-term, gate-to-gate concept for Trajectory-Based Operations. This paper presents a basic architectural framework for the far-term concept and discusses some observations about implementation of trajectory-based operations in the National Airspace System. Within the concept, operators and service providers collaboratively negotiate aircraft trajectories, providing agile, optimized, aircraft-specific routing to meet service provider gate-to-gate flow-management constraints and increasing capacity by smoothly and effectively combining flight-deck-based and ground-based metering, merging, and spacing in a mixed-equipage environment. The far-term TBO concept is intended to influence the direction of mid-term TBO research and to inform the definition of stable requirements and standards for TBO communications infrastructure and user equipage.

  16. Periodicity of the solar radius revisited by using empirical mode decomposition and the Lomb-Scargle method

    NASA Astrophysics Data System (ADS)

    Qu, Zhi-Ning; Feng, Wen; Liang, Hong-Fei

    2015-06-01

    Using the Hilbert-Huang transform and the Lomb-Scargle method, we investigate periodicities in the daily solar radius data during the time interval from February 1978 to October 1999 derived from Calern Observatory. The following prominent periods are found: (1) the rotation cycle signal; (2) several mid-term periods including 122, 162.9 and 225 days, annual-variation periodicities (319 and 359 days), quasi-triennial oscillations (3.46 and 3.94 years); (3) the 11-year Schwabe cycle, which is in anti-phase with solar activity. This result indicates that the strong magnetic field associated with the Sun has a greater inhibitive effect on the radius variation. Supported by the National Natural Science Foundation of China.

  17. Silicon CVD on powders in fluidized bed: Experimental and multifluid Eulerian modelling study

    SciTech Connect

    Cadoret, L.; Reuge, N.; Pannala, S.; Syamlal, M.; Coufort, C.; Caussat, B.

    2007-09-25

    The Computational Fluid Dynamics code MFIX was used for transient simulations of silicon Fluidized Bed Chemical Vapor Deposition (FBCVD) from silane (SiH4) on coarse alumina powders. FBCVD experiments were first performed to obtain a reference database for modelling. Experimental thermal profiles existing along the bed were considered in the model. 3D simulations provide better results than 2D ones and predict silane conversion rate with a mean deviation of 9% compared to experimental values. The model can predict the temporal and spatial evolutions of local void fractions, gas and particle velocities, species gas fractions and silicon deposition rate. We aim at mid term to model FBCVD treatments of submicronic powders in a vibrated reactor since we have performed experiments proving the efficacy of the process to treat submicronic particles.

  18. Atherectomy in complex infrainguinal lesions: a review.

    PubMed

    Engelberger, S; van den Berg, J C

    2015-02-01

    In the femoropopliteal segment, endovascular revascularization techniques have gained the role as a first line treatment strategy. Nitinol stent placement has improved the short- and mid-term primary patency rates in most lesion types and is therefore widely applied. Stenting has several shortcomings as in-stent restenosis, stent fractures and foreign material being left behind in the vessel. The concept of atherectomy is plaque debulking. This results in a potential reduction of inflation pressure requirements in angioplasty. Stent placement and consecutive in-stent restenosis may be avoided. In this non systematic literature review, the performance of different atherectomy techniques, such as direct atherectomy, orbital atherectomy, laser debulking and rotational atherectomy in the treatment of complex femoropopliteal lesions, including long lesions, moderately to heavily calcified lesions as well as occlusions and in-stent restenosis, has been analyzed. PMID:25399550

  19. Combined joint fusion for index and middle carpometacarpal instability in elite boxers.

    PubMed

    Nazarian, N; Page, R S; Hoy, G A; Hayton, M J; Loosemore, M

    2014-03-01

    Isolated instability of the index and middle finger carpometacarpal joints is uncommon. An unpublished injury pattern in a consecutive series of 13 elite boxers is described, with mid-term radiological and functional results of two novel surgical treatments. All the boxers (from Australia and the UK) were unable to compete owing to pain and weakness. Four boxers were managed initially by open reduction and temporary K-wire fixation. Nine boxers underwent primary carpometacarpal arthrodesis. All were able to return to their previous level of competition. One boxer who had undergone a soft tissue reconstruction competed at international level but required an arthrodesis because of recurrent symptoms. In elite boxers, simple reduction and wiring may be appropriate for an acute injury causing index or middle finger carpometacarpal joint instability, however, arthrodesis is the treatment of choice when instability and degenerative changes are present. PMID:23649012

  20. International spotlight: developing a gerontological social policy agenda for Turkey.

    PubMed

    Arun, Özgür

    2013-12-01

    From 1960 to 2013, the population of Turkey increased almost threefold, with older adults aged 65 and older increasing almost sevenfold. In light of the demographic revolution in the age composition of world populations, we investigated the following research questions from the perspective of Turkish gerontologists: What are the conditions of older people based on sociological factors such as gender, partnership status, income, education, health, religion, and ethnicity? What should Turkey's gerontological agenda contain for the short term, mid-term, and long term, particularly in view of the rapidly changing nature of political, social, and economic life in the country? By 2025, adults (aged 40-65) will make up the largest population group in Turkey's history. It is time for Turkey to embrace this demographic gift and identify its own gerontological agenda to pave the way for social justice and social citizenship. PMID:23856026

  1. Recurrent Dislocation of the Patella

    PubMed Central

    Benítez, Gustavo

    2015-01-01

    Purpose: To evaluate results of medial patellofemoral ligament (MPFL) reconstruction associated with lateral release and advancement of vastus medialis in recurrent dislocation of the patella. Methods: We retrospectively evaluated 11 patients with a mean follow-up of 19 months. Mean age was 23, mainly women. We did MPFL reconstruction with semitendinosus or gracilis tendon depending on BMI, associated with advancement of vastus medialis and lateral release. Results: Mean Kujala score improved from 46,54 pts. preoperative to 88,36 postoperative. Our main complication was 1 patient with rigid knee, who required movilization under anesthesia and arthroscopic arthrolisis to improve her outcome. Conclusion: The combination of this techniques are a good alternative to treat patients with recurrent patella disclocation, with good short and mid-term results. Biomechanic intra and postop complications of MPFL reconstruction are related to patellar fixation, anatomic positioning of femoral tunnel and knee position of the graft fixation.

  2. Mycotic aortic arch aneurysm coexistent with constrictive pericarditis: is surgery a dangerous resort?

    PubMed

    Yu, Peter S Y; Yu, Simon C H; Chu, Cheuk-Man; Kwok, Micky W T; Lam, Yuk-Hoi; Underwood, Malcolm J; Wong, Randolph H L

    2016-08-01

    An elderly man presented with fever and evidence of Salmonella infection, and was diagnosed to have coexisting constrictive pericarditis and mycotic aneurysm of the aortic arch. Pericardiectomy was performed under cardiopulmonary bypass with good result. To avoid deep hypothermic circulatory arrest, an aorto-brachiocephalic bypass, instead of total arch replacement, was performed. This was followed by a staged carotid-carotid bypass, thoracic endovascular stent graft placement. He was subsequently treated with prolonged antibiotics, and inflammatory marker normalized afterwards. He was last seen well 2 years after the operation. Follow-up computer tomography (CT) scan at 18 months post-op showed no evidence of endoleak or fistulation. Our case demonstrated that a hybrid treatment of open pericardiectomy and aortic debranching followed by thoracic endovascular stent graft placement is feasible and associated with satisfactory mid-term outcome. PMID:27621905

  3. Mycotic aortic arch aneurysm coexistent with constrictive pericarditis: is surgery a dangerous resort?

    PubMed Central

    Yu, Peter S. Y.; Yu, Simon C. H.; Chu, Cheuk-Man; Kwok, Micky W. T.; Lam, Yuk-Hoi; Underwood, Malcolm J.

    2016-01-01

    An elderly man presented with fever and evidence of Salmonella infection, and was diagnosed to have coexisting constrictive pericarditis and mycotic aneurysm of the aortic arch. Pericardiectomy was performed under cardiopulmonary bypass with good result. To avoid deep hypothermic circulatory arrest, an aorto-brachiocephalic bypass, instead of total arch replacement, was performed. This was followed by a staged carotid-carotid bypass, thoracic endovascular stent graft placement. He was subsequently treated with prolonged antibiotics, and inflammatory marker normalized afterwards. He was last seen well 2 years after the operation. Follow-up computer tomography (CT) scan at 18 months post-op showed no evidence of endoleak or fistulation. Our case demonstrated that a hybrid treatment of open pericardiectomy and aortic debranching followed by thoracic endovascular stent graft placement is feasible and associated with satisfactory mid-term outcome. PMID:27621905

  4. Total hip arthroplasty using S-ROM prosthesis in elder patients with type C and B bone

    PubMed Central

    Zhao, Zhong-Shou; Sun, Jun-Ying

    2013-01-01

    Objective The purpose of this study was to evaluate the clinical and radiological results using S-ROM prosthesis in patients with type C and B femoral bone requiring primary total hip arthroplasty (THA) for multiple reasons. Methods Sixteen hips were followed up for a mean of 38 months (range, 26–48), with a mean age at surgery of 72 years (range, 65–75). Results The average Harris hip score improved from 52.2 points to 88.5 points. All femoral stems showed stable fixation. Neither osteolysis around the femoral stem nor subsidence of the femoral stem were found at the final follow-up. Conclusion For the patients with poor bone quality, total hip arthroplasty with the use of the proximal modular femoral stem yielded good short-to-mid-term results with respect to the clinical and radiological criteria. PMID:24403752

  5. Reappraisal of intergender differences in the urethral striated sphincter explains why a completely circular arrangement is difficult in females: a histological study using human fetuses

    PubMed Central

    Takenaka, Atsushi; Rodríguez-Vázquez, Jose Francisco; Murakami, Gen; Matsubara, Akio

    2012-01-01

    To investigate why the development of a completely circular striated sphincter is so rare, we examined histological sections of 11 female and 11 male mid-term human fetuses. In male fetuses, the striated muscle initially extended in the frontal, rather than in the horizontal plane. However, a knee-like portion was absent in the female fetal urethra because, on the inferior side of the vaginal end, a wide groove for the future vestibule opened inferiorly. Accordingly, it was difficult for the developing striated muscle to surround the groove, even though there was not a great difference in width or thickness between the female vestibule and the male urethra. The development of a completely circular striated sphincter seems to be impossible in females because of interruption of the frontal plane by the groove-like vestibule. However, we cannot rule out the possibility that before descent of the vagina, the urethral striated muscle extends posteriorly. PMID:22822461

  6. [Femicide Across Europe COST Action, a transnational cooperation network for the study of and approach to femicide in Europe].

    PubMed

    Sanz-Barbero, Belén; Otero-García, Laura; Boira, Santiago; Marcuello, Chaime; Vives Cases, Carmen

    2016-01-01

    Femicide or the murder of women because of their gender is a recognised public health problem as well as a serious violation of human rights. Its magnitude worldwide is still unknown, given the methodological difficulties to differentiate these murders from other female homicides. The European Union programme entitled «European Cooperation in Science and Technology» (COST) launched the «Femicide across Europe» COST Action in 2013, establishing an optimal European framework for transnational cooperation among experts addressing great social and public health challenges such as femicide. This field note describes the main objectives, the participating groups of experts and the mid-term results of this experience. PMID:27321371

  7. The Use of the 'Preclosure' Technique for Antegrade Aspiration Thrombectomy with Large Catheters in Acute Limb Ischemia

    SciTech Connect

    Funke, C. Pfiffner, R.; Husmann, M.; Pfammatter, T.

    2013-04-15

    This study was designed to assess retrospectively short- and mid-term outcomes of the use of a suture-mediated closure device to close the antegrade access in patients undergoing percutaneous aspiration thrombectomy with large catheters for acute leg ischemia. Between November 2005 and February 2010, a suture-mediated active closure system (ProGlide{sup Registered-Sign} 6F, Abbott) was placed before arterial sheath (mean 9 F, range 6-12 F) introduction in 101 patients (74 men, 73 %, mean age 70.1 {+-} 12.6 years standard deviation). Data regarding mortality, complications, and factors contributing to vascular complications at the access site was collected for 6 month after the intervention to detect device-related problems. As a coincidence, 77 patients had follow-up visits for a duplex ultrasound. There were a total of 19 vascular complications (19 %) at the puncture site, all of which were of hemorrhagic nature and none of which consisted of vessel occlusion. Two major outcome complications (2 %) occurred. A retroperitoneal hematoma and a serious inguinal bleeding required additive treatment and did not result in permanent sequelae. Nine cases involved death of which eight were not attributable to the closure and one remained unclear. Successful closure was achieved in 95 patients (94 %); additional manual compression was sufficient in the majority of the remaining patients. Numerous factors contributing to vascular complications were encountered. With acceptable short- and mid-term outcomes, the 'preclose' technique can be a reliable option for the closure of a large antegrade femoral access even for patients at a high risk of vascular complications, such as those undergoing aspiration thrombectomy.

  8. Dumb and Lazy? A Comparison of Color Learning and Memory Retrieval in Drones and Workers of the Buff-Tailed Bumblebee, Bombus terrestris, by Means of PER Conditioning

    PubMed Central

    Lichtenstein, Leonie; Sommerlandt, Frank M. J.; Spaethe, Johannes

    2015-01-01

    More than 100 years ago, Karl von Frisch showed that honeybee workers learn and discriminate colors. Since then, many studies confirmed the color learning capabilities of females from various hymenopteran species. Yet, little is known about visual learning and memory in males despite the fact that in most bee species males must take care of their own needs and must find rewarding flowers to obtain food. Here we used the proboscis extension response (PER) paradigm to study the color learning capacities of workers and drones of the bumblebee, Bombus terrestris. Light stimuli were paired with sucrose reward delivered to the insects’ antennae and inducing a reflexive extension of the proboscis. We evaluated color learning (i.e. conditioned PER to color stimuli) in absolute and differential conditioning protocols and mid-term memory retention was measured two hours after conditioning. Different monochromatic light stimuli in combination with neutral density filters were used to ensure that the bumblebees could only use chromatic and not achromatic (e.g. brightness) information. Furthermore, we tested if bees were able to transfer the learned information from the PER conditioning to a novel discrimination task in a Y-maze. Both workers and drones were capable of learning and discriminating between monochromatic light stimuli and retrieved the learned stimulus after two hours. Drones performed as well as workers during conditioning and in the memory test, but failed in the transfer test in contrast to workers. Our data clearly show that bumblebees can learn to associate a color stimulus with a sugar reward in PER conditioning and that both workers and drones reach similar acquisition and mid-term retention performances. Additionally, we provide evidence that only workers transfer the learned information from a Pavlovian to an operant situation. PMID:26230643

  9. Single-Bundle Anterior Cruciate Ligament Reconstruction with Semitendinosus Tendon Using the PINN-ACL CrossPin System: Minimum 4-Year Follow-up

    PubMed Central

    Baek, Seung-Gil; Lee, Byoung-Joo; Lee, Chang-Hwa

    2015-01-01

    Purpose This study evaluated mid-term results of anterior cruciate ligament (ACL) reconstruction using the PINN-ACL CrossPin system that allowed for short graft fixation. Materials and Methods Forty-three patients underwent single-bundle ACL reconstruction with a 4-strand semitendinosus tendon graft using the PINN-ACL CrossPin system. Femoral fixation was done using the PINN-ACL CrossPin system, and the tibial side was fixed with post-tie and a bioabsorbable interference screw. The mean follow-up period was 50 months. Evaluation was done using the Lachman test, pivot-shift test, International Knee Documentation Committee (IKDC) score and grade. Anterior displacement was assessed. Results There was improvement in the Lachman test and pivot-shift test at final follow-up, form grade II (n=40) or III (n=3) to grade I (n=3) or 0 (n=40) and from grade I (n=20) or II (n=10) to grade I (n=8) or 0 (n=22), respectively. The mean IKDC score was 88.7, and grade A and B were 93.0% at final follow-up. Side-to-side difference was improved from 6.7 mm to 2.1 mm at final follow-up. Complications occurred in 3 patients, a re-ruptured due to trauma at 2 years after surgery and a deep infection and a superficial infection. Conclusions The mid-term follow-up results of ACL reconstruction with the PINN-ACL CrossPin system were satisfactory. The PINN-ACL CrossPin can be considered as a useful instrument for short graft fixation. PMID:25750893

  10. Separation of Changes in Hydroclimatic and Basin Controls on Late-Summer Low Flow in British Columbia, Canada

    NASA Astrophysics Data System (ADS)

    Stahl, K.; Moore, R. D.; Allen, D. M.; Whitfield, P. H.

    2009-12-01

    For catchments in the Pacific Northwest of North America with minimal or no glacier cover, the summer period is typically dominated by low flows associated with the relatively warm, dry summers in that region. In recent years summer low flow has become more critical in terms of water use and fisheries, and there is increasing concern regarding effects of future climate change. In particular, it is expected that earlier snowmelt timing in spring causes longer recession periods and consequently lower streamflow during late summer. This study examined the sensitivity of late summer flows of 153 ‘unregulated’ rivers over the period 1976-2003 to hydroclimatic influences using trend tests accounting for exogenous variables by regression. Regression models were fitted using simultaneous and lagged variables of precipitation and timing and magnitude of snowmelt. The residuals were tested for trends and serial correlation to assess potential secondary influences such as long-term groundwater storage changes or mid-term changes in evapotranspiration. The decrease in September flows found across most of the region is broadly consistent with a decline in September precipitation. The most important control on August flows for all streamflow regimes is August precipitation. The influence of lagged variables including snowmelt timing varies. Rain-dominated and hybrid catchments along the coast tended to have positive trends in their residuals in August, suggesting an increasing trend in groundwater storage. Snowmelt dominated catchments show varied trends but the runs test detected a substantial number of stations with non-random residuals, suggesting mid-term secondary influences possibly associated with evapotranspiration changes due to progressive forest harvesting. This regional study greatly improves the understanding of the hydroclimatic influences on extreme summer low flow in the region. Results suggest that (the less predictable) summer climate is a larger influence

  11. Effect of collaborative testing on learning and retention of course content in nursing students

    PubMed Central

    RIVAZ, MOZHGAN; MOMENNASAB, MARZIEH; SHOKROLLAHI, PAYMANEH

    2015-01-01

    Introduction Collaborative testing is a learning strategy that provides students with the opportunity to learn and practice collaboration. This study aimed to determine the effect of collaborative testing on test performance and retention of course content in nursing students of Shiraz University of Medical Sciences, Shiraz, Iran. Methods This quasi-experimental study was carried out on 84 students enrolled in the course of Medical-Surgical 2 in Spring 2013 and Fall 2013 semesters. The control group consisting of 39 students participated in the first mid-term exam in an individual format. The intervention group, on the other hand, consisted of 45 students who took the test in a two-stage process. The first stage included an individual testing, while the second stage was a collaborative one given in groups of five individuals chosen randomly. Four weeks later, in order to investigate retention of the course content, both groups took part in the second mid-term exam held individually. Results The study findings showed significant difference between the mean scores in the intervention group in the Fall 2013 semester (p=0.001). Besides, a statistically significant difference was found between the two groups regarding the tests mean scores (p=0.001). Moreover, retention of course content improved in the collaborative group (p=0.001). Conclusion The results indicated an increase in test performance and a long-term learning enhancement in collaborative testing compared with the traditional method. Collaborative testing, as an active learning technique and a valuable assessment method, can help nursing instructors provide the alumni with strong problem-solving and critical thinking abilities at healthcare environments. PMID:26457315

  12. Vascular Plug Assisted Retrograde Transvenous Obliteration (PARTO) for Gastric Varix Bleeding Patients in the Emergent Clinical Setting

    PubMed Central

    Yang, Heechul; Lee, Chun Kyon; Kim, Gun Bea

    2016-01-01

    Purpose To evaluate the technical feasibility and safety of vascular plug assisted retrograde transvenous obliteration (PARTO) for bleeding gastric varix performed in the emergent clinical setting and describe the mid-term clinical results. Materials and Methods From April 2012 to January 2015, emergent PARTO was tried in total 9 patients presented with active gastric varix bleeding. After initial insufficient or failure of endoscopic approach, they underwent PARTO in the emergent clinical setting. Gelatin sponge embolization of both gastrorenal (GR) shunt and gastric varix was performed after retrograde transvenous placement of a vascular plug in GR shunt. Coil assisted RTO (CARTO) was performed in one patient who had challenging GR shunt anatomy for vascular plug placement. Additional embolic materials, such as microcoils and NBCA glue-lipiodol mixture, were required in three patients to enhance complete occlusion of GR shunt or obliteration of competitive collateral vessels. Clinical success was defined as no variceal rebleeding and disappearance of gastric varix. Results All technical and clinical success–i.e., complete GR shunt occlusion and offending gastric varix embolization with immediate bleeding control–was achieved in all 9 patients. There was no procedure-related complication. All cases showed successful clinical outcome during mean follow up of 17 months (12–32 months), evidenced by imaging studies, endoscopy and clinical data. In 4 patients, mild worsening of esophageal varices or transient ascites was noted as portal hypertensive related change. Conclusion Emergent PARTO is technically feasible and safe, with acceptable mid-term clinical results, in treating active gastric varix bleeding. PMID:27189294

  13. Dumb and Lazy? A Comparison of Color Learning and Memory Retrieval in Drones and Workers of the Buff-Tailed Bumblebee, Bombus terrestris, by Means of PER Conditioning.

    PubMed

    Lichtenstein, Leonie; Sommerlandt, Frank M J; Spaethe, Johannes

    2015-01-01

    More than 100 years ago, Karl von Frisch showed that honeybee workers learn and discriminate colors. Since then, many studies confirmed the color learning capabilities of females from various hymenopteran species. Yet, little is known about visual learning and memory in males despite the fact that in most bee species males must take care of their own needs and must find rewarding flowers to obtain food. Here we used the proboscis extension response (PER) paradigm to study the color learning capacities of workers and drones of the bumblebee, Bombus terrestris. Light stimuli were paired with sucrose reward delivered to the insects' antennae and inducing a reflexive extension of the proboscis. We evaluated color learning (i.e. conditioned PER to color stimuli) in absolute and differential conditioning protocols and mid-term memory retention was measured two hours after conditioning. Different monochromatic light stimuli in combination with neutral density filters were used to ensure that the bumblebees could only use chromatic and not achromatic (e.g. brightness) information. Furthermore, we tested if bees were able to transfer the learned information from the PER conditioning to a novel discrimination task in a Y-maze. Both workers and drones were capable of learning and discriminating between monochromatic light stimuli and retrieved the learned stimulus after two hours. Drones performed as well as workers during conditioning and in the memory test, but failed in the transfer test in contrast to workers. Our data clearly show that bumblebees can learn to associate a color stimulus with a sugar reward in PER conditioning and that both workers and drones reach similar acquisition and mid-term retention performances. Additionally, we provide evidence that only workers transfer the learned information from a Pavlovian to an operant situation. PMID:26230643

  14. Outcomes of Thoracic Endovascular Aortic Repair and Subclavian Revascularization Techniques

    PubMed Central

    Zamor, Kimberly C; Eskandari, Mark K; Rodriguez, Heron E; Ho, Karen J; Morasch, Mark D; Hoel, Andrew W

    2015-01-01

    Background Practice guidelines regarding management of the left subclavian artery (LSA) during thoracic endovascular aortic repair (TEVAR) are based on low quality evidence and there is limited literature that addresses optimal revascularization techniques. The purpose of this study is to compare outcomes of LSA coverage during TEVAR and revascularization techniques. Study Design We performed a single-center retrospective cohort study from 2001–2013. Patients were categorized by LSA revascularization and by revascularization technique, carotid-subclavian bypass (CSB) or subclavian-carotid transposition (SCT). Thirty-day and mid-term stroke, spinal cord ischemia, vocal cord paralysis, upper extremity ischemia, primary patency of revascularization, and mortality were compared. Results Eighty patients underwent TEVAR with LSA coverage, 25% (n=20) were unrevascularized and the remaining patients underwent CSB (n=22, 27.5%) or SCT (n=38, 47.5%). Mean follow-up time was 24.9 months. Comparisons between unrevascularized and revascularized patients were significant for a higher rate of 30-day stroke (25% vs. 2%, p=0.003) and upper extremity ischemia (15% vs. 0%, p=0.014). However, there was no difference in 30-day or mid-term rates of spinal cord ischemia, vocal cord paralysis, or mortality. There were no statistically significant differences in 30-day or midterm outcomes for CSB vs. SCT. Primary patency of revascularizations was 100%. Survival analysis comparing unrevascularized vs. revascularized LSA, was statistically significant for freedom from stroke and upper extremity ischemia, p=0.02 and p=0.003, respectively. After adjustment for advanced age, urgency and coronary artery disease, LSA revascularization was associated with lower rates of peri-operative adverse events (OR 0.23, p=0.034). Conclusions During TEVAR, LSA coverage without revascularization is associated with an increased risk of stroke and upper extremity ischemia. When LSA coverage is required during

  15. Bone texture analysis on direct digital radiographic images: precision study and relationship with bone mineral density at the os calcis.

    PubMed

    Lespessailles, E; Gadois, C; Lemineur, G; Do-Huu, J P; Benhamou, L

    2007-02-01

    Assessment of bone microarchitecture in complement to bone mineral density (BMD) exam could improve prediction of osteoporotic fractures. A high-resolution X-ray prototype was developed to assess microarchitecture quality. Images were obtained on os calcis; then, three texture parameters were calculated on the same region of interest (ROI): a fractal parameter, a run-length parameter, and a co-occurrence parameter. This work describes the reproducibility of this method. We also examine the relationship between texture parameters and BMD at a site-matched ROI. Measurements on the left heel were performed on 30 healthy women, on the same day, with repositioning for short-term precision error. An additional measurement was done at 1 week to evaluate mid-term precision error on 14 subjects. Os calcis images from 10 healthy women were used to evaluate both intra- and interobserver reproducibility. Thirty other healthy patients were measured successively on two similar devices for interprototype comparison. BMD and texture analyses of the left heel were obtained from 57 women. Short-term precision errors ranged 1.16-1.24% according to the texture parameter. Mid-term precision error was slightly higher than short-term precision for the mean Hurst exponent parameter. Comparisons of texture parameters and BMD at a site-matched ROI on the os calcis showed no significant relationships. The results also show that the use of this high-resolution digital X-ray device improves the reproducibility of parameter measurement compared to the indirect digitization of radiologic films previously used. PMID:17308991

  16. Effect of traditional Chinese exercise on the quality of life and depression for chronic diseases: a meta-analysis of randomised trials

    PubMed Central

    Wang, Xueqiang; Pi, Yanling; Chen, Binglin; Chen, Peijie; Liu, Yu; Wang, Ru; Li, Xin; Zhu, Yi; Yang, Yujie; Niu, Zhanbin

    2015-01-01

    Traditional Chinese exercise (TCE) has many uses in the prevention and treatment of chronic diseases. However, there is no consensus regarding the benefit of TCE for chronic diseases. Our objective is to examine the effect of TCE on the quality of life and depression for chronic diseases by performing a meta-analysis of randomized controlled trials (RCTs). We only cover published RCTs. The outcome measures included quality of life and depression. Sixty articles with a total of 4311 patients were included. The pooling revealed that TCE could improve the SF-36 physical function subscale in the short term [SMD (95% CI) = 0.35 (0.13, 0.56), P = 0.002] and mid-term [SMD (95% CI) = 0.49 (0.12, 0.85), P = 0.009], GHQ [SMD (95% CI) = −0.68 (−1.26, −0.09), P = 0.02], the Center for Epidemiologic Studies depression scale in the short term [SMD (95% CI) = −0.86 (−1.42, −0.31), P = 0.002] and mid-term [SMD (95% CI) = −0.41 (−0.64, −0.18), P < 0.001]. The meta-analysis of RCT demonstrates that TCE can significantly improve the quality of life and depression of patients with chronic diseases. These findings provide useful information for patients with chronic diseases as well as for medical staff. PMID:26525282

  17. Experiences with the Plasmacup--early stability, wear, remodelling, and outcome.

    PubMed

    Wilkinson, J Mark; Gordon, Andrew; Stockley, Ian

    2003-01-01

    Whilst advances in cementing technique have led to improvement in the survival of cemented femoral stems in total hip arthroplasty (THA), cup failure due to aseptic loosening remains a major clinical problem. These observations have led to a move away from cemented cup designs, particularly in young patients, towards uncemented implants. The Plasmacup is a hemispherical, press-fit, cementless, titanium-shelled, acetabular component with a polyethylene liner. In this article we review our experience of its pattern of early migration, wear, bone remodelling, and mid-term survival. In 18 cups followed for 2 years in subjects with a mean age at operation of 58 years, the mean total vectorial cup migration was 0.75 mm, and cup orientation remained stable (EBRA method). The mean polyethylene linear wear rate over this period was 0.21 mm/year. In 27 cups followed for 6 months using dual-energy X-ray absorptiometry (DXA), average bone loss was -5%, and the pelvic bone-remodelling pattern was consistent with the rim-loading principle of the cup design. In a clinical review of the outcome of 128 cups in 104 patients with a mean age at operation of 51 years and follow-up of 59 months, we found that 82% of patients had a good or very good Merle D'Aubigne score, and cup survival rate was 98% (Kaplan-Meier). Four cups had small radiographic areas of focal osteolysis and three had been revised (two for recurrent dislocation and one for deep sepsis; none were revised for aseptic loosening). The mean linear wear rate in this series was 0.14 mm/year. In conclusion, the Plasmacup shows satisfactory early stability, a wear rate similar to other uncemented cups, and favourable mid-term clinical function and survival rates. PMID:14565679

  18. Single-visit endovenous laser treatment and tributary procedures for symptomatic great saphenous varicose veins

    PubMed Central

    Rahi, MA

    2014-01-01

    Introduction Endovenous ablation of saphenous varicose veins has decreased morbidity and recovery time compared with open surgery. This study assessed the outcome and mid-term patient satisfaction of single-visit endovenous laser treatment (EVLT) alone, EVLT combined with phlebectomies and endovenous chemical ablation. Methods A retrospective review was conducted of all patients (n=91) in 2008–2009 who underwent single-visit day-case EVLT using local anaesthesia under a single surgeon. Postoperative venous ultrasonography at 2 and 14 months was reviewed. A telephone questionnaire was carried out to assess recurrence of symptoms and quality of life at 42 months. Results Overall, 124 limbs underwent day-case EVLT under local anaesthesia using an 810nm diode laser at a continuous setting of 14W. Forty-eight of these underwent EVLT alone while fifty underwent EVLT with phlebectomies and twenty-six underwent EVLT with endovenous chemical ablation. Ninety-one per cent of limbs underwent two-month postoperative imaging. All had satisfactory great saphenous vein (GSV) ablation (anterior thigh vein patency: n=1). The majority (84%) of limbs underwent 14-month imaging with a 98% GSV ablation rate. Three per cent had anterior thigh vein and saphenofemoral junction incompetence. Recurrence of GSV patency and reflux was <1%. The response rate to the questionnaire was 60%: 95% of respondents confirmed improvement following treatment, 62% remained symptom free at 42 months while 65% of patients with a return of symptoms deemed them mild. The questionnaire was scored out of 56 for symptoms and quality of life. Those with symptoms scored significantly higher. Conclusions At 42 months, the majority of limbs remained asymptomatic. The short-term GSV ablation rates were excellent. Overall mid-term review of patients has shown a well received single-visit service with concomitant phlebectomy or endovenous ablation, and good ablation and patient satisfaction rates. PMID:24780019

  19. Using Ensemble Streamflows for Power Marketing at Bonneville Power Administration

    NASA Astrophysics Data System (ADS)

    Barton, S. B.; Koski, P.

    2014-12-01

    Bonneville Power Administration (BPA) is a federal non-profit agency within the Pacific Northwest responsible for marketing the power generated from 31 federal hydro projects throughout the Columbia River Basin. The basin encompasses parts of five states and portions of British Columbia, Canada. BPA works with provincial entities, federal and state agencies, and tribal members to manage the water resources for a variety of purposes including flood risk management, power generation, fisheries, irrigation, recreation, and navigation. This basin is subject to significant hydrologic variability in terms of seasonal volume and runoff shape from year to year which presents new water management challenges each year. The power generation planning group at BPA includes a team of meteorologists and hydrologists responsible for preparing both short-term (up to three weeks) and mid-term (up to 18 months) weather and streamflow forecasts including ensemble streamflow data. Analysts within the mid-term planning group are responsible for running several different hydrologic models used for planning studies. These models rely on these streamflow ensembles as a primary input. The planning studies are run bi-weekly to help determine the amount of energy available, or energy inventory, for forward marketing (selling or purchasing energy up to a year in advance). These studies are run with the objective of meeting the numerous multi-purpose objectives of the basin under the various streamflow conditions within the ensemble set. In addition to ensemble streamflows, an ensemble of seasonal volume forecasts is also provided for the various water conditions in order to set numerous constraints on the system. After meeting all the various requirements of the system, a probabilistic energy inventory is calculated and used for marketing purposes.

  20. Surgical dislocation of the hip for the fixation of acetabular fractures.

    PubMed

    Tannast, M; Krüger, A; Mack, P W; Powell, J N; Hosalkar, H S; Siebenrock, K A

    2010-06-01

    Surgical dislocation of the hip in the treatment of acetabular fractures allows the femoral head to be safely displaced from the acetabulum. This permits full intra-articular acetabular and femoral inspection for the evaluation and potential treatment of cartilage lesions of the labrum and femoral head, reduction of the fracture under direct vision and avoidance of intra-articular penetration with hardware. We report 60 patients with selected types of acetabular fracture who were treated using this approach. Six were lost to follow-up and the remaining 54 were available for clinical and radiological review at a mean follow-up of 4.4 years (2 to 9). Substantial damage to the intra-articular cartilage was found in the anteromedial portion of the femoral head and the posterosuperior aspect of the acetabulum. Labral lesions were predominantly seen in the posterior acetabular area. Anatomical reduction was achieved in 50 hips (93%) which was considerably higher than that seen in previous reports. There were no cases of avascular necrosis. Four patients subsequently required total hip replacement. Good or excellent results were achieved in 44 hips (81.5%). The cumulative eight-year survivorship was 89.0% (95% confidence interval 84.5 to 94.1). Significant predictors of poor outcome were involvement of the acetabular dome and lesions of the femoral cartilage greater than grade 2. The functional mid-term results were better than those of previous reports. Surgical dislocation of the hip allows accurate reduction and a predictable mid-term outcome in the management of these difficult injuries without the risk of the development of avascular necrosis. PMID:20513883

  1. Three-Year Follow-up of Conservative Treatments of Shoulder Osteoarthritis in Older Patients.

    PubMed

    Guo, Jiong Jiong; Wu, Kailun; Guan, Huaqing; Zhang, Lei; Ji, Cheng; Yang, Huilin; Tang, Tiansi

    2016-07-01

    Little is known about the mid-term results of nonsurgical treatment for shoulder osteoarthritis (OA), especially in a Chinese population. This study sought to determine the efficacy of nonsurgical management in older patients with shoulder OA. A total of 129 conservatively treated unilateral shoulder OA patients who were older than 65 years were evaluated prospectively at the initial office visit and then subsequently at 3, 6, 12, 18, 24, and 36 months later. During the 36-month follow-up period, all patients could receive conventional therapy, such as nonsteroidal anti-inflammatory medication, corticosteroid injection, sodium hyaluronate, and education, at the discretion of treating physicians. Some patients received physiotherapy, rehabilitation training, and a shoulder strap to improve the range of motion and muscular strength training from a physical therapist. Parameters measured included comparative effectiveness of each therapeutic method, visual analog scale (VAS), Simple Shoulder Test (SST), and Short Form (36) Health Survey (SF-36) scores. At 3-year follow-up, most patients had a significant increase from their pretreatment values in pain, self-assessed shoulder function, mental health, and 5 of 8 SF-36 domains. The study showed a decline in SST and VAS at 6 and 12 months after an initial ascent at 3 months, and then it was rescued and continued at 3-year follow-up. Combined therapy could improve symptoms significantly. This study suggests that a conservative approach may be more appropriate and can produce satisfactory mid-term outcomes in selected cases. The findings of this study suggest that conservative treatments should be extended for longer than 12 months before the decision regarding shoulder arthroplasty is made. [Orthopedics. 2016; 39(4):e634-e641.]. PMID:27286050

  2. Neurosciences research in space Future directions

    NASA Astrophysics Data System (ADS)

    Sulzman, Frank M.; Wolfe, James W.

    Future research in the neurosciences can best be understood in the context of NASA's life sciences goals in the near term (1990-1995), mid term (1995-2000), and long term (2000 and beyond). Since NASA is planning short-duration Spacelab and International Microgravity Laboratory (IML) flights for many years to come, the acute effects of exposure to microgravity will continue to be of experimental and operational interest in the near term. To this end, major new areas of research will be devoted to ground-based studies of preflight adaptation trainers and their efficacy in preventing or reducing the incidence of space motion sickness. In addition, an extensive series of studies of the vestibular system will be conducted inflight on the IML-1 mission The IML-2 mission will emphasize behavior and performance, biological rhythms, and further vestibular studies. In the mid-term period, Spacelab missions will employ new technology such as magnetic recording techniques in order to evaluate changes in the processing of sensory and motor inputs at the brainstem and cortical level during exposure to microgravity. Two Space Life Sciences (SLS) missions planned for the mid to late 1990's, SLS-4 and SLS-5, will utilize an onboard centrifuge facility that will enable investigators to study the effects of partial gravity on sensory and motor function. In the long term (2000 and beyond), Space Station Freedom and long-duration missions will provide opportunities to explore new options in the neurosciences, such as sensory substitution and augmentation, through the use of physical sensors to provide three-dimensional tactile-visual, tactile-auditory and tactile-somatosensory inputs. The use of this technology will be extremely important in the area of robotic telepresence. Finally, Space Station Freedom and proposed LifeSat missions will provide neuroscientists the opportunity to study the effects of partial gravity and microgravity on neuronal plasticity.

  3. Prognostic value of the ratio between prosthesis area and indexed annulus area measured by MultiSlice-CT for transcatheter aortic valve implantation procedures

    PubMed Central

    Debry, Nicolas; Sudre, Arnaud; Elquodeimat, Ibrahim; Delhaye, Cédric; Schurtz, Guillaume; Bical, Antoine; Koussa, Mohamad; Fattouch, Khalil; Modine, Thomas

    2016-01-01

    Background Postprocedural aortic regurgitations following transcatheter aortic valve implantation (TAVI) procedures remain an issue. Benefit of oversizing strategies to prevent them isn't well established. We compared different level of oversizing in our cohort of consecutive patients to address if severe oversizing compared to normal sizing had an impact on post-procedural outcomes. Methods From January 2010 to August 2013, consecutive patients were referred for TAVI with preoperative Multislice-CT (MSCT) and the procedures were achieved using Edwards Sapien® or Corevalve devices®. Retrospectively, according to pre-procedural MSCT and the valve size, patients were classified into three groups: normal, moderate and severe oversizing; depending on the ratio between the prosthesis area and the annulus area indexed and measured on MSCT. Main endpoint was mid-term mortality and secondary endpoints were the Valve Academic Research Consortium (VARC-2) endpoints. Results Two hundred and sixty eight patients had a MSCT and underwent TAVI procedure, with mainly Corevalve®. While all-cause and cardiovascular mortality rates were similar in all groups, post-procedural new pacemaker (PM) implantation rate was significantly higher in the severe oversizing group (P = 0.03), while we observed more in-hospital congestive heart-failure (P = 0.02) in the normal sizing group. There was a trend toward more moderate to severe aortic regurgitation (AR) in the normal sizing group (P = 0.07). Conclusions Despite a higher rate of PM implantation, oversizing based on this ratio reduces aortic leak with lower rates of post-procedural complications and a similar mid-term survival. PMID:27582762

  4. Decompression without Fusion for Low-Grade Degenerative Spondylolisthesis

    PubMed Central

    Cheung, Jason Pui Yin; Cheung, Prudence Wing Hang; Cheung, Kenneth Man Chee

    2016-01-01

    Study Design Retrospective series. Purpose Assess results of decompression-only surgery for low-grade degenerative spondylolisthesis with consideration of instability. Overview of Literature There is no consensus on whether fusion or decompression-only surgery leads to better outcomes for patients with low-grade degenerative spondylolisthesis. Current trends support fusion but many studies are flawed due to over-generalization without consideration of radiological instability and their variable presentations and natural history. Methods Patients with surgically treated degenerative spondylolisthesis from 1990–2013 were included. Clinical and radiological instability measures were included. Any residual or recurrence of symptoms, revision surgery performed and functional outcome scores including the numerical global rate of change scale, visual analogue scale, and modified Barthel index were measured. Follow-up periods for patients were divided into short-term (<5 years), mid-term (5–10 years) and long-term (>10 years). Results A total of 64 patients were recruited. Mechanical low back pain was noted in 48 patients and most (85.4%) had relief of back pain postoperatively. Radiological instability was noted in 4 subjects by flexion-extension radiographs and 12 subjects with prone traction radiographs by increased disc height and reduction of olisthesis and slip angle. From the results of the short-term, mid-term and long-term follow-up, reoperation only occurred within the first 5-year follow-up period. All functional scores improved from preoperative to postoperative 1-year follow-up. Conclusions Decompression-only for low-grade degenerative spondylolisthesis has good long-term results despite instability. Further higher-level studies should be performed on this patient group with radiological instability to suggest the superior surgical option. PMID:26949462

  5. A coordinated approach for real-time short term hydro scheduling

    SciTech Connect

    Tufegdzic, N.; Frowd, R.J.; Stadlin, W.O.

    1996-11-01

    The paper describes a coordinated approach to short-term hydro scheduling and dispatch that has been developed as a part of the Tasmanian Hydro Electric Commission`s (HEC) new Energy Management System (EMS), which is being delivered by Landis and Gyr Energy Management. Tasmania`s hydro generation system consists of 40 reservoirs in six river catchments. The daily water release for each plant is scheduled using the HEC`s mid-term operation policy. The Hydro Scheduling and Commitment (HSC) function schedules the hydro units on a half hourly basis so that the allocated water release maximizes the energy production. This maximization of energy production is achieved by maximizing the head and this ensures that operation is always as close as possible to maximum efficiency. Mixed Integer Linear Programming is used with a detailed model of the interconnected hydro system to determine the half-hourly operation schedule. The Hydro Economic Dispatch (HED) function is used to implement the schedules produced by HSC in the real-time operation. The HED also uses a detailed model of the hydro system with a Linear Programming algorithm to ensure that each unit operates as close as possible to its head-dependent theoretical maximum efficiency point while meeting the desired storage levels specified by the HSC solution. HSC and HED have been tested against a number of operational scenarios and when it is fully integrated within the new EMS it is expected to yield annual stored energy savings up to 0.5% through more efficient hydro-electric system operation. It is expected to also provide additional savings by fostering improvements to the mid-term operating plan.

  6. Long-term olfactory memories are stabilised via protein synthesis in Camponotus fellah ants.

    PubMed

    Guerrieri, Fernando J; d'Ettorre, Patrizia; Devaud, Jean-Marc; Giurfa, Martin

    2011-10-01

    Ants exhibit impressive olfactory learning abilities. Operant protocols in which ants freely choose between rewarded and non-rewarded odours have been used to characterise associative olfactory learning and memory. Yet, this approach precludes the use of invasive methods allowing the dissection of molecular bases of learning and memory. An open question is whether the memories formed upon olfactory learning that are retrievable several days after training are indeed based on de novo protein synthesis. Here, we addressed this question in the ant Camponotus fellah using a conditioning protocol in which individually harnessed ants learn an association between odour and reward. When the antennae of an ant are stimulated with sucrose solution, the insect extends its maxilla-labium to absorb the solution (maxilla-labium extension response). We differentially conditioned ants to discriminate between two long-chain hydrocarbons, one paired with sucrose and the other with quinine solution. Differential conditioning leads to the formation of a long-term memory retrievable at least 72 h after training. Long-term memory consolidation was impaired by the ingestion of cycloheximide, a protein synthesis blocker, prior to conditioning. Cycloheximide did not impair acquisition of either short-term memory (10 min) or early and late mid-term memories (1 or 12 h). These results show that, upon olfactory learning, ants form different memories with variable molecular bases. While short- and mid-term memories do not require protein synthesis, long-term memories are stabilised via protein synthesis. Our behavioural protocol opens interesting research avenues to explore the cellular and molecular bases of olfactory learning and memory in ants. PMID:21900478

  7. Faecal retention: a common cause in functional bowel disorders, appendicitis and haemorrhoids--with medical and surgical therapy.

    PubMed

    Raahave, Dennis

    2015-03-01

    The present studies explored whether faecal retention in the colon is a causative factor in functional bowel disease, appendicitis, and haemorrhoids. Faecal retention was characterized by colon transit time (CTT) after radio-opaque marker ingestion and estimation of faecal loading on abdominal radiographs at 48 h and 96 h. Specific hypotheses were tested in patients (n = 251 plus 281) and in healthy random controls (n = 44). A questionnaire was completed for each patient, covering abdominal and anorectal symptoms and without a priori grouping. Patients with functional bowel disorders, predominantly women, had a significantly increased CTT and faecal load compared to controls. The CTT was significantly and positively correlated with segmental and total faecal loading. The faecal load was equal at 48 h and 96 h, mirroring the presence of permanent faecal reservoirs. In these first clinical studies to correlate bowel symptoms with CTT and colon faecal loading, abdominal bloating was significantly correlated with faecal loading in the right colon, total faecal load, and CTT. Abdominal pain was significantly and positively correlated to distal faecal loading and significantly associated with bloating. A new phenomenon with a high faecal load and a normal CTT was observed in a subset of patients (n = 90), proving faecal retention as hidden constipation. The CTT and faecal load were significantly higher in the right-side compared to the left and distal segments. Within the control group of healthy persons, the right-sided faecal load was significantly greater than the left and distal load. The CTT and faecal load significantly positively correlated with a palpable mass in the left iliac fossa and meteorism. Cluster analysis revealed that CTT and faecal load positively correlated with a symptom factor consisting of bloating, proctalgia and infrequent defecation of solid faeces. On the other hand, CTT and faecal load negatively correlated with a symptom factor comprising

  8. Stroke risk in the early period after carotid related symptoms: a systematic review.

    PubMed

    Tsantilas, P; Kühnl, A; Kallmayer, M; Knappich, C; Schmid, S; Kuetchou, A; Zimmermann, A; Eckstein, H H

    2015-12-01

    Current guidelines recommend performing carotid endarterectomy in patients with symptomatic carotid disease as soon as possible after the neurological index event. However, early stroke risk has not been well documented for this patient group. We therefore conducted a systematic analysis of the current literature on the recurrent risk of ischemic events in patients with symptomatic carotid stenosis. Systematic review was performed by searching the MEDLINE® database from 1950 until June 8, 2015 (key words: cerebral ischemia, transient ischemic attack, amaurosis fugax, stroke, symptomatic carotid stenosis, recurrent risk, outcome, prognosis, follow-up, cohort and natural history). All studies reporting stroke risks in patients with symptomatic carotid stenosis after neurologic index events within a period of 7 days were included. Cumulative stroke risks with 95% confidence intervals after a neurologic index event were recalculated at 2-3, 7, 14 and 30 days and a meta-analysis including an analysis of heterogeneity were performed using the statistical package R and Excel for Mac 2003. Ten studies with a total number of 2634 patients were included. Results of an overall stroke risk were as follows: 2.0-17.2% at 2-3 days, 0-22.1% at 7 days, 0-29.6% at 14 days and 0-11.1% at 30 days in patients with a symptomatic extracranial carotid stenosis. The pooled stroke risk in the six studies with active follow-up was 6.0% (95% CI 2.4-14.4) at 2-3 days, 10.9% (6.1-18.7) at 7 days and 17.6% (9.7-29.9) at 14 days. Pooled stroke risk in the three studies with uncensored populations was even higher with 6.4% (1.5-23.8%) at 2-3 days, 19.5% (12.7-28.7) at 7 days and 26.1% (20.6-32.5%) at 14 days. Significant heterogeneity (P<0.001) could be explained by the different inclusion criteria and the study's design. Retrospective studies with passive follow-up had the lowest stroke risk whereas prospective studies with active follow-up and without bias through early intervention by carotid

  9. Impact of set-aside management on soil mesofauna

    NASA Astrophysics Data System (ADS)

    Landi, Silvia; d'Errico, Giada; Mazza, Giuseppe; Mocali, Stefano; Bazzoffi, Paolo; Roversi, Pio Federico

    2014-05-01

    (MI) resulted significantly higher in set-aside managements than in conventional crops in Fagna and Metaponto sites. In contrast, Caorle was characterized by a significant soil degradation (prevalence of extreme colonizers) and any increase of MI values in the set-aside have been not detected. About microarthropods, the taxa richness was significantly higher in set-aside managements than conventional crops in all the sites sampled. QBS index showed the same trend, but the differences were not significant. Caorle site was characterized by a lack of balance in the relative abundance among soil microarthropods taxa. In particular, set-aside managements showed a strong prevalence of an aggressive ants Solenopsis fugax (Hymenoptera: Formicidae). In conclusion, the best results were observed in Fagna and Metaponto sites, where MI and QBS values increased under set-aside management as compared to the conventional. Further analyses will be carried out over a long period to better understand the possible correlation between the enhancement of the organic matter observed in the soils less degraded and the biological quality improvement.

  10. Prevalent misconceptions about acute retinal vascular occlusive disorders.

    PubMed

    Hayreh, Sohan Singh

    2005-07-01

    occlusion; (xix) branch retinal vein occlusion can cause neovascular glaucoma; (xx) in eyes with CRAO, the artery is usually not completely occluded; (xxi) CRAO is always either embolic or thrombotic in origin; (xxii) amaurosis fugax is always due to retinal ischemia secondary to transient retinal arterial embolism; (xxiii) asymptomatic plaque(s) in retinal arteries do not require a detailed evaluation; (xxiv) retinal function can improve even when acute retinal ischemia due to CRAO has lasted for 20h or more; (xxv) CRAO, like ischemic CRVO, can result in development of ocular neovascularization; (xxvi) panretinal photocoagulation is needed for "disc neovascularization" in CRAO; (xxvii) fibrinolytic agents are the treatment of choice in CRAO; (xxviii) there is no chance of an eye with retinal arterial occlusion having spontaneous visual improvement; (xxix) absence of any abnormality on Doppler evaluation of the carotid artery or echography of the heart always rules out those sites as the source of embolism; and (xxx) absence of an embolus in the retinal artery means the occlusion was not caused by an embolus. The major cause of all these misconceptions is the lack of a proper understanding of basic scientific facts related to the various diseases. The objective of this paper is to discuss these misconceptions, based on these scientific facts, to clarify the understanding of these blinding disorders, and to place their management on a rational, scientific basis. PMID:15845346

  11. Treatment and prevention of pouchitis after ileal pouch-anal anastomosis for chronic ulcerative colitis

    PubMed Central

    Singh, Siddharth; Stroud, Andrea M; Holubar, Stefan D; Sandborn, William J; Pardi, Darrell S

    2016-01-01

    ) compared VSL#3 to placebo. Five studies assessed prevention of pouchitis. One study (40 participants) compared VSL#3 to placebo; another (28 participants) compared VLS# 3 to no treatment; one study (184 participants) compared allopurinol to placebo; another (12 participants) compared the probiotic Bifidobacterium longum to placebo; and one study (38 participants) compared tinidazole to placebo. Three studies were judged to be of high quality. Two studies were judged to be low quality and the quality of the other studies was unclear. Treatment of acute pouchitis The results of one small study (16 participants) suggest that ciprofloxacin may be more effective than metronidazole for the treatment of acute pouchitis. One hundred per cent (7/7) of ciprofloxacin patients achieved remission at two weeks compared to 33% (3/9) of metronidazole patients. A GRADE analysis indicated that the overall quality of the evidence supporting this outcome was very low due to high risk of bias (no blinding) and very sparse data (10 events). There was no difference in the proportion of patients who had at least one adverse event (RR 0.18, 95% CI 0.01 to 2.98). Adverse events included vomiting, dysgeusia or transient peripheral neuropathy. There were no differences between metronidazole and budesonide enemas in terms of clinical remission, clinical improvement or adverse events. Adverse events included anorexia, nausea, headache, asthenia, metallic taste, vomiting, paraesthesia, and depression. There were no differences between rifaximin and placebo in terms of clinical remission, clinical improvement, or adverse events. Adverse events included diarrhea, flatulence, nausea, proctalgia, vomiting, thirst, candida, upper respiratory tract infection, increased hepatic enzyme, and cluster headache. There was no difference in clinical improvement between Lactobacillus GG and placebo. The results of these studies are uncertain due to very low quality evidence. Treatment of chronic pouchitis A pooled

  12. Usefulness of Predilation Before Transcatheter Aortic Valve Implantation.

    PubMed

    Pagnesi, Matteo; Jabbour, Richard J; Latib, Azeem; Kawamoto, Hiroyoshi; Tanaka, Akihito; Regazzoli, Damiano; Mangieri, Antonio; Montalto, Claudio; Ancona, Marco B; Giannini, Francesco; Chieffo, Alaide; Montorfano, Matteo; Monaco, Fabrizio; Castiglioni, Alessandro; Alfieri, Ottavio; Colombo, Antonio

    2016-07-01

    Balloon predilation is historically considered a requirement before performing transcatheter aortic valve implantation (TAVI). As the procedure has evolved, it has been questioned whether it is actually needed, but data are lacking on mid-term outcomes. The aim of this study was to evaluate the effect of balloon predilation before TAVI. A total of 517 patients who underwent transfemoral TAVI from November 2007 to October 2015 were analyzed. The devices implanted included the Medtronic CoreValve (n = 216), Medtronic Evolut R (n = 30), Edwards SAPIEN XT (n = 210), and Edwards SAPIEN 3 (n = 61). Patients were divided into 2 groups depending on whether pre-implantation balloon aortic valvuloplasty (pre-BAV) was performed (n = 326) or not (n = 191). Major adverse cardiac and cerebrovascular events (MACCE) were primarily evaluated. Propensity score matching was used to adjust for differences in baseline characteristics and potential confounders (n = 113 pairs). In the overall cohort, patients without pre-BAV had a significantly higher MACCE rate at 30 days, driven by a higher incidence of stroke (0.3% pre-BAV vs 3.7% no-pre-BAV, p <0.01). MACCE and mortality at 1 year were, however, similar in both groups. Independent predictors of MACCE at 1 year included serum creatinine, NYHA class 3 to 4, logistic European System for Cardiac Operative Risk Evaluation, and postdilation. Of note, the postdilation rate was higher in the no-pre-BAV group (21.5% pre-BAV vs 35.6% no-pre-BAV, p <0.001). After propensity score matching, there were no differences in MACCE between the 2 groups. In conclusion, this study showed that, in selected patients and with specific transcatheter valves, TAVI without pre-BAV appears to be associated with similar mid-term outcomes compared with TAVI with pre-BAV, but it may increase the need for postdilation. PMID:27184169

  13. Health-related quality of life of patients after mechanical valve replacement surgery for rheumatic heart disease in a developing country

    PubMed Central

    Thomson Mangnall, Linda J; Sibbritt, David W; Fry, Margaret; Windus, Melanie; Gallagher, Robyn D

    2014-01-01

    Objective To evaluate the health-related quality of life (HRQoL) of people in Fiji (n=128) undergoing heart valve replacement (VR) surgery for rheumatic heart disease (RHD), conducted by Open Heart International. Methods Patients who had undergone surgery from 1991 to 2009 (n=72) and patients undergoing surgery for the years 2010–2012 (n=56) were surveyed prospectively, preoperatively and/or postoperatively (the mean follow-up time 5.9 years) using the standard recall Short-Form 36, V.2 (SF-36v2) HRQoL Survey. Results The sample had a mean age of 26.7 years and 56% (n=72) were women. Preoperative HRQoL is impaired but by early postoperative (1 year) there is significant improvement across all domains (p<0.05) apart from mental health (p=0.081). At mid-term (2 years), HRQoL remained substantially improved from preoperative measurement with mental health now significantly better (p=0.028). However, compared with the early follow-up outcomes, at mid-term physical function (p=0.001), role–physical (p=0.002) and role–emotional (p=0.042) domains significantly declined. By late follow-up (>2 years), all HRQoL domains, except for mental health, were significantly better than preoperative (p=0.066 ). Predictors of less improved HRQoL included having an isolated mitral valve replacement (MVR) (for six of eight health domains, p<0.05), older age (three domains; role–physical, vitality and bodily pain, p<0.05) and male gender (in the role–emotional domain, p<0.05). Conclusions This first investigation of the HRQoL of people in a developing country after VR surgery for RHD found significant improvement from surgery with this improvement generally sustained. The lack of improvement in mental health requires further exploration as does the influence of an isolated MVR, age and gender. PMID:27326199

  14. Effectiveness of a 'Global Postural Reeducation' program for persistent Low Back Pain: a non-randomized controlled trial

    PubMed Central

    2010-01-01

    Background The aim of this non-randomized controlled trial was to evaluate the effectiveness of a Global Postural Reeducation (GPR) program as compared to a Stabilization Exercise (SE) program in subjects with persistent low back pain (LBP) at short- and mid-term follow-up (ie. 3 and 6 months). Methods According to inclusion and exclusion criteria, 100 patients with a primary complaint of persistent LBP were enrolled in the study: 50 were allocated to the GPR group and 50 to the SE group. Primary outcome measures were Roland and Morris Disability Questionnaire (RMDQ) and Oswestry Disability Index (ODI). Secondary outcome measures were lumbar Visual Analogue Scale (VAS) and Fingertip-to-floor test (FFT). Data were collected at baseline and at 3/6 months by health care professionals unaware of the study. An intention to treat approach was used to analyze participants according to the group to which they were originally assigned. Results Of the 100 patients initially included in the study, 78 patients completed the study: 42 in the GPR group and 36 in the SE group. At baseline, the two groups did not differ significantly with respect to gender, age, BMI and outcome measures. Comparing the differences between groups at short- and mid-term follow-up, the GPR group revealed a significant reduction (from baseline) in all outcome measures with respect to the SE group. The ordered logistic regression model showed an increased likelihood of definitive improvement (reduction from baseline of at least 30% in RMDQ and VAS scores) for the GPR group compared to the SE group (OR 3.9, 95% CI 2.7 to 5.7). Conclusions Our findings suggest that a GPR intervention in subjects with persistent LBP induces a greater improvement on pain and disability as compared to a SE program. These results must be confirmed by further studies with higher methodological standards, including randomization, larger sample size, longer follow-up and subgrouping of the LBP subjects. Trial registration NCT

  15. A Comparison of Anatomic Double- And Single-bundle Techniques for Anterior Cruciate Ligament Reconstruction, A Prospective Randomized Study with A 5-year Follow-up

    PubMed Central

    Karikis, Ioannis; Desai, Neel; Sernert, Ninni; Rostgard-Christensen, Lars; Kartus, Juri T.

    2016-01-01

    Objectives: The purpose of this study was to compare the mid-term outcome after arthroscopic anterior cruciate ligament (ACL) reconstruction with either the anatomic double-bundle (DB) or anatomic single-bundle (SB) technique using hamstring tendon autografts in an unselected group of patients. Methods: 103 patients (33 women, 70 men; median age, 27 years; range, 18-52 years) were randomized and underwent ACL reconstruction (DB group; n=53 and SB group; n=50). All reconstructions were performed anatomically, identifying the ACL footprints, using the anteromedial portal for the femoral tunnel drilling and utilizing interference screw for tibial and femoral fixation. One blinded observer examined the patients both preoperatively and at follow-up (median, 64 months; range, 55-75 months). Radiographic evaluation of OA was performed using the Ahlbäck, Kellgren-Lawrence and Fairbanks grading systems in the early postoperative period and at follow up. Results: Preoperatively, no differences were found between the study groups apart from the pre-injury Tegner activity level, which was lower in the DB group (p=0.02). Eighty-seven patients (83%) were available for examination at 5-year follow-up. There were no significant differences between the groups in terms of the pivot-shift test, KT-1000 arthrometer laxity measurements, manual Lachman test, One-leg-hop test, Square-hop test, range of motion, Lysholm knee scoring scale, Tegner activity scale and Knee Injury and Osteoarthritis Outcome Score (KOOS). Correspondingly, no differences were found between the groups regarding the presence of OA at follow-up. Both DB and SB groups improved significantly at follow-up compared with the preoperative assessment. Conclusion: At mid-term follow-up of an unselected group of patients, anatomic DB reconstruction was not superior to anatomic SB reconstruction in terms of the pivot-shift test or subjective and objective outcome variables, as seen in this prospective randomized study

  16. An Adaptation Strategy to Address Sea Level Rise Along Coastal Developments

    NASA Astrophysics Data System (ADS)

    Trivedi, D. R.

    2010-12-01

    understanding of acceptable levels of risks, a strategy encompassing the near-term, mid-term, and long term was developed for the projects. Immovable structures such as buildings and vital infrastructure will be raised to above the conservative levels of identified sea level rise. Perimeter improvements would be built to mid-term values with adaptation strategies incorporated into the project documents.

  17. Impacts of Climate change on the watershed of the hydropower reservoir Gigerwaldsee using hydrological modeling

    NASA Astrophysics Data System (ADS)

    Etter, Simon; Seibert, Jan; Vis, Marc; Addor, Nans; Huss, Matthias; Finger, David

    2015-04-01

    Increasing temperatures and changing precipitation patterns will diminish snow cover and force glaciers to shrink in mountain environments. The runoff in Alpine catchments such as the watershed of the Gigerwaldsee, providing water resources for hydro power production in the Swiss Alps, will be affected by those changes. Using an updated version of the conceptual hydrological model HBV-light future hydro-climatic changes in the catchment where simulated. The hydrological model was driven by seven GCM-RCM combinations from the ENSEMBLES project under the emission scenario A1B. The climate projections were bias-corrected using quantile mapping. Besides a baseline scenario (1992-2021), a mid-term future scenario (2036-2065) and a long term scenario (2069-2098) were calculated. For calibration, the model was driven with a gridded dataset from MeteoSwiss and glacier extents from 1990. The calibration was performed using three datasets: i) discharge data, derived from a volume-lake level relationship of the Gigerwaldsee, ii) the fraction of the snow covered area in the catchment, retrieved from MODIS snowcover images and iii) extrapolated glacier mass balances. The parameters were determined using Pareto selection from 10'000 Monte Carlo simulation runs according to their performance over five objective functions. Two objective functions were used to evaluate the discharge simulation and two for snow cover, whereof one rated the simulation over the whole year and one only during summer. A fifth objective function was used for glacier mass balance simulations. An evaluation of different selections of parameter sets showed that relying on discharge, snowcover and glacier mass balance data led to a higher model consistency. The contribution of the climate scenarios, model parameters and glacier scenarios to the total uncertainty of the simulated future discharge was assessed using analysis of variance (ANOVA). The results indicate a decrease in runoff during the high flow

  18. a Stochastic Approach to Multiobjective Optimization of Large-Scale Water Reservoir Networks

    NASA Astrophysics Data System (ADS)

    Bottacin-Busolin, A.; Worman, A. L.

    2013-12-01

    A main challenge for the planning and management of water resources is the development of multiobjective strategies for operation of large-scale water reservoir networks. The optimal sequence of water releases from multiple reservoirs depends on the stochastic variability of correlated hydrologic inflows and on various processes that affect water demand and energy prices. Although several methods have been suggested, large-scale optimization problems arising in water resources management are still plagued by the high dimensional state space and by the stochastic nature of the hydrologic inflows. In this work, the optimization of reservoir operation is approached using approximate dynamic programming (ADP) with policy iteration and function approximators. The method is based on an off-line learning process in which operating policies are evaluated for a number of stochastic inflow scenarios, and the resulting value functions are used to design new, improved policies until convergence is attained. A case study is presented of a multi-reservoir system in the Dalälven River, Sweden, which includes 13 interconnected reservoirs and 36 power stations. Depending on the late spring and summer peak discharges, the lowlands adjacent to Dalälven can often be flooded during the summer period, and the presence of stagnating floodwater during the hottest months of the year is the cause of a large proliferation of mosquitos, which is a major problem for the people living in the surroundings. Chemical pesticides are currently being used as a preventive countermeasure, which do not provide an effective solution to the problem and have adverse environmental impacts. In this study, ADP was used to analyze the feasibility of alternative operating policies for reducing the flood risk at a reasonable economic cost for the hydropower companies. To this end, mid-term operating policies were derived by combining flood risk reduction with hydropower production objectives. The performance

  19. Bayesian approaches for Integrated Water Resources Management. A Mediterranean case study.

    NASA Astrophysics Data System (ADS)

    Gulliver, Zacarías; Herrero, Javier; José Polo, María

    2013-04-01

    This study presents the first steps of a short-term/mid-term analysis of the water resources in the Guadalfeo Basin, Spain. Within the basin the recent construction of the Rules dam has required the development of specific management tools and structures for this water system. The climate variability and the high water demand requirements for agriculture irrigation and tourism in this region may cause different controversies in the water management planning process. During the first stages of the study a rigorous analysis of the Water Framework Directive results was done in order to implement the legal requirements and the solutions for the gaps identified by the water authorities. In addition, the stakeholders and water experts identified the variables and geophysical processes for our specific water system case. These particularities need to be taken into account and are required to be reflected in the final computational tool. For decision making process purposes in a mid-term scale, a bayesian network has been used to quantify uncertainty which also provides a structure representation of probabilities, actions-decisions and utilities. On one hand by applying these techniques it is possible the inclusion of decision rules generating influence diagrams that provides clear and coherent semantics for the value of making an observation. On the other hand the utility nodes encode the stakeholders preferences which are measured on a numerical scale, choosing the action that maximizes the expected utility [MEU]. Also this graphical model allows us to identify gaps and project corrective measures, for example, formulating associated scenarios with different event hypotheses. In this sense conditional probability distributions of the seasonal water demand and waste water has been obtained between the established intervals. This fact will give to the regional water managers useful information for future decision making process. The final display is very visual and allows

  20. Management of Complicated Aortic Aneurysms Using Multiple Overlapping Uncovered Stents

    PubMed Central

    Zhang, Yongxue; Teng, Zhongzhao; Lu, Qingsheng; Zhao, Zhiqing; Bao, Junmin; Feng, Xiang; Feng, Rui; Chen, Zengsheng; Huang, Yuan; Sadat, Umar; Gillard, Jonathan H; Jing, Zaiping

    2014-01-01

    Abstract This study sought to report the mid-term outcome of a modified flow-diverting strategy in the treatment of complicated aortic aneurysms of different morphology. Historical data suggested aortic aneurysm expansion and rupture after endovascular treatment with current commercial flow-diverters, indicating the essentiality of further investigation of this technique prior to its large-scale clinical application. An alternative flow-diverting strategy using layer-by-layer assembled multiple overlapping uncovered stents was employed in this study. The treatment outcome in aneurysms of different morphology (saccular, fusiform, and dissecting) was assessed during a mid-term follow-up period. Of 42 patients enrolled in this study (30 male, mean age: 63.3 years), technical success was achieved in 40 cases. During an average follow-up period of 20.9 months, mean aneurysm diameter shrunk from 53.4 ± 13.6 mm to 48.8 ± 13.9 mm (P < 0.001), while stent-induced sac thrombosis ratio increased significantly (18.1 ± 14.9% to 93.6 ± 9.5%, P < 0.001). The majority of side branches (74/76 major visceral branches, 237/244 minor segmental arteries), covered by 3.3 stents on average, maintained their patency after stenting. Saccular aneurysms manifested the highest thrombus deposition speed (18/20 were totally thrombosed within 12 months) and most significant shrinkage (51.4 ± 13.3 mm pre-operatively vs 43.5 ± 10.2 mm during follow-up, P < 0.001) compared with fusiform and dissecting aneurysms. This modified flow-diverting strategy could be a feasible alternative in the management of complicated aortic aneurysms where vital branches need to be preserved. The treatment outcome may depend on the aneurysm type. Further studies with larger patient cohort and longer follow-up are required to substantiate these results. PMID:25501077

  1. An assessment of advanced technology for industrial cogeneration

    NASA Technical Reports Server (NTRS)

    Moore, N.

    1983-01-01

    The potential of advanced fuel utilization and energy conversion technologies to enhance the outlook for the increased use of industrial cogeneration was assessed. The attributes of advanced cogeneration systems that served as the basis for the assessment included their fuel flexibility and potential for low emissions, efficiency of fuel or energy utilization, capital equipment and operating costs, and state of technological development. Over thirty advanced cogeneration systems were evaluated. These cogeneration system options were based on Rankine cycle, gas turbine engine, reciprocating engine, Stirling engine, and fuel cell energy conversion systems. The alternatives for fuel utilization included atmospheric and pressurized fluidized bed combustors, gasifiers, conventional combustion systems, alternative energy sources, and waste heat recovery. Two advanced cogeneration systems with mid-term (3 to 5 year) potential were found to offer low emissions, multi-fuel capability, and a low cost of producing electricity. Both advanced cogeneration systems are based on conventional gas turbine engine/exhaust heat recovery technology; however, they incorporate advanced fuel utilization systems.

  2. Metal-on-metal total hip arthroplasty: the concerns.

    PubMed

    MacDonald, S J

    2004-12-01

    The metal-on-metal bearing couple is having a resurgence in clinical applications seen in total hip and hip resurfacing technologies. The most noteworthy advantage of a metal-on-metal implant is the improved wear characteristics seen in vitro on wear simulators and in vivo with retrieved implants. All bearings have disadvantages, and a metal-on-metal bearing is no exception. Concerns exist regarding the generation of metal ions seen in the blood and urine of patients with metal-on-metal implants. These elevated metal ions have theoretical, although not proven, risks related to carcinogenic and biologic concerns. Additionally, concerns exist regarding hypersensitivity, increased incidence of instability and increased costs. Specific patient selection issues arise with metal-on-metal implants. The current generation of implants has only early and mid-term results available, with no long-term series yet published. Therefore, although a metal-on-metal bearing may be considered a viable alternative to either polyethylene or ceramic implants, outstanding and unresolved issues continue to exist with this bearing, as they do with the alternatives. PMID:15577471

  3. The effect of a live Neospora caninum tachyzoite vaccine in naturally infected pregnant dairy cows.

    PubMed

    Mazuz, M L; Fish, L; Wolkomirsky, R; Leibovich, B; Reznikov, D; Savitsky, I; Golenser, J; Shkap, V

    2015-06-15

    Neosporosis, caused by the intracellular protozoan Neospora caninum, is a major cause of abortion and reproductive failure in cattle worldwide. The principal route of transmission of neosporosis is via in utero infection of the offspring. There is no effective prophylactic treatment or vaccine available against bovine neosporosis. A N. caninum NcIs491 isolate was examined for its ability to immunize and reduce abortions in naturally infected dairy cows under field conditions. N. caninum-seropositive pregnant dams were inoculated with 10(8) live tachyzoites during mid-term pregnancy. A total of 520 N. caninum seropositive dams were included in this study, of these, 146 were immunized and 374 cows served as a non-vaccinated control group. A significantly lower incidence of abortion was observed in vaccinated compared to non-vaccinated cows, 16 and 26% respectively (P=0.01), with a vaccine efficacy of 39%. However, the number of seropositive offspring remained similar in both groups. Overall, this field trial suggests that vaccination with live N. caninum tachyzoites should be considered as an effective measure to reduce abortions caused by neosporosis in naturally infected cows. PMID:25890821

  4. Evidence for effectiveness of Extracorporal Shock-Wave Therapy (ESWT) to treat calcific and non-calcific rotator cuff tendinosis--a systematic review.

    PubMed

    Huisstede, Bionka M A; Gebremariam, Lukas; van der Sande, Renske; Hay, Elaine M; Koes, Bart W

    2011-10-01

    Extracorporeal shock-wave therapy (ESWT) is suggested as a treatment alternative for calcific and non-calcific rotator cuff tendinosis (RC-tendinosis), which may decrease the need for surgery. In this study we assessed the evidence for effectiveness of ESWT for these disorders. The Cochrane Library, PubMed, Embase, Pedro, and Cinahl were searched for relevant systematic reviews and RCTs. Two reviewers independently extracted data and assessed the methodological quality. Seventeen RCTs (11 calcific, 6 non-calcific) were included. For calcific RC-tendinosis, strong evidence was found for effectiveness in favour of high-ESWT versus low-ESWT in short-term. Moderate evidence was found in favour of high-ESWT versus placebo in short-, mid- and long-term and versus low-ESWT in mid- and long-term. Moreover, high-ESWT was more effective (moderate evidence) with focus on calcific deposit versus focus on tuberculum major in short- and long-term. RSWT was more effective (moderate evidence) than placebo in mid-term. For non-calcific RC-tendinosis, no strong or moderate evidence was found in favour of low-, mid- or high-ESWT versus placebo, each other, or other treatments. This review shows that only high-ESWT is effective for treating calcific RC-tendinosis. No evidence was found for the effectiveness of ESWT to treat non-calcific RC-tendinosis. PMID:21396877

  5. Space Weather Models - What They Can and Cannot Do.

    NASA Astrophysics Data System (ADS)

    MacNeice, P. J.

    2014-12-01

    For more than 10 years, the CCMC has been hosting and testing almost all of the models currently used for space weather forecasting, and those in the pipeline for future use. This puts us in a unique position to review their capabilities, identify strengths and weaknesses, and project the arrival in the operational forecasting theatre of new, more accurate and more comprehensive forecasting tools. In this talk we will review the current status of forecasting models, focussing on those for the solar corona and inner heliosphere, including their impact on the Earth's magnetosphere. We will identify their capabilities and weaknesses. We will discuss how these weaknesses may be addressed in the near and mid-term, with new models, model updates and new supporting tools. We will assess the expected use of time dependent assimilative models of photospheric magnetic field and of time dependent high resolution and high cadence vector magnetograms on near term heliophysical model development. We will also discuss a web based semi-automated model validation project which the modeling community has been developing.

  6. Solar Weather Event Modelling and Prediction

    NASA Astrophysics Data System (ADS)

    Messerotti, Mauro; Zuccarello, Francesca; Guglielmino, Salvatore L.; Bothmer, Volker; Lilensten, Jean; Noci, Giancarlo; Storini, Marisa; Lundstedt, Henrik

    2009-11-01

    Key drivers of solar weather and mid-term solar weather are reviewed by considering a selection of relevant physics- and statistics-based scientific models as well as a selection of related prediction models, in order to provide an updated operational scenario for space weather applications. The characteristics and outcomes of the considered scientific and prediction models indicate that they only partially cope with the complex nature of solar activity for the lack of a detailed knowledge of the underlying physics. This is indicated by the fact that, on one hand, scientific models based on chaos theory and non-linear dynamics reproduce better the observed features, and, on the other hand, that prediction models based on statistics and artificial neural networks perform better. To date, the solar weather prediction success at most time and spatial scales is far from being satisfactory, but the forthcoming ground- and space-based high-resolution observations can add fundamental tiles to the modelling and predicting frameworks as well as the application of advanced mathematical approaches in the analysis of diachronic solar observations, that are a must to provide comprehensive and homogeneous data sets.

  7. New observing concepts for ESO survey telescopes

    NASA Astrophysics Data System (ADS)

    Bierwirth, T.; Szeifert, T.; Dorigo, D.; Nunes, P.; Rejkuba, M.; Baugh, K.; Klein Gebbinck, M.; Manning, A.; Muravov, D.; Vera, I.

    2010-07-01

    The start of operations of the VISTA survey telescope will not only offer a new facility to the ESO community, but also a new way of observing. Survey observation programs typically observe large areas of the sky and might span several years, corresponding to the execution of hundreds of observations blocks (OBs) in service mode. However, the execution time of an individual survey OB will often be rather short. We expect that up to twelve OBs may be executed per hour, as opposed to about one OB per hour on ESO's Very Large Telescope (VLT). OBs of different programs are competing for observation time and must be executed with adequate priority. For these reasons, the scheduling of survey OBs is required to be almost fully automated. Two new key concepts are introduced to address these challenges: ESO's phase 2 proposal preparation tool P2PP allows PIs of survey programs to express advanced mid-term observing strategies using scheduling containers of OBs (groups, timelinks, concatenations). Telescope operators are provided with effective short-term decision support based on ranking observable OBs. The ranking takes into account both empirical probability distributions of various constraints and the observing strategy described by the scheduling containers. We introduce the three scheduling container types and describe how survey OBs are ranked. We demonstrate how the new concepts are implemented in the preparation and observing tools and give an overview of the end-to-end workflow.

  8. Trajectory Assessment and Modification Tools for Next Generation Air Traffic Management Operations

    NASA Technical Reports Server (NTRS)

    Brasil, Connie; Lee, Paul; Mainini, Matthew; Lee, Homola; Lee, Hwasoo; Prevot, Thomas; Smith, Nancy

    2011-01-01

    This paper reviews three Next Generation Air Transportation System (NextGen) based high fidelity air traffic control human-in-the-loop (HITL) simulations, with a focus on the expected requirement of enhanced automated trajectory assessment and modification tools to support future air traffic flow management (ATFM) planning positions. The simulations were conducted at the National Aeronautics and Space Administration (NASA) Ames Research Centers Airspace Operations Laboratory (AOL) in 2009 and 2010. The test airspace for all three simulations assumed the mid-term NextGenEn-Route high altitude environment utilizing high altitude sectors from the Kansas City and Memphis Air Route Traffic Control Centers. Trajectory assessment, modification and coordination decision support tools were developed at the AOL in order to perform future ATFM tasks. Overall tool usage results and user acceptability ratings were collected across three areas of NextGen operatoins to evaluate the tools. In addition to the usefulness and usability feedback, feasibility issues, benefits, and future requirements were also addressed. Overall, the tool sets were rated very useful and usable, and many elements of the tools received high scores and were used frequently and successfully. Tool utilization results in all three HITLs showed both user and system benefits including better airspace throughput, reduced controller workload, and highly effective communication protocols in both full Data Comm and mixed-equipage environments.

  9. Comparative analysis of selected fuel cell vehicles

    SciTech Connect

    1993-05-07

    Vehicles powered by fuel cells operate more efficiently, more quietly, and more cleanly than internal combustion engines (ICEs). Furthermore, methanol-fueled fuel cell vehicles (FCVs) can utilize major elements of the existing fueling infrastructure of present-day liquid-fueled ICE vehicles (ICEVs). DOE has maintained an active program to stimulate the development and demonstration o fuel cell technologies in conjunction with rechargeable batteries in road vehicles. The purpose of this study is to identify and assess the availability of data on FCVs, and to develop a vehicle subsystem structure that can be used to compare both FCVs and ICEV, from a number of perspectives--environmental impacts, energy utilization, materials usage, and life cycle costs. This report focuses on methanol-fueled FCVs fueled by gasoline, methanol, and diesel fuel that are likely to be demonstratable by the year 2000. The comparative analysis presented covers four vehicles--two passenger vehicles and two urban transit buses. The passenger vehicles include an ICEV using either gasoline or methanol and an FCV using methanol. The FCV uses a Proton Exchange Membrane (PEM) fuel cell, an on-board methanol reformer, mid-term batteries, and an AC motor. The transit bus ICEV was evaluated for both diesel and methanol fuels. The transit bus FCV runs on methanol and uses a Phosphoric Acid Fuel Cell (PAFC) fuel cell, near-term batteries, a DC motor, and an on-board methanol reformer. 75 refs.

  10. Phase out the bomb

    SciTech Connect

    Blechman, B.M.; Fisher, C.S.

    1994-12-31

    The authors premise is that technology diffusion and economic interdependence are creating a modernistic world in which a growing number of states share important common interests, values, and perspectives. These common interests can ultimately provide a basis for cooperation to control and eliminate weapons of mass destruction. Republican and Democratic administrations have long recognized that the widespread dissemination of weapons of mass destruction would pose unacceptable risk to the U.S. security. Yet U.S. policy has only been able to slow proliferation, not end it. More gradually than anticipated, but inexorably, more countries have gained capabilities to manufacture weapons of mass destruction, along with the missile systems to deliver them rapidly. If the current trends continue, new countries seem likely to join the nuclear club in mid-term, and even more countries after that. A radically different approach is required if the U.S. is serious about stopping the spread of nuclear capabilities. The U.S. seeks to convince would-be proliferators that nuclear weapons are neither a legitimate nor an effective means of protecting national security, yet U.S. foreign and defense policies telegraph exactly the opposite message. An agenda for eventual elimination of Nuclear, Chemical and Biological weapons is given.

  11. The Vision and Challenges of Hokkaido Pharmaceutical University's Affiliated Pharmacy.

    PubMed

    Norose, Takahiko; Manabe, Tomohiro; Furuta, Seiichi; Watanabe, Kazuhiro

    2016-01-01

    Hokkaido Pharmaceutical University (HPU), according to its educational mission, seeks to "develop medical professionals who contribute to community medicine", and it has produced more than 6300 graduates since 1974. With recent medical advancements and a progressively aging society, the role of the pharmacist in community medicine has diversified and is increasing in importance. Therefore, in April 2012, the Hokkaido Pharmaceutical University Affiliated Pharmacy was established as a for-profit business of the Educational Foundation of the Hokkaido University of Science, the parent body of HPU. The pharmacy is located near the Sapporo station; it is operated by six pharmacists and four clerks, and supported by three faculty members who are engaged in providing HPU student education such as on-site clinical training, in addition to their pharmacy duties such as home care pharmaceutics. For the first two years it was open, the pharmacy focused on the establishment of pharmacy administration and fiscal consolidation. In April 2015, the Pharmacy Management Committee set the pharmacy's future vision, as well as its mid-term strategy, which consists of the four main components of pharmacy practices, education, research, and social contribution, in order for the pharmacy to serve as a model of community pharmacy. PMID:27150928

  12. Segmentation of extreme ultraviolet solar images via multichannel fuzzy clustering

    NASA Astrophysics Data System (ADS)

    Barra, Vincent; Delouille, Véronique; Hochedez, Jean-François

    2008-09-01

    The study of the variability of the solar corona and the monitoring of its traditional regions (Coronal Holes, Quiet Sun and Active Regions) are of great importance in astrophysics as well as in view of the Space Weather and Space Climate applications. Here we propose a multichannel unsupervised spatially constrained fuzzy clustering algorithm that automatically segments EUV solar images into Coronal Holes, Quiet Sun and Active Regions. Fuzzy logic allows to manage the various noises present in the images and the imprecision in the definition of the above regions. The process is fast and automatic. It is applied to SoHO EIT images taken from February 1997 till May 2005, i.e. along almost a full solar cycle. Results in terms of areas and intensity estimations are consistent with previous knowledge. The method reveal the rotational and other mid-term periodicities in the extracted time series across solar cycle 23. Further, such an approach paves the way to bridging observations between spatially resolved data from imaging telescopes and time series from radiometers. Time series resulting form the segmentation of EUV coronal images can indeed provide an essential component in the process of reconstructing the solar spectrum.

  13. Segmentation of SoHO/EIT Images using fuzzy clustering algorithms

    NASA Astrophysics Data System (ADS)

    Delouille, V.; Barra, V.; Hochedez, J.

    2007-12-01

    The study of the variability of the solar corona and the monitoring of its traditional regions (Coronal Holes, Quiet Sun and Active Regions) are of great importance in astrophysics as well as in view of the Space Weather and Space Climate applications. In this presentation, I will propose a multi-channel unsupervised spatially- constrained fuzzy clustering algorithm that automatically segments EUV solar images into Coronal Holes, Quiet Sun and Active Regions. The use of Fuzzy logic allows to manage the various noises present in the images and the imprecision in the definition of the above mentioned regions. The process is fast and automatic. It is applied to SoHO-EIT images taken from January 1997 till May 2005, spanning thus almost a full solar cycle. Results in terms of areas and intensity estimations are consistent with previous knowledge. The method reveal the rotational and other mid-term periodicities in the extracted time series across solar cycle 23. Further, such an approach paves the way to bridging observations between spatially resolved data from imaging telescopes and time series from radiometers. Time series resulting form the segmentation of EUV coronal images can indeed provide an essential component in the process of reconstructing the solar spectrum.

  14. Contegra conduit: current outcomes and concerns.

    PubMed

    Raja, Shahzad G

    2006-09-01

    A variety of congenital cardiac anomalies with severe right ventricular outflow tract (RVOT) obstruction or RVOT interruption require surgical reconstruction from the infundibulum up to the pulmonary artery bifurcation or even into the branches of the pulmonary arteries. Ideally, the conduit or valve required for such reconstruction has to be formed of autologous tissue that grows, resists infection, lasts for the life span of the patient and is readily available in all sizes. Such conduits, however, are not available and although several alternatives have been used, none of which are without potential drawbacks. Contegra valved bovine internal jugular vein conduit (Medtronic Inc., MN, USA) has recently emerged as a promising option for pediatric RVOT reconstruction and has been advocated for its 'off-the-shelf' availability in sizes ranging from 12 to 22 mm, surgical pliability and encouraging short- and mid-term success in experimental animal, as well as clinical studies. This review focuses on the current outcomes of Contegra conduit and highlights some of the major concerns related to the use of this conduit and strategies to tackle these concerns. PMID:17081094

  15. Long-term results of the threaded Weill cup in primary total hip arthroplasty

    PubMed Central

    Clarius, Michael; Jung, Alexander W.; Raiss, Patric; Streit, Marcus R.; Merle, Christian

    2009-01-01

    Uncemented, threaded acetabular components with smooth surface treatment were widely used in continental Europe in the 1970s and 1980s for primary total hip arthroplasty (THA). Previously published studies showed high failure rates in the mid-term. In a consecutive series of 116 patients, 127 threaded cups with smooth surface treatment (Weill cup; Zimmer, Winterthur, Switzerland) were implanted in combination with one type of uncemented stem. Patients were followed up clinically and radiographically. Mean time of follow-up was 17 years (range 15–20). At the time of follow-up, the acetabular component had been revised or was awaiting revision in 30 hips (24%). Two hips were revised for infection and 23 for aseptic loosening. Four polyethylene liners were exchanged because of excessive wear. One hip was awaiting revision. The survival rate for all acetabular revisions including one hip awaiting revision was 75% (95%CI: 65–85%) at 17 years. These results support the view that smooth, threaded acetabular components do not provide satisfactory long-term fixation and should be abandoned. It is important to closely monitor patients with these components as the failure rate remains high in the long-term. PMID:19629480

  16. Long-term results of the threaded Mecron cup in primary total hip arthroplasty

    PubMed Central

    Clarius, Michael; Jung, Alexander W.; Streit, Marcus R.; Merle, Christian; Raiss, Patric

    2009-01-01

    In the 1970s, high failure rates of cemented acetabular components, especially in young patients, in the middle- and long-term prompted a search for alternatives. The Mecring was one of the most popular first generation uncemented, threaded cups widely used in the 1980s for arthroplasty of the hip. First generation threaded cups commonly had smooth surface treatment and showed unacceptably high failure rates in the mid-term. In a consecutive series of 209 patients, 221 threaded uncemented acetabular cups with smooth surface treatment (Mecring) had been implanted in combination with one type of uncemented stem. Patients were followed up clinically and radiographically. The mean time of follow-up was 17 (range 15–20) years. In 91 (41%) hips the acetabular component had been revised or was awaiting revision: two hips for infection and 84 (38%) for aseptic loosening. Five hips were awaiting revision. The survival rate for all revisions including hips awaiting revision was 49% (95% CI: 41–57%) at 17 years. These results support the view that smooth, threaded acetabular components do not provide satisfactory long-term fixation and should be abandoned. Patients with these components must be closely monitored as the failure rate remains high in the long-term. PMID:19629481

  17. Aseptic stem loosening in primary THA: migration analysis of cemented and cementless fixation

    PubMed Central

    Kroell, Artur; Beaulé, Paul; Krismer, Martin; Behensky, Hannes; Stoeckl, Bernd

    2008-01-01

    Early migration has reportedly been predictive for later implant failure. Using four different migration patterns, this study aimed to analyse migration behaviour of the two types of implant fixation—cemented and cementless—throughout the process of loosening. Migrational behaviour of 69 revised stems (49 cemented, 20 uncemented) was analysed retrospectively with EBRA-FCA (Einzel-Bild-Röntgen-Analyse, Femoral Component Analysis). Uncemented stems failed after early and late onset migration alike, while late migration was the predominant pattern in cemented stems. Mean prosthetic failure after early migration occurred 5.8 (±4.4) years postoperatively due to insufficient primary stability. Initially stable stems with late onset migration were revised after 12.4 (±4.5) years. Measurement of early migration was found to be a valuable tool to screen short-term and mid-term failure. In the long run the method’s sensitivity decreased. Late onset migration, however, preceded long-term failure by a mean of three years. PMID:19066889

  18. Nanomedicine for the reduction of the thrombogenicity of stent coatings

    PubMed Central

    Karagkiozaki, Varvara C; Logothetidis, Stergios D; Kassavetis, Spyridon N; Giannoglou, George D

    2010-01-01

    The treatment of patients with drug-eluting stents (DES) continues to evolve with the current emergence of DES technology that offers a combination of pharmacological and mechanical approaches to prevent arterial restenosis. However, despite the promising short-term and mid-term outcomes of DES, there are valid concerns about adverse clinical effects of late stent thrombosis. In this study, we present an example of how nanomedicine can offer solutions for improving stent coating manufacturing, by producing nanomaterials with tailored and controllable properties. The study is based on the exploitation of human platelets response towards carbon-based nanocoatings via atomic force microscope (AFM). AFM can facilitate the comprehensive analysis of platelets behavior onto stent nanocoatings and enable the study of thrombogenicity. Platelet-rich plasma from healthy donors was used for the real-time study of biointerfacial interactions. The carbon nanomaterials were developed by rf magnetron sputtering technique under controllable deposition conditions to provide favorable surface nanotopography. It was shown that by altering the surface topography of nanocoatings, the activation of platelets can be affected, while the carbon nanocoatings having higher surface roughness were found to be less thrombogenic in terms of platelets adhesion. This is an actual solution for improving the stent coating fabrication. PMID:20463940

  19. Treatment and Prevention of (Early) Osteoarthritis Using Articular Cartilage Repair—Fact or Fiction? A Systematic Review

    PubMed Central

    de Windt, Tommy S.; Vonk, Lucienne A.; Brittberg, Mats

    2013-01-01

    Early osteoarthritis (OA) is increasingly being recognized in patients who wish to remain active while not accepting the limitations of conservative treatment or joint replacement. The aim of this systematic review was to evaluate the existing evidence for treatment of patients with early OA using articular cartilage repair techniques. A systematic search was performed in EMBASE, MEDLINE, and the Cochrane collaboration. Articles were screened for relevance and appraised for quality. Nine articles of generally low methodological quality (mean Coleman score 58) including a total of 502 patients (mean age range = 36-57 years) could be included. In the reports, both radiological and clinical criteria for early OA were applied. Of all patients included in this review, 75% were treated with autologous chondrocyte implantation. Good short-term clinical outcome up to 9 years was shown. Failure rates varied from 8% to 27.3%. The conversion to total knee arthroplasty rate was 2.5% to 6.5%. Although a (randomized controlled) trial in this patient category with long-term follow-up is needed, the literature suggests autologous chondrocyte implantation could provide good short- to mid-term clinical outcome and delay the need for total knee arthroplasty. The use of standardized criteria for early OA and implementation of (randomized) trials with long-term follow-up may allow for further expansion of the research field in articular cartilage repair to the challenging population with (early) OA. PMID:26069664

  20. Acquiring experience in pathology predominantly from what you see, not from what you read: the HIPON e-learning platform.

    PubMed

    Riccioni, Olga; Vrasidas, Charalambos; Brcic, Luka; Armenski, Goce; Seiwerth, Sven; Smeets, Annemieke; van Krieken, J Han Jm; Lazaris, Andreas C

    2015-01-01

    It is indisputable that nowadays one of the hardest and most important tasks in medicine and especially in medical education, is the conversion of the extensive amount of available data, into medical experience, after a proper analysis. A project under the title "ICT (Information and Communication Technology) eModules on HistoPathology: a useful online tool for students, researchers and professionals - HIPON", co-financed by the Lifelong Learning Program of the Education, Audiovisual and Culture Executive Agency (EACEA), The Commission of the European Union, has been launched at the beginning of 2013. HIPON's purpose is not to provide just another pathology website atlas, but to convey professional experience and thinking in pathology. HIPON has resulted in a well-structured and user-friendly, open resource, multi-language, e-learning platform which, taking advantage of modern image technology, offers medical students, researchers, and professionals a valuable teaching instrument so that they can acquire professional experience in pathology. The mid-term report of HIPON has been favorably evaluated by the EACEA experts who appreciated the potential of our teaching tool in providing the opportunity and the means to acquire medical experience. Through the use of virtual slides, educative videos and microscopic, high resolution, marked images accompanied by relevant questions and answers, HIPON project aims to make end-users able to think as experienced pathologists and become highly efficient in correlating pathologic data with other clinical-laboratory information. PMID:26089711

  1. Flexible Airspace Management (FAM) Research 2010 Human-in-the-Loop Simulation

    NASA Technical Reports Server (NTRS)

    Lee, Paul U.; Brasil, Connie; Homola, Jeffrey; Kessell, Angela; Prevot, Thomas; Smith, Nancy

    2011-01-01

    A human-in-the-Ioop (HITL) simulation was conducted to assess potential user and system benefits of Flexible Airspace Management (FAM) concept, as well as designing role definitions, procedures, and tools to support the FAM operations in the mid-term High Altitude Airspace (HAA) environment. The study evaluated the benefits and feasibility of flexible airspace reconfiguration in response to traffic overload caused by weather deviations, and compared them to those in a baseline condition without the airspace reconfiguration. The test airspace consisted of either four sectors in one Area of Specialization or seven sectors across two Areas. The test airspace was assumed to be at or above FL340 and fully equipped Vvith data communications (Data Comm). Other assumptions were consistent with those of the HAA concept. Overall, results showed that FAM operations with multiple Traffic Management Coordinators, Area Supervisors, and controllers worked remarkably well. The results showed both user and system benefits, some of which include the increased throughput, decreased flight distance, more manageable sector loads, and better utilized airspace. Also, the roles, procedures, airspace designs, and tools were all very well received. Airspace configuration options that resulted from a combination of algorithm-generated airspace configurations with manual modifications were well acceptec and posed little difficuIty and/or workload during airspace reconfiguration process. The results suggest a positive impact of FAM operations in HAA. Further investigation would be needed to evaluate if the benefits and feasibility would extend in either non-HAA or mixed equipage environment.

  2. Transvaginal cervical length and tobacco use in Appalachian women: association with increased risk for spontaneous preterm birth.

    PubMed

    Findley, Joseph; Seybold, Dara J; Broce, Mike; Yadav, Dolly; Calhoun, Byron C

    2015-01-01

    Currently ACOG recommends that a mid-term screening strategy may be considered to identify short cervix in low risk populations in an effort to prevent preterm birth. Vaginal progesterone is recommended for women with a cervical length ≤20 mm. Cerclage is recommended for women with prior spontaneous preterm birth who are already receiving progesterone supplementition and CL is <25 mm. This study examined risk factors for spontaneous preterm birth (SPB) <35 weeks among a general obstetrical population prior to these ACOG recommendations. However, cervical cerclage was a possible intervention. Study population included 1,074 patients from 1 Jan 2007-30 Jun 2008 receiving mid-trimester transvaginal ultrasounds during prenatal care at a tertiary medical center clinic. Receiver operator characteristic (ROC) curve cutoff optimal value was ≤34 mm, (n=224), corresponding to 8.9% SPB with shortened cervices compared to 1.4% in patients with normal cervices (>34 mm; n=850; p<0.001 (Area Under the Curve (AUC) 76.6, p<0.001). Cervical lengths <30 mm had 12 times the risk of SPB (p<0.001) while 30-34 mm had 5 times (p=0.005). Tobacco use (≥10 cigarettes per day), p=0.030, and low BMI, p=0.034, had additive effect. Shortened cervical length during routine screening independently predicted SPB while heavy smoking with shortened cervix during pregnancy doubled risk compared to shortened cervix alone. PMID:26050294

  3. Single injection of platelet-rich plasma as a novel treatment of carpal tunnel syndrome

    PubMed Central

    Malahias, Michael Alexander; Johnson, Elizabeth O.; Babis, George C.; Nikolaou, Vasileios S.

    2015-01-01

    Both in vitro and in vivo experiments have confirmed that platelet-rich plasma has therapeutic effects on many neuropathies, but its effects on carpal tunnel syndrome remain poorly understood. We aimed to investigate whether single injection of platelet-rich plasma can improve the clinical symptoms of carpal tunnel syndrome. Fourteen patients presenting with median nerve injury who had suffered from mild carpal tunnel syndrome for over 3 months were included in this study. Under ultrasound guidance, 1–2 mL of platelet-rich plasma was injected into the region around the median nerve at the proximal edge of the carpal tunnel. At 1 month after single injection of platelet-rich plasma, Visual Analogue Scale results showed that pain almost disappeared in eight patients and it was obviously alleviated in three patients. Simultaneously, the disabilities of the arm, shoulder and hand questionnaire showed that upper limb function was obviously improved. In addition, no ultrasonographic manifestation of the carpal tunnel syndrome was found in five patients during ultrasonographic measurement of the width of the median nerve. During 3-month follow-up, the pain was not greatly alleviated in three patients. These findings show very encouraging mid-term outcomes regarding use of platelet-rich plasma for the treatment of carpal tunnel syndrome. PMID:26807124

  4. [Serum mesothelin dosages in follow-up of previously exposed workers].

    PubMed

    Foddis, R; Vivaldi, A; Filiberti, R; Puntoni, R; Mutti, L; Ambrosino, N; Chella, A; Guglielmi, G; Gattini, V; Buselli, R; Perretta, S; Cristaudo, A

    2007-01-01

    High dosages of Serum Mesothelin have been demonstrated to be significantly associated to Pleural Malignant Mesothelioma. We recently demonstrated that Serum Mesothelin may be clinically helpful both for diagnostic and prognostic purposes, with the best cut-off corresponding to 1 nM. We also discovered that high levels of Serum Mesothelin are significantly associated to Lung Cancer. The usefulness of this marker in secondary prevention has been suggested, though never demonstrated. We therefore started a long-term prospective cohort study including previously asbestos-exposed workers. These subjects periodically underwent both radiological tests and serum mesothelin dosages. As a mid-term goal of this longitudinal study we decided to check the variability of mesothelin dosages, comparing baseline and follow-up values, as well as the possible correlation with age, duration of exposure, smoking, any abnormality of respiratory functional tests (RFT) and/or radiological tests. At baseline, Mesothelin mean value was 0.66 +/- 0.4 (range 0.08-2.2 nM). Both age (p = 0.04) and abnormal thoracic TC (p = 0.04) were significantly correlated with increased serum mesothelin levels and increasing age. No association was found between baseline mesothelin levels and duration of asbestos exposure (p = 0.5), smoking habits (p = 0.2), abnormal RFT, DLCO (carbon monoxide diffusing capacity) or thoracic X-ray. No significant variation was observed between mesothelin values at baseline and at follow-up (p = 0.2). PMID:18409716

  5. Development of a computer-based instructional system in pharmacokinetics: efficacy in clinical pharmacology teaching for senior medical students.

    PubMed

    Feldman, R D; Schoenwald, R; Kane, J

    1989-02-01

    The teaching of pharmacokinetics is acknowledged to be a key aspect of the core curriculum in clinical pharmacology and therapeutics, but is also widely acknowledged to be a very difficult part of the curriculum to teach. In order to assess the potential efficacy of interactive computer instruction in clinical pharmacokinetics we have developed a prototype computer-based instructional package. The courseware contains a comprehensive learning system including tutorial, simulation, and problem solving components. To determine the efficacy of this approach we randomly assigned senior medical student volunteers enrolled in the fourth year clinical pharmacology and therapeutics course to receive conventional teaching in clinical pharmacokinetics and/or adjuctive teaching using the computer-based instructional system. There was a high degree of acceptance of the program and over the short term of the trial those students using the computer program scored significantly higher [35%, P less than 0.05] on the mid-term pharmacokinetics quiz. The data suggests that a computerized instructional system in pharmacokinetics may significantly improve the teaching of clinical pharmacokinetics to medical students. PMID:2654201

  6. Coupling LMDZ physics in WRF model: Aqua-planet configuration tests

    NASA Astrophysics Data System (ADS)

    Fita, Lluís; Hourdin, Frédéric; Fairhead, Laurent; Drobinski, Phlippe

    2014-05-01

    Nowadays advances in climatological sciences, pose different challenges for the current global climate models (GCM). One of them is related to the resolution. In some exercises, GCMs are started to be used to that resolutions to which they were not designed for, or in advance of future uses, they have to be tested in order to know their limitations. With the mid term perspective in mind of future uses of the Laboratorie de Météorologie Dynamique Zoom (LMDZ) model, a framework has been designed in order to use the physical parameterizations of the LMDZ model coupled to the dynamical core of Weather Research and Forecasting (WRF) model. This framework will allow the analysis of different aspects such as: resolution thresholds of the LMDZ physics set, skill of LMDZ physics in comparison with cloud resolving simulations, impact of the primitive equations fully compressible dynamics from WRF in global runs among others. The design and implementation of the framework keeps almost all the original capabilities of both models. As a first step, results of an ensemble of 1-year low-resolution global aqua-planet runs performed with the original models using different physical configurations, and the new framework will be presented. These initial results show the correct performance of the new framework, and the sensitivity of the global circulation due to different dynamical atmospheric cores and physical parameterizations.

  7. Beamed Energy Propulsion: Research Status And Needs--Part 2

    SciTech Connect

    Birkan, Mitat

    2008-04-28

    One promising solution to the operationally responsive space is the application of remote electromagnetic energy to propel a launch vehicle into orbit. With beamed energy propulsion, one can leave the power source stationary on the ground or space, and direct heat propellant on the spacecraft with a beam from a fixed station. This permits the spacecraft to leave its power source at home, saving significant amounts of mass, greatly improving performance. This concept, which removes the mass penalty of carrying the propulsion energy source on board the vehicle, was first proposed by Arthur Kantrowitz in 1972; he invoked an extremely powerful ground based laser. The same year Michael Minovich suggested a conceptually similar 'in-space' laser rocket system utilizing a remote laser power station. In the late 1980's, Air Force Office of Scientific Research (AFOSR) funded continuous, double pulse laser and microwave propulsion while Strategic Defense Initiative Office (SDIO) funded ablative laser rocket propulsion. Currently AFOSR has been funding the concept initiated by Leik Myrabo, repetitively pulsed laser propulsion, which has been universally perceived, arguably, to be the closest for mid-term applications. This 2-part paper examines the investment strategies in beamed energy propulsion and technical challenges to be covers Part 2 covers the present research status and needs.

  8. Beamed Energy Propulsion: Research Status And Needs--Part 1

    SciTech Connect

    Birkan, Mitat

    2008-04-28

    One promising solution to the operationally responsive space is the application of remote electromagnetic energy to propel a launch vehicle into orbit. With beamed energy propulsion, one can leave the power source stationary on the ground or space, and direct heat propellant on the spacecraft with a beam from a fixed station. This permits the spacecraft to leave its power source at home, saving significant amounts of mass, greatly improving performance. This concept, which removes the mass penalty of carrying the propulsion energy source on board the vehicle, was first proposed by Arthur Kantrowitz in 1972; he invoked an extremely powerful ground based laser. The same year Michael Minovich suggested a conceptually similar 'in-space' laser rocket system utilizing a remote laser power station. In the late 1980's, Air Force Office of Scientific Research (AFOSR) funded continuous, double pulse laser and microwave propulsion while Strategic Defense Initiative Office (SDIO) funded ablative laser rocket propulsion. Currently AFOSR has been funding the concept initiated by Leik Myrabo, repetitively pulsed laser propulsion, which has been universally perceived, arguably, to be the closest for mid-term applications. This 2-part paper examines the investment strategies in beamed energy propulsion and technical challenges to be overcome. Part 1 presents a world-wide review of beamed energy propulsion research, including both laser and microwave arenas.

  9. Neuroprotective role of estrogens: relationship with insulin/IGF-1 signaling.

    PubMed

    Alonso, Ana; Gonzalez, Celestino

    2012-01-01

    Postmenopausal women have an elevated risk of developing a neurodegenerative disease. These clinical observation supported by basic research, suggest that estrogens are neuroprotective. Insulin resistance represents an independent factor in the etiology of age-associated disease and metabolic syndrome should be considered as a contributing factor to the higher post-menopausal vulnerability to neurological disorders. Elucidating the relationship between insulin resistance associated with aging in females, and the cross-talk between estradiol, insulin, and insulin-like growth factor (IGF-1) signaling pathways, will lead to a more complete understanding of the mechanism underlying estradiol-mediated neuroprotection. In past decades, estrogen replacement therapy (ERT) was commonly used as a palliative therapy during menopause, but the mid-term and long-term effects of estrogen as possible promoters of breast cancer and the increased risk of coronary illness or stroke, has limited current usage. A deeper understanding of the molecular mechanisms common to all forms of neurodegenerative diseases may hasten the development of protective strategies against chronic age-related deterioration and acute illness, ultimately providing a better quality of life for the elderly. PMID:22201898

  10. DC State of Mind; A Congressional update

    NASA Astrophysics Data System (ADS)

    Larsen, Kristopher

    2010-10-01

    Every day the headlines are dominated by news of a slow economic recovery, high unemployment, and a Congress focused on the next election. Deficit hawks, Tea Partiers, partisanship, and mid-term elections are all topics typically outside the ken of physics but are critically important to our ability to continue to pursue cutting edge innovative research. For example, during the last six months Congress has, among other things, worked on passing the 2011 federal budget and reauthorization of America COMPETES. Both of these major pieces of legislation are fundamental to how our country will fund physics research for the next few years. For the past two years, science has done very well thanks to the support of Congress and the administration. The coming years are going to be far more difficult and every physicist needs to commit themselves to defending the gains we have made. This talk will provide an overview of what has happened on Capitol Hill in the past few months and what, to the best of our knowledge, the physics community can expect for the coming years. The legislative successes of the last few months were, in part, made possibly with the aid of physicists who got involved. Around the country, physicists wrote opinion pieces for their local papers, wrote letters-to-the-editor, called their representatives, made their voices heard and helped shape policy.

  11. DC State of Mind; A Congressional update

    NASA Astrophysics Data System (ADS)

    Larsen, Kristopher

    2010-10-01

    Every day the headlines are dominated by news of a slow economic recovery, high unemployment, and a Congress focused on the next election. Deficit hawks, Tea Partiers, partisanship, and mid-term elections are all topics typically outside the ken of physics but are critically important to our ability to continue to pursue cutting edge innovative research. For example, during the last six months Congress has, among other things, worked on passing the 2011 federal budget and reauthorization of America COMPETES. Both of these major pieces of legislation are fundamental to how our country will fund physics research for the next few years. For the past two years, science has done very well thanks to the support of Congress and the administration. The coming years are going to be far more difficult and every physicist needs to commit themselves to defending the gains we have made. This poster will provide an overview of what has happened on Capitol Hill in the past few months and what, to the best of our knowledge, the physics community can expect for the coming years. The legislative successes of the last few months couldn't of happened without the aid of physicists who got involved. Around the country, physicists wrote opinion pieces for their local papers, wrote letters-to-the-editor, called their representatives, made their voices heard and helped shape policy.

  12. An overview of the zinc market

    SciTech Connect

    Murphy, J.N.; Walsh, K.

    1997-12-31

    The primary sources of zinc are discussed, as well as the primary methods of production. The zinc markets are presented focusing on the use of zinc in North America and its supply and demand. The growth of the zinc market will be fueled mainly by rapidly expanding Asian economies. Galvanized steel represents 50% of zinc consumption and its increased use in automobiles and construction worldwide is the major growth sector predicted for the zinc industry. Increases in consumption will not be matched by increases in production capacity in the short to mid term, indicating that there will be significant demand for secondary sources to supplement primary production of zinc metal. Recycling of new and old zinc scrap and processing of zinc wastes will play a significant role in the life cycle of the metal. Increased production of steel from scrap in electric arc furnaces and a continued increase in the use of galvanized steel indicate that zinc-bearing electric arc furnace dust is a growing source of secondary zinc. Secondary zinc availability will continue to grow as an increased awareness of the environment and sound economic principals dictate that scrap zinc be returned to the life cycle. Increased recycling and the continued development of current and new technologies, for processing secondary zinc, will supplement primary production.

  13. Recanalization of post-transplant late-onset long segmental portal vein thrombosis with bidirectional transhepatic and transmesenteric approach.

    PubMed

    Nosaka, Shunsuka; Isobe, Yoshinori; Kasahara, Mureo; Miyazaki, Osamu; Sakamoto, Seisuke; Uchida, Hajime; Shigeta, Takanobu; Masaki, Hidekazu

    2013-03-01

    PV complications are the most frequent vascular complications in pediatric LT. We have experienced a case with chronic postoperative PVT that necessitates combined transhepatic and transmesenteric approach and have confirmed mid-term patency. An eight-yr-old boy had successful LDLT with a left lateral segment graft at the age of two months for HBV-related acute liver failure. Seven years after transplantation, the patient suddenly showed a melena with hypovolemic shock. Doppler ultrasound and CT revealed intrahepatic bile duct dilatation and main PVT with collateral formation at hepatic hilus and mesenterium of the Roux-en-Y jejunal loop. Urgent splenic artery embolization was performed to control the bleeding and was temporarily effective. Therefore, recanalization of PVO was attempted. Because of long segmental PVO and steep angle between the intrahepatic PV and the portal trunk, bidirectional transhepatic and transmesenteric approach was selected and resulted in deploying three metallic stents necessitating additional infusion thrombolytic therapy. The patient is now followed as an outpatient with patent stents for two yr since the procedure. For the rescue of these patients, recanalization of obstructed PV trunk with bidirectional approach would be feasible with better graft survival and less invasiveness than conventional surgical interventions. PMID:23442104

  14. Governance and evaluation: the case of EU regional policy horizontal priorities.

    PubMed

    Gore, Tony; Wells, Peter

    2009-05-01

    This paper argues that the framing of many programme evaluations tends to eschew any rigorous exploration of the governance aspects of programme design and implementation. This is illustrated by an examination of the method-based approach endorsed by the European Commission for the evaluation of its regional policy programmes. In line with previous work, this found that such evaluations, particularly those using management-based approaches, underplay the role of social and political agency in programme framing and implementation, and therefore in explaining outcomes. Acknowledging such factors is especially important in evaluating cross-cutting themes such as equal opportunities, environmental sustainability and social inclusion. Known as horizontal priorities in European Union policies, such issues at their heart reflect unease with the traditional functional organisation of the modern state, which while providing organisational efficiency gains for planning, is not able to cater for complex and multiple social realities in a postmodern world. Using evidence from South Yorkshire, United Kingdom, and in particular the Mid Term Evaluation of the 2000-2006 European Union Structural Funds Programme, the paper argues that a robust evaluation of such horizontal priorities has to incorporate the full range of governance factors. This is because their framing, implementation and possible achievements are contingent on, and shaped by, the mobilisation of social and political actors. PMID:19081136

  15. Origin of the torus mandibularis: an embryological hypothesis.

    PubMed

    Rodríguez-Vázquez, José Francisco; Sakiyama, Koji; Verdugo-López, Samuel; Amano, Osamu; Murakami, Gen; Abe, Shinichi

    2013-11-01

    Torus mandibularis, a well-known protuberance in the dental field, has been defined as a hyperostosis in the lingual aspect of the body of the mandible above the mylohyoid line. However, the origin of the torus mandibularis has not yet been clarified. The aim of this study was to provide a better understanding on the origin of the torus in view of the specific development of Meckel's cartilage at the site corresponding to the adult torus. A total of 40 mid-term human fetuses at 7-16 weeks of gestation were examined. The 10-13 weeks stage corresponded to the critical period in which Meckel's cartilage with endochondral ossification underwent a bending at the beginning of the intramandibular course. At the level of mental foramen, which was located between the deciduous canine and the first deciduous molar germs, the medial lamina of the mandible protruded medially to reach Meckel's cartilage. Thus, the medial lamina covered the posterior and superior aspect of the bending Meckel's cartilage just above the attachment of the developing mylohyoid muscle (i.e., in the oral cavity). We considered a bony prominence, which composed the protruding medial lamina and the bending Meckel's cartilage as the fetal origin of the torus mandibularis. A new theory is proposed for the origin of the torus mandibularis based on the existence of an anlage formed during the development of the mandible, variable in morphology and size, but always constant. PMID:23813628

  16. Lunate Osteochondral Fracture Treated by Excision: A Case Report and Literature Review

    PubMed Central

    Saberi, Sadegh; Arabzadeh, Aidin; Farhoud, Amir Reza

    2016-01-01

    Introduction Lunate fracture is a rare injury. Most reports are associated with other wrist injuries such as perilunate dislocation and distal radius fracture. Isolated lunate fracture has been reported even more rarely. The choice of treatment and outcomes are consequently undetermined. Case Presentation In this case report we will describe a lunate avulsion fracture as an isolated injury after a fall from nine meters treated operatively by excision of the comminuted avulsed fragment. After 33 months of follow-up radiographs showed no sign of degenerative joint disorder on simple X-ray, but slight Volar Intercalated Segment Instability (VISI) by a capitolunate angle of 26 degrees was noted. Clinically, the patient was pain free near full wrist and forearm range of motion and could perform his previous vocational and recreational tasks without any limitations. Conclusions Despite apparently good short and mid-term clinical outcome, slight volar intercalated segment instability after 33 months of follow-up revealed that lunotriquetral ligament function was probably lost, which led to static instability. This ligament injury may be missed primarily. Excision of the avulsed osteochondral fragment should be the last option of treatment and most attempts should be tried to fix and/or restore the normal anatomy of ligamentous structure.

  17. Potential of the TCE-degrading endophyte Pseudomonas putida W619-TCE to improve plant growth and reduce TCE phytotoxicity and evapotranspiration in poplar cuttings

    SciTech Connect

    Weyens, N.; van der Lelie, D.; Truyens, S.; Dupae, J.; Newman, L.; Taghavi, S.; Carleer, R.; Vangronsveld, J.

    2010-09-01

    The TCE-degrading poplar endophyte Pseudomonas putida W619-TCE was inoculated in poplar cuttings, exposed to 0, 200 and 400 mg l{sup -1} TCE, that were grown in two different experimental setups. During a short-term experiment, plants were grown hydroponically in half strength Hoagland nutrient solution and exposed to TCE for 3 days. Inoculation with P. putida W619-TCE promoted plant growth, reduced TCE phytotoxicity and reduced the amount of TCE present in the leaves. During a mid-term experiment, plants were grown in potting soil and exposed to TCE for 3 weeks. Here, inoculation with P. putida W619-TCE had a less pronounced positive effect on plant growth and TCE phytotoxicity, but resulted in strongly reduced amounts of TCE in leaves and roots of plants exposed to 400 mg l{sup -1} TCE, accompanied by a lowered evapotranspiration of TCE. Dichloroacetic acid (DCAA) and trichloroacetic acid (TCAA), which are known intermediates of TCE degradation, were not detected. The endophyte P. putida W619-TCE degrades TCE during its transport through the xylem, leading to reduced TCE concentrations in poplar, and decreased TCE evapotranspiration.

  18. Superfund flop, new Congress fail to faze environmental execs

    SciTech Connect

    Bishop, J.

    1995-01-01

    Congressional failure to pass a Superfund reauthorization bill this fall disappointed environmental consulting and engineering companies, environmentalists and parties liable for site cleanups. The Clinton administration's reform bill was introduced in the House Feb. 3, six months overdue, only seven months before Congress' annual summer break and less than a year before mid-term elections. The House bill was revised in August, but reauthorization was declared a lost cause in October, when supporters faced the harsh political fact that Republicans would hold the line against passing a new law until after the November elections. Of the three major environmental laws overdue for reauthorization--the Resource Conservation and Recovery Act, Clean Water Act and Superfund (officially, the Comprehensive Environmental Response, Compensation and Liability Act)--the Superfund law appears to have the best chance of making it through the 104 Congress successfully. The latest version of the administration-sponsored bill received wide-spread support from environmentalists, industry and environmental business groups as being more reasonable and fair than the existing law.

  19. Management of failed rotator cuff repair: a systematic review

    PubMed Central

    Lädermann, Alexandre; Denard, Patrick J; Burkhart, Stephen S

    2016-01-01

    Importance Recurrent tear after rotator cuff repair (RCR) is common. Conservative, and open and arthroscopic revisions, have been advocated to treat these failures. Aim or objective The purpose of this systematic review was to evaluate the different options for managing recurrent rotator cuff tears. Evidence review A search was conducted of level I through 4 studies from January 2000 to October 2015, to identify studies reporting on failed RCR. 10 articles were identified. The overall quality of evidence was very low. Findings Mid-term to long-term follow-up of patients treated conservatively revealed acceptable results; a persistent defect is a well-tolerated condition that only occasionally requires subsequent surgery. Conservative treatment might be indicated in most patients, particularly in case of posterosuperior involvement and poor preoperative range of motion. Revision surgery might be indicated in a young patient with a repairable lesion, a 3 tendon tear, and in those with involvement of the subscapularis. Conclusions and relevance The current review indicates that arthroscopic revision RCR can lead to improvement in functional outcome despite a high retear rate. Further studies are needed to develop specific rehabilitation in the case of primary rotator cuff failure, to better understand the place of each treatment option, and, in case of repair, to optimise tendon healing. PMID:27134759

  20. Efficient production of multi-modified pigs for xenotransplantation by ‘combineering’, gene stacking and gene editing

    PubMed Central

    Fischer, Konrad; Kraner-Scheiber, Simone; Petersen, Björn; Rieblinger, Beate; Buermann, Anna; Flisikowska, Tatiana; Flisikowski, Krzysztof; Christan, Susanne; Edlinger, Marlene; Baars, Wiebke; Kurome, Mayuko; Zakhartchenko, Valeri; Kessler, Barbara; Plotzki, Elena; Szczerbal, Izabela; Switonski, Marek; Denner, Joachim; Wolf, Eckhard; Schwinzer, Reinhard; Niemann, Heiner; Kind, Alexander; Schnieke, Angelika

    2016-01-01

    Xenotransplantation from pigs could alleviate the shortage of human tissues and organs for transplantation. Means have been identified to overcome hyperacute rejection and acute vascular rejection mechanisms mounted by the recipient. The challenge is to combine multiple genetic modifications to enable normal animal breeding and meet the demand for transplants. We used two methods to colocate xenoprotective transgenes at one locus, sequential targeted transgene placement - ‘gene stacking’, and cointegration of multiple engineered large vectors - ‘combineering’, to generate pigs carrying modifications considered necessary to inhibit short to mid-term xenograft rejection. Pigs were generated by serial nuclear transfer and analysed at intermediate stages. Human complement inhibitors CD46, CD55 and CD59 were abundantly expressed in all tissues examined, human HO1 and human A20 were widely expressed. ZFN or CRISPR/Cas9 mediated homozygous GGTA1 and CMAH knockout abolished α-Gal and Neu5Gc epitopes. Cells from multi-transgenic piglets showed complete protection against human complement-mediated lysis, even before GGTA1 knockout. Blockade of endothelial activation reduced TNFα-induced E-selectin expression, IFNγ-induced MHC class-II upregulation and TNFα/cycloheximide caspase induction. Microbial analysis found no PERV-C, PCMV or 13 other infectious agents. These animals are a major advance towards clinical porcine xenotransplantation and demonstrate that livestock engineering has come of age. PMID:27353424

  1. Clinical, electrocardiographic and echocardiographic abnormalities in Latin American migrants with newly diagnosed Chagas disease 2005-2009, Barcelona, Spain.

    PubMed

    Valerio, L; Roure, S; Sabria, M; Balanzo, X; Valles, X; Seres, L

    2011-01-01

    Following Latin American migration, Chagas disease has inevitably appeared in non-endemic countries in Europe and elsewhere. New policies are necessary to prevent transmission in those countries but the long, often undetected chronic period of the early stages of the disease also renders epidemiological studies important. The main objective of our study was to determine the presence of clinical, electrocardiogram (ECG) and echocardiographic abnormalities in a population of Latin American migrants infected with Trypanosoma cruzi at the moment of diagnosis. We performed a hospital-based observational study of 100 adult patients with newly diagnosed Chagas infection between January 2005 and December 2009. Thirty-seven patients were classified within the Brazilian Consensus on Chagas cardiomyopathy early cardiac stages (A or B1) and 49 presented pathological findings (stage B2) according to the Panamerican Health Organization Classification. Overall, 49 patients showed ECG and/or echocardiographic alterations. The presence of ECG and ecocardiographic alterations were significantly associated (p=0.038). The most frequent ECG and echocardiographic findings were right bundle branch block (12 cases) and impaired left ventricular wall relaxation (24 cases), respectively. In conclusion, ECG and echocardiographic alterations coherent with Chagas cardiomyopathy were found in a large proportion of newly diagnosed Latin American migrants infected with T. cruzi. In the mid-term, Chagas disease might become an important cause of chronic cadiomyopathy in our attendance area. PMID:21958530

  2. Stent-Grafts for Unruptured Abdominal Aortic Aneurysms: Current Status

    SciTech Connect

    Rose, John

    2006-06-15

    Aortic stent-grafts were introduced at the beginning of the 1990s as a less invasive method of dealing with aortic aneurysms in patients with poor cardiovascular reserve. The numbers of procedures performed worldwide has increased exponentially despite the current lack of any substantial evidence for long-term efficacy in comparison with the gold standard of open surgical grafting. This review summarizes the evolution of the abdominal aortic stent-graft, the techniques used for assessment and deployment, and the effect of the procedure on both the patient and the device. The recent publication of two national multicenter trials has confirmed that the endovascular technique confers a 2.5-fold reduction in 30-day mortality in comparison with open surgery. However, over 4 years of follow-up, there is a 3-fold increase in the risk of reintervention and the overall costs are 30% greater with endovascular repair. Although the improvement in aneurysm-related mortality persists in the mid-term, because of the initial reduction in perioperative mortality, the all-cause mortality rate at 4 years is actually no better than for open surgery. Longer-term data from the randomized trials are awaited as well as results from the latest trials utilizing state-of-the-art devices. Whilst the overall management of abdominal aortic aneurysms has undoubtedly benefited from the introduction of stent-grafts, open repair currently remains the gold standard treatment.

  3. Resolved Abdominal Aortic Aneurysms Following Stent Graft Treatment: A Report of Five Cases

    SciTech Connect

    Rimon, Uri; Garniek, Alexander; Golan, Gil; Bensaid, Paul; Galili, Yair; Schneiderman, Jacob; Morag, Benyamina

    2004-03-15

    Complete aneurysm resolution is the hallmark of successful endoluminal stent-graft treatment. We describe 5 patients in whom an abdominal aortic aneurysm (AAA) disappeared completely at mid-term follow-up after endovascular stent-graft placement. We reviewed 45 patients (43 men and 2 women) who underwent AAA repair using an endovascular technique, from April 1997 to December 2001. Mean AAA diameter was 58.3 mm. On 48-month follow-up, 12 aneurysms had not changed in size, 4 had grown, 16 had shrunk, and 5 had resolved completely. We describe these 5 patients in detail. The 5 patients were all men, mean age 68 years; their mean aneurysmal sac diameter was 54 mm. The only common finding in all of them was patency of lumbar and inferior mesenteric arteries at pre-procedure evaluation as well as at follow-up. Mean time to complete resolution was 18 months. No major complications were encountered. AAA may resolve completely after endovascular stent-graft implantation. Patent side branches may perhaps contribute to AAA disappearance by antegrade flow. A larger patient population should be reviewed, however, before any statistical conclusion can be drawn.

  4. [Interventional MRI. Analysis of data and prospects].

    PubMed

    Clarisse, J; Rousseau, J; Sergent, G; Delomez, J; Daanen, V; Godard, F

    1999-11-01

    In spite of its many advantages: 3D imaging, improved tissue characterization, and lack of ionizing radiation, interventional MRI remains seldom used. Several factors are involved. The purpose of this paper is to analyze the factors preventing or slowing the development of this technique based on a review of data from the literature, work presented at the second symposium on interventional MRI (Düsseldorf, 1997), and our own experimental data. The following elements will be discussed: difficulties related to image quality and open magnets, control of targeted image acquisitions, MR environment and problems related to asepsis, as well as advances of other techniques. Finally, short-term and mid-term perspectives will be presented. These are related to the goals of the technique: open or short bore closed magnets? MR unit installed in a radiology department? MR unit dedicated to interventional procedures only or mixed diagnostic-interventional unit? interventional MR unit placed in a neurosurgery operating room? interventional MR unit installed in a general surgery operating room? PMID:10592909

  5. Radiographic evaluation of HDPE cemented and cementless Lord and An.C.A. screwed acetabular models.

    PubMed

    Toni, A; Sudanese, A; Viceconti, M; Montina, P P; Ciaroni, D; Calista, F; Terzi, S; Giunti, A

    1992-01-01

    A total of 187 alumina screwed porous-ceramic coated sockets (An.C.A.), 48 screwed smooth-surfaced Lord sockets, and 251 cemented polyethylene sockets were radiographically evaluated at an average follow-up of 30, 51 and 96 months respectively. After 6 years the Lord prostheses revealed a 38% incidence of loosening, similar to that observed for cemented sockets 10-12 years after surgery. The An.C.A. prostheses revealed radiographic loosening equal to 12% (6 cases) in the first 50 implants, and only 0.7% in the remaining 137 cases: overall, the An.C.A. acetabular prosthesis revealed an index of radiographic loosening equal to 3.3% (7/187). To guarantee "osteointegration" of the porous coating of An.C.A. sockets optimal stability must be obtained when the prosthesis is screwed in. Because the mid-term follow-up for this clinical experience is relatively short (30 months), an opinion on the reliability of the screwed "porous" sockets must await confirmation. PMID:1297574

  6. Noninferiority of Shanghai Cingular biotech’s bovine pericardial valve preclinical study in juvenile ovine model

    PubMed Central

    Chen, Jin-Miao; Ding, Yu; Lu, Shu-Yang; Pan, Sun; Abudupataer, Mieradilijiang

    2016-01-01

    Background This study introduces a newly Chinese domestic-designed/manufactured bovine pericardial valve, the SCBC valve (Shanghai Cingular Biotech Corporation, Shanghai, China), and evaluates its hemodynamic performance and calcification potential compared with the Carpentier-Edwards (CE) PerimountTM valve (Edwards Lifesciences, Irvine, CA, USA) in juvenile sheep for preclinical study. Methods Five SCBC valves in study group and three CE PerimountTM valves (6900P with TFX) in control group were implanted in the mitral position of juvenile sheep and followed up for five months. Transthoracic echocardiography (TTE) for hemodynamic measurement was performed ten days, three months and five months postoperatively. Valve calcification was assessed by X-ray after euthanasia. Other collected data included macroscopic examination, blood analysis, microorganism culture and histological assessment. Results All sheep in two groups lived to sacrifice without evidence of valvular dysfunction. The SCBC valve had similar hemodynamic performance and susceptibility of calcification compared with the CE PerimountTM valve in juvenile ovine model. In all other parameters, the SCBC valve also exhibited no significant difference compared with the CE PerimountTM valve. Conclusions Our study demonstrated that the SCBC valve can exhibit similar mid-term satisfactory safety and efficacy compared with the CE PerimountTM valve in the mitral position of juvenile sheep model. PMID:27293835

  7. Cruciate retaining and cruciate substituting ultra-congruent insert

    PubMed Central

    Deledda, Davide; Rosso, Federica; Ratto, Nicola; Bruzzone, Matteo; Bonasia, Davide Edoardo; Rossi, Roberto

    2016-01-01

    The posterior cruciate ligament (PCL) conservation and the polyethylene insert constraint in total knee arthroplasty (TKA) are still debated. The PCL is one of the primary stabilizers of the joint, but cruciate retaining (CR) implants have the disadvantage of a difficult balancing of the PCL. Postero-stabilized (PS) implants were introduced to reduce this problem. However, also the PS implants have some disadvantages, due to the cam-mechanism, such as high risk of cam-mechanism polyethylene wear. To minimize the polyethylene wear of the cam-mechanism and the bone sacrifice due to the intercondylar box, different types of inserts were developed, trying to increase the implant conformity and to reduce stresses on the bone-implant interface. In this scenario ultra-congruent (UC) inserts were developed. Those inserts are characterized by a high anterior wall and a deep-dished plate. This conformation should guarantee a good stability without the posterior cam. Few studies on both kinematic and clinical outcomes of UC inserts are available. Clinical and radiological outcomes, as well as kinematic data are similar between UC mobile bearing (MB) and standard PS MB inserts at short to mid-term follow-up. In this manuscript biomechanics and clinical outcomes of UC inserts will be described, and they will be compared to standard PS or CR inserts. PMID:26855938

  8. Integrated geological-engineering model of Patrick Draw field and examples of similarities and differences among various shoreline barrier systems

    SciTech Connect

    Schatzinger, R.A.; Szpakiewicz, M.J.; Jackson, S.R.; Chang, M.M.; Sharma, B.; Tham, M.K.; Cheng, A.M.

    1992-04-01

    The Reservoir Assessment and Characterization Research Program at NIPER employs an interdisciplinary approach that focuses on the high priority reservoir class of shoreline barrier deposits to: (1) determine the problems specific to this class of reservoirs by identifying the reservoir heterogeneities that influence the movement and trapping of fluids; and (2) develop methods to characterize effectively this class of reservoirs to predict residual oil saturation (ROS) on interwell scales and improve prediction of the flow patterns of injected and produced fluids. Accurate descriptions of the spatial distribution of critical reservoir parameters (e.g., permeability, porosity, pore geometry, mineralogy, and oil saturation) are essential for designing and implementing processes to improve sweep efficiency and thereby increase oil recovery. The methodologies and models developed in this program will, in the near- to mid-term, assist producers in the implementation of effective reservoir management strategies such as location of infill wells and selection of optimum enhanced oil recovery methods to maximize oil production from their reservoirs.

  9. Targeted technology applications for infield reserve growth: A synopsis of the Secondary Natural Gas Recovery project, Gulf Coast Basin. Topical report, September 1988--April 1993

    SciTech Connect

    Levey, R.A.; Finley, R.J.; Hardage, B.A.

    1994-06-01

    The Secondary Natural Gas Recovery (SGR): Targeted Technology Applications for Infield Reserve Growth is a joint venture research project sponsored by the Gas Research Institute (GRI), the US Department of Energy (DOE), the State of Texas through the Bureau of Economic Geology at The University of Texas at Austin, with the cofunding and cooperation of the natural gas industry. The SGR project is a field-based program using an integrated multidisciplinary approach that integrates geology, geophysics, engineering, and petrophysics. A major objective of this research project is to develop, test, and verify those technologies and methodologies that have near- to mid-term potential for maximizing recovery of gas from conventional reservoirs in known fields. Natural gas reservoirs in the Gulf Coast Basin are targeted as data-rich, field-based models for evaluating infield development. The SGR research program focuses on sandstone-dominated reservoirs in fluvial-deltaic plays within the onshore Gulf Coast Basin of Texas. The primary project research objectives are: To establish how depositional and diagenetic heterogeneities cause, even in reservoirs of conventional permeability, reservoir compartmentalization and hence incomplete recovery of natural gas. To document examples of reserve growth occurrence and potential from fluvial and deltaic sandstones of the Texas Gulf Coast Basin as a natural laboratory for developing concepts and testing applications. To demonstrate how the integration of geology, reservoir engineering, geophysics, and well log analysis/petrophysics leads to strategic recompletion and well placement opportunities for reserve growth in mature fields.

  10. Design rules for successful governmental payments for ecosystem services: Taking agri-environmental measures in Germany as an example.

    PubMed

    Meyer, Claas; Reutter, Michaela; Matzdorf, Bettina; Sattler, Claudia; Schomers, Sarah

    2015-07-01

    In recent years, increasing attention has been paid to financial environmental policy instruments that have played important roles in solving agri-environmental problems throughout the world, particularly in the European Union and the United States. The ample and increasing literature on Payments for Ecosystem Services (PES) and agri-environmental measures (AEMs), generally understood as governmental PES, shows that certain single design rules may have an impact on the success of a particular measure. Based on this research, we focused on the interplay of several design rules and conducted a comparative analysis of AEMs' institutional arrangements by examining 49 German cases. We analyzed the effects of the design rules and certain rule combinations on the success of AEMs. Compliance and noncompliance with the hypothesized design rules and the success of the AEMs were surveyed by questioning the responsible agricultural administration and the AEMs' mid-term evaluators. The different rules were evaluated in regard to their necessity and sufficiency for success using Qualitative Comparative Analysis (QCA). Our results show that combinations of certain design rules such as environmental goal targeting and area targeting conditioned the success of the AEMs. Hence, we generalize design principles for AEMs and discuss implications for the general advancement of ecosystem services and the PES approach in agri-environmental policies. Moreover, we highlight the relevance of the results for governmental PES program research and design worldwide. PMID:25909439

  11. Model documentation report: Industrial sector demand module of the National Energy Modeling System

    SciTech Connect

    1997-01-01

    This report documents the objectives, analytical approach, and development of the National Energy Modeling System (NEMS) Industrial Demand Model. The report catalogues and describes model assumptions, computational methodology, parameter estimation techniques, and model source code. This document serves three purposes. First, it is a reference document providing a detailed description of the NEMS Industrial Model for model analysts, users, and the public. Second, this report meets the legal requirement of the Energy Information Administration (EIA) to provide adequate documentation in support of its models. Third, it facilitates continuity in model development by providing documentation from which energy analysts can undertake model enhancements, data updates, and parameter refinements as future projects. 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 2015) 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 industrial output. Based on the values of these variables, the Industrial Model passes back to the NEMS system estimates of consumption by fuel types.

  12. Evaluation of energy recovery and CO{sub 2} reduction potential in Japan through integrated waste and utility management

    SciTech Connect

    Horio, M.; Shigeto, S. Shiga, M.

    2009-07-15

    This paper examines the potential of integrated waste and utility power management over the mid-term planning horizon in Japan. Energy recovery and CO{sub 2} emission reduction were estimated under two situations: (1) energy recovery efforts within the current waste management/power generation framework and (2) integrated waste management with sewage treatment systems and electric power industries. Scenario simulation results showed that under the current policy framework it is not feasible to achieve large energy recovery and CO{sub 2} emission reduction, while the integrated waste management scenarios show the potential of large energy recovery which is equivalent to about an 18 million t-CO{sub 2} emission reduction. The utilization of dry wastes for power generation at existing fossil power stations is significant in achieving the result. We also consider the effects of the 'CO{sub 2} emission per GW generated' for electric power generation on the total CO{sub 2} emission reduction because it varies by country and assumptions selected. Although this research did not include an economic analysis, based on estimated CO{sub 2} emissions and energy recovery, the integrated scenarios indicate a large potential in countries that have high dependence of fossil power generation and relatively low power generation efficiency.

  13. Managing maritime automobile terminals: an approach toward decision-support model for higher productivity

    NASA Astrophysics Data System (ADS)

    Beškovnik, Bojan; Twrdy, Elen

    2011-12-01

    The article describes actions and strategies to obtain higher productivity on maritime automobile terminals. The main focus is on elaboration of efficient and effective organizational structure to model and implement short-term, mid-term and long-term strategies. In addition, with an empiric approach we combined the analyses of current findings in important scientific papers and our acknowledgments in practical research of north Adriatic maritime automobile terminals. The main goal is to propose actions towards increasing system's productivity. Based on our research of the north Adriatic maritime automobile terminals and with Lambert's model an in-deep analysis of limiting factors, user's expectations and possibilities for productivity increase has been performed. Moreover, with our acknowledgments a three-level decision-support model is presented. With an adequate model implementation it is possible to efficiently develop and implement different strategies of productivity measurement and productivity increase, especially in the fields of internal transport productivity, entrance/exit truck gates operations and wagon manipulations. According to our observation a significant increase might be achieved in all three fields.

  14. [Interventional therapy of heart valve diseases: future perspectives].

    PubMed

    Figulla, H R; Lauten, A

    2015-04-01

    Transcatheter procedures have been adopted as novel treatment strategy for patients with valvular heart disease, particularly for those who are inoperable or at high risk for surgical valve procedures. Significant technological advances have resulted in an improvement of devices for transcatheter aortic valve replacement (TAVI) with downsizing of crossing profiles, reduction in the rate of paravalvular leakage and conduction abnormalities as well as a lower short- and mid-term mortality and a higher patient acceptance. In the near future, TAVI may potentially develop as first-line treatment for the majority of patients with aortic valve disease. For patients with mitral and pulmonary stenosis, balloon valvuloplasty is effective and well established and should be preferred over valve replacement, last but not least also for economic reasons. For treatment of mitral regurgitation, several transcatheter devices aiming to restore or replace mitral valve function are currently under investigation. This review summarizes the current state of interventional treatment of valvular heart disease along with implications for the future. PMID:25822420

  15. Coal: Energy for the future

    SciTech Connect

    1995-05-01

    This report was prepared in response to a request by the US Department of energy (DOE). The principal objectives of the study were to assess the current DOE coal program vis-a-vis the provisions of the Energy Policy Act of 1992 (EPACT), and to recommend the emphasis and priorities that DOE should consider in updating its strategic plan for coal. A strategic plan for research, development, demonstration, and commercialization (RDD and C) activities for coal should be based on assumptions regarding the future supply and price of competing energy sources, the demand for products manufactured from these sources, technological opportunities, and the need to control the environmental impact of waste streams. These factors change with time. Accordingly, the committee generated strategic planning scenarios for three time periods: near-term, 1995--2005; mid-term, 2006--2020; and, long-term, 2021--2040. The report is divided into the following chapters: executive summary; introduction and scope of the study; overview of US DOE programs and planning; trends and issues for future coal use; the strategic planning framework; coal preparation, coal liquid mixtures, and coal bed methane recovery; clean fuels and specialty products from coal; electric power generation; technology demonstration and commercialization; advanced research programs; conclusions and recommendations; appendices; and glossary. 174 refs.

  16. The impact of climate change on river discharges in Eastern Romania

    NASA Astrophysics Data System (ADS)

    Croitoru, Adina-Eliza; Minea, Ionut

    2014-05-01

    Climate changes imply many changes in different socioeconomic and environmental fields. Among the most important impacts are changes in water resources. Long- and mid-term river discharge flow analysis is essential for the effective management of water resources. In this work, the changes in two climatic parameters (temperature and precipitation) and river discharges and the connections between precipitation and river discharges were investigated. Seasonal and annual climatic and hydrological data collected at six weather stations and 17 hydrological stations were employed. The data sets cover 57 years (1950-2006). The modified Mann-Kendall test was used to calculate trends, and the Bravais-Pearson correlation index was chosen to detect the connections between precipitation and river discharge data series. The main findings are as follows: A general increase was identified in all the three parameters. The air temperature data series showed the highest frequency of statistically significant slopes, mainly in annual and spring series. All data series, except the series for winter, showed an increase in precipitation; in winter, a significant decrease in precipitation was observed at most of the stations. The increase in precipitation is reflected in the upward trends of the river discharge flows, as verified by the good Bravais-Pearson correlations, mainly for annual, summer, and autumn series

  17. The impact of climate changes on rivers discharge in Eastern Romania

    NASA Astrophysics Data System (ADS)

    Croitoru, Adina-Eliza; Minea, Ionus

    2015-05-01

    Climate changes imply many changes in different socioeconomic and environmental fields. Among the most important impacts are changes in water resources. Long- and mid-term river discharge flow analysis is essential for the effective management of water resources. In this work, the changes in temperature, precipitation, and river discharges as well as the connections between precipitation and river discharges were investigated. Seasonal and annual climatic and hydrological data collected at 6 weather stations and 17 hydrological stations were employed. The data sets cover 57 years (1950-2006). The modified Mann-Kendall test and Sen's slope were used to calculate trends and their slopes, whereas the Bravais-Pearson correlation index was chosen to detect the connections between precipitation and river discharge data series. The main findings are as follows: a general increase was identified in all the three variables; the air temperature data series showed the highest frequency of statistically significant slopes, mainly in annual and spring series; all data series, except the series for winter, showed an increase in precipitation, and in winter, a significant decrease in precipitation was observed at most of the stations. The increase in precipitation is reflected in the upward trends of the river discharge flows, as verified by the good Bravais-Pearson correlations, mainly for annual, summer, and autumn series.

  18. Energy and land use

    SciTech Connect

    Not Available

    1981-12-01

    This report addresses the land use impacts of past and future energy development and summarizes the major federal and state legislation which influences the potential land use impacts of energy facilities and can thus influence the locations and timing of energy development. In addition, this report describes and presents the data which are used to measure, and in some cases, predict the potential conflicts between energy development and alternative uses of the nation's land resources. The topics section of this report is divided into three parts. The first part describes the myriad of federal, state and local legislation which have a direct or indirect impact upon the use of land for energy development. The second part addresses the potential land use impacts associated with the extraction, conversion and combustion of energy resources, as well as the disposal of wastes generated by these processes. The third part discusses the conflicts that might arise between agriculture and energy development as projected under a number of DOE mid-term (1990) energy supply and demand scenarios.

  19. Laparoscopic resection of splenic flexure tumors.

    PubMed

    Carlini, Massimo; Spoletini, Domenico; Castaldi, Fabio; Giovannini, Cristiano; Passaro, Umberto

    2016-03-01

    In this paper a single institution experience in laparoscopic treatment of splenic flexure tumors (SFT) is reported. Low incidence of these tumors and complexity of the procedure make the laparoscopic resection not diffuse and not well standardized. Since 2004, in a specific database, we prospectively record clinicopathological features and outcome of all patients submitted to laparoscopic colorectal resection. From January 2004 to October 2015, out of 567 cases of minimally invasive colorectal procedures, we performed 20 laparoscopic resection of SFT, 11 with extracorporeal anastomosis and 9 totally laparoscopic. Twelve patients had an advanced disease. Conversion rate was null. The mean operative time was 105' (range 70'-135'). Comparing extracorporeal and intracorporeal anastomoses, we did not find any significant difference in mean duration of surgery. Mean distal margin was 9.4 ± 3.1 cm (mean ± DS), mean proximal margin 8.9 ± 2.7 cm. The mean number of harvested lymph nodes was 17.8 ± 5.6. Evaluating surgical short-term and oncological mid-term outcomes, laparoscopic resection of splenic flexure for tumors, even if challenging, resulted technically feasible and oncologically safe and it seems to be advisable. PMID:27040272

  20. Technology development goals for automotive fuel cell power systems. Final report

    SciTech Connect

    James, B.D.; Baum, G.N.; Kuhn, I.F. Jr.

    1994-08-01

    This report determines cost and performance requirements for Proton Exchange Membrane (PEM) fuel cell vehicles carrying pure H{sub 2} fuel, to achieve parity with internal combustion engine (ICE) vehicles. A conceptual design of a near term FCEV (fuel cell electric vehicle) is presented. Complete power system weight and cost breakdowns are presented for baseline design. Near term FCEV power system weight is 6% higher than ICE system, mid-term FCEV projected weights are 29% lower than ICE`s. There are no inherently high-cost components in FCE, and at automotive production volumes, near term FCEV cost viability is closer at hand than at first thought. PEM current vs voltage performance is presented for leading PEM manufacturers and researchers. 5 current and proposed onboard hydrogen storage techniques are critically compared: pressurized gas, cryogenic liquid, combined pressurized/cryogenic, rechargeable hydride, adsorption. Battery, capacitor, and motor/controller performance is summarized. Fuel cell power system component weight and cost densities (threshold and goal) are tabulated.

  1. Enhancing Student Learning in Large General Education Astronomy Classes

    NASA Astrophysics Data System (ADS)

    Christensen, Thomas

    2004-05-01

    The transformation of a large, introductory, college, general education, astronomy class will be presented. Emphasis will be on student reaction to changes in the teaching/learning environment and the academic impact of the changes. Enhanced web-based materials such as on-line lecture notes and gradebooks were popular. Students felt that in-class cooperative small group exercises helped significantly in learning. Examination of changes in student scores on test questions that were repeated between mid-term and final examinations suggest that the exercises had a positive impact. Repeated questions on topics that had been included in cooperative exercises showed significantly more improvement than those questions that were only covered in lecture. Preliminary observations based on one semester's experience with limited Just-in-Time Teaching (JiTT) methods will be discussed. Student acceptance of these methods in the general education class was lower than in an introductory physics class for technical majors. Students rated JITT methods comparable in value to the text.

  2. DC State of Mind: A Congressional update

    NASA Astrophysics Data System (ADS)

    Larsen, Kristopher

    2010-10-01

    Every day the headlines are dominated by news of a slow economic recovery, high unemployment, and a Congress focused on the next election. Deficit hawks, Tea Partiers, partisanship, and mid-term elections are all topics typically outside the ken of physics but are critically important to our ability to continue to pursue cutting edge innovative research. For example, during the last six months Congress has, among other things, worked on passing the 2011 federal budget and reauthorization of America COMPETES. Both of these major pieces of legislation are fundamental to how our country will fund physics research for the next few years. For the past two years, science has done very well thanks to the support of Congress and the administration. The coming years are going to be far more difficult and every physicist needs to commit themselves to defending the gains we have made. This talk will provide an overview of what has happened on Capitol Hill in the past few months and what, to the best of our knowledge, the physics community can expect for the coming years. Also included will be a discussion of how physicists can get involved, educate Congress, and assure that the United States retains a strong commitment to basic research.

  3. Quaternary downcutting rates from cave-deposited river sediment and Holocene erosion rates from river sand in the Central Pyrenees

    NASA Astrophysics Data System (ADS)

    Vernant, Philippe; Genti, Manon; Chéry, Jean; Cazes, Gaël; Braucher, Régis

    2016-04-01

    We use 26Al and 10Be to infer the time of cave-deposited river sediment emplacement in the Central Pyrenees and the Cevennes. Using these ages, we derive mid-term downcutting rates (1-4.106 a). We also use the cosmogenic radionuclides 10Be concentration in quartz extracted from river sand to estimate short-term (102-105 a) erosion rates. Along the N-S profile across the central Pyrenees, we do not see any significant change in erosion rates during the Quaternary. On the other hand, the erosion rates are highly correlated with the local elevation. They vary roughly from 50 m/Myr in the foreland up to 800 m/Myr in the axial part of the mountain range. The mechanisms responsible for the Pyrenees moderate, but frequent, seismicity have yet to be determined. Based on numerical modeling and our erosion rates, we propose that this seismicity could be explained by the isostatic rebound associated to the erosion of the range. To evaluate the likeliness of this hypothesis, we aim at comparing the Pyrenees and the Cevennes to check if the rates are significantly different between these mountain ranges with very different seismic behavior.

  4. Control of VTEC in Dutch livestock and meat production.

    PubMed

    Reinders, R D; Weber, M F; Lipman, L J; Verhoeff, J; Bijker, P G

    2001-05-21

    The Dutch government and the meat industry, recognising VTEC as having important public health, meat quality and economic implications, have taken a number of initiatives within the last 5 years to control VTEC in livestock and meat. These initiatives, brought together last year in a 'Masterplan VTEC', include short-, middle- and long-term priorities. Short-term priorities include advice on interventions in the cases of an outbreak of VTEC associated with a cattle herd, the implementation of handbooks for Good Manufacturing Practice (GMP) in slaughterhouses and deboning plants, and the execution of an action programme on zero-tolerance to faecal contamination of carcasses. Mid-term activities include surveillance of the occurrence of VTEC and other enteropathogens in livestock and meat, and the investigations of VTEC population dynamics in dairy farms, transportation and farm hygiene. In the longer term, this programme aims to produce a system of Integrated Quality Assurance, consolidating effective measures to control VTEC in Dutch livestock and meat, and integrating emerging means for control and prevention. PMID:11407551

  5. Sea-level Rise Increases the Frequency of Nuisance Flooding in Coastal Regions

    NASA Astrophysics Data System (ADS)

    Moftakhari Rostamkhani, H.; Aghakouchak, A.; Sanders, B. F.; Feldman, D.; Sweet, W.; Matthew, R.; Luke, A.

    2015-12-01

    The global warming-drivensea-level rise (SLR) posesa serious threat for population and assets in flood-prone coastal zones over the next century. The rate of SLR is accelerated in recent decades and is expected to increase based on current trajectories of anthropogenic activities and greenhouse gas emissions. Over the 20th century, an increase in the frequency of nuisance (minor) flooding has been reported due to the reduced gap between tidal datum and flood stage. Nuisance flooding (NF), however non-destructive, causes public inconvenience, business interruption, and substantial economic losses due to impacts such as road closures and degradation of infrastructure. It also portends an increased risk in severe floods. Here we report substantial increases in NF along the coasts of United States due to SLR over the past decades. We then take the projected SLR under the least and the most extreme representative concentration pathways (e.gRCP2.6 and RCP 8.5) to estimate the increase in NF in the near- (2030) and mid-term (2050) future. The results suggest that projected SLR will cause up to two-fold more frequent NF by 2050, compared with the 20th century. The projected increase in NF will have significant socio-economic impacts and pose public health risks especially in rapidly urbanized coastal regions.

  6. Economics of Direct Hydrogen Polymer Electrolyte Membrane Fuel Cell Systems

    SciTech Connect

    Mahadevan, Kathyayani

    2011-10-04

    Battelle's Economic Analysis of PEM Fuel Cell Systems project was initiated in 2003 to evaluate the technology and markets that are near-term and potentially could support the transition to fuel cells in automotive markets. The objective of Battelle?s project was to assist the DOE in developing fuel cell systems for pre-automotive applications by analyzing the technical, economic, and market drivers of direct hydrogen PEM fuel cell adoption. The project was executed over a 6-year period (2003 to 2010) and a variety of analyses were completed in that period. The analyses presented in the final report include: Commercialization scenarios for stationary generation through 2015 (2004); Stakeholder feedback on technology status and performance status of fuel cell systems (2004); Development of manufacturing costs of stationary PEM fuel cell systems for backup power markets (2004); Identification of near-term and mid-term markets for PEM fuel cells (2006); Development of the value proposition and market opportunity of PEM fuel cells in near-term markets by assessing the lifecycle cost of PEM fuel cells as compared to conventional alternatives used in the marketplace and modeling market penetration (2006); Development of the value proposition of PEM fuel cells in government markets (2007); Development of the value proposition and opportunity for large fuel cell system application at data centers and wastewater treatment plants (2008); Update of the manufacturing costs of PEM fuel cells for backup power applications (2009).

  7. Aircraft Loss of Control Causal Factors and Mitigation Challenges

    NASA Technical Reports Server (NTRS)

    Jacobson, Steven R.

    2010-01-01

    Loss of control is the leading cause of jet fatalities worldwide. Aside from their frequency of occurrence, accidents resulting from loss of aircraft control seize the public s attention by yielding a large number of fatalities in a single event. In response to the rising threat to aviation safety, the NASA Aviation Safety Program has conducted a study of the loss of control problem. This study gathered four types of information pertaining to loss of control accidents: (1) statistical data; (2) individual accident reports that cite loss of control as a contributing factor; (3) previous meta-analyses of loss of control accidents; and (4) inputs solicited from aircraft manufacturers, air carriers, researchers, and other industry stakeholders. Using these information resources, the study team identified the causal factors that were cited in the greatest number of loss of control accidents, and which were emphasized most by industry stakeholders. This report describes the study approach, the key causal factors for aircraft loss of control, and recommended mitigation strategies to make near-term impacts, mid-term impacts, and Next Generation Air Transportation System impacts on the loss of control accident statistics

  8. Comparison of single-bundle versus double-bundle anterior cruciate ligament reconstruction after a minimum of 3-year follow-up: a meta-analysis of randomized controlled trials

    PubMed Central

    Chen, Gang; Wang, Shouguo

    2015-01-01

    Both single-bundle (SB) and double-bundle (DB) procedures have been widely used in the treatment of anterior cruciate ligament (ACL) rupture; however, the optimal repair strategy remains considerably controversial. In this meta-analysis of published studies, we compared the results of these two techniques. After systematic review of electronic databases and websites, a total of 8 RCTs reporting data on 941 subjects were included. The objective and subjective functional recovery outcomes were meta-analyzed. The methodological quality was evaluated using the CBRG scale. The overall pooled data showed superiority in rotational stability, the degree of osteoarthritis (OA) changes, and subjective function score postoperatively in patients managed with DB compared with the SB procedure (pivot shift test, P = 0.02; degree of OA, P = 0.02; Lysholm score, P = 0.04; and Tegner scale, P = 0.002, respectively). However, subgroup analysis suggested no difference between the treatment procedures at long-term follow-up. This meta-analysis demonstrated that the DB technique could result in better rotational stability and higher subjective function score and was effective in preventing OA compared to SB in the mid-term treatment of the injured ACL. Further studies with better design involving larger sample sizes and longer-term follow-up are required. PMID:26628943

  9. A LARGE-SCALE SIMULATION OF INTERNATIONAL MARITIME CONTAINER SHIPPING CONSIDERING OPTIMAL BEHAVIOR OF SHIPPERS AND OCEANGOING CARRIERS

    NASA Astrophysics Data System (ADS)

    Shibasaki, Ryuichi; Watanabe, Tomihiro; Ieda, Hitoshi

    This paper develops a large-scale simulation model of international maritime container shipping industry considering optimal behaviors of both shippers and oceangoing carriers, in order to measure impact of port and international logistics policies for each country including Japan. Concretely, the authors develop a short-term model (income maximization model of carriers) including shippers' choice of carrier when maritime cargo shipping demand between ports are given and a mid-term model (Nash equilibrium model of shippers and carriers) including shippers' choice of import/export port and route of hinterland transport and carriers' profit maximization behavior when cargo shipping demand between regions are given. The developed model is applied to the actual large-scale international maritime container shipping network in Eastern Asia. From a trial calculation based on the actual cargo shipping demand, the performance of the model is validated in terms of convergency and reproducibility. Also, the sensitivity of the model output taking the actual port policies into account is confirmed.

  10. Lifetime of digital media: is optics the solution?

    NASA Astrophysics Data System (ADS)

    Spitz, Erich; Hourcade, Jean-Charles; Lalo", Franck

    2010-01-01

    While the short term and mid-term archiving of digital data and information can be handled reasonably well with modern techniques, the long term aspects of the problem (several decades or even centuries) are much more difficult to manage. The heart of the problem is the longevity of storage media, which presently does not go beyond a few years, maybe one or two decades in the best cases. In this article, we review the various strategies for long term archiving, with two main categories: active and passive. We evaluate the various recording media in terms of their longevity. We then discuss the recordable optical digital disks (RODDs) and the state of the art in this domain; the present situation is that, with the techniques that are implemented commercially, good prospects for long term archiving are not available. Nevertheless, the conceptual simplicity of RODDs could be exploited to create new recordable digital media; the improvements that are needed seem to be reachable with reasonable development effort. Since RODDs are now in strong competition with other systems (hard disks or flash memory for instance) that constantly make enormous progress, there seems to be little hope to see RODDs win the race of capacity; nevertheless, longevity could provide them with a new market, since the need for long term archiving is so pressing everywhere in the world.

  11. Maximum in the Middle: Nonlinear Response of Microbial Plankton to Ultraviolet Radiation and Phosphorus

    PubMed Central

    Medina-Sánchez, Juan Manuel; Delgado-Molina, José Antonio; Bratbak, Gunnar; Bullejos, Francisco José; Villar-Argaiz, Manuel; Carrillo, Presentación

    2013-01-01

    The responses of heterotrophic microbial food webs (HMFW) to the joint action of abiotic stressors related to global change have been studied in an oligotrophic high-mountain lake. A 2×5 factorial design field experiment performed with large mesocosms for >2 months was used to quantify the dynamics of the entire HMFW (bacteria, heterotrophic nanoflagellates, ciliates, and viruses) after an experimental P-enrichment gradient which approximated or surpassed current atmospheric P pulses in the presence vs. absence of ultraviolet radiation. HMFW underwent a mid-term (<20 days) acute development following a noticeable unimodal response to P enrichment, which peaked at intermediate P-enrichment levels and, unexpectedly, was more accentuated under ultraviolet radiation. However, after depletion of dissolved inorganic P, the HMFW collapsed and was outcompeted by a low-diversity autotrophic compartment, which constrained the development of HMFW and caused a significant loss of functional biodiversity. The dynamics and relationships among variables, and the response patterns found, suggest the importance of biotic interactions (predation/parasitism and competition) in restricting HMFW development, in contrast to the role of abiotic factors as main drivers of autotrophic compartment. The response of HMFW may contribute to ecosystem resilience by favoring the maintenance of the peculiar paths of energy and nutrient-mobilization in these pristine ecosystems, which are vulnerable to threats by the joint action of abiotic stressors related to global change. PMID:23593178

  12. Endoscopic management of complications of chronic pancreatitis

    PubMed Central

    Dumonceau, Jean-Marc; Macias-Gomez, Carlos

    2013-01-01

    Pseudocysts and biliary obstructions will affect approximately one third of patients with chronic pancreatitis (CP). For CP-related, uncomplicated, pancreatic pseudocysts (PPC), endoscopy is the first-choice therapeutic option. Recent advances have focused on endosonography-guided PPC transmural drainage, which tends to replace the conventional, duodenoscope-based coma immediately approach. Ancillary material is being tested to facilitate the endosonography-guided procedure. In this review, the most adequate techniques depending on PPC characteristics are presented along with supporting evidence. For CP-related biliary obstructions, endoscopy and surgery are valid therapeutic options. Patient co-morbidities (e.g., portal cavernoma) and expected patient compliance to repeat endoscopic procedures are important factors when selecting the most adapted option. Malignancy should be reasonably ruled out before embarking on the endoscopic treatment of presumed CP-related biliary strictures. In endoscopy, the gold standard technique consists of placing simultaneous, multiple, side-by-side, plastic stents for a one-year period. Fully covered self-expandable metal stents are challenging this method and have provided 50% mid-term success. PMID:24259962

  13. Estimation of desmosponge (Porifera, Demospongiae) larval settlement rates from short-term recruitment rates: Preliminary experiments

    NASA Astrophysics Data System (ADS)

    Zea, Sven

    1992-09-01

    During a study of the spatial and temporal patterns of desmosponge (Porifera, Demospongiae) recruitment on rocky and coral reef habitats of Santa Marta, Colombian Caribbean Sea, preliminary attempts were made to estimate actual settlement rates from short-term (1 to a few days) recruitment censuses. Short-term recruitment rates on black, acrylic plastic plates attached to open, non-cryptic substratum by anchor screws were low and variable (0 5 recruits/plate in 1 2 days, sets of n=5 10 plates), but reflected the depth and seasonal trends found using mid-term (1 to a few months) censusing intervals. Moreover, mortality of recruits during 1 2 day intervals was low (0 12%). Thus, short-term censusing intervals can be used to estimate actual settlement rates. To be able to make statistical comparisons, however, it is necessary to increase the number of recruits per census by pooling data of n plates per set, and to have more than one set per site or treatment.

  14. Randomized comparison between the cemented Scientific Hip Prosthesis and Omnifit: 2-year DEXA and minimum 10-year clinical follow-up.

    PubMed

    Broeke, René H M Ten; Harings, Steffie E J M; Emans, Pieter J; Jutten, Liesbeth M C; Kessels, Alfons G H; Geesink, Rudolph G T

    2013-09-01

    Radiostereometry (RSA) of the cemented Scientific Hip Prosthesis (SHP) reported excessive migration and predicted high failure rates. In a prospective randomized clinical trial we compared minimum 10 years results of the SHP (n=38) with the Omnifit-stem (n=37). Two-year bone remodelling, compared with dual energy x-ray absorptiometry and assessed in regions of interest A-D based on the 7 Gruen zones, showed better periprosthetic bone preservation around the SHP in all but one regions (P<.05). At 10 years Harris Hip Score was better for the SHP (P=.0001) but Oxford Hip Score was the same (P=.79). There were no revisions in either group, but radiographic loosening was definite in 1 SHP and 1 Omnifit. Based on earlier RSA studies, the rough surface finish of the SHP was expected to cause cement abrasion, osteolysis and inferior survival. However our clinical and remodelling results could not confirm these expectations, suggesting that the link of early migration and mid-term clinical results is not sufficiently clear for the SHP. PMID:23453292

  15. A Study of Heliospheric Modulation and Periodicities of Galactic Cosmic Rays During Cycle 24

    NASA Astrophysics Data System (ADS)

    Chowdhury, Partha; Kudela, K.; Moon, Y.-J.

    2016-02-01

    Galactic cosmic rays (GCRs) are energetic, charged particles coming from outside the solar system. These particles encounter an outward-moving turbulent solar wind with cyclic magnetic-field fluctuations when entering the heliosphere. This causes convection and diffusion in the heliosphere. The GCR counts detected by the ground-based neutron-monitor stations show intensity changes with a fluctuation of ˜ 11 years and are anti-correlated with the sunspot numbers with some time lags. GCRs experience various types of modulation from different solar activity features and are important components of space weather. The previous solar cycle, Cycle 23, has shown anomalous behavior with a prolonged deep minimum, which was characterized by a record-setting high Galactic cosmic-ray flux observed at Earth. Solar Cycle 24 started much later than expected and progressed sluggishly toward its maxima. In this paper, we study the heliospheric modulation and intermediate-term periodicities of GCRs during the ascending phase of Cycle 24. We utilize simultaneous solar, interplanetary plasma, magnetic field, and geomagnetic activity data including the tilt angle of the heliospheric current sheet, and we study their relation with GCRs. The wavelet power spectrum of GCRs exhibits the presence of a variety of prominent short- and mid-term periodicities including the well-known Rieger and quasi-biennial periodicities. Possible explanations of the observed results are discussed in the light of numerical models.

  16. Bioresorbable vascular scaffolds—time to vanish?

    PubMed Central

    Arroyo, Diego; Cook, Stéphane

    2016-01-01

    The fully bioabsorbable vascular scaffold (BVS) has been developed to reduce late adverse events after coronary stenting such as device thrombosis. The device consists of polylactic acid, which is gradually absorbed within the first few years after its implantation. The initial experience with the device in low-risk patients presenting with simple lesions was satisfying and generated optimism among interventional cardiologists by promising better patient outcomes. However, the unrestricted use of the device in patients presenting with a higher baseline risk and more complex lesions came at the cost of alarmingly high rates of early device thrombosis. The performance of the device largely depends on an optimal implantation technique, which differs from that employed with metallic drug-eluting stents due to the device’s distinct physical propensity. Mid-term outcomes in large-scale randomized clinical trial were disappointing. Although its non-inferiority compared to metallic everolimus-eluting stents was formally met, there was a clear trend towards an increased occurrence of myocardial infarction and device thrombosis during the first year after device implantation. However, the BVS’s putative advantages are expected to manifest themselves at long-term, that is 3 to 5 years after the device has been implanted. Evidence pertaining to these long-term outcomes is eagerly awaited. PMID:27293872

  17. Experiences in US-Guided Percutaneous Radiofrequency Ablation of 44 Renal Tumors in 31 Patients: Analysis of Predictors for Complications and Technical Success

    SciTech Connect

    Veltri, Andrea Calvo, Amedeo; Tosetti, Irene; Pagano, Eva; Genovesio, Andrea; Virzi, Valentina; Ferrando, Ugo; Fontana, Dario; Gandini, Giovanni

    2006-10-15

    Purpose. Preliminary clinical studies have shown the feasibility, safety, and efficacy of radiofrequency thermal ablation (RFA) of renal tumors, but only a few have analyzed the prognostic factors for technical success and there are no long-term results. Our objective was to statistically evaluate our mid-term results of percutaneous US-guided RFA in order to define predictors for complications and technical success. Methods. We selected for treatment 44 tumors in 31 patients (24 with renal cell carcinoma, 7 with hereditary tumors, 15 with a solitary kidney), up to 5 cm in diameter. Results. Eight adverse events occurred; 3 (6.8%) were major complications, successfully treated with interventional radiology procedures in 2 cases. Exophytic extension of the tumor was protective against complications (p 0.040). Technical success was obtained in 38 lesions after one RFA session and in 39 (89%) after one more session, when possible. At the end of treatment, central extension was the only negative predictor for technical success (p = 0.007), while neither size >3 cm (p = 0.091) nor other prognostic factors were statistically significant. Conclusion. US-guided percutaneous RFA can be proposed for non-central renal tumors up to 5 cm, also in patients without surgical contraindications, thanks to a low incidence of complications and a high success rate. Randomized controlled trials versus surgery are now needed to investigate long-term comparative results.

  18. Coupled ocean-atmosphere modeling on horizontally icosahedral and vertically hybrid-isentropic/isopycnic grids.

    NASA Astrophysics Data System (ADS)

    Bleck, Rainer; Sun, Shan; Li, Haiqin; Benjamin, Stan

    2016-04-01

    Current efforts to close the gap between weather prediction and climate models have led to the construction of a coupled ocean-atmosphere system consisting of two high-resolution component models, operating on matching icosahedral grids and utilizing adaptive, near-isentropic/isopycnic vertical coordinates. The two components models, FIM and HYCOM (the latter converted to an icosahedral mesh for this purpose), have been tested extensively in twice-daily global medium-range weather prediction (http://fim.noaa.gov) and in real-time ocean data assimilation (http://hycom.org), respectively. The use of matching horizontal grids, currently at resolutions of 15km, 30km and 60km, avoids coastline ambiguities and interpolation errors at the air-sea interface. The intended purpose of the coupled model being subseasonal-to-seasonal prediction, our focus is on mid-term precipitation biases and the statistical steadiness of the atmospheric circulation (blocking frequency, Rossby wave breaking, meridional heat transport, etc.), as well as on possible causes of ocean model drift. An attempt is made to isolate the weather model's role in modifying water mass properties and ocean circulations (including meridional overturning) by comparing coupled model results to ocean-only experiments forced by observed atmospheric boundary conditions. A multi-decadal run at 60km resolution is used to illustrate ENSO variability in the coupled system.

  19. The space exposure biology assembly (SEBA)-results of the phase a study

    NASA Astrophysics Data System (ADS)

    Schulte, W.; Hofmann, P.; König, H.

    In the past ESA has successfully flown several experiment facilities for research in space biology, such as the `Exobiology Radiation Assembly' on the EURECA free-flyer and the exposure facility `BIOPAN' on Russian retrievable FOTON satellites. A flight opportunity in the mid-term future well suited to experiments in the field of exobiology and radiation research will be the `Space Exposure Biology Assembly' (SEBA). This new multi-user facility will be installed as an external payload on one of the EXPRESS Pallets that are attached to the truss structure of the International Space Station. In its baseline configuration SEBA consists of two multi-user experiment units: ■ EXPOSE, a sun exposed experiment unit, designed for photobiology and photoprocessing experiments; this unit will be mounted on a sun pointing device ■ MATROSHKA, an experiment unit for the simulation of extravehicular activities of man by using a phantom of a human body equipped with sensors for radiation dosimetric measurements. In addition, SEBA will provide resources to accommodate further self-standing biological or dosimetry add-on experiments. All SEBA elements will be installed on a single EXPRESS Pallet Adapter with an exchange interval of one to three years.

  20. System level traffic shaping in disk servers with heterogeneous protocols

    NASA Astrophysics Data System (ADS)

    Cano, Eric; Kruse, Daniele Francesco

    2014-06-01

    Disk access and tape migrations compete for network bandwidth in CASTORs disk servers, over various protocols: RFIO, Xroot, root and GridFTP. As there are a limited number of tape drives, it is important to keep them busy all the time, at their nominal speed. With potentially 100s of user read streams per server, the bandwidth for the tape migrations has to be guaranteed to a controlled level, and not the fair share the system gives by default. Xroot provides a prioritization mechanism, but using it implies moving exclusively to the Xroot protocol, which is not possible in short to mid-term time frame, as users are equally using all protocols. The greatest commonality of all those protocols is not more than the usage of TCP/IP. We investigated the Linux kernel traffic shaper to control TCP/ IP bandwidth. The performance and limitations of the traffic shaper have been understood in test environment, and satisfactory working point has been found for production. Notably, TCP offload engines' negative impact on traffic shaping, and the limitations of the length of the traffic shaping rules were discovered and measured. A suitable working point has been found and the traffic shaping is now successfully deployed in the CASTOR production systems at CERN. This system level approach could be transposed easily to other environments.

  1. Nature of the Warm Excess in eps Eri: Asteroid belt or Dragged-in Grains

    NASA Astrophysics Data System (ADS)

    Su, Kate Y. L.; Rieke, George; Marengo, Massimo; Stapelfeldt, Karl R.

    2016-01-01

    Eps Eri and its debris disk provide a unique opportunity to probe the outer zones of a planetary system due to its young age (roughly 1 Gyr) and proximity (3.22 pc, the closest prominent debris disk by more than a factor of two). It is the Rosetta Stone for more distant exoplanetary debris systems and thus critical to understanding the mid-term evolution of our Solar System. From resolved images in the far-infrared and submillimeter along with spectra from 10-35 and 55-95 microns, the eps Eri disk was suggested to have a complex structure, with multiple zones in both warm (asteroid-like) and cold (KBO-like) components. Alternatively, the warm excess can also originate from small grains in the cold disk, which are transported inward by the combination of Poynting-Robertson and stellar wind drags. Here we present a SOFIA/FORCAST 35 micron image of the system, and provide additional constraints on the nature of the warm excess inferred fromprevious Spitzer and Herschel observations.

  2. Proceedings of the natural gas research and development contractors review meeting

    SciTech Connect

    Malone, R.D.; Shoemaker, H.D.; Byrer, C.W.

    1990-11-01

    The purpose of this meeting was to present results of the research in the DOE-sponsored Natural Gas Program, and simultaneously to provide a forum for real-time technology transfer, to the active research community, to the interested public, and to the natural gas industry, who are the primary users of this technology. The current research focus is to expand the base of near-term and mid-term economic gas resources through research activities in Eastern Tight Gas, Western Tight Gas, Secondary Gas Recovery (increased recovery of gas from mature fields); to enhance utilization, particularly of remote gas resources through research in Natural Gas to Liquids Conversion; and to develop additional, long term, potential gas resources through research in Gas Hydrates and Deep Gas. With the increased national emphasis on the use of natural gas, this forum has been expanded to include summaries of DOE-sponsored research in energy-related programs and perspectives on the importance of gas to future world energy. Thirty-two papers and fourteen poster presentations were given in seven formal, and one informal, sessions: Three general sessions (4 papers); Western Tight Gas (6 papers); Eastern Tight Gas (8 papers); Conventional/Speculative Resources (8 papers); and Gas to Liquids (6 papers). Individual reports are processed separately on the data bases.

  3. When and how to replace the aortic root in type A aortic dissection

    PubMed Central

    Leshnower, Bradley G.

    2016-01-01

    Management of aortic root pathology during repair of acute type A aortic dissection (TAAD) requires a comprehensive evaluation of the patient’s anatomy, demographics, comorbidities and physiologic status at the time of emergent operative intervention. Surgical options include conservative repair of the root (CRR) (with or without replacement of the aortic valve), replacement of the native valve and aortic root using a composite valve-conduit and valve sparing root replacement (VSRR). The primary objective of this review is to provide data for surgeons to aid in their decision-making process regarding management of the aortic root during repair of TAAD. No time or language restrictions were imposed and references of the selected studies were checked for additional relevant citations. Multiple retrospective reviews have demonstrated equivalent operative mortality between aortic root repair and replacement during TAAD. There is a higher incidence of aortic root reintervention with aortic root repair compared to aortic root replacement (ARR). Experienced, high-volume aortic centers have demonstrated the safety of VSRR in young, hemodynamically stable patients presenting with TAAD. In conclusion, aortic root repair can safely be performed in the vast majority of patients with TAAD. Despite the increased surgical complexity, ARR does not increase operative mortality and improves the freedom from root reintervention. VSRR can be performed in highly selected populations of patients with TAAD with durable mid-term valve function. PMID:27563551

  4. 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

    PubMed Central

    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) are formed upon multiple-trial conditioning: an early phase (e-LTM) which depends on translation from already available mRNA, and a late phase (l-LTM) which requires de novo transcription and translation. Here we combined olfactory PER conditioning and neuropharmacological inhibition and studied the involvement of the NO–cGMP pathway, and of specific molecules, such as cyclic nucleotide-gated channels (CNG), calmodulin (CaM), adenylyl cyclase (AC), and Ca2+/calmodulin-dependent protein kinase (CaMKII), in the formation of olfactory LTM in bees. We show that in addition to NO–cGMP and cAMP–PKA, CNG channels, CaM, AC, and CaMKII also participate in the formation of a l-LTM (72-h post-conditioning) that is specific for the learned odor. Importantly, the same molecules are dispensable for olfactory learning and for the formation of both MTM (in the minute and hour range) and e-LTM (24-h post-conditioning), thus suggesting that the signaling pathways leading to l-LTM or e-LTM involve different molecular actors. PMID:24741108

  5. Conceptual design of a sodium sulfur cell for US electric van batteries

    NASA Astrophysics Data System (ADS)

    Binden, Peter J.

    1993-05-01

    A conceptual design of an advanced sodium/sulfur cell for US electric-van applications has been completed. The important design factors included specific physical and electrical requirements, service life, manufacturability, thermal management, and safety. The capacity of this cell is approximately the same as that for the PB cell being developed by Silent Power Limited (10 Ah). The new cell offers a 50% improvement in energy capacity and nearly a 100% improvement in peak power over the existing PB cells. A battery constructed with such cells would significantly exceed the USABC's mid-term performance specifications. In addition, a similar cell and battery design effort was completed for an advanced passenger car application. A battery using the van cell would have nearly 3 times the energy compared to lead-acid batteries, yet weigh 40% less; a present-day battery using a cell specifically designed for this car would provide 50% more energy in a package 60% smaller and 50% lighter.

  6. Monitoring progress of the role of integration of environmental health education with water and sanitation services in changing community behaviours.

    PubMed

    Metwally, Ammal M; Saad, Amal; Ibrahim, Nihad A; Emam, Hanaa M; El-Etreby, Lobna A

    2007-02-01

    The health benefits of clean water, improved sanitation and better hygiene are now more recognized than ever before. The objective of the present study focused on monitoring the progress of behavioural changes towards appropriate behaviours related to water, environment and sanitation (WES). This was achieved through assessing the baseline community behaviours towards WES, exploring to what extent community hygienic behaviours had changed towards desirable and sustainable behaviours, through monitoring progress. The expected behavioural changes are results of an integrated package; safe water supply, sanitation, and hygiene education interventions produced by governmental and non-governmental organizations. The monitoring progress consisted of three household surveys that were administered over three years in four Egyptian districts within three Governorates; Fayoum, Beni Suef, and El-Menia. Behavioural changes were detected through special observation checklist indicators. These indicators were 7, 6, and 9 indicators each for personal hygienic behaviours, proper handling of drinking water, and proper use and maintenance of simple constructed sanitary latrines. The results from the baseline to mid-term and final surveys suggested improvement in the majority of the household behaviours towards the desirable behaviours. The proportions of the householders who practiced desirable behaviours were not to the same levels in the four districts. The results provide support to the concept that integrated interventions can produce a significant sustainable improvement in health promotion. PMID:17365081

  7. TOTAL ANKLE REPLACEMENT: WHY, WHEN AND HOW?

    PubMed Central

    Bonasia, Davide Edoardo; Dettoni, Federico; Femino, John E; Phisitkul, Phinit; Germano, Margherita; Amendola, Annunziato

    2010-01-01

    Total ankle replacement (TAR) was first attempted in the 1970s, but poor results led to its being considered inferior to ankle fusion until the late 1980s and early 1990s. By that time, newer designs which more closely replicated the natural anatomy of the ankle, showed improved clinical outcomes.1 Currently, even though controversy still exists about the effectiveness of TAR compared to ankle fusion, TAR has shown promising mid-term results and should no longer be considered an experimental procedure. Factors related to improved TAR outcomes include: 1) better patient selection, 2) more precise knowledge and replication of ankle biomechanics, 3) the introduction of less-constrained designs with reduced bone resection and no need for cementation, and 4) greater awareness of soft-tissue balance and component alignment. When TAR is performed, a thorough knowledge of ankle anatomy, pathologic anatomy and biomechanics is needed along with a careful pre-operative plan. These are fundamental in obtaining durable and predictable outcomes. The aim of this paper is to outline these aspects through a literature review. PMID:21045984

  8. Lifestyle behaviors associated with exposures to endocrine disruptors

    PubMed Central

    Martina, Camille A.; Weiss, Bernard; Swan, Shanna H.

    2013-01-01

    Identifying and characterizing sources of exposure to phthalates and bisphenol A (BPA) have proved challenging due to the presence of multiple co-exposures resulting from a wide variety of home environments and lifestyles. We hypothesized that the consistent lifestyle of an Old Order Mennonite (OOM) community would provide an ideal setting in which to characterize sources of exposure to BPA and phthalates. We obtained urine samples from ten mid-term pregnant OOM women (ages-21–39) to determine concentrations of 9 phthalate metabolites and BPA and collected a self-reported survey of participants' household environment, product use, and lifestyle within a 48-h period prior to urine collection. We compared their metabolite concentrations to pregnant women included in the National Health and Nutrition Examination Survey (NHANES 2007–2008). Although OOM participants reported some use of plastic and fragranced household products, concentrations of metabolites were lower and significantly less for BPA (p = 0.002) and phthalate metabolites MEHP (p = 0.0215), MiBP (p = 0.0020) and MEP (p = 0.021), when compared to NHANES pregnant women. Levels of other phthalate metabolites were also lower in this population. Our data suggest three practices that may contribute to these lower levels: (1) consuming mostly homegrown produce (ingestion), (2) no cosmetics and limited use of personal care products, and (3) transportation primarily by sources other than automobiles. PMID:22739065

  9. Efficacy of kinesio tape application on pain and muscle strength in patients with myofascial pain syndrome: a placebo-controlled trial

    PubMed Central

    Öztürk, Gülcan; Külcü, Duygu Geler; Mesci, Nilgün; Şilte, Ayşe Duygu; Aydog, Ece

    2016-01-01

    [Purpose] The purpose of this study was to determine the short- and mid-term effects of Kinesio taping on the trapezius muscle in individuals with myofascial pain syndrome. [Subjects and Methods] Thirty-seven patients with active upper trapezius myofascial trigger points were randomly divided to 2 groups: group 1 received Kinesio taping for the upper trapezius muscle, and group 2 received a sham Kinesio taping application. Neck pain (Visual Analog Scale and pressure algometry) and trapezius muscle strength data were collected at baseline, immediately after Kinesio taping application, and at one month follow-up. [Results] The mean changes in Visual Analog Scale scores were significantly different between groups at T2 and T1, with less pain in group 1. The mean changes in algometry scores were significantly different between groups at T3 compared with T2 in favor of group 1. The mean changes in trapezius muscle strength were significantly different between the groups at T2 compared with T1 in favor of group 1. [Conclusion] Patients with myofascial pain syndrome receiving an application of Kinesio taping exhibited statistically significant improvements in pain and upper trapezius muscle strength. PMID:27190430

  10. Electrochemical energy — progress towards a cleaner future: lead/acid batteries and the competition

    NASA Astrophysics Data System (ADS)

    Appleby, A. J.

    Electric vehicles (EVs) with conventional architecture may be capable of a range of 72-80 km (45-50 miles) with a 35 Wh kg -1 lead/acid battery with a weight equal to 25% of that of the vehicle. An improved vehicle (such as the GM Impact) with lower energy utilization and architecture that allows greater battery weight may attain 160 km (100 miles). A battery corresponding to the mid-term goal of the US Advanced Battery Consortium in an Impact-type vehicle could allow 480 km (300 miles) range. It remains to be seen if this will be technically and economically attained. The EV is more likely to be made practical with the development of a satisfactory polymer-exchange-membrane (PEM) fuel cell, which will involve the same recharging logistics as those of a gasoline vehicle, with much improved energy efficiency. Considerable progress is still required, but one major problem, the amount of platinum catalyst required per vehicle, appears to have been overcome. A loading of 0.15 g/kW now appears to be feasible, so major production of such vehicles will allow platinum producers to keep pace. The advent of the PEM-fuel-cell/battery hybrid vehicle wiil open up a larger market for rechargeable bateries than that for vehicles which use traction batteries alone. Economics seem to point to the fact that such vehicles will use lead/acid batteries for the hybrid peak power and regenerative braking element.

  11. Scoliosis bracing and exercise for pain management in adults—a case report

    PubMed Central

    Weiss, Hans-Rudolf; Moramarco, Kathryn; Moramarco, Marc

    2016-01-01

    [Purpose] For adult patients with late-onset idiopathic scoliosis, cosmetic concerns and pain are the main reasons for seeking treatment at a physician’s office. The purpose of this paper was to describe the mid-term effect of physical rehabilitation and part-time bracing on an adult scoliosis patient who had been suffering from chronic low back pain for fourteen years. [Subject and Methods] Case description: A 37-year-old female patient with late-onset idiopathic scoliosis presented in the office of the first author in January 2014. She reported having chronic pain (low back pain) since the age of 23 and reported daily pain at a level of 5–7 on average on a Visual Analogue Scale of 0 to 10. She received a short scoliosis-specific Schroth exercise program and was also fitted with a Gensingen brace for part-time wear. [Results] At a 16 month follow-up, the patient no longer suffered from daily low back pain (with heavy lifting only) and was fully active. Additionally, her lumbar Cobb angle and angle of trunk rotation improved. [Conclusion] Patients with late-onset idiopathic scoliosis and pain may benefit from a pattern-specific conservative treatment approach. In this population, surgical intervention should be regarded as the last resort, since there are many long-term unknowns with surgery.

  12. Treadmill exercise reduces self-administration of morphine in male rats.

    PubMed

    Hosseini, Mahmoud; Alaei, Hojjat Allah; Naderi, Asieh; Sharifi, Mohammad Reza; Zahed, Reza

    2009-06-01

    Exercise can activate the same pathways as morphine. The aim of the present study was to clarify the effect of short-term and mid-term exercises on the self-administration of morphine in rats. Male Wistar rats were initially trained to receive small pellets of food by pressing the active lever in self-administration apparatus. Rats were divided into 4 groups: Saline, Morphine, Exercise 1 (11 days) and Exercise 2 (30 days). Their jugular vein was cannulated. The animals were placed in self-administration apparatus and allowed to self-administer morphine (0.5mg per infusion all test groups) or saline (Saline group) during consecutive days, for 2h/sessions. In the group 1 the rats were running before each session of self-administration and of group Exercise 2, 30 days before surgery as well as before each session. The pressing numbers of active and passive levers in each group and among different groups were compared. The number of active lever pressing of Morphine group was significantly higher than Saline group (p<0.001). In Exercise 1 and Exercise 2 groups, the number of active lever pressing was significantly lower than Morphine group (p<0.001). As exercise can activate many neurotransmitter systems involved in the addiction process and increase the release of endorphins, it is likely that could decrease the morphine self-administration in this experimental setup. PMID:19131225

  13. Interruption of aortic arch in adults: surgical experience with extra-anatomic bypass.

    PubMed

    Sai Krishna, C; Bhan, Anil; Sharma, Sanjeev; Kiran, Usha; Venugopal, Panangipalli

    2005-01-01

    We reviewed our 3-year experience in treating interruption of the aorta in adult patients. Clinical profiles, surgical management, and results of early and mid-term follow-up are presented. From August 2001 through June 2003, 7 adult patients underwent an extra-anatomic bypass procedure to repair interruption of the aortic arch. Five patients underwent ventral aortic repair through a mid-sternotomy and an upper midline laparotomy, and 2 patients underwent repair through a left posterolateral thoracotomy. A bovine collagen-impregnated polyester fiber graft was used in 6 patients, and a Gore-Tex graft was interposed in 1 patient. All repairs were performed without cardiopulmonary bypass. Follow-up was complete in all patients. The mean follow-up was 1728 +/- 1 months (range, 9-31 months). No neurologic, renal, or gastrointestinal complications were noted in any patient. There was no in-hospital or late mortality or need for re-intervention. All patients were asymptomatic; however, 5 patients had mild residual hypertension. Graft patency in all the patients was confirmed by computed tomographic angiography. Interruption of the aorta is rare in adults. Ventral aortic repair through a midline approach is our preferred technique for surgical repair of this entity, because it avoids the extensive network of collateral vessels on the chest wall, enables simultaneous treatment of associated lesions, and in all likelihood reduces morbidity and mortality. PMID:16107103

  14. Haemocyanin is essential for embryonic development and survival in the migratory locust.

    PubMed

    Chen, B; Ma, R; Ma, G; Guo, X; Tong, X; Tang, G; Kang, L

    2015-10-01

    Haemocyanins are commonly known as copper-containing oxygen carriers within the haemolymph of arthropods, and have been found in many orders of insects. However, it remains unresolved why haemocyanins persist in insects that possess elaborate tracheal systems for oxygen diffusion to cells. Here we identified haemocyanins in the migratory locust Locusta migratoria that consists of two distinct subunits, Hc1 and Hc2. Genomic sequence analysis indicated that Hc1 and Hc2 have four and three gene copies, respectively, which may have evolved via gene duplication followed by divergent evolution of introns. The two subunits exhibit abundant and embryonic-specific expression at the mRNA and protein level; their expression peaks in the mid-term embryo and is not detectable in the late nymphal and adult stages. A larger proportion of the haemocyanins is present in the yolk compared with that in the embryo. Immunostaining shows that haemocyanins in the embryo are mainly expressed in the epidermis. Knockdown of Hc1 and Hc2 results in significant embryonic developmental delay and abnormality as well as reduced egg hatchability, ie the proportion of hatched eggs. These results reveal a previously unappreciated and fundamental role for haemocyanins in embryonic development and survival in insects, probably involving the exchange of molecules (eg O2 ) between the embryo and its environment. PMID:26010377

  15. Near-term Horizontal Launch for Flexible Operations: Results of the DARPA/NASA Horizontal Launch Study

    NASA Technical Reports Server (NTRS)

    Bartolotta, Paul A.; Wilhite, Alan W.; Schaffer, Mark G.; Huebner, Lawrence D.; Voland, Randall T.; Voracek, David F.

    2012-01-01

    Horizontal launch has been investigated for 60 years by over 130 different studies. During this time only one concept, Pegasus, has ever been in operation. The attractiveness of horizontal launch is the capability to provide a "mobile launch pad" that can use existing aircraft runways, cruise above weather, loiter for mission instructions, and provide precise placement for orbital intercept, rendezvous, or reconnaissance. A jointly sponsored study by DARPA and NASA, completed in 2011, explored the trade space of horizontal launch system concepts which included an exhaustive literature review of the past 70 years. The Horizontal Launch Study identified potential near- and mid-term concepts capable of delivering 15,000 lb payloads to a 28.5 due East inclination, 100 nautical-mile low-Earth orbit. Results are presented for a range of near-term system concepts selected for their availability and relatively low design, development, test, and evaluation (DDT&E) costs. This study identified a viable low-cost development path forward to make a robust and resilient horizontal launch capability a reality.

  16. Augmented Fish Health Monitoring, 1989 Annual Report.

    SciTech Connect

    Michak, Patty

    1990-05-01

    Since 1986 Washington Department of Fisheries (WDF) has participated in the Columbia Basin Augmented Fish Health Monitoring Project, funded by Bonneville Power Administration (BPA). This interagency project was developed to provide a standardized level of fish health information from all Agencies rearing fish in the Columbia Basin. Agencies involved in the project are: WDF, Washington Department of Wildlife, Oregon Fish and Wildlife, Idaho Fish and Game, and the US Fish and Wildlife Service. WDF has actively participated in this project, and completed its third year of fish health monitoring, data collection and pathogen inspection during 1989. This report will present data collected from January 1, 1989 to December 31, 1989 and will compare sampling results from screening at spawning for viral pathogens and bacterial kidney disease (BKD), and evaluation of causes of pre-spawning loss. The juvenile analysis will include pre-release examination results, mid-term rearing exam results and evaluation of the Organosomatic Analysis completed on stocks. 2 refs., 4 figs., 15 tabs.

  17. Efficacy of kinesio tape application on pain and muscle strength in patients with myofascial pain syndrome: a placebo-controlled trial.

    PubMed

    Öztürk, Gülcan; Külcü, Duygu Geler; Mesci, Nilgün; Şilte, Ayşe Duygu; Aydog, Ece

    2016-04-01

    [Purpose] The purpose of this study was to determine the short- and mid-term effects of Kinesio taping on the trapezius muscle in individuals with myofascial pain syndrome. [Subjects and Methods] Thirty-seven patients with active upper trapezius myofascial trigger points were randomly divided to 2 groups: group 1 received Kinesio taping for the upper trapezius muscle, and group 2 received a sham Kinesio taping application. Neck pain (Visual Analog Scale and pressure algometry) and trapezius muscle strength data were collected at baseline, immediately after Kinesio taping application, and at one month follow-up. [Results] The mean changes in Visual Analog Scale scores were significantly different between groups at T2 and T1, with less pain in group 1. The mean changes in algometry scores were significantly different between groups at T3 compared with T2 in favor of group 1. The mean changes in trapezius muscle strength were significantly different between the groups at T2 compared with T1 in favor of group 1. [Conclusion] Patients with myofascial pain syndrome receiving an application of Kinesio taping exhibited statistically significant improvements in pain and upper trapezius muscle strength. PMID:27190430

  18. Engaging with Policy Makers

    NASA Astrophysics Data System (ADS)

    Massey, R.; Miller, S.; Heward, A.

    2011-10-01

    The need to engage with Europe's policy makers is more crucial now than ever. MEPs' understanding of the contribution and importance of planetary science to European research, industry, culture, education and job-creation may have major implications for both the direction of research and future funding for Europe's planetary science community. The mid-term review of the European Commission's Seventh Framework Programme is currently in progress and these discussions will feed into the drafting of Framework Eight. With space-going nations around the world redefining priorities, Europe may have an opportunity to take a lead in planetology on a global scale. This should be taken into account when considering planetology within the frameworks of the European Space Policy. This panel discussion, hosted by Dr Robert Massey, Deputy Executive of the Royal Astronomical Session, will look at engaging with policy makers from the point of view of those working in the European Parliament, European Commission, industry, as well as the planetary community.

  19. Superior caval venous syndrome after atrial switch procedure: relief of complete venous obstruction by gradual angioplasty and placement of stents.

    PubMed

    Michel-Behnke, I; Hagel, K J; Bauer, J; Schranz, D

    1998-10-01

    Superior caval venous syndrome is one of the late problems known to occur after Mustard repair of complete transposition. Reoperation may leave residual stenosis, and carries substantial risk for the patient. It is now feasible to use intravascular stents to overcome systemic venous baffle obstructions, and such an approach is probably more effective. The purpose of our study therefore, was to assess immediate and medium term results of inserting stents subsequent to gradual balloon enlargement of acquired atresia of the intraatrial baffle in patients who had undergone an atrial switch operation. We investigated five patients with complete obstruction of the superior caval venous pathway at perforation of the atretic segment was achieved using a guide wire technique. The procedure was successful in all patients. Gradual angioplasty was performed and intravascular stents were implanted. The pressure in the superior caval vein dropped to normal values, symptoms improved, and the patency of the newly created venoatrial communication was proven at mid-term follow-up. Thus critical obstructions at the superior caval venous pathway after the Mustard procedure can be reopened by interventional catheterization. Implantation of balloon-expandable intravascular stents is safe and effective in the acute relief of the obstructions, but careful long-term follow-up is mandatory. PMID:9855097

  20. The significance of photovoltaics for a climatically benign energy supply in Baden-Wuerttemberg, a state in southern Germany

    SciTech Connect

    Moesslein, J.

    1994-12-31

    The contribution to the realization of a climatically benign energy supply in Middle Europe by the inland use of photovoltaics (PV) has been identified to serve as an assessment for political decisions. The roof area of Baden-Wuerttemberg is large enough to install a total PV power that generates at least 20% of the consumed electricity. For this share, the fluctuations of PV power do not cause more than 2% of the total electricity to be unused if no storage systems are used. The small size of the current world market for PV systems, as well as the comparably high prices for PV electricity will impede a fast extension of grid-connected PV systems mid-term. Therefore, public subsidies will still be needed to accelerate both demand and supply of PV systems. Given these boundary conditions a scenario where no more than maybe 100 MWp will be installed until the year 2005 is most probable. Then, the share of the electricity generation by PV will only be in the 0.1% range. Logistic functions for the PV market after the year 2005 show that only if they start to support the integration of PV systems in the electricity system already today, shares of the PV electricity in the 10--20% range will be obtainable around the year 2020.

  1. Portable Diagnostics Technology Assessment for Space Missions. Part 1; General Technology Capabilities for NASA Exploration Missions

    NASA Technical Reports Server (NTRS)

    Nelson, Emily S.; Chait, Arnon

    2010-01-01

    The changes in the scope of NASA s mission in the coming decade are profound and demand nimble, yet insightful, responses. On-board clinical and environmental diagnostics must be available for both mid-term lunar and long-term Mars exploration missions in an environment marked by scarce resources. Miniaturization has become an obvious focus. Despite solid achievements in lab-based devices, broad-based, robust tools for application in the field are not yet on the market. The confluence of rapid, wide-ranging technology evolution and internal planning needs are the impetus behind this work. This report presents an analytical tool for the ongoing evaluation of promising technology platforms based on mission- and application-specific attributes. It is not meant to assess specific devices, but rather to provide objective guidelines for a rational down-select of general categories of technology platforms. In this study, we have employed our expertise in the microgravity operation of fluidic devices, laboratory diagnostics for space applications, and terrestrial research in biochip development. A rating of the current state of technology development is presented using the present tool. Two mission scenarios are also investigated: a 30-day lunar mission using proven, tested technology in 5 years; and a 2- to 3-year mission to Mars in 10 to 15 years.

  2. [Experience of 3 successfully treated cases of tracheo-innominate artery fistula and significance of preventive surgery].

    PubMed

    Kawahito, Tomohisa; Takano, Shinji; Egawa, Yoshiyasu; Yoshida, Homare

    2012-12-01

    Tracheo-innominate artery fistula (TIF) is a rare but fatal complication after tracheostomy. Necessary lifesaving measures include proper ventilation, temporary hemostasis, and surgery. Recently, we successfully managed 3 cases of TIF. Ventilation and temporary hemostasis were secured by a long endotracheal tube and overinflated cuff. Division of the innominate artery, restoration of the tracheal fistula with an autologous pericardial patch or direct closure, and aorto-innominate bypass grafting or extra-anatomical bypass grafting with a polytetrafluoroethylene (PTFE) graft were performed through an emergency median sternotomy. All 3 patients recovered with no problems. After TIF occurs, the patient's condition rapidly worsens, and the risk of bacterial contamination in the operative field may increase. Surgical intervention should be performed for patients with tracheal stenosis who are judged to be at high risk for TIF. This preventive surgery includes bypass grafting to divide the innominate artery and partial resection of the anterior bony thorax(upper sternum, medial part of clavicles, and anterior part of upper ribs if necessary). We believe that this procedure will improve tracheal stenosis and minimize the risk of TIF. Thus far, 10 patients have undergone this operation, and their mid-term results are satisfactory. PMID:23202704

  3. Uncertainty Representation in Stochastic Reservoir Optimization

    NASA Astrophysics Data System (ADS)

    Lamontagne, J. R.; Stedinger, J. R.; Shoemaker, C. A.; Tan, S. N.

    2014-12-01

    Water resources managers attempt to operate reservoir and hydropower systems to maximize system objectives, subject to a host of physical and policy constraints, and in light of uncertainty about future conditions. Optimization models are widely used to advise the decision making process. An important aspect of such models is how uncertainties related to future hydrologic and economic conditions are represented, and the extent to which different uncertainty representations affect the quality of recommended decisions. This study explores the consequences of different uncertainty representations in stochastic optimization models of hydropower systems by comparing simulated system performance using different stochastic optimization models. An important question is whether the added computational burden from greater uncertainty resolution (which can be prohibitive for operational models in many cases) actually improves model recommendations. This is particularly relevant as more complex, ensemble forecasts are incorporated into short- and mid-term planning models. Another important consideration is how watershed hydrology (both seasonal and episodic characteristics), system size, economic context, and the temporal resolution of the model influence how uncertainty should be represented. These topics are explored through several US examples including a sampling stochastic dynamic programming (SSDP) model of a small single-reservoir system on the Kennebec River in Maine, and a stochastic programming model of the large multi-reservoir Federal Columbia River system in the Pacific Northwest. These studies highlight the importance of flexible model frameworks which allow exploration of different representations of a system and of uncertainties before locking operational decision support system development into a specific representation.

  4. Solar Central Receiver Hybrid Power Systems sodium-cooled receiver concept. Final report. Volume III. Appendices

    SciTech Connect

    1980-01-01

    The overall, long term objective of the Solar Central Receiver Hybrid Power System is to identify, characterize, and ultimately demonstrate the viability and cost effectiveness of solar/fossil, steam Rankine cycle, hybrid power systems that: (1) consist of a combined solar central receiver energy source and a nonsolar energy source at a single, common site, (2) may operate in the base, intermediate, and peaking capacity modes, (3) produce the rated output independent of variations in solar insolation, (4) provide a significant savings (50% or more) in fuel consumpton, and (5) produce power at the minimum possible cost in mills/kWh. It is essential that these hybrid concepts be technically feasible and economically competitive with other systems in the near to mid-term time period (1985-1990) on a commercial scale. The program objective for Phase I is to identify and conceptually characterize solar/fossil steam Rankine cycle, commercial-scale, power plant systems that are economically viable and technically feasible. This volume contains appendices to the conceptual design and systems analysis studies gien in Volume II, Books 1 and 2. (WHK)

  5. Effects of Platelet-Rich Plasma (PRP) on a Model of Renal Ischemia-Reperfusion in Rats

    PubMed Central

    Martín-Solé, Oriol; Rodó, Joan; García-Aparicio, Lluís; Blanch, Josep; Cusí, Victoria; Albert, Asteria

    2016-01-01

    Renal ischemia-reperfusion injury is a major cause of acute renal failure, causing renal cell death, a permanent decrease of renal blood flow, organ dysfunction and chronic kidney disease. Platelet-rich plasma (PRP) is an autologous product rich in growth factors, and therefore able to promote tissue regeneration and angiogenesis. This product has proven its efficacy in multiple studies, but has not yet been tested on kidney tissue. The aim of this work is to evaluate whether the application of PRP to rat kidneys undergoing ischemia-reperfusion reduces mid-term kidney damage. A total of 30 monorrenal Sprague-Dawley male rats underwent renal ischemia-reperfusion for 45 minutes. During ischemia, PRP (PRP Group, n = 15) or saline solution (SALINE Group, n = 15) was administered by subcapsular renal injection. Control kidneys were the contralateral organs removed immediately before the start of ischemia in the remaining kidneys. Survival, body weight, renal blood flow on Doppler ultrasound, kidney weight, kidney volume, blood biochemistry and histopathology were determined for all subjects and kidneys, as applicable. Correlations between these variables were searched for. The PRP Group showed significantly worse kidney blood flow (p = 0.045) and more histopathological damage (p<0.0001). Correlations were found between body weight, kidney volume, kidney weight, renal blood flow, histology, and serum levels of creatinine and urea. Our study provides the first evidence that treatment with PRP results in the deterioration of the kidney’s response to ischemia-reperfusion injury. PMID:27551718

  6. An experience of liver transplantation in Latin America: a medical center in Colombia

    PubMed Central

    Londoño, Mauricio; Marín, Juan; Muñoz, Octavio; Mena, Álvaro; Guzmán, Carlos; Hoyos, Sergio; Restrepo, Juan; Arbeláez, María; Correa, Gonzalo

    2015-01-01

    Objectives: Liver transplantation is the treatment of choice for acute and chronic liver failure, for selected cases of tumors, and for conditions resulting from errors in metabolism. This paper reports the experience of a medical center in Latin America. Methods: Were conducted 305 orthotopic liver transplantations on 284 patients between 2004 and 2010. Of these patients, 241 were adults undergoing their first transplantation. Results: The average age of patients was 52 years old, and 62% of the individuals were male. The most common indication was alcoholic cirrhosis. The rate of patient survival after 1 and 5 years was 82 and 72% respectively. The rate of liver graft survival after 1 and 5 years was 78 and 68% respectively. The main cause of death was sepsis. Complications in the hepatic artery were documented for 5% of the patients. Additionally, 14.5% of the patients had complications in the biliary tract. Infections were found in 41% of the individuals. Acute rejection was observed in 30% of the subjects, and chronic rejection in 3%. Conclusion: In conclusion, liver transplantation at our medical center in Colombia offers good mid-term results, with a complication rate similar to that reported by other centers around the world. PMID:26019379

  7. Solar Electric Propulsion

    NASA Technical Reports Server (NTRS)

    LaPointe, Michael

    2006-01-01

    The Solar Electric Propulsion (SEP) technology area is tasked to develop near and mid-term SEP technology to improve or enable science mission capture while minimizing risk and cost to the end user. The solar electric propulsion investments are primarily driven by SMD cost-capped mission needs. The technology needs are determined partially through systems analysis tasks including the recent "Re-focus Studies" and "Standard Architecture Study." These systems analysis tasks transitioned the technology development to address the near term propulsion needs suitable for cost-capped open solicited missions such as Discovery and New Frontiers Class missions. Major SEP activities include NASA's Evolutionary Xenon Thruster (NEXT), implementing a Standard Architecture for NSTAR and NEXT EP systems, and developing a long life High Voltage Hall Accelerator (HiVHAC). Lower level investments include advanced feed system development and xenon recovery testing. Future plans include completion of ongoing ISP development activities and evaluating potential use of commercial electric propulsion systems for SMD applications. Examples of enhanced mission capability and technology readiness dates shall be discussed.

  8. Development of an on-board charge and discharge management system for electric-vehicle batteries

    NASA Astrophysics Data System (ADS)

    Alzieu, J.; Gagnol, P.; Smimite, H.

    To improve the service quality of its electric-vehicle (EV) fleet (≈500 vehicles) and master the behaviour of the valve-regulated lead/acid (VRLA) batteries, which power the major part of it, Electricité de France (EDF) has developed an on-board battery-management system. Information on the operating battery behaviour is given to the driver. Overdischarges can then be avoided. Rapid charging of VRLA batteries is monitored. The main available functions of this device are: (i) battery life recording, short- and long-term information storage is available; (ii) charge monitoring, communication with a 23 kW charger is established through an ISO 9141 interface; a fast-charging algorithm for VRLA batteries has been developed and up to 50% of the range can be returned to the EV in 20 min; (iii) battery management during driving, 'orange' and 'red' alarms related to the depth-of-discharge help the driver to manage the driving; cell overdischarges can then be avoided; (iv) maintenance, the faulty groups of cells are identified; (v) gauge (state-of-charge indicator), this function requires mid-term R and D; for the moment, only charged and discharged Ah are indicated but when more accurate state-of-charge prediction algorithms are available, the software will be up-graded.

  9. Life cycle assessment of switchgrass- and corn stover-derived ethanol-fueled automobiles.

    PubMed

    Spatari, Sabrina; Zhang, Yimin; MacLean, Heather L

    2005-12-15

    Utilizing domestically produced cellulose-derived ethanol for the light-duty vehicle fleet can potentially improve the environmental performance and sustainability of the transport and energy sectors of the economy. A life cycle assessment model was developed to examine environmental implications of the production and use of ethanol in automobiles in Ontario, Canada. The results were compared to those of low-sulfur reformulated gasoline (RFG) in a functionally equivalent automobile. Two time frames were evaluated, one near-term (2010), which examines converting a dedicated energy crop (switchgrass) and an agricultural residue (corn stover) to ethanol; and one midterm (2020), which assumes technological improvements in the switchgrass-derived ethanol life cycle. Near-term results show that, compared to a RFG automobile, life cycle greenhouse gas (GHG) emissions are 57% lower for an E85-fueled automobile derived from switchgrass and 65% lower for ethanol from corn stover, on a grams of CO2 equivalent per kilometer basis. Corn stover ethanol exhibits slightly lower life cycle GHG emissions, primarily due to sharing emissions with grain production. Through projected improvements in crop and ethanol yields, results for the mid-term scenario show that GHG emissions could be 25-35% lower than those in 2010 and that, even with anticipated improvements in RFG automobiles, E85 automobiles could still achieve up to 70% lower GHG emissions across the life cycle. PMID:16475363

  10. Serial transverse enteroplasty to facilitate enteral autonomy in selected children with short bowel syndrome

    PubMed Central

    Wester, T; Borg, H; Naji, H; Stenström, P; Westbacke, G; Lilja, H E

    2014-01-01

    Background Serial transverse enteroplasty (STEP) was first described in 2003 as a method for lengthening and tapering of the bowel in short bowel syndrome. The aim of this multicentre study was to review the outcome of a Swedish cohort of children who underwent STEP. Methods All children who had a STEP procedure at one of the four centres of paediatric surgery in Sweden between September 2005 and January 2013 were included in this observational cohort study. Demographic details, and data from the time of STEP and at follow-up were collected from the case records and analysed. Results Twelve patients had a total of 16 STEP procedures; four children underwent a second STEP. The first STEP was performed at a median age of 5·8 (range 0·9–19·0) months. There was no death at a median follow-up of 37·2 (range 3·0–87·5) months and no child had small bowel transplantation. Seven of the 12 children were weaned from parenteral nutrition at a median of 19·5 (range 2·3–42·9) months after STEP. Conclusion STEP is a useful procedure for selected patients with short bowel syndrome and seems to facilitate weaning from parenteral nutrition. At mid-term follow-up a majority of the children had achieved enteral autonomy. The study is limited by the small sample size and lack of a control group. Good results in selected children PMID:25043139

  11. Generic Airspace Concepts and Research

    NASA Technical Reports Server (NTRS)

    Mogford, Richard H.

    2010-01-01

    The purpose of this study was to evaluate methods for reducing the training and memorization required to manage air traffic in mid-term, Next Generation Air Transportation System (NextGen) airspace. We contrasted the performance of controllers using a sector information display and NextGen automation tools while working with familiar and unfamiliar sectors. The airspace included five sectors from Oakland and Salt Lake City Centers configured as a "generic center" called "West High Center." The Controller Information Tool was used to present essential information for managing these sectors. The Multi Aircraft Control System air traffic control simulator provided data link and conflict detection and resolution. There were five experienced air traffic controller participants. Each was familiar with one or two of the five sectors, but not the others. The participants rotated through all five sectors during the ten data collection runs. The results addressing workload, traffic management, and safety, as well as controller and observer comments, supported the generic sector concept. The unfamiliar sectors were comparable to the familiar sectors on all relevant measures.

  12. A model to forecast data centre infrastructure costs.

    NASA Astrophysics Data System (ADS)

    Vernet, R.

    2015-12-01

    The computing needs in the HEP community are increasing steadily, but the current funding situation in many countries is tight. As a consequence experiments, data centres, and funding agencies have to rationalize resource usage and expenditures. CC-IN2P3 (Lyon, France) provides computing resources to many experiments including LHC, and is a major partner for astroparticle projects like LSST, CTA or Euclid. The financial cost to accommodate all these experiments is substantial and has to be planned well in advance for funding and strategic reasons. In that perspective, leveraging infrastructure expenses, electric power cost and hardware performance observed in our site over the last years, we have built a model that integrates these data and provides estimates of the investments that would be required to cater to the experiments for the mid-term future. We present how our model is built and the expenditure forecast it produces, taking into account the experiment roadmaps. We also examine the resource growth predicted by our model over the next years assuming a flat-budget scenario.

  13. Operative Management of Lumbar Degenerative Disc Disease.

    PubMed

    Lee, Yu Chao; Zotti, Mario Giuseppe Tedesco; Osti, Orso Lorenzo

    2016-08-01

    Lumbar degenerative disc disease is extremely common. Current evidence supports surgery in carefully selected patients who have failed non-operative treatment and do not exhibit any substantial psychosocial overlay. Fusion surgery employing the correct grafting and stabilization techniques has long-term results demonstrating successful clinical outcomes. However, the best approach for fusion remains debatable. There is some evidence supporting the more complex, technically demanding and higher risk interbody fusion techniques for the younger, active patients or patients with a higher risk of non-union. Lumbar disc arthroplasty and hybrid techniques are still relatively novel procedures despite promising short-term and mid-term outcomes. Long-term studies demonstrating superiority over fusion are required before these techniques may be recommended to replace fusion as the gold standard. Novel stem cell approaches combined with tissue engineering therapies continue to be developed in expectation of improving clinical outcomes. Results with appropriate follow-up are not yet available to indicate if such techniques are safe, cost-effective and reliable in the long-term. PMID:27559465

  14. Potential of Securitization in Solar PV Finance

    SciTech Connect

    Lowder, T.; Mendelsohn, M.

    2013-12-01

    This report aims to demonstrate, hypothetically and at a high level, what volumes of solar deployment could be supported given solar industry access to the capital markets in the form of security issuance. Securitization is not anticipated to replace tax equity in the near- to mid-term, but it could provide an additional source of funds that would be comparatively inexpensive and could reduce the weighted average cost of capital for a given solar project or portfolio. Thus, the potential to securitize solar assets and seek financing in the capital markets could help to sustain the solar industry when the investment tax credit (ITC) -- one of the federal incentives that has leveraged billions of dollars of private capital in the solar industry -- drops from 30% to 10% at the close of 2016. The report offers analysis on the size of the U.S. third-party financed solar market, as well as on the volumes (in MW) of solar asset origination possible through a $100 million securitization fund (assuming no overcollateralization). It also provides data on the size of the relevant securities markets and how the solar asset class may fit into these markets.

  15. Bacterial Diversity Analysis during the Fermentation Processing of Traditional Chinese Yellow Rice Wine Revealed by 16S rDNA 454 Pyrosequencing.

    PubMed

    Fang, Ruo-si; Dong, Ya-chen; Chen, Feng; Chen, Qi-he

    2015-10-01

    Rice wine is a traditional Chinese fermented alcohol drink. Spontaneous fermentation with the use of the Chinese starter and wheat Qu lead to the growth of various microorganisms during the complete brewing process. It's of great importance to fully understand the composition of bacteria diversity in rice wine in order to improve the quality and solve safety problems. In this study, a more comprehensive bacterial description was shown with the use of bacteria diversity analysis, which enabled us to have a better understanding. Rarefaction, rank abundance, alpha Diversity, beta diversity and principal coordinates analysis simplified their complex bacteria components and provide us theoretical foundation for further investigation. It has been found bacteria diversity is more abundant at mid-term and later stage of brewing process. Bacteria community analysis reveals there is a potential safety hazard existing in the fermentation, since most of the sequence reads are assigned to Enterobacter (7900 at most) and Pantoea (7336 at most), followed by Staphylococcus (2796 at most) and Pseudomonas (1681 at most). Lactic acid bacteria are rare throughout the fermentation process which is not in accordance with other reports. This work may offer us an opportunity to investigate micro ecological fermentation system in food industry. PMID:26409170

  16. Evaluation of energy recovery and CO2 reduction potential in Japan through integrated waste and utility management.

    PubMed

    Horio, M; Shigeto, S; Shiga, M

    2009-07-01

    This paper examines the potential of integrated waste and utility power management over the mid-term planning horizon in Japan. Energy recovery and CO(2) emission reduction were estimated under two situations: (1) energy recovery efforts within the current waste management/power generation framework and (2) integrated waste management with sewage treatment systems and electric power industries. Scenario simulation results showed that under the current policy framework it is not feasible to achieve large energy recovery and CO(2) emission reduction, while the integrated waste management scenarios show the potential of large energy recovery which is equivalent to about an 18 million t-CO(2) emission reduction. The utilization of dry wastes for power generation at existing fossil power stations is significant in achieving the result. We also consider the effects of the 'CO(2) emission per GW generated' for electric power generation on the total CO(2) emission reduction because it varies by country and assumptions selected. Although this research did not include an economic analysis, based on estimated CO(2) emissions and energy recovery, the integrated scenarios indicate a large potential in countries that have high dependence of fossil power generation and relatively low power generation efficiency. PMID:19272763

  17. Safety and feasibility of radiofrequency ablation for treatment of Bosniak IV renal cysts

    PubMed Central

    de Menezes, Marcos Roberto; Viana, Publio Cesar Cavalcante; Yamanari, Tássia Regina; Reis, Leonardo Oliveira; Nahas, William

    2016-01-01

    ABSTRACT Purpose To describe our initial experience with radiofrequency ablation (RFA) of Bosniak IV renal cysts. Materials and Methods From 2010 to 2014, 154 renal tumor cases were treated with percutaneous thermal ablation, of which 10 cases (6.4%) from nine patients were complex renal cysts and were treated with radiofrequency ablation. Results All complex cysts were classified as Bosniak IV (four women and five men; mean age: 63.6 yrs, range: 33–83 years). One patient had a single kidney. Lesion size ranged from 1.5 to 4.1cm (mean: 2.5cm) and biopsy was performed on four cysts immediately before the procedure, all of which were malignant (two clear cell and two papillary carcinoma). Mean volume reduction of complex cysts was 25% (range: 10–40%). No patients required retreatment with RFA and no immediate or late complications were observed. The follow-up of Bosniak IV cysts had a median of 27 months (interquartile range [IQR], 23 to 38) and no recurrence or significant loss of renal function were observed. Conclusions Mid-term follow-up of the cases in our database suggests that image-guided percutaneous RFA can treat Bosniak IV cysts with very low complication rates and satisfactorily maintain renal function. PMID:27286107

  18. Solar Central Receiver Hybrid Power Systems sodium-cooled receiver concept. Final report. Volume II, Book 1. Conceptual design, Sections 1 through 4

    SciTech Connect

    1980-01-01

    The overall, long-term objective of the Solar Central Receiver Hybrid Power System program is to identify, characterize, and ultimately demonstrate the viability and cost effectiveness of solar/fossil, steam Rankine cycle, hybrid power systems that: (1) consist of a combined solar central receiver energy source and a nonsolar energy source at a single, common site, (2) may operate in the base, intermediate, and peaking capacity modes, (3) produce the rated output independent of variations in solar insolation, (4) provide a significant savings (50% or more) in fuel consumption, and (5) produce power at the minimum possible cost in mills/kWh. It is essential that these hybrid concepts be technically feasible and economically competitive with other systems in the near to mid-term time period (1985-1990) on a commercial scale. The program objective for Phase I is to identify and conceptually characterize solar/fossil steam Rankine cycle, commercial-scale, power plant systems that are economically viable and technically feasible. This volume presents in detail the market analysis, parametric analysis, and the selection process for the preferred system. (WHK)

  19. High Performance Healthcare Buildings: A Roadmap to Improved Energy Efficiency

    SciTech Connect

    Singer, Brett C.; Tschudi, William F.

    2009-09-08

    This document presents a road map for improving the energy efficiency of hospitals and other healthcare facilities. The report compiles input from a broad array of experts in healthcare facility design and operations. The initial section lists challenges and barriers to efficiency improvements in healthcare. Opportunities are organized around the following ten themes: understanding and benchmarking energy use; best practices and training; codes and standards; improved utilization of existing HVAC designs and technology; innovation in HVAC design and technology; electrical system design; lighting; medical equipment and process loads; economic and organizational issues; and the design of next generation sustainable hospitals. Achieving energy efficiency will require a broad set of activities including research, development, deployment, demonstration, training, etc., organized around 48 specific objectives. Specific activities are prioritized in consideration of potential impact, likelihood of near- or mid-term feasibility and anticipated cost-effectiveness. This document is intended to be broad in consideration though not exhaustive. Opportunities and needs are identified and described with the goal of focusing efforts and resources.

  20. Efficient production of multi-modified pigs for xenotransplantation by 'combineering', gene stacking and gene editing.

    PubMed

    Fischer, Konrad; Kraner-Scheiber, Simone; Petersen, Björn; Rieblinger, Beate; Buermann, Anna; Flisikowska, Tatiana; Flisikowski, Krzysztof; Christan, Susanne; Edlinger, Marlene; Baars, Wiebke; Kurome, Mayuko; Zakhartchenko, Valeri; Kessler, Barbara; Plotzki, Elena; Szczerbal, Izabela; Switonski, Marek; Denner, Joachim; Wolf, Eckhard; Schwinzer, Reinhard; Niemann, Heiner; Kind, Alexander; Schnieke, Angelika

    2016-01-01

    Xenotransplantation from pigs could alleviate the shortage of human tissues and organs for transplantation. Means have been identified to overcome hyperacute rejection and acute vascular rejection mechanisms mounted by the recipient. The challenge is to combine multiple genetic modifications to enable normal animal breeding and meet the demand for transplants. We used two methods to colocate xenoprotective transgenes at one locus, sequential targeted transgene placement - 'gene stacking', and cointegration of multiple engineered large vectors - 'combineering', to generate pigs carrying modifications considered necessary to inhibit short to mid-term xenograft rejection. Pigs were generated by serial nuclear transfer and analysed at intermediate stages. Human complement inhibitors CD46, CD55 and CD59 were abundantly expressed in all tissues examined, human HO1 and human A20 were widely expressed. ZFN or CRISPR/Cas9 mediated homozygous GGTA1 and CMAH knockout abolished α-Gal and Neu5Gc epitopes. Cells from multi-transgenic piglets showed complete protection against human complement-mediated lysis, even before GGTA1 knockout. Blockade of endothelial activation reduced TNFα-induced E-selectin expression, IFNγ-induced MHC class-II upregulation and TNFα/cycloheximide caspase induction. Microbial analysis found no PERV-C, PCMV or 13 other infectious agents. These animals are a major advance towards clinical porcine xenotransplantation and demonstrate that livestock engineering has come of age. PMID:27353424

  1. The Third Pacific Basin Biofuels Workshop: Proceedings

    NASA Astrophysics Data System (ADS)

    Among the many compelling reasons for the development of biofuels on remote Pacific islands, several of the most important include: (1) a lack of indigenous fossil fuels necessitates their import at great economic loss to local island economics, (2) ideal conditions for plant growth exist on many Pacific islands to produce yields of biomass feedstocks, (3) gaseous and liquid fuels such as methane, methanol and ethanol manufactured locally from biomass feedstocks are the most viable alternatives to gasoline and diesel fuels for transportation, and (4) the combustion of biofuels is cleaner than burning petroleum products and contributes no net atmospheric CO2 to aggravate the greenhouse effect and the subsequent threat of sea level rise to low islands. Dr. Vic Phillips, HNEI Program Manager of the Hawaii Integrated Biofuels Research Program welcomed 60 participants to the Third Pacific Basin Biofuels Workshop at the Sheraton Makaha Hotel, Waianae, Oahu, on March 27 and 28, 1989. The objectives of the workshop were to update progress since the Second Pacific Basin Biofuels Workshop in April 1987 and to develop a plan for action for biofuels R and D, technology transfer, and commercialization now (immediate attention), in the near-term (less than two years), in the mid-term (three to five years), and in the long-term (more than six years). An emerging theme of the workshop was how the production, conversion, and utilization of biofuels can help increase environmental and economic security locally and globally. Individual papers are processed separately for the data base.

  2. Capital Requirements Estimating Model (CREMOD) for electric utilities. Volume I. Methodology description, model, description, and guide to model applications. [For each year up to 1990

    SciTech Connect

    Collins, D E; Gammon, J; Shaw, M L

    1980-01-01

    The Capital Requirements Estimating Model for the Electric Utilities (CREMOD) is a system of programs and data files used to estimate the capital requirements of the electric utility industry for each year between the current one and 1990. CREMOD disaggregates new electric plant capacity levels from the Mid-term Energy Forecasting System (MEFS) Integrating Model solution over time using actual projected commissioning dates. It computes the effect on aggregate capital requirements of dispersal of new plant and capital expenditures over relatively long construction lead times on aggregate capital requirements for each year. Finally, it incorporates the effects of real escalation in the electric utility construction industry on these requirements and computes the necessary transmission and distribution expenditures. This model was used in estimating the capital requirements of the electric utility sector. These results were used in compilation of the aggregate capital requirements for the financing of energy development as published in the 1978 Annual Report to Congress. This volume, Vol. I, explains CREMOD's methodology, functions, and applications.

  3. A Generic Framework for Tsunami Evacuation Planning

    NASA Astrophysics Data System (ADS)

    Scheer, Stefan; Eftichidis, George; Guillande, Richard

    2010-05-01

    Coastal communities are vulnerable with regard to the devastating impacts tsunami waves may generate to life, lifelines, assets and economy. The risk is quantified by rather rare occurrence on one hand, and by high damage to be expected on the other hand. Hence a pure numerical calculation could easily become meaningless. Yet over-dramatizing the threat could become counter-productive taking into account social behaviour and human perception of potential risk of tsunami waves. Local communities would therefore rather act in a "silent" way by gradually improving the level of preparedness. The goal should be to create a concept of an emergency and evacuation plan that could easily be invoked if necessary. Obviously such concepts are based on a huge variety of parameters which can be set in an individual way considering local particularities, scopes and questions of applicability. Nevertheless guidance through all these parameters and their calculations is difficult to find. This abstract proposes a generic framework that summarizes the application of various steps to be taken, the interdependencies of these steps and the three phases of repetition due to generation, mid-term maintenance and long-term revision of such emergency and evacuation plans. The abstract represents the outcome of research work done as part of the EU-funded SCHEMA (scenarios for hazard-induced emergencies management) project.

  4. The modern, hybrid total hip arthroplasty for primary osteoarthritis at the Hospital for Special Surgery.

    PubMed

    González Della Valle, A; Sharrock, N; Barlow, M; Caceres, L; Go, G; Salvati, E A

    2016-01-01

    We describe our technique and rationale using hybrid fixation for primary total hip arthroplasty (THA) at the Hospital for Special Surgery. Modern uncemented acetabular components have few screw holes, or no holes, polished inner surfaces, improved locking mechanisms, and maximised thickness and shell-liner conformity. Uncemented sockets can be combined with highly cross-linked polyethylene liners, which have demonstrated very low wear and osteolysis rates after ten to 15 years of implantation. The results of cement fixation with a smooth or polished surface finished stem have been excellent, virtually eliminating complications seen with cementless fixation like peri-operative femoral fractures and thigh pain. Although mid-term results of modern cementless stems are encouraging, the long-term data do not show reduced revision rates for cementless stems compared with cemented smooth stems. In this paper we review the conduct of a hybrid THA, with emphasis on pre-operative planning, surgical technique, hypotensive epidural anaesthesia, and intra-operative physiology. PMID:26733642

  5. In-Space Propulsion Technology Program Solar Electric Propulsion Technologies

    NASA Technical Reports Server (NTRS)

    Dankanich, John W.

    2006-01-01

    NASA's In-space Propulsion (ISP) Technology Project is developing new propulsion technologies that can enable or enhance near and mid-term NASA science missions. The Solar Electric Propulsion (SEP) 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. Status and expected capabilities of the SEP technologies are reviewed in this presentation. The SEP technology area supports numerous mission studies and architecture analyses to determine which investments will give the greatest benefit to science missions. Both the NEXT and HiVHAC thrusters have modified their nominal throttle tables to better utilize diminished solar array power on outbound missions. A new life extension mechanism has been implemented on HiVHAC to increase the throughput capability on low-power systems to meet the needs of cost-capped missions. Lower complexity, more reliable feed system components common to all electric propulsion (EP) systems are being developed. ISP has also leveraged commercial investments to further validate new ion and hall thruster technologies and to potentially lower EP mission costs.

  6. NASA's In-Space Propulsion Technology Program: A Step Toward Interstellar Exploration

    NASA Technical Reports Server (NTRS)

    Johnson, Les; James, Bonnie; Baggett, Randy; Montgomery, Sandy

    2005-01-01

    NASA's In-Space Propulsion Technology Program is investing in technologies that have the potential to revolutionize the robotic exploration of deep space. For robotic exploration and science missions, increased efficiencies of future propulsion systems are critical to reduce overall life-cycle costs and, in some cases, enable missions previously considered impossible. Continued reliance on conventional chemical propulsion alone will not enable the robust exploration of deep space. The maximum theoretical efficiencies have almost been reached and are insufficient to meet needs for many ambitious science missions currently being considered. By developing the capability to support mid-term robotic mission needs, the program is laying the technological foundation for travel to nearby interstellar space. The In-Space Propulsion Technology Program s technology portfolio includes many advanced propulsion systems. From the next-generation ion propulsion systems operating in the 5-10 kW range, to solar sail propulsion, substantial advances in spacecraft propulsion performance are anticipated. Some of the most promising technologies for achieving these goals use the environment of space itself for energy and propulsion and are generically called "propellantless" because they do not require onboard fuel to achieve thrust. Propellantless propulsion technologies include scientific innovations, such as solar sails, electrodynamic and momentum transfer tethers, and aerocapture. This paper will provide an overview of those propellantless and propellant-based advanced propulsion technologies that will most significantly advance our exploration of deep space.

  7. NASA's In-Space Propulsion Technology Program: A Step Toward Interstellar Exploration

    NASA Astrophysics Data System (ADS)

    Johnson, L.; James, B.; Baggett, R.; Montgomery, E. E., IV

    NASA's In-Space Propulsion Technology Program is investing in technologies that have the potential to revolutionize the robotic exploration of deep space. For robotic exploration and science missions, increased efficiencies of future propulsion systems are critical to reduce overall life-cycle costs and, in some cases, enable missions previously considered impossible. Continued reliance on conventional chemical propulsion alone will not enable the robust exploration of deep space. The maximum theoretical efficiencies have almost been reached and are insufficient to meet needs for many ambitious science missions currently being considered. By developing the capability to support mid-term robotic mission needs, the program is laying the technological foundation for travel to nearby interstellar space. The In-Space Propulsion Technology Program's technology portfolio includes many advanced propulsion systems. From the next-generation ion propulsion systems operating in the 5-10 kW range, to solar sail propulsion, substantial advances in spacecraft propulsion performance are anticipated. Some of the most promising technologies for achieving these goals use the environment of space itself for energy and propulsion and are generically called “propellantless” because they do not require onboard fuel to achieve thrust. Propellantless propulsion technologies include scientific innovations such as solar sails and aerocapture. This paper will provide an overview of those propellantless and propellant-based advanced propulsion technologies that will most significantly advance our exploration of deep space.

  8. Picard, a solar mission dedicated to the study of the Sun: current results

    NASA Astrophysics Data System (ADS)

    Meftah, Mustapha; Hochedez, Jean-François; Dewitte, Steven; Hauchecorne, Alain; Irbah, Abdanour; Boumier, Patrick; Corbard, Thierry; Turck-Chi, Sylvaine; Zhu, Ping

    PICARD is a mission dedicated to the simultaneous measurements of the solar total and spectral irradiances, its diameter and asphericity. It also probes seismically the solar interior by analysing its local intensity variation. PICARD contains a double program with in-space and on-ground measurements. Space observations are a priori most favourable, however, space entails also technical challenges, a harsh environment, and a finite mission lifetime. The PICARD spacecraft, launched on June 15, 2010 will retire in April 2014. On ground, the instruments are less affected by in-space degradation and maintenance is easily provided so if the atmosphere is properly monitored and taken into account, they still represent an opportunity to generate the needed long-term time-series. That is why ground measurements have been carried out since May 2011-and will be pursued after the space program. In this talk, we describe both sets of instruments, and then present our current results. In particular, we show new estimates of the absolute values of the total solar irradiance, diameter and oblateness. We also report about helioseismic studies and about the apparent absence of mid-term trend in the measurement of the diameter.

  9. Trends in pesticide concentrations and use for major rivers of the United States.

    PubMed

    Ryberg, Karen R; Gilliom, Robert J

    2015-12-15

    Trends in pesticide concentrations in 38 major rivers of the United States were evaluated in relation to use trends for 11 commonly occurring pesticide compounds. Pesticides monitored in water were analyzed for trends in concentration in three overlapping periods, 1992-2001, 1997-2006, and 2001-2010 to facilitate comparisons among sites with variable sample distributions over time and among pesticides with changes in use during different periods and durations. Concentration trends were analyzed using the SEAWAVE-Q model, which incorporates intra-annual variability in concentration and measures of long-term, mid-term, and short-term streamflow variability. Trends in agricultural use within each of the river basins were determined using interval-censored regression with high and low estimates of use. Pesticides strongly dominated by agricultural use (cyanazine, alachlor, atrazine and its degradate deethylatrazine, metolachlor, and carbofuran) had widespread agreement between concentration trends and use trends. Pesticides with substantial use in both agricultural and nonagricultural applications (simazine, chlorpyrifos, malathion, diazinon, and carbaryl) had concentration trends that were mostly explained by a combination of agricultural-use trends, regulatory changes, and urban use changes inferred from concentration trends in urban streams. When there were differences, concentration trends usually were greater than use trends (increased more or decreased less). These differences may occur because of such factors as unaccounted pesticide uses, delayed transport to the river through groundwater, greater uncertainty in the use data, or unquantified land use and management practice changes. PMID:26318227

  10. Mass-reduction effort of the electric and hybrid vehicle

    SciTech Connect

    Freeman, R. B.; Jahnle, H. A.

    1980-03-01

    Weight reduction, cost competitiveness, and elimination of the intrusion beam resulted from the redesign and fabrication using composite materials of the door outer panel and intrusion beam from a 1977 Chevrolet Impala. The basis of the redesign involved replacing these two steel parts with a single compression molding using the unique approach of simultaneously curing a sheet molding compound outside panel with a continuous glass-fiber intrusion strap. A weight reduction of nearly 11 pounds per door was achieved. Additional weight savings are possible by taking advantage of the elimination of the intrusion beam to design thinner door structures. The parts-consolidation approach allows the composite structures to be cost-competitive with the original steel design for both the lower-production car models and for the near- to mid-term production contemplated for electric and hybrid vehicles using current state-of-the-art composite production techniques. In addition to the design, prototype fabrication, and costing phases, two appendices containing materials description, properties, and compression-molding production requirements are included.

  11. Measuring the Lake Level Evolution in the Qinghai-Tibet Plateau with Radar Altimeters

    NASA Astrophysics Data System (ADS)

    Garcia-Mondejar, Albert; Martinez Val, Bernat; Escorihuela, Ma Jose; Nilo Garcia, Pablo; Martin-Puig, Cristina; Yang, Jungang; Liao, Jingjuan

    2014-11-01

    The lake-level change is one of the important indicators for the water balance of the Qinghai-Tibetan Plateau (QTP). In this region lake level is directly affected by the temperature both upstream and in the surroundings. In addition, other factors like: precipitation, evaporation, glaciers, perennial snow cover and permafrost do have an impact as well. With global climate warming, it is becoming more necessary to strengthen the monitoring of lake levels. Although there are thousands of lakes in the QTP, most of them are in remote areas with difficult accessibility. Therefore, it is difficult to set up hydrological stations for the monitoring. Remote sensing offers a convenient solution for continuous monitoring over that region This paper presents the comparison of the lake level evolutions measured with current altimeters since 2010 and the followed methodology to process and cross calibrate the data. A description of the improvements achieved with the incorporation of the new high resolution altimeters, the Chinese first altimeter and the Ka band altimeter will also be incorporated. The Qinghai and the Zhari Namco lakes have been selected in order to validate the methodology independently for each radar altimeter and later retrieve the time series for the rest of the Plateau lakes. This is an ongoing study. The mid-term results presented here will be updated and presented in the following Dragon-3 symposiums.

  12. Humeral Head Arthroplasty and Meniscal Allograft Resurfacing of the Glenoid: A Concise Follow-up of a Previous Report and Survivorship Analysis.

    PubMed

    Bois, Aaron J; Whitney, Ian J; Somerson, Jeremy S; Wirth, Michael A

    2015-10-01

    The two to five-year results of humeral head arthroplasty and lateral meniscal allograft resurfacing of the glenoid in patients fifty-five years of age or younger were previously reported by the senior author (M.A.W.). The purpose of the present study was to report the survival rate, clinical findings, and radiographic results of the original thirty shoulders (thirty patients) followed for a mean duration of 8.3 years (range, five to twelve years). The scores on the visual analog scale for pain, American Shoulder and Elbow Surgeons scoring system, and Simple Shoulder Test were significantly improved at the latest follow-up evaluation compared with the preoperative findings (p < 0.001). Radiographic indices of posterior subluxation did not significantly increase from the immediate postoperative imaging to the latest radiographs, while the glenohumeral joint space demonstrated a gradual decrease. Nine (30%) of thirty shoulders were known to have undergone a reoperation. The present study demonstrated that biological glenoid resurfacing combined with hemiarthroplasty can provide significant improvement in shoulder function and pain relief in young patients with glenohumeral arthritis; however, mid-term follow-up at a mean of over eight years demonstrated a high reoperation rate. PMID:26446964

  13. When and how to replace the aortic root in type A aortic dissection.

    PubMed

    Leshnower, Bradley G; Chen, Edward P

    2016-07-01

    Management of aortic root pathology during repair of acute type A aortic dissection (TAAD) requires a comprehensive evaluation of the patient's anatomy, demographics, comorbidities and physiologic status at the time of emergent operative intervention. Surgical options include conservative repair of the root (CRR) (with or without replacement of the aortic valve), replacement of the native valve and aortic root using a composite valve-conduit and valve sparing root replacement (VSRR). The primary objective of this review is to provide data for surgeons to aid in their decision-making process regarding management of the aortic root during repair of TAAD. No time or language restrictions were imposed and references of the selected studies were checked for additional relevant citations. Multiple retrospective reviews have demonstrated equivalent operative mortality between aortic root repair and replacement during TAAD. There is a higher incidence of aortic root reintervention with aortic root repair compared to aortic root replacement (ARR). Experienced, high-volume aortic centers have demonstrated the safety of VSRR in young, hemodynamically stable patients presenting with TAAD. In conclusion, aortic root repair can safely be performed in the vast majority of patients with TAAD. Despite the increased surgical complexity, ARR does not increase operative mortality and improves the freedom from root reintervention. VSRR can be performed in highly selected populations of patients with TAAD with durable mid-term valve function. PMID:27563551

  14. Simulated Performance of the Orbiting Wide-angle Light Collectors (OWL) Experiment

    NASA Technical Reports Server (NTRS)

    Krizmanic, J. F.; Whitaker, Ann F. (Technical Monitor)

    2001-01-01

    The Orbiting Wide-angle Light collectors (OWL) experiment is in NASA's mid-term strategic plan and will stereoscopically image, from equatorial orbit, the air fluorescence signal generated by airshowers induced by the ultrahigh energy (E greater than few x 10(exp 19) eV) component of the cosmic radiation. The use of a space-based platform enables an extremely large event acceptance aperture and thus will allow a high statistics measurement of these rare events. Detailed Monte Carlo simulations are required to quantify the physics potential of the mission as well as optimize the instrumental parameters. This paper reports on the results of the GSFC Monte Carlo simulation for two different, OWL instrument baseline designs. These results indicate that, assuming a continuation of the cosmic ray spectrum (theta approximately E(exp -2.75), OWL could have an event rate of 4000 events/year with E greater than or equal to 10(exp 20) eV. Preliminary results, based upon these Monte Carlo simulations, indicate that events can be accurately reconstructed in the detector focal plane arrays for the OWL instrument baseline designs under consideration.

  15. Experimental results from a preclinical X-ray phase-contrast CT scanner

    PubMed Central

    Tapfer, Arne; Bech, Martin; Velroyen, Astrid; Meiser, Jan; Mohr, Jürgen; Walter, Marco; Schulz, Joachim; Pauwels, Bart; Bruyndonckx, Peter; Liu, Xuan; Sasov, Alexander; Pfeiffer, Franz

    2012-01-01

    To explore the future clinical potential of improved soft-tissue visibility with grating-based X-ray phase contrast (PC), we have developed a first preclinical computed tomography (CT) scanner featuring a rotating gantry. The main challenge in the transition from previous bench-top systems to a preclinical scanner are phase artifacts that are caused by minimal changes in the grating alignment during gantry rotation. In this paper, we present the first experimental results from the system together with an adaptive phase recovery method that corrects for these phase artifacts. Using this method, we show that the scanner can recover quantitatively accurate Hounsfield units in attenuation and phase. Moreover, we present a first tomography scan of biological tissue with complementary information in attenuation and phase contrast. The present study hence demonstrates the feasibility of grating-based phase contrast with a rotating gantry for the first time and paves the way for future in vivo studies on small animal disease models (in the mid-term future) and human diagnostics applications (in the long-term future). PMID:23019354

  16. Hip resurfacing: a large, US single-surgeon series.

    PubMed

    Brooks, P J

    2016-01-01

    Hip resurfacing has been proposed as an alternative to traditional total hip arthroplasty in young, active patients. Much has been learned following the introduction of metal-on-metal resurfacing devices in the 1990s. The triad of a well-designed device, implanted accurately, in the correct patient has never been more critical than with these implants. Following Food and Drug Administration approval in 2006, we studied the safety and effectiveness of one hip resurfacing device (Birmingham Hip Resurfacing) at our hospital in a large, single-surgeon series. We report our early to mid-term results in 1333 cases followed for a mean of 4.3 years (2 to 5.7) using a prospective, observational registry. The mean patient age was 53.1 years (12 to 84); 70% were male and 91% had osteoarthritis. Complications were few, including no dislocations, no femoral component loosening, two femoral neck fractures (0.15%), one socket loosening (0.08%), three deep infections (0.23%), and three cases of metallosis (0.23%). There were no destructive pseudotumours. Overall survivorship at up to 5.7 years was 99.2%. Aseptic survivorship in males under the age of 50 was 100%. We believe this is the largest United States series of a single surgeon using a single resurfacing system. PMID:26733633

  17. Functional outcomes post-radial head arthroplasty: a systematic review of literature

    PubMed Central

    MacDermid, Joy C; Grewal, Ruby R; Stratford, Paul W; Woodhouse, Linda J

    2014-01-01

    Background The present study was conducted to determine the quality and content of research on the functional outcomes and complications post-metal radial head arthroplasty (RHAP). Methods A comprehensive search of medical databases for studies reporting on functional outcomes of patients undergoing metallic RHAP was conducted. The Structured Effectiveness Quality Evaluation Scale (SEQES) was used to evaluate quality of the studies. Results We identified 21 Sackett’s Level IV studies reporting on 391 radial heads. The mean duration of follow-up was 47.2 months and the mean (SD) age of patients was 48.4 years (6.9 years). The male to female ratio was found to be 1.05 : 1 and the dominant arm was involved in 54% of patients. When functional outcomes achieved post-RHAP were compared with normative scores, the comparison suggested that RHAP has good to excellent functional outcomes in short- to mid-term follow-up. The weighted mean (SD) Mayo Elbow Performance Score was 85.8 (4.1) (95% confidence interval 85.3 to 86.3). Incidences of implant removal (3.06%) and revision (2.22%) were found to be low. Conclusions There is consistent low-quality evidence of positive functional outcomes following RHAP. The heterogeneity of type of implant, patient characteristics and outcome measures used, along with an inadequate reporting of study details, restrict any definitive conclusions being made.

  18. Mission Assessment of the Faraday Accelerator with Radio-frequency Assisted Discharge (FARAD)

    NASA Technical Reports Server (NTRS)

    Dankanich, John W.; Polzin, Kurt A.

    2008-01-01

    Pulsed inductive thrusters have typically been considered for future, high-power, missions requiring nuclear electric propulsion. These high-power systems, while promising equivalent or improved performance over state-of-the-art propulsion systems, presently have no planned missions for which they are well suited. The ability to efficiently operate an inductive thruster at lower energy and power levels may provide inductive thrusters near term applicability and mission pull. The Faraday Accelerator with Radio-frequency Assisted Discharge concept demonstrated potential for a high-efficiency, low-energy pulsed inductive thruster. The added benefits of energy recapture and/or pulse compression are shown to enhance the performance of the pulsed inductive propulsion system, yielding a system that con compete with and potentially outperform current state-of-the-art electric propulsion technologies. These enhancements lead to mission-level benefits associated with the use of a pulsed inductive thruster. Analyses of low-power near to mid-term missions and higher power far-term missions are undertaken to compare the performance of pulsed inductive thrusters with that delivered by state-of-the-art and development-level electric propulsion systems.

  19. Operative Management of Lumbar Degenerative Disc Disease

    PubMed Central

    Lee, Yu Chao; Osti, Orso Lorenzo

    2016-01-01

    Lumbar degenerative disc disease is extremely common. Current evidence supports surgery in carefully selected patients who have failed non-operative treatment and do not exhibit any substantial psychosocial overlay. Fusion surgery employing the correct grafting and stabilization techniques has long-term results demonstrating successful clinical outcomes. However, the best approach for fusion remains debatable. There is some evidence supporting the more complex, technically demanding and higher risk interbody fusion techniques for the younger, active patients or patients with a higher risk of non-union. Lumbar disc arthroplasty and hybrid techniques are still relatively novel procedures despite promising short-term and mid-term outcomes. Long-term studies demonstrating superiority over fusion are required before these techniques may be recommended to replace fusion as the gold standard. Novel stem cell approaches combined with tissue engineering therapies continue to be developed in expectation of improving clinical outcomes. Results with appropriate follow-up are not yet available to indicate if such techniques are safe, cost-effective and reliable in the long-term. PMID:27559465

  20. Feasibility study for producing a carrot/potato matrix reference material for 11 selected pesticides at EU MRL level: material processing, homogeneity and stability assessment.

    PubMed

    Saldanha, Helena; Sejerøe-Olsen, Berit; Ulberth, Franz; Emons, Hendrik; Zeleny, Reinhard

    2012-05-01

    The feasibility for producing a matrix reference material for selected pesticides in a carrot/potato matrix was investigated. A commercially available baby food (carrot/potato-based mash) was spiked with 11 pesticides at the respective EU maximum residue limits (MRLs), and further processed by either freezing or freeze-drying. Batches of some 150 units were produced per material type. First, the materials were assessed for the relative amount of pesticide recovered after processing (ratio of pesticide concentration in the processed material to the initially spiked pesticide concentration). In addition, the materials' homogeneity (bottle-to-bottle variation), and the short-term (1 month) and mid-term (5 months) stability at different temperatures were assessed. For this, an in-house validated GC-EI-MS method operated in the SIM mode with a sample preparation procedure based on the QuEChERS ("quick, easy, cheap, effective, rugged, and safe") principle was applied. Measurements on the frozen material provided the most promising results (smallest analyte losses during production), and also freeze-drying proved to be a suitable alternative processing technique for most of the investigated pesticides. Both the frozen and the freeze-dried material showed to be sufficiently homogeneous for the intended use, and storage at -20°C for 5 months did not reveal any detectable material degradation. The results constitute an important step towards the development of a pesticide matrix reference material. PMID:26434333