Using Upper Extremity Skin Temperatures to Assess Thermal Comfort in Office Buildings in Changsha, China.

PubMed

Wu, Zhibin; Li, Nianping; Cui, Haijiao; Peng, Jinqing; Chen, Haowen; Liu, Penglong

2017-09-21

Existing thermal comfort field studies are mainly focused on the relationship between the indoor physical environment and the thermal comfort. In numerous chamber experiments, physiological parameters were adopted to assess thermal comfort, but the experiments' conclusions may not represent a realistic thermal environment due to the highly controlled thermal environment and few occupants. This paper focuses on determining the relationships between upper extremity skin temperatures (i.e., finger, wrist, hand and forearm) and the indoor thermal comfort. Also, the applicability of predicting thermal comfort by using upper extremity skin temperatures was explored. Field studies were performed in office buildings equipped with split air-conditioning (SAC) located in the hot summer and cold winter (HSCW) climate zone of China during the summer of 2016. Psychological responses of occupants were recorded and physical and physiological factors were measured simultaneously. Standard effective temperature (SET*) was used to incorporate the effect of humidity and air velocity on thermal comfort. The results indicate that upper extremity skin temperatures are good indicators for predicting thermal sensation, and could be used to assess the thermal comfort in terms of physiological mechanism. In addition, the neutral temperature was 24.7 °C and the upper limit for 80% acceptability was 28.2 °C in SET*.

Upper bounds on secret-key agreement over lossy thermal bosonic channels

NASA Astrophysics Data System (ADS)

Kaur, Eneet; Wilde, Mark M.

2017-12-01

Upper bounds on the secret-key-agreement capacity of a quantum channel serve as a way to assess the performance of practical quantum-key-distribution protocols conducted over that channel. In particular, if a protocol employs a quantum repeater, achieving secret-key rates exceeding these upper bounds is evidence of having a working quantum repeater. In this paper, we extend a recent advance [Liuzzo-Scorpo et al., Phys. Rev. Lett. 119, 120503 (2017), 10.1103/PhysRevLett.119.120503] in the theory of the teleportation simulation of single-mode phase-insensitive Gaussian channels such that it now applies to the relative entropy of entanglement measure. As a consequence of this extension, we find tighter upper bounds on the nonasymptotic secret-key-agreement capacity of the lossy thermal bosonic channel than were previously known. The lossy thermal bosonic channel serves as a more realistic model of communication than the pure-loss bosonic channel, because it can model the effects of eavesdropper tampering and imperfect detectors. An implication of our result is that the previously known upper bounds on the secret-key-agreement capacity of the thermal channel are too pessimistic for the practical finite-size regime in which the channel is used a finite number of times, and so it should now be somewhat easier to witness a working quantum repeater when using secret-key-agreement capacity upper bounds as a benchmark.

Discharge hemoglobin and outcome in patients with acute nonvariceal upper gastrointestinal bleeding

PubMed Central

Lee, Jae Min; Kim, Eun Sun; Chun, Hoon Jai; Hwang, Young-Jae; Lee, Jae Hyung; Kang, Seung Hun; Yoo, In Kyung; Kim, Seung Han; Choi, Hyuk Soon; Keum, Bora; Seo, Yeon Seok; Jeen, Yoon Tae; Lee, Hong Sik; Um, Soon Ho; Kim, Chang Duck

2016-01-01

Background and study aims: Many patients with acute gastrointestinal bleeding present with anemia and frequently require red blood cell (RBC) transfusion. A restrictive transfusion strategy and a low hemoglobin (Hb) threshold for transfusion had been shown to produce acceptable outcomes in patients with acute upper gastrointestinal bleeding. However, most patients are discharged with mild anemia owing to the restricted volume of packed RBCs (pRBCs). We investigated whether discharge Hb influences the outcome in patients with acute nonvariceal upper gastrointestinal bleeding. Patients and methods: We retrospectively analyzed patients with upper gastrointestinal bleeding who had received pRBCs during hospitalization between January 2012 and January 2014. Patients with variceal bleeding, malignant lesion, stroke, or cardiovascular disease were excluded. We divided the patients into 2 groups, low (8 g/dL ≤ Hb < 10 g/dL) and high (Hb ≥ 10 [g/dL]) discharge Hb, and compared the clinical course and Hb changes between these groups. Results: A total of 102 patients met the inclusion criteria. Fifty patients were discharged with Hb levels < 10 g/dL, whereas 52 were discharged with Hb levels > 10 g/dL. Patients in the low Hb group had a lower consumption of pRBCs and shorter hospital stay than did those in the high Hb group. The Hb levels were not fully recovered at outpatient follow-up until 7 days after discharge; however, most patients showed Hb recovery at 45 days after discharge. The rate of rebleeding after discharge was not significantly different between the 2 groups. Conclusions: In patients with acute upper gastrointestinal bleeding, a discharge Hb between 8 and 10 g/dL was linked to favorable outcomes on outpatient follow-up. Most patients recovered from anemia without any critical complication within 45 days after discharge. PMID:27540574

An Unusual Cause of Acute Upper Gastrointestinal Bleeding: Acute Esophageal Necrosis

PubMed Central

Tokala, Madhusudhan R.; Dhillon, Sonu; Pisoh, Watcoun-Nchinda; Walayat, Saqib; Vanar, Vishwas; Puli, Srinivas R.

2016-01-01

Acute esophageal necrosis (AEN), also called “black esophagus,” is a condition characterized by circumferential necrosis of the esophagus with universal distal involvement and variable proximal extension with clear demarcation at the gastroesophageal junction. It is an unusual cause of upper gastrointestinal bleeding and is recognized with distinct and striking mucosal findings on endoscopy. The patients are usually older and are critically ill with shared comorbidities, which include atherosclerotic cardiovascular disease, diabetes mellitus, hypertension, chronic renal insufficiency, and malnutrition. Alcoholism and substance abuse could be seen in younger patients. Patients usually have systemic hypotension along with upper abdominal pain in the background of clinical presentation of hematemesis and melena. The endoscopic findings confirm the diagnosis and biopsy is not always necessary unless clinically indicated in atypical presentations. Herein we present two cases with distinct clinical presentation and discuss the endoscopic findings along with a review of the published literature on the management of AEN. PMID:27642529

Anaemia only causes a small reduction in the upper critical temperature of sea bass: is oxygen delivery the limiting factor for tolerance of acute warming in fishes?

PubMed

Wang, Tobias; Lefevre, Sjannie; Iversen, Nina K; Findorf, Inge; Buchanan, Rasmus; McKenzie, David J

2014-12-15

To address how the capacity for oxygen transport influences tolerance of acute warming in fishes, we investigated whether a reduction in haematocrit, by means of intra-peritoneal injection of the haemolytic agent phenylhydrazine, lowered the upper critical temperature of sea bass. A reduction in haematocrit from 42±2% to 20±3% (mean ± s.e.m.) caused a significant but minor reduction in upper critical temperature, from 35.8±0.1 to 35.1±0.2°C, with no correlation between individual values for haematocrit and upper thermal limit. Anaemia did not influence the rise in oxygen uptake between 25 and 33°C, because the anaemic fish were able to compensate for reduced blood oxygen carrying capacity with a significant increase in cardiac output. Therefore, in sea bass the upper critical temperature, at which they lost equilibrium, was not determined by an inability of the cardio-respiratory system to meet the thermal acceleration of metabolic demands. © 2014. Published by The Company of Biologists Ltd.

A study of clinical and endoscopic profile of acute upper, gastrointestinal bleeding.

PubMed

Dewan, K R; Patowary, B S; Bhattarai, S

2014-01-01

Acute Upper Gastrointestinal Bleeding is a common medical emergency with a hospital mortality of approximately 10 percent. Higher mortality rate is associated with rebleeding. Rockall scoring system identifies patients at higher risk of rebleed and mortality. To study the clinical and endoscopic profile of acute upper gastrointestinal bleed to know the etiology, clinical presentation, severity of bleeding and outcome. This is a prospective, descriptive hospital based study conducted in Gastroenterology unit of College of Medical Sciences and Teaching Hospital, Bharatpur, Nepal from January 2012 to January 2013. It included 120 patients at random presenting with manifestations of upper gastrointestinal bleed. Their clinical and endoscopic profiles were studied. Rockall scoring system was used to assess their prognosis. Males were predominant (75%). Age ranged from 14 to 88 years, mean being 48.76+17.19. At presentation 86 patients (71.7%) had both hematemesis and malena, 24 patients (20%) had only malena and 10 patients (8.3%) had only hematemesis. Shock was detected in 21.7%, severe anemia and high blood urea were found in 34.2% and 38.3% respectively. Upper Gastrointestinal Bleeding endoscopy revealed esophageal varices (47.5%), peptic ulcer disease (33.3%), erosive mucosal disease (11.6%), Mallory Weiss tear (4.1%) and malignancy (3.3%). Median hospital stay was 7.28+3.18 days. Comorbidities were present in 43.3%. Eighty six patients (71.7%) had Rockall score < 5 and 34 (28.3%) had >6. Five patients (4.2%) expired. Risk factors for death being massive rebleeeding, comorbidities and Rockall score >6. Acute Upper Gastrointestinal bleeding is a medical emergency. Mortality is associated with massive bleeding, comorbidities and Rockall score >6. Urgent, appropriate hospital management definitely helps to reduce morbidity and mortality.

On the Roles of Upper- versus Lower-level Thermal Forcing in Shifting the Eddy-Driven Jet

NASA Astrophysics Data System (ADS)

Zhang, Y.; Nie, Y.; Chen, G.; Yang, X. Q.

2017-12-01

One most drastic atmospheric change in the global warming scenario is the increase in temperature over tropical upper-troposphere and polar surface. The strong warming over those two area alters the spacial distributions of the baroclinicity in the upper-troposphere of subtropics and in the lower-level of subpolar region, with competing effects on the mid-latitude atmospheric circulation. The final destination of the eddy-driven jet in future climate could be "a tug of war" between the impacts of such upper- versus lower-level thermal forcing. In this study, the roles of upper- versus lower-level thermal forcing in shifting the eddy-driven jet are investigated using a nonlinear multi-level quasi-geostrophic channel model. All of our sensitivity experiments show that the latitudinal position of the eddy-driven jet is more sensitive to the upper-level thermal forcing. Such upper-level dominance over the lower-level forcing can be attributed to the different mechanisms through which eddy-driven jet responses to them. The upper-level thermal forcing induces a jet shift mainly by affecting the baroclinic generation of eddies, which supports the latitudinal shift of the eddy momentum flux convergence. The jet response to the lower-level thermal forcing, however, is strongly "eddy dissipation control". The lower-level forcing, by changing the baroclinicity in the lower troposphere, induces a direct thermal zonal wind response in the upper level thus modifies the nonlinear wave breaking and the resultant irreversible eddy mixing, which amplifies the latitudinal shift of the eddy-driven jet. Whether the eddy response is "generation control" or "dissipation control" may strongly depend on the eddy behavior in its baroclinic processes. Only the anomalous eddy generation that penetrates into the upper troposphere can have a striking impact on the eddy momentum flux, which pushes the jet shift more efficiently and dominates the eddy response.

Chronic warm exposure impairs growth performance and reduces thermal safety margins in the common triplefin fish (Forsterygion lapillum).

PubMed

McArley, Tristan J; Hickey, Anthony J R; Herbert, Neill A

2017-10-01

Intertidal fish species face gradual chronic changes in temperature and greater extremes of acute thermal exposure through climate-induced warming. As sea temperatures rise, it has been proposed that whole-animal performance will be impaired through oxygen and capacity limited thermal tolerance [OCLTT; reduced aerobic metabolic scope (MS)] and, on acute exposure to high temperatures, thermal safety margins may be reduced because of constrained acclimation capacity of upper thermal limits. Using the New Zealand triplefin fish ( Forsterygion lapillum ), this study addressed how performance in terms of growth and metabolism (MS) and upper thermal tolerance limits would be affected by chronic exposure to elevated temperature. Growth was measured in fish acclimated (12 weeks) to present and predicted future temperatures and metabolic rates were then determined in fish at acclimation temperatures and with acute thermal ramping. In agreement with the OCLTT hypothesis, chronic exposure to elevated temperature significantly reduced growth performance and MS. However, despite the prospect of impaired growth performance under warmer future summertime conditions, an annual growth model revealed that elevated temperatures may only shift the timing of high growth potential and not the overall annual growth rate. While the upper thermal tolerance (i.e. critical thermal maxima) increased with exposure to warmer temperatures and was associated with depressed metabolic rates during acute thermal ramping, upper thermal tolerance did not differ between present and predicted future summertime temperatures. This suggests that warming may progressively decrease thermal safety margins for hardy generalist species and could limit the available habitat range of intertidal populations. © 2017. Published by The Company of Biologists Ltd.

Acute Upper Gastro-Intestinal Bleeding in Morocco: What Have Changed?

PubMed Central

Timraz, A.; Khannoussi, W.; Ajana, F. Z.; Essamri, W.; Benelbarhdadi, I.; Afifi, R.; Benazzouz, M.; Essaid, A.

2011-01-01

Objective. In the present study, we aimed to investigate epidemiological, clinical, and etiological characteristics of acute upper gastro-intestinal bleeding. Materials and Methods. This retrospective study was conducted between January 2003 and December 2008. It concerned all cases of acute upper gastroduodenal bleeding benefited from an urgent gastro-intestinal endoscopy in our department in Morocco. Characteristics of patients were evaluated in terms of age, gender, medical history, presenting symptoms, results of rectal and clinical examinations, and endoscopy findings. Results. 1389 cases were registered. As 66% of the patients were male, 34% were female. Mean age was 49. 12% of patients had a history of previous hemorrhage, and 26% had a history of NSAID and aspirin use. Endoscopy was performed in 96%. The gastroduodenal ulcer was the main etiology in 38%, followed by gastritis and duodenitis in 32.5%. Conclusion. AUGIB is still a frequent pathology, threatening patients' life. NSAID and aspirin are still the major risk factors. Their impact due to peptic ulcer remains stable in our country. PMID:21991509

Predictors for the need for endoscopic therapy in patients with presumed acute upper gastrointestinal bleeding.

PubMed

Kim, Su Sun; Kim, Kyung Up; Kim, Sung Jun; Seo, Seung In; Kim, Hyoung Su; Jang, Myoung Kuk; Kim, Hak Yang; Shin, Woon Geon

2017-12-15

Selecting patients with an urgent need for endoscopic hemostasis is difficult based only on simple parameters of presumed acute upper gastrointestinal bleeding. This study assessed easily applicable factors to predict cases in need of urgent endoscopic hemostasis due to acute upper gastrointestinal bleeding. The consecutively included patients were divided into the endoscopic hemostasis and nonendoscopic hemostasis groups. We reviewed the enrolled patients' medical records and analyzed various variables and parameters for acute upper gastrointestinal bleeding outcomes such as demographic factors, comorbidities, symptoms, signs, laboratory findings, rebleeding rate, and mortality to evaluate simple predictive factors for endoscopic treatment. A total of 613 patients were analyzed, including 329 patients in the endoscopic hemostasis and 284 patients in the non-endoscopic hemostasis groups. In the multivariate analysis, a bloody nasogastric lavage (adjusted odds ratio [AOR], 6.786; 95% confidence interval [CI], 3.990 to 11.543; p < 0.0001) and a hemoglobin level less than 8.6 g/dL (AOR, 1.768; 95% CI, 1.028 to 3.039; p = 0.039) were independent predictors for endoscopic hemostasis. Significant differences in the morbidity rates of endoscopic hemostasis were detected between the group with no predictive factors and the group with one or more predictive factors (OR, 2.677; 95% CI, 1.920 to 3.733; p < 0.0001). A bloody nasogastric lavage and hemoglobin < 8.6 g/dL were independent predictors of endoscopic hemostasis in patients with acute upper gastrointestinal bleeding.

Influencing the practice and outcome in acute upper gastrointestinal haemorrhage. Steering Committee of the National Audit of Acute Upper Gastrointestinal Haemorrhage.

PubMed

Rockall, T A; Logan, R F; Devlin, H B; Northfield, T C

1997-11-01

To assess changes in practice and outcome in acute upper gastrointestinal haemorrhage following the feedback of data, the reemphasis of national guidelines, and specific recommendations following an initial survey. A prospective, multicentre, audit cycle. Forty five hospitals from three health regions participated in two phases of the audit cycle. Phase I: 2332 patients with acute upper gastrointestinal haemorrhage; phase II: 1625 patients with upper gastrointestinal haemorrhage. Patients were evaluated with respect to management (with reference to the recommendations in the national guidelines), mortality, and length of hospital stay. Following the distribution of data from the first phase of the National Audit and the formulation of specific recommendations for improving practice, the proportion of hospitals with local guidelines or protocols for the management of upper gastrointestinal haemorrhage rose from 71% (32/45) to 91% (41/45); 12 of the 32 hospitals with guidelines during the first phase revised their guidelines following the initial survey. There was a small but significant increase in the proportion of all patients who underwent endoscopy (from 81% to 86%), the proportion who underwent endoscopy within 24 hours of admission (from 50% to 56%), and the use of central venous pressure monitoring in patients with organ failure requiring blood transfusion or those with profound shock (from 30% to 43%). There was, however, no change in the use of high dependency beds or joint medical/surgical management in high risk cases. There was no significant change in crude or risk standardised mortality (13.4% in the first phase and 14.4% in the second phase). Although many of the participating hospitals have made efforts to improve practice by producing or updating guidelines or protocols, there has been only a small demonstrable change in some areas of practice during the National Audit. The failure to detect any improvement in mortality may reflect this lack of

21 CFR 868.5115 - Device to relieve acute upper airway obstruction.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Device to relieve acute upper airway obstruction. 868.5115 Section 868.5115 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5115 Device to...

21 CFR 868.5115 - Device to relieve acute upper airway obstruction.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Device to relieve acute upper airway obstruction. 868.5115 Section 868.5115 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5115 Device to...

21 CFR 868.5115 - Device to relieve acute upper airway obstruction.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Device to relieve acute upper airway obstruction. 868.5115 Section 868.5115 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5115 Device to...

Predicting outcome of acute non-variceal upper gastrointestinal haemorrhage without endoscopy using the clinical Rockall Score.

PubMed

Tham, T C K; James, C; Kelly, M

2006-11-01

The Rockall risk scoring system uses clinical criteria and endoscopy to identify patients at risk of adverse outcomes after acute upper gastrointestinal haemorrhage. A clinical Rockall score obtained using only the clinical criteria may be able to predict outcome without endoscopy. To validate the clinical Rockall Score in predicting outcome after acute non-variceal upper gastrointestinal haemorrhage. A retrospective observational study of consecutive patients who were admitted with non-variceal acute upper gastrointestinal haemorrhage was undertaken. Medical records were abstracted using a standardised form. 102 cases were identified (51 men and 51 women; mean age 59 years). 38 (37%) patients considered to be at low risk of adverse outcomes (clinical Rockall Score 0) had no adverse outcomes and did not require transfusion. Patients with a clinical Rockall Score of 1-3 had no adverse outcomes, although 13 of 45 (29%) patients required blood transfusions. Clinical Rockall Scores >3 (n = 19) were associated with adverse outcomes (rebleeding in 4 (21%), surgery in 1 (5%) and death in 2 (10%)). The clinical Rockall Score without endoscopy may be a useful prognostic indicator in this cohort of patients with acute non-variceal upper gastrointestinal haemorrhage. This score may reduce the need for urgent endoscopy in low-risk patients, which can instead be carried out on a more elective outpatient basis.

Comparative burial and thermal history of lower Upper Cretaceous strata, Powder River basin, Wyoming

DOE Office of Scientific and Technical Information (OSTI.GOV)

Nuccio, V.F.

1989-03-01

Burial histories were reconstructed for three localities in the Powder River basin (PRB), Wyoming. Thermal maturity of lower Upper Cretaceous source rocks was determined by vitrinite reflectance (R/sub m/) and time-temperature index (TTI) modeling, producing independent estimates for timing of the oil window (0.55-1.35% R/sub m/). In the northwestern PRB, lower Upper Cretaceous rocks were buried to about 12,500 ft and achieved a thermal maturity of 0.50% to 0.56% at maximum burial, 10 Ma, based on measured R/sub m/. TTI modeling suggests a slightly higher thermal maturity, with an R/sub m/ equivalent of approximately 0.75%, placing the source rocks atmore » the beginning of the oil window 30 Ma. In the southwestern PRB, lower Upper Cretaceous rocks have been buried to about 15,000 ft and achieved thermal maturities between 0.66% and 0.75% about 10 Ma based on measured R/sub m/; therefore, petroleum generation may have begun slightly earlier. TTI modeling estimates an R/sub m/ equivalent of 1.10%, placing the beginning of the oil window at 45 Ma. In the northeastern PRB, lower Upper Cretaceous rocks have been buried only to approximately 5500 ft. Measured R/sub m/ and TTI modeling indicate a thermal maturity for lower Upper Cretaceous rocks between 0.45% and 0.50% R/sub m/, too low for petroleum generation. The higher R/sub m/ values determined by the TTI models may be due to overestimation of maximum burial depth and/or paleogeothermal gradients. The two independent maturity indicators do, however, constrain fairly narrowly the onset of petroleum generation.« less

High temperature polyimide foams for shuttle upper surface thermal insulation

NASA Technical Reports Server (NTRS)

Ball, G. L., III; Leffingwell, J. W.; Salyer, I. O.; Werkmeister, D. W.

1974-01-01

Polyimide foams developed by Monsanto Company were examined for use as upper surface space shuttle thermal insulation. It was found that postcured polyimide foams having a density of 64 kg/cu m (4 lb/cu ft) had acceptable physical properties up to and exceeding 700 K (800 F). Physical tests included cyclic heating and cooling in vacuum, weight and dimensional stability, mechanical strength and impact resistance, acoustic loading and thermal conductivity. Molding and newly developed postcuring procedures were defined.

Antifibrinolytic amino acids for upper gastrointestinal bleeding in people with acute or chronic liver disease.

PubMed

Martí-Carvajal, Arturo J; Solà, Ivan

2015-06-09

Upper gastrointestinal bleeding is one of the most frequent causes of morbidity and mortality in the course of liver cirrhosis. People with liver disease frequently have haemostatic abnormalities such as hyperfibrinolysis. Therefore, antifibrinolytic amino acids have been proposed to be used as supplementary interventions alongside any of the primary treatments for upper gastrointestinal bleeding in people with liver diseases. This is an update of this Cochrane review. To assess the beneficial and harmful effects of antifibrinolytic amino acids for upper gastrointestinal bleeding in people with acute or chronic liver disease. We searched The Cochrane Hepato-Biliary Controlled Trials Register (February 2015), Cochrane Central Register of Controlled Trials (CENTRAL) (Issue 2 of 12, 2015), MEDLINE (Ovid SP) (1946 to February 2015), EMBASE (Ovid SP) (1974 to February 2015), Science Citation Index EXPANDED (1900 to February 2015), LILACS (1982 to February 2015), World Health Organization Clinical Trials Search Portal (accessed 26 February 2015), and the metaRegister of Controlled Trials (accessed 26 February 2015). We scrutinised the reference lists of the retrieved publications. Randomised clinical trials irrespective of blinding, language, or publication status for assessment of benefits and harms. Observational studies for assessment of harms. We planned to summarise data from randomised clinical trials using standard Cochrane methodologies and assessed according to the GRADE approach. We found no randomised clinical trials assessing antifibrinolytic amino acids for treating upper gastrointestinal bleeding in people with acute or chronic liver disease. We did not identify quasi-randomised, historically controlled, or observational studies in which we could assess harms. This updated Cochrane review identified no randomised clinical trials assessing the benefits and harms of antifibrinolytic amino acids for upper gastrointestinal bleeding in people with acute or

Role of enhanced multi-detector-row computed tomography before urgent endoscopy in acute upper gastrointestinal bleeding.

PubMed

Miyaoka, Youichi; Amano, Yuji; Ueno, Sayaka; Izumi, Daisuke; Mikami, Hironobu; Yazaki, Tomotaka; Okimoto, Eiko; Sonoyama, Takayuki; Ito, Satoko; Fujishiro, Hirofumi; Kohge, Naruaki; Imaoka, Tomonori

2014-04-01

Multi-detector-row computed tomography (MDCT) has been reported to be a potentially useful modality for detection of the bleeding origin in patients with acute upper massive gastrointestinal (GI) bleeding. The purpose of this study is to investigate the efficacy of MDCT as a routine method for detecting the origin of acute upper GI bleeding prior to urgent endoscopy. Five hundred seventy-seven patients with acute upper GI bleeding (514 nonvariceal patients, 63 variceal patients) who underwent urgent upper GI endoscopy were retrospectively analyzed. Patients were divided into three groups: enhanced MDCT, unenhanced MDCT, and no MDCT before endoscopy. The diagnostic accuracy of MDCT for detection of the bleeding origin was evaluated, and the average procedure times needed to endoscopically identify the bleeding origin were compared between groups. Diagnostic accuracy among endoscopists was 55.3% and 14.7% for the enhanced MDCT and unenhanced MDCT groups, respectively. Among nonvariceal patients, accuracy was 50.2% in the enhanced MDCT group, which was significantly better than that in the unenhanced MDCT group (16.5%). In variceal patients, accuracy was significantly better in the enhanced MDCT group (96.4%) than in the unenhanced MDCT group (0.0%). These accuracies were similar to those achieved by expert radiologists. The average procedure time to endoscopic detection of the bleeding origin in the enhanced MDCT group was significantly faster than that in the unenhanced MDCT and no-MDCT groups. Enhanced MDCT preceding urgent endoscopy may be an effective modality for the detection of bleeding origin in patients with acute upper GI bleeding. © 2013 Journal of Gastroenterology and Hepatology Foundation and Wiley Publishing Asia Pty Ltd.

Unusual case of acute appendicitis with left upper quadrant abdominal pain.

PubMed

Tawk, Charbel M; Zgheib, Rana R; Mehanna, Seba

2012-01-01

Acute appendicitis is one of the most frequent causes of surgical abdominal pain presenting to the Emergency Department. The diagnosis is confirmed by a set of clinical signs, blood tests and imaging. The typical presentation consists of periumbilical pain radiating to the right lower quadrant with peritoneal reaction on palpation (Mac Burney). In this article, we report a case of acute appendicitis presenting with a left upper quadrant pain due to intestinal malrotation and we describe the radiologic findings on computed tomography. With an Alvarado score of 4 and a nonconclusive abdominal U/S, the diagnosis of acute appendicitis was a long shot. Persistence of pain and increasing inflammatory parameters in her blood exams pushed the medical team to further investigate and a CT scan revealed intestinal malrotation with acute appendicitis. An examining physician should not be mislead by the atypical presentation of acute appendicitis and should bear in mind the diagnosis to avoid serious complications. Copyright © 2012 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

Air pollution and hospital visits for acute upper and lower respiratory infections among children in Ningbo, China: A time-series analysis.

PubMed

Zheng, Pei-Wen; Wang, Jian-Bing; Zhang, Zhen-Yu; Shen, Peng; Chai, Peng-Fei; Li, Die; Jin, Ming-Juan; Tang, Meng-Ling; Lu, Huai-Chu; Lin, Hong-Bo; Chen, Kun

2017-08-01

Acute upper and lower respiratory infections are main causes of mortality and morbidity in children. Air pollution has been recognized as an important contributor to development and exacerbation of respiratory infections. However, few studies are available in China. In this study, we investigated the short-term effect of air pollution on hospital visits for acute upper and lower respiratory infections among children under 15 years in Ningbo, China. Poisson generalized models were used to estimate the associations between air pollution and hospital visits for acute upper and lower respiratory infections adjusted for temporal, seasonal, and meteorological effects. We found that four pollutants (PM 2.5 , PM 10 , NO 2 , and SO 2 ) were significantly associated with hospital visits for acute upper and lower respiratory infections. The effect estimates for acute upper respiratory infections tended to be higher (PM 2.5 ER = 3.46, 95% CI 2.18, 4.76; PM 10 ER = 2.81, 95% CI 1.93, 3.69; NO 2 ER = 11.27, 95% CI 8.70, 13.89; SO 2 ER = 15.17, 95% CI 11.29, 19.19). Significant associations for gaseous pollutants (NO 2 and SO 2 ) were observed after adjustment for particular matter. Stronger associations were observed among older children and in the cold period. Our study suggested that short-term exposure to outdoor air pollution was associated with hospital visits for acute upper and lower respiratory infections in Ningbo.

21 CFR 868.5115 - Device to relieve acute upper airway obstruction.

Code of Federal Regulations, 2014 CFR

2014-04-01

... the event of choking on a foreign body, can be applied to the abdomen and pushed upward to generate... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Device to relieve acute upper airway obstruction. 868.5115 Section 868.5115 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN...

21 CFR 868.5115 - Device to relieve acute upper airway obstruction.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Device to relieve acute upper airway obstruction. 868.5115 Section 868.5115 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... the event of choking on a foreign body, can be applied to the abdomen and pushed upward to generate...

Procalcitonin Testing to Guide Antibiotic Therapy in Acute Upper and Lower Respiratory Tract Infections.

PubMed

Schuetz, Philipp; Wirz, Yannick; Mueller, Beat

2018-03-06

Is the use of procalcitonin for guiding antibiotic decisions in patients with acute upper and lower respiratory tract infections associated with improved clinical outcomes compared with usual care? Among patients with varying types and severity of acute respiratory infection, using procalcitonin to guide decisions about antibiotics is associated with lower rates of antibiotic exposure, antibiotic-related adverse effects, and mortality.

Effects of hypoxia and ocean acidification on the upper thermal niche boundaries of coral reef fishes.

PubMed

Ern, Rasmus; Johansen, Jacob L; Rummer, Jodie L; Esbaugh, Andrew J

2017-07-01

Rising ocean temperatures are predicted to cause a poleward shift in the distribution of marine fishes occupying the extent of latitudes tolerable within their thermal range boundaries. A prevailing theory suggests that the upper thermal limits of fishes are constrained by hypoxia and ocean acidification. However, some eurythermal fish species do not conform to this theory, and maintain their upper thermal limits in hypoxia. Here we determine if the same is true for stenothermal species. In three coral reef fish species we tested the effect of hypoxia on upper thermal limits, measured as critical thermal maximum (CT max ). In one of these species we also quantified the effect of hypoxia on oxygen supply capacity, measured as aerobic scope (AS). In this species we also tested the effect of elevated CO 2 (simulated ocean acidification) on the hypoxia sensitivity of CT max We found that CT max was unaffected by progressive hypoxia down to approximately 35 mmHg, despite a substantial hypoxia-induced reduction in AS. Below approximately 35 mmHg, CT max declined sharply with water oxygen tension ( P w O 2 ). Furthermore, the hypoxia sensitivity of CT max was unaffected by elevated CO 2 Our findings show that moderate hypoxia and ocean acidification do not constrain the upper thermal limits of these tropical, stenothermal fishes. © 2017 The Author(s).

[Cefazolin efficacy and antibiotic sensitivity against pathogenic bacteria in pediatric with acute upper urinary tract infection].

PubMed

Fuke, Toshiya; Abe, Yoshifusa; Hoshino, Akihiro; Oto, Hideyasu; Sakai, Naho; Murayama, Junichiro; Yoshida, Koichiro; Itabashi, Kazuo

2010-05-01

Acute upper urinary tract infection may cause sepsis, especially in neonates and infants, mandating the choice of appropriate, effective antibacterials minimizing increasing bacterial resistance. Frequently prescribing broad-spectrum cephalosporinin is one such example. Different antibacterial therapies are initiated clinically due to treatment protocol differences among institutions, disease severity, etc. We studied the efficacy of cefazolin (CEZ), a first-generation cephalosporin, as first-line parenteral treatment in acute upper urinary tract infection. We found that 88.9% of microbial infections have indications for CEZ. CEZ efficacy is 91.3%, and 97.2% of urine cultures show negative results. Escherichia coli sensitivity to antibacterial agents is 90.9% of the minimal inhibitory concentration (MIC) < 4 for CEZ, 93.9% of MIC < 1 for ceftazidime (CAZ), 63.6% of MIC < 4 for ampicillin, and 81.8% of MIC < 2 for gentamicin. CEZ thus has the same efficacy as CAZ and is more effective than other antibacterial agents against E. coli. We concluded that CEZ is an effective antibacterial in initial antibacterial pediatric therapy in acute upper urinary tract infection.

Management of Acute Upper Gastrointestinal Disease While at Sea.

PubMed

Carr, Matthew J; Oxner, Christopher; Elster, Eric A; Ritter, Eric M; Vicente, Diego

2018-02-06

Management of complex acute surgical pathology in austere environments necessitates rapid evaluation and resource appropriate management to avoid time-associated morbidity and potentially mortality. Obstructive upper gastrointestinal (UGI) pathologies can be particularly challenging and associated with significant morbidity. Herein, we present six patients with UGI obstructions encountered over the course of an 8-mo deployment onboard a US Navy Aircraft Carrier. Each patient presented to our medical department with signs and symptoms of obstructive UGI pathology including one gastric volvulus requiring operative management at sea, one with a new diagnosis of achalasia requiring transportation and continental United States outpatient evaluation, and four patients with food impaction requiring urgent endoscopic management. Although UGI pathology is seldom encountered at sea, definitive surgical interventions, including prompt evaluation and management of these acute pathologies, can be performed in an austere environment. We wish to call attention to these potential encounters in order that underway deployed medical units and supporting resources ashore are prepared and equipped to intervene on acute UGI obstructive pathology. © Association of Military Surgeons of the United States 2018. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Thermal bifurcation in the upper photosphere inferred from heterodyne spectroscopy of OH rotational lines

NASA Technical Reports Server (NTRS)

Deming, D.; Kostiuk, T.; Mumma, M. J.; Hillman, J. J.; Zipoy, D. M.

1984-01-01

Low-noise (S/N greater than 100), high spectral resolution observations of two pure rotation transitions of OH from the solar photosphere are used to make inferences concerning the thermal structure and inhomogeneity of the upper photosphere. It is found that the v = O R22(24.5)e line strengthens at the solar limb, in contradiction to the predictions of current one-dimensional photospheric models. The results for this line support a two-dimensional model in which horizontal thermal fluctuations in the upper photosphere are of the order plus or minus 800 K. This thermal bifurcation may be maintained by the presence of magnetic flux tubes and may be related to the solar limb extensions observed in the 30-200-micron region.

The effects of very early mirror therapy on functional improvement of the upper extremity in acute stroke patients.

PubMed

Yeldan, Ipek; Huseyınsınoglu, Burcu Ersoz; Akıncı, Buket; Tarakcı, Ela; Baybas, Sevim; Ozdıncler, Arzu Razak

2015-11-01

[Purpose] The aim of the study was to evaluate the effects of a very early mirror therapy program on functional improvement of the upper extremity in acute stroke patients. [Subjects] Eight stroke patients who were treated in an acute neurology unit were included in the study. [Methods] The patients were assigned alternatively to either the mirror therapy group receiving mirror therapy and neurodevelopmental treatment or the neurodevelopmental treatment only group. The primary outcome measures were the upper extremity motor subscale of the Fugl-Meyer Assessment, Motricity Index upper extremity score, and the Stroke Upper Limb Capacity Scale. Somatosensory assessment with the Ayres Southern California Sensory Integration Test, and the Barthel Index were used as secondary outcome measures. [Results] No statistically significant improvements were found for any measures in either group after the treatment. In terms of minimally clinically important differences, there were improvements in Fugl-Meyer Assessment and Barthel Index in both mirror therapy and neurodevelopmental treatment groups. [Conclusion] The results of this pilot study revealed that very early mirror therapy has no additional effect on functional improvement of upper extremity function in acute stroke patients. Multicenter trials are needed to determine the results of early application of mirror therapy in stroke rehabilitation.

Observations Of General Learning Patterns In An Upper-Level Thermal Physics Course

NASA Astrophysics Data System (ADS)

Meltzer, David E.

2009-11-01

I discuss some observations from using interactive-engagement instructional methods in an upper-level thermal physics course over a two-year period. From the standpoint of the subject matter knowledge of the upper-level students, there was a striking persistence of common learning difficulties previously observed in students enrolled in the introductory course, accompanied, however, by some notable contrasts between the groups. More broadly, I comment on comparisons and contrasts regarding general pedagogical issues among different student sub-populations, for example: differences in the receptivity of lower- and upper-level students to diagrammatic representations; varying receptivity to tutorial-style instructional approach within the upper-level population; and contrasting approaches to learning among physics and engineering sub-populations in the upper-level course with regard to use of symbolic notation, mathematical equations, and readiness to employ verbal explanations.

Upper thermal limits of cardiac function for Arctic cod Boreogadus saida, a key food web fish species in the Arctic Ocean.

PubMed

Drost, H E; Carmack, E C; Farrell, A P

2014-06-01

The objective of this study was to determine the upper thermal limits of Arctic cod Boreogadus saida by measuring the response of maximum heart rate (f(Hmax)) to acute warming. One set of fish were tested in a field laboratory in Cambridge Bay (CB), Nunavut (north of the Arctic Circle), and a second set were tested after air transport to and 6 month temperature acclimation at the Vancouver Aquarium (VA) laboratory. In both sets of tests, with B. saida acclimated to 0° C, f(Hmax) increased during acute warming up to temperatures considerably higher than the acclimation temperature and the near-freezing Arctic temperatures in which they are routinely found. Indeed, f(Hmax) increased steadily between 0.5 and 5.5° C, with no significant difference between the CB and VA tests (P > 0.05) and with an overall mean ± s.e. Q10 of 2.4 ± 0.5. The first Arrhenius breakpoint temperature (T(AB)) for f(Hmax) was also statistically indistinguishable for the two sets of tests (mean ± s.e. 3.2 ± 0.3 and 3.6 ± 0.3° C), suggesting that the temperature optimum for B. saida could be reliably measured after live transport to a more southerly laboratory location. Continued warming above 5.5° C revealed a large variability among individuals in the upper thermal limits that triggered cardiac arrhythmia (T(arr)), ranging from 10.2 to 15.2° C with mean ± s.e. 12.4 ± 0.4° C (n = 11) for the field study. A difference did exist between the CB and VA breakpoint temperatures when the Q10 value decreased below 2 (the Q10 breakpoint temperature; T(QB)) at 8.0 and 5.5° C, respectively. These results suggest that factors, other than thermal tolerance and associated cardiac performance, may influence the realized distribution of B. saida within the Arctic Circle. © 2014 The Fisheries Society of the British Isles.

The mirror therapy program enhances upper-limb motor recovery and motor function in acute stroke patients.

PubMed

Lee, Myung Mo; Cho, Hwi-Young; Song, Chang Ho

2012-08-01

The purpose of this study was to evaluate the effects of the mirror therapy program on upper-limb motor recovery and motor function in patients with acute stroke. Twenty-six patients who had an acute stroke within 6 mos of study commencement were assigned to the experimental group (n = 13) or the control group (n = 13). Both experimental and control group members participated in a standard rehabilitation program, but only the experimental group members additionally participated in mirror therapy program, for 25 mins twice a day, five times a week, for 4 wks. The Fugl-Meyer Assessment, Brunnstrom motor recovery stage, and Manual Function Test were used to assess changes in upper-limb motor recovery and motor function after intervention. In upper-limb motor recovery, the scores of Fugl-Meyer Assessment (by shoulder/elbow/forearm items, 9.54 vs. 4.61; wrist items, 2.76 vs. 1.07; hand items, 4.43 vs. 1.46, respectively) and Brunnstrom stages for upper limb and hand (by 1.77 vs. 0.69 and 1.92 vs. 0.50, respectively) were improved more in the experimental group than in the control group (P < 0.05). In upper-limb motor function, the Manual Function Test score (by shoulder item, 5.00 vs. 2.23; hand item, 5.07 vs. 0.46, respectively) was significantly increased in the experimental group compared with the control group (P < 0.01). No significant differences were found between the groups for the coordination items in Fugl-Meyer Assessment. This study confirms that mirror therapy program is an effective intervention for upper-limb motor recovery and motor function improvement in acute stroke patients. Additional research on mirror therapy program components, intensity, application time, and duration could result in it being used as a standardized form of hand rehabilitation in clinics and homes.

[Asymmetric negative pressure pulmonary edema after acute upper airway obstruction: case report].

PubMed

Peixoto, Aldo José

2002-06-01

Negative pressure pulmonary edema after acute upper airway obstruction is a well-described event, though infrequently diagnosed and reported. This report aimed at presenting a case of upper airway obstruction negative pressure pulmonary edema following acute upper airway obstruction characterized by pulmonary edema asymmetry, being more prominent in the right lung. A 4-year-old boy, 17 kg, phisical status ASA I submitted to combined tonsillectomy, adenoidectomy and turbinate cauterization under general anesthesia with sevoflurane/nitrous oxide/O2. Surgery duration was 90 minutes without complications. During anesthetic recovery and spontaneously breathing, patient reacted to tracheal tube, which was removed. Following, ventilatory efforts resulted in chest wall retraction without apparent air movement, being impossible to ventilate him with facial mask. Symptoms evolved to severe hypoxemia (50% SpO2) requiring reintubation. At this point, it was observed that the lung was stiffer and there were bilateral rales characterizing pulmonary edema. A chest X-ray showed diffuse bilateral infiltrates, right upper lobe atelectasis and marked pulmonary edema asymmetry (right greater than left). Patient was mechanically ventilated with PEEP for 20 hours when he was extubated. There was a progressive pulmonary edema improvement and patient was discharged 48 hours later. Negative pressure pulmonary edema (NPPE) is a rare event with high morbidity risk. It is often not diagnosed and requires from the anesthesiologist an updated knowledge and adequate management. It is usually bilateral, rarely unilateral, and exceptionally asymmetric as in this case. Most cases are treated by mechanical ventilation with PEEP or CPAP without any other therapy. The prognosis is favorable, with most cases recovering within the first 24 hours.

Effects of virtual reality training with modified constraint-induced movement therapy on upper extremity function in acute stage stroke: a preliminary study.

PubMed

Ji, Eun-Kyu; Lee, Sang-Heon

2016-11-01

[Purpose] The purpose of this study was to investigate the effects of virtual reality training combined with modified constraint-induced movement therapy on upper extremity motor function recovery in acute stage stroke patients. [Subjects and Methods] Four acute stage stroke patients participated in the study. A multiple baseline single subject experimental design was utilized. Modified constraint-induced movement therapy was used according to the EXplaining PLastICITy after stroke protocol during baseline sessions. Virtual reality training with modified constraint-induced movement therapy was applied during treatment sessions. The Manual Function Test and the Box and Block Test were used to measure upper extremity function before every session. [Results] The subjects' upper extremity function improved during the intervention period. [Conclusion] Virtual reality training combined with modified constraint-induced movement is effective for upper extremity function recovery in acute stroke patients.

Acute citrulline malate supplementation improves upper- and lower-body submaximal weightlifting exercise performance in resistance-trained females.

PubMed

Glenn, Jordan M; Gray, Michelle; Wethington, Lauren N; Stone, Matthew S; Stewart, Rodger W; Moyen, Nicole E

2017-03-01

Citrulline malate (CM) is a nonessential amino acid that increases exercise performance in males. However, based on physiological differences between genders, these results cannot be extrapolated to females. Therefore, the purpose of this investigation was to evaluate effects of acute CM supplementation on upper- and lower-body weightlifting performance in resistance-trained females. Fifteen females (23 ± 3 years) completed two randomized, double-blind trials consuming either CM (8 g dextrose + 8 g CM) or a placebo (8 g dextrose). One hour after supplement consumption, participants performed six sets each of upper- (i.e., bench press) and lower-body (i.e., leg press) exercises to failure at 80 % of previously established one-repetition maximum. Immediately after each set, repetitions completed, heart rate and rating of perceived exertion (RPE) were recorded. Repeated-measures analysis of variance indicated that subjects completed significantly (p = .045) more repetitions throughout upper-body exercise when consuming CM versus placebo (34.1 ± 5.7 vs. 32.9 ± 6.0, respectively). When consuming CM, similar significant (p = .03) improvements in total repetitions completed were observed for lower-body exercise (66.7 ± 30.5 vs. 55.13 ± 20.64, respectively). Overall RPE score was significantly lower (p = .02) in upper-body exercise when subjects consumed CM versus placebo (7.9 ± 0.3 and 8.6 ± 0.2, respectively). The supplement consumed exhibited no significant effects on heart rate at any time point. Acute CM supplementation in females increased upper- and lower-body resistance exercise performance and decreased RPE during upper-body exercise. These data indicate that athletes competing in sports with muscular endurance-based requirements may potentially improve performance by acutely supplementing CM.

Probiotics for preventing acute upper respiratory tract infections.

PubMed

Hao, Qiukui; Dong, Bi Rong; Wu, Taixiang

2015-02-03

Probiotics may improve a person's health by regulating their immune function. Some trials have shown that probiotic strains can prevent respiratory infections. Even though the previous version of our review showed benefits of probiotics for acute upper respiratory tract infections (URTIs), several new studies have been published. To assess the effectiveness and safety of probiotics (any specified strain or dose), compared with placebo, in the prevention of acute URTIs in people of all ages, at risk of acute URTIs. We searched CENTRAL (2014, Issue 6), MEDLINE (1950 to July week 3, 2014), EMBASE (1974 to July 2014), Web of Science (1900 to July 2014), the Chinese Biomedical Literature Database, which includes the China Biological Medicine Database (from 1978 to July 2014), the Chinese Medicine Popular Science Literature Database (from 2000 to July 2014) and the Masters Degree Dissertation of Beijing Union Medical College Database (from 1981 to July 2014). We also searched the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) and ClinicalTrials.gov for completed and ongoing trials on 31 July 2014. Randomised controlled trials (RCTs) comparing probiotics with placebo to prevent acute URTIs. Two review authors independently assessed the eligibility and quality of trials, and extracted data using the standard methodological procedures expected by The Cochrane Collaboration. We included 13 RCTs, although we could only extract data to meta-analyse 12 trials, which involved 3720 participants including children, adults (aged around 40 years) and older people. We found that probiotics were better than placebo when measuring the number of participants experiencing episodes of acute URTI (at least one episode: odds ratio (OR) 0.53; 95% confidence interval (CI) 0.37 to 0.76, P value < 0.001, low quality evidence; at least three episodes: OR 0.53; 95% CI 0.36 to 0.80, P value = 0.002, low quality evidence); the mean duration of an episode of

Outcomes of patients hospitalized with peptic ulcer disease diagnosed in acute upper endoscopy.

PubMed

Malmi, Hanna; Kautiainen, Hannu; Virta, Lauri J; Färkkilä, Martti A

2017-11-01

The incidence and complications of peptic ulcer disease (PUD) have declined, but mortality from bleeding ulcers has remained unchanged. The aims of the current study were to evaluate the significance of PUD among patients admitted for acute upper endoscopy and to evaluate the survival of PUD patients. In this prospective, observational cohort study, data on 1580 acute upper endoscopy cases during 2012-2014 were collected. A total of 649 patients were included with written informed consent. Data on patients' characteristics, living habits, comorbidities, drug use, endoscopy and short-term and long-term survival were collected. Of all patients admitted for endoscopy, 147/649 (23%) had PUD with the main symptom of melena. Of these PUD patients, 35% had major stigmata of bleeding (Forrest Ia-IIb) in endoscopy. Patients with major stigmata had significantly more often renal insufficiency, lower level of blood pressure with tachycardia and lower level of haemoglobin, platelets and ratio of thromboplastin time. No differences in drug use, Charlson comorbidity class, BMI, smoking or alcohol use were found. Of the PUD patients, 31% were Helicobacter pylori positive. The 30-day mortality was 0.7% (95% confidence interval: 0.01-4.7), 1-year mortality was 12.9% (8.4-19.5) and the 2-year mortality was 19.4% (13.8-26.8), with no difference according to major or minor stigmata of bleeding. Comorbidity (Charlson>1) was associated with decreased survival (P=0.029) and obesity (BMI≥30) was associated with better survival (P=0.023). PUD is still the most common cause for acute upper endoscopy with very low short-term mortality. Comorbidity, but not the stigmata of bleeding, was associated with decreased long-term survival.

Acute Effect of Upper and Lower Body Postactivation Exercises on Shot Put Performance.

PubMed

Kontou, Eleni I; Berberidou, Fani T; Pilianidis, Theophilos C; Mantzouranis, Nikolaos I; Methenitis, Spyridon K

2018-04-01

Kontou, EI, Berberidou, FT, Pilianidis, TC, Mantzouranis, NI, and Methenitis, SK. Acute effect of upper and lower body postactivation exercises on shot put performance. J Strength Cond Res 32(4): 970-982, 2018-The purpose of this study was to investigate the effect of different types of upper and lower' extremities exercises on acute increase of shot put performance, in moderate experienced throwers. Eight (n = 8) males and 9 (n = 9) female throwers participated in this study. Their bench press and squat maximum strength were measured while their shot put performance from power position was evaluated before and after 4 interventions: (a) plyometric push-ups (Plyo), (b) 6 s isometric push-ups (Iso), (c) 3 countermovement jumps (CMJs) and (d) 10 reps. of skipping (Skip). Interventions were performed in counterbalanced order with a 48-hour interval. Significant increase (p < 0.05) of shot put performances was observed after Plyo, Iso, and CMJ (range: 2.30 ± 1.82%-5.72 ± 4.32%). In addition, Iso induced the highest increase while Skip did not induce any improvement of throwing performance. The highest increases were recorded in men's performance after CMJ (5.72 ± 4.32%) while in women's performance after Iso (3.59 ± 2.7%). Javelin and discus throwers increase higher their performance after CMJs while shot putters after Iso. Significant correlations were found between training experience, maximum/relative strength, shot put performance and increase of throwing performance (%) after the interventions (r: 0.519-0.991, p < 0.05). Percentage increase of performance between Iso and Plyo have negative correlations (r: -0.569, p < 0.05) in contrast of those between Skip and CMJ (r: 0.710, p < 0.05). These results suggest that upper or lower body postactivation interventions may acutely increase the throwing performance. However, experience and strength are significant determinant of this increase.

Vitamin K for upper gastrointestinal bleeding in people with acute or chronic liver diseases.

PubMed

Martí-Carvajal, Arturo J; Solà, Ivan

2015-06-09

Upper gastrointestinal bleeding is one of the most frequent causes of morbidity and mortality in the course of liver cirrhosis. Several treatments are used for upper gastrointestinal bleeding in people with liver diseases. One of them is vitamin K administration, but it is not known whether it benefits or harms people with acute or chronic liver disease and upper gastrointestinal bleeding. This is an update of this Cochrane review. To assess the beneficial and harmful effects of vitamin K for people with acute or chronic liver disease and upper gastrointestinal bleeding. We searched The Cochrane Hepato-Biliary Controlled Trials Register (February 2015), the Cochrane Central Register of Controlled Trials (CENTRAL) (Issue 2 of 12, 2015), MEDLINE (Ovid SP) (1946 to February 2015), EMBASE (Ovid SP) (1974 to February 2015), Science Citation Index EXPANDED (1900 to February 2015), and LILACS (1982 to 25 February 2015). We sought additional randomised trials from two registries of clinical trials: the World Health Organization Clinical Trials Search Portal and the metaRegister of Controlled Trials. We looked through the reference lists of the retrieved publications and review articles. Randomised clinical trials irrespective of blinding, language, or publication status for assessment of benefits and harms. We considered observational studies for assessment of harms only. \\We aimed to summarise data from randomised clinical trials using Standard Cochrane methodology and assess them according to the GRADE approach. We found no randomised trials on vitamin K for upper gastrointestinal bleeding in people with liver diseases assessing benefits and harms of the intervention. We identified no quasi-randomised studies, historically controlled studies, or observational studies assessing harms. This updated review found no randomised clinical trials of vitamin K for upper gastrointestinal bleeding in people with liver diseases. The benefits and harms of vitamin K need to be tested

Guidelines for the Antibiotic Use in Adults with Acute Upper Respiratory Tract Infections

PubMed Central

Park, Chan-Soon; Kim, Jae Wook; Hwang, Kyurin; Lee, Sei Young; Kim, Tae Hoon; Park, Do-Yang; Kim, Hyun Jun; Kim, Dong-Young; Lee, Hyun Jong; Shin, Hyun-Young; You, Yong Kyu; Park, Dong-Ah

2017-01-01

These guidelines were developed as part of the 2016 Policy Research Servicing Project by the Korea Centers for Disease Control and Prevention. A multidisciplinary approach was taken to formulate this guideline to provide practical information about the diagnosis and treatment of adults with acute upper respiratory tract infection, with the ultimate aim to promote the appropriate use of antibiotics. The formulation of this guideline was based on a systematic literature review and analysis of the latest research findings to facilitate evidence-based practice, and focused on key questions to help clinicians obtain solutions to clinical questions that may arise during the care of a patient. These guidelines mainly cover the subjects on the assessment of antibiotic indications and appropriate selection of antibiotics for adult patients with acute pharyngotonsillitis or acute sinusitis. PMID:29299900

Acute effects of verbal feedback on upper-body performance in elite athletes.

PubMed

Argus, Christos K; Gill, Nicholas D; Keogh, Justin Wl; Hopkins, Will G

2011-12-01

Argus, CK, Gill, ND, Keogh, JWL, and Hopkins, WG. Acute effects of verbal feedback on upper-body performance in elite athletes. J Strength Cond Res 25(12): 3282-3287, 2011-Improved training quality has the potential to enhance training adaptations. Previous research suggests that receiving feedback improves single-effort maximal strength and power tasks, but whether quality of a training session with repeated efforts can be improved remains unclear. The purpose of this investigation was to determine the effects of verbal feedback on upper-body performance in a resistance training session consisting of multiple sets and repetitions in well-trained athletes. Nine elite rugby union athletes were assessed using the bench throw exercise on 4 separate occasions each separated by 7 days. Each athlete completed 2 sessions consisting of 3 sets of 4 repetitions of the bench throw with feedback provided after each repetition and 2 identical sessions where no feedback was provided after each repetition. When feedback was received, there was a small increase of 1.8% (90% confidence limits, ±2.7%) and 1.3% (±0.7%) in mean peak power and velocity when averaged over the 3 sets. When individual sets were compared, there was a tendency toward the improvements in mean peak power being greater in the second and third sets. These results indicate that providing verbal feedback produced acute improvements in upper-body power output of well-trained athletes. The benefits of feedback may be greatest in the latter sets of training and could improve training quality and result in greater long-term adaptation.

Incidence of upper limb oedema in patients with acute hemiparetic stroke.

PubMed

Gebruers, Nick; Truijen, Steven; Engelborghs, Sebastiaan; De Deyn, Peter Paul

2011-01-01

 Assessment of the incidence of upper limb oedema in an acute care setting by means of clinical and volumetric evaluation.  Patients with acute hemiparetic stroke were recruited from 2006 until 2009 (n = 125). Baseline measurements consisted of the National Institute of Health Stroke Scale, Fugl-Meyer Assessment Arm Section and demographic characteristics. Oedema assessment was performed at 7 days after inclusion and at 1 month and 3 months follow-up. A standardised water displacement method (objective measurement) was used to define oedema and was compared to data from visual inspection and palpation (subjective measurement).  In literature, the incidence of upper limb oedema ranges from 16-83%, defined by a variety of definitions. Oedema incidence in this study was defined by strict criteria using water displacement and ranged from 9-13.9%, while the incidence of oedema defined by visual inspection and palpation ranged from 6-18.5% during the different stages of follow-up. The agreement (Kappa) between both measurements ranged from 0.23-0.38, which is not more than 'moderate' but comparable to the agreement of 0.34 found in literature.  An objective and subjective assessment of oedema was used; the agreement between both methods was only moderate. The incidence of oedema found in this study is lower than the incidences found in literature.

Combining levodopa and virtual reality-based therapy for rehabilitation of the upper limb after acute stroke: pilot study Part II

PubMed Central

Samuel, Geoffrey Sithamparapillai; Oey, Nicodemus Edrick; Choo, Min; Ju, Han; Chan, Wai Yin; Kok, Stanley; Ge, Yu; Dongen, Antonius M Van; Ng, Yee Sien

2017-01-01

INTRODUCTION This study aimed to evaluate the safety and efficacy of a combination of levodopa and virtual reality (VR)-based therapy for the enhancement of upper limb recovery following acute stroke. METHODS This was a pilot single-blinded case series of acute stroke patients with upper extremity hemiparesis. Patients were randomised to standard care with concomitant administration of either levodopa alone (control group) or combination therapy consisting of VR-based motivational visuomotor feedback training with levodopa neuromodulation (VR group). Main clinical outcome measures were the Fugl-Meyer Upper Extremity (FM-UE) assessment and Action Research Arm Test (ARAT). Kinematic measurements of affected upper limb movement were evaluated as a secondary measure of improvement. RESULTS Of 42 patients screened, four patients were enrolled in each of the two groups. Two patients dropped out from the control group during the trial. Patients receiving combination therapy had clinically significant improvements in FM-UE assessment scores of 16.5 points compared to a 3.0-point improvement among control patients. Similarly, ARAT scores of VR group patients improved by 15.3 points compared to a 10.0-point improvement in the control group. Corresponding improvements were noted in kinematic measures, including hand-path ratio, demonstrating that the quality of upper limb movement improved in the VR group. CONCLUSION Our results suggest that VR-based therapy and pharmacotherapy may be combined for acute stroke rehabilitation. Bedside acquisition of kinematic measurements allows accurate assessment of the quality of limb movement, offering a sensitive clinical tool for quantifying motor recovery during the rehabilitation process after acute stroke. PMID:27311739

Emergency extracorporeal shockwave lithotripsy for acute renal colic caused by upper urinary-tract stones.

PubMed

Kravchick, Sergey; Bunkin, Igor; Stepnov, Eugeny; Peled, Ronit; Agulansky, Leonid; Cytron, Shmuel

2005-01-01

To evaluate emergency SWL for the treatment of upper urinary-tract stones causing renal colic. Between January 1999 and June 2003, 53 patients with a mean age of 46.6 years (range 22-65 years) were enrolled. The inclusion criteria were acute renal colic, radiopaque 5-mm to 1.5-cm calculi in the ureteropelvic junction (N=10) or upper ureter (N=43), and no evidence of urinary-tract infection or acute renal failure. The mean stone size was 7.14 mm (range 5-13 mm). Patients were randomly assigned to the control (N=28) and study (N=25) groups using previously prepared cards in envelopes. Patients in the study group underwent emergency SWL, while patients in the control group underwent scheduled SWL within 30 days. Stone status was evaluated 4 weeks after lithotripsy. There was no significant difference between the control and study groups with respect to age, sex, stone location or volume, renal obstruction, or days spent in the hospital for pain control. Available fragments of stones were sent for infrared spectroscopy. Preoperative and postoperative data were compared in the two groups using SPSS 10.0 statistical software. The SWL treatment lasted 50+/-11 minutes. The stone-free rates were 72% and 64% and the efficiency quotients were 53% and 44% in study and control groups, respectively. Patients in the control group spent more time in the hospital (P=0.014) and in recovery at home (P=0.011). Emergency SWL for acute renal colic caused by upper-ureteral stones is a safe procedure and offers effective release from pain and obstruction. It also decreases hospitalization days and hastens return to normal activity.

Acute thermal stressor increases glucocorticoid response but minimizes testosterone and locomotor performance in the cane toad (Rhinella marina).

PubMed

Narayan, Edward J; Hero, Jean-Marc

2014-01-01

Climatic warming is a global problem and acute thermal stressor in particular could be considered as a major stressor for wildlife. Cane toads (Rhinella marina) have expanded their range into warmer regions of Australia and they provide a suitable model species to study the sub-lethal impacts of thermal stressor on the endocrine physiology of amphibians. Presently, there is no information to show that exposure to an acute thermal stressor could initiate a physiological stress (glucocorticoid) response and secondly, the possible effects on reproductive hormones and performance. Answering these questions is important for understanding the impacts of extreme temperature on amphibians. In this study, we experimented on cane toads from Queensland, Australia by acclimating them to mildly warm temperature (25°C) and then exposing to acute temperature treatments of 30°, 35° or 40°C (hypothetical acute thermal stressors). We measured acute changes in the stress hormone corticosterone and the reproductive hormone testosterone using standard capture and handling protocol and quantified the metabolites of both hormones non-invasively using urinary enzyme-immunoassays. Furthermore, we measured performance trait (i.e. righting response score) in the control acclimated and the three treatment groups. Corticosterone stress responses increased in all toads during exposure to an acute thermal stressor. Furthermore, exposure to a thermal stressor also decreased testosterone levels in all toads. The duration of the righting response (seconds) was longer for toads that were exposed to 40°C than to 30°, 35° or 25°C. The increased corticosterone stress response with increased intensity of the acute thermal stressor suggests that the toads perceived this treatment as a stressor. Furthermore, the results also highlight a potential trade-off with performance and reproductive hormones. Ultimately, exposure acute thermal stressors due to climatic variability could impact amphibians at

Acute Thermal Stressor Increases Glucocorticoid Response but Minimizes Testosterone and Locomotor Performance in the Cane Toad (Rhinella marina)

PubMed Central

Narayan, Edward J.; Hero, Jean-Marc

2014-01-01

Climatic warming is a global problem and acute thermal stressor in particular could be considered as a major stressor for wildlife. Cane toads (Rhinella marina) have expanded their range into warmer regions of Australia and they provide a suitable model species to study the sub-lethal impacts of thermal stressor on the endocrine physiology of amphibians. Presently, there is no information to show that exposure to an acute thermal stressor could initiate a physiological stress (glucocorticoid) response and secondly, the possible effects on reproductive hormones and performance. Answering these questions is important for understanding the impacts of extreme temperature on amphibians. In this study, we experimented on cane toads from Queensland, Australia by acclimating them to mildly warm temperature (25°C) and then exposing to acute temperature treatments of 30°, 35° or 40°C (hypothetical acute thermal stressors). We measured acute changes in the stress hormone corticosterone and the reproductive hormone testosterone using standard capture and handling protocol and quantified the metabolites of both hormones non-invasively using urinary enzyme-immunoassays. Furthermore, we measured performance trait (i.e. righting response score) in the control acclimated and the three treatment groups. Corticosterone stress responses increased in all toads during exposure to an acute thermal stressor. Furthermore, exposure to a thermal stressor also decreased testosterone levels in all toads. The duration of the righting response (seconds) was longer for toads that were exposed to 40°C than to 30°, 35° or 25°C. The increased corticosterone stress response with increased intensity of the acute thermal stressor suggests that the toads perceived this treatment as a stressor. Furthermore, the results also highlight a potential trade-off with performance and reproductive hormones. Ultimately, exposure acute thermal stressors due to climatic variability could impact amphibians at

Guidelines for the diagnosis and treatment of acute non-variceal upper gastrointestinal bleeding (2015, Nanchang, China).

PubMed

Bai, Yu; Li, Zhao Shen

2016-02-01

Acute non-variceal upper gastrointestinal bleeding (ANVUGIB) is one of the most common medical emergencies in China and worldwide. In 2009, we published the "Guidelines for the diagnosis and treatment of acute non-variceal upper gastrointestinal bleeding" for the patients in China; however, during the past years numerous studies on the diagnosis and treatment of ANVUGIB have been conducted, and the management of ANVUGIB needs to be updated. The guidelines were updated after the databases including PubMed, Embase and CNKI were searched to retrieve the clinical trials on the management of ANVUGIB. The clinical trials were evaluated for high-quality evidence, and the advances in definitions, diagnosis, etiology, severity evaluation, treatment and prognosis of ANVUGIB were carefully reviewed, the recommendations were then proposed. After several rounds of discussions and revisions among the national experts of digestive endoscopy, gastroenterology, radiology and intensive care, the 2015 version of "Guidelines for the diagnosis and treatment of acute non-variceal upper gastrointestinal bleeding" was successfully developed by the Chinese Journal of Internal Medicine, National Medical Journal of China, Chinese Journal of Digestion and Chinese Journal of Digestive Endoscopy. It shall be noted that although much progress has been made, the clinical management of ANVUGIB still needs further improvement and refinement, and high-quality randomized trials are required in the future. © 2016 Chinese Medical Association Shanghai Branch, Chinese Society of Gastroenterology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.

[Status of acute upper respiratory infection, influenza-like illness, and influenza vaccination coverage among community residents in Jinan].

PubMed

Liu, Ying; Song, Shaoxia; Wang, Wei; Geng, Xingyi; Liu, Wen; Han, Debiao; Liu, Ti; Wu, Julong; Li, Zhong; Wang, Xianjun; Bi, Zhenqiang

2015-12-01

To analyze the status of acute upper respiratory infection and influenza-like illness (ILI) among community residents in Jinan in 2015, and to make a understand of the patient's medical treatment behavior and influenza vaccination coverage status in 2014. Balloting method and convenient sampling method were used to launch a household survey. The residents who had been in Jinan for more than 3 months were selected, to investigate the residents' attack ratio of acute upper respiratory and influenza-like from Jan. 8 to Feb. 7, 2015. Totally, 1 300 persons from 410 families were involved in this survey which recovered 1 241 valid questionnaires with the efficiency of 95.5%. Based on the national age-urban demographic statistics in 2010, the attack rates of acute respiratory infections, influenza-like illness were estimated by the direct standardization method, and the influenza vaccination rates were also calculated in this study. χ(2)-test method was used to compare the different status of incidence and vaccination among residents with different features. The attack rate of acute upper respiratory infection and influenza-like illness in Jinan from January 8, 2015 to February 7, 2015 were 30.2% (375 cases), and 6.1% (76 cases), respectively, with a standardized rate of 29.1% and 5.4%. 5.3% (66 cases) of the residents have vaccinated with the influenza vaccine inoculation, with an adjusted rate of 3.8%. The attack rate difference of acute upper respiratory tract infections was statistically significant between each age group (χ(2)=17.121, P= 0.002). The 0-4 age group had a highest attack rate (45.4%) of acute respiratory infection, while the 15-24 age group got the lowest (26.5%). 38.9% (146 cases) of patients went for a treatment in hospital. Among them, 37.7% (55 cases) of them selected the county level hospitals for treatment, 37.7% (55 cases) selected the community level hospitals, and 24.6% (36 cases) selected the individual clinic. Significant differences of

Can physiological engineering/programming increase multi-generational thermal tolerance to extreme temperature events?

PubMed

Sorby, Kris L; Green, Mark P; Dempster, Tim D; Jessop, Tim S

2018-05-29

Organisms increasingly encounter higher frequencies of extreme weather events as a consequence of global climate change. Currently, few strategies are available to mitigate climate change effects on animals arising from acute extreme high temperature events. We tested the capacity of physiological engineering to influence the intra- and multi-generational upper thermal tolerance capacity of a model organism Artemia , subjected to extreme high temperatures. Enhancement of specific physiological regulators during development could affect thermal tolerances or life-history attributes affecting subsequent fitness. Using experimental Artemia populations we exposed F0 individuals to one of four treatments; heat hardening (28°C to 36°C, 1°C per 10 minutes), heat hardening plus serotonin (0.056 µg ml -1 ), heat hardening plus methionine (0.79 mg ml -1 ), and a control treatment. Regulator concentrations were based on previous literature. Serotonin may promote thermotolerance, acting upon metabolism and life-history. Methionine acts as a methylation agent across generations. For all groups, measurements were collected for three performance traits of individual thermal tolerance (upper sublethal thermal limit, lethal limit, and dysregulation range) over two generations. Results showed no treatment increased upper thermal limit during acute thermal stress, although serotonin-treated and methionine-treated individuals outperformed controls across multiple thermal performance traits. Additionally, some effects were evident across generations. Together these results suggest phenotypic engineering provides complex outcomes; and if implemented with heat hardening can further influence performance in multiple thermal tolerance traits, within and across generations. Potentially, such techniques could be up-scaled to provide resilience and stability in populations susceptible to extreme temperature events. © 2018. Published by The Company of Biologists Ltd.

Cardiac function in an endothermic fish: cellular mechanisms for overcoming acute thermal challenges during diving

PubMed Central

Shiels, H. A.; Galli, G. L. J.; Block, B. A.

2015-01-01

Understanding the physiology of vertebrate thermal tolerance is critical for predicting how animals respond to climate change. Pacific bluefin tuna experience a wide range of ambient sea temperatures and occupy the largest geographical niche of all tunas. Their capacity to endure thermal challenge is due in part to enhanced expression and activity of key proteins involved in cardiac excitation–contraction coupling, which improve cardiomyocyte function and whole animal performance during temperature change. To define the cellular mechanisms that enable bluefin tuna hearts to function during acute temperature change, we investigated the performance of freshly isolated ventricular myocytes using confocal microscopy and electrophysiology. We demonstrate that acute cooling and warming (between 8 and 28°C) modulates the excitability of the cardiomyocyte by altering the action potential (AP) duration and the amplitude and kinetics of the cellular Ca2+ transient. We then explored the interactions between temperature, adrenergic stimulation and contraction frequency, and show that when these stressors are combined in a physiologically relevant way, they alter AP characteristics to stabilize excitation–contraction coupling across an acute 20°C temperature range. This allows the tuna heart to maintain consistent contraction and relaxation cycles during acute thermal challenges. We hypothesize that this cardiac capacity plays a key role in the bluefin tunas' niche expansion across a broad thermal and geographical range. PMID:25540278

Female upper body and breast skin temperature and thermal comfort following exercise.

PubMed

Ayres, B; White, J; Hedger, W; Scurr, J

2013-01-01

Breast support reduces breast pain and movement during exercise, however, an extra layer of clothing may affect thermoregulation. This preliminary study investigated female upper body and breast skin temperature and thermal comfort following short-duration exercise. Eight female participants with C-cup breasts had thermal images (infra-red camera, FLIR systems) of the bare breasts, the breasts in two sports bras (composite and polyester) and the abdomen, taken before and after 20 min of exercise at 28(o)C. Following exercise, bare-breast, bra and abdomen temperatures reduced by 0.61(o)C, 0.92(o)C and 2.06(o)C, respectively. The polyester sports bra demonstrated greater thermal comfort and enabled a greater change in skin temperature than the composite sports bra. It is concluded that following short-duration exercise, sports bras reduced the cooling ability of the breast. Material properties of the bras affect thermal comfort and post-exercise skin temperature; this should be an important consideration for sports bra manufacturers. This study investigates the effect of sports bras on thermal regulation of the breast following exercise. Sports bras negatively affected the cooling ability of the skin on the breast, with the material properties of the bra affecting thermal comfort following exercise. These results present important considerations for sports bra manufacturers.

Thermal conductivity, bulk properties, and thermal stratigraphy of silicic tuffs from the upper portion of hole USW-G1, Yucca Mountain, Nye County, Nevada

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lappin, A.R.; VanBuskirk, R.G.; Enniss, D.O.

1982-03-01

Thermal-conductivity and bulk-property measurements were made on welded and nonwelded silicic tuffs from the upper portion of Hole USW-G1, located near the southwestern margin of the Nevada Test Site. Bulk-property measurements were made by standard techniques. Thermal conductivities were measured at temperatures as high as 280{sup 0}C, confining pressures to 10 MPa, and pore pressures to 1.5 MPa. Extrapolation of measured saturated conductivities to zero porosity suggests that matrix conductivity of both zeolitized and devitrified tuffs is independent of stratigraphic position, depth, and probably location. This fact allows development of a thermal-conductivity stratigraphy for the upper portion of Hole G1.more » Estimates of saturated conductivities of zeolitized nonwelded tuffs and devitrified tuffs below the water table appear most reliable. Estimated conductivities of saturated densely welded devitrified tuffs above the water table are less reliable, due to both internal complexity and limited data presently available. Estimation of conductivity of dewatered tuffs requires use of different air thermal conductivities in devitrified and zeolitized samples. Estimated effects of in-situ fracturing generally appear negligible.« less

Cochrane Commentary: Probiotics For Prevention of Acute Upper Respiratory Infection.

PubMed

Quick, Melissa

2015-01-01

Probiotics may improve a person's health by regulating their immune function. Some trials have shown that probiotic strains can prevent respiratory infections. Even though the previous version of our review showed benefits of probiotics for acute upper respiratory tract infections (URTIs), several new studies have been published. To assess the effectiveness and safety of probiotics (any specified strain or dose), compared with placebo, in the prevention of acute URTIs in people of all ages, who are at risk of acute URTIs. We searched CENTRAL (2014, Issue 6), MEDLINE (1950 to July week 3, 2014), EMBASE (1974 to July 2014), Web of Science (1900 to July 2014), the Chinese Biomedical Literature Database, which includes the China Biological Medicine Database (from 1978 to July 2014), the Chinese Medicine Popular Science Literature Database (from 2000 to July 2014) and the Masters Degree Dissertation of Beijing Union Medical College Database (from 1981 to July 2014). We also searched the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) and ClinicalTrials.gov for completed and ongoing trials on 31 July 2014. Randomised controlled trials (RCTs) comparing probiotics with placebo to prevent acute URTIs. Two review authors independently assessed the eligibility and quality of trials, and extracted data using the standard methodological procedures expected by The Cochrane Collaboration. We included 13 RCTs, although we could only extract data to meta-analyze 12 trials, which involved 3720 participants including children, adults (aged around 40 years) and older people. We found that probiotics were better than placebo when measuring the number of participants experiencing episodes of acute URTI [at least one episode: odds ratio (OR): 0.53; 95% CI = 0.37-0.76, P < .001, low quality evidence; at least three episodes: OR: 0.53; 95% CI = 0.36-0.80, P = .002, low quality evidence]; the mean duration of an episode of acute URTI [mean difference

Thermal maturity map of the lower part of the Upper Cretaceous Mesaverde Group, Uintah Basin, Utah

USGS Publications Warehouse

Nuccio, Vito F.; Johnson, Ronald C.

1986-01-01

The ability of rock to generate oil and gas is directly related to the type and quantity of kerogen and to its thermal maturity; therefore, thermal maturity is a commonly used tool for oil and gas exploration.  The purpose of this study ws to provide a thermal-maturity map for the lower part of the Upper Cretaceous Mesaverde Group in the eastern part of the Uinta Basin.  Prior to this study, thermal-maturity data were not available for the Uinta Basin.  This study uses coal rank to show the thermal maturity of the associated rocks.  The map was prepared in cooperation with the U.S. Department of Energy under its western gas sands project.

Incidence of Helicobacter pylori in operatively managed acute nonvariceal upper gastrointestinal bleeding.

PubMed

Callicutt, C S; Behrman, S W

2001-01-01

Helicobacter pylori is a known contributor to ulcerogenesis and nonvariceal acute upper gastrointestinal hemorrhage. Its incidence in operatively managed patients with upper gastrointestinal hemorrhage is ill defined. Patients undergoing surgery for upper gastrointestinal hemorrhage secondary to gastroduodenal ulceration between 1993 and 1998 at the University of Tennessee were retrospectively reviewed. Factors examined included age, nonsteroidal drug use, endoscopic intervention, urgency of operation, and H. pylori status confirmed by histologic examination. Forty-two patients had surgery with three excluded because of a lack of histologic evaluation. The site of bleeding was gastric in 23 and duodenal in 14. H. pylori infection was present in nine (39.1%) gastric and 11 (68.7%) duodenal ulcers. The incidence of H. pylori infection was reduced in those over 60 years of age (28.6%). Endoscopy was performed in all patients, but only two had biopsies for assessment of H. pylori. Operative morbidity was 17.9% and mortality was 5.1%. No patient had rebleeding following surgery. The incidence of H. pylori in this population is less than that reported in uncomplicated ulcer disease. Those older than 60 tended to be H. pylori negative. Endoscopic assessment for H. pylori was infrequent. Traditional indications for surgical intervention in ulcer hemorrhage should not be altered based on H. pylori status.

Thermoregulatory behavior of bluegill, Lepomis macrochirus from a thermally stressed ecosystem. [Lepomis macrochirus

DOE Office of Scientific and Technical Information (OSTI.GOV)

Fischer, R.U. Jr.

1984-12-01

Bluegills, Lepomis macrochirus were used as a representative aquatic ectotherm to determine the importance of behavior in thermoregulation of fish inhabiting a thermally stressed ecosystem. In the first part of the study, the mean final temperature preferenda for small bluegills from the heated and normothermic sites (25.2/sup 0/C vs 25.0/sup 0/C) were not significantly different. In the second part of the study, the acute preferred temperatures of large L. macrochirus (anti X = 26.3/sup 0/C) showed a statistically significant difference from that of small bluegills (anti X = 25.2/sup 0/C). There was no significant difference in the acute preferred temperaturesmore » for bluegill from the heated and normothermic sites. In the last phase of the study L. macrochirus from both a thermally stressed and normothermic site were tested for upper avoidance temperature in the absence of and in the presence of two sizes of predators (Micropterus salmoides, largemouth bass). In the absence of a predator the small bluegill had a mean upper avoidance temperature of 30.0/sup 0/C as compared to 29.8/sup 0/C for the large bluegills. In the presence of a small and large predator the small bluegills had a mean upper avoidance temperature of 34.0/sup 0/C and 33.9/sup 0/C respectively, while the large bluegills had mean upper avoidance temperatures of 33.8/sup 0/C and 33.1/sup 0/C. In the presence of a predator bluegill upper avoidance temperatures were significantly higher, however, predator size did not influence this relationship. During the determinations of final temperature preferendum, acute preferred temperature, and upper avoidance temperature, the fish from the heated site always exhibited less variability in temperature measurements than those from the control site. 41 refs., 9 figs., 10 tabs.« less

Effects of acute upper-body vibration on strength and power variables in climbers.

PubMed

Cochrane, Darryl J; Hawke, Emma J

2007-05-01

Whole-body vibration training has recently received a lot of attention with reported enhancements of strength and power qualities in athletes. This study investigated whether upper-body vibration would be able to augment muscular attributes for climbing performance. Twelve healthy active climbers volunteered for the study. All participants underwent 3 treatments--arm cranking (AC), upper-body vibration (UBV), and non-UBV (NUBV)--in a balanced random order, conducted on separate days. Upper-body vibration was generated via a commercialized electric-powered dumbbell with a rotating axis that delivered oscillatory movements to the shoulders and arms. The UBV treatment consisted of performing 5 upper-body exercises for a total duration of 5 minutes. The UBV frequency was set at 26 Hz, amplitude 3 mm. For the NUBV treatment, the participants performed the exact exercises and time constraints as UBV; however, the vibration dumbbell was set at 0 Hz and 0 mm amplitude. The third treatment consisted of AC, which was performed at 75 k.min(-1) for 5 minutes. Pre- and postmuscular performance measures of medicine ball throw, hand grip strength, and a specific climbing maneuver were performed after each treatment. There were no significant treatment differences on medicine ball throw, hand grip strength, and the specific climbing maneuver. Acute UBV exposure did not demonstrate the expected potential neuromuscular enhancements on the climbing performance tests selected for this study.

Factors affecting survival of patients in the acute phase of upper cervical spine injuries.

PubMed

Morita, Tomonori; Takebayashi, Tsuneo; Irifune, Hideto; Ohnishi, Hirofumi; Hirayama, Suguru; Yamashita, Toshihiko

2017-04-01

In recent years, on the one hand, the mortality rates of upper cervical spine injuries, such as odontoid fractures, were suggested to be not so high, but on the other hand reported to be significantly high. Furthermore, it has not been well documented the relationship between survival rates and various clinical features in those patients during the acute phase of injury because of few reports. This study aimed to evaluate survival rates and acute-phase clinical features of upper cervical spine injuries. We conducted a retrospective review of all patients who were transported to the advanced emergency medical center and underwent computed tomography of the cervical spine at our hospital between January 2006 and December 2015. We excluded the patients who were discovered in a state of cardiopulmonary arrest (CPA) and could not be resuscitated after transportation. Of the 215 consecutive patients with cervical spine injuries, we examined 40 patients (18.6%) diagnosed with upper cervical spine injury (males, 28; females, 12; median age, 58.5 years). Age, sex, mechanism of injury, degree of paralysis, the level of cervical injury, injury severity score (ISS), and incidence of CPA at discovery were evaluated and compared among patients classified into the survival and mortality groups. The survival rate was 77.5% (31/40 patients). In addition, complete paralysis was observed in 32.5% of patients. The median of ISS was 34.0 points, and 14 patients (35.0%) presented with CPA at discovery. Age, the proportion of patients with complete paralysis, a high ISS, and incidence of CPA at discovery were significantly higher in the mortality group (p = 0.038, p = 0.038, p < 0.001, and p < 0.001, respectively). Elderly people were more likely to experience upper cervical spine injuries, and their mortality rate was significantly higher than that in injured younger people. In addition, complete paralysis, high ISS, a state of CPA at discovery, was significantly higher

Various upper endoscopic findings of acute esophageal thermal injury induced by diverse food: a case series.

PubMed

Lee, Yu Mi; Kim, Sun Moon; Kim, Ji Young; Song, Hyun Jung; Koo, Hoon Sup; Song, Kyung Ho; Kim, Yong Seok; Huh, Kyu Chan

2014-09-01

Esophageal thermal injury caused by food has been reported to occur mostly after drinking hot liquid food, and is known to produce alternating white and red linear mucosal bands. In addition, thermal injury caused by ingestion of hot solid foods is documented to be a cause of esophageal ulcers or pseudomembranes. From January 2006 to August 2012, five patients with suspected esophageal thermal injury underwent esophagogastroduodenoscopy with biopsy. A "candy-cane" appearance was observed in one case, pseudomembrane was observed in two cases, an esophageal ulcer was observed in one case, and a friable and edematous mucosa was noted in one case. We believe that the endoscopic findings of esophageal thermal injury depend on the following factors: causative materials, amount of food consumed, exposure period, and time to endoscopy after the incident. Therefore, physicians who encounter patients with suspected esophageal thermal injury should carefully take the patient's history considering these factors.

Solar thermal upper stage: Economic advantage and development status

NASA Technical Reports Server (NTRS)

Adams, Alan M.

1995-01-01

A solar thermal upper stage (STUS) is envisioned as a propulsive concept for the future. The STUS will be used for low Earth orbit (LEO) to geostationary-Earth orbit (GEO) transfer and for planetary exploration missions. The STUS offers significant performance gains over conventional chemical propulsion systems. These performance gains translate into a more economical, more efficient method of placing useful payloads in space and maximizing the benefits derived from space activity. This paper will discuss the economical advantages of an STUS compared to conventional chemical propulsion systems, the potential market for an STUS, and the recent activity in the development of an STUS. The results of this assessment combined with the performance gains, will provide a strong justification for the development of an STUS.

Ocean acidification narrows the acute thermal and salinity tolerance of the Sydney rock oyster Saccostrea glomerata.

PubMed

Parker, Laura M; Scanes, Elliot; O'Connor, Wayne A; Coleman, Ross A; Byrne, Maria; Pörtner, Hans-O; Ross, Pauline M

2017-09-15

Coastal and estuarine environments are characterised by acute changes in temperature and salinity. Organisms living within these environments are adapted to withstand such changes, yet near-future ocean acidification (OA) may challenge their physiological capacity to respond. We tested the impact of CO 2 -induced OA on the acute thermal and salinity tolerance, energy metabolism and acid-base regulation capacity of the oyster Saccostrea glomerata. Adult S. glomerata were acclimated to three CO 2 levels (ambient 380μatm, moderate 856μatm, high 1500μatm) for 5weeks (24°C, salinity 34.6) before being exposed to a series of acute temperature (15-33°C) and salinity (34.2-20) treatments. Oysters acclimated to elevated CO 2 showed a significant metabolic depression and extracellular acidosis with acute exposure to elevated temperature and reduced salinity, especially at the highest CO 2 of 1500μatm. Our results suggest that the acute thermal and salinity tolerance of S. glomerata and thus its distribution will reduce as OA continues to worsen. Copyright © 2017 Elsevier Ltd. All rights reserved.

Upper-limb robot-assisted therapy in rehabilitation of acute stroke patients: focused review and results of new randomized controlled trial.

PubMed

Masiero, Stefano; Armani, Mario; Rosati, Giulio

2011-01-01

The successful motor rehabilitation of stroke patients requires early intensive and task-specific therapy. A recent Cochrane Review, although based on a limited number of randomized controlled trials (RCTs), showed that early robotic training of the upper limb (i.e., during acute or subacute phase) can enhance motor learning and improve functional abilities more than chronic-phase training. In this article, a new subacute-phase RCT with the Neuro-Rehabilitation-roBot (NeReBot) is presented. While in our first study we used the NeReBot in addition to conventional therapy, in this new trial we used the same device in substitution of standard proximal upper-limb rehabilitation. With this protocol, robot patients achieved similar reductions in motor impairment and enhancements in paretic upper-limb function to those gained by patients in a control group. By analyzing these results and those of previous studies, we hypothesize a new robotic protocol for acute and subacute stroke patients based on both treatment modalities (in addition and in substitution).

Mantle transition zone structure and upper mantle S velocity variations beneath Ethiopia: Evidence for a broad, deep-seated thermal anomaly

NASA Astrophysics Data System (ADS)

Benoit, Margaret H.; Nyblade, Andrew A.; Owens, Thomas J.; Stuart, Graham

2006-11-01

Ethiopia has been subjected to widespread Cenozoic volcanism, rifting, and uplift associated with the Afar hot spot. The hot spot tectonism has been attributed to one or more thermal upwellings in the mantle, for example, starting thermal plumes and superplumes. We investigate the origin of the hot spot by imaging the S wave velocity structure of the upper mantle beneath Ethiopia using travel time tomography and by examining relief on transition zone discontinuities using receiver function stacks. The tomographic images reveal an elongated low-velocity region that is wide (>500 km) and extends deep into the upper mantle (>400 km). The anomaly is aligned with the Afar Depression and Main Ethiopian Rift in the uppermost mantle, but its center shifts westward with depth. The 410 km discontinuity is not well imaged, but the 660 km discontinuity is shallower than normal by ˜20-30 km beneath most of Ethiopia, but it is at a normal depth beneath Djibouti and the northwestern edge of the Ethiopian Plateau. The tomographic results combined with a shallow 660 km discontinuity indicate that upper mantle temperatures are elevated by ˜300 K and that the thermal anomaly is broad (>500 km wide) and extends to depths ≥660 km. The dimensions of the thermal anomaly are not consistent with a starting thermal plume but are consistent with a flux of excess heat coming from the lower mantle. Such a broad thermal upwelling could be part of the African Superplume found in the lower mantle beneath southern Africa.

Puhimau thermal area: a window into the upper east rift zone of Kilauea Volcano, Hawaii?

USGS Publications Warehouse

McGee, K.A.; Sutton, A.J.; Elias, T.; Doukas, M.P.; Gerlach, T.M.

2006-01-01

We report the results of two soil CO2 efflux surveys by the closed chamber circulation method at the Puhimau thermal area in the upper East Rift Zone (ERZ) of Kilauea volcano, Hawaii. The surveys were undertaken in 1996 and 1998 to constrain how much CO2 might be reaching the ERZ after degassing beneath the summit caldera and whether the Puhimau thermal area might be a significant contributor to the overall CO2 budget of Kilauea. The area was revisited in 2001 to determine the effects of surface disturbance on efflux values by the collar emplacement technique utilized in the earlier surveys. Utilizing a cutoff value of 50 g m−2 d−1 for the surrounding forest background efflux, the CO2 emission rates for the anomaly at Puhimau thermal area were 27 t d−1 in 1996 and 17 t d−1 in 1998. Water vapor was removed before analysis in all cases in order to obtain CO2 values on a dry air basis and mitigate the effect of water vapor dilution on the measurements. It is clear that Puhimau thermal area is not a significant contributor to Kilauea's CO2 output and that most of Kilauea's CO2 (8500 t d−1) is degassed at the summit, leaving only magma with its remaining stored volatiles, such as SO2, for injection down the ERZ. Because of the low CO2 emission rate and the presence of a shallow water table in the upper ERZ that effectively scrubs SO2 and other acid gases, Puhimau thermal area currently does not appear to be generally well suited for observing temporal changes in degassing at Kilauea.

Upper-Ocean Thermal Structure and the Western North Pacific Category 5 Typhoons. Part 1. Ocean Features and the Category 5 Typhoons’ Intensification

DTIC Science & Technology

2008-09-01

Structure and the Western North Pacific Category 5 Typhoons. Part 1: Ocean Features and the Category 5 Typhoons’ Intensification 5a. CONTRACT NUMBER...intensification of category 5 cyclones. Based on 13 yr of satellite altimetry data, in situ &climatological upper-ocean thermal structure data, best-track...Form 298 (Rev. 8/98) Prescribed by ANSI Std. Z39.18 3288 MONTHLY WEATHER REVIEW VOLUME 136 Upper-Ocean Thermal Structure and the Western North

Therapeutic options for acute cough due to upper respiratory infections in children.

PubMed

Paul, Ian M

2012-02-01

Cough due to upper respiratory tract infections (URIs) is one of the most frequent complaints encountered by pediatric health-care providers, and one of the most disruptive symptoms for children and families. Despite the frequency of URIs, there is limited evidence to support the few therapeutic agents currently available in the United States (US) to treat acute cough due to URI. Published, well-designed, contemporary research supporting the efficacy of narcotics (codeine, hydrocodone) and US Food and Drug Administration (FDA)-approved over-the-counter (OTC) oral antitussives and expectorants (dextromethorphan, diphenhydramine, chlophedianol, and guaifenesin) is absent for URI-associated pediatric cough. Alternatively, honey and topically applied vapor rubs may be effective antitussives.

Oxygen concentration affects upper thermal tolerance in a terrestrial vertebrate.

PubMed

Shea, Tanner K; DuBois, P Mason; Claunch, Natalie M; Murphey, Nicolette E; Rucker, Kiley A; Brewster, Robert A; Taylor, Emily N

2016-09-01

We tested the oxygen limitation hypothesis, which states that animals decline in performance and reach the upper limits of their thermal tolerance when the metabolic demand for oxygen at high temperatures exceeds the circulatory system's ability to supply adequate oxygen, in air-breathing lizards exposed to air with different oxygen concentrations. Lizards exposed to hypoxic air (6% O2) gaped, panted, and lost their righting response at significantly lower temperatures than lizards exposed to normoxic (21% O2) or hyperoxic (35% O2) air. A greater proportion of lizards in the hyperoxic treatment were able to withstand body temperatures above 44°C than in the normoxic treatment. We also found that female lizards had a higher panting threshold than male lizards, while sex had no effect on gaping threshold and loss of righting response. Body size affected the temperature at which lizards lost the righting response, with larger lizards losing the response at lower temperatures than smaller lizards when exposed to hypoxic conditions. These data suggest that oxygen limitation plays a mechanistic role in the thermal tolerance of lizards. Copyright © 2016 Elsevier Inc. All rights reserved.

Solar Thermal Upper Stage Cryogen System Engineering Checkout Test

NASA Technical Reports Server (NTRS)

Olsen, A. D; Cady, E. C.; Jenkins, D. S.

1999-01-01

The Solar Thermal Upper Stage technology (STUSTD) program is a solar thermal propulsion technology program cooperatively sponsored by a Boeing led team and by NASA MSFC. A key element of its technology program is development of a liquid hydrogen (LH2) storage and supply system which employs multi-layer insulation, liquid acquisition devices, active and passive thermodynamic vent systems, and variable 40W tank heaters to reliably provide near constant pressure H2 to a solar thermal engine in the low-gravity of space operation. The LH2 storage and supply system is designed to operate as a passive, pressure fed supply system at a constant pressure of about 45 psia. During operation of the solar thermal engine over a small portion of the orbit the LH2 storage and supply system propulsively vents through the enjoy at a controlled flowrate. During the long coast portion of the orbit, the LH2 tank is locked up (unvented). Thus, all of the vented H2 flow is used in the engine for thrust and none is wastefully vented overboard. The key to managing the tank pressure and therefore the H2 flow to the engine is to manage and balance the energy flow into the LH2 tank with the MLI and tank heaters with the energy flow out of the LH2 tank through the vented H2 flow. A moderate scale (71 cu ft) LH2 storage and supply system was installed and insulated at the NASA MSFC Test Area 300. The operation of the system is described in this paper. The test program for the LH2 system consisted of two parts: 1) a series of engineering tests to characterize the performance of the various components in the system: and 2) a 30-day simulation of a complete LEO and GEO transfer mission. This paper describes the results of the engineering tests, and correlates these results with analytical models used to design future advanced Solar Orbit Transfer Vehicles.

Observed Evolution of the Upper-level Thermal Structure in Tropical Cyclones

NASA Astrophysics Data System (ADS)

Rivoire, L.; Birner, T.; Knaff, J. A.

2016-12-01

Tropical cyclones (TCs) are associated with tropopause-level cooling above the well-known tropospheric warm core. While the investigation of tropopause-level structures started as early as 1951, there is no clear consensus on the mechanisms involved. In addition, the large-scale average vertical and radial structure of the tropopause-level cooling is yet to be examined. Tropopause-level cooling destabilizes the upper atmosphere to convection, which potentially allows existing convection to reach higher altitudes. This is of particular importance during the early stages of tropical cyclogenesis. Other important characteristics of the tropopause-level cooling include its amplitude, its position relative to that of the warm core, its radial extent, and its evolution during the lifetime of TCs. These potentially influence TC structure, surface pressure gradients and maximum winds, intensity evolution, and outflow entropy. We use the 322 hurricane-strength TCs from the best-track archive in 2007-2014, along with high vertical resolution temperature measurements from the Constellation Observing System for Meteorology, Ionosphere, and Climate (COSMIC). These measurements are composited about the Lifetime Maximum Intensity (LMI) to examine the evolution of the fine-scale upper-level thermal structure inside TCs. We find that the tropopause-cooling has an amplitude similar to that of the warm core. Relative to the far-field structure (the area average between 1300-1500 km radii), tropopause-level cooling is found to occur several days before the warm core is established. Cold anomalies extend up to 1000 km away from the storm center, and may take part in a large-scale poleward transport of cold, dry air in the UTLS. Lastly, cold air masses move away from the storm center (and warm core) after LMI, and their remains lie around the 400-700 km radius -essentially inward of the radius of maximum tangential anticyclonic winds in the outflow layer. We discuss these results in the

Upper arm anthropometrics versus DXA scan in survivors of acute respiratory distress syndrome.

PubMed

Chan, Kitty S; Mourtzakis, Marina; Aronson Friedman, Lisa; Dinglas, Victor D; Hough, Catherine L; Ely, E Wesley; Morris, Peter E; Hopkins, Ramona O; Needham, Dale M

2018-04-01

Survivors of acute respiratory distress syndrome (ARDS) experience severe muscle wasting. Upper arm anthropometrics can provide a quick, non-invasive estimate of muscle status, but its accuracy is unknown. This study examines the accuracy of upper arm percent muscle area (UAMA) with reference measures of lean mass from dual energy X-ray absorptiometry (DXA). Data are from 120 ARDS survivors participating in a multicenter national study. Receiver operating characteristic (ROC) curves, by patient sex, demonstrated that UAMA did no better than chance in discriminating low appendicular skeletal muscle mass identified using DXA findings (c-statistics, 6 months: 0.50-0.59, 12 months: 0.54-0.57). Modest correlations of UAMA with DXA measures (whole-body: r = 0.46-0.49, arm-specific: r = 0.50-0.51, p < 0.001) and Bland-Altman plots indicate poor precision. UAMA is not an appropriate screening measure for estimating muscle mass when compared to a DXA reference standard. Alternate screening measures should be evaluated in ARDS survivors.

Maps showing thermal maturity of Upper Cretaceous marine shales in the Wind River Basin, Wyoming

USGS Publications Warehouse

Finn, Thomas M.; Pawlewicz, Mark J.

2013-01-01

The Wind River Basin is a large Laramide (Late Cretaceous through Eocene) structural and sedimentary basin that encompasses about 7,400 square miles in central Wyoming. The basin is bounded by the Washakie Range, Owl Creek, and southern Bighorn Mountains on the north, the Casper arch on the east and northeast, the Granite Mountains on the south, and the Wind River Range on the west. Important conventional and unconventional oil and gas resources have been discovered and produced from reservoirs ranging in age from Mississippian through Tertiary. It has been suggested that various Upper Cretaceous marine shales are the principal hydrocarbon source rocks for many of these accumulations. Numerous source rock studies of various Upper Cretaceous marine shales throughout the Rocky Mountain region have led to the conclusion that these rocks have generated, or are capable of generating, oil and (or) gas. With recent advances and success in horizontal drilling and multistage fracture stimulation there has been an increase in exploration and completion of wells in these marine shales in other Rocky Mountain Laramide basins that were traditionally thought of only as hydrocarbon source rocks. Important parameters that control hydrocarbon production from shales include: reservoir thickness, amount and type of organic matter, and thermal maturity. The purpose of this report is to present maps and a structural cross section showing levels of thermal maturity, based on vitrinite reflectance (Ro), for Upper Cretaceous marine shales in the Wind River Basin.

Predictors of in-hospital mortality in a cohort of elderly Egyptian patients with acute upper gastrointestinal bleeding.

PubMed

Elsebaey, Mohamed A; Elashry, Heba; Elbedewy, Tamer A; Elhadidy, Ahmed A; Esheba, Noha E; Ezat, Sherif; Negm, Manal Saad; Abo-Amer, Yousry Esam-Eldin; Abgeegy, Mohamed El; Elsergany, Heba Fadl; Mansour, Loai; Abd-Elsalam, Sherief

2018-04-01

Acute upper gastrointestinal bleeding (UGIB) affects large number of elderly with high rates of morbidity and mortality. Early identification and management of the factors predicting in-hospital mortality might decrease mortality. This study was conducted to identify the causes of acute UGIB and the predictors of in-hospital mortality in elderly Egyptian patients.286 elderly patients with acute UGIB were divided into: bleeding variceal group (161 patients) and bleeding nonvariceal group (125 patients). Patients' monitoring was done during hospitalization to identify the risk factors that might predict in-hospital mortality in elderly.Variceal bleeding was the most common cause of acute UGIB in elderly Egyptian patients. In-hospital mortality rate was 8.74%. Increasing age, hemodynamic instability at presentation, co-morbidities (especially liver cirrhosis associated with other co-morbidity) and failure to control bleeding were the predictors of in-hospital mortality.Increasing age, hemodynamic instability at presentation, co-morbidities (especially liver cirrhosis associated with other co-morbidity) and failure to control bleeding should be considered when triaging those patients for immediate resuscitation, close observation, and early treatment.

Near-Inertial and Thermal Upper Ocean Response to Atmospheric Forcing in the North Atlantic Ocean

DTIC Science & Technology

2010-06-01

meridional transport of heat (Hoskins and Valdes, 1990). Formation of North Atlantic Subtropical Mode Water is thought to take place during the...North Atlantic Ocean MIT/WHOI Joint Program in Oceanography/ Applied Ocean Science and Engineering Massachusetts Institute of Technology Woods Hole...Oceanographic Institution MITIWHOI 2010-16 Near-inertial and Thermal Upper Ocean Response to Atmospheric Forcing in the North Atlantic Ocean by

Linking transcriptional responses to organismal tolerance reveals mechanisms of thermal sensitivity in a mesothermal endangered fish.

PubMed

Komoroske, Lisa M; Connon, Richard E; Jeffries, Ken M; Fangue, Nann A

2015-10-01

Forecasting species' responses to climate change requires understanding the underlying mechanisms governing environmental stress tolerance, including acclimation capacity and acute stress responses. Current knowledge of these physiological processes in aquatic ectotherms is largely drawn from eurythermal or extreme stenothermal species. Yet many species of conservation concern exhibit tolerance windows and acclimation capacities in between these extremes. We linked transcriptome profiles to organismal tolerance in a mesothermal endangered fish, the delta smelt (Hypomesus transpacificus), to quantify the cellular processes, sublethal thresholds and effects of thermal acclimation on acute stress responses. Delta smelt initiated rapid molecular changes in line with expectations of theoretical thermal limitation models, but also exhibited diminished capacity to modify the expression of some genes and cellular mechanisms key to coping with acute thermal stress found in eurytherms. Sublethal critical thresholds occurred 4-6 °C below their upper tolerance limits, and thermal acclimation shifted the onset of acute thermal stress and tolerance as predicted. However, we found evidence that delta smelt's limited thermal plasticity may be partially due to an inability of individuals to effectively make physiological adjustments to truly achieve new homoeostasis under heightened temperatures, resulting in chronic thermal stress. These findings provide insight into the physiological basis of the diverse patterns of thermal tolerances observed in nature. Moreover, understanding how underlying molecular mechanisms shape thermal acclimation capacity, acute stress responses and ultimately differential phenotypes contributes to a predictive framework to deduce species' responses in situ to changes in selective pressures due to climate change. © 2015 John Wiley & Sons Ltd.

Shear wave velocity, seismic attenuation, and thermal structure of the continental upper mantle

USGS Publications Warehouse

Artemieva, I.M.; Billien, M.; Leveque, J.-J.; Mooney, W.D.

2004-01-01

Seismic velocity and attenuation anomalies in the mantle are commonly interpreted in terms of temperature variations on the basis of laboratory studies of elastic and anelastic properties of rocks. In order to evaluate the relative contributions of thermal and non-thermal effects on anomalies of attenuation of seismic shear waves, QS-1, and seismic velocity, VS, we compare global maps of the thermal structure of the continental upper mantle with global QS-1 and Vs maps as determined from Rayleigh waves at periods between 40 and 150 S. We limit the comparison to three continental mantle depths (50, 100 and 150 km), where model resolution is relatively high. The available data set does not indicate that, at a global scale, seismic anomalies in the upper mantle are controlled solely by temperature variations. Continental maps have correlation coefficients of <0.56 between VS and T and of <0.47 between QS and T at any depth. Such low correlation coefficients can partially be attributed to modelling arrefacts; however, they also suggest that not all of the VS and QS anomalies in the continental upper mantle can be explained by T variations. Global maps show that, by the sign of the anomaly, VS and QS usually inversely correlate with lithospheric temperatures: most cratonic regions show high VS and QS and low T, while most active regions have seismic and thermal anomalies of the opposite sign. The strongest inverse correlation is found at a depth of 100 km, where the attenuation model is best resolved. Significantly, at this depth, the contours of near-zero QS anomalies approximately correspond to the 1000 ??C isotherm, in agreement with laboratory measurements that show a pronounced increase in seismic attenuation in upper mantle rocks at 1000-1100 ??C. East-west profiles of VS, QS and T where continental data coverage is best (50??N latitude for North America and 60??N latitude for Eurasia) further demonstrate that temperature plays a dominant, but non-unique, role in

Intrathecal clonidine and bupivacaine have synergistic analgesia for acute thermally or inflammatory-induced pain in rats.

PubMed

Nishiyama, Tomoki; Hanaoka, Kazuo

2004-04-01

We investigated the interaction between spinally administered bupivacaine and clonidine using an animal model of acute and inflammatory pain. Rats implanted with lumbar intrathecal catheters were injected intrathecally with saline (control), bupivacaine (1 to 100 microg), or clonidine (0.1 to 3 microg) and tested for their responses to thermal stimulation to the tail (tail flick test) and subcutaneous formalin injection into the hindpaw (formalin test). The effects of the combination of bupivacaine and clonidine on both stimuli were tested by isobolographic analysis. General behavior and motor function were examined as side effects. The 50% effective doses of bupivacaine and clonidine were significantly smaller when combined compared with each single drug in both the tail flick test (2.82 and 0.11 microg versus 7.1 and 0.29 microg, respectively) and phase 1 (0.24 and 0.009 microg versus 5.7 and 0.15 microg) and phase 2 (0.31 and 0.012 microg versus 3.2 and 0.16 microg) of the formalin test. Side effects were decreased by the combination. These results suggest a favorable combination of intrathecal bupivacaine and clonidine in the management of acute and inflammatory pain. The analgesic interaction between intrathecally administered bupivacaine and clonidine was examined during acute thermal and inflammatory-induced pain in rats. The analgesia produced by the combination of these two drugs was synergistic in both acute thermal and inflammatory induced pain, with a decrease in behavioral side effects.

Parental Effect of Long Acclimatization on Thermal Tolerance of Juvenile Sea Cucumber Apostichopus japonicus

PubMed Central

Dong, Yun-wei

2015-01-01

To evaluate the thermal resistance of marine invertebrates to elevated temperatures under scenarios of future climate change, it is crucial to understand parental effect of long acclimatization on thermal tolerance of offspring. To test whether there is parental effect of long acclimatization, adult sea cucumbers (Apostichopus japonicus) from the same broodstock were transplanted southward and acclimatized at high temperature in field mesocosms. Four groups of juvenile sea cucumbers whose parents experienced different durations of high temperature acclimatization were established. Upper thermal limits, oxygen consumption and levels of heat shock protein mRNA of juveniles was determined to compare thermal tolerance of individuals from different groups. Juvenile sea cucumbers whose parents experienced high temperature could acquire high thermal resistance. With the increase of parental exposure duration to high temperature, offspring became less sensitive to high temperature, as indicated by higher upper thermal limits (LT50), less seasonal variations of oxygen consumption, and stable oxygen consumption rates between chronic and acute thermal stress. The relatively high levels of constitutive expression of heat-shock proteins should contribute to the high thermal tolerance. Together, these results indicated that the existence of a parental effect of long acclimatization would increase thermal tolerance of juveniles and change the thermal sensitivity of sea cucumber to future climate change. PMID:26580550

Parental Effect of Long Acclimatization on Thermal Tolerance of Juvenile Sea Cucumber Apostichopus japonicus.

PubMed

Wang, Qing-Lin; Yu, Shan-Shan; Dong, Yun-Wei

2015-01-01

To evaluate the thermal resistance of marine invertebrates to elevated temperatures under scenarios of future climate change, it is crucial to understand parental effect of long acclimatization on thermal tolerance of offspring. To test whether there is parental effect of long acclimatization, adult sea cucumbers (Apostichopus japonicus) from the same broodstock were transplanted southward and acclimatized at high temperature in field mesocosms. Four groups of juvenile sea cucumbers whose parents experienced different durations of high temperature acclimatization were established. Upper thermal limits, oxygen consumption and levels of heat shock protein mRNA of juveniles was determined to compare thermal tolerance of individuals from different groups. Juvenile sea cucumbers whose parents experienced high temperature could acquire high thermal resistance. With the increase of parental exposure duration to high temperature, offspring became less sensitive to high temperature, as indicated by higher upper thermal limits (LT50), less seasonal variations of oxygen consumption, and stable oxygen consumption rates between chronic and acute thermal stress. The relatively high levels of constitutive expression of heat-shock proteins should contribute to the high thermal tolerance. Together, these results indicated that the existence of a parental effect of long acclimatization would increase thermal tolerance of juveniles and change the thermal sensitivity of sea cucumber to future climate change.

Acute thermal tolerance of tropical estuarine fish occupying a man-made tidal lake, and increased exposure risk with climate change

NASA Astrophysics Data System (ADS)

Waltham, Nathan J.; Sheaves, Marcus

2017-09-01

Understanding acute hyperthermic exposure risk to animals, including fish in tropical estuaries, is increasingly necessary under future climate change. To examine this hypothesis, fish (upper water column species - glassfish, Ambassis vachellii; river mullet, Chelon subviridis; diamond scale mullet, Ellochelon vaigiensis; and ponyfish, Leiognathus equulus; and lower water bottom dwelling species - whiting Sillago analis) were caught in an artificial tidal lake in tropical north Queensland (Australia), and transported to a laboratory tank to acclimate (3wks). After acclimation, fish (between 10 and 17 individuals each time) were transferred to a temperature ramping experimental tank, where a thermoline increased (2.5 °C/hr; which is the average summer water temperature increasing rate measured in the urban lakes) tank water temperature to establish threshold points where each fish species lost equilibrium (defined here as Acute Effect Temperature; AET). The coolest AET among all species was 33.1 °C (S. analis), while the highest was 39.9 °C (A. vachellii). High frequency loggers were deployed (November and March representing Austral summer) in the same urban lake where fish were sourced, to measure continuous (20min) surface (0.15 m) and bottom (0.1 m) temperature to derive thermal frequency curves to examine how often lake temperatures exceed AET thresholds. For most fish species examined, water temperature that could be lethal were exceeded at the surface, but rarely, if ever, at the bottom waters suggesting deep, cooler, water provides thermal refugia for fish. An energy-balance model was used to estimate daily mean lake water temperature with good accuracy (±1 °C; R2 = 0.91, modelled vs lake measured temperature). The model was used to predict climate change effects on lake water temperature, and the exceedance of thermal threshold change. A 2.3 °C climate warming (based on 2100 local climate prediction) raised lake water temperature by 1.3 °C. However

[Factors influencing antibiotics prescribing of primary health physicians in acute upper respiratory infections].

PubMed

Kim, Nam-Soon; Jang, Soong Nang; Jang, Sun-Mee

2005-02-01

To explore the factors influencing antibiotics prescription by primary health physicians for acute upper respiratory infections (URI). We performed a survey of 370 primary health physicians randomly sampled in April, 2003. The questionnaire consisted of a prescription on the scenario of acute bronchitis case, along with opinions and reasons for prescribing antibiotics on URI. We found that 54.7% of the physicians prescribed antibiotics on the example case of acute bronchitis which is known as not needing antibiotics. Female physicians and ENT physicians had a greater tendency to prescribe antibiotics. The factors influencing antibiotics prescription on URI were the belief about the effectiveness of antibiotics, preference for their own experiences rather than clinical guidelines, perception of patients' expectations, and perception of competitive environment. The prescription of antibiotics in the example case was affected by how much they usually prescribe antibiotics (OR = 2.400, 95% CI = 1.470-3.917) and the physicians who thought that antibiotics were helpful for their income prescribed antibiotics more than others (OR = 6.773, 95% CI = 1.816-25.254). These findings demonstrated that the false belief on the effectiveness of antibiotics, patient's expectation of medication and fast relief of symptoms, and perception of competitive environment all affected the physicians' prescription of antibiotics on URI. It may help to find barriers to accommodate scientific evidence and clinical guidelines among physicians and to specify subgroups for education about appropriate prescription behaviors.

Can lower mantle slab-like seismic anomalies be explained by thermal coupling between the upper and lower mantles?

NASA Astrophysics Data System (ADS)

Čížková, Hana; Čadek, Ondřej; van den Berg, Arie P.; Vlaar, Nicolaas J.

Below subduction zones, high resolution seismic tomographic models resolve fast anomalies that often extend into the deep lower mantle. These anomalies are generally interpreted as slabs penetrating through the 660-km seismic discontinuity, evidence in support of whole-mantle convection. However, thermal coupling between two flow systems separated by an impermeable interface might provide an alternative explanation of the tomographic results. We have tested this hypothesis within the context of an axisymmetric model of mantle convection in which an impermeable boundary is imposed at a depth of 660 km. When an increase in viscosity alone is imposed across the impermeable interface, our results demonstrate the dominant role of mechanical coupling between shells, producing lower mantle upwellings (downwellings) below upper mantle downwellings (upwellings). However, we find that the effect of mechanical coupling can be significantly weakened if a narrow low viscosity zone exists beneath the 660-km discontinuity. In such a case, both thermally induced ‘slabs’ in the lower mantle and thermally activated plumes that rise from the upper/lower mantle boundary are observed even though mass transfer between the shells does not exist.

Upper gastrointestinal bleeding.

PubMed

Feinman, Marcie; Haut, Elliott R

2014-02-01

Upper gastrointestinal (GI) bleeding remains a commonly encountered diagnosis for acute care surgeons. Initial stabilization and resuscitation of patients is imperative. Stable patients can have initiation of medical therapy and localization of the bleeding, whereas persistently unstable patients require emergent endoscopic or operative intervention. Minimally invasive techniques have surpassed surgery as the treatment of choice for most upper GI bleeding. Copyright © 2014 Elsevier Inc. All rights reserved.

Survey of clinical pharmacists' knowledge of appropriateness of antimicrobial therapy for upper respiratory infections and acute bronchitis.

PubMed

Mainous, A G; MacFarlane, L L; Connor, M K; Green, L A; Fowler, K; Hueston, W J

1999-04-01

We conducted a survey to assess clinical pharmacists' recommendation of antibiotics for upper respiratory infections (URIs) and acute bronchitis. A random sample of 752 members of the American College of Clinical Pharmacy were mailed a multiple-choice survey that presented four examples consistent with clinical symptoms of the two disorders. Respondents were asked what treatment they would recommend for each example. The response rate was 59%. Pharmacists recommended antibiotics for the treatment of both URIs and acute bronchitis significantly more if patients' symptoms included discolored discharge or sputum as opposed to clear discharge. Those who were board certified were less likely than nonboard-certified pharmacists to recommend antibiotics for URIs with discolored discharge. Pharmacists who specialized in either ambulatory care or infectious disease were less likely than those in other specialties to recommend antibiotics for acute bronchitis with discolored sputum. Clinical pharmacists are similar to patients and physicians in their belief that antibiotics are appropriate for URIs and acute bronchitis with discolored discharge. Considering the role that pharmacists play as clinical consultants to physicians, greater efforts should be made to educate them regarding appropriate prescription of antibiotics.

Interleukin-6 Induced "Acute" Phenotypic Microenvironment Promotes Th1 Anti-Tumor Immunity in Cryo-Thermal Therapy Revealed By Shotgun and Parallel Reaction Monitoring Proteomics.

PubMed

Xue, Ting; Liu, Ping; Zhou, Yong; Liu, Kun; Yang, Li; Moritz, Robert L; Yan, Wei; Xu, Lisa X

2016-01-01

Cryo-thermal therapy has been emerged as a promising novel therapeutic strategy for advanced breast cancer, triggering higher incidence of tumor regression and enhanced remission of metastasis than routine treatments. To better understand its anti-tumor mechanism, we utilized a spontaneous metastatic mouse model and quantitative proteomics to compare N-glycoproteome changes in 94 serum samples with and without treatment. We quantified 231 highly confident N-glycosylated proteins using iTRAQ shotgun proteomics. Among them, 53 showed significantly discriminated regulatory patterns over the time course, in which the acute phase response emerged as the most enhanced pathway. The anti-tumor feature of the acute response was further investigated using parallel reaction monitoring target proteomics and flow cytometry on 23 of the 53 significant proteins. We found that cryo-thermal therapy reset the tumor chronic inflammation to an "acute" phenotype, with up-regulation of acute phase proteins including IL-6 as a key regulator. The IL-6 mediated "acute" phenotype transformed IL-4 and Treg-promoting ICOSL expression to Th1-promoting IFN-γ and IL-12 production, augmented complement system activation and CD86(+)MHCII(+) dendritic cells maturation and enhanced the proliferation of Th1 memory cells. In addition, we found an increased production of tumor progression and metastatic inhibitory proteins under such "acute" environment, favoring the anti-metastatic effect. Moreover, cryo-thermal on tumors induced the strongest "acute" response compared to cryo/hyperthermia alone or cryo-thermal on healthy tissues, accompanying by the most pronounced anti-tumor immunological effect. In summary, we demonstrated that cryo-thermal therapy induced, IL-6 mediated "acute" microenvironment shifted the tumor chronic microenvironment from Th2 immunosuppressive and pro-tumorigenic to Th1 immunostimulatory and tumoricidal state. Moreover, the magnitude of "acute" and "danger" signals play a key

[Acute right-sided upper abdominal pain in a 46-year-old woman].

PubMed

Bauder, M; Fiala, A; Klinger, C; Kersjes, W; Caca, K

2018-02-01

A 46-year-old woman presented with acute abdominal pain in the right upper quadrant. Esophagogastroduodenoscopy revealed a duodenal stenosis within the horizontal part of the duodenum. Based on the findings of abdominal computed tomography (CT), endosonography, Doppler duplex sonography and angiography, the diagnosis of an aneurysm of a branch of the inferior pancreaticoduodenal artery was established. This arterial branch was part of a collateral circulation between the superior mesenteric artery and the proper hepatic artery caused by obturation of the celiac artery. The symptomatic duodenal stenosis was the result of a local hematoma due to prior rupture of an aneurysm. After successful coiling of the afferent vessels to the aneurysm follow-up examinations showed progredient resorption of the hematoma and the patient was free of complaints.

Medicine use practices in management of symptoms of acute upper respiratory tract infections in children (≤12 years) in Kampala city, Uganda.

PubMed

Ocan, Moses; Aono, Mary; Bukirwa, Clare; Luyinda, Emmanuel; Ochwo, Cathy; Nsambu, Elastus; Namugonza, Stella; Makoba, Joseph; Kandaruku, Enock; Muyende, Hannington; Nakawunde, Aida

2017-09-21

Medicines are commonly accessed and used for management of illness in children without a prescription. This potentially increases the risk of unwanted treatment outcomes. We investigated medicine use practices in management of symptoms of acute upper respiratory tract infections among children (≤12 years) in households in Nakawa division, Kampala city. This was a cross-sectional study conducted among 390 randomly selected children. Data on use of medicines in children (≤12 years) during recent episode of acute upper respiratory tract infection was collected from their care takers using an interviewer administered questionnaire. A recall period of two weeks (14 days) was used in during data collection. The prevalence of giving children non-prescription antimicrobial medicines was 44.8% (38.3-52.2). The most common disease symptoms that the children reportedly had included flu, 84.9% (331/390), cough, 83.1% (324/390), and undefined fever, 69.7% (272/390). Medicines commonly given to children included, paracetamol 53.1% (207/390), Coartem 29.7% (116/390), cough linctus 20.8% (81/390), amoxicillin 18.9% (74/390), Co-trimoxazole 18.5% (72/390), and diphenhydramine 15.4% (60/390). The major sources of medicines given to the children was hospital/clinic, 57.26% (223/390). Most of the children, 81% were given more than one medicine at a time. The majority, 62.3% (243/390) of the care takers who gave the children medicine during the recent illness were not aware of any medicine (s) that should not be given to children. The predictors of non-prescription use of antimicrobial medicines in managing symptoms of acute upper respiratory tract infections in children included, medicines obtained from drug shop (PR: 1.45, CI: 1.14-1.85), medicines at home (PR: 1.8, CI: 0.83-1.198) and type of medicine (antimalarial) (PR: 2.8, CI: 1.17-6.68). Children are commonly given multiple medicines during episodes of acute upper respiratory tract infections with most antimicrobial

Thermal regimes, nonnative trout, and their influences on native Bull Trout in the Upper Klamath River Basin, Oregon

USGS Publications Warehouse

Benjamin, Joseph R.; Heltzel, Jeannie; Dunham, Jason B.; Heck, Michael; Banish, Nolan P.

2016-01-01

The occurrence of fish species may be strongly influenced by a stream’s thermal regime (magnitude, frequency, variation, and timing). For instance, magnitude and frequency provide information about sublethal temperatures, variability in temperature can affect behavioral thermoregulation and bioenergetics, and timing of thermal events may cue life history events, such as spawning and migration. We explored the relationship between thermal regimes and the occurrences of native Bull Trout Salvelinus confluentus and nonnative Brook Trout Salvelinus fontinalis and Brown Trout Salmo trutta across 87 sites in the upper Klamath River basin, Oregon. Our objectives were to associate descriptors of the thermal regime with trout occurrence, predict the probability of Bull Trout occurrence, and estimate upper thermal tolerances of the trout species. We found that each species was associated with a different suite of thermal regime descriptors. Bull Trout were present at sites that were cooler, had fewer high-temperature events, had less variability, and took longer to warm. Brook Trout were also observed at cooler sites with fewer high-temperature events, but the sites were more variable and Brook Trout occurrence was not associated with a timing descriptor. In contrast, Brown Trout were present at sites that were warmer and reached higher temperatures faster, but they were not associated with frequency or variability descriptors. Among the descriptors considered, magnitude (specifically June degree-days) was the most important in predicting the probability of Bull Trout occurrence, and model predictions were strengthened by including Brook Trout occurrence. Last, all three trout species exhibited contrasting patterns of tolerating longer exposures to lower temperatures. Tolerance limits for Bull Trout were lower than those for Brook Trout and Brown Trout, with contrasts especially evident for thermal maxima. Our results confirm the value of exploring a suite of thermal

Thermal bifurcation in the upper solar photosphere inferred from heterodyne spectroscopy of OH rotational lines

NASA Technical Reports Server (NTRS)

Deming, D.; Hillman, J. J.; Kostiuk, T.; Mumma, M. J.; Zipoy, D. M.

1984-01-01

Low noise high spectral resolution observations of two pure rotation transitions of OH from the solar photosphere were obtained. The observations were obtained using the technique of optically null-balanced infrared heterodyne spectroscopy, and consist of center-to-limb line profiles of a v=1 and a v=0 transition near 12 microns. These lines should be formed in local thermodynamic equilibrium (LTE), and are diagnostics of the thermal structure of the upper photosphere. The v=0 R22 (24.5)e line strengthens at the solar limb, in contradiction to the predictions of current one dimensional photospheric models. Data for this line support a two dimensional model in which horizontal thermal fluctuations of order + or - 800K occur in the region Tau (sub 5000) approximately .001 to .01. This thermal bifurcation may be maintained by the presence of magnetic flux tubes, and may be related to the solar limb extensions observed in the 30 to 200 micron region.

Repeated thermal stressor causes chronic elevation of baseline corticosterone and suppresses the physiological endocrine sensitivity to acute stressor in the cane toad (Rhinella marina).

PubMed

Narayan, Edward J; Hero, Jean-Marc

2014-04-01

Extreme environmental temperature could impact the physiology and ecology of animals. The stress endocrine axis provides necessary physiological stress response to acute (day-day) stressors. Presently, there are no empirical evidences showing that exposure to extreme thermal stressor could cause chronic stress in amphibians. This could also modulate the physiological endocrine sensitivity to acute stressors and have serious implications for stress coping in amphibians, particularly those living in fragmented and disease prone environments. We addressed this important question using the cane toad (Rhinella marina) model from its introduced range in Queensland, Australia. We quantified their physiological endocrine sensitivity to a standard acute (capture and handling) stressor after exposing the cane toads to thermal shock at 35°C for 30min daily for 34 days. Corticosterone (CORT) responses to the capture and handling protocol were measured on three sampling intervals (days 14, 24, and 34) to determine whether the physiological endocrine sensitivity was maintained or modulated over-time. Two control groups (C1 for baseline CORT measurement only and C2 acute handled only) and two temperature treatment groups (T1 received daily thermal shock up to day 14 only and a recovery phase of 20 days and T2 received thermal shock daily for 34 days). Results showed that baseline CORT levels remained high on day 14 (combined effect of capture, captivity and thermal stress) for both T1 and T2. Furthermore, baseline CORT levels decreased for T1 once the thermal shock was removed after day 14 and returned to baseline by day 29. On the contrary, baseline CORT levels kept on increasing for T2 over the 34 days of daily thermal shocks. Furthermore, the magnitudes of the acute CORT responses or physiological endocrine sensitivity were consistently high for both C1 and T1. However, acute CORT responses for T2 toads were dramatically reduced between days 24 and 34. These novel findings

Geomechanical characterization of the Upper Carboniferous under thermal stress for the evaluation of a High Temperature - Mine Thermal Energy Storage (HT-MTES)

NASA Astrophysics Data System (ADS)

Hahn, Florian; Brüggemann, Nina; Bracke, Rolf; Alber, Michael

2017-04-01

The goal of this R&D project is to create a technically and economically feasible conceptual model for a High Temperature - Mine Thermal Energy Storage (HT-MTES) for the energetic reuse of a mine on the example of the Prosper-Haniel coal mine in Bottrop, Germany. This project is funded by the "Initiative Energy Storage" program of the German Federal Ministries BMWi, BMU and BMBF. At the end of 2018, the last operative coal mine in North Rhine-Westphalia, Germany (Prosper-Haniel), is going to be closed down, plugged and abandoned. Large amounts of subsurface infrastructures, resembled mainly by open parts of former galleries and mining faces are going to be flooded, after the mine is closed down and therefore have the potential to become an enormous geothermal reservoir for a seasonal heat storage. During the summer non-used (waste) heat from solar thermal power plants, garbage incineration, combined heat and power plants (CHP) or industrial production processes can be stored within dedicated drifts of the mine. During the winter season, this surplus heat can be extracted and directly utilized in commercial and/or residential areas. For the evaluation of such a HT-MTES within a former coal mine, the corresponding geomechanical parameters of the Upper Carboniferous under thermal stress needs to be evaluated. Therefore the main rock types of the Upper Carboniferous (claystone, siltstone and sandstone) are subject to a geomechanical characterization before and after thermal cyclic loadings of temperatures up to 200 °C. The samples have been collected directly from the coal mine Prosper-Haniel within a depth range of 1000 - 1200 m. Unconfined compressive and tensile strengths, as well as triaxial tests were performed at room temperature. Furthermore, a range of petrophysical properties like density, thin-section analysis and P-wave velocities were determined. First results show an indication that the overall strength properties of the samples are not effected by

Emergency readmission following acute upper gastrointestinal bleeding.

PubMed

Strömdahl, Martin; Helgeson, Johan; Kalaitzakis, Evangelos

2017-01-01

To assess the occurrence, clinical predictors, and associated mortality of all-cause emergency readmissions after acute upper gastrointestinal bleeding (AUGIB). All patients with AUGIB from an area of 600 000 inhabitants in Sweden admitted in a single institution in 2009-2011 were retrospectively identified. All medical records were scrutinized and relevant data (such as comorbid illness and medications, endoscopy, rebleeding, inhospital mortality, and 30-day emergency readmission) were extracted. The Charlson comorbidity index was calculated. A total of 174 out of 1056 patients discharged alive following AUGIB (16.5%) had an emergency readmission within 30 days. Nineteen percent of readmissions were because of rebleeding, whereas the rest were because of other reasons, mainly bacterial infections (9.8%) and cardiovascular events (8%). Inhospital mortality did not differ significantly between index admissions and readmissions (13.7 vs. 9.8%, P=0.181). In logistic regression analysis, only a higher Charlson comorbidity index [odds ratio (OR): 1.154, 95% confidence interval (CI): 1.056-1.261] was related to emergency readmission. Bisphosphonate use (OR: 3.933, 95% CI: 1.264-12.233), previous AUGIB (OR: 2.407, 95% CI: 1.157-5.009), and length of stay at index admission (>5 days; OR: 0.246, 95% CI: 0.093-0.649) were found to be independent predictors of postdischarge rebleeding. All-cause emergency readmission following AUGIB is frequent. It is related to rebleeding in one-fifth of cases and mortality is similar to that in index admissions. The presence of comorbid illness appears to predict readmissions. Reduced length of stay and bisphosphonate use appear to be important, potentially modifiable, predictors of postdischarge rebleeding.

Fluid inclusions and biomarkers in the Upper Mississippi Valley zinc-lead district; implications for the fluid-flow and thermal history of the Illinois Basin

USGS Publications Warehouse

Rowan, E. Lanier; Goldhaber, Martin B.

1996-01-01

The Upper Mississippi Valley zinc-lead district is hosted by Ordovician carbonate rocks at the northern margin of the Illinois Basin. Fluid inclusion temperature measurements on Early Permian sphalerite ore from the district are predominantly between 90?C and I50?C. These temperatures are greater than can be explained by their reconstructed burial depth, which was a maximum of approximately 1 km at the time of mineralization. In contrast to the temperatures of mineral formation derived from fluid inclusions, biomarker maturities in the Upper Mississippi Valley district give an estimate of total thermal exposure integrated over time. Temperatures from fluid inclusions trapped during ore genesis with biomarker maturities were combined to construct an estimate of the district's overall thermal history and, by inference, the late Paleozoic thermal and hydrologic history of the Illinois Basin. Circulation of groundwater through regional aquifers, given sufficient flow rates, can redistribute heat from deep in a sedimentary basin to its shallower margins. Evidence for regional-scale circulation of fluids is provided by paleomagnetic studies, regionally correlated zoned dolomite, fluid inclusions, and thermal maturity of organic matter. Evidence for igneous acti vity contemporaneous with mineralization in the vicinity of the Upper Mississippi Valley district is absent. Regional fluid and heat circulation is the most likely explanation for the elevated fluid inclusion temperatures (relative to maximum estimated burial depth) in the Upper Mississippi Valley district. One plausible driving mechanism and flow path for the ore-forming fluids is groundwater recharge in the late Paleozoic Appalachian-Ouachita mountain belt and northward flow through the Reelfoot rift and the proto- Illinois Basin to the Upper Mississippi Valley district. Warm fluid flowing laterally through Cambrian and Ordovician aquifers would then move vertically upward through the fractures that control

3D structure and conductive thermal field of the Upper Rhine Graben

NASA Astrophysics Data System (ADS)

Freymark, Jessica; Sippel, Judith; Scheck-Wenderoth, Magdalena; Bär, Kristian; Stiller, Manfred; Fritsche, Johann-Gerhard; Kracht, Matthias

2016-04-01

The Upper Rhine Graben (URG) was formed as part of the European Cenozoic Rift System in a complex extensional setting. At present-day, it has a large socioeconomic relevance as it provides a great potential for geothermal energy production in Germany and France. For the utilisation of this energy resource it is crucial to understand the structure and the observed temperature anomalies in the rift basin. In the framework of the EU-funded "IMAGE" project (Integrated Methods for Advanced Geothermal Exploration), we apply a data-driven numerical modelling approach to quantify the processes and properties controlling the spatial distribution of subsurface temperatures. Typically, reservoir-scale numerical models are developed for predictions on the subsurface hydrothermal conditions and for reducing the risk of drilling non-productive geothermal wells. One major problem related to such models is setting appropriate boundary conditions that define, for instance, how much heat enters the reservoir from greater depths. Therefore, we first build a regional lithospheric-scale 3D structural model, which covers not only the entire URG but also adjacent geological features like the Black Forest and the Vosges Mountains. In particular, we use a multidisciplinary dataset (e.g. well data, seismic reflection data, existing structural models, gravity) to construct the geometries of the sediments, the crust and the lithospheric mantle that control the spatial distribution of thermal conductivity and radiogenic heat production and hence temperatures. By applying a data-based and lithology-dependent parameterisation of this lithospheric-scale 3D structural model and a 3D finite element method, we calculate the steady-state conductive thermal field for the entire region. Available measured temperatures (down to depths of up to 5 km) are considered to validate the 3D thermal model. We present major characteristics of the lithospheric-scale 3D structural model and results of the 3D

Antibiotic Prescribing for Nonbacterial Acute Upper Respiratory Infections in Elderly Persons.

PubMed

Silverman, Michael; Povitz, Marcus; Sontrop, Jessica M; Li, Lihua; Richard, Lucie; Cejic, Sonny; Shariff, Salimah Z

2017-06-06

Reducing inappropriate antibiotic prescribing for acute upper respiratory tract infections (AURIs) requires a better understanding of the factors associated with this practice. To determine the prevalence of antibiotic prescribing for nonbacterial AURIs and whether prescribing rates varied by physician characteristics. Retrospective analysis of linked administrative health care data. Primary care physician practices in Ontario, Canada (January-December 2012). Patients aged 66 years or older with nonbacterial AURIs. Patients with cancer or immunosuppressive conditions and residents of long-term care homes were excluded. Antibiotic prescriptions for physician-diagnosed AURIs. A multivariable logistic regression model with generalized estimating equations was used to examine whether prescribing rates varied by physician characteristics, accounting for clustering of patients among physicians and adjusting for patient-level covariates. The cohort included 8990 primary care physicians and 185 014 patients who presented with a nonbacterial AURI, including the common cold (53.4%), acute bronchitis (31.3%), acute sinusitis (13.6%), or acute laryngitis (1.6%). Forty-six percent of patients received an antibiotic prescription; most prescriptions were for broad-spectrum agents (69.9% [95% CI, 69.6% to 70.2%]). Patients were more likely to receive prescriptions from mid- and late-career physicians than early-career physicians (rate difference, 5.1 percentage points [CI, 3.9 to 6.4 percentage points] and 4.6 percentage points [CI, 3.3 to 5.8 percentage points], respectively), from physicians trained outside of Canada or the United States (3.6 percentage points [CI, 2.5 to 4.6 percentage points]), and from physicians who saw 25 to 44 patients per day or 45 or more patients per day than those who saw fewer than 25 patients per day (3.1 percentage points [CI, 2.1 to 4.0 percentage points] and 4.1 percentage points [CI, 2.7 to 5.5 percentage points], respectively). Physician

Importance of viruses in acute otitis media.

PubMed

Nokso-Koivisto, Johanna; Marom, Tal; Chonmaitree, Tasnee

2015-02-01

Acute otitis media occurs as a complication of viral upper respiratory tract infection. Bacterial otopathogens and respiratory viruses interact and play important roles in acute otitis media development. A better understanding of viral and bacterial interactions may lead to innovative ways to lessen the burden of this common childhood disease. There has been increasing evidence that acute otitis media occurs during upper respiratory infection, even in the absence of nasopharyngeal bacterial colonization. Among the types of viruses associated with acute otitis media, respiratory syncytial virus continues to be the most commonly detected. It is still unclear whether viral load plays an important role in acute otitis media development, but symptomatic upper respiratory tract infection (as opposed to asymptomatic viral infection) is crucial. Widespread use of bacterial and viral vaccines in young children, including pneumococcal conjugate and influenza vaccines, has led to the reduction in otitis media-related healthcare use between 2001 and 2011. There has been no new vaccine against respiratory viruses other than influenza. Progress has been made toward the reduction of the burden of acute otitis media in the last decade. Success in reducing acute otitis media incidence will rely mainly on prevention of nasopharyngeal otopathogen colonization, as well as reduction in the incidence of viral upper respiratory tract infection.

Solar Thermal Upper Stage Liquid Hydrogen Pressure Control Testing and Analytical Modeling

NASA Technical Reports Server (NTRS)

Olsen, A. D.; Cady, E. C.; Jenkins, D. S.; Chandler, F. O.; Grayson, G. D.; Lopez, A.; Hastings, L. J.; Flachbart, R. H.; Pedersen, K. W.

2012-01-01

The demonstration of a unique liquid hydrogen (LH2) storage and feed system concept for solar thermal upper stage was cooperatively accomplished by a Boeing/NASA Marshall Space Flight Center team. The strategy was to balance thermodynamic venting with the engine thrusting timeline during a representative 30-day mission, thereby, assuring no vent losses. Using a 2 cubic m (71 cubic ft) LH2 tank, proof-of-concept testing consisted of an engineering checkout followed by a 30-day mission simulation. The data were used to anchor a combination of standard analyses and computational fluid dynamics (CFD) modeling. Dependence on orbital testing has been incrementally reduced as CFD codes, combined with standard modeling, continue to be challenged with test data such as this.

Heat shock response and metabolic stress in the tropical estuarine copepod Pseudodiaptomus annandalei converge at its upper thermal optimum.

PubMed

Low, Joyce S Y; Chew, Li Lee; Ng, Ching Ching; Goh, Hao Chin; Lehette, Pascal; Chong, Ving Ching

2018-05-01

Heat shock response (HSR), in terms of transcription regulation of two heat shock proteins genes hsp70 and hsp90), was analysed in a widespread tropical copepod Pseudodiaptomus annandalei. The mRNA transcripts of both genes were quantified after copepods at a salinity of 20 underwent an acclimation process involving an initial acclimation temperature of 29 °C, followed by gradual thermal ramping to the target exposure temperature range of 24-36 °C. The respective cellular HSR and organismal metabolism, measured by respiratory activity at exposure temperatures, were compared. The fold change in mRNA expression for both hsp70 and hsp90 (8-9 fold) peaks at 32 °C, which is very close to 32.4 °C, the upper thermal optimum for respiration in the species. Unexpectedly, the modelled HSR curves peak at only 3 °C (hsp90) and 3.5 °C (hsp70) above the mean water temperature (29.32 °C) of the copepod in the field. We propose that copepods in tropical waters adopt a preparative HSR strategy, early at the upper limit of its thermal optimum, due to the narrow thermal range of its habitat thus precluding substantial energy demand at higher temperatures. However, the model suggests that the species could survive to at least 36 °C with short acclimation time. Nevertheless, the significant overlap between its thermal range of hsp synthesis and the narrow temperature range of its habitat also suggests that any unprecedented rise in sea temperature would have a detrimental effect on the species. Copyright © 2018 Elsevier Ltd. All rights reserved.

Conodont color alteration index and upper Paleozoic thermal history of the Amazonas Basin, Brazil

NASA Astrophysics Data System (ADS)

Cardoso, Cassiane Negreiros; Sanz-López, Javier; Blanco-Ferrera, Silvia; Lemos, Valesca Brasil; Scomazzon, Ana Karina

2015-12-01

The conodont color alteration index (CAI) was determined in elements from core samples of the Frasnian Barreirinha Formation (one well) and of the Pennsylvanian-Permian Tapajós Group (twenty three wells and one limestone quarry) in the Amazonas Basin. The thermal history of the basin is analyzed using the CAI value distribution represented in maps and stratigraphic sections through correlation schemes, and in conjunction with previously published data. The pattern of palaeotemperatures for CAI values of 1.5-3 is coincident with organic matter maturation under a sedimentary overburden providing diagenetic conditions in the oil/gas window. Locally, conodonts show metamorphism (CAI value of 6-7) in relation to the intrusion of diabase bodies in beds including high geothermal gradient evaporites. Microtextural alteration on the surface conodonts commonly shows several types of overgrowth microtextures developed in diagenetic conditions. Locally, recrystallization in conodonts with a high CAI value is congruent with contact metamorphism in relation to Mesozoic intrusions. The CAI values of 1.5 or 2 observed close to the surface in several areas of the basin may be interpreted in relation to a high thermal palaeogradient derived from the magmatic episode or/and to the local denudation of the upper part of the Paleozoic succession prior to this thermal event.

Telemetric real-time sensor for the detection of acute upper gastrointestinal bleeding.

PubMed

Schostek, Sebastian; Zimmermann, Melanie; Keller, Jan; Fode, Mario; Melbert, Michael; Schurr, Marc O; Gottwald, Thomas; Prosst, Ruediger L

2016-04-15

Acute upper gastrointestinal bleedings from ulcers or esophago-gastric varices are life threatening medical conditions which require immediate endoscopic therapy. Despite successful endoscopic hemostasis, there is a significant risk of rebleeding often requiring close surveillance of these patients in the intensive care unit (ICU). Any time delay to recognize bleeding may lead to a high blood loss and increases the risk of death. A novel telemetric real-time bleeding sensor can help indicate blood in the stomach: the sensor is swallowed to detect active bleeding or is anchored endoscopically on the gastrointestinal wall close to the potential bleeding source. By telemetric communication with an extra-corporeal receiver, information about the bleeding status is displayed. In this study the novel sensor, which measures characteristic optical properties of blood, has been evaluated in an ex-vivo setting to assess its clinical applicability and usability. Human venous blood of different concentrations, various fluids, and liquid food were tested. The LED-based sensor was able to reliably distinguish between concentrated blood and other liquids, especially red-colored fluids. In addition, the spectrometric quality of the small sensor (size: 6.5mm in diameter, 25.5mm in length) was comparable to a much larger and technically more complex laboratory spectrophotometer. The experimental data confirm the capability of a miniaturized sensor to identify concentrated blood, which could help in the very near future the detection of upper gastrointestinal bleeding and to survey high-risk patients for rebleeding. Copyright © 2015 Elsevier B.V. All rights reserved.

Prevention of neural hypersensitivity after acute upper limb burns: Development and pilot of a cortical training protocol.

PubMed

Edgar, Dale; Zorzi, Lisa M; Wand, Ben M; Brockman, Nathalie; Griggs, Carolyn; Clifford, Matthew; Wood, Fiona

2011-06-01

Acute burn patients suffer pain and secondary hyperalgesia. This alters movement patterns and impairs function. Non-pharmacological methods of treatment are limited and lack rigorous testing and evidence for use. The treatment in this case series was designed to direct conscious attention to, and normalise sensation of, the injured limb in pain free way. The aim of the study was to describe a cortical training programme (CTP) in acute upper limb burn patients and to investigate the efficacy, safety and feasibility of the protocol. The study is a descriptive case series (n=6). Study tasks engaged sensory and motor nerves to influence the perception of the injured area. Visual and tactile inputs to maintain and, or normalise the homuncular map were central to the intervention. One patient, who commenced the study without resting pain, responded negatively. The remaining five patients had reduced pain and fear avoidance behaviours with associated improvement in arm function. The CTP approach is safe and feasible for use with acute burn patients where pain is reported at rest. Comparative studies are required to determine the relative efficacy of the program to usual interventions and the patients who may benefit from the technique. Copyright © 2011 Elsevier Ltd and ISBI. All rights reserved.

Effectiveness of multifaceted interventions on rational use of antibiotics for patients with upper respiratory tract infections and acute diarrhea.

PubMed

Boonyasiri, Adhiratha; Thamlikitkul, Visanu

2014-03-01

To implement multifaceted interventions to promote rational use of antibiotics for out-patients with upper respiratory tract infection (URI) and acute diarrhea. The present study was conducted at ambulatory care facility for patients under Social Security Healthcare Benefit Scheme and Universal Health Coverage Scheme of Siriraj Hospital from January to April 2012. Multifaceted interventions were: Training responsible healthcare personnel on rational use of antibiotics, Clinical practice guidelines, Preprinted medical record forms for patients, Throat swab or stool culture to be taken from the patients (if responsible physicians needed these); and provision of brochures containing causes, necessity and harm of antibiotics for URI and acute diarrhea to patients as well as their relatives while waiting for receiving care. Pre-printed medical records were collected every day. Each patient was called on day 3 after receiving care by an investigator to determine clinical responses. There were 1,241 episodes of URI and 210 episodes of acute diarrhea during the study period. Rates of antibiotic prescriptions were 13.0% for URI and 19.1% for acute diarrhea. Throat swab cultures recovered group A beta-hemolytic streptococci in 3.8% of URI patients and non-typhoidal Salmonella spp. in 14.6% of acute diarrhea patients. Clinical responses of the patients on day 3 after receiving care revealed that more than 97% of the patients who received antibiotics and who did not receive antibiotics were cured or improved. Multifaceted interventions are very effective for promoting rational use of antibiotics for out-patients with URI and acute diarrhea at Siriraj Hospital.

Robotic upper limb rehabilitation after acute stroke by NeReBot: evaluation of treatment costs.

PubMed

Stefano, Masiero; Patrizia, Poli; Mario, Armani; Ferlini, Gregorio; Rizzello, Roberto; Rosati, Giulio

2014-01-01

Stroke is the first cause of disability. Several robotic devices have been developed for stroke rehabilitation. Robot therapy by NeReBot is demonstrated to be an effective tool for the treatment of poststroke paretic upper limbs, able to improve the activities of daily living of stroke survivors when used both as additional treatment and in partial substitution of conventional rehabilitation therapy in the acute and subacute phases poststroke. This study presents the evaluation of the costs related to delivering such therapy, in comparison with conventional rehabilitation treatment. By comparing several NeReBot treatment protocols, made of different combinations of robotic and nonrobotic exercises, we show that robotic technology can be a valuable and economically sustainable aid in the management of poststroke patient rehabilitation.

Comparison of treatment effect of neuromuscular electrical stimulation and thermal-tactile stimulation on patients with sub-acute dysphagia caused by stroke.

PubMed

Byeon, Haewon; Koh, Hyeung Woo

2016-06-01

[Purpose] The effectiveness of neuromuscular electrical stimulation in the rehabilitation of swallowing remains controversial. This study compared the effectiveness of neuromuscular electrical stimulation and thermal tactile oral stimulation, a traditional swallowing recovery treatment, in patients with sub-acute dysphagia caused by stroke. [Subjects and Methods] Subjects of the present study were 55 patients diagnosed with dysphagia caused by stroke. This study had a nonequivalent control group pretest-posttest design. [Results] Analysis of pre-post values of videofluoroscopic studies of the neuromuscular electrical stimulation and thermal tactile oral stimulation groups using a paired t-test showed no significant difference between the two groups despite both having decreased mean values of the videofluoroscopic studies after treatment. [Conclusion] This study's findings show that both neuromuscular electrical stimulation and thermal tactile oral stimulation significantly enhanced the swallowing function of patients with sub-acute dysphagia.

Comparison of treatment effect of neuromuscular electrical stimulation and thermal-tactile stimulation on patients with sub-acute dysphagia caused by stroke

PubMed Central

Byeon, Haewon; Koh, Hyeung Woo

2016-01-01

[Purpose] The effectiveness of neuromuscular electrical stimulation in the rehabilitation of swallowing remains controversial. This study compared the effectiveness of neuromuscular electrical stimulation and thermal tactile oral stimulation, a traditional swallowing recovery treatment, in patients with sub-acute dysphagia caused by stroke. [Subjects and Methods] Subjects of the present study were 55 patients diagnosed with dysphagia caused by stroke. This study had a nonequivalent control group pretest-posttest design. [Results] Analysis of pre-post values of videofluoroscopic studies of the neuromuscular electrical stimulation and thermal tactile oral stimulation groups using a paired t-test showed no significant difference between the two groups despite both having decreased mean values of the videofluoroscopic studies after treatment. [Conclusion] This study’s findings show that both neuromuscular electrical stimulation and thermal tactile oral stimulation significantly enhanced the swallowing function of patients with sub-acute dysphagia. PMID:27390421

Restrictive versus liberal blood transfusion for acute upper gastrointestinal bleeding (TRIGGER): a pragmatic, open-label, cluster randomised feasibility trial.

PubMed

Jairath, Vipul; Kahan, Brennan C; Gray, Alasdair; Doré, Caroline J; Mora, Ana; James, Martin W; Stanley, Adrian J; Everett, Simon M; Bailey, Adam A; Dallal, Helen; Greenaway, John; Le Jeune, Ivan; Darwent, Melanie; Church, Nicholas; Reckless, Ian; Hodge, Renate; Dyer, Claire; Meredith, Sarah; Llewelyn, Charlotte; Palmer, Kelvin R; Logan, Richard F; Travis, Simon P; Walsh, Timothy S; Murphy, Michael F

2015-07-11

Transfusion thresholds for acute upper gastrointestinal bleeding are controversial. So far, only three small, underpowered studies and one single-centre trial have been done. Findings from the single-centre trial showed reduced mortality with restrictive red blood cell (RBC) transfusion. We aimed to assess whether a multicentre, cluster randomised trial is a feasible method to substantiate or refute this finding. In this pragmatic, open-label, cluster randomised feasibility trial, done in six university hospitals in the UK, we enrolled all patients aged 18 years or older with new presentations of acute upper gastrointestinal bleeding, irrespective of comorbidity, except for exsanguinating haemorrhage. We randomly assigned hospitals (1:1) with a computer-generated randomisation sequence (random permuted block size of 6, without stratification or matching) to either a restrictive (transfusion when haemoglobin concentration fell below 80 g/L) or liberal (transfusion when haemoglobin concentration fell below 100 g/L) RBC transfusion policy. Neither patients nor investigators were masked to treatment allocation. Feasibility outcomes were recruitment rate, protocol adherence, haemoglobin concentration, RBC exposure, selection bias, and information to guide design and economic evaluation of the phase 3 trial. Main exploratory clinical outcomes were further bleeding and mortality at day 28. We did analyses on all enrolled patients for whom an outcome was available. This trial is registered, ISRCTN85757829 and NCT02105532. Between Sept 3, 2012, and March 1, 2013, we enrolled 936 patients across six hospitals (403 patients in three hospitals with a restrictive policy and 533 patients in three hospitals with a liberal policy). Recruitment rate was significantly higher for the liberal than for the restrictive policy (62% vs 55%; p=0·04). Despite some baseline imbalances, Rockall and Blatchford risk scores were identical between policies. Protocol adherence was 96% (SD 10) in

Human thermal bioclimatic conditions associated with acute cardiovascular syndromes in Crete Island, Greece

NASA Astrophysics Data System (ADS)

Bleta, Anastasia G.; Nastos, Panagiotis T.

2013-04-01

The aim of this study is to quantify the association between bioclimatic conditions and daily counts of admissions for non-fatal acute cardiovascular (acute coronary syndrome, arrhythmia, decompensation of heart failure) syndromes (ACS) registered by the two main hospitals in Heraklion, Crete Island, during a five-year period 2008-2012. The bioclimatic conditions analyzed are based on human thermal bioclimatic indices such as the Physiological Equivalent Temperature (PET) and the Universal Thermal Climate Index (UTCI). Mean daily meteorological parameters, such as air temperature, relative humidity, wind speed and cloudiness, were acquired from the meteorological station of Heraklion (Hellenic National Meteorological Service). These parameters were used as input variables in modeling the aforementioned thermal indices, in order to interpret the grade of the thermo-physiological stress. The PET and UTCI analysis was performed by the use of the radiation and bioclimate model, "RayMan", which is well-suited to calculate radiation fluxes and human biometeorological indices. Generalized linear models (GLM) were applied to time series of daily numbers of outpatients with ACS against bioclimatic variations, after controlling for possible confounders and adjustment for season and trends. The interpretation of the results of this analysis suggests a significant association between cold weather and increased coronary heart disease incidence, especially in the elderly and males. Additionally, heat stress plays an important role in the configuration of daily ACS outpatients, even in temperate climate, as that in Crete Island. In this point it is worth mentioning that Crete Island is frequently affected by Saharan outbreaks, which are associated in many cases with miscellaneous phenomena, such as Föhn winds - hot and dry winds - causing extreme bioclimatic conditions (strong heat stress). Taking into consideration the projected increased ambient temperature in the future, ACS

Thermal and mechanical structure of the upper mantle: A comparison between continental and oceanic models

NASA Technical Reports Server (NTRS)

Froidevaux, C.; Schubert, G.; Yuen, D. A.

1976-01-01

Temperature, velocity, and viscosity profiles for coupled thermal and mechanical models of the upper mantle beneath continental shields and old ocean basins show that under the continents, both tectonic plates and the asthenosphere, are thicker than they are beneath the oceans. The minimum value of viscosity in the continental asthenosphere is about an order of magnitude larger than in the shear zone beneath oceans. The shear stress or drag underneath continental plates is also approximately an order of magnitude larger than the drag on oceanic plates. Effects of shear heating may account for flattening of ocean floor topography and heat flux in old ocean basins.

Upper Limits for Power Yield in Thermal, Chemical, and Electrochemical Systems

NASA Astrophysics Data System (ADS)

Sieniutycz, Stanislaw

2010-03-01

We consider modeling and power optimization of energy converters, such as thermal, solar and chemical engines and fuel cells. Thermodynamic principles lead to expressions for converter's efficiency and generated power. Efficiency equations serve to solve the problems of upgrading or downgrading a resource. Power yield is a cumulative effect in a system consisting of a resource, engines, and an infinite bath. While optimization of steady state systems requires using the differential calculus and Lagrange multipliers, dynamic optimization involves variational calculus and dynamic programming. The primary result of static optimization is the upper limit of power, whereas that of dynamic optimization is a finite-rate counterpart of classical reversible work (exergy). The latter quantity depends on the end state coordinates and a dissipation index, h, which is the Hamiltonian of the problem of minimum entropy production. In reacting systems, an active part of chemical affinity constitutes a major component of the overall efficiency. The theory is also applied to fuel cells regarded as electrochemical flow engines. Enhanced bounds on power yield follow, which are stronger than those predicted by the reversible work potential.

Acute Effects of Static Stretching, Dynamic Exercises, and High Volume Upper Extremity Plyometric Activity on Tennis Serve Performance

PubMed Central

Gelen, Ertugrul; Dede, Muhittin; Bingul, Bergun Meric; Bulgan, Cigdem; Aydin, Mensure

2012-01-01

The purpose of this study was to compare the acute effects of static stretching; dynamic exercises and high volume upper extremity plyometric activity on tennis serve performance. Twenty-six elite young tennis players (15.1 ± 4.2 years, 167.9 ± 5.8 cm and 61.6 ± 8.1 kg) performed 4 different warm-up (WU) routines in a random order on non-consecutive days. The WU methods consisted of traditional WU (jogging, rally and serve practice) (TRAD); traditional WU and static stretching (TRSS); traditional WU and dynamic exercise (TRDE); and traditional WU and high volume upper extremity plyometric activity (TRPLYP). Following each WU session, subjects were tested on a tennis serve ball speed test. TRAD, TRSS, TRDE and TRPLYO were compared by repeated measurement analyses of variance and post-hoc comparisons. In this study a 1 to 3 percent increase in tennis serve ball speed was recorded in TRDE and TRPLYO when compared to TRAD (p< 0.05). However, no significant change in ball speed performance between TRSS and TRAD. (p> 0.05). ICCs for ball speed showed strong reliability (0.82 to 0.93) for the ball speed measurements.The results of this study indicate that dynamic and high volume upper extremity plyometric WU activities are likely beneficial to serve speed of elite junior tennis players. Key points After the traditional warm up in tennis, static stretching has no effect on serve speed. Tennis players should perform dynamic exercises and/or high volume upper extremity plyometric activities to improve their athletic performance. PMID:24150068

The thermal regimes of the upper mantle beneath Precambrian and Phanerozoic structures up to the thermobarometry data of mantle xenoliths

NASA Astrophysics Data System (ADS)

Glebovitsky, V. A.; Nikitina, L. P.; Khiltova, V. Ya.; Ovchinnikov, N. O.

2004-05-01

The thermal state of the upper mantle beneath tectonic structures of various ages and types (Archaean cratons, Early Proterozoic accretionary and collisional orogens, and Phanerozoic structures) is characterized by geotherms and by thermal gradients (TG) derived from data on the P- T conditions of mineral equilibria in garnet and garnet-spinel peridotite xenoliths from kimberlites (East Siberia, Northeastern Europe, India, Central Africa, North America, and Canada) and alkali basalts (Southeastern Siberia, Mongolia, southeastern China, southeastern Australia, Central Africa, South America, and the Solomon and Hawaiian islands). The use of the same garnet-orthopyroxene thermobarometer (Theophrastus Contributions to Advanced Studies in Geology. 3: Capricious Earth: Models and Modelling of Geologic Processes and Objects 2000 44) for all xenoliths allowed us to avoid discrepancies in estimation of the P- T conditions, which may be a result of the mismatch between different thermometers and barometers, and to compare the thermal regimes in the mantle in various regions. Thus, it was established that (1) mantle geotherms and geothermal gradients, obtained from the estimation of P- T equilibrium conditions of deep xenoliths, correspond to the age of crust tectonic structures and respectively to the time of lithosphere stabilization; it can be suggested that the ancient structures of the upper mantle were preserved within continental roots; (2) thermal regimes under continental mantle between the Archaean cratons and Palaeoproterozoic belts are different today; (3) the continental mantle under Neoproterozoic and Phanerozoic belts is characterized by significantly higher values of geothermal gradient compared to the mantle under Early Precambrian structures; (4) lithosphere dynamics seems to change at the boundary between Early and Mezo-Neoproterozoic and Precambrian and Phanerozoic.

Solar thermal upper stage technology demonstrator liquid hydrogen storage and feed system test program

NASA Astrophysics Data System (ADS)

Cady, E. C.

1997-01-01

The Solar Thermal Upper Stage Technology Demonstrator (STUSTD) Liquid Hydrogen Storage and Feed System (LHSFS) Test Program is described. The test program consists of two principal phases. First, an engineering characterization phase includes tests performed to demonstrate and understand the expected tank performance. This includes fill and drain; baseline heat leak; active Thermodynamic Vent System (TVS); and flow tests. After the LHSFS performance is understood and performance characteristics are determined, a 30 day mission simulation test will be conducted. This test will simulate a 30 day transfer mission from low earth orbit (LEO) to geosynchronous equatorial orbit (GEO). Mission performance predictions, based on the results of the engineering characterization tests, will be used to correlate the results of the 30 day mission simulation.

TMI-2 upper-core particle bed thermal behavior

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kuan, P.

1987-08-01

Models of dryout heat fluxes of particle beds believed to be applicable to the TMI-2 upper-core particle bed are reviewed and developed. A simplified Lipinski model and a model based on flooding are shown to agree between themselves and with experiments. These models are applied to the calculation of the dryout heat flux of the TMI-2 upper-core particle bed. The TMI-2 upper-core particle bed is shown to be: (a) coolable, if little heat is transferred to it from the consolidated region below, (b) only marginally coolable, if not uncoolable, before material relocation from the consolidated region, if most of themore » heat in the consolidiated region is transferred to it, and (c) coolable, after the relocation, regardless of heat transfer from the remaining consolidated region. Based on an analogy to quenching experiments, which show that the heat flux during the quench of a particle bed is approximately equal to the dryout heat flux, the time required to quench the TMI-2 upper-core particle bed from 2000 K to the saturation temperature of water during the accident is estimated. The bed was either quenched by 225 min after the initiation of the accident (assuming no heat was transferred to it from the consolidated region) or, at the latest, by 245 min (20 min after molten material relocation to the lower plenum from the consolidated region; assuming most of the heat generated in the consolidated region, both before and after the relocation, was transferred to the particle bed).« less

Kinematic measures for upper limb motor assessment during robot-mediated training in patients with severe sub-acute stroke.

PubMed

Duret, Christophe; Courtial, Ophélie; Grosmaire, Anne Gaelle

2016-01-01

Kinematic assessments are increasingly used as motor outcome measures during upper limb robot-assisted training, in addition to clinical scales. However, their relevance has not been evaluated much. Thirty-eight patients with severe sub-acute stroke (age 56 ± 17 [19-87] years; time since stroke, 55 ± 22 days) carried out 16 sessions (average 3/week, 35 ± 15 days) of upper limb robot-assisted training combined with standard therapy. Pre/post motor performance was evaluated using the Fugl-Meyer Assessment scale, Motor Status Scale (MSS) and kinematic measures. Motor outcomes were compared and relationships between clinical and kinematic outcomes were analyzed. All clinical and kinematic outcomes improved after training (p <  0.01). FM score increased from 17.7 ± 10.0 to 28.6 ± 15.4. All baseline kinematic measures were strongly correlated with clinical scores. Correlations between clinical and kinematic changes were moderate (r = -0.65 for change in FM Proximal score and change in accuracy measure). However, smoothness and accuracy indicators were shown to be responsive measures. This study demonstrated that baseline kinematic measures and their pre/post training changes were significantly correlated with clinical motor outcome measures. However, even if kinematic measures are valid for the evaluation of motor impairment we cannot propose to substitute common clinical measures of motor function which also evaluate functional abilities of the upper limb.

Influence of tramadol on acute thermal and mechanical cutaneous nociception in dogs.

PubMed

Schütter, Alexandra F; Tünsmeyer, Julia; Kästner, Sabine B R

2017-03-01

The aim of the study was to evaluate the influence of tramadol on acute nociception in dogs. Experimental, blinded, randomized, crossover study. Six healthy laboratory Beagle dogs. Dogs received three treatments intravenously (IV): isotonic saline placebo (P), tramadol 1 mg kg -1 (T1) and tramadol 4 mg kg -1 (T4). Thermal thresholds were determined by ramped contact heat stimulation (0.6 °C second -1 ) at the lateral thoracic wall. Mechanical thresholds (MT) were measured using a probe containing three blunted pins which were constantly advanced over the radial bone, using a rate of force increase of 0.8 N second -1 . Stimulation end points were defined responses (e.g. skin twitch, head turn, repositioning, vocalization) or pre-set cut-out values (55 °C, 20 N). Thresholds were determined before treatment and at predetermined time points up to 24 hours after treatment. At each measurement point, blood was collected for determination of O-desmethyltramadol concentrations. The degree of sedation and behavioural side effects were recorded. Data were analysed by one-way anova and two-way anova for repeated measurements. Thermal nociception was not influenced by drug treatment. Mechanical nociception was significantly increased between P and T1 at 120 and 240 minutes, and between P and T4 at 30, 60, 240 and 420 minutes. T1 and T4 did not differ. O-desmethyltramadol (M1) maximum plasma concentrations (C max ) were 4.2±0.8 ng mL -1 and 14.3±2.8 ng mL -1 for T1 and T4, respectively. Times to reach maximum plasma concentrations (T max ) were 27.6±6.3 minutes for T1 and 32.1±7.8 minutes for T4. No sedation occurred. There were signs of nausea and mild to moderate salivation in both groups. Tramadol was metabolized marginally to O-desmethyltramadol and failed to produce clinically relevant acute antinociception. Therefore, the use of tramadol for acute nociceptive pain is questionable in dogs. Copyright © 2017 Association of Veterinary Anaesthetists and

At the edge of the thermal window: effects of elevated temperature on the resting metabolism, hypoxia tolerance and upper critical thermal limit of a widespread African cichlid

PubMed Central

McDonnell, Laura H.; Chapman, Lauren J.

2015-01-01

Tropical inland fishes are predicted to be especially vulnerable to thermal stress because they experience small temperature fluctuations that may select for narrow thermal windows. In this study, we measured resting metabolic rate (RMR), critical oxygen tension (Pcrit) and critical thermal maximum (CTMax) of the widespread African cichlid (Pseudocrenilabrus multicolor victoriae) in response to short-term acclimation to temperatures within and above their natural thermal range. Pseudocrenilabrus multicolor collected in Lake Kayanja, Uganda, a population living near the upper thermal range of the species, were acclimated to 23, 26, 29 and 32°C for 3 days directly after capture, and RMR and Pcrit were then quantified. In a second group of P. multicolor from the same population, CTMax and the thermal onset of agitation were determined for fish acclimated to 26, 29 and 32°C for 7 days. Both RMR and Pcrit were significantly higher in fish acclimated to 32°C, indicating decreased tolerance to hypoxia and increased metabolic requirements at temperatures only slightly (∼1°C) above their natural thermal range. The CTMax increased with acclimation temperature, indicating some degree of thermal compensation induced by short-term exposure to higher temperatures. However, agitation temperature (likely to represent an avoidance response to increased temperature during CTMax trials) showed no increase with acclimation temperature. Overall, the results of this study demonstrate that P. multicolor is able to maintain its RMR and Pcrit across the range of temperatures characteristic of its natural habitat, but incurs a higher cost of resting metabolism and reduced hypoxia tolerance at temperatures slightly above its present range. PMID:27293734

[Bacterial culture and drug sensitivity analysis of upper urinary tract calculi complicating with infection].

PubMed

Wang, Shu; Shi, Yong-kang; Huang, Xiao-bo; Ma, Kai; Xu, Qing-quan; Xiong, Lin-lin; Li, Jian-xing; Wang, Xia-feng

2014-10-18

To investigate the bacteriology and drug sensitivity of upper urinary tract calculi patients, and to provide information for choosing suitable antibiotics. In the study, 21 patients who suffered from lithiasis in upper urinary tract and required an emergency drainage for acute obstruction and infection were the "acute group"; 64 patients with calculi in upper urinary tract and accompanied with no infectious symptoms were the "common group". The bacteriology and drug sensitivity of the two groups were investigated. Gram-negative bacteria infected the most common of upper urinary tract calculi patients with infection, accounting for 71.4% in the acute group and 65.7% in the common group, among which Escherichia coli were the predominant ones (35.7% in the acute group and 32.9% in the common group). No difference was found between these two groups in bacterial distribution (P>0.05). Although the average drug resistance rate of Gram-negative bacteria in the acute group was higher than that in the common group, it revealed no significant difference (P>0.05). The drug resistance rate to semisynthetic penicillin, cefuroxime and ceftriaxone were more than 50%, 60%, and 50%, respectively. Quinolones, such as ciprofloxacin and levofloxacin, got a 45% drug resistance. Aminoglycoside, carbapenema were sensitive to Gram-negative bacteria. Cefoperazone/sulbactam and piperacillin/tazobactam were more effective than ceftriaxone and piperacillin, respectively. There was no significant difference between upper urinary tract calculi patients with acute infection and common infection in bacteriology and drug sensitivity. Semisynthetic penicillin, the second generation of cephalosporin and quinolone were no longer the good choices of empirical use. Antibiotics combined with β-lactamase inhibitors would be an ideal empirical therapeutic choice.

Integrating both interaction pathways between warming and pesticide exposure on upper thermal tolerance in high- and low-latitude populations of an aquatic insect.

PubMed

Op de Beeck, Lin; Verheyen, Julie; Stoks, Robby

2017-05-01

Global warming and chemical pollution are key anthropogenic stressors with the potential to interact. While warming can change the impact of pollutants and pollutants can change the sensitivity to warming, both interaction pathways have never been integrated in a single experiment. Therefore, we tested the effects of warming and multiple pesticide pulses (allowing accumulation) of chlorpyrifos on upper thermal tolerance (CTmax) and associated physiological traits related to aerobic/anaerobic energy production in the damselfly Ischnura elegans. To also assess the role of latitude-specific thermal adaptation in shaping the impact of warming and pesticide exposure on thermal tolerance, we exposed larvae from replicated high- and low-latitude populations to the pesticide in a common garden rearing experiment at 20 and 24 °C, the mean summer water temperatures at high and low latitudes. As expected, exposure to chlorpyrifos resulted in a lower CTmax. Yet, this pesticide effect on CTmax was lower at 24 °C compared to 20 °C because of a lower accumulation of chlorpyrifos in the medium at 24 °C. The effects on CTmax could partly be explained by reduction of the aerobic scope. Given that these effects did not differ between latitudes, gradual thermal evolution is not expected to counteract the negative effect of the pesticide on thermal tolerance. By for the first time integrating both interaction pathways we were not only able to provide support for both of them, but more importantly demonstrate that they can directly affect each other. Indeed, the warming-induced reduction in pesticide impact generated a lower pesticide-induced climate change sensitivity (in terms of decreased upper thermal tolerance). Our results indicate that, assuming no increase in pesticide input, global warming might reduce the negative effect of multiple pulse exposures to pesticides on sensitivity to elevated temperatures. Copyright © 2016 Elsevier Ltd. All rights reserved.

Acute on chronic gastrointestinal bleeding: a unique clinical entity.

PubMed

Rockey, Don C; Hafemeister, Adam C; Reisch, Joan S

2017-06-01

Gastrointestinal bleeding is defined in temporal-spatial terms-as acute or chronic, and/or by its location in the gastrointestinal tract. Here, we define a distinct type of bleeding, which we have coined 'acute on chronic' gastrointestinal bleeding. We prospectively identified all patients who underwent endoscopic evaluation for any form of gastrointestinal bleeding at a University Hospital. Acute on chronic bleeding was defined as the presence of new symptoms or signs of acute bleeding in the setting of chronic bleeding, documented as iron deficiency anemia. Bleeding lesions were categorized using previously established criteria. We identified a total of 776, 254, and 430 patients with acute, chronic, or acute on chronic bleeding, respectively. In patients with acute on chronic gastrointestinal bleeding, lesions were most commonly identified in esophagus (28%), colon and rectum (27%), and stomach (21%) (p<0.0001 vs locations for acute or chronic bleeding). In those specifically with acute on chronic upper gastrointestinal bleeding (n=260), bleeding was most commonly due to portal hypertensive lesions, identified in 47% of subjects compared with 29% of acute and 25% of chronic bleeders, (p<0.001). In all patients with acute on chronic bleeding, 30-day mortality was less than that after acute bleeding alone (2% (10/430) vs 7% (54/776), respectively, p<0.001). Acute on chronic gastrointestinal bleeding is common, and in patients with upper gastrointestinal bleeding was most often a result of portal hypertensive upper gastrointestinal tract pathology. Reduced mortality in patients with acute on chronic gastrointestinal bleeding compared with those with acute bleeding raises the possibility of an adaptive response. Copyright © 2017 American Federation for Medical Research.

Initial Assessment and Resuscitation in Nonvariceal Upper Gastrointestinal Bleeding.

PubMed

Simon, Tracey G; Travis, Anne C; Saltzman, John R

2015-07-01

Acute nonvariceal upper gastrointestinal bleeding remains an important cause of hospital admission with an associated mortality of 2-14%. Initial patient evaluation includes rapid hemodynamic assessment, large-bore intravenous catheter insertion and volume resuscitation. A hemoglobin transfusion threshold of 7 g/dL is recommended, and packed red blood cell transfusion may be necessary to restore intravascular volume and improve tissue perfusion. Patients should be risk stratified into low- and high-risk categories, using validated prognostic scoring systems such as the Glasgow-Blatchford, AIMS65 or Rockall scores. Effective early management of acute, nonvariceal upper gastrointestinal hemorrhage is critical for improving patient outcomes. Copyright © 2015 Elsevier Inc. All rights reserved.

Parental knowledge, attitudes and antibiotic use for acute upper respiratory tract infection in children attending a primary healthcare clinic in Malaysia.

PubMed

Chan, G C; Tang, S F

2006-04-01

A study was carried out in a primary healthcare clinic in the Hulu Langat district of Malaysia to assess the parental knowledge, attitudes and antibiotic use for common childhood acute upper respiratory tract infection (URTI). A cross-sectional study involving 421 parents, who were surveyed by using an interviewer-administered questionnaire, from April to June 2001. Approximately 59 percent of parents from this study believed that weather was the main cause of acute URTI of their children, 13 percent thought it was due to food, and only about 27 percent said it was caused by germs. Nearly 68 percent, 69 percent and 76 percent of them believed that antibiotics was helpful in treating the common cold, cough and fever, respectively. 29 percent of parents who thought that their child with acute URTI needed antibiotics were not prescribed with any. On the other hand, 17 percent believed that antibiotics were unnecessary when prescribed. 28 percent of parents had requested for antibiotics, and 93 percent received what they requested for their child with acute URTI. About 31 percent of parents who did not request any antibiotics claimed that private general practitioners habitually prescribed antibiotics. The antibiotic compliance was poor with only 74 percent completing the entire course, with 85 percent of them stopping once they improved symptomatically. 15 percent of parents gave "leftover" antibiotics, 24 percent gave "shared" antibiotics, and 5.5 percent bought antibiotics for their child with acute URTI without consulting a doctor. This study shows that parents often have inadequate knowledge and misconceptions on antibiotic use for acute URTI in children. Improved parental education may reduce unnecessary antibiotic prescription and antimicrobial resistance in the community.

Rockall score in predicting outcomes of elderly patients with acute upper gastrointestinal bleeding

PubMed Central

Wang, Chang-Yuan; Qin, Jian; Wang, Jing; Sun, Chang-Yi; Cao, Tao; Zhu, Dan-Dan

2013-01-01

AIM: To validate the clinical Rockall score in predicting outcomes (rebleeding, surgery and mortality) in elderly patients with acute upper gastrointestinal bleeding (AUGIB). METHODS: A retrospective analysis was undertaken in 341 patients admitted to the emergency room and Intensive Care Unit of Xuanwu Hospital of Capital Medical University with non-variceal upper gastrointestinal bleeding. The Rockall scores were calculated, and the association between clinical Rockall scores and patient outcomes (rebleeding, surgery and mortality) was assessed. Based on the Rockall scores, patients were divided into three risk categories: low risk ≤ 3, moderate risk 3-4, high risk ≥ 4, and the percentages of rebleeding/death/surgery in each risk category were compared. The area under the receiver operating characteristic (ROC) curve was calculated to assess the validity of the Rockall system in predicting rebleeding, surgery and mortality of patients with AUGIB. RESULTS: A positive linear correlation between clinical Rockall scores and patient outcomes in terms of rebleeding, surgery and mortality was observed (r = 0.962, 0.955 and 0.946, respectively, P = 0.001). High clinical Rockall scores > 3 were associated with adverse outcomes (rebleeding, surgery and death). There was a significant correlation between high Rockall scores and the occurrence of rebleeding, surgery and mortality in the entire patient population (χ2 = 49.29, 23.10 and 27.64, respectively, P = 0.001). For rebleeding, the area under the ROC curve was 0.788 (95%CI: 0.726-0.849, P = 0.001); For surgery, the area under the ROC curve was 0.752 (95%CI: 0.679-0.825, P = 0.001) and for mortality, the area under the ROC curve was 0.787 (95%CI: 0.716-0.859, P = 0.001). CONCLUSION: The Rockall score is clinically useful, rapid and accurate in predicting rebleeding, surgery and mortality outcomes in elderly patients with AUGIB. PMID:23801840

Methods of Testing Thermal Insulation and Associated Test Apparatus

NASA Technical Reports Server (NTRS)

Fesmire, James E. (Inventor); Augustynowicz, Stanislaw D. (Inventor)

2004-01-01

The system and method for testing thermal insulation uses a cryostatic insulation tester having a vacuum chamber and a cold mass including a test chamber and upper and lower guard chambers adjacent thereto. The thermal insulation is positioned within the vacuum chamber and adjacent the cold mass. Cryogenic liquid is supplied to the test chamber, upper guard and lower guard to create a first gas layer in an upper portion of the lower guard chamber and a second gas layer in an upper portion of the test chamber. Temperature are sensed within the vacuum chamber to test the thermal insulation.

Does assist-as-needed upper limb robotic therapy promote participation in repetitive activity-based motor training in sub-acute stroke patients with severe paresis?

PubMed

Grosmaire, Anne-Gaëlle; Duret, Christophe

2017-01-01

Repetitive, active movement-based training promotes brain plasticity and motor recovery after stroke. Robotic therapy provides highly repetitive therapy that reduces motor impairment. However, the effect of assist-as-needed algorithms on patient participation and movement quality is not known. To analyze patient participation and motor performance during highly repetitive assist-as-needed upper limb robotic therapy in a retrospective study. Sixteen patients with sub-acute stroke carried out a 16-session upper limb robotic training program combined with usual care. The Fugl-Meyer Assessment (FMA) score was evaluated pre and post training. Robotic assistance parameters and Performance measures were compared within and across sessions. Robotic assistance did not change within-session and decreased between sessions during the training program. Motor performance did not decrease within-session and improved between sessions. Velocity-related assistance parameters improved more quickly than accuracy-related parameters. An assist-as-needed-based upper limb robotic training provided intense and repetitive rehabilitation and promoted patient participation and motor performance, facilitating motor recovery.

Upper respiratory tract infections in athletes.

PubMed

Page, Clifton L; Diehl, Jason J

2007-07-01

Upper respiratory tract infections (URTIs) represent the most common acute illnesses in the general population and account for the leading acute diagnoses in the outpatient setting. Given the athlete's expectation to return to activity as soon as possible, the sports medicine physician should be able to accurately diagnose and aggressively treat these illnesses. This article discusses the common pathogens, diagnosis, treatment options, and return-to-play decisions for URTIs, with a focus on the common cold, sinusitis, pharyngitis, and infectious mononucleosis in the athlete.

Thermal inertias in the upper millimeters of the Martian surace derived using Phobus' shadow

NASA Technical Reports Server (NTRS)

Betts, Bruce H.; Murray, Bruce C.; Svitek, Tomas

1995-01-01

The first thermal images of Phobos' shadow on the surface of Mars, in addition to simultaneous visible images, were obtained by the Phobus '88 Termoskan instrument. The best observed shadow occurence was on the flanks of Arsia Mons. For this occurence, we combined the observed decrease in visible illumination of the surface with the observed decrease in brightness temperature to calculate thermal inertias of the Martian surface. The most realistic of our three models of eclipse cooling improves upon our preliminary model by including nonisothermal initial conditions and downward atmospheric flux. Most of our derived inertias fall within the range 38 to 59 J/Sq m/S(exp 0.5)K (0.9 to 1.4 10(exp -3)Cal/Sq m/S(exp 0.5)/K), corresponding to dust-sized particles (for a homogeneous surface), consistent with previous theories of Tharsis as a currrent area of dust deposition. Viking infrared thermal mapper (IRTM) inertias are diurnally derived and are sensitive to centimeter depths, whereas the shadow-derived inertias sample the upper tenths of a millimeter of the surface. The shadow-derived inertias are lower than those derived from Viking IRTM measurements (84 to 147), however, uncertainties in both sets of derived inertias make conclusions about layering tenuous. Thus, near-surface millimeter versus centimeter layering may exist in this region, but if it does, it is likely not very significant. Both eclipse and diurnal inertias appear to increase near the eastern end of the shadow occurence. We also analyzed a shadow occurence near the crater Herschel that showed no observed cooling. This analysis was limited by cool morning temperatures and instrument sensitivity, but yielded a lower bound of 80 on eclipse inertias in that region. Based upon our results, we strongly recommend future spacecraft thermal observations of Phobus' shadow, and suggest that they will be most useful if they improve upon Termoskan's geographic and temporal coverage and its accuracy.

Thermal inertias in the upper millimeters of the Martian surface derived using Phobos' shadow

NASA Technical Reports Server (NTRS)

Betts, Bruce H.; Murray, Bruce C.; Svitek, Tomas

1995-01-01

The first thermal images of Phobos' shadow on the surface of Mars, in addition to simultaneous visible images, were obtained by the Phobos'88 Termoskan instrument. The best observed shadow occurrence was on the flanks of Arsia Mons. For this occurrence, we combined the observed decrease in visible illumination of the surface with the observed decrease in brightness temperature to calculate thermal inertias of the Martian surface. The most realistic of our three models of eclipse cooling improves upon our preliminary model by including nonisothermal initial conditions and downward atmospheric flux. Most of our derived inertias fall within the range 38 to 59 J/(sq m s(exp 1/2) K), (0.9 to 1.4 x 10(exp -3) cal/(sq cm s(exp 1/2) K)) corresponding to dust-sized particles (for a homogeneous surface), consistent with previous theories of Tharsis as a current area of dust deposition. Viking infrared thermal mapper (IRTM) inertias are diurnally derived and are sensitive to centimeter depths, whereas the shadow-derived inertias sample the upper tenths of a millimeter of the surface. The shadow-derived inertias are lower than those derived from Viking IRTM measurements (84 to 147), however, uncertainties in both sets of derived inertias make conclusions about layering tenuous. Thus, near-surface millimeter versus centimeter layering may exist in this region, but if it does, it is likely not very significant. Both eclipse and diurnal inertias appear to increase near the eastern end of the shadow occurrence. We also analyzed a shadow occurrence near the crater Herschel that showed no observed cooling. This analysis was limited by cool morning temperatures and instrument sensitivity, but yielded a lower bound of 80 on eclipse inertias in that region. Based upon our results, we strongly recommend future spacecraft thermal observations of Phobos' shadow, and suggest that they will be most useful if they improve upon Terinoskan's geographic and temporal coverage and its accuracy.

Physiological effects of environmentally relevant, multi-day thermal stress on wild juvenile Atlantic salmon (Salmo salar).

PubMed

Corey, Emily; Linnansaari, Tommi; Cunjak, Richard A; Currie, Suzanne

2017-01-01

The frequency of extreme thermal events in temperate freshwater systems is expected to increase alongside global surface temperature. The Miramichi River, located in eastern Canada, is a prominent Atlantic salmon ( Salmo salar ) river where water temperatures can exceed the proposed upper thermal limit for the species (~27°C). Current legislation closes the river to recreational angling when water temperatures exceed 20°C for two consecutive nights. We aimed to examine how natural thermal variation, representative of extreme high thermal events, affected the thermal tolerance and physiology of wild, juvenile Atlantic salmon. We acclimated fish to four thermal cycles, characteristic of real-world thermal conditions while varying daily thermal minima (16°C, 18°C, 20°C or 22°C) and diel thermal fluctuation (e.g. Δ5°C-Δ9°C). In each cycling condition, we assessed the role that thermal minima played on the acute thermal tolerance (critical thermal maximum, (CTMax)), physiological (e.g. heat shock protein 70 (HSP70), ubiquitin) and energetic (e.g. hepatic glycogen, blood glucose and lactate) status of juvenile Atlantic salmon throughout repeated thermal cycles. Exposure to 16-21°C significantly increased CTMax (+0.9°C) compared to a stable acclimation temperature (16°C), as did exposure to diel thermal fluctuations of 18-27°C, 20-27°C and 22-27°C, yet repeated exposure provided no further increases in acute thermal tolerance. In comparison to the reference condition (16-21°C), consecutive days of high temperature cycling with different thermal minima resulted in significant increases in HSP70 and ubiquitin, a significant decrease in liver glycogen, and no significant cumulative effect on either blood glucose or lactate. However, comparison between thermally taxed treatments suggested the diel thermal minima had little influence on the physiological or energetic response of juvenile salmon, despite the variable thermal cycling condition. Our results

Pediatric thermal injury: acute care and reconstruction update.

PubMed

Armour, Alexis D; Billmire, David A

2009-07-01

The acute and reconstructive care of each pediatric burn patient presents unique challenges to the plastic surgeon and the burn care team. : The purpose of this review article is to highlight the interdependence between the acute and reconstructive needs of pediatric burn patients as it pertains to each anatomical site. Relevant principles of acute pediatric burn care and burn reconstruction are outlined, based on the authors' experience and review of the literature. The need for late reconstruction in pediatric burn survivors is significantly influenced by the acute surgical and rehabilitative treatments. With their vulnerability to airway swelling, hypothermia, pulmonary edema, and ischemia-reperfusion injury, pediatric patients with large burns require precise, life-saving treatment in the acute phase. Decision-making in pediatric burn reconstruction must take into account the patient's future growth, maturity, and often lack of suitable donor sites. Appropriately selected reconstructive techniques are essential to optimize function, appearance, and quality of life in pediatric burn survivors.

Acute pancreatitis in pregnancy: an overview.

PubMed

Papadakis, Efstathios P; Sarigianni, Maria; Mikhailidis, Dimitri P; Mamopoulos, Apostolos; Karagiannis, Vasilios

2011-12-01

Acute pancreatitis is rare in pregnancy but it is associated with increased incidence of maternal and fetal mortality. It should be considered in the differential diagnosis of upper quadrant abdominal pain with or without nausea and vomiting. The commonest identified causes of acute pancreatitis in pregnancy are gallstones, alcohol and hypertriglyceridemia. The main laboratory finding is increased amylase activity. Appropriate investigations include ultrasound of the right upper quadrant and measurement of serum triglycerides and ionized calcium. Management of gallstone pancreatitis is controversial, although laparoscopic cholecystectomy and endoscopic retrograde cholangiopancreatography (ERCP) are often used and may be associated with lower complication rates. In hypertriglyceridemia-induced acute pancreatitis ω-3 fatty acids and even therapeutic plasma exchange can be used. We also discuss preventive measures. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Thermal Conductances Of Metal Contacts

NASA Technical Reports Server (NTRS)

Salerno, L. J.; Kittel, P.; Scherkenbach, F. E.; Spivak, A. L.

1988-01-01

Report presents results of measurements of thermal conductances of aluminum and stainless-steel contacts at temperatures from 1.6 to 6.0 K. Measurement apparatus includes gearmotor assembly connected to rocker arm by music wire to load sample pair with forces up to 670 N. Heater placed above upper sample. Germanium resistance thermometers in upper and lower samples measured temperature difference across interface over range of heater powers from 0.1 to 10.0 mW. The thermal conductance calculated from temperature difference. Measurements provide data for prediction of thermal conductances of bolted joints in cryogenic infrared instruments.

The effect of body shape on weight-for-height and mid-upper arm circumference based case definitions of acute malnutrition in Ethiopian children.

PubMed

Myatt, Mark; Duffield, Arabella; Seal, Andrew; Pasteur, Frances

2009-01-01

Nutritional anthropometry surveys from Somalia and Ethiopia have reported that standard weight-for-height z-score (WHZ) and mid-upper arm circumference (MUAC) case definitions return different estimates of the prevalence of acute malnutrition in pastoralist livelihood zones but similar estimates of the prevalence of acute malnutrition in the agrarian livelihood zones. A study undertaken in Somalia to investigate this finding reported that children from pastoralist livelihood zones tended to have longer limbs and lower SSRs than children from agrarian livelihood zones. The present study investigated the relationship between weight-for-height and body shape and the relationship between MUAC and body shape in different populations of Ethiopian children. Six cross-sectional nutritional anthropometry surveys were undertaken. The combined survey datasets form the study sample. Data sources were grouped according to the livelihood zone from which data originated (either settled agrarian or semi-nomadic pastoralist). Case definitions of acute malnutrition using WHZ calculated using the NCHS and WHO reference populations and MUAC uncorrected for age or height were used. The SSR was used as an index of body shape. The association between body shape and the different case definitions of acute malnutrition were investigated using standard statistical techniques. Weight-for-height and MUAC case definitions yielded similar estimates of the prevalence of acute malnutrition in agrarian children but different estimates of the prevalence of acute malnutrition in pastoralist children. These populations also exhibit different SSRs. The SSR is an important predictor of weight-for-height. The SSR is a poor predictor of MUAC. WHZ and WHZ case status in children are associated with body shape and may overestimate the prevalence of acute malnutrition in some populations. Consideration should be given as to whether WHZ should be replaced by MUAC for the purposes of estimating the prevalence

Nasopharyngeal polymicrobial colonization during health, viral upper respiratory infection and upper respiratory bacterial infection.

PubMed

Xu, Qingfu; Wischmeyer, Jareth; Gonzalez, Eduardo; Pichichero, Michael E

2017-07-01

We sought to understand how polymicrobial colonization varies during health, viral upper respiratory infection (URI) and acute upper respiratory bacterial infection to understand differences in infection-prone vs. non-prone patients. Nasopharyngeal (NP) samples were collected from 74 acute otitis media (AOM) infection-prone and 754 non-prone children during 2094 healthy visits, 673 viral URI visits and 631 AOM visits. Three otopathogens Streptococcus pneumoniae (Spn), Nontypeable Haemophilus influenzae (NTHi), and Moraxella catarrhalis (Mcat) were identified by culture. NP colonization rates of multiple otopathogens during health were significantly lower than during viral URI, and during URI they were lower than at onset of upper respiratory bacterial infection in both AOM infection-prone and non-prone children. AOM infection-prone children had higher polymicrobial colonization rates than non-prone children during health, viral URI and AOM. Polymicrobial colonization rates of AOM infection-prone children during health were equivalent to that of non-prone children during viral URI, and during viral URI were equivalent to that of non-prone during AOM infection. Spn colonization was positively associated with NTHi and Mcat colonization during health, but negatively during AOM infection. The infection-prone patients more frequently have multiple potential bacterial pathogens in the NP than the non-prone patients. Polymicrobial interaction in the NP differs during health and at onset of infection. Copyright © 2017 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

Remote Ischemic Postconditioning (RIPC) of the Upper Arm Results in Protection from Cardiac Ischemia-Reperfusion Injury Following Primary Percutaneous Coronary Intervention (PCI) for Acute ST-Segment Elevation Myocardial Infarction (STEMI)

PubMed Central

Cao, Bangming; Wang, Haipeng; Zhang, Chi; Xia, Ming

2018-01-01

Background The aim of this study was to evaluate the role of remote ischemic postconditioning (RIPC) of the upper arm on protection from cardiac ischemia-reperfusion injury following primary percutaneous coronary intervention (PCI) in patients with acute ST-segment elevation myocardial infarction (STEMI). Material/Methods Eighty patients with STEMI were randomized into two groups: primary PCI (N=44) and primary PCI+RIPC (N=36). RIPC consisted of four cycles of 5 minutes of occlusion and five minutes of reperfusion by cuff inflation and deflation of the upper arm, commencing within one minute of the first PCI balloon dilatation. Peripheral venous blood samples were collected before PCI and at 0.5, 8, 24, 48, and 72 hours after PCI. Levels of creatine kinase-MB (CK-MB), serum creatinine (Cr), nitric oxide (NO), and stromal cell-derived factor-1α (SDF-1α) were measured. The rates of acute kidney injury (AKI) and the estimated glomerular filtration rate (eGFR) were calculated. Results Patients in the primary PCI+RIPC group, compared with the primary PCI group, had significantly lower peak CK-MB concentrations (P<0.01), a significantly increased left ventricular ejection fraction (LVEF) (P=0.01), a significantly lower rate of AKI (P<0.01) a significantly increased eGFR (P<0.01), and decreased area under the curve (AUC) of CK-MB, NO and SDF-1α. Conclusions RIPC of the upper arm following primary PCI in patients with acute STEMI might provide cardiac and renal protection from ischemia-reperfusion injury via the actions of SDF-1α, and NO. PMID:29456238

Remote Ischemic Postconditioning (RIPC) of the Upper Arm Results in Protection from Cardiac Ischemia-Reperfusion Injury Following Primary Percutaneous Coronary Intervention (PCI) for Acute ST-Segment Elevation Myocardial Infarction (STEMI).

PubMed

Cao, Bangming; Wang, Haipeng; Zhang, Chi; Xia, Ming; Yang, Xiangjun

2018-02-19

BACKGROUND The aim of this study was to evaluate the role of remote ischemic postconditioning (RIPC) of the upper arm on protection from cardiac ischemia-reperfusion injury following primary percutaneous coronary intervention (PCI) in patients with acute ST-segment elevation myocardial infarction (STEMI). MATERIAL AND METHODS Eighty patients with STEMI were randomized into two groups: primary PCI (N=44) and primary PCI+RIPC (N=36). RIPC consisted of four cycles of 5 minutes of occlusion and five minutes of reperfusion by cuff inflation and deflation of the upper arm, commencing within one minute of the first PCI balloon dilatation. Peripheral venous blood samples were collected before PCI and at 0.5, 8, 24, 48, and 72 hours after PCI. Levels of creatine kinase-MB (CK-MB), serum creatinine (Cr), nitric oxide (NO), and stromal cell-derived factor-1α (SDF-1α) were measured. The rates of acute kidney injury (AKI) and the estimated glomerular filtration rate (eGFR) were calculated. RESULTS Patients in the primary PCI+RIPC group, compared with the primary PCI group, had significantly lower peak CK-MB concentrations (P<0.01), a significantly increased left ventricular ejection fraction (LVEF) (P=0.01), a significantly lower rate of AKI (P<0.01) a significantly increased eGFR (P<0.01), and decreased area under the curve (AUC) of CK-MB, NO and SDF-1α. CONCLUSIONS RIPC of the upper arm following primary PCI in patients with acute STEMI might provide cardiac and renal protection from ischemia-reperfusion injury via the actions of SDF-1α, and NO.

Divergent thermal specialisation of two South African entomopathogenic nematodes.

PubMed

Hill, Matthew P; Malan, Antoinette P; Terblanche, John S

2015-01-01

Thermal physiology of entomopathogenic nematodes (EPN) is a critical aspect of field performance and fitness. Thermal limits for survival and activity, and the ability of these limits to adjust (i.e., show phenotypic flexibility) depending on recent thermal history, are generally poorly established, especially for non-model nematode species. Here we report the acute thermal limits for survival, and the thermal acclimation-related plasticity thereof for two key endemic South African EPN species, Steinernema yirgalemense and Heterorhabditis zealandica. Results including LT50 indicate S. yirgalemense (LT50 = 40.8 ± 0.3 °C) has greater high temperature tolerance than H. zealandica (LT50 = 36.7 ± 0.2 °C), but S. yirgalemense (LT50 = -2.4 ± 0 °C) has poorer low temperature tolerance in comparison to H. zealandica (LT50 = -9.7 ± 0.3 °C), suggesting these two EPN species occupy divergent thermal niches to one another. Acclimation had both negative and positive effects on temperature stress survival of both species, although the overall variation meant that many of these effects were non-significant. There was no indication of a consistent loss of plasticity with improved basal thermal tolerance for either species at upper lethal temperatures. At lower temperatures measured for H. zealandica, the 5 °C acclimation lowered survival until below -12.5 °C, where after it increased survival. Such results indicate that the thermal niche breadth of EPN species can differ significantly depending on recent thermal conditions, and should be characterized across a broad range of species to understand the evolution of thermal limits to performance and survival in this group.

Upper Extremity Compartment Syndrome in a Patient with Acute Gout Attack but without Trauma or Other Typical Causes.

PubMed

Skedros, John G; Smith, James S; Henrie, Marshall K; Finlinson, Ethan D; Trachtenberg, Joel D

2018-01-01

We report the case of a 30-year-old Polynesian male with a severe gout flare of multiple joints and simultaneous acute compartment syndrome (ACS) of his right forearm and hand without trauma or other typical causes. He had a long history of gout flares, but none were known to be associated with compartment syndrome. He also had concurrent infections in his right elbow joint and olecranon bursa. A few days prior to this episode of ACS, high pain and swelling occurred in his right upper extremity after a minimal workout with light weights. A similar episode occurred seven months prior and was attributed to a gout flare. Unlike past flares that resolved with colchicine and/or anti-inflammatory medications, his current upper extremity pain/swelling worsened and became severe. Hand and forearm fasciotomies were performed. Workup included general medicine, rheumatology and infectious disease consultations, myriad blood tests, and imaging studies including Doppler ultrasound and CT angiography. Additional clinical history suggested that he had previously unrecognized recurrent exertional compartment syndrome that led to the episode of ACS reported here. Chronic exertional compartment syndrome (CECS) presents a difficult diagnosis when presented with multiple symptoms concurrently. This case provides an example of one such diagnosis.

Upper Extremity Compartment Syndrome in a Patient with Acute Gout Attack but without Trauma or Other Typical Causes

PubMed Central

Smith, James S.; Henrie, Marshall K.; Finlinson, Ethan D.; Trachtenberg, Joel D.

2018-01-01

We report the case of a 30-year-old Polynesian male with a severe gout flare of multiple joints and simultaneous acute compartment syndrome (ACS) of his right forearm and hand without trauma or other typical causes. He had a long history of gout flares, but none were known to be associated with compartment syndrome. He also had concurrent infections in his right elbow joint and olecranon bursa. A few days prior to this episode of ACS, high pain and swelling occurred in his right upper extremity after a minimal workout with light weights. A similar episode occurred seven months prior and was attributed to a gout flare. Unlike past flares that resolved with colchicine and/or anti-inflammatory medications, his current upper extremity pain/swelling worsened and became severe. Hand and forearm fasciotomies were performed. Workup included general medicine, rheumatology and infectious disease consultations, myriad blood tests, and imaging studies including Doppler ultrasound and CT angiography. Additional clinical history suggested that he had previously unrecognized recurrent exertional compartment syndrome that led to the episode of ACS reported here. Chronic exertional compartment syndrome (CECS) presents a difficult diagnosis when presented with multiple symptoms concurrently. This case provides an example of one such diagnosis. PMID:29796328

HATS (High Altitude Thermal Sounder): a passive sensor solution to 3D high-resolution mapping of upper atmosphere dynamics (Conference Presentation)

NASA Astrophysics Data System (ADS)

Gordley, Larry; Marshall, Benjamin T.; Lachance, Richard L.

2016-10-01

This presentation introduces a High Altitude Thermal Sensor (HATS) that has the potential to resolve the thermal structure of the upper atmosphere (cloud top to 100km) with both horizontal and vertical resolution of 5-7 km or better. This would allow the complete characterization of the wave structures that carry weather signature from the underlying atmosphere. Using a novel gas correlation technique, an extremely high-resolution spectral scan is accomplished by measuring a Doppler modulated signal as the atmospheric thermal scene passes through the HATS 2D FOV. This high spectral resolution, difficult to impossible to achieve with any other passive technique, enables the separation of radiation emanating at high altitudes from that emanating at low altitudes. A principal component analysis of these modulation signals then exposes the complete thermal structure of the upper atmosphere. We show that nadir sounding from low earth orbit, using various branches of CO2 emission in the 17 to 15 micron region, with sufficient spectral resolution and spectral measurement range, can distinguish thermal energy that peaks at various altitudes. By observing the up-welling atmospheric emission through a low pressure (Doppler broadened) gas cell, as the scene passes through our FOV, a modulation signal is created as the atmospheric emission lines are shifted through the spectral position of the gas cell absorption lines. The modulation signal is shown to be highly correlated to the emission coming from the spectral location of the gas cell lines relative to the atmospheric emission lines. This effectively produces a scan of the atmospheric emission with a Doppler line resolution. Similar to thermal sounding of the troposphere, a principal component analysis of the modulation signal can be used to produce an altitude resolved profile, given a reasonable a priori temperature profile. It is then shown that with the addition of a limb observation with one CO2 broadband channel

[Antithrombotic therapy and nonvariceal upper gastrointestinal bleeding].

PubMed

Belanová, Veronika; Gřiva, Martin

2015-12-01

The incidence of acute upper gastrointestinal bleeding is about 85-108/100,000 inhabitants per year, nonvariceal bleeding accounts for 80-90%. Antiplatelet and anticoagulation treatment are the significant risk factors for upper gastrointestinal bleeding. To evaluate the occurrence of upper gastrointestinal bleeding in the general community of patients in a county hospital. And to compare the role played by antiplatelet and anticoagulation drugs and other risk medication. Retrospective analysis of patients over 18 years of age who underwent endoscopy for acute upper gastrointestinal bleeding or anaemia (haemoglobin<100 g/l) with proved source of blood losses in upper gastrointestinal tract during a hospital stay in 2013 (from January to June). We included 111 patients of average age 69±15 years, men 60%. Nonvariceal bleeding accounted for 90% of the cases. None of the patients with variceal bleeding (10% of patients) took antiplatelet or anticoagulation therapy. There were 100 patients with nonvariceal bleeding of average age 70±15, 61% men. With the symptoms of acute bleeding (hematemesis, melena) presented in 73% of patients. The most frequent cause of bleeding was gastric and duodenal ulcer (54%). 32% of patients with nonvariceal bleeding had antiplatelets, 19% anticoagulants and 10% used nonsteroidal anti-inflammatory drugs, selective serotonin reuptake inhibitors or corticosteroids. 30-days mortality of patients with nonvariceal bleeding was 11%, annual mortality was 23%. There was no significant difference in mortality, blood transfusion requirements or surgical intervention between the patients with antithrombotic agents and without them. 25% of patients (8 patients) using acetylsalicylic acid did not fulfil the indication for this treatment. Among the patients examined by endoscopy for symptomatic nonvariceal bleeding and/or anaemia (haemoglobin<100 g/l) significantly higher portions of patients are taking antiplatelet rather than anticoagulation therapy

Maps showing thermal maturity of Upper Cretaceous marine shales in the Bighorn Basin, Wyoming and Montana

USGS Publications Warehouse

Finn, Thomas M.; Pawlewicz, Mark J.

2014-01-01

The Bighorn Basin is one of many structural and sedimentary basins that formed in the Rocky Mountain foreland during the Laramide orogeny, a period of crustal instability and compressional tectonics that began in latest Cretaceous time and ended in the Eocene. The basin is nearly 180 mi long, 100 mi wide, and encompasses about 10,400 mi2 in north-central Wyoming and south-central Montana. The basin is bounded on the northeast by the Pryor Mountains, on the east by the Bighorn Mountains, and on the south by the Owl Creek Mountains). The north boundary includes a zone of faulting and folding referred to as the Nye-Bowler lineament. The northwest and west margins are formed by the Beartooth Mountains and Absaroka Range, respectively. Important conventional oil and gas resources have been discovered and produced from reservoirs ranging in age from Cambrian through Tertiary. In addition, a potential unconventional basin-centered gas accumulation may be present in Cretaceous reservoirs in the deeper parts of the basin. It has been suggested by numerous authors that various Cretaceous marine shales are the principal source rock for these accumulations. Numerous studies of various Upper Cretaceous marine shales in the Rocky Mountain region have led to the general conclusion that these rocks have generated or are capable of generating oil and (or) gas. In recent years, advances in horizontal drilling and multistage fracture stimulation have resulted in increased exploration and completion of wells in Cretaceous marine shales in other Rocky Mountain Laramide basins that were previously thought of only as hydrocarbon source rocks. Important parameters controlling hydrocarbon production from these shale reservoirs include: reservoir thickness, amount and type of organic matter, and thermal maturity. The purpose of this report is to present maps and a cross section showing levels of thermal maturity, based on vitrinite reflectance (Ro), for selected Upper Cretaceous marine

Provision of out-of-hours services for acute upper gastrointestinal bleeding in England: results of the 2014-2015 BSG/NHS England national survey.

PubMed

Nedjat-Shokouhi, Bahman; Glynn, Michael; Denton, Erika R E; Greenfield, Simon M

2017-01-01

There has been a drive to raise the standard of management of acute upper gastrointestinal bleeding (AUGIB) in the UK, including three previous audits, sponsored by the British Society of Gastroenterology (BSG). To review the results of the latest BSG/National Health Service (NHS) England national survey of endoscopy services in England between 2014 and 2015. All NHS hospitals accepting acute admissions in England (168) were invited to respond to the survey. Overall, 142 hospitals (84%) returned data. 85% of hospitals used a validated risk assessment score at the time of patient's admission. While 80% of hospitals provided a 24/7 endoscopy service for unstable patients, and another 10% were in network to provide an acute service, only 60% performed an endoscopy within 24 hours for stable acute admissions or inpatients with AUGIB. 11% of hospitals operated an out-of-hours ad hoc rota. 43% felt that pressure from routine work affected their ability to offer a next-day oesophagogastroduodenoscopy service, while 20% of hospitals struggled to recruit endoscopists. 28% of units reported that the previous national audit performed in 2013 had a positive influence on service development. This survey has revealed significant deficiencies in provision of services for patients with AUGIB in England, without a significant increase in number of hospitals providing an emergency AUGIB service since the last national audit in 2013.

The origin and nature of thermal evolution during Granite emplacement and differentiation and its influence on upper crustal dynamics.

NASA Astrophysics Data System (ADS)

Buchwaldt, R.; Toulkeridis, T.; Todt, W.

2014-12-01

Structural geological, geochemical and geochronological data were compiled with the purpose to exercise models for the construction of upper crustal batholith. Models for pulsed intrusion of small magma batches over long timescales versus transfer of larger magma bodies on a shorter time scales are able to predict a different thermal, metamorphic, and rheological state of the crust. For this purpose we have applied the chronostratigraphic framework for magma differentiation on three granite complexes namely the St. Francois Mountain granite pluton (Precambrian), the Galway granite (Cambrian), and the Sithonia Plutonic Complex (Eocene). These plutons have similar sizes and range in composition from quartz diorites through granodiorites and granites to alkali granites, indicating multiple intrusive episodes. Thermobarometric calculations imply an upper crustal emplacement. Geochemical, isotopic and petrological data indicate a variety of pulses from each pluton allowing to be related through their liquid line of decent, which is supported by fractional crystallization of predominantly plagioclase, K-feldspar, biotite, hornblende and some minor accessory mineral phases, magma mingling and mixing as well as crustal contamination. To obtain the temporal relationship we carried out high-precision CA-TIMS zircon geochronology on selected samples along the liquid line of decent. The obtained data indicate a wide range of rates: such as different pulses evolved on timescales of about only 10-30ka, although, the construction time of the different complexes ranges from millions of years with prolonged tectonically inactive phases to relatively short lived time ranges of about ~300 ka. For a better understanding how these new data were used and evaluated in order to reconstruct constraints on the dynamics of the magmatic plumbing system, we integrated the short-lived, elevated heat production, due to latent heat of crystallization, into a 2D numerical model of the thermal

Inertial Upper Stage Thermal Test Program

DTIC Science & Technology

1989-04-12

EPDM , a tnermal insuiative rubber material covering the SRM ignitor housing, were made in both convective and radiative heater environments under...N2 to ensure an inert environment for these tests. 11 EPDM RUBBER FIBERGLAS PHENOLIC Fig. 2. IUS SRM-2 ignitor. 12 RADIA TOR EMI SHIELD-,," MOVABLE...testing. EPDM Grafoil seal, Viton Thermal-protection materials , IBSTRACT (Continue on reve4 if necessary and identify by block number) An extensive ther

Shell tile thermal protection system

NASA Technical Reports Server (NTRS)

Macconochie, I. O.; Lawson, A. G.; Kelly, H. N. (Inventor)

1984-01-01

A reusable, externally applied thermal protection system for use on aerospace vehicles subject to high thermal and mechanical stresses utilizes a shell tile structure which effectively separates its primary functions as an insulator and load absorber. The tile consists of structurally strong upper and lower metallic shells manufactured from materials meeting the thermal and structural requirements incident to tile placement on the spacecraft. A lightweight, high temperature package of insulation is utilized in the upper shell while a lightweight, low temperature insulation is utilized in the lower shell. Assembly of the tile which is facilitated by a self-locking mechanism, may occur subsequent to installation of the lower shell on the spacecraft structural skin.

Keeping pace with climate change: what is wrong with the evolutionary potential of upper thermal limits?

PubMed Central

Santos, Mauro; Castañeda, Luis E; Rezende, Enrico L

2012-01-01

The potential of populations to evolve in response to ongoing climate change is partly conditioned by the presence of heritable genetic variation in relevant physiological traits. Recent research suggests that Drosophila melanogaster exhibits negligible heritability, hence little evolutionary potential in heat tolerance when measured under slow heating rates that presumably mimic conditions in nature. Here, we study the effects of directional selection for increased heat tolerance using Drosophila as a model system. We combine a physiological model to simulate thermal tolerance assays with multilocus models for quantitative traits. Our simulations show that, whereas the evolutionary response of the genetically determined upper thermal limit (CTmax) is independent of methodological context, the response in knockdown temperatures varies with measurement protocol and is substantially (up to 50%) lower than for CTmax. Realized heritabilities of knockdown temperature may grossly underestimate the true heritability of CTmax. For instance, assuming that the true heritability of CTmax in the base population is h2 = 0.25, realized heritabilities of knockdown temperature are around 0.08–0.16 depending on heating rate. These effects are higher in slow heating assays, suggesting that flawed methodology might explain the apparently limited evolutionary potential of cosmopolitan D. melanogaster. PMID:23170220

Outcome of non-variceal acute upper gastrointestinal bleeding in relation to the time of endoscopy and the experience of the endoscopist: A two-year survey

PubMed Central

Parente, Fabrizio; Anderloni, Andrea; Bargiggia, Stefano; Imbesi, Venerina; Trabucchi, Emilio; Baratti, Cinzia; Gallus, Silvano; Porro, Gabriele Bianchi

2005-01-01

AIM: To prospectively assess the impact of time of endoscopy and endoscopist’s experience on the outcome of non-variceal acute upper gastrointestinal (GI) bleeding patients in a large teaching hospital. METHODS: All patients admitted for non-variceal acute upper GI bleeding for over a 2-year period were potentially eligible for this study. They were managed by a team of seven endoscopists on 24-h call whose experience was categorized into two levels (high and low) according to the number of endoscopic hemostatic procedures undertaken before the study. Endoscopic treatment was standardized according to Forrest classification of lesions as well as the subsequent medical therapy. Time of endoscopy was subdivided into two time periods: routine (8 a.m.-5 p.m.) and on-call (5 p.m.-8 a.m.). For each category of experience and time periods rebleeding rate, transfusion requirement, need for surgery, length of hospital stay and mortality we compared. Multivariate analysis was used to discriminate the impact of different variables on the outcomes that were considered. RESULTS: Study population consisted of 272 patients (mean age 67.3 years) with endoscopic stigmata of hemorrhage. The patients were equally distributed among the endoscopists, whereas only 19% of procedures were done out of working hours. Rockall score and Forrest classification at admission did not differ between time periods and degree of experience. Univariate analysis showed that higher endoscopist’s experience was associated with significant reduction in rebleeding rate (14% vs 37%), transfusion requirements (1.8±0.6 vs 3.0±1.7 units) as well as surgery (4% vs 10%), but not associated with the length of hospital stay nor mortality. By contrast, outcomes did not significantly differ between the two time periods of endoscopy. On multivariate analysis, endoscopist’s experience was independently associated with rebleeding rate and transfusion requirements. Odds ratios for low experienced endoscopist

Convectively driven PCR thermal-cycling

DOEpatents

Benett, William J.; Richards, James B.; Milanovich, Fred P.

2003-07-01

A polymerase chain reaction system provides an upper temperature zone and a lower temperature zone in a fluid sample. Channels set up convection cells in the fluid sample and move the fluid sample repeatedly through the upper and lower temperature zone creating thermal cycling.

The role thermal physiology plays in species invasion

PubMed Central

Kelley, Amanda L.

2014-01-01

The characterization of physiological phenotypes that may play a part in the establishment of non-native species can broaden our understanding about the ecology of species invasion. Here, an assessment was carried out by comparing the responses of invasive and native species to thermal stress. The goal was to identify physiological patterns that facilitate invasion success and to investigate whether these traits are widespread among invasive ectotherms. Four hypotheses were generated and tested using a review of the literature to determine whether they could be supported across taxonomically diverse invasive organisms. The four hypotheses are as follows: (i) broad geographical temperature tolerances (thermal width) confer a higher upper thermal tolerance threshold for invasive rather than native species; (ii) the upper thermal extreme experienced in nature is more highly correlated with upper thermal tolerance threshold for invasive vs. native animals; (iii) protein chaperone expression—a cellular mechanism that underlies an organism's thermal tolerance threshold—is greater in invasive organisms than in native ones; and (iv) acclimation to higher temperatures can promote a greater range of thermal tolerance for invasive compared with native species. Each hypothesis was supported by a meta-analysis of the invasive/thermal physiology literature, providing further evidence that physiology plays a substantial role in the establishment of invasive ectotherms. PMID:27293666

Dopamine and Pain Sensitivity: Neither Sulpiride nor Acute Phenylalanine and Tyrosine Depletion Have Effects on Thermal Pain Sensations in Healthy Volunteers

PubMed Central

Becker, Susanne; Ceko, Marta; Louis-Foster, Mytsumi; Elfassy, Nathaniel M.; Leyton, Marco; Shir, Yoram; Schweinhardt, Petra

2013-01-01

Based on animal studies and some indirect clinical evidence, dopamine has been suggested to have anti-nociceptive effects. Here, we investigated directly the effects of increased and decreased availability of extracellular dopamine on pain perception in healthy volunteers. In Study 1, participants ingested, in separate sessions, a placebo and a low dose of the centrally acting D2-receptor antagonist sulpiride, intended to increase synaptic dopamine via predominant pre-synaptic blockade. No effects were seen on thermal pain thresholds, tolerance, or temporal summation. Study 2 used the acute phenylalanine and tyrosine depletion (APTD) method to transiently decrease dopamine availability. In one session participants ingested a mixture that depletes the dopamine amino acid precursors, phenylalanine and tyrosine. In the other session they ingested a nutritionally balanced control mixture. APTD led to a small mood-lowering response following aversive thermal stimulation, but had no effects on the perception of cold, warm, or pain stimuli. In both studies the experimental manipulation of dopaminergic neurotransmission was successful as indicated by manipulation checks. The results contradict proposals that dopamine has direct anti-nociceptive effects in acute experimental pain. Based on dopamine’s well-known role in reward processing, we hypothesize that also in the context of pain, dopamine acts on stimulus salience and might play a role in the initiation of avoidance behavior rather than having direct antinociceptive effects in acute experimental pain. PMID:24236199

The adenoid as a key factor in upper airway infections.

PubMed

van Cauwenberge, P B; Bellussi, L; Maw, A R; Paradise, J L; Solow, B

1995-06-01

The adenoids (and the nasopharynx) play a key role in the normal functioning and in various pathologies of the upper respiratory tract. In this paper the role of adenoidal pathology and the beneficial effect of adenoidectomy in some upper respiratory tract and facial anomalies and diseases are discussed; otitis media with effusion, recurrent acute otitis media, sinusitis, snoring and sleep apnea and abnormal patterns in the midface growth and development.

Comparison of three scoring systems for risk stratification in elderly patients wıth acute upper gastrointestinal bleeding.

PubMed

Kalkan, Çağdaş; Soykan, Irfan; Karakaya, Fatih; Tüzün, Ali; Gençtürk, Zeynep Bıyıklı

2017-04-01

Acute gastrointestinal bleeding is a potentially life-threatening condition that requires rapid assessment and dynamic management. Several scoring systems are used to predict mortality and rebleeding in such cases. The aim of the present study was to compare three scoring systems for predicting short-term mortality, rebleeding, duration of hospitalization and the need for blood transfusion in elderly patients with upper gastrointestinal bleeding. The present study included 335 elderly patients with upper gastrointestinal bleeding. Pre- and post-endoscopic Rockall, Glasgow-Blatchford and AIMS65 scores were calculated. The ability of these scores to predict rebleeding, mortality, duration of hospitalization and the need for blood transfusion was determined. Pre- (4.5) and post-endoscopic (7.5) Rockall scores were superior to the Glasgow-Blatchford (12.5) score for predicting mortality (P = 0.006 and P = 0.015). Likewise, pre- (4.5) and post-endoscopic Rockall scores were superior to the respective Glasgow-Blatchford scores for predicting rebleeding (P = 0.013 and P = 0.03). There was an association between duration of hospitalization and mortality; as the duration of hospitalization increased the mortality rate increased. In all, 94% of patients hospitalized for a mean of 5 days were alive versus 56.1% of those hospitalized for 20 days, and 20.2% of those hospitalized for 40 days. In elderly patients with upper gastrointestinal bleeding, the Rockall score is clinically more useful for predicting mortality and rebleeding than the Glasgow-Blatchford and AIMS65 scores; however, for predicting duration of hospitalization and the need for blood transfusion, the Glasgow-Blatchford score is superior to the Rockall and AIMS65 scores. Geriatr Gerontol Int 2017; 17: 575-583. © 2016 Japan Geriatrics Society.

Homeopathic medications as clinical alternatives for symptomatic care of acute otitis media and upper respiratory infections in children.

PubMed

Bell, Iris R; Boyer, Nancy N

2013-01-01

The public health and individual risks of inappropriate antibiotic prescribing and conventional over-the-counter symptomatic drugs in pediatric treatment of acute otitis media (AOM) and upper respiratory infections (URIs) are significant. Clinical research suggests that over-the-counter homeopathic medicines offer pragmatic treatment alternatives to conventional drugs for symptom relief in children with uncomplicated AOM or URIs. Homeopathy is a controversial but demonstrably safe and effective 200-year-old whole system of complementary and alternative medicine used worldwide. Numerous clinical studies demonstrate that homeopathy accelerates early symptom relief in acute illnesses at much lower risk than conventional drug approaches. Evidence-based advantages for homeopathy include lower antibiotic fill rates during watchful waiting in otitis media, fewer and less serious side effects, absence of drug-drug interactions, and reduced parental sick leave from work. Emerging evidence from basic and preclinical science research counter the skeptics' claims that homeopathic remedies are biologically inert placebos. Consumers already accept and use homeopathic medicines for self care, as evidenced by annual US consumer expenditures of $2.9 billion on homeopathic remedies. Homeopathy appears equivalent to and safer than conventional standard care in comparative effectiveness trials, but additional well-designed efficacy trials are indicated. Nonetheless, the existing research evidence on safety supports pragmatic use of homeopathy in order to "first do no harm" in the early symptom management of otherwise uncomplicated AOM and URIs in children.

Upper thermal tolerance plasticity in tropical amphibian species from contrasting habitats: implications for warming impact prediction.

PubMed

Simon, Monique Nouailhetas; Ribeiro, Pedro Leite; Navas, Carlos Arturo

2015-02-01

Tropical ectothermic species are currently depicted as more vulnerable to increasing temperatures because of the proximity between their upper thermal limits and environmental temperatures. Yet, the acclimatory capacity of thermal limits has rarely been measured in tropical species, even though they are generally predicted to be smaller than in temperate species. We compared critical thermal maximum (CTmax) and warming tolerance (WT: the difference between CTmax and maximum temperature, Tmax), as well as CTmax acclimatory capacity of toad species from the Atlantic forest (AF) and the Brazilian Caatinga (CAA), a semi-arid habitat with high temperatures. Acclimation temperatures represented the mean temperatures of AF and CAA habitats, making estimates of CTmax and WT more ecologically realistic. CAA species mean CTmax was higher compared to AF species in both acclimation treatments. Clutches within species, as well as between AF and CAA species, differed in CTmax plasticity and we discuss the potential biological meaning of these findings. We did not find a trade-off between absolute CTmax and CTmax plasticity, indicating that species can have both high CTmax and high CTmax plasticity. Although CTmax was highly correlated to Tmax, CTmax plasticity was not related to Tmax or Tmax coefficients of variation. CAA species mean WT was lower than for AF species, but still very high for all species, diverging from other studies with tropical species. This might be partially related to over-estimation of vulnerability due to under-appreciation of realistic acclimation treatments in CTmax estimation. Thus, some tropical species might not be as vulnerable to warming as previously predicted if CTmax is considered as a shifting population parameter. Copyright © 2014 Elsevier Ltd. All rights reserved.

Cerebral gas embolism due to upper gastrointestinal endoscopy.

PubMed

ter Laan, Mark; Totte, Erik; van Hulst, Rob A; van der Linde, Klaas; van der Kamp, Wim; Pierie, Jean-Pierre E

2009-07-01

Cerebral gas embolism as a result of upper gastrointestinal endoscopy is a rare complication and bares a high morbidity. A patient is presented who underwent an upper endoscopy for evaluation of a gastric-mediastinal fistula after subtotal oesophagectomy and gastric tube reconstruction because of oesophageal cancer. During the procedure, cerebral gas emboli developed resulting in an acute left-sided hemiparesis. After hyperbaric oxygen therapy, the patient recovered almost completely. The aetiology and treatment is discussed based on the reviewed literature. Once cerebral gas emboli are recognized, patient outcome can be improved by hyperbaric oxygen therapy.

Prevalence of incidental pancreatic cyst on upper endoscopic ultrasound

PubMed Central

Martínez, Belén; Martínez, Juan F.; Aparicio, José R.

2018-01-01

Background: This study aimed to determine the prevalence of incidental pancreatic cysts in patients undergoing upper endoscopic ultrasound without a known pancreatic abnormality. Methods: This prospective study was conducted in two hospitals in Spain and enrolled consecutive patients referred for upper endoscopic ultrasound for a condition unrelated to the pancreas. Patients with a previous pancreatic anomaly, history of acute or chronic pancreatitis, evidence of acute pancreatitis, previous upper gastrointestinal surgery, or chronic abdominal pain suggestive of pancreatic origin were excluded. Univariate logistic regression was performed to evaluate individual covariates and the incidental pancreatic cyst risk. Results: A total of 298 patients were included, of whom 64 had pancreatic cysts (21.5%; 16.9-26.6%). The mean size of the cysts was 6.3±3.7 (range 3-25) mm. Six cysts (2%) were >10 mm and 16 (5.4%) were compatible with branch duct intraductal papillary mucinous neoplasm. The pancreatic cyst prevalence was similar in the two hospitals and increased significantly with age. Conclusion: The prevalence of incidental pancreatic cysts during endoscopic ultrasound was very high in our study population. PMID:29333072

Upper temperature limits of tropical marine ectotherms: global warming implications.

PubMed

Nguyen, Khanh Dung T; Morley, Simon A; Lai, Chien-Houng; Clark, Melody S; Tan, Koh Siang; Bates, Amanda E; Peck, Lloyd S

2011-01-01

Animal physiology, ecology and evolution are affected by temperature and it is expected that community structure will be strongly influenced by global warming. This is particularly relevant in the tropics, where organisms are already living close to their upper temperature limits and hence are highly vulnerable to rising temperature. Here we present data on upper temperature limits of 34 tropical marine ectotherm species from seven phyla living in intertidal and subtidal habitats. Short term thermal tolerances and vertical distributions were correlated, i.e., upper shore animals have higher thermal tolerance than lower shore and subtidal animals; however, animals, despite their respective tidal height, were susceptible to the same temperature in the long term. When temperatures were raised by 1°C hour(-1), the upper lethal temperature range of intertidal ectotherms was 41-52°C, but this range was narrower and reduced to 37-41°C in subtidal animals. The rate of temperature change, however, affected intertidal and subtidal animals differently. In chronic heating experiments when temperature was raised weekly or monthly instead of every hour, upper temperature limits of subtidal species decreased from 40°C to 35.4°C, while the decrease was more than 10°C in high shore organisms. Hence in the long term, activity and survival of tropical marine organisms could be compromised just 2-3°C above present seawater temperatures. Differences between animals from environments that experience different levels of temperature variability suggest that the physiological mechanisms underlying thermal sensitivity may vary at different rates of warming.

Rock Climbing Injuries: Acute and Chronic Repetitive Trauma.

PubMed

Chang, Connie Y; Torriani, Martin; Huang, Ambrose J

2016-01-01

Rock climbing has increased in popularity as a sport, and specific injuries related to its practice are becoming more common. Chronic repetitive injuries are more common than acute injuries, although acute injuries tend to be more severe. We review both acute and chronic upper and lower extremity injuries. Understanding the injury pattern in rock climbers is important for accurate diagnosis. Copyright © 2015 Mosby, Inc. All rights reserved.

Mapping spatial and temporal variation of stream water temperature in the upper Esopus Creek watershed

NASA Astrophysics Data System (ADS)

Chien, H.; McGlinn, L.

2017-12-01

The upper Esopus Creek and its tributary streams located in the Catskill Mountain region of New York State provide habitats for cold-adapted aquatic species. However, ongoing global warming may change the stream water temperature within a watershed and disturb the persistence of coldwater habitats. Characterizing thermal regimes within the upper Esopus Creek watershed is important to provide information of thermally suitable habitats for aquatic species. The objectives of this study are to measure stream water temperature and map thermal variability among tributaries to the Esopus Creek and within Esopus Creek. These objectives will be achieved by measuring stream water temperature for at least two years. More than 100 water temperature data loggers have been placed in the upper Esopus Creek and their tributaries to collect 30-minute interval water temperatures. With the measured water temperature, we will use spatial interpolation in ArcGIS to create weekly and monthly water temperature surface maps to evaluate the thermal variation over time and space within the upper Esopus Creek watershed. We will characterize responsiveness of water temperature in tributary streams to air temperature as well. This information of spatial and temporal variation of stream water temperature will assist stream managers with prioritizing management practices that maintain or enhance connectivity of thermally suitable habitats in high priority areas.

Antipyretic and analgesic effects of zaltoprofen for the treatment of acute upper respiratory tract infection: verification of a noninferiority hypothesis using loxoprofen sodium.

PubMed

Azuma, Arata; Kudoh, Shoji; Nakashima, Mitsuyoshi; Nagatake, Tsuyoshi

2011-01-01

A multicenter, placebo-controlled, double-dummy, randomized, parallel-group, double-blind study was conducted to verify the hypothesis of noninferiority for single-dose administration of zaltoprofen 160 mg, a nonsteroidal anti-inflammatory drug, compared with loxoprofen sodium 60 mg (loxoprofen), in terms of antipyretic and analgesic effects in patients with acute upper respiratory tract infection. The eligible 330 patients were assigned to one of 3 groups: zaltoprofen 160 mg, loxoprofen 60 mg and placebo. The analysis set consisted of 322 patients. Antipyretic effects were assessed by measuring body temperature, and analgesic effects were evaluated using a visual analog scale (VAS) for 4 h under the control of study staff. A detection kit for influenza virus A and B antigens was used to determine the presence of influenza virus infection. Compared with immediately before administration and with the placebo group, significant decreases in body temperature and summary VAS pain scores were noted in both the zaltoprofen and loxoprofen groups at 4 h after drug administration. Based on the degree of decrease in body temperature and the summary VAS pain scores up to 4 h after administration, noninferiority in terms of antipyretic and analgesic effects of zaltoprofen compared with those of loxoprofen was confirmed after single administration. Similar antipyretic and analgesic effects were also confirmed in influenza virus antigen-positive patients (73 patients). No clinical concerns were identified regarding safety. Zaltoprofen and loxoprofen are confirmed to be safe and useful for patients with acute upper respiratory tract infection, including those with influenza infection. Copyright © 2011 S. Karger AG, Basel.

Analytical thermal resistance model for high power double-clad fiber on rectangular plate with convective cooling at upper and lower surfaces

NASA Astrophysics Data System (ADS)

Lv, Yi; Zheng, Huai; Liu, Sheng

2018-07-01

Whether convective heat transfer on the upper surface of the substrate is used or not, the thermal resistance network models of optical fiber embedded in the substrate are established in this research. These models are applied to calculate the heat dissipation in a high power ytterbium doped double-clad fiber (YDCF) power amplifier. Firstly, the temperature values of two points on the fiber are tested when there is no convective heat transfer on the upper surface. Then, the numerical simulation is used to verify the temperature change of the fiber with the effective convective heat transfer coefficient of the lower surface heff increasing when the upper surface is subjected to three loading conditions with hu as 1, 5 and 15 W/(m2 K), respectively. The axial temperature distribution of the optical fiber is also presented at four different values for hu when heff is 30 W/(m2 K). Absolute values of the relative errors are less than 7.08%. The results show that the analytical models can accurately calculate the temperature distribution of the optical fiber when the fiber is encapsulated into the substrate. The corresponding relationship is helpful to further optimize packaging design of the fiber cooling system.

Histologic and molecular correlation in shelter cats with acute upper respiratory infection.

PubMed

Burns, Rachel E; Wagner, Denae C; Leutenegger, Christian M; Pesavento, Patricia A

2011-07-01

This is a descriptive study designed to correlate diagnostic real-time PCR results with histopathologic lesions in cats with clinical signs of upper respiratory infection (URI). The study occurred over a 9-month period in a single open-intake animal shelter. Cats that were selected for euthanasia by the shelter staff and additionally had URI were included in the study, for a total of 22 study cats. Combined conjunctival and oropharyngeal swab specimens were tested by quantitative real-time PCR (qPCR) for feline herpesvirus type 1 (FHV-1), feline calicivirus (FCV), Mycoplasma felis, Chlamydophila felis, and Bordetella bronchiseptica. Necropsy was performed on all cats, and a complete set of respiratory tract tissues was examined by histopathology. Among 22 cats, 20 were qPCR positive for FHV-1, 7 for M. felis, 5 for FCV, 1 for C. felis, and 0 for B. bronchiseptica. Nine cats were positive for two or more pathogens. Histopathologic lesions were present in all cats, with consistent lesions in the nasal cavity, including acute necroulcerative rhinitis in 16 cats. Histologic or antigenic detection of FHV-1 was seen in 18 of 20 cats positive for FHV-1 by qPCR. No lesions that could be specifically attributed to FCV, M. felis, or C. felis were seen, although interpretation in this cohort could be confounded by coinfection with FHV-1. A significant agreement was found between the amount of FHV-1 DNA determined by qPCR and the presence of specific histopathologic lesions for FHV-1 but not for the other respiratory pathogens.

Effects of acute thermal stress on the survival, predator avoidance, and physiology of juvenile fall Chinook salmon

USGS Publications Warehouse

Mesa, M.G.; Weiland, L.K.; Wagner, P.

2002-01-01

We subjected juvenile fall chinook salmon from the Hanford Reach of the Columbia River to acute thermal stressors in the laboratory that were derived from field data. We assessed the effects of thermal stress on: (1) the extent of direct mortality; (2) the vulnerability of fish to predation by smallmouth bass; and (3) some general physiological stress responses and synthesis of heat shock protein 70 (hsp70). Thermally-stressed fish showed little direct mortality and no increases in vulnerability to predation. However, these fish showed transient increases in plasma concentrations of cortisol, glucose, and lactate, and a dramatic (25-fold higher than controls) and persistent (lasting 2 wk) increase in levels of liver hsp70. Our results indicate that exposure of Hanford Reach juvenile fall chinook salmon to such stressors did not lead to significant increases in direct mortality or vulnerability to predation, but did alter physiological homeostasis, which should be of concern to those managing this resource. Because our fish received only a single exposure to one of the stressors we examined, we are also concerned about the consequences of exposing fish to multiple, cumulative stressors - a likely scenario for fish in the wild.

Solar Thermal Propulsion Concept

NASA Technical Reports Server (NTRS)

2004-01-01

Harnessing the Sun's energy through Solar Thermal Propulsion will propel vehicles through space by significantly reducing weight, complexity, and cost while boosting performance over current conventional upper stages. Another solar powered system, solar electric propulsion, demonstrates ion propulsion is suitable for long duration missions. Pictured is an artist's concept of space flight using solar thermal propulsion.

Embolization of Acute Nonvariceal Upper Gastrointestinal Hemorrhage Resistant to Endoscopic Treatment: Results and Predictors of Recurrent Bleeding

DOE Office of Scientific and Technical Information (OSTI.GOV)

Loffroy, Romaric, E-mail: romaric.loffroy@yahoo.fr; Rao, Pramod; Ota, Shinichi

2010-12-15

Acute nonvariceal upper gastrointestinal (UGI) hemorrhage is a frequent complication associated with significant morbidity and mortality. The most common cause of UGI bleeding is peptic ulcer disease, but the differential diagnosis is diverse and includes tumors; ischemia; gastritis; arteriovenous malformations, such as Dieulafoy lesions; Mallory-Weiss tears; trauma; and iatrogenic causes. Aggressive treatment with early endoscopic hemostasis is essential for a favorable outcome. However, severe bleeding despite conservative medical treatment or endoscopic intervention occurs in 5-10% of patients, requiring surgery or transcatheter arterial embolization. Surgical intervention is usually an expeditious and gratifying endeavor, but it can be associated with high operativemore » mortality rates. Endovascular management using superselective catheterization of the culprit vessel, < sandwich> occlusion, or blind embolization has emerged as an alternative to emergent operative intervention for high-risk patients and is now considered the first-line therapy for massive UGI bleeding refractory to endoscopic treatment. Indeed, many published studies have confirmed the feasibility of this approach and its high technical and clinical success rates, which range from 69 to 100% and from 63 to 97%, respectively, even if the choice of the best embolic agent among coils, cyanaocrylate glue, gelatin sponge, or calibrated particles remains a matter of debate. However, factors influencing clinical outcome, especially predictors of early rebleeding, are poorly understood, and few studies have addressed this issue. This review of the literature will attempt to define the role of embolotherapy for acute nonvariceal UGI hemorrhage that fails to respond to endoscopic hemostasis and to summarize data on factors predicting angiographic and embolization failure.« less

ENDOSCOPIC FINDINGS OF UPPER GASTROINTESTINAL BLEEDING IN PATIENTS WITH LIVER CIRROSIS.

PubMed

Hadayat, Rania; Jehangiri, Attique-ur-Rehman; Gul, Rahid; Khan, Adil Naseer; Said, Khalid; Gandapur, Asadullah

2015-01-01

Acute upper gastrointestinal (GI) bleeding is a common medical emergency. A common risk factor of upper GI bleeding is cirrhosis of liver, which can lead to variceal haemorrhage. 30-40% of cirrhotic patients who bleed may have non-variceal upper GI bleeding and it is frequently caused by peptic ulcers, portal gastropathy, Mallory-Weiss tear, and gastroduodenal erosions. The objective of this study was to determine the frequency of upper gastrointestinal endoscopic findings among patients presenting with upper gastrointestinal bleeding with liver cirrhosis. This descriptive cross-sectional study was carried out in Gastroenterology & Hepatology Department of Ayub Teaching Hospital, Abbottabad from February 2012 to June 2013. 252 patients diagnosed with cirrhosis, presenting with upper GI bleed, age 50 years of either gender, and were included in the study. Non-probability consecutive sampling was used, Endoscopy was performed on each patient and the findings documented. The mean age was 57.84 +/- 6.29 years. There were 158 (62.7%) males and 94 (37.3%) females. The most common endoscopic finding was oesophageal varices (92.9%, n=234) followed by portal hypertensive gastropathy (38.9%, n=98) with almost equal distribution among males and females. Gastric varices were found in 33.3% of patients (n=84). Among other non-variceal lesions, peptic ulcer disease was seen in 26 patients (10.3%) while gastric erosions were found in 8 patients (3.2%). In patients with acute upper GI bleeding and liver cirrhosis, the most common endoscopic finding is oesophageal varices, with a substantially higher value in our part of the country, apart from other non-variceal causes.

Acute inflammatory edema of the uvula (uvulitis) as a cause of respiratory distress: a case report.

PubMed

Hawke, M; Kwok, P

1987-06-01

Acute inflammatory edema of the uvula (uvulitis) is a relatively rare cause of upper airway distress or obstruction. The authors present a case report of a 37-year-old man who developed an acute cellulitis and edema of the uvula with upper airway distress, which was managed by an emergency uvulectomy.

Upper extremity golf injuries.

PubMed

Cohn, Michael A; Lee, Steven K; Strauss, Eric J

2013-01-01

Golf is a global sport enjoyed by an estimated 60 million people around the world. Despite the common misconception that the risk of injury during the play of golf is minimal, golfers are subject to a myriad of potential pathologies. While the majority of injuries in golf are attributable to overuse, acute traumatic injuries can also occur. As the body's direct link to the golf club, the upper extremities are especially prone to injury. A thorough appreciation of the risk factors and patterns of injury will afford accurate diagnosis, treatment, and prevention of further injury.

Homeopathic Medications as Clinical Alternatives for Symptomatic Care of Acute Otitis Media and Upper Respiratory Infections in Children

PubMed Central

Boyer, Nancy N

2013-01-01

The public health and individual risks of inappropriate antibiotic prescribing and conventional over-the-counter symptomatic drugs in pediatric treatment of acute otitis media (AOM) and upper respiratory infections (URIs) are significant. Clinical research suggests that over-the-counter homeopathic medicines offer pragmatic treatment alternatives to conventional drugs for symptom relief in children with uncomplicated AOM or URIs. Homeopathy is a controversial but demonstrably safe and effective 200-year-old whole system of complementary and alternative medicine used worldwide. Numerous clinical studies demonstrate that homeopathy accelerates early symptom relief in acute illnesses at much lower risk than conventional drug approaches. Evidence-based advantages for homeopathy include lower antibiotic fill rates during watchful waiting in otitis media, fewer and less serious side effects, absence of drug-drug interactions, and reduced parental sick leave from work. Emerging evidence from basic and preclinical science research counter the skeptics' claims that homeopathic remedies are biologically inert placebos. Consumers already accept and use homeopathic medicines for self care, as evidenced by annual US consumer expenditures of $2.9 billion on homeopathic remedies. Homeopathy appears equivalent to and safer than conventional standard care in comparative effectiveness trials, but additional well-designed efficacy trials are indicated. Nonetheless, the existing research evidence on safety supports pragmatic use of homeopathy in order to “first do no harm” in the early symptom management of otherwise uncomplicated AOM and URIs in children. PMID:24381823

Large Scale Testing of a Foam/Multilayer Insulation Thermal Control System (TCS) for Cryogenic Upper Stages

NASA Technical Reports Server (NTRS)

Hastings, Leon; Martin, James

1998-01-01

The development of high energy cryogenic upper stages is essential for the efficient delivery of large payloads to various destinations envisioned in future programs. A key element in such upper stages is cryogenic fluid management (CFM) advanced development/technology. Due to the cost of and limited opportunities for orbital experiments, ground testing must be employed to the fullest extent possible. Therefore, a system level test bed termed the Multipurpose Hydrogen Test Bed (MHTB), which is representative in size and shape (3 meter diameter by 3 meter long with a volume of 18 cubic meters) of a fully integrated space transportation vehicle liquid hydrogen propellant tank has been established. To date, upper stage studies have often baselined the foam/multilayer insulation (FMLI) combination concept; however, hardware experience with the concept is minimal and was therefore selected for the MHTB. The foam element (isofoam SS-1 171 with an average thickness of 3.5 centimeters) is designed to protect against ground hold/ascent flight environments, and allows for the use of a dry nitrogen purge as opposed to the more complex/heavy helium purge subsystem normally required with MLI in cryogenic applications. The MLI (45 layers of Double Aluminized Mylar with Dacron spacers) provides protection in the vacuum environment of space and is designed for an on-orbit storage period of 45 days. Several unique features were incorporated in the MLI concept and included: variable density MLI (reduces weight and radiation losses by changing the layer density), larger but fewer DAM perforations for venting during ascent to orbit (reduces radiation losses), and roll wrap installation of the MLI with a commercially established process to lower assembly man-hours and reduce seam heat leak. Thermal performance testing of the MHTB TCS was conducted during three test series conducted between September 1995 and May 1996. Results for the ground hold portion of the tests were as expected

Performance of Quick Sequential (Sepsis Related) and Sequential (Sepsis Related) Organ Failure Assessment to Predict Mortality in Patients with Acute Pyelonephritis Associated with Upper Urinary Tract Calculi.

PubMed

Fukushima, Hiroshi; Kobayashi, Masaki; Kawano, Keizo; Morimoto, Shinji

2018-06-01

The Third International Consensus Definitions for Sepsis and Septic Shock Task Force proposed a new definition of sepsis based on the SOFA (Sequential [Sepsis-related] Organ Failure Assessment) score and introduced a novel scoring system, quickSOFA, to screen patients at high risk for sepsis. However, the clinical usefulness of these systems is unclear. Therefore, we investigated predictive performance for mortality in patients with acute pyelonephritis associated with upper urinary tract calculi. This retrospective study included 141 consecutive patients who were clinically diagnosed with acute pyelonephritis associated with upper urinary tract calculi outside the intensive care unit. We evaluated the performance of the quickSOFA, SOFA and SIRS (systemic inflammatory response syndrome) scores to predict in-hospital mortality and intensive care unit admission using the AUC of the ROC curve, net reclassification, integrated discrimination improvements and decision curve analysis. A total of 11 patients (8%) died in the hospital and 26 (18%) were admitted to the intensive care unit. The AUC of quickSOFA to predict in-hospital mortality and intensive care unit admission was significantly greater than that of SIRS (each p <0.001) and comparable to that of SOFA (p = 0.47 and 0.57, respectively). When incorporated into the baseline model consisting of patient age, gender and the Charlson Comorbidity Index, quickSOFA and SOFA provided a greater change in AUC, and in net classification and integrated discrimination improvements than SIRS for each outcome. Decision curve analyses revealed that the quickSOFA and SOFA incorporated models showed a superior net benefit compared to the SIRS incorporated model for most examined probabilities of the 2 outcomes. The in-hospital mortality rate of patients with a quickSOFA score of 2 or greater and a SOFA score of 7 or greater, which were the optimal cutoffs determined by the Youden index, was 18% and 28%, respectively. SOFA and

Transcatheter arterial embolization for endoscopically unmanageable non-variceal upper gastrointestinal bleeding.

PubMed

Lee, Han Hee; Park, Jae Myung; Chun, Ho Jong; Oh, Jung Suk; Ahn, Hyo Jun; Choi, Myung-Gyu

2015-07-01

Transcatheter arterial embolization (TAE) is a therapeutic option for endoscopically unmanageable upper gastrointestinal (GI) bleeding. We aimed to assess the efficacy and clinical outcomes of TAE for acute non-variceal upper GI bleeding and to identify predictors of recurrent bleeding within 30 days. Visceral angiography was performed in 66 patients (42 men, 24 women; mean age, 60.3 ± 12.7 years) who experienced acute non-variceal upper GI bleeding that failed to be controlled by endoscopy during a 7-year period. Clinical information was reviewed retrospectively. Outcomes included technical success rates, complications, and 30-day rebleeding and mortality rates. TAE was feasible in 59 patients. The technical success rate was 98%. Rebleeding within 30 days was observed in 47% after an initial TAE and was managed with re-embolization in 8, by endoscopic intervention in 5, by surgery in 2, and by conservative care in 12 patients. The 30-day overall mortality rate was 42.4%. In the case of initial endoscopic hemostasis failure (n = 34), 31 patients underwent angiographic embolization, which was successful in 30 patients (96.8%). Rebleeding occurred in 15 patients (50%), mainly because of malignancy. Two factors were independent predictors of rebleeding within 30 days by multivariate analysis: coagulopathy (odds ratio [OR] = 4.37; 95% confidence interval [CI]: 1.25-15.29; p = 0.021) and embolization in ≥2 territories (OR = 4.93; 95% CI: 1.43-17.04; p = 0.012). Catheterization-related complications included hepatic artery dissection and splenic embolization. TAE controlled acute non-variceal upper GI bleeding effectively. TAE may be considered when endoscopic therapy is unavailable or unsuccessful. Correction of coagulopathy before TAE is recommended.

Hydration-reduced lattice thermal conductivity of olivine in Earth's upper mantle.

PubMed

Chang, Yun-Yuan; Hsieh, Wen-Pin; Tan, Eh; Chen, Jiuhua

2017-04-18

Earth's water cycle enables the incorporation of water (hydration) in mantle minerals that can influence the physical properties of the mantle. Lattice thermal conductivity of mantle minerals is critical for controlling the temperature profile and dynamics of the mantle and subducting slabs. However, the effect of hydration on lattice thermal conductivity remains poorly understood and has often been assumed to be negligible. Here we have precisely measured the lattice thermal conductivity of hydrous San Carlos olivine (Mg 0.9 Fe 0.1 ) 2 SiO 4 (Fo90) up to 15 gigapascals using an ultrafast optical pump-probe technique. The thermal conductivity of hydrous Fo90 with ∼7,000 wt ppm water is significantly suppressed at pressures above ∼5 gigapascals, and is approximately 2 times smaller than the nominally anhydrous Fo90 at mantle transition zone pressures, demonstrating the critical influence of hydration on the lattice thermal conductivity of olivine in this region. Modeling the thermal structure of a subducting slab with our results shows that the hydration-reduced thermal conductivity in hydrated oceanic crust further decreases the temperature at the cold, dry center of the subducting slab. Therefore, the olivine-wadsleyite transformation rate in the slab with hydrated oceanic crust is much slower than that with dry oceanic crust after the slab sinks into the transition zone, extending the metastable olivine to a greater depth. The hydration-reduced thermal conductivity could enable hydrous minerals to survive in deeper mantle and enhance water transportation to the transition zone.

Right Upper Quadrant Pain: Ultrasound First!

PubMed

Revzin, Margarita V; Scoutt, Leslie M; Garner, Joseph G; Moore, Christopher L

2017-10-01

Acute right upper quadrant (RUQ) pain is a common presenting symptom in emergency departments and outpatient medical practices, and is most commonly attributable to biliary and hepatic pathology. Ultrasound should be used as a first-line imaging modality for the diagnosis of gallstones and cholecystitis, as it allows the differentiation of medical and surgical causes of upper abdominal pathology, and in many circumstances is sufficient to guide patient management. Knowledge of strengths and limitations of ultrasound in the evaluation of RUQ is paramount in correct diagnosis. A spectrum of RUQ pathology for which a RUQ ultrasound examination should reasonably be considered as the initial imaging modality of choice will be reviewed. © 2017 by the American Institute of Ultrasound in Medicine.

Composition and thermal profiles of the Jovian upper atmosphere determined by the Voyager ultraviolet stellar occultation experiment

NASA Technical Reports Server (NTRS)

Festou, M. C.; Atreya, S. K.; Donahue, T. M.; Sandel, B. R.; Shemansky, D. E.; Broadfoot, A. L.

1981-01-01

During the occultation of the star Regulus (B7 type) by Jupiter as seen from the Voyager 2 spacecraft on July 9, 1979, two absorbing regions were detected. Between 911 and 1200 A, H2 was absorbing over a 600 km altitude range. Above 1300 A, the rapid increase of the absorption by the hydrocarbons was observed over an altitude interval of approximately 100 km with a height resolution of 3 km. The analysis of these absorption features has provided the height profiles of molecular hydrogen, methane, ethane, and acetylene, as well as the thermal profile in the upper atmosphere of Jupiter. Combining the Voyager ultraviolet spectrometer results with other data, such as those obtained by the Voyager infrared and radioscience instruments, has yielded a comprehensive model of the composition and structure of the atmosphere of Jupiter.

PROPOSAL OF A CLINICAL CARE PATHWAY FOR THE MANAGEMENT OF ACUTE UPPER GASTROINTESTINAL BLEEDING.

PubMed

Franco, Matheus Cavalcante; Nakao, Frank Shigueo; Rodrigues, Rodrigo; Maluf-Filho, Fauze; Paulo, Gustavo Andrade de; Libera, Ermelindo Della

2015-12-01

Upper gastrointestinal bleeding implies significant clinical and economic repercussions. The correct establishment of the latest therapies for the upper gastrointestinal bleeding is associated with reduced in-hospital mortality. The use of clinical pathways for the upper gastrointestinal bleeding is associated with shorter hospital stay and lower hospital costs. The primary objective is the development of a clinical care pathway for the management of patients with upper gastrointestinal bleeding, to be used in tertiary hospital. It was conducted an extensive literature review on the management of upper gastrointestinal bleeding, contained in the primary and secondary information sources. The result is a clinical care pathway for the upper gastrointestinal bleeding in patients with evidence of recent bleeding, diagnosed by melena or hematemesis in the last 12 hours, who are admitted in the emergency rooms and intensive care units of tertiary hospitals. In this compact and understandable pathway, it is well demonstrated the management since the admission, with definition of the inclusion and exclusion criteria, passing through the initial clinical treatment, posterior guidance for endoscopic therapy, and referral to rescue therapies in cases of persistent or rebleeding. It was also included the care that must be taken before hospital discharge for all patients who recover from an episode of bleeding. The introduction of a clinical care pathway for patients with upper gastrointestinal bleeding may contribute to standardization of medical practices, decrease in waiting time for medications and services, length of hospital stay and costs.

Management of Patients with Acute Lower Gastrointestinal Bleeding

PubMed Central

Strate, Lisa L.; Gralnek, Ian M.

2016-01-01

This guideline provides recommendations for the management of patients with acute overt lower gastrointestinal hemorrhage. Hemodynamic status should be initially assessed with intravascular volume resuscitation started as needed. Risk stratification based upon clinical parameters should be performed to help distinguish patients at high and low-risk of adverse outcomes. Hematochezia associated with hemodynamic instability may be indicative of an upper GI bleeding source and thus warrants an upper endoscopy. In the majority of patients, colonoscopy should be the initial diagnostic procedure and should be performed within 24 hours of patient presentation after adequate colon preparation. Endoscopic hemostasis therapy should be provided to patients with high risk endoscopic stigmata of bleeding including active bleeding, non-bleeding visible vessel, or adherent clot. The endoscopic hemostasis modality used (mechanical, thermal, injection or combination) is most often guided by the etiology of bleeding, access to the bleeding site, and endoscopist experience with the various hemostasis modalities. Repeat colonoscopy, with endoscopic hemostasis performed if indicated, should be considered for patients with evidence of recurrent bleeding. Radiographic interventions (tagged red blood cell scintigraphy, CT angiography, angiography) should be considered in high-risk patients with ongoing bleeding who do not respond adequately to resuscitation, and who are unlikely to tolerate bowel preparation and colonoscopy. Strategies to prevent recurrent bleeding should be considered. NSAID use should be avoided in patients with a history of acute lower GI bleeding particularly if secondary to diverticulosis or angioectasia. In patients with established cardiovascular disease who require aspirin (secondary prophylaxis), aspirin should not be discontinued. The exact timing depends on the severity of bleeding, perceived adequacy of hemostasis and the risk of a thromboembolic event. Surgery

Determination of the tolerable upper intake level of leucine in acute dietary studies in young men.

PubMed

Elango, Rajavel; Chapman, Karen; Rafii, Mahroukh; Ball, Ronald O; Pencharz, Paul B

2012-10-01

Leucine has been suggested to improve athletic performance. Therefore, the branched-chain amino acids (BCAAs), especially leucine, are popular as dietary supplements in strength-training athletes; however, the intake of leucine in excess of requirements raises concerns regarding adverse effects. Currently, the tolerable upper intake level (UL) for leucine is unknown. The objective of the current study was to determine the UL for leucine in adult men under acute dietary conditions. Five healthy adults (20-35 y) each received graded stepwise increases in leucine intakes of 50, 150, 250, 500, 750, 1000, and 1250 mg · kg⁻¹ · d⁻¹, which corresponded to the Estimated Average Requirement (EAR) and the EAR ×3, ×5, ×10, ×15, ×20, and ×25 in a total of 29 studies. The UL of leucine was identified by the measurement of plasma and urinary biochemical variables and changes in leucine oxidation by using l-[1-¹³C]-leucine. A significant increase in blood ammonia concentrations above normal values, plasma leucine concentrations, and urinary leucine excretion were observed with leucine intakes >500 mg · kg⁻¹ · d⁻¹. The oxidation of l-[1-¹³C]-leucine expressed as label tracer oxidation in breath (F¹³CO₂), leucine oxidation, and α-ketoisocaproic acid (KIC) oxidation led to different results: a plateau in F¹³CO₂ observed after 500 mg · kg⁻¹ · d⁻¹, no clear plateau observed in leucine oxidation, and KIC oxidation appearing to plateau after 750 mg · kg⁻¹ · d⁻¹. On the basis of plasma and urinary variables, the UL for leucine in healthy adult men can be suggested at 500 mg · kg⁻¹ · d⁻¹ or ~35 g/d as a cautious estimate under acute dietary conditions.

Thermal biology of Pacific cicada killers, Sphecius convallis Patton, in the Upper Sonoran Desert.

PubMed

Coelho, Joseph R; Holliday, Charles W; Hastings, Jon M; Phillips, Christy M

2016-04-01

A comprehensive investigation of the Pacific cicada killer, Sphecius convallis Patton, was undertaken to examine the behavioral and physiological mechanisms by which they are able to complete their life cycle in the thermal extremes of the Upper Sonoran Desert. S. convallis were endothermic, exhibiting elevated and relatively constant thorax temperatures during many activities. Males basked in trees at dawn to warm up, then used a variety of behaviors and perching strategies to maintain thorax temperature during territorial behavior. The thorax temperature of females was highest during provisioning and orientation flights, somewhat lower while investigating burrows, and lowest while digging burrows. The optimal thorax temperature for flight was about 40°C, which was approximated most closely by males resting in the shade during the afternoon. In mating clusters, the mated male was the hottest, the female was coolest and the other males were intermediate. Wasps lost about 5% of body mass during heating treatments, and may use evaporative water loss for cooling. Pacific cicada killers use a complex suite of behavioral and physiological adaptations to regulate body temperature during their nesting season. Copyright © 2016 Elsevier Ltd. All rights reserved.

Histopathology of acute human immunodeficiency virus exanthema.

PubMed Central

Balslev, E; Thomsen, H K; Weismann, K

1990-01-01

Acute exanthema occurs in patients who are human immunodeficiency virus (HIV) positive before they become seropositive. The patients have influenza like symptoms and a macular skin rash on the upper trunk. Histopathological investigation of skin punch biopsy specimens from four patients with acute HIV exanthema showed a normal epidermis and a sparse dermal, mainly perivascular, lymphocytic/histiocytic infiltrate around vessels of the superficial plexus. Histopathological changes of the exanthema of acute HIV infection are non-specific and resemble those of other acute viral exanthema, but when both the histopathological features and the clinical picture are suggestive, the clinician should take into consideration the possibility of HIV infection. Images PMID:2332516

[Antibiotic prescribing in acute respiratory tract infections in general practice].

PubMed

Malo, S; Bjerrum, L; Feja, C; Lallana, M J; Poncel, A; Rabanaque, M J

2015-06-01

Antimicrobial resistance is a worldwide threat to public health. Acute respiratory tract infections are the main reason for antibiotic prescribing in the Spanish paediatric population. The aim of the study was to describe the frequency of antibiotic prescription and their pattern of use in acute respiratory tract infections diagnosed in children in Primary Care in Aragón (Spain). A study was conducted over a 1-year period on children between 0 and 14 years-old, recording all episodes of acute otitis, acute pharyngotonsillitis, non-specific upper respiratory infection, and acute bronchitis. The proportion of episodes within each diagnosis receiving an antibiotic prescription was calculated, and the prescribing pattern was determined. Half (50%) of the children in Aragón were diagnosed with a respiratory tract infection during the study period. Non-specific upper respiratory infection was the most frequent diagnosis. An antibiotic was prescribed in 75% of pharyngotonsillitis episodes, 72% of otitis, 27% of bronchitis, and 16% of non-specific upper respiratory infections. Broad spectrum antibiotics, mainly amoxicillin and amoxicillin-clavulanic, were predominantly prescribed. Antibiotic prescribing in respiratory tract infections in children was generally high, and the choice of antibiotics was probably inappropriate in a high percentage of cases. Therefore an improvement in antibiotic prescribing in children appears to be needed. Copyright © 2014 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.

THE ETIOLOGY OF ACUTE UPPER RESPIRATORY INFECTION (COMMON COLD)

PubMed Central

Long, Perrin H.; Doull, James A.; Bourn, Janet M.; McComb, Emily

1931-01-01

Experimental upper respiratory infections similar to "common colds" were transmitted singly and in series through two and four passages in nine out of fifteen persons, by intransal inoculations with bacteria-free filtrates of nasopharyngeal washings obtained from individuals ill with natural "colds." These observations conform with those reported by previous workers and lend further support to the view that the incitant of the "common cold" is a filtrable virus. PMID:19869857

Antibiotic treatment of acute respiratory infections in acute care settings.

PubMed

Gonzales, Ralph; Camargo, Carlos A; MacKenzie, Thomas; Kersey, Ayanna S; Maselli, Judith; Levin, Sara K; McCulloch, Charles E; Metlay, Joshua P

2006-03-01

To examine the patterns of antibiotic use for acute respiratory tract infections (ARIs) in acute care settings. Chart reviews were performed retrospectively on a random sample of adult ARI visits to seven Veterans Affairs (VA) and seven non-VA emergency departments (EDs) for the period of November 2003 to February 2004. Visits were limited to those discharged to home and those with primary diagnoses of antibiotic-responsive (pneumonia, acute exacerbation of chronic bronchitis, pharyngitis, sinusitis) and antibiotic-nonresponsive conditions (acute bronchitis, nonspecific upper respiratory tract infection [URI]). Results are expressed as adjusted odds ratios with 95% confidence intervals. Of 2,270 ARI visits, 62% were for antibiotic-nonresponsive diagnoses. Seventy-two percent of acute bronchitis and 38% of URI visits were treated with antibiotics (p < 0.001). Stratified analyses show that antibiotic prescription rates were similar among attending-only and housestaff-associated visits for antibiotic-responsive diagnoses (p = 0.11), and acute bronchitis (76% vs. 59%; p = 0.31). However, the antibiotic prescription rate for URIs was greater for attending-only visits compared with housestaff-associated visits (48% vs. 15%; p = 0.01). Antibiotic prescription rates for total ARIs varied between sites, ranging from 42% to 89%. Patient age, gender, race and ethnicity, smoking status, comorbidities, and clinical setting (VA vs. non-VA) were not independently associated with antibiotic prescribing. Acute care settings are important targets for reducing inappropriate antibiotic prescribing. The mechanisms accounting for lower antibiotic prescription rates observed with housestaff-associated visits merit further study.

Upper Respiratory Tract Diseases in Athletes in Different Sports Disciplines.

PubMed

Gałązka-Franta, Anna; Jura-Szołtys, Edyta; Smółka, Wojciech; Gawlik, Radosław

2016-12-01

Upper respiratory tract diseases in athletes are a very common medical problem. Training conditions in different sports disciplines increase the risk of upper respiratory disease. Epidemiological evidence suggests that heavy acute or chronic exercise is related to an increased incidence of upper respiratory tract infections in athletes. Regular physical exercise at high intensity may lead to transient immunosuppression due to high prevalence of allergic diseases in athletes. Regardless of the cause they can exclude athletes from the training program and significantly impair their performance. In the present work, the most common upper respiratory tract diseases in athletes taking into account the disciplines in which they most often occur were presented. The focus was laid on symptoms, diagnostic methods and pharmacotherapy. Moreover, preventive procedures which can help reduce the occurrence of upper respiratory tract disease in athletes were presented. Management according to anti-doping rules, criteria for return to training and competition as an important issues of athlete's health were discussed.

The thermal structure and energy balance of the Uranian upper atmosphere

NASA Technical Reports Server (NTRS)

French, R. G.; Dunham, E. W.; Allen, D. A.; Elias, J. H.; Frogel, J. A.; Elliot, J. L.; Liller, W.

1983-01-01

Uranus upper atmosphere occultation observations are reported for August 15-16, 1980, and April 26, 1981. Mean atmospheric light curves of 154 + or - 15 K and 132 + or - 15 K, respectively, are derived from the light curves. A comparison of all available Uranus occultation data since March 1977 suggests a significant mean atmospheric temperature change, with a typical 15 K/year variation. It is suggested that molecular and eddy diffusion, together with atmospheric dynamics, are potentially as important as radiation in the upper atmosphere heat balance of Uranus. The close agreement of occultation immersion and emersion temperatures further suggests that effective meridional transport occurs on Uranus.

Histologic and Molecular Correlation in Shelter Cats with Acute Upper Respiratory Infection ▿

PubMed Central

Burns, Rachel E.; Wagner, Denae C.; Leutenegger, Christian M.; Pesavento, Patricia A.

2011-01-01

This is a descriptive study designed to correlate diagnostic real-time PCR results with histopathologic lesions in cats with clinical signs of upper respiratory infection (URI). The study occurred over a 9-month period in a single open-intake animal shelter. Cats that were selected for euthanasia by the shelter staff and additionally had URI were included in the study, for a total of 22 study cats. Combined conjunctival and oropharyngeal swab specimens were tested by quantitative real-time PCR (qPCR) for feline herpesvirus type 1 (FHV-1), feline calicivirus (FCV), Mycoplasma felis, Chlamydophila felis, and Bordetella bronchiseptica. Necropsy was performed on all cats, and a complete set of respiratory tract tissues was examined by histopathology. Among 22 cats, 20 were qPCR positive for FHV-1, 7 for M. felis, 5 for FCV, 1 for C. felis, and 0 for B. bronchiseptica. Nine cats were positive for two or more pathogens. Histopathologic lesions were present in all cats, with consistent lesions in the nasal cavity, including acute necroulcerative rhinitis in 16 cats. Histologic or antigenic detection of FHV-1 was seen in 18 of 20 cats positive for FHV-1 by qPCR. No lesions that could be specifically attributed to FCV, M. felis, or C. felis were seen, although interpretation in this cohort could be confounded by coinfection with FHV-1. A significant agreement was found between the amount of FHV-1 DNA determined by qPCR and the presence of specific histopathologic lesions for FHV-1 but not for the other respiratory pathogens. PMID:21562109

Comparative expression profile of NOD1/2 and certain acute inflammatory cytokines in thermal-stressed cell culture model of native and crossbred cattle

NASA Astrophysics Data System (ADS)

Bhanuprakash, V.; Singh, Umesh; Sengar, Gyanendra Singh; Raja, T. V.; Sajjanar, Basavraj; Alex, Rani; Kumar, Sushil; Alyethodi, R. R.; Kumar, Ashish; Sharma, Ankur; Kumar, Suresh; Bhusan, Bharat; Deb, Rajib

2017-05-01

Thermotolerance depends mainly on the health and immune status of the animals. The variation in the immune status of the animals may alter the level of tolerance of animals exposed to heat or cold stress. The present study was conducted to investigate the expression profile of two important nucleotide binding and oligomerization domain receptors (NLRs) (NOD1 and NOD2) and their central signalling molecule RIP2 gene during in vitro thermal-stressed bovine peripheral blood mononuclear cells (PBMCs) of native (Sahiwal) and crossbred (Sahiwal X HF) cattle. We also examined the differential expression profile of certain acute inflammatory cytokines in in vitro thermal-stressed PBMC culture among native and its crossbred counterparts. Results revealed that the expression profile of NOD1/2 positively correlates with the thermal stress, signalling molecule and cytokines. Present findings also highlighted that the expression patterns during thermal stress were comparatively superior among indigenous compared to crossbred cattle which may add references regarding the better immune adaptability of Zebu cattle.

Transcatheter arterial embolization for upper gastrointestinal tract bleeding

PubMed Central

Širvinskas, Audrius; Smolskas, Edgaras; Brimienė, Vilma; Brimas, Gintautas

2017-01-01

Introduction Transcatheter arterial embolization is a possible treatment for patients with recurrent bleeding from the upper gastrointestinal tract after failed endoscopic management and is also an alternative to surgical treatment. Aim To analyze the outcomes of transcatheter arterial embolization and identify the clinical and technical factors that influenced the rates of morbidity and mortality. Material and methods A retrospective analysis was carried out, based on the data of 36 patients who underwent transcatheter arterial embolization for acute nonvariceal upper gastrointestinal bleeding in 2013 to 2015 in our center. An analysis was performed between early rebleeding rates, mortality and the following factors: patient sex, age, number of units of packed red blood cells and packed plasma administered to the patients, length of hospital stay, therapeutic or prophylactic embolization. Results The technical success rate of the embolization procedure was 100%. There were 15 (41.70%) therapeutic embolizations and 21 (58.3%) prophylactic embolizations. There was a 77.8% clinical success rate. Following embolization, 10 (27.80%) patients had repeated bleeding and 9 (25.0%) patients died. Significant associations were found between rebleeding and prophylactic embolization (OR = 10.53; p = 0.04) and between mortality and prophylactic embolization (OR = 10.53; p = 0.04) and units of packed red blood cells (OR = 1.25; p < 0.01). Conclusions In our experience, transcatheter arterial embolization is a safe treatment method for acute nonvariceal upper gastrointestinal bleeding and a possible alternative to surgery for high-risk patients. PMID:29362654

The role of stochastic thermal environments in modulating the thermal physiology of an intertidal limpet, Lottia digitalis.

PubMed

Drake, Madeline J; Miller, Nathan A; Todgham, Anne E

2017-09-01

Much of our understanding of the thermal physiology of intertidal organisms comes from experiments with animals acclimated under constant conditions and exposed to a single heat stress. In nature, however, the thermal environment is more complex. Aerial exposure and the unpredictable nature of thermal stress during low tides may be critical factors in defining the thermal physiology of intertidal organisms. In the fingered limpet, Lottia digitalis , we investigated whether upper temperature tolerance and thermal sensitivity were influenced by the pattern of fluctuation with which thermal stress was applied. Specifically, we examined whether there was a differential response (measured as cardiac performance) to repeated heat stress of a constant and predictable magnitude compared with heat stress applied in a stochastic and unpredictable nature. We also investigated differences in cellular metabolism and damage following immersion for insights into biochemical mechanisms of tolerance. Upper temperature tolerance increased with aerial exposure, but no significant differences were found between predictable treatments of varying magnitudes (13°C versus 24°C versus 32°C). Significant differences in thermal tolerance were found between unpredictable trials with different heating patterns. There were no significant differences among treatments in basal citrate synthase activity, glycogen content, oxidative stress or antioxidants. Our results suggest that aerial exposure and recent thermal history, paired with relief from high low-tide temperatures, are important factors modulating the capacity of limpets to deal with thermal stress. © 2017. Published by The Company of Biologists Ltd.

Simulation of the Velocity and Temperature Distribution of Inhalation Thermal Injury in a Human Upper Airway Model by Application of Computational Fluid Dynamics.

PubMed

Chang, Yang; Zhao, Xiao-zhuo; Wang, Cheng; Ning, Fang-gang; Zhang, Guo-an

2015-01-01

Inhalation injury is an important cause of death after thermal burns. This study was designed to simulate the velocity and temperature distribution of inhalation thermal injury in the upper airway in humans using computational fluid dynamics. Cervical computed tomography images of three Chinese adults were imported to Mimics software to produce three-dimensional models. After grids were established and boundary conditions were defined, the simulation time was set at 1 minute and the gas temperature was set to 80 to 320°C using ANSYS software (ANSYS, Canonsburg, PA) to simulate the velocity and temperature distribution of inhalation thermal injury. Cross-sections were cut at 2-mm intervals, and maximum airway temperature and velocity were recorded for each cross-section. The maximum velocity peaked in the lower part of the nasal cavity and then decreased with air flow. The velocities in the epiglottis and glottis were higher than those in the surrounding areas. Further, the maximum airway temperature decreased from the nasal cavity to the trachea. Computational fluid dynamics technology can be used to simulate the velocity and temperature distribution of inhaled heated air.

The upper atmosphere of Uranus

NASA Technical Reports Server (NTRS)

Strobel, Darrell F.; Yelle, Roger V.; Shemansky, Donald E.; Atreya, Sushil K.

1991-01-01

Voyager measurements of the upper atmosphere of Uranus are analyzed and developed. The upper atmosphere of Uranus is predominantly H2, with at most 10 percent He by volume, and the dominant constituent of the exosphere is H. The thermosphere is warm, with an asymptotic isothermal temperature of about 800 K. Atomic hydrogen at this temperature forms an extensive thermal corona and creates gas drag that severely limits the lifetime of small ring particles. The upper atmosphere emits copious amounts of UV radiation from pressures greater than 0.01 microbar. The depth of this emission level imposes a powerful constraint on permissible emission mechanisms. Electron excitation from a thin layer near the exobase appears to violate this constraint. Solar fluorescence is consistent with the observed trend in solar zenith-angle variation of the emissions and is absent from the night side of the planet. On Uranus, it accounts for the observed Lyman beta to H2 bands intensity ratio and an important fraction of the observed intensity (about 55 percent).

Effects of alumina refinery wastewater and signature metal constituents at the upper thermal tolerance of: 1. The tropical diatom Nitzschia closterium.

PubMed

Harford, A J; Hogan, A C; Tsang, J J; Parry, D L; Negri, A P; Adams, M S; Stauber, J L; van Dam, R A

2011-03-01

Ecotoxicological studies, using the tropical marine diatom, Nitzschia closterium (72-h growth rate), were undertaken to assess potential issues relating to the discharge from an alumina refinery in northern Australia. The studies assessed: (i) the species' upper thermal tolerance; (ii) the effects of three signature metals, aluminium (Al), vanadium (V) and gallium (Ga) (at 32°C); and (iii) the effects of wastewater (at 27 and 32°C). The critical thermal maximum and median inhibition temperature for N. closterium were 32.7°C and 33.1°C, respectively. Single metal toxicity tests found that N. closterium was more sensitive to Al compared to Ga and V, with IC(50)s (95% confidence limits) of 190 (140-280), 19,640 (11,600-25,200) and 42,000 (32,770-56,000) μg L(-1), respectively. The undiluted wastewater samples were of low toxicity to N. closterium (IC(50)s>100% wastewater). Environmental chemistry data suggested that the key metals and discharge are a very low risk to this species. Crown Copyright © 2011. Published by Elsevier Ltd. All rights reserved.

Acute heat tolerance of cardiac excitation in the brown trout (Salmo trutta fario).

PubMed

Vornanen, Matti; Haverinen, Jaakko; Egginton, Stuart

2014-01-15

The upper thermal tolerance and mechanisms of heat-induced cardiac failure in the brown trout (Salmo trutta fario) was examined. The point above which ion channel function and sinoatrial contractility in vitro, and electrocardiogram (ECG) in vivo, started to fail (break point temperature, BPT) was determined by acute temperature increases. In general, electrical excitation of the heart was most sensitive to heat in the intact animal (electrocardiogram, ECG) and least sensitive in isolated cardiac myocytes (ion currents). BPTs of Ca(2+) and K(+) currents of cardiac myocytes were much higher (>28°C) than BPT of in vivo heart rate (23.5 ± 0.6°C) (P<0.05). A striking exception among sarcolemmal ion conductances was the Na(+) current (INa), which was the most heat-sensitive molecular function, with a BPT of 20.9 ± 0.5°C. The low heat tolerance of INa was reflected as a low BPT for the rate of action potential upstroke in vitro (21.7 ± 1.2°C) and the velocity of impulse transmission in vivo (21.9 ± 2.2°C). These findings from different levels of biological organization strongly suggest that heat-dependent deterioration of Na(+) channel function disturbs normal spread of electrical excitation over the heart, leading to progressive variability of cardiac rhythmicity (missed beats, bursts of fast beating), reduction of heart rate and finally cessation of the normal heartbeat. Among the cardiac ion currents INa is 'the weakest link' and possibly a limiting factor for upper thermal tolerance of electrical excitation in the brown trout heart. Heat sensitivity of INa may result from functional requirements for very high flux rates and fast gating kinetics of the Na(+) channels, i.e. a trade-off between high catalytic activity and thermal stability.

Hydration-reduced lattice thermal conductivity of olivine in Earth’s upper mantle

PubMed Central

Chang, Yun-Yuan; Hsieh, Wen-Pin; Tan, Eh; Chen, Jiuhua

2017-01-01

Earth’s water cycle enables the incorporation of water (hydration) in mantle minerals that can influence the physical properties of the mantle. Lattice thermal conductivity of mantle minerals is critical for controlling the temperature profile and dynamics of the mantle and subducting slabs. However, the effect of hydration on lattice thermal conductivity remains poorly understood and has often been assumed to be negligible. Here we have precisely measured the lattice thermal conductivity of hydrous San Carlos olivine (Mg0.9Fe0.1)2SiO4 (Fo90) up to 15 gigapascals using an ultrafast optical pump−probe technique. The thermal conductivity of hydrous Fo90 with ∼7,000 wt ppm water is significantly suppressed at pressures above ∼5 gigapascals, and is approximately 2 times smaller than the nominally anhydrous Fo90 at mantle transition zone pressures, demonstrating the critical influence of hydration on the lattice thermal conductivity of olivine in this region. Modeling the thermal structure of a subducting slab with our results shows that the hydration-reduced thermal conductivity in hydrated oceanic crust further decreases the temperature at the cold, dry center of the subducting slab. Therefore, the olivine−wadsleyite transformation rate in the slab with hydrated oceanic crust is much slower than that with dry oceanic crust after the slab sinks into the transition zone, extending the metastable olivine to a greater depth. The hydration-reduced thermal conductivity could enable hydrous minerals to survive in deeper mantle and enhance water transportation to the transition zone. PMID:28377520

Clinical outcome of acute nonvariceal upper gastrointestinal bleeding after hours: the role of urgent endoscopy.

PubMed

Ahn, Dong-Won; Park, Young Soo; Lee, Sang Hyub; Shin, Cheol Min; Hwang, Jin-Hyeok; Kim, Jin-Wook; Jeong, Sook-Hyang; Kim, Nayoung; Lee, Dong Ho

2016-05-01

This study was performed to investigate the clinical role of urgent esophagogastroduodenoscopy (EGD) for acute nonvariceal upper gastrointestinal bleeding (ANVUGIB) performed by experienced endoscopists after hours. A retrospective analysis was performed for consecutively collected data of patients with ANVUGIB between January 2009 and December 2010. A total of 158 patients visited the emergency unit for ANVUGIB after hours. Among them, 60 underwent urgent EGD (within 8 hours) and 98 underwent early EGD (8 to 24 hours) by experienced endoscopists. The frequencies of hemodynamic instability, fresh blood aspirate on the nasogastric tube, and high-risk endoscopic findings were significantly higher in the urgent EGD group. Primary hemostasis was achieved in all except two patients. There were nine cases of recurrent bleeding, and 30-day mortality occurred in three patients. There were no significant differences between the two groups in primary hemostasis, recurrent bleeding, and 30-day mortality. In a multiple linear regression analysis, urgent EGD significantly reduced the hospital stay compared with early EGD. In patients with a high clinical Rockall score (more than 3), urgent EGD tended to decrease the hospital stay, although this was not statistically significant (7.7 days vs. 12.0 days, p > 0.05). Urgent EGD after hours by experienced endoscopists had an excellent endoscopic success rate. However, clinical outcomes were not significantly different between the urgent and early EGD groups.

Ceramic-ceramic shell tile thermal protection system and method thereof

NASA Technical Reports Server (NTRS)

Riccitiello, Salvatore R. (Inventor); Smith, Marnell (Inventor); Goldstein, Howard E. (Inventor); Zimmerman, Norman B. (Inventor)

1986-01-01

A ceramic reusable, externally applied composite thermal protection system (TPS) is proposed. The system functions by utilizing a ceramic/ceramic upper shell structure which effectively separates its primary functions as a thermal insulator and as a load carrier to transmit loads to the cold structure. The composite tile system also prevents impact damage to the atmospheric entry vehicle thermal protection system. The composite tile comprises a structurally strong upper ceramic/ceramic shell manufactured from ceramic fibers and ceramic matrix meeting the thermal and structural requirements of a tile used on a re-entry aerospace vehicle. In addition, a lightweight high temperature ceramic lower temperature base tile is used. The upper shell and lower tile are attached by means effective to withstand the extreme temperatures (3000 to 3200F) and stress conditions. The composite tile may include one or more layers of variable density rigid or flexible thermal insulation. The assembly of the overall tile is facilitated by two or more locking mechanisms on opposing sides of the overall tile assembly. The assembly may occur subsequent to the installation of the lower shell tile on the spacecraft structural skin.

Predicting the Occurrence of Hypotension in Stable Patients With Nonvariceal Upper Gastrointestinal Bleeding: Point-of-Care Lactate Testing.

PubMed

Ko, Byuk Sung; Kim, Won Young; Ryoo, Seung Mok; Ahn, Shin; Sohn, Chang Hwan; Seo, Dong Woo; Lee, Yoon-Seon; Lim, Kyoung Soo; Jung, Hwoon-Yong

2015-11-01

It is difficult to assess risk in normotensive patients with upper gastrointestinal bleeding. The aim of this study was to evaluate whether the initial lactate value can predict the in-hospital occurrence of hypotension in stable patients with acute nonvariceal upper gastrointestinal bleeding. Retrospective, observational, single-center study. Emergency department of a tertiary-care, university-affiliated hospital during a 5-year period. Medical records of 3,489 patients with acute upper gastrointestinal bleeding who were normotensive at presentation to the emergency department. We analyzed the ability of point-of-care testing of lactate at emergency department admission to predict hypotension development (defined as systolic blood pressure <90 mm Hg) within 24 hours after emergency department admission. None. Of the 1,003 patients with acute nonvariceal upper gastrointestinal bleeding, 157 patients experienced hypotension within 24 hours. Lactate was independently associated with hypotension development (odds ratio, 1.6; 95% CI, 1.4-1.7), and the risk of hypotension significantly increased as the lactate increased from 2.5-4.9 mmol/L (odds ratio, 2.2) to 5.0-7.4 mmol/L (odds ratio, 4.0) and to greater than or equal to 7.5 mmol/L (odds ratio, 39.2) (p<0.001). Lactate elevation (≥2.5 mmol/L) was associated with 90% specificity and an 84% negative predictive value for hypotension development. When the lactate levels were greater than 5.0 mmol/L, the specificity and negative predictive value increased to 98% and 87%, respectively. Point-of-care testing of lactate can predict in-hospital occurrence of hypotension in stable patients with acute nonvariceal upper gastrointestinal bleeding. However, subsequently, prospective validate research will be required to clarify this.

How to avoid the inappropriate use of antibiotics in upper respiratory tract infections? A position statement from an expert panel.

PubMed

Piltcher, Otávio Bejzman; Kosugi, Eduardo Macoto; Sakano, Eulalia; Mion, Olavo; Testa, José Ricardo Gurgel; Romano, Fabrizio Ricci; Santos, Marco Cesar Jorge; Di Francesco, Renata Cantisani; Mitre, Edson Ibrahim; Bezerra, Thiago Freire Pinto; Roithmann, Renato; Padua, Francini Greco; Valera, Fabiana Cardoso Pereira; Lubianca Neto, José Faibes; Sá, Leonardo Conrado Barbosa; Pignatari, Shirley Shizue Nagata; Avelino, Melissa Ameloti Gomes; Caixeta, Juliana Alves de Souza; Anselmo-Lima, Wilma Terezinha; Tamashiro, Edwin

Bacterial resistance burden has increased in the past years, mainly due to inappropriate antibiotic use. Recently it has become an urgent public health concern due to its impact on the prolongation of hospitalization, an increase of total cost of treatment and mortality associated with infectious disease. Almost half of the antimicrobial prescriptions in outpatient care visits are prescribed for acute upper respiratory infections, especially rhinosinusitis, otitis media, and pharyngotonsillitis. In this context, otorhinolaryngologists play an important role in orienting patients and non-specialists in the utilization of antibiotics rationally and properly in these infections. To review the most recent recommendations and guidelines for the use of antibiotics in acute otitis media, acute rhinosinusitis, and pharyngotonsillitis, adapted to our national reality. A literature review on PubMed database including the medical management in acute otitis media, acute rhinosinusitis, and pharyngotonsillitis, followed by a discussion with a panel of specialists. Antibiotics must be judiciously prescribed in uncomplicated acute upper respiratory tract infections. The severity of clinical presentation and the potential risks for evolution to suppurative and non-suppurative complications must be taken into 'consideration'. Periodic revisions on guidelines and recommendations for treatment of the main acute infections are necessary to orient rationale and appropriate use of antibiotics. Continuous medical education and changes in physicians' and patients' behavior are required to modify the paradigm that all upper respiratory infection needs antibiotic therapy, minimizing the consequences of its inadequate and inappropriate use. Copyright © 2018 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

Gross mismatch between thermal tolerances and environmental temperatures in a tropical freshwater snail: climate warming and evolutionary implications.

PubMed

Polgar, Gianluca; Khang, Tsung Fei; Chua, Teddy; Marshall, David J

2015-01-01

The relationship between acute thermal tolerance and habitat temperature in ectotherm animals informs about their thermal adaptation and is used to assess thermal safety margins and sensitivity to climate warming. We studied this relationship in an equatorial freshwater snail (Clea nigricans), belonging to a predominantly marine gastropod lineage (Neogastropoda, Buccinidae). We found that tolerance of heating and cooling exceeded average daily maximum and minimum temperatures, by roughly 20°C in each case. Because habitat temperature is generally assumed to be the main selective factor acting on the fundamental thermal niche, the discordance between thermal tolerance and environmental temperature implies trait conservation following 'in situ' environmental change, or following novel colonisation of a thermally less-variable habitat. Whereas heat tolerance could relate to an historical association with the thermally variable and extreme marine intertidal fringe zone, cold tolerance could associate with either an ancestral life at higher latitudes, or represent adaptation to cooler, higher-altitudinal, tropical lotic systems. The broad upper thermal safety margin (difference between heat tolerance and maximum environmental temperature) observed in this snail is grossly incompatible with the very narrow safety margins typically found in most terrestrial tropical ectotherms (insects and lizards), and hence with the emerging prediction that tropical ectotherms, are especially vulnerable to environmental warming. A more comprehensive understanding of climatic vulnerability of animal ectotherms thus requires greater consideration of taxonomic diversity, ecological transition and evolutionary history. Copyright © 2014 Elsevier Ltd. All rights reserved.

CVD Rhenium Engines for Solar-Thermal Propulsion Systems

NASA Technical Reports Server (NTRS)

Williams, Brian E.; Fortini, Arthur J.; Tuffias, Robert H.; Duffy, Andrew J.; Tucker, Stephen P.

1999-01-01

Solar-thermal upper-stage propulsion systems have the potential to provide specific impulse approaching 900 seconds, with 760 seconds already demonstrated in ground testing. Such performance levels offer a 100% increase in payload capability compared to state-of-the-art chemical upper-stage systems, at lower cost. Although alternatives such as electric propulsion offer even greater performance, the 6- to 18- month orbital transfer time is a far greater deviation from the state of the art than the one to two months required for solar propulsion. Rhenium metal is the only material that is capable of withstanding the predicted thermal, mechanical, and chemical environment of a solar-thermal propulsion device. Chemical vapor deposition (CVD) is the most well-established and cost-effective process for the fabrication of complex rhenium structures. CVD rhenium engines have been successfully constructed for the Air Force ISUS program (bimodal thrust/electricity) and the NASA Shooting Star program (thrust only), as well as under an Air Force SBIR project (thrust only). The bimodal engine represents a more long-term and versatile approach to solar-thermal propulsion, while the thrust-only engines provide a potentially lower weight/lower cost and more near-term replacement for current upper-stage propulsion systems.

C-reactive protein as a prognostic indicator for rebleeding in patients with nonvariceal upper gastrointestinal bleeding.

PubMed

Lee, Han Hee; Park, Jae Myung; Lee, Soon-Wook; Kang, Seung Hun; Lim, Chul-Hyun; Cho, Yu Kyung; Lee, Bo-In; Lee, In Seok; Kim, Sang Woo; Choi, Myung-Gyu

2015-05-01

In patients with acute nonvariceal upper gastrointestinal bleeding, rebleeding after an initial treatment is observed in 10-20% and is associated with mortality. To investigate whether the initial serum C-reactive protein level could predict the risk of rebleeding in patients with acute nonvariceal upper gastrointestinal bleeding. This was a retrospective study using prospectively collected data for upper gastrointestinal bleeding. Initial clinical characteristics, endoscopic features, and C-reactive protein levels were compared between those with and without 30-day rebleeding. A total of 453 patients were included (mean age, 62 years; male, 70.9%). The incidence of 30-day rebleeding was 15.9%. The mean serum C-reactive protein level was significantly higher in these patients than in those without rebleeding (P<0.001). The area under the receiver operating characteristics curve with a cutoff value of 0.5mg/dL was 0.689 (P<0.001). High serum C-reactive protein level (odds ratio, 2.98; confidence interval, 1.65-5.40) was independently associated with the 30-day rebleeding risk after adjustment for the main confounding risk factors, including age, blood pressure, and initial haemoglobin level. The serum C-reactive protein was an independent risk factor for 30-day rebleeding in patients with acute nonvariceal upper gastrointestinal bleeding, indicating a possible role as a useful screening indicator for predicting the risk of rebleeding. Copyright © 2015 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

Flexible thermal apparatus for mounting of thermoelectric cooler

NASA Technical Reports Server (NTRS)

Jones, Jack A. (Inventor); Petrick, S. Walter (Inventor); Bard, Steven (Inventor)

1991-01-01

A flexible heat transfer apparatus used to flexibly connect and thermally couple a thermoelectric cooler to an object to be cooled is disclosed. The flexible heat transfer apparatus consists of a pair of flexible corrugated sheets made from high thermal conductivity materials such as copper, aluminum, gold, or silver. The ridges of the corrugated sheets are oriented perpendicular to one another and bonded sandwich-fashion between three plates to define an upper section and a lower section. The upper section provides X flexure, the lower section provides Y flexure, and both sections together provide Z flexure.

Global analysis of thermal tolerance and latitude in ectotherms

PubMed Central

Sunday, Jennifer M.; Bates, Amanda E.; Dulvy, Nicholas K.

2011-01-01

A tenet of macroecology is that physiological processes of organisms are linked to large-scale geographical patterns in environmental conditions. Species at higher latitudes experience greater seasonal temperature variation and are consequently predicted to withstand greater temperature extremes. We tested for relationships between breadths of thermal tolerance in ectothermic animals and the latitude of specimen location using all available data, while accounting for habitat, hemisphere, methodological differences and taxonomic affinity. We found that thermal tolerance breadths generally increase with latitude, and do so at a greater rate in the Northern Hemisphere. In terrestrial ectotherms, upper thermal limits vary little while lower thermal limits decrease with latitude. By contrast, marine species display a coherent poleward decrease in both upper and lower thermal limits. Our findings provide comprehensive global support for hypotheses generated from studies at smaller taxonomic subsets and geographical scales. Our results further indicate differences between terrestrial and marine ectotherms in how thermal physiology varies with latitude that may relate to the degree of temperature variability experienced on land and in the ocean. PMID:21106582

Student learning of upper-level thermal and statistical physics: The derivation and use of the Boltzmann factor

NASA Astrophysics Data System (ADS)

Thompson, John

2015-04-01

As the Physical Review Focused Collection demonstrates, recent frontiers in physics education research include systematic investigations at the upper division. As part of a collaborative project, we have examined student understanding of several topics in upper-division thermal and statistical physics. A fruitful context for research is the Boltzmann factor in statistical mechanics: the standard derivation involves several physically justified mathematical steps as well as the invocation of a Taylor series expansion. We have investigated student understanding of the physical significance of the Boltzmann factor as well as its utility in various circumstances, and identified various lines of student reasoning related to the use of the Boltzmann factor. Results from written data as well as teaching interviews suggest that many students do not use the Boltzmann factor when answering questions related to probability in applicable physical situations, even after lecture instruction. We designed an inquiry-based tutorial activity to guide students through a derivation of the Boltzmann factor and to encourage deep connections between the physical quantities involved and the mathematics. Observations of students working through the tutorial suggest that many students at this level can recognize and interpret Taylor series expansions, but they often lack fluency in creating and using Taylor series appropriately, despite previous exposure in both calculus and physics courses. Our findings also suggest that tutorial participation not only increases the prevalence of relevant invocation of the Boltzmann factor, but also helps students gain an appreciation of the physical implications and meaning of the mathematical formalism behind the formula. Supported in part by NSF Grants DUE-0817282, DUE-0837214, and DUE-1323426.

SolSTUS: Solar Source Thermal Upper Stage

NASA Astrophysics Data System (ADS)

This paper was written by members of the Utah State University (USU) Space Systems Design class, fall quarter 1993. The class is funded by NASA and administered by the University Space Research Association (USRA). The focus of the class is to give students some experience in design of space systems and as a source of original ideas for NASA. This paper is a summary of the work done by members of the Space Systems Design class during the opening phase of the course. The class was divided into groups to work on different areas of the Solar Thermal Rocket (STR) booster in order to produce a design reference mission that would identify the key design issues. The design reference mission focused upon a small satellite mission to Mars. There are several critical components in a Solar Thermal Rocket. STR's produce a very low thrust, but have a high specific impulse, meaning that they take longer to reach the desired orbit, but use a lot less fuel in doing it. The complexity of the rocket is discussed in this paper. Some of the more critical design problems discussed are: (1) the structural and optical complexity of collecting and focusing sunlight onto a specific point, (2) long term storage of fuel (liquid hydrogen), (3) attitude control while thrusting in an elliptical orbit and orienting the mirrors to collect sunlight, and (4) power and communications for the rocket and it's internal systems. The design reference mission discussed here is a very general mission to Mars. A first order trajectory design has been done and a possible basic science payload for Mars has been suggested. This paper summarizes the design reference mission (DRM) formulated by the USU students during fall quarter and identifies major design challenges that will confront the design team during the next two quarters here at USU.

SolSTUS: Solar Source Thermal Upper Stage

NASA Technical Reports Server (NTRS)

1994-01-01

This paper was written by members of the Utah State University (USU) Space Systems Design class, fall quarter 1993. The class is funded by NASA and administered by the University Space Research Association (USRA). The focus of the class is to give students some experience in design of space systems and as a source of original ideas for NASA. This paper is a summary of the work done by members of the Space Systems Design class during the opening phase of the course. The class was divided into groups to work on different areas of the Solar Thermal Rocket (STR) booster in order to produce a design reference mission that would identify the key design issues. The design reference mission focused upon a small satellite mission to Mars. There are several critical components in a Solar Thermal Rocket. STR's produce a very low thrust, but have a high specific impulse, meaning that they take longer to reach the desired orbit, but use a lot less fuel in doing it. The complexity of the rocket is discussed in this paper. Some of the more critical design problems discussed are: (1) the structural and optical complexity of collecting and focusing sunlight onto a specific point, (2) long term storage of fuel (liquid hydrogen), (3) attitude control while thrusting in an elliptical orbit and orienting the mirrors to collect sunlight, and (4) power and communications for the rocket and it's internal systems. The design reference mission discussed here is a very general mission to Mars. A first order trajectory design has been done and a possible basic science payload for Mars has been suggested. This paper summarizes the design reference mission (DRM) formulated by the USU students during fall quarter and identifies major design challenges that will confront the design team during the next two quarters here at USU.

Thermal tolerance in tropical versus subtropical Pacific reef corals

DOE Office of Scientific and Technical Information (OSTI.GOV)

Coles, S.L.; Jokiel, P.L.; Lewis, C.R.

1976-04-01

Upper lethal temperature tolerances of reef corals in Hawaii and at Enewetak, Marshall Islands, were determined in the field and under controlled laboratory conditions. Enewetak corals survived in situ temperatures of nearly 34/sup 0/C, whereas 32/sup 0/C was lethal to Hawaiian corals for similar short-term exposures. Laboratory determinations indicate that the upper thermal limits of Hawaiian corals are approximately 2/sup 0/C less than congeners from the tropical Pacific. Differences in coral thermal tolerances correspond to differences in the ambient temperature patterns between geographic areas.

Upper stage technology evaluation studies

NASA Technical Reports Server (NTRS)

1972-01-01

Studies to evaluate advanced technology relative to chemical upper stages and orbit-to-orbit stages are reported. The work described includes: development of LH2/LOX stage data, development of data to indicate stage sensitivity to engine tolerance, modified thermal routines to accommodate storable propellants, added stage geometries to computer program for monopropellant configurations, determination of the relative gain obtainable through improvement of stage mass fraction, future propulsion concepts, effect of ultrahigh chamber-pressure increases, and relative gains obtainable through improved mass fraction.

Upper Stage Tank Thermodynamic Modeling Using SINDA/FLUINT

NASA Technical Reports Server (NTRS)

Schallhorn, Paul; Campbell, D. Michael; Chase, Sukhdeep; Piquero, Jorge; Fortenberry, Cindy; Li, Xiaoyi; Grob, Lisa

2006-01-01

Modeling to predict the condition of cryogenic propellants in an upper stage of a launch vehicle is necessary for mission planning and successful execution. Traditionally, this effort was performed using custom, in-house proprietary codes, limiting accessibility and application. Phenomena responsible for influencing the thermodynamic state of the propellant have been characterized as distinct events whose sequence defines a mission. These events include thermal stratification, passive thermal control roll (rotation), slosh, and engine firing. This paper demonstrates the use of an off the shelf, commercially available, thermal/fluid-network code to predict the thermodynamic state of propellant during the coast phase between engine firings, i.e. the first three of the above identified events. Results of this effort will also be presented.

Thermal modeling in Ceuta, Maracaibo Basin, Venezuela

DOE Office of Scientific and Technical Information (OSTI.GOV)

Marcano, F.; Padron, S.

1993-02-01

Hydrocarbon generation from Upper Cretaceous source rocks (Fm.La Luna) in Ceuta, center-eastern Maracaibo lake area in Venezuela, is modeled here, using a kinetic method and the conventional Time-Temperature Index (TTI) procedure. Geological evolution, burial and erosional history is based on available interpretation of 3D seismic and well data. Fragmentary present-day subsurface temperature data comes from corrected measurements in a few wells. Paleogradient/heat paleoflux was estimated during the thermal modeling on wells, by calculating vitrinite reflectances (Ro) or Tmax values and then comparing them with measured ones. However, thermal-indicator data does not always appear to be consistent and some data hadmore » to be rejected. Paleogradient evolution in the Cretaceous is controlled by the development of a isolated thermal compartment related to overpressures in a thick shaly sequence in the Upper Cretaceous. A geological section was studied in detail to illustrate possible migration paths to known fields and undrilled traps. Results show a good fit between the thermal evolution of the source rock and the maturity of the crude produced in the area.« less

XUV-exposed, non-hydrostatic hydrogen-rich upper atmospheres of terrestrial planets. Part I: atmospheric expansion and thermal escape.

PubMed

Erkaev, Nikolai V; Lammer, Helmut; Odert, Petra; Kulikov, Yuri N; Kislyakova, Kristina G; Khodachenko, Maxim L; Güdel, Manuel; Hanslmeier, Arnold; Biernat, Helfried

2013-11-01

The recently discovered low-density "super-Earths" Kepler-11b, Kepler-11f, Kepler-11d, Kepler-11e, and planets such as GJ 1214b represent the most likely known planets that are surrounded by dense H/He envelopes or contain deep H₂O oceans also surrounded by dense hydrogen envelopes. Although these super-Earths are orbiting relatively close to their host stars, they have not lost their captured nebula-based hydrogen-rich or degassed volatile-rich steam protoatmospheres. Thus, it is interesting to estimate the maximum possible amount of atmospheric hydrogen loss from a terrestrial planet orbiting within the habitable zone of late main sequence host stars. For studying the thermosphere structure and escape, we apply a 1-D hydrodynamic upper atmosphere model that solves the equations of mass, momentum, and energy conservation for a planet with the mass and size of Earth and for a super-Earth with a size of 2 R(Earth) and a mass of 10 M(Earth). We calculate volume heating rates by the stellar soft X-ray and extreme ultraviolet radiation (XUV) and expansion of the upper atmosphere, its temperature, density, and velocity structure and related thermal escape rates during the planet's lifetime. Moreover, we investigate under which conditions both planets enter the blow-off escape regime and may therefore experience loss rates that are close to the energy-limited escape. Finally, we discuss the results in the context of atmospheric evolution and implications for habitability of terrestrial planets in general.

ACG Clinical Guideline: Management of Patients With Acute Lower Gastrointestinal Bleeding.

PubMed

Strate, Lisa L; Gralnek, Ian M

2016-04-01

This guideline provides recommendations for the management of patients with acute overt lower gastrointestinal bleeding. Hemodynamic status should be initially assessed with intravascular volume resuscitation started as needed. Risk stratification based on clinical parameters should be performed to help distinguish patients at high- and low-risk of adverse outcomes. Hematochezia associated with hemodynamic instability may be indicative of an upper gastrointestinal (GI) bleeding source and thus warrants an upper endoscopy. In the majority of patients, colonoscopy should be the initial diagnostic procedure and should be performed within 24 h of patient presentation after adequate colon preparation. Endoscopic hemostasis therapy should be provided to patients with high-risk endoscopic stigmata of bleeding including active bleeding, non-bleeding visible vessel, or adherent clot. The endoscopic hemostasis modality used (mechanical, thermal, injection, or combination) is most often guided by the etiology of bleeding, access to the bleeding site, and endoscopist experience with the various hemostasis modalities. Repeat colonoscopy, with endoscopic hemostasis performed if indicated, should be considered for patients with evidence of recurrent bleeding. Radiographic interventions (tagged red blood cell scintigraphy, computed tomographic angiography, and angiography) should be considered in high-risk patients with ongoing bleeding who do not respond adequately to resuscitation and who are unlikely to tolerate bowel preparation and colonoscopy. Strategies to prevent recurrent bleeding should be considered. Nonsteroidal anti-inflammatory drug use should be avoided in patients with a history of acute lower GI bleeding, particularly if secondary to diverticulosis or angioectasia. Patients with established high-risk cardiovascular disease should not stop aspirin therapy (secondary prophylaxis) in the setting of lower GI bleeding. [corrected]. The exact timing depends on the

Distinctive inflammatory profile between acute focal bacterial nephritis and acute pyelonephritis in children.

PubMed

Mizutani, Makoto; Hasegawa, Shunji; Matsushige, Takeshi; Ohta, Naoki; Kittaka, Setsuaki; Hoshide, Madoka; Kusuda, Takeshi; Takahashi, Kazumasa; Ichihara, Kiyoshi; Ohga, Shouichi

2017-11-01

Acute focal bacterial nephritis (AFBN) is a severe form of upper urinary tract infection (UTI) with neurological manifestations and focal renal mass lesions on computed tomography (CT). Prolonged antibiotic therapy may improve the renal outcome, but the early differential diagnosis of AFBN from acute pyelonephritis (APN) is challenging. We searched for effective biomarkers of AFBN based on the pathophysiology of upper UTIs. Of 52 upper UTI cases treated at Yamaguchi University between 2009 and 2016, 38 pediatric patients with AFBN (n=17) or APN (n=21) who underwent ultrasonography and/or CT were enrolled. The clinical data and serum cytokine concentrations were analyzed to differentiate AFBN from APN. AFBN patients tended to be older, and have a higher body temperature, longer febrile period, more frequent neurological symptoms, higher immature neutrophil count, lower lymphocyte count, higher procalcitonin and urine β 2 -microglobulin levels. AFBN patients showed higher serum levels of IFN-γ, IL-6, IL-10 and soluble TNF-receptor 1 (sTNFR1) (all p<0.05). Although the cytokine levels were variably correlated among each other, multiple logistic regression analysis revealed that combination of IFN-γ and IL-6 levels were most relevant for distinguishing AFBN from APN. The discriminant power of the logistic equation was 0.86 in terms of the area under the curve by the ROC analysis. Circulating 4 out of 7 cytokines in AFBN patients were at higher levels compared with those in APN patients. IFN-γ and IL-6 levels might most effectively distinguish AFBN from APN. Copyright © 2017 Elsevier Ltd. All rights reserved.

Exploring the impact of visual and movement based priming on a motor intervention in the acute phase post-stroke in persons with severe hemiparesis of the upper extremity.

PubMed

Patel, Jigna; Qiu, Qinyin; Yarossi, Mathew; Merians, Alma; Massood, Supriya; Tunik, Eugene; Adamovich, Sergei; Fluet, Gerard

2017-07-01

Explore the potential benefits of using priming methods prior to an active hand task in the acute phase post-stroke in persons with severe upper extremity hemiparesis. Five individuals were trained using priming techniques including virtual reality (VR) based visual mirror feedback and contralaterally controlled passive movement strategies prior to training with an active pinch force modulation task. Clinical, kinetic, and neurophysiological measurements were taken pre and post the training period. Clinical measures were taken at six months post training. The two priming simulations and active training were well tolerated early after stroke. Priming effects were suggested by increased maximal pinch force immediately after visual and movement based priming. Despite having no clinically observable movement distally, the subjects were able to volitionally coordinate isometric force and muscle activity (EMG) in a pinch tracing task. The Root Mean Square Error (RMSE) of force during the pinch trace task gradually decreased over the training period suggesting learning may have occurred. Changes in motor cortical neurophysiology were seen in the unaffected hemisphere using Transcranial Magnetic Stimulation (TMS) mapping. Significant improvements in motor recovery as measured by the Action Research Arm Test (ARAT) and the Upper Extremity Fugl Meyer Assessment (UEFMA) were demonstrated at six months post training by three of the five subjects. This study suggests that an early hand-based intervention using visual and movement based priming activities and a scaled motor task allows participation by persons without the motor control required for traditionally presented rehabilitation and testing. Implications for Rehabilitation Rehabilitation of individuals with severely paretic upper extremities after stroke is challenging due to limited movement capacity and few options for therapeutic training. Long-term functional recovery of the arm after stroke depends on early return

Lessons Learned from Ares I Upper Stage Structures and Thermal Design

NASA Technical Reports Server (NTRS)

Ahmed, Rafiq

2012-01-01

The Ares 1 Upper Stage was part of the vehicle intended to succeed the Space Shuttle as the United States manned spaceflight vehicle. Although the Upper Stage project was cancelled, there were many lessons learned that are applicable to future vehicle design. Lessons learned that are briefly detailed in this Technical Memorandum are for specific technical areas such as tank design, common bulkhead design, thrust oscillation, control of flight and slosh loads, purge and hazardous gas system. In addition, lessons learned from a systems engineering and vehicle integration perspective are also included, such as computer aided design and engineering, scheduling, and data management. The need for detailed systems engineering in the early stages of a project is emphasized throughout this report. The intent is that future projects will be able to apply these lessons learned to keep costs down, schedules brief, and deliver products that perform to the expectations of their customers.

Effect of Heavy Dynamic Resistive Exercise on Acute Upper-Body Power.

ERIC Educational Resources Information Center

Hrysomallis, Con; Kidgell, Dawson

2001-01-01

Determined the influence of a heavy-load bench press on indicators of upper-body power during an explosive pushup, examining the influence of a set of 5 repetitions of 5 repetition maximum (RM) bench press preceding explosive pushups. There were no significant differences for any of the force platform data when explosive pushups were preceded by…

Solar Thermal Propulsion Optical Figure Measuring and Rocket Engine Testing

NASA Technical Reports Server (NTRS)

Bonometti, Joseph

1997-01-01

Solar thermal propulsion has been an important area of study for four years at the Propulsion Research Center. Significant resources have been devoted to the development of the UAH Solar Thermal Laboratory that provides unique, high temperature, test capabilities. The facility is fully operational and has successfully conducted a series of solar thruster shell experiments. Although presently dedicated to solar thermal propulsion, the facility has application to a variety of material processing, power generation, environmental clean-up, and other fundamental research studies. Additionally, the UAH Physics Department has joined the Center in support of an in-depth experimental investigation on Solar Thermal Upper Stage (STUS) concentrators. Laboratory space has been dedicated to the concentrator evaluation in the UAH Optics Building which includes a vertical light tunnel. Two, on-going, research efforts are being sponsored through NASA MSFC (Shooting Star Flight Experiment) and the McDonnell Douglas Corporation (Solar Thermal Upper Stage Technology Ground Demonstrator).

Interventional Therapy for Upper Extremity Deep Vein Thrombosis

PubMed Central

Carlon, Timothy A.; Sudheendra, Deepak

2017-01-01

Approximately 10% of all deep vein thromboses occur in the upper extremity, and that number is increasing due to the use of peripherally inserted central catheters. Sequelae of upper extremity deep vein thrombosis (UEDVT) are similar to those for lower extremity deep vein thrombosis (LEDVT) and include postthrombotic syndrome and pulmonary embolism. In addition to systemic anticoagulation, there are multiple interventional treatment options for UEDVT with the potential to reduce the incidence of these sequelae. To date, there have been no randomized trials to define the optimal management strategy for patients presenting with UEDVT, so many conclusions are drawn from smaller, single-center studies or from LEDVT research. In this article, the authors describe the evidence for the currently available treatment options and an approach to a patient with acute UEDVT. PMID:28265130

Vocal Function and Upper Airway Thermoregulation in Five Different Environmental Conditions

PubMed Central

Sandage, Mary J.; Connor, Nadine P.; Pascoe, David D.

2013-01-01

Purpose Phonation threshold pressure and perceived phonatory effort were hypothesized to increase and upper airway temperature decrease following exposure to cold and/or dry air. Greater changes were expected with mouth versus nose breathing. Method Using a within-participant repeated measures design, 15 consented participants (7 men, 8 women) completed 20-minute duration trials to allow for adequate thermal equilibration for both nose and mouth breathing in five different environments: three temperatures (°C) matched for relative humidity (%RH): cold (15°C/40% RH), thermally neutral (25°C/40% RH), and hot (35°C/40% RH); and two temperatures with variable relative humidity to match vapor pressure for the neutral environment (25°C/40% RH): cold (15°C/74% RH) and hot (35°C; 23% RH). Following each equilibration trial, measures were taken in this order: upper airway temperature (transnasal thermistor probe), phonation threshold pressure, and perceived phonatory effort. Results Data were analyzed using repeated measures analysis of variance and no significant differences were established. Conclusions The study hypotheses were not supported. Findings suggest that the upper airway is tightly regulated for temperature when challenged by a realistic range of temperature/relative humidity environments. This is the first study of its kind to include measurement of upper airway temperature in conjunction with measures of vocal function. PMID:23900031

Vocal function and upper airway thermoregulation in five different environmental conditions.

PubMed

Sandage, Mary J; Connor, Nadine P; Pascoe, David D

2014-02-01

Phonation threshold pressure and perceived phonatory effort were hypothesized to increase and upper airway temperature to decrease following exposure to cold and/or dry air. Greater changes were expected with mouth versus nose breathing. In a within-participant repeated measures design, 15 consented participants (7 men, 8 women) completed 20-min duration trials to allow for adequate thermal equilibration for both nose and mouth breathing in 5 different environments: 3 temperatures (°C) matched for relative humidity (% RH), cold (15 °C, 40% RH), thermally neutral (25 °C, 40% RH), and hot (35 °C, 40% RH); and 2 temperatures with variable relative humidity to match vapor pressure for the neutral environment (25 °C, 40% RH), cold (15 °C, 74% RH) and hot (35 °C, 23% RH). Following each equilibration trial, measures were taken in this order: upper airway temperature (transnasal thermistor probe), phonation threshold pressure, and perceived phonatory effort. Data were analyzed using repeated measures analysis of variance, and no significant differences were established. The study hypotheses were not supported. Findings suggest that the upper airway is tightly regulated for temperature when challenged by a realistic range of temperature and relative humidity environments. This is the first study of its kind to include measurement of upper airway temperature in conjunction with measures of vocal function.

Thermal maturity and petroleum kitchen areas of Liassic Black Shales (Lower Jurassic) in the central Upper Rhine Graben, Germany

NASA Astrophysics Data System (ADS)

Böcker, Johannes; Littke, Ralf

2016-03-01

In the central Upper Rhine Graben (URG), several major oil fields have been sourced by Liassic Black Shales. In particular, the Posidonia Shale (Lias ɛ, Lower Toarcian) acts as excellent and most prominent source rock in the central URG. This study is the first comprehensive synthesis of Liassic maturity data in the URG area and SW Germany. The thermal maturity of the Liassic Black Shales has been analysed by vitrinite reflectance (VRr) measurements, which have been verified with T max and spore coloration index (SCI) data. In outcrops and shallow wells (<600 m), the Liassic Black Shales reached maturities equivalent to the very early or early oil window (ca. 0.50-0.60 % VRr). This maturity is found in Liassic outcrops and shallow wells in the entire URG area and surrounding Swabian Jura Mountains. Maximum temperatures of the Posidonia Shale before graben formation are in the order of 80-90 °C. These values were likely reached during Late Cretaceous times due to significant Upper Jurassic and minor Cretaceous deposition and influenced by higher heat flows of the beginning rift event at about 70 Ma. In this regard, the consistent regional maturity data (VRr, T max, SCI) of 0.5-0.6 % VRr for the Posidonia Shale close to surface suggest a major burial-controlled maturation before graben formation. These consistent maturity data for Liassic outcrops and shallow wells imply no significant oil generation and expulsion from the Posidonia Shale before formation of the URG. A detailed VRr map has been created using VRr values of 31 wells and outcrops with a structure map of the Posidonia Shale as reference map for a depth-dependent gridding operation. Highest maturity levels occur in the area of the Rastatt Trough (ca. 1.5 % VRr) and along the graben axis with partly very high VRr gradients (e.g. well Scheibenhardt 2). In these deep graben areas, the maximum temperatures which were reached during upper Oligocene to Miocene times greatly exceed those during the Cretaceous.

Acclimation-dependent expression of heat shock protein 70 in Pacific abalone ( Haliotis discus hannai Ino) and its acute response to thermal exposure

NASA Astrophysics Data System (ADS)

Li, Jiaqi; He, Qingguo; Sun, Hui; Liu, Xiao

2012-01-01

Heat shock protein 70 (Hsp70) is one important member of heat shock protein (Hsp) family that is responsible for various stresses, especially thermal stress. Here we examined the response of Hsp70 gene to both chronic and acute thermal exposure in Pacific abalone ( Haliotis discus hannai Ino). For the chronic exposure, abalones were maintained at 8, 12, 20, and 30°C for four months and their mRNA levels were measured. The highest mRNA level of Hsp70 gene relative to actin gene was detected in the 30°C-acclimated group, followed by the 8°C-acclimated group and then the 12°C- and 20°C-acclimated groups. After the long-term acclimation, gills from each of the above acclimation groups were dissected and exposed to different temperatures between 8°C and 38°C for 30 min. Hsp70 expression in gills acclimated to different temperatures responded differentially to the same temperature exposure. The incubation temperature that induced maximum Hsp70 mRNA expression was higher in the higher temperature acclimation groups than lower temperature groups. Pacific abalones could alter the expression pattern of Hsp70 gene according to environmental thermal conditions, through which they deal with the stress of thermal variations.

Multiple sessions of transcranial direct current stimulation and upper extremity rehabilitation in stroke: A review and meta-analysis.

PubMed

Tedesco Triccas, L; Burridge, J H; Hughes, A M; Pickering, R M; Desikan, M; Rothwell, J C; Verheyden, G

2016-01-01

To systematically review the methodology in particular treatment options and outcomes and the effect of multiple sessions of transcranial direct current stimulation (tDCS) with rehabilitation programmes for upper extremity recovery post stroke. A search was conducted for randomised controlled trials involving tDCS and rehabilitation for the upper extremity in stroke. Quality of included studies was analysed using the Modified Downs and Black form. The extent of, and effect of variation in treatment parameters such as anodal, cathodal and bi-hemispheric tDCS on upper extremity outcome measures of impairment and activity were analysed using meta-analysis. Nine studies (371 participants with acute, sub-acute and chronic stroke) were included. Different methodologies of tDCS and upper extremity intervention, outcome measures and timing of assessments were identified. Real tDCS combined with rehabilitation had a small non-significant effect of +0.11 (p=0.44) and +0.24 (p=0.11) on upper extremity impairments and activities at post-intervention respectively. Various tDCS methods have been used in stroke rehabilitation. The evidence so far is not statistically significant, but is suggestive of, at best, a small beneficial effect on upper extremity impairment. Future research should focus on which patients and rehabilitation programmes are likely to respond to different tDCS regimes. Copyright © 2015 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

A Rat Model of Full Thickness Thermal Injury Characterized by Thermal Hyperalgesia, Mechanical Allodynia, Pronociceptive Peptide Release and Tramadol Analgesia

DTIC Science & Technology

2014-01-01

tramadol reduces acute, postoperative, neuropathic and cancer pain [9,10,12 14] and may have a lower propensity to induce addiction [15] with little to...opioid systems simultaneously, we next examined whether tramadol could attenuate burn evoked pain behaviors in our rat model of full thickness thermal...injury. Tramadol attenuated thermal hyperalgesia when administered one week following thermal injury, a time point when pain behaviors peak in this

A Case of Acute Pancreatitis developing after Extracorporeal Shock Wave Lithotripsy.

PubMed

Goral, Vedat; Sahin, Erkan; Arslan, Murat

2015-01-01

Extracorporeal shock wave lithotripsy (ESWL) is a standard treatment method used for the treatment of renal calculi and upper ureteral calculi. Acute pancreatitis is a serious condition which develops due to multiple etiologic factors and is characterized by autodigestion of the pancreas. A case of acute pancreatitis which developed following ESWL performed for right renal calculi treatment is presented here. Goral V, Sahin E, Arslan M. A Case of Acute Pancreatitis developing after Extracorporeal Shock Wave Lithotripsy. Euroasian J Hepato-Gastroenterol 2015;5(1):52-54.

Second report on the Oak Ridge Y-12 Plant fish kill for Upper East Fork Poplar Creek

DOE Office of Scientific and Technical Information (OSTI.GOV)

Etnier, E.L.; Opresko, D.M.; Talmage, S.S.

1994-08-01

This report summarizes the monitoring of fish kills in upper East Fork Poplar Creek (EFPC) from July 1990 to June 1993. Since the opening of Lake Reality (LR) in 1988, total numbers of fish inhabiting upper EFPC have increased. However, species diversity has remained poor. Water quality data have been collected in upper EFPC during the time period covered in this report. Total residual chlorine (TRC) levels have exceeded federal and state water quality criteria over the years. However, with the installation of two dechlorination systems in late 1992, TRC levels have been substantially lowered in most portions of uppermore » EFPC. By June 1993, concentrations of TRC were 0.04 to 0.06 mg/L at the north-south pipes (NSP) and below detection limits at sampling station AS-8 and were 0 to 0.01 mg/L at the inlet and outlet of LR. The daily chronic fish mortality in upper EFPC has been attributed to background stress resulting from the continuous discharge of chlorine into upper EFPC. Mean daily mortality rates for 22 acute fish kills were three fold or more above background and usually exceeded ten fish per day. Total number of dead fish collected per acute kill event ranged from 30 to over 1,000 fish; predominant species killed were central stonerollers (Campostoma anomalum) and striped shiners (Luxilus chrysocephalus). Spills or elevated releases of toxic chemicals, such as acids, organophosphates, aluminum nitrate, ammonia, or chlorine, were identified as possible causative agents; however, a definitive cause-effect relationship was rarely established for any acute kills. Ambient toxicity testing, in situ chemical monitoring, and streamside experiments were used to examine TRC dynamics and ambient toxicity in EFPC.« less

XUV-Exposed, Non-Hydrostatic Hydrogen-Rich Upper Atmospheres of Terrestrial Planets. Part I: Atmospheric Expansion and Thermal Escape

PubMed Central

Lammer, Helmut; Odert, Petra; Kulikov, Yuri N.; Kislyakova, Kristina G.; Khodachenko, Maxim L.; Güdel, Manuel; Hanslmeier, Arnold; Biernat, Helfried

2013-01-01

Abstract The recently discovered low-density “super-Earths” Kepler-11b, Kepler-11f, Kepler-11d, Kepler-11e, and planets such as GJ 1214b represent the most likely known planets that are surrounded by dense H/He envelopes or contain deep H2O oceans also surrounded by dense hydrogen envelopes. Although these super-Earths are orbiting relatively close to their host stars, they have not lost their captured nebula-based hydrogen-rich or degassed volatile-rich steam protoatmospheres. Thus, it is interesting to estimate the maximum possible amount of atmospheric hydrogen loss from a terrestrial planet orbiting within the habitable zone of late main sequence host stars. For studying the thermosphere structure and escape, we apply a 1-D hydrodynamic upper atmosphere model that solves the equations of mass, momentum, and energy conservation for a planet with the mass and size of Earth and for a super-Earth with a size of 2 REarth and a mass of 10 MEarth. We calculate volume heating rates by the stellar soft X-ray and extreme ultraviolet radiation (XUV) and expansion of the upper atmosphere, its temperature, density, and velocity structure and related thermal escape rates during the planet's lifetime. Moreover, we investigate under which conditions both planets enter the blow-off escape regime and may therefore experience loss rates that are close to the energy-limited escape. Finally, we discuss the results in the context of atmospheric evolution and implications for habitability of terrestrial planets in general. Key Words: Stellar activity—Low-mass stars—Early atmospheres—Earth-like exoplanets—Energetic neutral atoms—Ion escape—Habitability. Astrobiology 13, 1011–1029. PMID:24251443

An analysis of the vertical structure equation for arbitrary thermal profiles

NASA Technical Reports Server (NTRS)

Cohn, Stephen E.; Dee, Dick P.

1989-01-01

The vertical structure equation is a singular Sturm-Liouville problem whose eigenfunctions describe the vertical dependence of the normal modes of the primitive equations linearized about a given thermal profile. The eigenvalues give the equivalent depths of the modes. The spectrum of the vertical structure equation and the appropriateness of various upper boundary conditions, both for arbitrary thermal profiles were studied. The results depend critically upon whether or not the thermal profile is such that the basic state atmosphere is bounded. In the case of a bounded atmosphere it is shown that the spectrum is always totally discrete, regardless of details of the thermal profile. For the barotropic equivalent depth, which corresponds to the lowest eigen value, upper and lower bounds which depend only on the surface temperature and the atmosphere height were obtained. All eigenfunctions are bounded, but always have unbounded first derivatives. It was proved that the commonly invoked upper boundary condition that vertical velocity must vanish as pressure tends to zero, as well as a number of alternative conditions, is well posed. It was concluded that the vertical structure equation always has a totally discrete spectrum under the assumptions implicit in the primitive equations.

An analysis of the vertical structure equation for arbitrary thermal profiles

NASA Technical Reports Server (NTRS)

Cohn, Stephen E.; Dee, Dick P.

1987-01-01

The vertical structure equation is a singular Sturm-Liouville problem whose eigenfunctions describe the vertical dependence of the normal modes of the primitive equations linearized about a given thermal profile. The eigenvalues give the equivalent depths of the modes. The spectrum of the vertical structure equation and the appropriateness of various upper boundary conditions, both for arbitrary thermal profiles were studied. The results depend critically upon whether or not the thermal profile is such that the basic state atmosphere is bounded. In the case of a bounded atmosphere it is shown that the spectrum is always totally discrete, regardless of details of the thermal profile. For the barotropic equivalent depth, which corresponds to the lowest eigen value, upper and lower bounds which depend only on the surface temperature and the atmosphere height were obtained. All eigenfunctions are bounded, but always have unbounded first derivatives. It was proved that the commonly invoked upper boundary condition that vertical velocity must vanish as pressure tends to zero, as well as a number of alternative conditions, is well posed. It was concluded that the vertical structure equation always has a totally discrete spectrum under the assumptions implicit in the primitive equations.

Aeronomy of the Venus Upper Atmosphere

NASA Astrophysics Data System (ADS)

Gérard, J.-C.; Bougher, S. W.; López-Valverde, M. A.; Pätzold, M.; Drossart, P.; Piccioni, G.

2017-11-01

We present aeronomical observations collected using remote sensing instruments on board Venus Express, complemented with ground-based observations and numerical modeling. They are mostly based on VIRTIS and SPICAV measurements of airglow obtained in the nadir mode and at the limb above 90 km. They complement our understanding of the behavior of Venus' upper atmosphere that was largely based on Pioneer Venus observations mostly performed over thirty years earlier. Following a summary of recent spectral data from the EUV to the infrared, we examine how these observations have improved our knowledge of the composition, thermal structure, dynamics and transport of the Venus upper atmosphere. We then synthesize progress in three-dimensional modeling of the upper atmosphere which is largely based on global mapping and observations of time variations of the nitric oxide and O2 nightglow emissions. Processes controlling the escape flux of atoms to space are described. Results based on the VeRA radio propagation experiment are summarized and compared to ionospheric measurements collected during earlier space missions. Finally, we point out some unsolved and open questions generated by these recent datasets and model comparisons.

Thermal maturity patterns (conodont color alteration index and vitrinite reflectance) in Upper Ordovician and Devonian rocks of the Appalachian basin: a major revision of USGS Map I-917-E using new subsurface collections: Chapter F.1 in Coal and petroleum resources in the Appalachian basin: distribution, geologic framework, and geochemical character

USGS Publications Warehouse

Repetski, John E.; Ryder, Robert T.; Weary, David J.; Harris, Anita G.; Trippi, Michael H.; Ruppert, Leslie F.; Ryder, Robert T.

2014-01-01

carbon (TOC) content in weight percent. Although the RockEval and TOC data are included in this chapter (table 1), they are not shown on the maps. The revised CAI isograd and percent vitrinite reflectance isograd maps cover all or parts of Kentucky, New York, Ohio, Pennsylvania, Virginia, and West Virginia (fig. 1), and the following three stratigraphic intervals: Upper Ordovician carbonate rocks, Lower and Middle Devonian carbonate rocks, and Middle and Upper Devonian black shales. These stratigraphic intervals were chosen for the following reasons: (1) they represent target reservoirs for much of the oil and gas exploration in the Appalachian basin; (2) they are stratigraphically near probable source rocks for most of the oil and gas; (3) they include geologic formations that are nearly continuous across the basin; (4) they contain abundant carbonate grainstone-packstone intervals, which give a reasonable to good probability of recovery of conodont elements from small samples of drill cuttings; and (5) the Middle and Upper Devonian black shale contains large amounts of organic matter for RockEval, TOC, and dispersed vitrinite analyses. Thermal maturity patterns of the Upper Ordovician Trenton Limestone are of particular interest here, because they closely approximate the thermal maturity patterns in the overlying Upper Ordovician Utica Shale, which is the probable source rock for oil and gas in the Upper Cambrian Rose Run Sandstone (sandstone), Upper Cambrian and Lower Ordovician Knox Group (Dolomite), Lower and Middle Ordovician Beekmantown Group (dolomite or Dolomite), Upper Ordovician Trenton and Black River Limestones, and Lower Silurian Clinton/Medina sandstone (Cole and others, 1987; Jenden and others, 1993; Laughrey and Baldassare, 1998; Ryder and others, 1998; Ryder and Zagorski, 2003). The thermal maturity patterns of the Lower Devonian Helderberg Limestone (Group), Middle Devonian Onondaga Limestone, and Middle Devonian Marcellus Shale-Upper Devonian Rhine

Upper gastrointestinal sensory-motor dysfunction in diabetes mellitus

PubMed Central

Zhao, Jing-Bo; Frøkjær, Jens Brøndum; Drewes, Asbjørn Mohr; Ejskjaer, Niels

2006-01-01

Gastrointestinal (GI) sensory-motor abnormalities are common in patients with diabetes mellitus and may involve any part of the GI tract. Abnormalities are frequently sub-clinical, and fortunately only rarely do severe and life-threatening problems occur. The pathogenesis of abnormal upper GI sensory-motor function in diabetes is incompletely understood and is most likely multi-factorial of origin. Diabetic autonomic neuropathy as well as acute suboptimal control of diabetes has been shown to impair GI motor and sensory function. Morphological and biomechanical remodeling of the GI wall develops during the duration of diabetes, and may contribute to motor and sensory dysfunction. In this review sensory and motility disorders of the upper GI tract in diabetes is discussed; and the morphological changes and biomechanical remodeling related to the sensory-motor dysfunction is also addressed. PMID:16718808

Prediction of esophageal varices and variceal hemorrhage in patients with acute upper gastrointestinal bleeding.

PubMed

Rockey, Don C; Elliott, Alan; Lyles, Thomas

2016-03-01

In patients with upper gastrointestinal bleeding (UGIB), identifying those with esophageal variceal hemorrhage prior to endoscopy would be clinically useful. This retrospective study of a large cohort of patients with UGIB used logistic regression analyses to evaluate the platelet count, aspartate aminotransferase (AST) to platelet ratio index (APRI), AST to alanine aminotransferase (ALT) ratio (AAR) and Lok index (all non-invasive blood markers) as predictors of variceal bleeding in (1) all patients with UGIB and (2) patients with cirrhosis and UGIB. 2233 patients admitted for UGIB were identified; 1034 patients had cirrhosis (46%) and of these, 555 patients (54%) had acute UGIB due to esophageal varices. In all patients with UGIB, the platelet count (cut-off 122,000/mm(3)), APRI (cut-off 5.1), AAR (cut-off 2.8) and Lok index (cut-off 0.9) had area under the curve (AUC)s of 0.80 0.82, 0.64, and 0.80, respectively, for predicting the presence of varices prior to endoscopy. To predict varices as the culprit of bleeding, the platelet count (cut-off 69,000), APRI (cut-off 2.6), AAR (cut-off 2.5) and Lok Index (0.90) had AUCs of 0.76, 0.77, 0.57 and 0.73, respectively. Finally, in patients with cirrhosis and UGIB, logistic regression was unable to identify optimal cut-off values useful for predicting varices as the culprit bleeding lesion for any of the non-invasive markers studied. For all patients with UGIB, non-invasive markers appear to differentiate patients with varices from those without varices and to identify those with a variceal culprit lesion. However, these markers could not distinguish between a variceal culprit and other lesions in patients with cirrhosis. Copyright © 2016 American Federation for Medical Research.

Comparing Prognostic Strength of Acute Corticospinal Tract Injury Measured by a New Diffusion Tensor Imaging Based Template Approach Versus Common Approaches

PubMed Central

Hirai, Kelsi K.; Groisser, Benjamin N.; Copen, William A.; Singhal, Aneesh B.; Schaechter, Judith D.

2015-01-01

Background Long-term motor outcome of acute stroke patients with severe motor impairment is difficult to predict. While measure of corticospinal tract (CST) injury based on diffusion tensor imaging (DTI) in subacute stroke patients strongly predicts motor outcome, its predictive value in acute stroke patients is unclear. Using a new DTI-based, density-weighted CST template approach, we demonstrated recently that CST injury measured in acute stroke patients with moderately-severe to severe motor impairment of the upper limb strongly predicts motor outcome of the limb at 6 months. New Method The current study compared the prognostic strength of CST injury measured in 10 acute stroke patients with moderately-severe to severe motor impairment of the upper limb by the new density-weighted CST template approach versus several variants of commonly used DTI-based approaches. Results and Comparison with Existing Methods Use of the density-weighted CST template approach yielded measurements of acute CST injury that correlated most strongly, in absolute magnitude, with 6-month upper limb strength (rs = 0.93), grip (rs = 0.94) and dexterity (rs = 0.89) compared to all other 11 approaches. Formal statistical comparison of correlation coefficients revealed that acute CST injury measured by the density-weighted CST template approach correlated significantly more strongly with 6-month upper limb strength, grip and dexterity than 9, 10 and 6 of the 11 alternative measurements, respectively. Conclusions Measurements of CST injury in acute stroke patients with substantial motor impairment by the density-weighted CST template approach may have clinical utility for anticipating healthcare needs and improving clinical trial design. PMID:26386285

Widespread gas hydrate instability on the upper U.S. Beaufort margin

USGS Publications Warehouse

Phrampus, Benjamin J.; Hornbach, Matthew J.; Ruppel, Carolyn D.; Hart, Patrick E.

2014-01-01

The most climate-sensitive methane hydrate deposits occur on upper continental slopes at depths close to the minimum pressure and maximum temperature for gas hydrate stability. At these water depths, small perturbations in intermediate ocean water temperatures can lead to gas hydrate dissociation. The Arctic Ocean has experienced more dramatic warming than lower latitudes, but observational data have not been used to study the interplay between upper slope gas hydrates and warming ocean waters. Here we use (a) legacy seismic data that constrain upper slope gas hydrate distributions on the U.S. Beaufort Sea margin, (b) Alaskan North Slope borehole data and offshore thermal gradients determined from gas hydrate stability zone thickness to infer regional heat flow, and (c) 1088 direct measurements to characterize multidecadal intermediate ocean warming in the U.S. Beaufort Sea. Combining these data with a three-dimensional thermal model shows that the observed gas hydrate stability zone is too deep by 100 to 250 m. The disparity can be partially attributed to several processes, but the most important is the reequilibration (thinning) of gas hydrates in response to significant (~0.5°C at 2σ certainty) warming of intermediate ocean temperatures over 39 years in a depth range that brackets the upper slope extent of the gas hydrate stability zone. Even in the absence of additional ocean warming, 0.44 to 2.2 Gt of methane could be released from reequilibrating gas hydrates into the sediments underlying an area of ~5–7.5 × 103 km2 on the U.S. Beaufort Sea upper slope during the next century.

Widespread gas hydrate instability on the upper U.S. Beaufort margin

NASA Astrophysics Data System (ADS)

Phrampus, Benjamin J.; Hornbach, Matthew J.; Ruppel, Carolyn D.; Hart, Patrick E.

2014-12-01

The most climate-sensitive methane hydrate deposits occur on upper continental slopes at depths close to the minimum pressure and maximum temperature for gas hydrate stability. At these water depths, small perturbations in intermediate ocean water temperatures can lead to gas hydrate dissociation. The Arctic Ocean has experienced more dramatic warming than lower latitudes, but observational data have not been used to study the interplay between upper slope gas hydrates and warming ocean waters. Here we use (a) legacy seismic data that constrain upper slope gas hydrate distributions on the U.S. Beaufort Sea margin, (b) Alaskan North Slope borehole data and offshore thermal gradients determined from gas hydrate stability zone thickness to infer regional heat flow, and (c) 1088 direct measurements to characterize multidecadal intermediate ocean warming in the U.S. Beaufort Sea. Combining these data with a three-dimensional thermal model shows that the observed gas hydrate stability zone is too deep by 100 to 250 m. The disparity can be partially attributed to several processes, but the most important is the reequilibration (thinning) of gas hydrates in response to significant (~0.5°C at 2σ certainty) warming of intermediate ocean temperatures over 39 years in a depth range that brackets the upper slope extent of the gas hydrate stability zone. Even in the absence of additional ocean warming, 0.44 to 2.2 Gt of methane could be released from reequilibrating gas hydrates into the sediments underlying an area of ~5-7.5 × 103 km2 on the U.S. Beaufort Sea upper slope during the next century.

Acute retinal necrosis as a novel complication of chickenpox in adults.

PubMed Central

Matsuo, T; Koyama, M; Matsuo, N

1990-01-01

Three patients in their 20s suffered from chickenpox while in an immunocompromised state: one in pregnancy, one during a long course of corticosteroid for severe nephrotic syndrome, and the third with repeated upper airway infection due to bronchiectasis. They developed acute retinal necrosis about three weeks after the onset of chickenpox. Since acute retinal necrosis threatens sight, this unusual complication of chickenpox in adults needs serious consideration. Images PMID:2378860

Thermal Conductance of Pressed Bimetal Contact Pairs at Liquid Nitrogen Temperatures

NASA Technical Reports Server (NTRS)

Kittle, Peter; Salerno, Louis J.; Spivak, Alan L.

1994-01-01

Large Dewars often use aluminum radiation shields and stainless steel vent lines. A simple, low cost method of making thermal contact between the shield and the line is to deform the shield around the line. A knowledge of the thermal conductance of such a joint is needed to thermally analyze the system. The thermal conductance of pressed metal contacts consisting of one aluminum and one stainless steel contact has been measured at 77 K, with applied forces from 8.9 N to 267 N. Both 5052 or 5083 aluminum were used as the upper contact. The lower contact was 304L stainless steel. The thermal conductance was found to be linear in temperature over the narrow temperature range of measurement. As the force was increased, the thermal conductance ranged from roughly 9 to 21 mW/K within a range of errors from 3% to 8%. Within the range of error no difference could be found between the using either of the aluminum alloys as the upper contact. Extrapolating the data to zero applied force does not result in zero thermal conductance. Possible causes of this anomalous effect are discussed.

Epifauna and thermal additions in the upper Patuxent River estuary

USGS Publications Warehouse

Cory, R.L.; Nauman, J.W.

1969-01-01

In the upper Patuxent Estuary environmental changes in temperature, salinity, and turbidity over a 5-year period are linked to changes in epifaunal production and species distribution. During 1967 a series of monthly panels showed dry weight production averaged 2.8 times greater in a steam electric station heated effluent than in the intake. A downriver shift in epifanual production in 1967 and changes in species abundance was noted and attributed to natural changes in salinity and turbidity and man-induced changes in temperature. ?? 1969 Estuarine Research Federation.

Prognosis of West Nile virus associated acute flaccid paralysis: a case series.

PubMed

Johnstone, Jennie; Hanna, Steven E; Nicolle, Lindsay E; Drebot, Michael A; Neupane, Binod; Mahony, James B; Loeb, Mark B

2011-08-19

Little is known about the long-term health related quality of life outcomes in patients with West Nile virus associated acute flaccid paralysis. We describe the quality of life scores of seven patients with acute flaccid paralysis who presented to hospital between 2003 and 2006, and were followed for up to two years. Between 2003 and 2006, 157 symptomatic patients with West Nile virus were enrolled in a longitudinal cohort study of West Nile virus in Canada. Seven patients (4%) had acute flaccid paralysis. The first patient was a 55-year-old man who presented with left upper extremity weakness. The second patient was a 54-year-old man who presented with bilateral upper extremity weakness. The third patient was a 66-year-old woman who developed bilateral upper and lower extremity weakness. The fourth patient was a 67-year-old man who presented with right lower extremity weakness. The fifth patient was a 60-year-old woman who developed bilateral lower extremity weakness. The sixth patient was a 71-year-old man with a history of Parkinson's disease and acute onset bilateral lower extremity weakness. The seventh patient was a 52-year-old man who presented with right lower extremity weakness. All were Caucasian. Patients were followed for a mean of 1.1 years. At the end of follow-up the mean score on the Physical Component Summary of the Short-Form 36 scale had only slightly increased to 39. In contrast, mean score on the Mental Component Summary of the Short-Form 36 scale at the end of follow-up had normalized to 50. Despite the poor physical prognosis for patients with acute flaccid paralysis, the mental health outcomes are generally favorable.

Analysis of Dosimetric Parameters Associated With Acute Gastrointestinal Toxicity and Upper Gastrointestinal Bleeding in Locally Advanced Pancreatic Cancer Patients Treated With Gemcitabine-Based Concurrent Chemoradiotherapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Nakamura, Akira; Shibuya, Keiko, E-mail: kei@kuhp.kyoto-u.ac.jp; Matsuo, Yukinori

2012-10-01

Purpose: To identify the dosimetric parameters associated with gastrointestinal (GI) toxicity in patients with locally advanced pancreatic cancer (LAPC) treated with gemcitabine-based chemoradiotherapy. Methods and Materials: The data from 40 patients were analyzed retrospectively. Chemoradiotherapy consisted of conventional fractionated three-dimensional radiotherapy and weekly gemcitabine. Treatment-related acute GI toxicity and upper GI bleeding (UGB) were graded according to the Common Toxicity Criteria Adverse Events, version 4.0. The dosimetric parameters (mean dose, maximal absolute dose which covers 2 cm{sup 3} of the organ, and absolute volume receiving 10-50 Gy [V{sub 10-50}]) of the stomach, duodenum, small intestine, and a composite structure ofmore » the stomach and duodenum (StoDuo) were obtained. The planning target volume was also obtained. Univariate analyses were performed to identify the predictive factors for the risk of grade 2 or greater acute GI toxicity and grade 3 or greater UGB, respectively. Results: The median follow-up period was 15.7 months (range, 4-37). The actual incidence of acute GI toxicity was 33%. The estimated incidence of UGB at 1 year was 20%. Regarding acute GI toxicity, a V{sub 50} of {>=}16 cm{sup 3} of the stomach was the best predictor, and the actual incidence in patients with V{sub 50} <16 cm{sup 3} of the stomach vs. those with V{sub 50} of {>=}16 cm{sup 3} was 9% vs. 61%, respectively (p = 0.001). Regarding UGB, V{sub 50} of {>=}33 cm{sup 3} of the StoDuo was the best predictor, and the estimated incidence at 1 year in patients with V{sub 50} <33 cm{sup 3} of the StoDuo vs. those with V{sub 50} {>=}33 cm{sup 3} was 0% vs. 44%, respectively (p = 0.002). The dosimetric parameters correlated highly with one another. Conclusion: The irradiated absolute volume of the stomach and duodenum are important for the risk of acute GI toxicity and UGB. These results could be helpful in escalating the radiation doses using novel

The "Prometeo" study: online collection of clinical data and outcome of Italian patients with acute nonvariceal upper gastrointestinal bleeding.

PubMed

Del Piano, Mario; Bianco, Maria Antonia; Cipolletta, Livio; Zambelli, Alessandro; Chilovi, Fausto; Di Matteo, Giovanni; Pagliarulo, Michela; Ballarè, Marco; Rotondano, Gianluca

2013-04-01

To implement an online, prospective collection of clinical data and outcome of patients with acute nonvariceal upper gastrointestinal bleeding (UGIB) in Italy ("Prometeo" study). Epidemiology, clinical features, and outcomes of nonvariceal UGIB are mainly known by retrospective studies and are probably changing. Data were collected by 13 Gastrointestinal Units in Italy from June 2006 to June 2007 (phase 1) and from December 2008 to December 2009 (phase 2): an interim analysis of data was performed between the 2 phases to optimize the online database. All the patients consecutively admitted for acute nonvariceal UGIB were enrolled. Demographic and clinical data were collected, a diagnostic endoscopy performed, with endoscopic hemostasis if indicated. One thousand four hundred thirteen patients (M=932, mean age±SD=66.5±15.8; F=481, mean age±SD=74.2±14.6) were enrolled. Comorbidities were present in 83%. 52.4% were treated with acetyl salicylic acid or other nonsteroidal anti-inflammatory drugs (NSAIDs): only 13.9% had an effective gastroprotection. Previous episodes of UGIB were present in 13.3%. Transfusion were needed in 43.9%. Shock was present in 9.3%. Endoscopic diagnosis was made in 93.2%: peptic lesions were the main cause of bleeding (duodenal ulcer 36.2%, gastric ulcer 29.6%, gastric/duodenal erosions 10.9%). At endoscopy, Helicobacter pylori was searched in 37.2%, and found positive in 51.3% of tested cases. Early rebleeding was observed in 5.4%: surgery was required in 14.3% of them. Bleeding-related death occurred in 4.0%: at multivariate analysis, the risk of death was correlated with female sex [odds ratio (OR=2.19, P=0.0089)], presence of neoplasia (OR=2.70, P=0.0057) or multiple comorbidities (OR=5.04, P=0.0280), shock at admission (OR=4.55, P=0.0001), and early rebleeding (OR=1.47, P=0.004). Prometeo database has provided an up-to-date picture of acute nonvariceal UGIB in Italy: patients are elderly, predominantly males, and with important

Polarized Light Scanning Cryomacroscopy, Part II: Thermal Modeling and Analysis of Experimental Observations

PubMed Central

Feig, Justin S.G.; Solanki, Prem K.; Eisenberg, David P.; Rabin, Yoed

2016-01-01

This study aims at developing thermal analysis tools and explaining experimental observations made by means of polarized-light cryomacroscopy (Part I). Thermal modeling is based on finite elements analysis (FEA), where two model parameters are extracted from thermal measurements: (i) the overall heat transfer coefficient between the cuvette and the cooling chamber, and (ii) the effective thermal conductivity within the cryoprotective agent (CPA) at the upper part of the cryogenic temperature range. The effective thermal conductivity takes into account enhanced heat transfer due to convection currents within the CPA, creating the so-called Bénard cells. Comparison of experimental results with simulation data indicates that the uncertainty in simulations due to the propagation of uncertainty in measured physical properties exceeds the uncertainty in experimental measurements, which validates the modeling approach. It is shown in this study that while a cavity may form in the upper-center portion of the vitrified CPA, it has very little effect on estimating the temperature distribution within the domain. This cavity is driven by thermal contraction of the CPA, with the upper-center of the domain transitioning to glass last. Finally, it is demonstrated in this study that additional stresses may develop within the glass transition temperature range due to nonlinear behavior of the thermal expansion coefficient. This effect is reported here for the first time in the context of cryobiology, using the capabilities of polarized-light cryomacroscopy. PMID:27343139

Polarized light scanning cryomacroscopy, part II: Thermal modeling and analysis of experimental observations.

PubMed

Feig, Justin S G; Solanki, Prem K; Eisenberg, David P; Rabin, Yoed

2016-10-01

This study aims at developing thermal analysis tools and explaining experimental observations made by means of polarized-light cryomacroscopy (Part I). Thermal modeling is based on finite elements analysis (FEA), where two model parameters are extracted from thermal measurements: (i) the overall heat transfer coefficient between the cuvette and the cooling chamber, and (ii) the effective thermal conductivity within the cryoprotective agent (CPA) at the upper part of the cryogenic temperature range. The effective thermal conductivity takes into account enhanced heat transfer due to convection currents within the CPA, creating the so-called Bénard cells. Comparison of experimental results with simulation data indicates that the uncertainty in simulations due to the propagation of uncertainty in measured physical properties exceeds the uncertainty in experimental measurements, which validates the modeling approach. It is shown in this study that while a cavity may form in the upper-center portion of the vitrified CPA, it has very little effect on estimating the temperature distribution within the domain. This cavity is driven by thermal contraction of the CPA, with the upper-center of the domain transitioning to glass last. Finally, it is demonstrated in this study that additional stresses may develop within the glass transition temperature range due to nonlinear behavior of the thermal expansion coefficient. This effect is reported here for the first time in the context of cryobiology, using the capabilities of polarized-light cryomacroscopy. Copyright © 2016. Published by Elsevier Inc.

Tropical fish in a warming world: thermal tolerance of Nile perch Lates niloticus (L.) in Lake Nabugabo, Uganda.

PubMed

Chrétien, Emmanuelle; Chapman, Lauren J

2016-01-01

Key to predicting the response of fishes to climate change is quantifying how close fish are to their critical thermal limits in nature and their ability to adjust their thermal sensitivity to maintain performance. Here, we evaluated the effects of body size and habitat on aerobic scope (AS) and thermal tolerance of Nile perch Lates niloticus (L.), a fish of great economic and food security importance in East Africa, using respirometry and critical thermal maximum (CTmax) trials. Juvenile Nile perch from distinct habitats (high or low dissolved oxygen concentrations) of Lake Nabugabo, Uganda were exposed for 4.6 ± 0.55 days to a temperature treatment (25.5, 27.5, 29.5 or 31.5°C) prior to experimentation, with the lowest temperature corresponding to the mean annual daytime temperature in Lake Nabugabo and the highest temperature being 3°C higher than the maximal monthly average. As expected, metabolic rates increased with body mass. Although resting metabolic rate increased with temperature, maximal metabolic rate showed no change. Likewise, AS did not vary across treatments. The CTmax increased with acclimation temperature. There was no effect of habitat on maximal metabolic rate, AS or CTmax; however, there was a trend towards a lower resting metabolic rate for Nile perch captured in the low-dissolved oxygen habitat than in well-oxygenated waters. This study shows that juvenile Nile perch maintain a large AS at temperatures near the upper limit of their natural thermal range and provides evidence that Nile perch have physiological mechanisms to deal with acute exposure to thermal stress.

Development of diapiric structures in the upper mantle due to phase transitions

NASA Technical Reports Server (NTRS)

Liu, M.; Yuen, D. A.; Zhao, W.; Honda, S.

1991-01-01

Solid-state phase transition in time-dependent mantle convection can induce diapiric flows in the upper mantle. When a deep mantle plume rises toward phase boundaries in the upper mantle, the changes in the local thermal buoyancy, local heat capacity, and latent heat associated with the phase change at a depth of 670 kilometers tend to pinch off the plume head from the feeding stem and form a diapir. This mechanism may explain episodic hot spot volcanism. The nature of the multiple phase boundaries at the boundary between the upper and lower mantle may control the fate of deep mantle plumes, allowing hot plumes to go through and retarding the tepid ones.

Relative importance of different surface regions for thermal comfort in humans.

PubMed

Nakamura, Mayumi; Yoda, Tamae; Crawshaw, Larry I; Kasuga, Momoko; Uchida, Yuki; Tokizawa, Ken; Nagashima, Kei; Kanosue, Kazuyuki

2013-01-01

In a previous study, we investigated the contribution of the surface of the face, chest, abdomen, and thigh to thermal comfort by applying local temperature stimulation during whole-body exposure to mild heat or cold. In hot conditions, humans prefer a cool face, and in cold they prefer a warm abdomen. In this study, we extended investigation of regional differences in thermal comfort to the neck, hand, soles, abdomen (Experiment 1), the upper and lower back, upper arm, and abdomen (Experiment 2). The methodology was similar to that used in the previous study. To compare the results of each experiment, we utilized the abdomen as the reference area in these experiments. Thermal comfort feelings were not particularly strong for the limbs and extremities, in spite of the fact that changes in skin temperature induced by local temperature stimulation of the limbs and extremities were always larger than changes that were induced in the more proximal body parts. For the trunk areas, a significant difference in thermal comfort was not observed among the abdomen, and upper and lower back. An exception involved local cooling during whole-body mild cold exposure, wherein the most dominant preference was for a warmer temperature of the abdomen. As for the neck and abdomen, clear differences were observed during local cooling, while no significant difference was observed during local warming. We combined the results for the current and the previous study, and characterized regional differences in thermal comfort and thermal preference for the whole-body surface.

Acute pancreatitis caused by Mycoplasma pneumoniae: an unusual etiology.

PubMed

Valdés Lacasa, Teresa; Duarte Borges, María Alejandra; García Marín, Alicia; Gómez Cuervo, Covadonga

2017-06-01

It is well known that the most important etiologies of acute pancreatitis are gallstones and alcohol consumption. Once these causes have been ruled out, especially in young adults, it is important to consider less frequent etiologic factors such as drugs, trauma, malformations, autoimmunity or systemic diseases. Other rare and less well studied causes of this pathology are infections, among which Mycoplasma pneumoniae has been reported to cause acute pancreatitis as an unusual extrapulmonary manifestation. Here, we report the case of a 21-year-old patient who had acute idiopathic pancreatitis associated with an upper respiratory tract infection. After an in-depth study, all other causes of pancreatitis were ruled out and Mycoplasma was established as the clinical etiology.

Systematic review of mirror therapy compared with conventional rehabilitation in upper extremity function in stroke survivors.

PubMed

Pérez-Cruzado, David; Merchán-Baeza, Jose Antonio; González-Sánchez, Manuel; Cuesta-Vargas, Antonio I

2017-04-01

Stroke is a leading cause of disability in developed countries. One of the most widespread techniques in clinical practice is mirror therapy (MT). To determine the effectiveness of MT over other methods of intervention in the recovery of upper limb function in people who have had a stroke. A systematic review was conducted. The search string was established based on the last systematic review about MT that dated from 2009: "upper extremity" OR "upper limb "AND "mirror therapy" AND stroke. For this search Pubmed, Scopus and SciELO databases were used. Fifteen studies were included in the systematic review. Recovery of the upper limb, upper limb function and gross manual dexterity were frequently measured in these studies. In the primary variables in promoting recovery, MT alone showed better results in acute and chronic stroke patients in upper limb functioning than either conventional rehabilitation (CR) or CR plus MT. PROSPERO registration number: CRD42015026869. © 2016 Occupational Therapy Australia.

Delayed prescribing for upper respiratory tract infections: a qualitative study of GPs' views and experiences

PubMed Central

Høye, Sigurd; Frich, Jan; Lindbœk, Morten

2010-01-01

Background Delayed prescribing has been promoted as a strategy that meets patients' expectations and helps to avoid unnecessary use of antibiotics in upper respiratory tract infections. Aim To explore GPs' views on and experiences with delayed prescribing in patients with acute upper respiratory tract infections. Design of study Qualitative study involving focus groups. Setting Norwegian general practice. Method Qualitative analysis of data collected from five focus groups comprising 33 GPs who took part in a quality-improvement programme of antibiotic prescribing. Results The views of GPs differed on the usefulness of delayed prescribing. GPs who endorsed the strategy emphasised shared decision making and the creation of opportunities for educating patients, whereas GPs who were negative applied the strategy mainly when being pressed to prescribe. Mild and mainly harmless conditions of a possible bacterial origin, such as acute sinusitis and acute otitis, were considered most suitable for delayed prescribing. A key argument for issuing a wait-and-see prescription was that it helped patients avoid seeking after-hours care. For issuing a wait-and-see prescription, the GPs required that the patient was ‘knowledgeable’, able to understand the indications for antibiotics, and motivated for shared decision making. GPs emphasised that patients should be informed thoroughly when receiving a wait-and-see prescription. Conclusion Not all GPs endorse delayed prescribing; however, it appears to be a feasible approach for managing patients with early symptoms of mild upper respiratory tract infections of a possible bacterial origin. Informing the patients properly while issuing wait-and-see prescriptions is essential. PMID:21144201

Thermal Vacuum Test Correlation of A Zero Propellant Load Case Thermal Capacitance Propellant Gauging Analytics Model

NASA Technical Reports Server (NTRS)

McKim, Stephen A.

2016-01-01

This thesis describes the development and test data validation of the thermal model that is the foundation of a thermal capacitance spacecraft propellant load estimator. Specific details of creating the thermal model for the diaphragm propellant tank used on NASA's Magnetospheric Multiscale spacecraft using ANSYS and the correlation process implemented to validate the model are presented. The thermal model was correlated to within plus or minus 3 degrees Centigrade of the thermal vacuum test data, and was found to be relatively insensitive to uncertainties in applied heat flux and mass knowledge of the tank. More work is needed, however, to refine the thermal model to further improve temperature predictions in the upper hemisphere of the propellant tank. Temperatures predictions in this portion were found to be 2-2.5 degrees Centigrade lower than the test data. A road map to apply the model to predict propellant loads on the actual MMS spacecraft toward its end of life in 2017-2018 is also presented.

The North American upper mantle: density, composition, and evolution

USGS Publications Warehouse

Mooney, Walter D.; Kaban, Mikhail K.

2010-01-01

The upper mantle of North America has been well studied using various seismic methods. Here we investigate the density structure of the North American (NA) upper mantle based on the integrative use of the gravity field and seismic data. The basis of our study is the removal of the gravitational effect of the crust to determine the mantle gravity anomalies. The effect of the crust is removed in three steps by subtracting the gravitational contributions of (1) topography and bathymetry, (2) low-density sedimentary accumulations, and (3) the three-dimensional density structure of the crystalline crust as determined by seismic observations. Information regarding sedimentary accumulations, including thickness and density, are taken from published maps and summaries of borehole measurements of densities; the seismic structure of the crust is based on a recent compilation, with layer densities estimated from P-wave velocities. The resultant mantle gravity anomaly map shows a pronounced negative anomaly (−50 to −400 mGal) beneath western North America and the adjacent oceanic region and positive anomalies (+50 to +350 mGal) east of the NA Cordillera. This pattern reflects the well-known division of North America into the stable eastern region and the tectonically active western region. The close correlation of large-scale features of the mantle anomaly map with those of the topographic map indicates that a significant amount of the topographic uplift in western NA is due to buoyancy in the hot upper mantle, a conclusion supported by previous investigations. To separate the contributions of mantle temperature anomalies from mantle compositional anomalies, we apply an additional correction to the mantle anomaly map for the thermal structure of the uppermost mantle. The thermal model is based on the conversion of seismic shear-wave velocities to temperature and is consistent with mantle temperatures that are independently estimated from heat flow and heat production data

Metabolic depression in cunner (Tautogolabrus adspersus) is influenced by ontogeny, and enhances thermal tolerance.

PubMed

Kelly, Nick I; Alzaid, Abdullah; Nash, Gordon W; Gamperl, A Kurt

2014-01-01

To examine the effect of ontogeny on metabolic depression in the cunner (Tautogolabrus adspersus), and to understand how ontogeny and the ability to metabolically depress influence this species' upper thermal tolerance: 1) the metabolic rate of 9°C-acclimated cunner of three size classes [0.2-0.5 g, young of the year (YOY); 3-6 g, small; and 80-120 g, large (adult)] was measured during a 2°C per day decrease in temperature; and 2) the metabolic response of the same three size classes of cunner to an acute thermal challenge [2°C h(-1) from 10°C until Critical Thermal Maximum, CTMax] was examined, and compared to that of the Atlantic cod (Gadus morhua). The onset-temperature for metabolic depression in cunner increased with body size, i.e. from 5°C in YOY cunner to 7°C in adults. In contrast, the extent of metabolic depression was ∼80% (Q10 = ∼15) for YOY fish, ∼65% (Q10 = ∼8) for small fish and ∼55% (Q10 = ∼5) for adults, and this resulted in the metabolic scaling exponent (b) gradually increasing from 0.84 to 0.92 between 9°C to 1°C. All size classes of cunner had significantly (approximately 60%) lower routine metabolic rates at 10°C than Atlantic cod. However, there was no species' difference in the temperature-induced maximum metabolic rate, and this resulted in factorial metabolic scope values that were more than two-fold greater for cunner, and CTMax values that were 6-9°C higher (∼21 vs. 28°C). These results: 1) show that ontogeny influences the temperature of initiation and the extent of metabolic depression in cunner, but not O2 consumption when in a hypometabolic state; and 2) suggest that the evolution of cold-induced metabolic depression in this northern wrasse species has not resulted in a trade-off with upper thermal tolerance, but instead, an enhancement of this species' metabolic plasticity.

Metabolic Depression in Cunner (Tautogolabrus adspersus) Is Influenced by Ontogeny, and Enhances Thermal Tolerance

PubMed Central

Nash, Gordon W.; Gamperl, A. Kurt

2014-01-01

To examine the effect of ontogeny on metabolic depression in the cunner (Tautogolabrus adspersus), and to understand how ontogeny and the ability to metabolically depress influence this species' upper thermal tolerance: 1) the metabolic rate of 9°C-acclimated cunner of three size classes [0.2–0.5 g, young of the year (YOY); 3–6 g, small; and 80–120 g, large (adult)] was measured during a 2°C per day decrease in temperature; and 2) the metabolic response of the same three size classes of cunner to an acute thermal challenge [2°C h−1 from 10°C until Critical Thermal Maximum, CTMax] was examined, and compared to that of the Atlantic cod (Gadus morhua). The onset-temperature for metabolic depression in cunner increased with body size, i.e. from 5°C in YOY cunner to 7°C in adults. In contrast, the extent of metabolic depression was ∼80% (Q10 = ∼15) for YOY fish, ∼65% (Q10 = ∼8) for small fish and ∼55% (Q10 = ∼5) for adults, and this resulted in the metabolic scaling exponent (b) gradually increasing from 0.84 to 0.92 between 9°C to 1°C. All size classes of cunner had significantly (approximately 60%) lower routine metabolic rates at 10°C than Atlantic cod. However, there was no species' difference in the temperature-induced maximum metabolic rate, and this resulted in factorial metabolic scope values that were more than two-fold greater for cunner, and CTMax values that were 6–9°C higher (∼21 vs. 28°C). These results: 1) show that ontogeny influences the temperature of initiation and the extent of metabolic depression in cunner, but not O2 consumption when in a hypometabolic state; and 2) suggest that the evolution of cold-induced metabolic depression in this northern wrasse species has not resulted in a trade-off with upper thermal tolerance, but instead, an enhancement of this species' metabolic plasticity. PMID:25514755

Water and sediment temperatures at mussel beds in the upper Mississippi River basin

USGS Publications Warehouse

Newton, Teresa J.; Sauer, Jennifer; Karns, Byron

2013-01-01

Native freshwater mussels are in global decline and urgently need protection and conservation. Declines in the abundance and diversity of North American mussels have been attributed to human activities that cause pollution, waterquality degradation, and habitat destruction. Recent studies suggest that effects of climate change may also endanger native mussel assemblages, as many mussel species are living close to their upper thermal tolerances. Adult and juvenile mussels spend a large fraction of their lives burrowed into sediments of rivers and lakes. Our objective was to measure surface water and sediment temperatures at known mussel beds in the Upper Mississippi (UMR) and St. Croix (SCR) rivers to estimate the potential for sediments to serve as thermal refugia. Across four mussel beds in the UMR and SCR, surface waters were generally warmer than sediments in summer, and were cooler than sediments in winter. This suggests that sediments may act as a thermal buffer for mussels in these large rivers. Although the magnitude of this effect was usually <3.0°C, sediments were up to 7.5°C cooler at one site in May, suggesting site-specific variation in the ability of sediments to act as thermal buffers. Sediment temperatures in the UMR exceeded those shown to cause mortality in laboratory studies. These data suggest that elevated water temperatures resulting from global warming, thermal discharges, water extraction, and/or droughts have the potential to adversely affect native mussel assemblages.

Acute Esophageal Necrosis: An Update

PubMed Central

Inayat, Faisal; Hurairah, Abu; Virk, Hafeez Ul Hassan

2016-01-01

Acute esophageal necrosis (AEN) or “black esophagus” is a rare clinical entity with an unclear etiology. It is diagnosed at upper gastrointestinal endoscopy with the presence of strikingly black necrotic esophagus. The treatment is primarily medical, but the prognosis is generally poor due to advanced age and comorbid illnesses in patients who develop AEN. Herein, we discussed the implications of poor glycemic control in regards with AEN and undertook a literature review of this rare diagnosis. PMID:27583242

Management, clinical outcomes, and complications of acute cannula-related peripheral vein phlebitis of the upper extremity: A retrospective study.

PubMed

Dunda, S E; Demir, E; Mefful, O J; Grieb, G; Bozkurt, A; Pallua, N

2015-07-01

Acute phlebitis due to peripheral vein catheter use is frequently observed in clinical practice, and requires surgical therapy in severe cases. In this retrospective study, we aimed to increase awareness, evaluate current treatment options, and develop recommendations to optimize treatment outcomes. A total of 240 hospitalized patients with a diagnosis of upper extremity phlebitis from 2006 to 2011 were evaluated in terms of initial clinical features, parameters, co-morbidities and treatment regimes. Severity of phlebitis was graded according to the Baxter scale by assessing clinical symptoms such as pain, erythema, induration, swelling, or palpable venous cord (grade 0-5). Patients were divided in two subgroups: conservative (n = 132) and operative (n = 108) treatment. Surgical intervention rates and severity were higher for cannula insertion in the cubital fossa region than for cannula insertion in the forearm and hand region (p < 0.05). Baxter scale grades were higher in the surgical treatment group than in the conservative treatment group (4.47 vs. 2.67, respectively). The cubital fossa region is vulnerable to severe phlebitis and is not recommended as the first site of choice for cannulation. Phlebitis of Baxter scale grade 4 or 5 should be considered for early surgical intervention. © The Author(s) 2014.

Apparent thermal inertia and the surface heterogeneity of Mars

NASA Astrophysics Data System (ADS)

Putzig, Nathaniel E.; Mellon, Michael T.

2007-11-01

Thermal inertia derivation techniques generally assume that surface properties are uniform at horizontal scales below the footprint of the observing instrument and to depths of several decimeters. Consequently, surfaces with horizontal or vertical heterogeneity may yield apparent thermal inertia which varies with time of day and season. To investigate these temporal variations, we processed three Mars years of Mars Global Surveyor Thermal Emission Spectrometer observations and produced global nightside and dayside seasonal maps of apparent thermal inertia. These maps show broad regions with diurnal and seasonal differences up to 200 J m -2 K -1s -1/2 at mid-latitudes (60° S to 60° N) and 600 J m -2 K -1s -1/2 or greater in the polar regions. We compared the seasonal mapping results with modeled apparent thermal inertia and created new maps of surface heterogeneity at 5° resolution, delineating regions that have thermal characteristics consistent with horizontal mixtures or layers of two materials. The thermal behavior of most regions on Mars appears to be dominated by layering, with upper layers of higher thermal inertia (e.g., duricrusts or desert pavements over fines) prevailing in mid-latitudes and upper layers of lower thermal inertia (e.g., dust-covered rock, soils with an ice table at shallow depths) prevailing in polar regions. Less common are regions dominated by horizontal mixtures, such as those containing differing proportions of rocks, sand, dust, and duricrust or surfaces with divergent local slopes. Other regions show thermal behavior that is more complex and not well-represented by two-component surface models. These results have important implications for Mars surface geology, climate modeling, landing-site selection, and other endeavors that employ thermal inertia as a tool for characterizing surface properties.

Mirror therapy in chronic stroke survivors with severely impaired upper limb function: a randomized controlled trial.

PubMed

Colomer, Carolina; NOé, Enrique; Llorens, Roberto

2016-06-01

Mirror therapy (MT) has been proposed to improve the motor function of chronic individuals with stroke with mild to moderate impairment. With regards to severe upper limb paresis, MT has shown to provide limited motor improvement in the acute or sub-acute phase. However, no previous research has described the effects of MT in chronic individuals with stroke with severely impaired upper limb function. The aim of this study was to determine the effectiveness of MT on chronic stroke survivors with severe upper-limb impairment in comparison with passive mobilization. A randomized controlled trial. Rehabilitative outpatient unit. A total of 31 chronic subjects poststroke with severely impaired upper limb function were randomly assigned to either an experimental group (N.=15), or a control group (N.=16). Twenty-four intervention sessions were performed for both groups. Each session included 45-minute period of MT (experimental group) or passive mobilization (control group), administered three days a week. Participants were assessed before and after the intervention with the Wolf Motor Function Test, the Fugl-Meyer Assessment, and the Nottingham Sensory Assessment. Improvement in motor function was observed in both groups on the time (P=0.002) and ability (P=0.001) subscales of the Wolf Motor Function Test. No differences were detected in kinesthesis or stereognosis. However, the experimental group showed a significant improvement in tactile sensation that was mainly observed as an increased sensitivity to light touches. In comparison with passive mobilization, MT in chronic stroke survivors with severely impaired upper-limb function may provide a limited but positive effect on light touch sensitivity while providing similar motor improvement. MT is a therapeutic approach that can be used in the rehabilitation of severely impaired upper limb in chronic stroke survivors, specifically to address light touch sensitivity deficits.

[Synchronous acute cholecystolithiasis and perforated acute appendicitis. Case report].

PubMed

Padrón-Arredondo, Guillermo; de Atocha Rosado-Montero, Manuel

2016-01-01

Acute appendicitis and acute cholecystitis are among the most common diagnoses that general surgeons operate on. However, it is rarely described in its synchronous form. A 43 year-old woman attending the clinic for right upper quadrant pain of 11 days duration. The patient refers to intermittent radiating pain in the right side, with positive Murphy, tachycardia, and fever. The laboratory results showed white cells 16,200/mm(3), glucose 345 mg/dl, abnormal liver function tests. Acute cholecystitis was reported with ultrasound. A Masson-type incision was made, noting an enlarged pyogenic gallbladder with thickened walls, sub-hepatic abscess of approximately 300 ml, greenish-yellow colour, and foetid. An anterograde subtotal cholecystectomy is performed due to difficulty in identifying elements of Calot triangle due to the inflammatory process, opening it and extracting stones. The right iliac fossa is reviewed, finding a plastron and a sub-serous retrocaecal appendix perforated in its middle third with free fecalith and an abscess in the pelvic cavity. An anterograde appendectomy was performed and the patient progressed satisfactorily, later being discharged due to improvement. In this patient, with a history of recurrent episodes of gallbladder pain and disseminated acute abdominal pain without peritoneal irritation, clinical suspicion was exacerbated cholecystitis with probable empyema of the gallbladder. Open surgery approach for this patient allowed access to both the appendix and gallbladder in order to perform a complete exploration of the abdominal cavity. The synchronous presentation of cholecystolithiasis and complicated appendicitis has not been reported in the literature. Copyright © 2015 Academia Mexicana de Cirugía A.C. Published by Masson Doyma México S.A. All rights reserved.

Acute Esophageal Necrosis Presenting With Henoch-Schönlein Purpura

PubMed Central

Bernstein, Gregory R.; Malik, Zubair; Schey, Ron

2015-01-01

A 63-year-old woman with abdominal pain and melena developed a palpable, purpuric rash and acute kidney injury. Skin and kidney biopsy confirmed Henoch-Schönlein purpura. Upper endoscopy revealed diffuse, circumferential, black-appearing mucosa of the esophagus consistent with acute esophageal necrosis (AEN), also known as black esophagus. AEN is a very rare cause of gastrointestinal hemorrhage with a high mortality risk. To our knowledge, there have been no prior reports of AEN associated with Henoch-Schonlein purpura or other vasculitis. PMID:26504868

Internal gravity waves in the upper atmosphere, generated by tropospheric jet streams

NASA Technical Reports Server (NTRS)

Chunchuzov, Y. P.; Torgashin, Y. M.

1979-01-01

A mechanism of internal gravity wave generation by jet streams in the troposphere is considered. Evaluations of the energy and pulse of internal gravity waves emitted into the upper atmosphere are given. The obtained values of flows can influence the thermal and dynamic regime of these layers.

Rapid changes in cell physiology as a result of acute thermal stress house sparrows, Passer domesticus.

PubMed

Jimenez, Ana G; Williams, Joseph B

2014-12-01

Given that our climate is rapidly changing, Physiological Ecologists have the critical task of identifying characteristics of species that make them either resilient or susceptible to changes in their natural air temperature regime. Because climate change models suggest that heat events will become more common, and in some places more extreme, it is important to consider how extreme heat events might affect the physiology of a species. The implications of more frequent heat wave events for birds have only recently begun to be addressed, however, the impact of these events on the cellular physiology of a species is difficult to assess. We have developed a novel approach using dermal fibroblasts to explore how short-term thermal stress at the whole animal level might affect cellular rates of metabolism. House sparrows, Passer domesticus were separated into a "control group" and a "heat shocked" group, the latter acclimated to 43°C for 24h. We determined the plasticity of cellular thermal responses by assigning a "recovery group" that was heat shocked as above, but then returned to room temperature for 24h. Primary dermal fibroblasts were grown from skin of all treatment groups and the pectoralis muscle was collected. We found that glycolysis (ECAR) and oxygen consumption rates (OCR), measured using a Seahorse XF 96 analyzer, were significantly higher in the fibroblasts from the heat shocked group of House sparrows compared with their control counterparts. Additionally, muscle fiber diameters decreased and, in turn, Na(+)-K(+)-ATPase maximal activity in the muscle significantly increased in heat shocked sparrows compared with birds in the control group. All of these physiological alterations due to short-term heat exposure were reversible within 24h of recovery at room temperature. These results show that acute exposure to heat stress significantly alters the cellular physiology of sparrows, but that this species is plastic enough to recover from such a thermal

Applicability of Thermal Storage Systems to Air Force Facilities

DTIC Science & Technology

1990-09-01

Analisis of Region 6 Upper Limit Retrofit Scenario 30% Reduction .... ............. 4.52 4.58 Economic Analysis of Region 7 Upper Limit Retrofit Scenario...or a dynamic-direct contact type. They usually include all the controls, chilling and storage equipment in one self-contained, skid mounted, factory ...SCS technology. One promising trend in reducing system construction costs is the factory -packaged thermal storage cooling unit. As of February 1989

Non-steroidal anti-inflammatory drug related upper gastrointestinal bleeding: types of drug use and patient profiles in real clinical practice.

PubMed

Sostres, Carlos; Carrera-Lasfuentes, Patrica; Lanas, Angel

2017-10-01

The best available evidence regarding non-steroidal anti-inflammatory drug (NSAID)-related gastrointestinal (GI) bleeding comes from randomized controlled trials including patients who use NSAIDs to manage chronic rheumatic diseases; however, patients with varying background profiles commonly take NSAIDs for many other reasons, often without prescription, and such usage has not been well studied. To define the characteristics of patients hospitalized for upper GI bleeding in clinical practice, we conducted a case-control study among patients with endoscopy-proven major upper GI bleeding due to gastroduodenal peptic lesions and control subjects. We used adjusted logistic regression models to estimate bleeding risks. Data analysis was performed using SPSS 22.0. Our analysis included 3785 cases and 6540 controls, including 1270 cases (33.55%) and 834 controls (12.75%) reporting recent use (<30 days) of NSAIDs including high-dose acetylsalicylic acid (ASA). NSAID use was associated with increased risk of upper GI bleeding, with an adjusted relative risk of 4.86 (95% CI, 4.32-5.46). Acute musculoskeletal pain (36.1%), chronic osteoarthritis (13.5%), and headache (13.6%) were the most common reasons for NSAID use. Among cases, only 17.31% took NSAIDs and 6.38% took high dose ASA due to chronic osteoarthritis. Demographic characteristics significantly differed between subjects with chronic vs. acute musculoskeletal pain. Proton pump inhibitor use was significantly higher in patients who used NSAIDs due to chronic osteoarthritis compared to patients with acute musculoskeletal pain. NSAID (65.15%) or high-dose ASA use (65.83%) preceding upper GI bleeding was most often short-term. In over half of cases (63.62%), the upper GI bleeding event was not preceded by dyspeptic warning symptoms. The majority of patients hospitalized due to NSAID-related upper GI bleeding reported short-term NSAID use for reasons other than chronic rheumatic disease. These findings suggest that

Low-Thermal-Conductivity Pyrochlore Oxide Materials Developed for Advanced Thermal Barrier Coatings

NASA Technical Reports Server (NTRS)

Bansal, Narottam P.; Zhu, Dong-Ming

2005-01-01

When turbine engines operate at higher temperatures, they consume less fuel, have higher efficiencies, and have lower emissions. The upper-use temperatures of the base materials (superalloys, silicon-based ceramics, etc.) used for the hot-section components of turbine engines are limited by the physical, mechanical, and corrosion characteristics of these materials. Thermal barrier coatings (TBCs) are applied as thin layers on the surfaces of these materials to further increase the operating temperatures. The current state-of-the-art TBC material in commercial use is partially yttria-stabilized zirconia (YSZ), which is applied on engine components by plasma spraying or by electron-beam physical vapor deposition. At temperatures higher than 1000 C, YSZ layers are prone to sintering, which increases thermal conductivity and makes them less effective. The sintered and densified coatings can also reduce thermal stress and strain tolerance, which can reduce the coating s durability significantly. Alternate TBC materials with lower thermal conductivity and better sintering resistance are needed to further increase the operating temperature of turbine engines.

Acute fascioliasis--clinical and epidemiological features of four patients in Chile.

PubMed

Fica, A; Dabanch, J; Farias, C; Castro, M; Jercic, M I; Weitzel, T

2012-01-01

Because of its infrequent and protean presentation and the lack of clinical data, the management of acute infections with the foodborne trematode Fasciola hepatica is challenging. We report four serologically confirmed cases that illustrate our experience with this parasitic infection in Chile. All patients were adults presenting with upper abdominal pain. Other symptoms included fever, nausea/vomiting, and cutaneous manifestations. In all cases, marked eosinophilia was present. All patients lived in an urban environment, and three reported the consumption of raw watercress. Computed tomography (CT) scans showed hypodense hepatic lesions, whereas ultrasonography findings were unremarkable. One patient suffered portal vein thrombosis, which might be a rare complication of acute fascioliasis. All patients were successfully treated with triclabendazole. Our case series demonstrates that patients with acute fascioliasis typically present with a combination of upper abdominal pain, marked eosinophilia, and hypodense hepatic lesions on CT imaging. Diagnosis should be confirmed by serological investigation. A history of recent consumption of raw watercress is an important finding, but in some patients the source of infection remains obscure. © 2011 The Authors. Clinical Microbiology and Infection © 2011 European Society of Clinical Microbiology and Infectious Diseases.

Thermal Vacuum Test Correlation of a Zero Propellant Load Case Thermal Capacitance Propellant Gauging Analytical Model

NASA Technical Reports Server (NTRS)

Mckim, Stephen A.

2016-01-01

This thesis describes the development and correlation of a thermal model that forms the foundation of a thermal capacitance spacecraft propellant load estimator. Specific details of creating the thermal model for the diaphragm propellant tank used on NASA's Magnetospheric Multiscale spacecraft using ANSYS and the correlation process implemented are presented. The thermal model was correlated to within plus or minus 3 degrees Celsius of the thermal vacuum test data, and was determined sufficient to make future propellant predictions on MMS. The model was also found to be relatively sensitive to uncertainties in applied heat flux and mass knowledge of the tank. More work is needed to improve temperature predictions in the upper hemisphere of the propellant tank where predictions were found to be 2 to 2.5 C lower than the test data. A road map for applying the model to predict propellant loads on the actual MMS spacecraft toward its end of life in 2017-2018 is also presented.

Acute Necrotizing Esophagitis Followed by Duodenal Necrosis

PubMed Central

del Hierro, Piedad Magdalena

2011-01-01

Acute Necrotizing Esophagitis is an uncommon pathology, characterized by endoscopic finding of diffuse black coloration in esophageal mucosa and histological presence of necrosis in patients with upper gastrointestinal bleeding. The first case of acute necrotizing esophagitis followed by duodenal necrosis, in 81 years old woman with a positive history of Type 2 Diabetes Mellitus, Hypertension, and usual intake of Nonsteroidal Anti-inflammatory drugs, is reported. Although its etiology remains unknown, the duodenal necrosis suggests that ischemia could be the main cause given that the branches off the celiac axis provide common blood supply to the distal esophageal and duodenal tissue. The massive gastroesophagic reflux and NSAID intake could be involved. PMID:27957030

Tropical fish in a warming world: thermal tolerance of Nile perch Lates niloticus (L.) in Lake Nabugabo, Uganda

PubMed Central

Chrétien, Emmanuelle; Chapman, Lauren J.

2016-01-01

Key to predicting the response of fishes to climate change is quantifying how close fish are to their critical thermal limits in nature and their ability to adjust their thermal sensitivity to maintain performance. Here, we evaluated the effects of body size and habitat on aerobic scope (AS) and thermal tolerance of Nile perch Lates niloticus (L.), a fish of great economic and food security importance in East Africa, using respirometry and critical thermal maximum (CTmax) trials. Juvenile Nile perch from distinct habitats (high or low dissolved oxygen concentrations) of Lake Nabugabo, Uganda were exposed for 4.6 ± 0.55 days to a temperature treatment (25.5, 27.5, 29.5 or 31.5°C) prior to experimentation, with the lowest temperature corresponding to the mean annual daytime temperature in Lake Nabugabo and the highest temperature being 3°C higher than the maximal monthly average. As expected, metabolic rates increased with body mass. Although resting metabolic rate increased with temperature, maximal metabolic rate showed no change. Likewise, AS did not vary across treatments. The CTmax increased with acclimation temperature. There was no effect of habitat on maximal metabolic rate, AS or CTmax; however, there was a trend towards a lower resting metabolic rate for Nile perch captured in the low-dissolved oxygen habitat than in well-oxygenated waters. This study shows that juvenile Nile perch maintain a large AS at temperatures near the upper limit of their natural thermal range and provides evidence that Nile perch have physiological mechanisms to deal with acute exposure to thermal stress. PMID:27990290

Efficacy of a homeopathic complex on acute viral tonsillitis.

PubMed

Malapane, Eunice; Solomon, Elizabeth M; Pellow, Janice

2014-11-01

Acute viral tonsillitis is an upper respiratory tract infection prevalent in school-aged children. Because this condition is self-limiting, conventional treatment options are usually palliative. Homeopathic remedies are a useful alternative to conventional medications in acute uncomplicated upper respiratory tract infections in children, offering earlier symptom resolution, cost-effectiveness, and fewer adverse effects. This study aimed to determine the efficacy of a homeopathic complex on the symptoms of acute viral tonsillitis in African children in South Africa. This was a randomized, double-blind, placebo-controlled, 6-day pilot study. Thirty children, age 6 to 12 years, with acute viral tonsillitis were recruited from a primary school in Gauteng, South Africa. Participants took two tablets of the medication four times daily. The treatment group received lactose tablets medicated with the homeopathic complex (Atropa belladonna D4, Calcarea phosphoricum D4, Hepar sulphuris D4, Kalium bichromat D4, Kalium muriaticum D4, Mercurius protoiodid D10, and Mercurius biniodid D10). The placebo consisted of the unmedicated vehicle only. The Wong-Baker FACES Pain Rating Scale measured pain intensity, and a Symptom Grading Scale assessed changes in tonsillitis signs and symptoms. The treatment group had a statistically significant improvement in the following symptoms compared with the placebo group: pain associated with tonsillitis, pain on swallowing, erythema and inflammation of the pharynx, and tonsil size. The homeopathic complex used in this study exhibited significant anti-inflammatory and pain-relieving qualities in children with acute viral tonsillitis. No patients reported any adverse effects. These preliminary findings are promising; however, the sample size was small and therefore a definitive conclusion cannot be reached. A larger, more inclusive research study should be undertaken to verify the findings of this study.

Infectious Mononucleosis Complicated with Acute Cerebral Infarction: A Case Report.

PubMed

Chen, Jiann-Jy; Chang, Hsin-Feng; Liu, Chih-Yang; Chen, Dem-Lion

2015-03-01

Infectious mononucleosis (IM) complicated with a neurological manifestation, including acute cerebellar ataxia, Guillain-Barre syndrome, meningitis, encephalitis, cranial nerve palsies, optic neuritis or transverse myelitis, has been rarely reported; however, IM complicated with acute cerebral infarction has never been reported in the literature. A 49-year-old man with diabetic mellitus suffered from IM with fever, pharyngitis, parotiditis with lymphadenopathies, thrombocytopenia and splenomegaly. After two weeks of conservative treatment, left upper limb paresis and left hemihypesthesia occurred. Neuroimaging demonstrated acute ischemic stroke involving the right frontal lobe. In view of the underlying infection, immediate intravenous rt-PA was not recommended; hence, oral aspirin 100 mg daily was prescribed and he received regular rehabilitation in the subsequent follow up. Although IM is known to be self-limited, it could contribute to acute cerebral infarction, which is a rare IM neurological complication.

Thermal and chemical variations of the Nigerian Benue trough lead-zinc-barite-fluorite deposits

NASA Astrophysics Data System (ADS)

Ogundipe, Ibukun Emmanuel

2017-08-01

The Benue trough is an intra-continental rift initiated in the Cretaceous during the opening of the South Atlantic Ocean. Lead-zinc-barite-fluorite mineralization occurs along the 600 km axis of the trough in three discrete sub-basins which coincide with the lower, middle and upper mineral districts of the Benue Valley. Lithologically these sub-basins are dominated by black carbonaceous shale in the Lower Benue, platform carbonates in the Middle Benue and sandstones in the Upper Benue. Micro-thermometric analysis of fluid inclusions in sphalerite, fluorite, barite and quartz have shown that each mineral district has its own unique thermal and chemical imprint. For example, the temperature can be bracketed between 109 °C and 160 °C for lower Benue, 89 °C-144 °C for the Middle Benue and 176 °C-254 °C for the Upper Benue. Chemical differentiation also exists between each mineral district with the Lower Benue having 22 wt % equivalent NaCl while the Middle and Upper Benue have 18 and 16 wt % equivalent NaCl respectively. This study shows that inter-district thermal and chemical variations exist between the ore-stage sulfide and post-sulfide gangue minerals of the entire Benue Valley. Similarly, intra-district thermal and chemical variations have also been observed among all the paragenetic minerals of each district. The thermal variations may be as a result of variations in the geothermal gradient accompanying continental rifting from one district to the other. The variations in the chemistry between the Lower Benue and the Upper Benue paragenic minerals may be as a result of the distinct lithological differences across the Benue Trough.

The Olson method for detection of acute myocardial ischemia in patients with coronary occlusion.

PubMed

Lindow, Thomas; Olson, Charles W; Swenne, Cees A; Man, Sumche; Pahlm, Olle

An automated ECG-based method may provide diagnostic support in the management of patients with acute coronary syndrome. The Olson method has previously proved to accurately identify the culprit artery in patients with acute coronary occlusion. The Olson method was applied to 360 patients without acute myocardial ischemia and 52 patients with acute coronary occlusion. This study establishes the normal variation of the Olson wall scores in patients without acute myocardial ischemia, which provides the basis for implementation of the Olson method for triage of patients with acute coronary syndrome. All patients with acute occlusion had Olson wall scores above the upper limit of normal. The Olson method can be used for ischemia detection with very high sensitivity. Future studies are needed to explore specificity in patients with non-ischemic ST elevation. Copyright © 2016 Elsevier Inc. All rights reserved.

Duration of mineralization and fluid-flow history of the Upper Mississippi Valley zinc-lead district

USGS Publications Warehouse

Rowan, E.L.; Goldhaber, M.B.

1995-01-01

Studies of fluid inclusions in sphalerite and biomarkers from the Upper Mississippi Valley zinc district show homogenization temperatures to be primarily between 90 and 150??C, yet show relatively low levels of thermal maturity. Numerical calculations are used to simulate fluid and heat flow through fracture-controlled ore zones and heat transfer to the adjacent rocks. Combining a best-fit path through fluid-inclusion data with measured thermal alteration of biomarkers, the time interval during which mineralizing fluids circulated through the Upper Mississippi Valley district was calculated to be on the order of 200 ka. Cambrian and Ordovician aquifers underlying the district, principally the St. Peter and Mt. Simon Sandstones, were the source of the mineralizing fluid. The duration of mineralization thus reflects the fluid-flow history of these regional aquifers. -from Authors

High and low thermal conductivity of amorphous macromolecules

NASA Astrophysics Data System (ADS)

Xie, Xu; Yang, Kexin; Li, Dongyao; Tsai, Tsung-Han; Shin, Jungwoo; Braun, Paul V.; Cahill, David G.

2017-01-01

We measure the thermal conductivity, heat capacity and sound velocity of thin films of five polymers, nine polymer salts, and four caged molecules to advance the fundamental understanding of the lower and upper limits to heat conduction in amorphous macromolecules. The thermal conductivities vary by more than one order of magnitude, from 0.06 W m-1K-1 for [6,6]-phenyl-C71-butyric acid methyl ester to 0.67 W m-1K-1 for poly(vinylphosphonic acid calcium salt). Minimum thermal conductivity calculated from the measured sound velocity and effective atomic density is in good agreement with the thermal conductivity of macromolecules with various molecular structures and intermolecular bonding strength.

Effect of Upper-Cycle Temperature on the Load-Biased, Strain-Temperature Response of NiTi

NASA Technical Reports Server (NTRS)

Padula, Santo, II; Noebe, Ronald; Bigelow, Glen; Qiu, Shipeng; Vaidyanathan, Raj; Gaydosh, Darrell; Garg, Anita

2011-01-01

Over the past decade, interest in shape memory alloy based actuators has increased as the primary benefits of these solid-state devices have become more apparent. However, much is still unknown about the characteristic behavior of these materials when used in actuator applications. Recently we have shown that the maximum temperature reached during thermal cycling under isobaric conditions could significantly affect the observed mechanical response of NiTi (55 wt% Ni), especially the amount of transformation strain available for actuation and thus work output. The investigation we report here extends that original work to ascertain whether further increases in the upper-cycle temperature would produce additional changes in the work output of the material, which has a stress-free austenite finish temperature of 113 C, and to determine the optimum cyclic conditions. Thus, isobaric, thermal-cycle experiments were conducted on the aforementioned alloy at various stresses from 50-300 MPa using upper-cycle temperatures of 165, 200, 230, 260, 290, 320 and 350 C. The data indicated that the amount of applied stress influenced the transformation strain, as would be expected. However, the maximum temperature reached during the thermal excursion also plays an equally significant role in determining the transformation strain, with the maximum transformation strain observed during thermal cycling to 290 C. In situ neutron diffraction at stress and temperature showed that the differences in transformation strain were mostly related to changes in martensite texture when cycling to different upper-cycle temperatures. Hence, understanding this effect is important to optimizing the operation of SMA-based actuators and could lead to new methods for processing and training shape memory alloys for optimal performance.

Effect of Upper-Cycle Temperature on the Load-Biased, Strain-Temperature Response of NiTi

NASA Technical Reports Server (NTRS)

Padula, Santo, II; Vaidyanathan, Raj; Gaydosh, Darrell; Noebe, Ronald; Bigelow, Glen; Garg, Anita

2008-01-01

Over the past decade, interest in shape memory alloy based actuators has increased as the primary benefits of these solid-state devices have become more apparent. However, much is still unknown about the characteristic behavior of these materials when used in actuator applications. Recently we have shown that the maximum temperature reached during thermal cycling under isobaric conditions could significantly affect the observed mechanical response of NiTi (55 wt% Ni), especially the amount of transformation strain available for actuation and thus work output. This investigation extends that original work to ascertain whether further increases in the upper-cycle temperature would produce additional improvement in the work output of the material, which has a stress-free Af of 113 oC, and to determine the optimum cyclic conditions. Thus, isobaric, thermal-cycle experiments were conducted in the aforementioned alloy at various stress levels from 50-300 MPa using upper-cycle temperatures of 165, 200, 230, 260, 290, 320 and 350 oC. The data indicated that the amount of applied stress influenced the transformation strain available in the system, as would be expected. However, the maximum temperature reached during the thermal excursion also plays a role in determining the transformation strain, with the maximum transformation strain being developed by thermal cycling to 290 oC. In situ, neutron diffraction showed that the differences in transformation strain were related to differences in martensite texture within the microstructure when cycling to different upper-cycle temperatures. Hence, understanding this effect is important to optimizing the operation of SMA-based actuators and could lead to new methods for processing and training shape memory alloys for optimal performance.

Thermal Stress Limit Rafting Migration of Seahorses: Prediction Based on Physiological and Behavioral Responses to Thermal Stress

NASA Astrophysics Data System (ADS)

Qin, G.; Li, C.; Lin, Q.

2017-12-01

Marine fish species escape from harmful environment by migration. Seahorses, with upright posture and low mobility, could migrate from unfavorable environment by rafting with their prehensile tail. The present study was designed to examine the tolerance of lined seahorse Hippocampus erectus to thermal stress and evaluate the effects of temperature on seahorse migration. The results figured that seahorses' tolerance to thermal stress was time dependent. Acute thermal stress (30°C) increased breathing rate and HSP genes expression significantly, but didn't affect seahorse feeding behavior. Chronic thermal treatment lead to persistent high expression of HSP genes, higher breathing rate, and decreasing feeding, and final higher mortality, suggesting that seahorse cannot adapt to thermal stress by acclimation. No significant negative effects were found in seahorse reproduction in response to chronic thermal stress. Given that seahorses make much slower migration by rafting on sea surface compared to other fishes, we suggest that thermal stress might limit seahorse migration range. and the influence might be magnified by global warming in future.

Recent advances in endovascular techniques for management of acute nonvariceal upper gastrointestinal bleeding

PubMed Central

Loffroy, Romaric F; Abualsaud, Basem A; Lin, Ming D; Rao, Pramod P

2011-01-01

Over the past two decades, transcatheter arterial embolization has become the first-line therapy for the management of upper gastrointestinal bleeding that is refractory to endoscopic hemostasis. Advances in catheter-based techniques and newer embolic agents, as well as recognition of the effectiveness of minimally invasive treatment options, have expanded the role of interventional radiology in the management of hemorrhage for a variety of indications, such as peptic ulcer bleeding, malignant disease, hemorrhagic Dieulafoy lesions and iatrogenic or trauma bleeding. Transcatheter interventions include the following: selective embolization of the feeding artery, sandwich coil occlusion of the gastroduodenal artery, blind or empiric embolization of the supposed bleeding vessel based on endoscopic findings and coil pseudoaneurysm or aneurysm embolization by three-dimensional sac packing with preservation of the parent artery. Transcatheter embolization is a fast, safe and effective, minimally invasive alternative to surgery when endoscopic treatment fails to control bleeding from the upper gastrointestinal tract. This article reviews the various transcatheter endovascular techniques and devices that are used in a variety of clinical scenarios for the management of hemorrhagic gastrointestinal emergencies. PMID:21860697

Sudden quadriplegia after acute cervical disc herniation.

PubMed

Sadanand, Venkatraman; Kelly, Michael; Varughese, George; Fourney, Daryl R

2005-08-01

Acute neurological deterioration secondary to cervical disc herniation not related to external trauma is very rare, with only six published reports to date. In most cases, acute symptoms were due to progression of disc herniation in the presence of pre-existing spinal canal stenosis. A 42-year-old man developed weakness and numbness in his arms and legs immediately following a sneeze. On physical examination he had upper motor neuron signs that progressed over a few hours to a complete C5 quadriplegia. An emergent magnetic resonance imaging study revealed a massive C4/5 disc herniation. He underwent emergency anterior cervical discectomy and fusion. Postoperatively, the patient remained quadriplegic. Eighteen days later, while receiving rehabilitation therapy, he expired secondary to a pulmonary embolus. Autopsy confirmed complete surgical decompression of the spinal cord. Our case demonstrates that acute quadriplegia secondary to cervical disc herniation may occur without a history of myelopathy or spinal canal stenosis after an event as benign as a sneeze.

The management of acute and chronic pancreatitis.

PubMed

Banks, Peter A; Conwell, Darwin L; Toskes, Phillip P

2010-02-01

Pancreatitis, which is most generally described as any inflammation of the pancreas, is a serious condition that manifests in either acute or chronic forms. Chronic pancreatitis results from irreversible scarring of the pancreas, resulting from prolonged inflammation. Six major etiologies for chronic pancreatitis have been identified: toxic/ metabolic, idiopathic, genetic, autoimmune, recurrent and severe acute pancreatitis, and obstruction. The most common symptom associated with chronic pancreatitis is pain localized to the upper-to-middle abdomen, along with food malabsorption, and eventual development of diabetes. Treatment strategies for acute pancreatitis include fasting and short-term intravenous feeding, fluid therapy, and pain management with narcotics for severe pain or nonsteroidal anti-inflammatories for milder cases. Patients with chronic disease and symptoms require further care to address digestive issues and the possible development of diabetes. Dietary restrictions are recommended, along with enzyme replacement and vitamin supplementation. More definitive outcomes may be achieved with surgical or endoscopic methods, depending on the role of the pancreatic ducts in the manifestation of disease.

[Feasibility and short-term efficacy of simplified intensity-modulated radiotherapy and concurrent chemotherapy for neck and upper thoracic esophageal carcinoma].

PubMed

Zhu, Wei-Guo; Yu, Chang-Hua; Han, Ji-Hua; Li, Tao; Zhou, Xi-Lei; Tao, Guang-Zhou

2009-12-01

For neck and upper thoracic esophageal carcinoma, three dimensional conformal radiation therapy (3D-CRT) does not necessarily meet all clinical requirements while intensity modulated radiation therapy (IMRT) may take up a lot of labour power and material resources. This study was to explore the feasibility of simplified IMPT(sIMRT) and concurrent chemotherapy for neck and upper thoracic esophageal carcinoma, and to investigate the acute toxicities and short-term efficacy of this treatment modality. sIMRT plans were designed for 30 patients with neck and upper thoracic esophageal carcinoma. Two target volumes were defined: PTV1, which was designed to irradiate to 64 Gy (2.13 Gy x 30 fractions); PTV2, which was given to 54 Gy (1.8 Gy x 30). The sIMRT plan included five equiangular coplanar beams. All patients concurrently received DDP+5-FU regimen with radiotherapy on d1-5 and d29-33. Chemotherapy was repeated for two cycles 28 days after radiotherapy. The treatment was completed for all patients within 6 weeks, and only one patient had Grade 3 acute bronchitis. The complete response (CR) rate was 90.0% (27/30) and the partial response (PR) rate 10.0% (3/30). Overall response was 100% for esophageal lesions and the CR rate 76.5% (13/17). The PR rate was 23.5% (4/17) in lymph node lesions. The major toxicities observed were Grades I-II leukocytopenia. sIMRT can generate desirable dose distribution for neck and upper thoracic esophageal carcinoma, which is similar to sophisticated IMRT but obviously better than 3D-CRT. The short-term efficacy of sIMRT is satisfactory and its acute toxicities are tolerable.

Risk of acute myocardial infarction in upper tract urothelial carcinoma patients receiving radical nephroureterectomy: a population-based cohort study

PubMed Central

Lin, Shih-Yi; Lin, Cheng-Li; Chang, Chao-Hsiang; Wu, His-Chin; Wang, I-Kuan; Chou, Che-Yi; Liang, Ji-An

2017-01-01

Background The outcomes of upper tract urothelial carcinoma (UTUC) receiving radical nephroureterectomy were usually limited to small sample size, case-control studies, and often focused on cancer progression. Risk of acute myocardial infarction (AMI) in these patients was never investigated. Results The overall incidences of AMI were 3.39, 1.44, and 1.70 per 10,000 person-years in the radical nephroureterectomy, nonnephroureterectomy, and non-UTUC cohorts, respectively. Multivariable Cox proportional hazard regression analysis revealed a significantly higher AMI risk in the radical nephroureterectomy cohort [adjusted HR (aHR) = 1.83, 95% confidence interval (CI) = 1.08–3.11], compared with non-UTUC cohorts. The risk of mortality were the highest in patients with UTUC who had undergone radical nephroureterectomy [adjusted HR (aHR) = 5.37, 95% confidence interval (CI) = 4.80–6.02]. Materials and Methods From the Taiwan National Health Insurance claims data, 1,359 patients with UTUC who had undergone radical nephroureterectomy and 3,154 patients with UTUC who had undergone nephron sparing surgery and were newly diagnosed between 2000 and 2010 were identified. For each patient, 4 individuals without UTUC were randomly selected and frequency matched by age, sex, and diagnosis year. Conclusions Patients with UTUC who have undergone radical nephroureterectomy are at a higher risk of developing AMI, compared with those receiving nephron sparing surgery. PMID:29108329

A Mathematical Model of the Human Small Intestine Following Acute Radiation and Burn Exposures

DTIC Science & Technology

2016-08-01

Acronyms and Symbols ARA Applied Research Associates, Inc. ARS Acute radiation syndrome d Days DE Differential Evolution DTRA Defense Threat...04-08-2016 Technical Report A Mathematical Model of the Human Small Intestine Following Acute Radiation and Burn Exposures HDTRA1...epithelial cells to acute radiation alone. The model has been modified for improved radiation response, and an addition to the model allows for thermal injury

Does Muscular Force of the Upper Body Increase Following Acute, Direct Vibration?

PubMed

Cochrane, D J

2016-06-01

The aim of the current study was to examine the acute effect of direct vibration has on bicep curl force-generating capacity. 11 healthy team and individual sport-trained males performed right and left DB bicep curl at 50% of 1 RM where peak force (PF), mean force (MF), rate of force development (RFD) and electromyography (EMG) were assessed during the concentric phase before and immediately after direct vibration. Using new vibration technology utilizing a pulsing frequency (0-170 Hz) each arm was randomly assigned to receive either 10 min of direct vibration or control (no vibration). Following direct vibration PF increased 6.6±4.5 N (difference pre-post±90 CL; p>0.05) compared to control FP (-1.2±65 N; p>0.05) however, this was not significant. Furthermore, there were no other significant changes (p>0.05) in MP, RFD and EMG between vibration and control arms. This is in agreement with other research that has reported that acute strength changes from vibration elicits negligible changes, however it appears that there are no detrimental effects of using this new vibration device. © Georg Thieme Verlag KG Stuttgart · New York.

The Hepatic Response to Thermal Injury: Is the Liver Important for Postburn Outcomes?

PubMed Central

Jeschke, Marc G

2009-01-01

Thermal injury produces a profound hypermetabolic and hypercatabolic stress response characterized by increased endogenous glucose production via gluconeogenesis and glycogenolysis, lipolysis, and proteolysis. The liver is the central body organ involved in these metabolic responses. It is suggested that the liver, with its metabolic, inflammatory, immune, and acute phase functions, plays a pivotal role in patient survival and recovery by modulating multiple pathways following thermal injury. Studies have evaluated the role and function of the liver during the postburn response and showed that liver integrity and function are essential for survival, and that hepatic acute phase proteins are strong predictors for postburn survival. This review discusses these studies and delineates the pivotal role of the liver in patients following severe thermal injury. PMID:19603107

Clozapine-induced acute gastrointestinal necrosis: a case report.

PubMed

Osterman, Mark T; Foley, Caitlin; Matthias, Isaac

2017-09-23

Clozapine is known to cause fecal impaction and ileus with resultant colonic necrosis due to compression of colonic mucosa. There are rare reports of clozapine causing necrosis of other portions of the gastrointestinal tract unrelated to constipation. We describe a case of acute necrosis of the upper gastrointestinal tract and small bowel to due to clozapine and quetiapine. A 66-year-old white man with a past medical history of schizophrenia, maintained on clozapine and quetiapine, presented with hypoxic respiratory failure caused by aspiration of feculent emesis due to impacted stool throughout his colon. His constipation resolved with discontinuation of clozapine and quetiapine, and his clinical condition improved. These medicines were restarted after 2 weeks, resulting in acute gastrointestinal necrosis from the mid esophagus through his entire small bowel. He died due to septic shock with Gram-negative rod bacteremia. Clozapine may cause acute gastrointestinal necrosis.

Thermal tolerance of the invasive Belonesox belizanus, pike killifish, throughout ontogeny.

PubMed

Kerfoot, James Roy

2012-06-01

The goal of this study was to characterize the variability of thermal tolerances between life-history stages of the invasive Belonesox belizanus and attempt to describe the most likely stage of dispersal across south Florida. In the laboratory, individuals were acclimated to three temperatures (20, 25, or 30°C). Upper and lower lethal thermal limits and temperatures at which feeding ceased were measured for neonates, juveniles, and adults. Thermal tolerance polygons were developed to represent the thermal tolerance range of each life-history stage. Results indicated that across acclimation temperatures upper lethal thermal limits were similar for all three stages (38°C). However, minimum lethal thermal limits were significantly different at the 30°C acclimation temperature, where juveniles (9°C) had an approximately 2.0°C and 4.0°C lower minimum lethal thermal limit compared with adults and neonates, respectively. According to thermal tolerance polygons, juveniles had an average tolerance polygonal area almost 20°C(2) larger than adults, indicating the greatest thermal tolerance of the three life-history stages. Variation in cessation of feeding temperatures indicated no significant difference between juveniles and adults. Overall, results of this study imply that juvenile B. belizanus may be equipped with the physiological flexibility to exercise habitat choice and reduce potential intraspecific competition with adults for limited food resources. Given its continued dispersal, the minimum thermal limit of juveniles may aid in continued dispersal of this species, especially during average winter temperatures throughout Florida where juveniles could act to preserve remnant populations until seasonal temperatures increase. © 2012 WILEY PERIODICALS, INC.

[Massive hemorrhage of upper gastrointestinal tract caused by gastrointestinal stromal tumor of the stomach--case report].

PubMed

Lalović, Nenad; Dukić Vladicić, Nikolina; Marić, Radmil; Cuk, Mirjana; Simatović, Milan; Jokanović, Dragana

2012-01-01

Acute bleeding from the upper gastrointestinal system is a medical emergency which is followed by high mortality rate, ranging from 6 to 15% in spite of modern diagnostic methods and treatment. Bleeding from the upper gastrointestinal system may be caused by gastrointestinal stromal tumors of the stomach, which are mainly characterized by occult bleeding, while profuse bleeding rarely occurs accompanied by hemorrhagic shock. Gastrointestinal stromal tumors of stomach are the most common mesenchimal tumors of the gastrointestinal tract. In our study we showed a 60-year-old female patient with profuse bleeding from the stomach and the clinical picture of severe hemorrhagic shock, caused by gastrointestinal stromal tumor. An ovoid junction, raised towards the lumen, covered with ulcerated mucosa in several places and followed by massive arterial bleeding was found intraoperatively, after the performed gastrotomy. Histopathological examination with immunohistochemical analysis confirmed that this was a gastrointestinal stromal tumor of the stomach. Acute bleeding from the digestive system is a sudden and serious condition of the body. Urgent esophagogastroduodenoscopy is a sensitive and specific diagnostic and therapeutic method of choice. Massive bleeding from the upper gastrointestinal tract is very rarely caused by gastrointestinal stromal tumors, whose clinical picture is very heterogeneous and depends on tumor size and location. Abundant bleeding from the tumor is an indication for urgent surgical intervention. According to the literature massive hemorrhage of the upper digestive system can rarely be caused by gastrointestinal stromal tumor of the stomach. It is shown that abundant hemorrhage of the upper digestive tract can be caused with gastric gastrointestinal stromal tumor. Surgical resection is the main form of treatment of gastrointestinal stromal tumors of the digestive system and bleeding from these tumors caused by failure of endoscopic hemostasis.

Transmyocardial laser revascularization in the acute ischaemic heart: no improvement of acute myocardial perfusion or prevention of myocardial infarction.

PubMed

Eckstein, F S; Scheule, A M; Vogel, U; Schmid, S T; Miller, S; Jurmann, M J; Ziemer, G

1999-05-01

Transmyocardial laser revascularization (TMLR) has been used to provide enhanced myocardial perfusion in patients not suitable for coronary revascularization or angioplasty. This study investigates the acute changes in myocardial perfusion after TMLR with a Holmium:Yttrium-Aluminium-Garnet (YAG) laser with a thermal imaging camera in a model of acute ischaemia, and confirms its midterm effects by post-mortem investigation of magnetic resonance imaging and histopathological examination. Acute myocardial ischaemia was induced by occlusion of the dominant diagonal branch in ten sheep. Perfusion measurements were undertaken first in the unaffected myocardium, then after temporary occlusion of the coronary to obtain a control measurement for ischaemic myocardium. Myocardial perfusion was then evaluated during reperfusion after release of coronary occlusion. Then the coronary was permanently occluded and 20.5+/-2 channels were drilled with the Holmium:YAG laser and perfusion was measured again. The other four sheep served as control with untreated ischaemia. All animals were sacrificed after 28 days following administration of gadolinium i.v. to serve as contrast medium for magnetic resonance tomography. The hearts were subjected to magnetic resonance tomography and histopathological examination. Intraoperative perfusion measurements revealed a decreased perfusion after temporary occlusion and an increased perfusion in reperfused myocardium. After TMLR, no improvement of myocardial perfusion above the ischaemic level could be shown. Magnetic resonance images could neither confirm patent laser channels nor viable myocardium within ischaemic areas. On histology no patent endocardial laser channel could be detected. The transmural features were myocardial infarct with scar tissue. In the presented sheep model with acute ischaemia, TMLR with a Holmium:YAG laser did not provide acute improvement of myocardial perfusion as assessed by a thermal imaging camera. This would

Acute thoracolumbar pain due to cholecystitis: a case study.

PubMed

Carter, Chris T

2015-01-01

This article describes and discusses the case of an adult female with cholecystitis characterized on initial presentation as acute thoracolumbar pain. A 34-year-old female presented for care with a complaint of acute right sided lower thoracic and upper lumbar pain with associated significant hyperalgesia and muscular hypertonicity. The patient was examined, referred, and later diagnosed by use of ultrasound imaging. Despite many initial physical examination findings of musculoskeletal dysfunction, this case demonstrates the significance of visceral referred pain, viscerosomatic hyperalgesia & hypertonicity, and how these neurological processes can mimic mechanical pain syndromes. A clinical neurological discussion of cholecystitis visceral pain and referred viscerosomatic phenomena is included.

Upper respiratory tract infection in children, domestic temperatures, and humidity.

PubMed Central

Ross, A; Collins, M; Sanders, C

1990-01-01

STUDY OBJECTIVE--The aim of the study was to seek for a possible association between the incidence of upper respiratory tract infections and air temperature and humidity in the home. DESIGN--Recordings of temperature and relative humidity were made in living rooms and children's bedrooms over a six month period and related to incidence of upper respiratory tract infection. SETTING--The study was carried out in one general practice of 10,000 patients. PATIENTS--297 children aged 24-59 months were studied, selected in random order from the practice age-sex register. MEASUREMENTS AND MAIN RESULTS--Temperature and humidity recordings were made with thermohygrograph recorders over six days. Upper respiratory tract infections were recorded (a) retrospectively over the previous 12 months, and (b) during the study period. Past history of acute otitis media and recent family history of respiratory infection were also obtained. No significant association was found between the variables, although the bedrooms of children with reported upper respiratory tract infections were cooler overnight than those of non-infected children (mean difference 0.8 degrees C, 95% confidence limits 0.7 degrees C). No association was found between reported or recorded upper respiratory tract infections and age or type of home, family size, level of occupancy, social class, or smoking habits. Only 15 children (5%) were identified by their parents as having had asthma, but 58 (19.5%) had had a "wheezy chest". A greater proportion of children who wheezed slept in cooler bedrooms, had gas fires rather than central heating, and had more smokers in the house. CONCLUSIONS--No association between upper respiratory tract infection and domestic temperature or humidity levels could be shown in this study. Since dampness is repeatedly presented as a health risk, further study is required. PMID:2370503

Outdoor thermal comfort in public space in warm-humid Guayaquil, Ecuador

NASA Astrophysics Data System (ADS)

Johansson, Erik; Yahia, Moohammed Wasim; Arroyo, Ivette; Bengs, Christer

2018-03-01

The thermal environment outdoors affects human comfort and health. Mental and physical performance is reduced at high levels of air temperature being a problem especially in tropical climates. This paper deals with human comfort in the warm-humid city of Guayaquil, Ecuador. The main aim was to examine the influence of urban micrometeorological conditions on people's subjective thermal perception and to compare it with two thermal comfort indices: the physiologically equivalent temperature (PET) and the standard effective temperature (SET*). The outdoor thermal comfort was assessed through micrometeorological measurements of air temperature, humidity, mean radiant temperature and wind speed together with a questionnaire survey consisting of 544 interviews conducted in five public places of the city during both the dry and rainy seasons. The neutral and preferred values as well as the upper comfort limits of PET and SET* were determined. For both indices, the neutral values and upper thermal comfort limits were lower during the rainy season, whereas the preferred values were higher during the rainy season. Regardless of season, the neutral values of PET and SET* are above the theoretical neutral value of each index. The results show that local people accept thermal conditions which are above acceptable comfort limits in temperate climates and that the subjective thermal perception varies within a wide range. It is clear, however, that the majority of the people in Guayaquil experience the outdoor thermal environment during daytime as too warm, and therefore, it is important to promote an urban design which creates shade and ventilation.

Outdoor thermal comfort in public space in warm-humid Guayaquil, Ecuador.

PubMed

Johansson, Erik; Yahia, Moohammed Wasim; Arroyo, Ivette; Bengs, Christer

2018-03-01

The thermal environment outdoors affects human comfort and health. Mental and physical performance is reduced at high levels of air temperature being a problem especially in tropical climates. This paper deals with human comfort in the warm-humid city of Guayaquil, Ecuador. The main aim was to examine the influence of urban micrometeorological conditions on people's subjective thermal perception and to compare it with two thermal comfort indices: the physiologically equivalent temperature (PET) and the standard effective temperature (SET*). The outdoor thermal comfort was assessed through micrometeorological measurements of air temperature, humidity, mean radiant temperature and wind speed together with a questionnaire survey consisting of 544 interviews conducted in five public places of the city during both the dry and rainy seasons. The neutral and preferred values as well as the upper comfort limits of PET and SET* were determined. For both indices, the neutral values and upper thermal comfort limits were lower during the rainy season, whereas the preferred values were higher during the rainy season. Regardless of season, the neutral values of PET and SET* are above the theoretical neutral value of each index. The results show that local people accept thermal conditions which are above acceptable comfort limits in temperate climates and that the subjective thermal perception varies within a wide range. It is clear, however, that the majority of the people in Guayaquil experience the outdoor thermal environment during daytime as too warm, and therefore, it is important to promote an urban design which creates shade and ventilation.

Hypothyroid-induced acute compartment syndrome in all extremities.

PubMed

Musielak, Matthew C; Chae, Jung Hee

2016-12-20

Acute compartment syndrome (ACS) is an uncommon complication of uncontrolled hypothyroidism. If unrecognized, this can lead to ischemia, necrosis and potential limb loss. A 49-year-old female presented with the sudden onset of bilateral lower and upper extremity swelling and pain. The lower extremity anterior compartments were painful and tense. The extensor surface of the upper extremities exhibited swelling and pain. Motor function was intact, however, limited due to pain. Bilateral lower extremity fasciotomies were performed. Postoperative Day 1, upper extremity motor function decreased significantly and paresthesias occurred. She therefore underwent bilateral forearm fasciotomies. The pathogenesis of hypothyroidism-induced compartment syndrome is unclear. Thyroid-stimulating hormone-induced fibroblast activation results in increased glycosaminoglycan deposition. The primary glycosaminoglycan in hypothyroid myxedematous changes is hyaluronic acid, which binds water causing edema. This increases vascular permeability, extravasation of proteins and impaired lymphatic drainage. These contribute to increased intra-compartmental pressure and subsequent ACS. Published by Oxford University Press and JSCR Publishing Ltd. All rights reserved. © The Author 2016.

Acute olanzapine overdose in a toddler: a case report.

PubMed

Tanoshima, Reo; Chandranipapongse, Weerawadee; Colantonio, David; Stefan, Cristiana; Nulman, Irena

2013-10-01

We describe a 17-month-old female presented with an acute overdose of olanzapine, an atypical antipsychotic. She displayed prolonged extrapyramidal symptoms as compared with that in previous reports and prolactin levels above the upper limits of normal ranges. This is the first report to measure serum prolactin levels in an olanzapine-overdosed toddler and the second to calculate olanzapine's elimination half-life.

Low thermal resistance power module assembly

DOEpatents

Hassani, Vahab; Vlahinos, Andreas; Bharathan, Desikan

2007-03-13

A power module assembly with low thermal resistance and enhanced heat dissipation to a cooling medium. The assembly includes a heat sink or spreader plate with passageways or openings for coolant that extend through the plate from a lower surface to an upper surface. A circuit substrate is provided and positioned on the spreader plate to cover the coolant passageways. The circuit substrate includes a bonding layer configured to extend about the periphery of each of the coolant passageways and is made up of a substantially nonporous material. The bonding layer may be solder material which bonds to the upper surface of the plate to provide a continuous seal around the upper edge of each opening in the plate. The assembly includes power modules mounted on the circuit substrate on a surface opposite the bonding layer. The power modules are positioned over or proximal to the coolant passageways.

Factors predicting mortality in severe acute pancreatitis.

PubMed

Compañy, L; Sáez, J; Martínez, J; Aparicio, J R; Laveda, R; Griñó, P; Pérez-Mateo, M

2003-01-01

Acute pancreatitis (AP) is a common disorder in which ensuing serious complications may lead to a fatal outcome in patients. To describe a large series of patients with severe AP (SAP) who were admitted to our hospital and to identify factors predicting mortality. In a retrospective study, all patients with SAP diagnosed between February 1996 and October 2000 according to the Atlanta criteria were studied. Out of a total of 363 AP patients, 67 developed SAP. The mean age of the patients was 69; the commonest etiology was biliary; 55.2% developed necrosis; the commonest systemic complication was respiratory failure (44.7%), followed by acute renal failure (35.8%) and shock (20.9%). A total of 31.3% of the patients died. Factors significantly related to mortality were age, upper digestive tract bleeding, acute renal failure, respiratory failure and shock by univariate analysis. However, pseudocysts seemed to have a protective effect. By multivariate analysis, independent prognostic factors were age, acute renal failure and respiratory failure. Patients with SAP mainly died due to systemic complications, especially acute renal failure and respiratory failure. Necrosis (in the absence or presence of infection) was not correlated with increased mortality. A pseudocyst was found to be a protective factor, probably because the definition itself led to the selection of patients who had survived multiorgan failure. Copyright 2003 S. Karger AG, Basel and IAP

ISAMS and MLS for NASA's Upper Atmosphere Research Satellite

NASA Astrophysics Data System (ADS)

Llewellyn-Jones, D.; Dickinson, P. H. G.

1990-04-01

The primary goal of NASA's Upper Atmosphere Research Satellite (UARS), planned to be launched in 1991, is to compile data about the structure and behavior of the stratospheric ozone layer, and especially about the threat of the chlorine-based pollutants to its stablility. Two of the payload instruments, manufactured in the UK, are described: the Improved Stratospheric and Mesospheric Sounder (ISAMS), a radiometer designed to measure thermal emission from selected atmospheric constituents at the earth's limb, then making it possible to obtain nearly global coverage of the vertical distribution of temperature and composition from 80 deg S to 80 deg N latitude; and the Microwave Limb Sounder (MLS), a limb sounding radiometer, measuring atmospheric thermal emission from selected molecular spectral lines at mm wavelength, in the frequency regions of 63, 183, and 205 GHz.

Thermograpic study of upper extremities in patients with cerebral palsy

NASA Astrophysics Data System (ADS)

Lampe, R.; Kawelke, S.; Mitternacht, J.; Turova, V.; Blumenstein, T.; Alves-Pinto, A.

2015-03-01

Trophic disorders like reduced skin blood circulation are well-known epiphenomenon of cerebral palsy (CP). They can influence quality of life and can lead to skin damages and, as a consequence, to decubitus. Therefore, it is important to analyse temperature regulation in patients with CP. Thermal imaging camera FLIR BCAM SD was used to study the dependency of skin blood circulation in upper extremities of patients with CP on hand dominance, hand force and hand volume. The hand force was evaluated using a conventional dynamometer. The hand volume was measured with a volumeter. A cold stress test for hands was applied in 22 patients with CP and 6 healthy subjects. The warming up process after the test was recorded with the thermal camera. It was confirmed that the hands of patients warm up slower comparing to healthy persons. The patients' working hands warm up faster than non-working ones. A slight correlation was established between the hand grip force of the working hands and their warm up time. No correlation was found between the warming up time and the volume of the hand. The results confirm our assumption that there is a connection of peripheral blood circulation to upper limb motor functions.

Stationary waves and slowly moving features in the night upper clouds of Venus

NASA Astrophysics Data System (ADS)

Peralta, J.; Hueso, R.; Sánchez-Lavega, A.; Lee, Y. J.; Muñoz, A. García; Kouyama, T.; Sagawa, H.; Sato, T. M.; Piccioni, G.; Tellmann, S.; Imamura, T.; Satoh, T.

2017-08-01

At the cloud top level of Venus (65-70 km altitude) the atmosphere rotates 60 times faster than the underlying surface—a phenomenon known as superrotation1,2. Whereas on Venus's dayside the cloud top motions are well determined3,4,5,6 and Venus general circulation models predict the mean zonal flow at the upper clouds to be similar on both the day and nightside2, the nightside circulation remains poorly studied except for the polar region7,8. Here, we report global measurements of the nightside circulation at the upper cloud level. We tracked individual features in thermal emission images at 3.8 and 5.0 μm obtained between 2006 and 2008 by the Visible and Infrared Thermal Imaging Spectrometer-Mapper onboard Venus Express and in 2015 by ground-based measurements with the Medium-Resolution 0.8-5.5 Micron Spectrograph and Imager at the National Aeronautics and Space Administration Infrared Telescope Facility. The zonal motions range from -110 to -60 m s-1, which is consistent with those found for the dayside but with larger dispersion6. Slow motions (-50 to -20 m s-1) were also found and remain unexplained. In addition, abundant stationary wave patterns with zonal speeds from -10 to +10 m s-1 dominate the night upper clouds and concentrate over the regions of higher surface elevation.

Relationship between the upper mantle high velocity seismic lid and the continental lithosphere

NASA Astrophysics Data System (ADS)

Priestley, Keith; Tilmann, Frederik

2009-04-01

useful in mapping the thickness of the high velocity upper mantle lid because this type of analysis often determines wave speed perturbations from an unknown horizontal average and not absolute velocities. Thus, any feature which extends laterally across the whole region beneath a seismic network becomes invisible in the teleseismic body-wave tomographic image. We compare surface-wave and body-wave tomographic results using southern Africa as an example. Surface-wave tomographic images for southern Africa show a strong, high velocity upper mantle lid confined to depths shallower than ~ 200 km, whereas body-wave tomographic images show weak high velocity in the upper mantle extending to depths of ~ 300 km or more. However, synthetic tests show that these results are not contradictory. The absolute seismic velocity structure of the upper mantle provided by surface wave analysis can be used to map the thermal lithosphere. Priestley and McKenzie (Priestley, K., McKenzie, D., 2006. The thermal structure of the lithosphere from shear wave velocities. Earth and Planetary Science Letters 244, 285-301.) derive an empirical relationship between shear wave velocity and temperature. This relationship is used to obtain temperature profiles from the surface-wave tomographic models of the continental mantle. The base of the lithosphere is shown by a change in the gradient of the temperature profiles indicative of the depth where the mode of heat transport changes from conduction to advection. Comparisons of the geotherms determined from the conversion of surface-wave wave speeds to temperatures with upper mantle nodule-derived geotherms demonstrate that estimates of lithospheric thickness from Vs and from the nodule mineralogy agree to within about 25 km. The lithospheric thickness map for Africa derived from the surface-wave tomographic results shows that thick lithosphere underlies most of the Archean crust in Africa. The distribution of diamondiferous kimberlites provides an

Is mid-upper arm circumference alone sufficient for deciding admission to a nutritional programme for childhood severe acute malnutrition in Bangladesh?

PubMed

Ali, Engy; Zachariah, Rony; Shams, Zubair; Vernaeve, Lieven; Alders, Petra; Salio, Flavio; Manzi, Marcel; Allaouna, Malik; Draguez, Bertrand; Delchevalerie, Pascale; Harries, Anthony D

2013-05-01

Mid-upper arm circumference (MUAC) and weight-for-height Z-score (WHZ) identify different populations of children with severe acute malnutrition (SAM) with only some degree of overlap. In an urban slum in Bangladesh, we conducted a prospective cohort study on children assessed as being severely malnourished by WHZ (<-3) but not by MUAC (>115 mm), to: 1. Assess their nutritional outcomes, and 2. Report on morbidity and mortality. Children underwent 2-weekly prospective follow-up home visits for 3 months and their anthropometric evolution, morbidity and mortality were monitored. Of 158 children, 21 did not complete follow-up (six were lost to follow-up and 15 changed residence). Of the remaining 137 children, nine (7%) required admission to the nutrition programme because of: MUAC dropping to <115 mm (5/9 children), weight loss ≥ 10% (1/9 children) and severe medical complications (3/9 children, of whom one died). Of the remaining 128 children who completed follow-up, 91 (66%) improved in nutritional status while 37 (27%) maintained a WHZ of <-3. Cough was less frequent among those whose nutritional status improved. It seems acceptable to rely on MUAC as a single assessment tool for case finding and for admission of children with SAM to nutritional programmes.

Inhalation of diethylamine--acute nasal effects and subjective response

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lundqvist, G.R.; Yamagiwa, M.; Pedersen, O.F.

1992-03-01

Adult volunteers were exposed to 25 ppm (75 mg/m3) diethylamine in a climate chamber for 15 min in order to study the acute nasal reactions to an exposure equivalent to the present threshold limit value-short-term exposure limit. Changes in nasal volume and nasal resistance were measured by acoustic rhinometry and by rhinomanometry. Acute change in nasal volume, usually seen as acute nasal mucosa response to thermal stimuli, was not observed, nor was an acute change in nasal airway resistance. In a subsequent experiment, the aim was to measure acute sensory effects. Exposure to a concentration increasing from 0 to 12more » ppm took place for 60 min, equal to an average concentration of 10 ppm (30 mg/m3). A moderate to strong olfactory response and distinct nasal and eye irritation were observed. In spite of considerable individual variation, the results were in agreement with sensory effect estimates obtained from animal studies.« less

Self-Reported Mental Health Predicts Acute Respiratory Infection.

PubMed

Maxwell, Lizzie; Barrett, Bruce; Chase, Joseph; Brown, Roger; Ewers, Tola

2015-06-01

Poor mental health conditions, including stress and depression, have been recognized as a risk factor for the development of acute respiratory infection. Very few studies have considered the role of general mental health in acute respiratory infection occurrence. The aim of this analysis is to determine if overall mental health, as assessed by the mental component of the Short Form 12 Health Survey, predicts incidence, duration, or severity of acute respiratory infection. Data utilized for this analysis came from the National Institute of Health-funded Meditation or Exercise for Preventing Acute Respiratory Infection (MEPARI) and MEPARI-2 randomized controlled trials examining the effects of meditation or exercise on acute respiratory infection among adults aged > 30 years in Madison, Wisconsin. A Kendall tau rank correlation compared the Short Form 12 mental component, completed by participants at baseline, with acute respiratory infection incidence, duration, and area-under-the-curve (global) severity, as assessed by the Wisconsin Upper Respiratory Symptom Survey. Participants were recruited from Madison, Wis, using advertisements in local media. Short Form 12 mental health scores significantly predicted incidence (P = 0.037) of acute respiratory infection, but not duration (P = 0.077) or severity (P = 0.073). The Positive and Negative Affect Schedule (PANAS) negative emotion measure significantly predicted global severity (P = 0.036), but not incidence (P = 0.081) or duration (P = 0.125). Mindful Attention Awareness Scale scores significantly predicted incidence of acute respiratory infection (P = 0.040), but not duration (P = 0.053) or severity (P = 0.70). The PHQ-9, PSS-10, and PANAS positive measures did not show significant predictive associations with any of the acute respiratory infection outcomes. Self-reported overall mental health, as measured by the mental component of Short Form 12, predicts acute respiratory infection incidence.

The second case of a young man with L-arginine-induced acute pancreatitis.

PubMed

Binet, Quentin; Dufour, Inès; Agneessens, Emmanuel; Debongnie, Jean-Claude; Aouattah, Tarik; Covas, Angélique; Coche, Jean-Charles; De Koninck, Xavier

2018-04-21

Dietary supplementation of arginine has been used by numerous world-class athletes and professional bodybuilders over the past 30 years. L-Arginine indeed enhances muscular power and general performance via maintaining ATP level. However, L-arginine is also known to induce acute pancreatitis in murine models. We report the case of young man presenting with upper abdominal pain and increased serum lipase levels. Contrast-enhanced computed tomography confirms a mild acute pancreatitis. Common etiologies have been ruled out and toxicological anamnestic screening reveals the intake of protein powder. This is, to the best of our knowledge, the second case in human of arginine-induced acute pancreatitis. This case report suggests that every patient presenting with acute pancreatitis without obvious etiology should be evaluated for the intake of toxics other than alcohol, including L-arginine.

Comparison of Mid-Upper Arm Circumference and Weight-for-Height to Diagnose Severe Acute Malnutrition: A Study in Southern Ethiopia

PubMed Central

Tadesse, Amare Worku; Tadesse, Elazar; Berhane, Yemane; Ekström, Eva-Charlotte

2017-01-01

Weight-for-height Z-score (WHZ) and mid-upper arm circumference (MUAC) are two independent anthropometric indicators for diagnosing and admitting children with severe acute malnutrition (SAM) for treatment. While severely wasted children are at high risk of mortality, MUAC and WHZ do not always identify the same population of children as having SAM. Understanding how this discrepancy relates to age and sex may provide valuable information for care programmes for children with SAM. Age and sex distribution for differences between children identified as SAM by MUAC and WHZ were examined and the degree of agreement calculated. Children (n = 4297) aged 6–59 months with validated anthropometric measures were recruited from a population-based survey conducted in rural southern Ethiopia. MUAC < 115 mm and WHZ < −3 were used to define severe wasting as per the World Health Organization (WHO) classification. The kappa coefficient (κ) was calculated. There was fair agreement between the MUAC and WHZ definitions of severe wasting in boys (κ = 0.37) and children younger than 24 months (κ = 0.32) but poor agreement in girls (κ = 0.15) and children aged 24 months and above (κ = 0.13). More research is needed on response to treatment and prediction of mortality using different anthropometric measurements in relation to ages and sex of children. PMID:28287482

Integrated Solar Upper Stage Technical Support

NASA Technical Reports Server (NTRS)

Jaworske, Donald A.

1998-01-01

NASA Lewis Research Center is participating in the Integrated Solar Upper Stage (ISUS) program. This program is a ground-based demonstration of an upper stage concept that will be used to generate both solar propulsion and solar power. Solar energy collected by a primary concentrator is directed into the aperture of a secondary concentrator and further concentrated into the aperture of a heat receiver. The energy stored in the receiver-absorber-converter is used to heat hydrogen gas to provide propulsion during the orbital transfer portion of the mission. During the balance of the mission, electric power is generated by thermionic diodes. Several materials issues were addressed as part of the technical support portion of the ISUS program, including: 1) Evaluation of primary concentrator coupons; 2) Evaluation of secondary concentrator coupons; 3) Evaluation of receiver-absorber-converter coupons; 4) Evaluation of in-test witness coupons. Two different types of primary concentrator coupons were evaluated from two different contractors-replicated coupons made from graphite-epoxy composite and coupons made from microsheet glass. Specular reflectivity measurements identified the replicated graphite-epoxy composite coupons as the primary concentrator material of choice. Several different secondary concentrator materials were evaluated, including a variety of silver and rhodium reflectors. The specular reflectivity of these materials was evaluated under vacuum at temperatures up to 800 C. The optical properties of several coupons of rhenium on graphite were evaluated to predict the thermal performance of the receiver-absorber-converter. Finally, during the ground test demonstration, witness coupons placed in strategic locations throughout the thermal vacuum facility were evaluated for contaminants. All testing for the ISUS program was completed successfully in 1997. Investigations related to materials issues have proven helpful in understanding the operation of the test

Feasibility of incorporating functionally relevant virtual rehabilitation in sub-acute stroke care: perception of patients and clinicians.

PubMed

Demers, Marika; Chan Chun Kong, Daniel; Levin, Mindy F

2018-03-11

To determine user satisfaction and safety of incorporating a low-cost virtual rehabilitation intervention as an adjunctive therapeutic option for cognitive-motor upper limb rehabilitation in individuals with sub-acute stroke. A low-cost upper limb virtual rehabilitation application incorporating realistic functionally-relevant unimanual and bimanual tasks, specifically designed for cognitive-motor rehabilitation was developed for patients with sub-acute stroke. Clinicians and individuals with stroke interacted with the intervention for 15-20 or 20-45 minutes, respectively. The study had a mixed-methods convergent parallel design that included a focus group interview with clinicians working in a stroke program and semi-structured interviews and standardized assessments (Borg Perceived Exertion Scale, Short Feedback Questionnaire) for participants with sub-acute stroke undergoing rehabilitation. The occurrence of adverse events was also noted. Three main themes emerged from the clinician focus group and patient interviews: Perceived usefulness in rehabilitation, satisfaction with the virtual reality intervention and aspects to improve. All clinicians and the majority of participants with stroke were highly satisfied with the intervention and perceived its usefulness to decrease arm motor impairment during functional tasks. No participants experienced major adverse events. Incorporation of this type of functional activity game-based virtual reality intervention in the sub-acute phase of rehabilitation represents a way to transfer skills learned early in the clinical setting to real world situations. This type of intervention may lead to better integration of the upper limb into everyday activities. Implications for Rehabilitation • Use of a cognitive-motor low-cost virtual reality intervention designed to remediate arm motor impairments in sub-acute stroke is feasible, safe and perceived as useful by therapists and patients for stroke rehabilitation. �

Mortality and need of surgical treatment in acute upper gastrointestinal bleeding: a one year study in a tertiary center with a 24 hours / day-7 days / week endoscopy call. Has anything changed?

PubMed

Botianu, Am; Matei, D; Tantau, M; Acalovschi, M

2013-01-01

Acute upper gastrointestinal bleeding, previously often a surgical problem, is now the most common gastroenterological emergency. To evaluate the current situation in terms of mortality and need of surgery. Retrospective non-randomised clinical study performed between 1st January-31st December 2011, at "Professor Dr. Octavian Fodor" Regional Institute of Gastroenterology and Hepatology in Cluj Napoca. 757 patients with upper gastrointestinal bleeding were endoscopically examined within 24 hours from presentation in the emergency unit. Data were collected from admission charts and Hospital Manager programme. Statistical analysis was performed with GraphPad 2004, using the following tests: chi square, Spearman, Kruskall-Wallis, Mann-Whitney, area under receiver operating curve. Non-variceal etiology was predominant, the main cause was bleeding being peptic ulcer. In hospital global mortality was of 10.43%, global rebleeding rate was 12.02%, surgery was performed in 7.66% of patients. Urgent haemostatic surgery was needed in 3.68% of patients with nonvariceal bleeding. The need for surgery correlated with the postendoscopic Rockall score (p=0.0425). In peptic ulcer, the need for surgery was not influenced by time to endoscopy or type of treatment (p=0.1452). Weekend (p=0.996) or night (p=0.5414) admission were not correlated with a higher need for surgery. Over the last decade, the need for urgent surgery in upper gastrointestinal bleeding has decreased by half, but mortality has remained unchanged. Celsius.

Pre-eruptive intracoronal resorption in a third upper molar: clinical, tomographic and histological analysis.

PubMed

Lenzi, R; Marceliano-Alves, M F; Alves, Frf; Pires, F R; Fidel, S

2017-06-01

Radiolucent or hypodense lesions in the crown of unerupted teeth may be due to pre-eruptive intracoronal resorption. Clinicians must be aware of this risk so that they can diagnose and appropriately treat this condition. The purpose of this study is to present a well-documented clinical case of pre-eruptive intracoronal resorption in an impacted third upper left molar of a 63 year old female patient. This was an unexpected finding, which occurred after cone-beam computed tomography was used to investigate the first upper left molar, which had an acute periradicular abscess. A multidisciplinary team followed up the case to describe clinical, radiographic and histological findings. The available treatment options were discussed, and the tooth extraction was the option chosen. Previous case studies describing such resorption in third upper molars have not been reported. This case shows that all permanent teeth in a pre-eruptive stage must be analysed radiographically to detect early pre-eruptive intracoronal resorption. © 2016 Australian Dental Association.

Early esophagogastroduodenoscopy is associated with better Outcomes in upper gastrointestinal bleeding: a nationwide study

PubMed Central

Garg, Sushil K.; Anugwom, Chimaobi; Campbell, James; Wadhwa, Vaibhav; Gupta, Nancy; Lopez, Rocio; Shergill, Sukhman; Sanaka, Madhusudhan R.

2017-01-01

Background and study aims We analyzed NIS (National Inpatient Sample) database from 2007 – 2013 to determine if early esophagogastroduodenoscopy (EGD) (24 hours) for upper gastrointestinal bleeding improved the outcomes in terms of mortality, length of stay and costs. Patients and methods Patients were classified as having upper gastrointestinal hemorrhage by querying all diagnostic codes for the ICD-9-CM codes corresponding to upper gastrointestinal bleeding. For these patients, performance of EGD during admission was determined by querying all procedural codes for the ICD-9-CM codes corresponding to EGD; early EGD was defined as having EGD performed within 24 hours of admission and late EGD was defined as having EGD performed after 24 hours of admission. Results A total of 1,789,532 subjects with UGIH were identified. Subjects who had an early EGD were less likely to have hypovolemia, acute renal failure and acute respiratory failure. On multivariable analysis, we found that subjects without EGD were 3 times more likely to die during the admission than those with early EGD. In addition, those with late EGD had 50 % higher odds of dying than those with an early EGD. Also, after adjusting for all factors in the model, hospital stay was on average 3 and 3.7 days longer for subjects with no or late EGD, respectively, then for subjects with early EGD. Conclusion Early EGD (within 24 hours) is associated with lower in-hospital mortality, morbidity, shorter length of stay and lower total hospital costs. PMID:28512647

Low thermal resistance power module assembly

DOEpatents

Hassani, Vahab; Vlahinos, Andreas; Bharathan, Desikan

2010-12-28

A power module assembly (400) with low thermal resistance and enhanced heat dissipation to a cooling medium. The assembly includes a heat sink or spreader plate (410) with passageways or openings (414) for coolant that extend through the plate from a lower surface (411) to an upper surface (412). A circuit substrate (420) is provided and positioned on the spreader plate (410) to cover the coolant passageways. The circuit substrate (420) includes a bonding layer (422) configured to extend about the periphery of each of the coolant passageways and is made up of a substantially nonporous material. The bonding layer (422) may be solder material which bonds to the upper surface (412) of the plate to provide a continuous seal around the upper edge of each opening (414) in the plate. The assembly includes power modules (430) mounted on the circuit substrate (420) on a surface opposite the bonding layer (422). The power modules (430) are positioned over or proximal to the coolant passageways.

Rapid change in the thermal tolerance of a tropical lizard.

PubMed

Leal, Manuel; Gunderson, Alex R

2012-12-01

The predominant view is that the thermal physiology of tropical ectotherms, including lizards, is not labile over ecological timescales. We used the recent introduction (∼35 years ago) of the Puerto Rican lizard Anolis cristatellus to Miami, Florida, to test this thermal rigidity hypothesis. We measured lower (critical thermal minimum [CT(min)]) and upper (critical thermal maximum [CT(max)]) thermal tolerances and found that the introduced population tolerates significantly colder temperatures (by ∼3°C) than does the Puerto Rican source population; however, CT(max) did not differ. These results mirror the thermal regimes experienced by each population: Miami reaches colder ambient temperatures than Puerto Rico, but maximum ambient temperatures are similar. The differences in CT(min) were observed even though lizards from both sites experienced nearly identical conditions for 49 days before CT(min) measurement. Our results demonstrate that changes in thermal tolerance occurred relatively rapidly (∼35 generations), which strongly suggests that the thermal physiology of tropical lizards is more labile than previously proposed.

Thermal effects of dorsal head immersion in cold water on nonshivering humans.

PubMed

Giesbrecht, Gordon G; Lockhart, Tamara L; Bristow, Gerald K; Steinman, Allan M

2005-11-01

Personal floatation devices maintain either a semirecumbent flotation posture with the head and upper chest out of the water or a horizontal flotation posture with the dorsal head and whole body immersed. The contribution of dorsal head and upper chest immersion to core cooling in cold water was isolated when the confounding effect of shivering heat production was inhibited with meperidine (Demerol, 2.5 mg/kg). Six male volunteers were immersed four times for up to 60 min, or until esophageal temperature = 34 degrees C. An insulated hoodless dry suit or two different personal floatation devices were used to create four conditions: 1) body insulated, head out; 2) body insulated, dorsal head immersed; 3) body exposed, head (and upper chest) out; and 4) body exposed, dorsal head (and upper chest) immersed. When the body was insulated, dorsal head immersion did not affect core cooling rate (1.1 degrees C/h) compared with head-out conditions (0.7 degrees C/h). When the body was exposed, however, the rate of core cooling increased by 40% from 3.6 degrees C/h with the head out to 5.0 degrees C/h with the dorsal head and upper chest immersed (P < 0.01). Heat loss from the dorsal head and upper chest was approximately proportional to the extra surface area that was immersed (approximately 10%). The exaggerated core cooling during dorsal head immersion (40% increase) may result from the extra heat loss affecting a smaller thermal core due to intense thermal stimulation of the body and head and resultant peripheral vasoconstriction. Dorsal head and upper chest immersion in cold water increases the rate of core cooling and decreases potential survival time.

Psychosocial stress alters the strength of reticulospinal input to the human upper trapezius.

PubMed

Marker, Ryan J; Campeau, Serge; Maluf, Katrina S

2017-01-01

Psychosocial stress has been shown to influence several aspects of human motor control associated with the fight-or-flight response, including augmentation of upper trapezius muscle activity. Given the established role of the reticular formation in arousal, this study investigated the contribution of reticulospinal activation to trapezius muscle activity during exposure to an acute psychosocial stressor. Twenty-five healthy adults were exposed to startling acoustic stimuli (SAS) while performing a motor task during periods of low and high psychosocial stress. Acoustic startle reflexes (ASRs) were recorded in the upper trapezius during low intensity contractions using both surface and intramuscular electromyography. Exposure to the stressor increased subjective and physiological measures of arousal (P < 0.01). The majority of participants demonstrated inhibitory ASRs, whereas a small subgroup with significantly higher trait anxiety (n = 5) demonstrated excitatory ASRs in the low stress condition. Changes in synaptic input for inhibitory ASRs were confirmed by decreases in the discharge rate of single motor units in response to the SAS. ASRs decreased in magnitude for all participants during exposure to the acute psychosocial stressor. These findings suggest that the reticular formation has predominately inhibitory effects on the human upper trapezius during an ongoing motor task and that disinhibition caused by psychosocial stress may contribute to augmentation of trapezius muscle activity. Further research is required to investigate mechanisms underlying the complex ASRs characterized by this study, particularly the phase reversal to excitatory responses observed among more anxious individuals. This study is the first to quantify stress-evoked changes in the acoustic startle reflex in the upper trapezius muscle of humans, and our findings reveal a complex pattern of inhibitory and facilitatory responses consistent with observations in nonhuman primates. We further

Psychosocial stress alters the strength of reticulospinal input to the human upper trapezius

PubMed Central

Marker, Ryan J.; Campeau, Serge

2016-01-01

Psychosocial stress has been shown to influence several aspects of human motor control associated with the fight-or-flight response, including augmentation of upper trapezius muscle activity. Given the established role of the reticular formation in arousal, this study investigated the contribution of reticulospinal activation to trapezius muscle activity during exposure to an acute psychosocial stressor. Twenty-five healthy adults were exposed to startling acoustic stimuli (SAS) while performing a motor task during periods of low and high psychosocial stress. Acoustic startle reflexes (ASRs) were recorded in the upper trapezius during low intensity contractions using both surface and intramuscular electromyography. Exposure to the stressor increased subjective and physiological measures of arousal (P < 0.01). The majority of participants demonstrated inhibitory ASRs, whereas a small subgroup with significantly higher trait anxiety (n = 5) demonstrated excitatory ASRs in the low stress condition. Changes in synaptic input for inhibitory ASRs were confirmed by decreases in the discharge rate of single motor units in response to the SAS. ASRs decreased in magnitude for all participants during exposure to the acute psychosocial stressor. These findings suggest that the reticular formation has predominately inhibitory effects on the human upper trapezius during an ongoing motor task and that disinhibition caused by psychosocial stress may contribute to augmentation of trapezius muscle activity. Further research is required to investigate mechanisms underlying the complex ASRs characterized by this study, particularly the phase reversal to excitatory responses observed among more anxious individuals. NEW & NOTEWORTHY This study is the first to quantify stress-evoked changes in the acoustic startle reflex in the upper trapezius muscle of humans, and our findings reveal a complex pattern of inhibitory and facilitatory responses consistent with observations in nonhuman

Thermal anomalies and magmatism due to lithospheric doubling and shifting

NASA Astrophysics Data System (ADS)

Vlaar, N. J.

1983-11-01

We present some thermal and magmatic consequences of the processes of lithospheric doubling and lithospheric shifting. Lithospheric doubling concerns the obduction of a cold continental or old oceanic lithospheric plate over a young and hot oceanic lithosphere/upper mantle system, including an oceanic ridge. Lithospheric shifting concerns the translation and rotation of a lithospheric plate relative to the upper mantle. In both cases the resulting thermal state of the upper mantle below the obducting or shifting lithosphere may be perturbed relative to a "normal" continental or oceanic geothermal situation. The perturbed geothermal state gives rise to a density inversion at depth and thus induces a vertical gravitational instability which favours magmatism. We speculate about the magmatic consequences of this situation and infer that in the case of lithospheric doubling our model may account for the petrology and geochemistry of the resulting magma. The original layering and composition of the overridden young oceanic lithosphere may strongly influence magmatic processes. We dwell shortly on the genesis of kimberlites within the framework of our lithospheric doubling model and on magmatism in general. Lithospheric recycling is inherent to the mechanism of lithospheric doubling.

Global warming-induced upper-ocean freshening and the intensification of super typhoons

PubMed Central

Balaguru, Karthik; Foltz, Gregory R.; Leung, L. Ruby; Emanuel, Kerry A.

2016-01-01

Super typhoons (STYs), intense tropical cyclones of the western North Pacific, rank among the most destructive natural hazards globally. The violent winds of these storms induce deep mixing of the upper ocean, resulting in strong sea surface cooling and making STYs highly sensitive to ocean density stratification. Although a few studies examined the potential impacts of changes in ocean thermal structure on future tropical cyclones, they did not take into account changes in near-surface salinity. Here, using a combination of observations and coupled climate model simulations, we show that freshening of the upper ocean, caused by greater rainfall in places where typhoons form, tends to intensify STYs by reducing their ability to cool the upper ocean. We further demonstrate that the strengthening effect of this freshening over the period 1961–2008 is ∼53% stronger than the suppressive effect of temperature, whereas under twenty-first century projections, the positive effect of salinity is about half of the negative effect of ocean temperature changes. PMID:27886199

Global warming-induced upper-ocean freshening and the intensification of super typhoons.

PubMed

Balaguru, Karthik; Foltz, Gregory R; Leung, L Ruby; Emanuel, Kerry A

2016-11-25

Super typhoons (STYs), intense tropical cyclones of the western North Pacific, rank among the most destructive natural hazards globally. The violent winds of these storms induce deep mixing of the upper ocean, resulting in strong sea surface cooling and making STYs highly sensitive to ocean density stratification. Although a few studies examined the potential impacts of changes in ocean thermal structure on future tropical cyclones, they did not take into account changes in near-surface salinity. Here, using a combination of observations and coupled climate model simulations, we show that freshening of the upper ocean, caused by greater rainfall in places where typhoons form, tends to intensify STYs by reducing their ability to cool the upper ocean. We further demonstrate that the strengthening effect of this freshening over the period 1961-2008 is ∼53% stronger than the suppressive effect of temperature, whereas under twenty-first century projections, the positive effect of salinity is about half of the negative effect of ocean temperature changes.

Antibiotics for upper respiratory tract infections: an overview of Cochrane reviews.

PubMed

Arroll, B

2005-03-01

The aim of this paper is to review the four Cochrane reviews of antibiotics for upper respiratory tract infections. Each Cochrane review was read and summarized, and results presented as odds ratios (as in the Internet version) and, where relevant, numbers needed to treat. The reviews of antibiotics for acute otitis media have concluded that benefit is not great with a number needed to treat for a benefit (NNTB) of 15. Recent US guidelines are recommending a delay in prescriptions in children over the age of 6 months. For streptococcal tonsillitis, the Cochrane reviewers suggest that antibiotic use seems to be discretionary rather than prohibited or mandatory. This is because the benefit in terms of symptoms is only about 16h (NNTB from 2 to 7 at day 3 for pain) compared with placebo, and that serious complications, such as rheumatic fever and glomerulonephritis, are now rare in developed countries. The reviewers do, however, suggest that antibiotics are considered in populations in whom these complications are more common. This is an area of debate, as the Infectious Disease Society of America (2002) recommends routine treatment. [Clin. Infect. Dis. 35 (2002) 113] There is good evidence and consensus that there is no indication for antibiotics for the common cold. The situation with acute purulent rhinitis is less clear, as new evidence suggests that antibiotics may be effective for acute purulent rhinitis (NNTB from 6 to 8). However, as most people with acute purulent rhinitis improve without antibiotics, giving antibiotics is not justified as an initial treatment. For acute maxillary sinusitis, the evidence suggests that antibiotics are effective for people with radiologically confirmed sinusitis. The reviewers suggest that clinicians should weigh up the modest benefits (NNTB from 3 to 6) against the potential for adverse effects. The use of antibiotics for acute otitis media, sore throat and streptococcal tonsillitis, common cold and acute purulent rhinitis

Design and fabrication of titanium multi-wall Thermal Protection System (TPS) test panels

NASA Technical Reports Server (NTRS)

Blair, W.; Meaney, J. E., Jr.; Rosenthal, H. A.

1980-01-01

A titanium multiwall thermal protection system panel was designed. The panel is a nine sheet sandwich structure consisting of an upper and lower face sheet; four dimpled sheets, three septum sheets, and clips for attachment to a vehicle structure. An acceptable fabrication process was developed, and the panel design was verified through mechanical and thermal testing of component specimens. A design was completed which takes into consideration fabrication techniques, thermal properties, mechanical properties, and materials availability.

Predictive Value of Upper Limb Muscles and Grasp Patterns on Functional Outcome in Cervical Spinal Cord Injury.

PubMed

Velstra, Inge-Marie; Bolliger, Marc; Krebs, Jörg; Rietman, Johan S; Curt, Armin

2016-05-01

To determine which single or combined upper limb muscles as defined by the International Standards for the Neurological Classification of Spinal Cord Injury (ISNCSCI); upper extremity motor score (UEMS) and the Graded Redefined Assessment of Strength, Sensibility, and Prehension (GRASSP), best predict upper limb function and independence in activities of daily living (ADLs) and to assess the predictive value of qualitative grasp movements (QlG) on upper limb function in individuals with acute tetraplegia. As part of a Europe-wide, prospective, longitudinal, multicenter study ISNCSCI, GRASSP, and Spinal Cord Independence Measure (SCIM III) scores were recorded at 1 and 6 months after SCI. For prediction of upper limb function and ADLs, a logistic regression model and unbiased recursive partitioning conditional inference tree (URP-CTREE) were used. Results: Logistic regression and URP-CTREE revealed that a combination of ISNCSCI and GRASSP muscles (to a maximum of 4) demonstrated the best prediction (specificity and sensitivity ranged from 81.8% to 96.0%) of upper limb function and identified homogenous outcome cohorts at 6 months. The URP-CTREE model with the QlG predictors for upper limb function showed similar results. Prediction of upper limb function can be achieved through a combination of defined, specific upper limb muscles assessed in the ISNCSCI and GRASSP. A combination of a limited number of proximal and distal muscles along with an assessment of grasping movements can be applied for clinical decision making for rehabilitation interventions and clinical trials. © The Author(s) 2015.

Nonvariceal upper gastrointestinal bleeding in elderly people: Clinical outcomes and prognostic factors.

PubMed

González-González, José A; Monreal-Robles, Roberto; García-Compean, Diego; Paz-Delgadillo, Jonathan; Wah-Suárez, Martín; Maldonado-Garza, Héctor J

2017-04-01

To analyze the clinical characteristics, outcomes and prognostic factors in elderly patients (aged 75 years and elder) with acute nonvariceal upper gastrointestinal bleeding (UGIB). Consecutive patients admitted with acute nonvariceal UGIB who underwent upper gastrointestinal endoscopy were prospectively recruited and subdivided into two age-based groups, elderly (aged ≥75 years) and younger patients (<75 years). The patients' characteristics and outcomes were recorded. Altogether 1136 patients were included in the study, 276 (24.3%) aged ≥75 years. Peptic ulcers, gastroduodenal erosions and esophagitis represented the three most common endoscopic lesions found in 87.7% of the elderly patients compared with 80.8% in younger patients ( P  = 0.008). Overall, the rebleeding rate (4.0% vs 3.3%, P = 0.568), need for blood transfusion (66.3% vs 61.0%, P = 0.122), surgery rate (1.2% vs 1.4%, P = 0.947) and in-hospital mortality (13.0% vs 10.0%, P = 0.157) were not different between the two groups. In elderly patients, serum albumin was the only predictive variable independently associated with mortality in the overall analysis (OR 5.867, 95% CI 2.206-15.604, P < 0.001) and in the subgroup patients with peptic ulcers (OR 5.230, 95% CI 2.099-13.029, P = 0.001). Elderly patients with serum albumin >23.5 g/L at admission presented a low mortality (negative predictive value 97.3%). Clinical evolution and mortality do not differ between the elderly and younger patients with acute nonvariceal UGIB. Serum albumin level at admission is a prognostic marker for mortality in elder patients. © 2017 Chinese Medical Association Shanghai Branch, Chinese Society of Gastroenterology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.

Thymus-directed immunotoxicity of airborne dust particles from Upper Silesia (Poland) under acute extrapulmonary studies in mice

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kozlowska, E.; Krzystniak, K.; Drela, N.

1996-12-27

Industrial air pollutants from Upper Silesia, Poland, contain over 250 polycyclic and heterocyclic aromatic hydrocarbons and heavy metals, including mutagenic and carcinogenic chemicals that have been shown to from DNA adducts. Over 4 million habitants of Silesia are permanently exposed to the industrial pollution by pulmonary and dermal routes and by contaminated food and water. These chemicals, when examined separately in animals models, were proven immunotoxic. We studied the extrapulmonary immunotoxic potential of a typical mixture of Silesian filter-suspended matter from a selected area, over a specific season and time period. Early changes in the immune system were analyzed inmore » BALB/c mice exposed ip to acute doses of 20-330 mg dust mixture/kg body weight (0.06-1.0 LD50). No major changes were noted for weight and the cellularity of spleen, liver and kidneys. However, dramatic decrease in thymus weight index and thymocyte cell count were noted as early as 24-72 h postexposure, which correlated with almost complete depletion of immature, double-positive CD4{sup +}CD8{sup +} thymocytes. Changes in spleen were less profound; however, increased depletion of B cells over T cells was noted at high doses of the suspended matter. Exposure to the airborne dust also decreased cytokine production by spleen cells, such as interferon-{gamma} (IFN-{gamma}) and tumor necrosis factor-{alpha} (TNF-{alpha}). Overall, a single exposure to Silesian dust, even at the relatively low 0.06 LD50 dose, affected lymphokine production, suppressed B-cell proliferative response, and depleted thymuses of immature, double-positive CD4{sup +}CD8{sup +} cells. A chemical synergism is suspected. To our knowledge, none of the known components of Silesian suspended matter, when examined as a single chemical, was shown to exert such a profound biological effect. 32 refs., 5 figs.« less

Virtual reality based rehabilitation speeds up functional recovery of the upper extremities after stroke: a randomized controlled pilot study in the acute phase of stroke using the rehabilitation gaming system.

PubMed

da Silva Cameirão, Mónica; Bermúdez I Badia, Sergi; Duarte, Esther; Verschure, Paul F M J

2011-01-01

Given the incidence of stroke, the need has arisen to consider more self-managed rehabilitation approaches. A promising technology is Virtual Reality (VR). Thus far, however, it is not clear what the benefits of VR systems are when compared to conventional methods. Here we investigated the clinical impact of one such system, the Rehabilitation Gaming System (RGS), on the recovery time course of acute stroke. RGS combines concepts of action execution and observation with an automatic individualization of training. METHODS. Acute stroke patients (n = 8) used the RGS during 12 weeks in addition to conventional therapy. A control group (n = 8) performed a time matched alternative treatment, which consisted of intense occupational therapy or non-specific interactive games. RESULTS. At the end of the treatment, between-group comparisons showed that the RGS group displayed significantly improved performance in paretic arm speed that was matched by better performance in the arm subpart of the Fugl-Meyer Assessment Test and the Chedoke Arm and Hand Activity Inventory. In addition, the RGS group presented a significantly faster improvement over time for all the clinical scales during the treatment period. CONCLUSIONS. Our results suggest that rehabilitation with the RGS facilitates the functional recovery of the upper extremities and that this system is therefore a promising tool for stroke neurorehabilitation.

Perceptions of Emergency Medicine Residency and Hand Surgery Fellowship Program Directors in the Appropriate Disposition of Upper Extremity Emergencies.

PubMed

Drolet, Brian C; Lifchez, Scott D; Jacoby, Sidney M; Varone, Andrew; Regan, Linda A; Baren, Jill M; Akelman, Edward; Osterman, A Lee; Levin, L Scott

2015-12-01

To survey emergency medicine (EM) residency and hand surgery fellowship program directors (PDs) to identify consensus in their perceptions of appropriate emergency care of upper extremity emergencies. We created a framework to group common upper extremity emergency diagnoses and surveyed PDs to evaluate the training background--EM, general orthopedic or plastic surgery, or hand fellowship--most appropriate to provide acute, point-of-care management for each of these diagnostic groupings. Responses were pooled and consensus was established with greater than 75% agreement between groups. We received 79 responses from hand fellowship PDs (90% response rate) and 151 responses from EM PDs (49% response rate). We identified consensus for the training background that PDs in both specialties felt was appropriate to care for 17 of 21 diagnostic groupings in the framework. There was a high level of consensus between EM and hand surgery PDs regarding diagnoses that acutely require training in hand surgery versus those that can be managed by an EM physician. Our diagnostic framework may help reduce unnecessary hand surgery consultation and may help to identify patients who do not require more specialized acute care and thus decrease unnecessary transfers. Economic and Decision Analyses IV. Copyright © 2015 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Thermal Aging of Oceanic Asthenosphere

NASA Astrophysics Data System (ADS)

Paulson, E.; Jordan, T. H.

2013-12-01

To investigate the depth extent of mantle thermal aging beneath ocean basins, we project 3D Voigt-averaged S-velocity variations from an ensemble of global tomographic models onto a 1x1 degree age-based regionalization and average over bins delineated by equal increments in the square-root of crustal age. From comparisons among the bin-averaged S-wave profiles, we estimate age-dependent convergence depths (minimum depths where the age variations become statistically insignificant) as well as S travel times from these depths to a shallow reference surface. Using recently published techniques (Jordan & Paulson, JGR, doi:10.1002/jgrb.50263, 2013), we account for the aleatory variability in the bin-averaged S-wave profiles using the angular correlation functions of the individual tomographic models, we correct the convergence depths for vertical-smearing bias using their radial correlation functions, and we account for epistemic uncertainties through Bayesian averaging over the tomographic model ensemble. From this probabilistic analysis, we can assert with 90% confidence that the age-correlated variations in Voigt-averaged S velocities persist to depths greater than 170 km; i.e., more than 100 km below the mean depth of the G discontinuity (~70 km). Moreover, the S travel time above the convergence depth decays almost linearly with the square-root of crustal age out to 200 Ma, consistent with a half-space cooling model. Given the strong evidence that the G discontinuity approximates the lithosphere-asthenosphere boundary (LAB) beneath ocean basins, we conclude that the upper (and probably weakest) part of the oceanic asthenosphere, like the oceanic lithosphere, participates in the cooling that forms the kinematic plates, or tectosphere. In other words, the thermal boundary layer of a mature oceanic plate appears to be more than twice the thickness of its mechanical boundary layer. We do not discount the possibility that small-scale convection creates heterogeneities

Thermal metamorphism of the Arunachal Himalaya, India: Raman thermometry and thermochronological constraints on the tectono-thermal evolution

NASA Astrophysics Data System (ADS)

Mathew, George; De Sarkar, Sharmistha; Pande, Kanchan; Dutta, Suryendu; Ali, Shakir; Rai, Apritam; Netrawali, Shilpa

2013-09-01

Determination of the peak thermal condition is vital in order to understand tectono-thermal evolution of the Himalayan belt. The Lesser Himalayan Sequence (LHS) in the Western Arunachal Pradesh, being rich in carbonaceous material (CM), facilitates the determination of peak metamorphic temperature based on Raman spectroscopy of carbonaceous material (RSCM). In this study, we have used RSCM method of Beyssac et al. (J Metamorph Geol 20:859-871, 2002a) and Rahl et al. (Earth Planet Sci Lett 240:339-354, 2005) to estimate the thermal history of LHS and Siwalik foreland from the western Arunachal Pradesh. The study indicates that the temperature of 700-800 °C in the Greater Himalayan Sequence (GHS) decreases to 650-700 °C in the main central thrust zone (MCTZ) and decreases further to <200 °C in the Mio-Pliocene sequence of Siwaliks. The work demonstrates greater reliability of Rahl et al.'s (Earth Planet Sci Lett 240:339-354, 2005) RSCM method for temperatures >600 and <340 °C. We show that the higher and lower zones of Bomdila Gneiss (BG) experienced temperature of ~600 °C and exhumed at different stages along the Bomdila Thrust (BT) and Upper Main Boundary Thrust (U.MBT). Pyrolysis analysis of the CM together with the Fission Track ages from upper Siwaliks corroborates the RSCM thermometry estimate of ~240 °C. The results indicate that the Permian sequence north of Lower MBT was deposited at greater depths (>12 km) than the upper Siwalik sediments to its south at depths <8 km before they were exhumed. The 40Ar/39Ar ages suggest that the upper zones of Se La evolved ~13-15 Ma. The middle zone exhumed at ~11 Ma and lower zone close to ~8 Ma indicating erosional unroofing of the MCT sheet. The footwall of MCTZ cooled between 6 and 8 Ma. Analyses of P-T path imply that LHS between MCT and U.MBT zone falls within the kyanite stability field with near isobaric condition. At higher structural level, the temperatures increase gradually with P-T conditions in the

Non-LTE models of Titan's upper atmosphere

NASA Technical Reports Server (NTRS)

Yelle, Roger V.

1991-01-01

Models for the thermal structure of Titan's upper atmosphere, between 0.1 mbar and 0.01 nbar are presented. The calculations include non-LTE heating/cooling in the rotation-vibration bands of CH4, C2H2, and C2H6, absorption of solar IR radiation in the near-IR bands of CH4 and subsequent cascading to the nu-4 band of CH4, absorption of solar EUV and UV radiation, thermal conduction and cooling by HCN rotational lines. Unlike earlier models, the calculated exospheric temperature agrees well with observations, because of the importance of HCN cooling. The calculations predict a well-developed mesopause with a temperature of 135-140 K at an altitude of approximately 600 km and pressure of about 0.1 microbar. The mesopause is at a higher pressure than predicted by earlier calculations because non-LTE radiative transfer in the rotation-vibration bands of CH4, C2H2, and C2H6 is treated in an accurate manner. The accuracy of the LTE approximation for source functions and heating rates is discussed.

Thermal escape from extrasolar giant planets.

PubMed

Koskinen, Tommi T; Lavvas, Panayotis; Harris, Matthew J; Yelle, Roger V

2014-04-28

The detection of hot atomic hydrogen and heavy atoms and ions at high altitudes around close-in extrasolar giant planets (EGPs) such as HD209458b implies that these planets have hot and rapidly escaping atmospheres that extend to several planetary radii. These characteristics, however, cannot be generalized to all close-in EGPs. The thermal escape mechanism and mass loss rate from EGPs depend on a complex interplay between photochemistry and radiative transfer driven by the stellar UV radiation. In this study, we explore how these processes change under different levels of irradiation on giant planets with different characteristics. We confirm that there are two distinct regimes of thermal escape from EGPs, and that the transition between these regimes is relatively sharp. Our results have implications for thermal mass loss rates from different EGPs that we discuss in the context of currently known planets and the detectability of their upper atmospheres.

Thermal alterations of organic matter in coal wastes from Upper Silesia, Poland

NASA Astrophysics Data System (ADS)

Misz-Kennan, Magdalena

2010-01-01

Self-heating and self-combustion are currently taking place in some coal waste dumps in the Upper Silesian Coal Basin, Poland, e.g. the dumps at Rymer Cones, Starzykowiec, and the Marcel Coal Mine, all in the Rybnik area. These dumps are of similar age and self-heating and combustion have been occurring in all three for many years. The tools of organic petrography (maceral composition, rank, etc.), gas chromatography-mass spectrometry, and proximate and ultimate analysis are used to investigate the wastes. Organic matter occurs in quantities up to 85 vol.%, typically a few to several vol.%, in the wastes. All three maceral groups (vitrinite, liptinite, and inertinite) are present as unaltered and variously-altered constituents associated with newly-formed petrographic components (bitumen expulsions, pyrolytic carbon). The predominant maceral group is vitrinite with alterations reflected in the presence of irregular cracks, oxidation rims and, rarely, devolatilisation pores. In altered wastes, paler grey-vitrinite and/or coke dominates. The lack of plasticity, the presence of paler-coloured particles, isotropic massive coke, dispersed coked organic matter, and expulsions of bitumens all indicate that heating was slow and extended over a long time. Macerals belonging to other groups are present in unaltered form or with colours paler than the colours of the parent macerals. Based on the relative contents of organic compounds, the most important groups of these identified in the wastes are n-alkanes, acyclic isoprenoids, hopanes, polycyclic aromatic hydrocarbons (PAHs) and their derivatives, phenol and its derivatives. These compounds occur in all wastes except those most highly altered where they were probably destroyed by high temperatures. These compounds were generated mainly from liptinite-group macerals. Driven by evaporation and leaching, they migrated within and out of the dump. Their presence in some wastes in which microscopically visible

Physiological Benefits of Being Small in a Changing World: Responses of Coho Salmon (Oncorhynchus kisutch) to an Acute Thermal Challenge and a Simulated Capture Event

PubMed Central

Clark, Timothy D.; Donaldson, Michael R.; Pieperhoff, Sebastian; Drenner, S. Matthew; Lotto, Andrew; Cooke, Steven J.; Hinch, Scott G.; Patterson, David A.; Farrell, Anthony P.

2012-01-01

Evidence is building to suggest that both chronic and acute warm temperature exposure, as well as other anthropogenic perturbations, may select for small adult fish within a species. To shed light on this phenomenon, we investigated physiological and anatomical attributes associated with size-specific responses to an acute thermal challenge and a fisheries capture simulation (exercise+air exposure) in maturing male coho salmon (Oncorhynchus kisutch). Full-size females were included for a sex-specific comparison. A size-specific response in haematology to an acute thermal challenge (from 7 to 20°C at 3°C h−1) was apparent only for plasma potassium, whereby full-size males exhibited a significant increase in comparison with smaller males (‘jacks’). Full-size females exhibited an elevated blood stress response in comparison with full-size males. Metabolic recovery following exhaustive exercise at 7°C was size-specific, with jacks regaining resting levels of metabolism at 9.3±0.5 h post-exercise in comparison with 12.3±0.4 h for full-size fish of both sexes. Excess post-exercise oxygen consumption scaled with body mass in male fish with an exponent of b = 1.20±0.08. Jacks appeared to regain osmoregulatory homeostasis faster than full-size males, and they had higher ventilation rates at 1 h post-exercise. Peak metabolic rate during post-exercise recovery scaled with body mass with an exponent of b∼1, suggesting that the slower metabolic recovery in large fish was not due to limitations in diffusive or convective oxygen transport, but that large fish simply accumulated a greater ‘oxygen debt’ that took longer to pay back at the size-independent peak metabolic rate of ∼6 mg min−1 kg−1. Post-exercise recovery of plasma testosterone was faster in jacks compared with full-size males, suggesting less impairment of the maturation trajectory of smaller fish. Supporting previous studies, these findings suggest that environmental change and non

Dose to organs at risk in the upper abdomen in patients treated with extended fields by helical tomotherapy: a dosimetric and clinical preliminary study.

PubMed

Bresciani, Sara; Garibaldi, Elisabetta; Cattari, Gabriella; Maggio, Angelo; Di Dia, Amalia; Delmastro, Elena; Gabriele, Domenico; Stasi, Michele; Gabriele, Pietro

2013-10-25

The aim of this work was to determine the technical feasibility and safety of extended-field radiotherapy (EF), performed by Helical TomoTherapy, in patients with positive pelvic and/or para-aortic nodes. Dosimetric data were collected and acute and sub-acute toxicities of the upper abdominal organs at risk (OAR) were evaluated. Twenty-nine patients suitable for EF irradiation for local disease and/or nodal disease in the pelvic or para-aortic area were treated. The prescription dose was 50.4/54 Gy (1.7-1.8 Gy/fraction) for prophylactic lymph nodes (N-) and 60-70.5 Gy (2-2.35 Gy/fraction) for clinically evident gross disease (N+). Modulation factor (MF), pitch and field width (FW) were chosen to optimize dose distribution and treatment duration. Dose values of PTVs and OAR were analysed. The length of the treatment field, the N + and N- volumes, and treatment duration were reported. To evaluate the safety of treatment, haematological, hepatic, renal and pancreatic functions were assessed before, during and after treatment. The median follow-up time was 17.6 months (range: 6-22 months). The treatment was well tolerated and all patients but one completed treatment without interruption. Four of the 29 patients experienced G3 haematological acute toxicity (13.8%), but no patient experienced sub-acute grade G3 toxicity. Ten patients experienced G1 and three G2 acute gastrointestinal toxicity (nausea). No sub-acute gastrointestinal or renal toxicity was observed. Only one (3.7%) patient had a persistent slight increase of pancreatic enzymes and two (7.4%) patients a slight increase of hepatic enzymes six months after radiotherapy (G1 toxicity). With our treatment design and dose regimen, we found that EF treatment by TomoTherapy could be safely and effectively delivered with minimal acute and sub-acute toxicities in the upper abdomen area.

On Integral Upper Limits Assuming Power-law Spectra and the Sensitivity in High-energy Astronomy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ahnen, Max L., E-mail: m.knoetig@gmail.com

The high-energy non-thermal universe is dominated by power-law-like spectra. Therefore, results in high-energy astronomy are often reported as parameters of power-law fits, or, in the case of a non-detection, as an upper limit assuming the underlying unseen spectrum behaves as a power law. In this paper, I demonstrate a simple and powerful one-to-one relation of the integral upper limit in the two-dimensional power-law parameter space into the spectrum parameter space and use this method to unravel the so-far convoluted question of the sensitivity of astroparticle telescopes.

Severe acute malnutrition.

PubMed

Nel, E D

2016-05-01

The mortality and morbidity associated with severe acute malnutrition (SAM) remain high. A summary of recent studies that are of interest to clinicians treating children with SAM is provided. Three important themes emerged in 2015: the use of anthropometry in the diagnosis of SAM and its correlation with body composition; the composition of ready-to-use therapeutic feeds (RUTF); and an improved understanding of the pathophysiology of SAM. Standard anthropometry does not accurately predict body composition and mid-upper arm circumference more accurately reflects fat mass in children. As single measure, mid-upper arm circumference identifies those children who are most likely to die from SAM and is not influenced by dehydration. However, a significant proportion of SAM children requiring treatment will not be detected. Present RUTF formulations are deficient in long chain polyunsaturated fatty acids. Current evidence suggests that preformed docosahexaenoic acid should be added and/or the content of linoleic acid reduced in RUTF. In contrast to an animal model, stabile children with SAM have the same cardiac index as children without SAM. The situation in haemodynamically unstable children is unknown, continued conservative use of intravenous fluids seems advisable. A reduction in variability of the faecal DNA virome may account for increased susceptibility to malnutrition in vulnerable children.

Prevalence, codetection and seasonal distribution of upper airway viruses and bacteria in children with acute respiratory illnesses with cough as a symptom.

PubMed

O'Grady, K F; Grimwood, K; Sloots, T P; Whiley, D M; Acworth, J P; Phillips, N; Goyal, V; Chang, A B

2016-06-01

Most studies exploring the role of upper airway viruses and bacteria in paediatric acute respiratory infections (ARI) focus on specific clinical diagnoses and/or do not account for virus-bacteria interactions. We aimed to describe the frequency and predictors of virus and bacteria codetection in children with ARI and cough, irrespective of clinical diagnosis. Bilateral nasal swabs, demographic, clinical and risk factor data were collected at enrollment in children aged <15 years presenting to an emergency department with an ARI and where cough was a symptom. Swabs were tested by polymerase chain reaction for 17 respiratory viruses and seven respiratory bacteria. Logistic regression was used to investigate associations between child characteristics and codetection of the organisms of interest. Between December 2011 and August 2014, swabs were collected from 817 (93.3%) of 876 enrolled children, median age 27.7 months (interquartile range 13.9-60.3 months). Overall, 740 (90.6%) of 817 specimens were positive for any organism. Both viruses and bacteria were detected in 423 specimens (51.8%). Factors associated with codetection were age (adjusted odds ratio (aOR) for age <12 months = 4.9, 95% confidence interval (CI) 3.0, 7.9; age 12 to <24 months = 6.0, 95% CI 3.7, 9.8; age 24 to <60 months = 2.4, 95% CI 1.5, 3.9), male gender (aOR 1.46; 95% CI 1.1, 2.0), child care attendance (aOR 2.0; 95% CI 1.4, 2.8) and winter enrollment (aOR 2.0; 95% CI 1.3, 3.0). Haemophilus influenzae dominated the virus-bacteria pairs. Virus-H. influenzae interactions in ARI should be investigated further, especially as the contribution of nontypeable H. influenzae to acute and chronic respiratory diseases is being increasingly recognized. Copyright © 2016 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Acute hemorrhagic edema of infancy: a report of two cases.

PubMed

Dongre, Atul; Adhe, Vijay; Kothari, Dimple; Kardekar, Suchitra; Khopkar, Uday

2012-01-01

Acute hemorrhagic edema of infancy is one of the clinical forms of leukocytoclastic vasculitis seen in children. The condition runs a benign course. We report two male children who presented with upper respiratory tract infection followed by limb swelling and purpuric and ecchymotic lesions on the skin. Skin biopsy revealed leukocytoclastic vasculitis in both patients. In both cases, the lesions resolved completely without any sequelae.

Duodenal Obstruction Caused by Acute Appendicitis with Intestinal Malrotation in a Child.

PubMed

Biçer, Şenol; Çelik, Ali

2015-08-27

In patients with intestinal malrotation, the diagnosis of acute appendicitis can be difficult due to atypical presentation. Duodenal obstruction caused by acute appendicitis with the presence of malrotation has rarely been reported in children. We report the case of a 14-year-old male patient with bilious vomiting and abdominal distension. A diagnosis could not be made by computed tomography, ultrasonography, or endoscopy. We observed a dilated stomach and malrotation in laparotomy. The caecum was in the right upper quadrant, and an inflamed appendix was located in the subhepatic region. After the appendectomy, the cecum was mobilized and fixed in the right lower quadrant. In children with intestinal malrotation, acute appendicitis can present as duodenal obstruction without abdominal pain, and standard imaging methods can miss the correct diagnosis.

Mirror therapy in complex regional pain syndrome type 1 of the upper limb in stroke patients.

PubMed

Cacchio, Angelo; De Blasis, Elisabetta; De Blasis, Vincenzo; Santilli, Valter; Spacca, Giorgio

2009-10-01

Complex regional pain syndrome type 1 (CRPSt1) of the upper limb is a painful and debilitating condition, frequent after stroke, and interferes with the rehabilitative process and outcome. However, treatments used for CRPSt1 of the upper limb are limited. . This randomized controlled study was conducted to compare the effectiveness on pain and upper limb function of mirror therapy on CRPSt1 of upper limb in patients with acute stroke. . Of 208 patients with first episode of unilateral stroke admitted to the authors' rehabilitation center, 48 patients with CRPSt1 of the affected upper limb were enrolled in a randomized controlled study, with a 6-month follow-up, and assigned to either a mirror therapy group or placebo control group. The primary end points were a reduction in the visual analogue scale score of pain at rest, on movement, and brush-induced tactile allodynia. The secondary end points were improvement in motor function as assessed by the Wolf Motor Function Test and Motor Activity Log. . The mean scores of both the primary and secondary end points significantly improved in the mirror group (P < .001). No statistically significant improvement was observed in any of the control group values (P > .001). Moreover, statistically significant differences after treatment (P < .001) and at the 6-month follow-up were found between the 2 groups. . The results indicate that mirror therapy effectively reduces pain and enhances upper limb motor function in stroke patients with upper limb CRPSt1.

Acute and chronic symptoms of mononucleosis.

PubMed

Lambore, S; McSherry, J; Kraus, A S

1991-07-01

The clinical symptoms and durations of illness of patients with infectious mononucleosis (IM) are variable and are poorly documented in the scientific literature. Patients who presented for care at the Student Health Service of a Canadian university between September 1985 and May 1988 and had been diagnosed as having IM were surveyed. Health experience during the acute and convalescent phases of IM was compared with that of a group of patients matched for age, sex, date of diagnosis, and year of study, who had suffered acute upper respiratory tract infections (URI), other than Epstein-Barr virus (EBV)-induced, during the same period. Students were sicker for longer after IM than after non-EBV-induced URI. During the acute phase of illness, the symptoms of fatigue (P = less than .000001), night sweats (P = .000001), and painful neck swelling (P = .00003) were seen significantly more often in the IM group. The severity and duration of these symptoms were also significantly worse in IM patients. Getting tired easily (P = .002), diurnal somnolence (P = .002), and depression (P = .002) were significantly more common postacute symptoms. Eleven percent of IM patients reported persistence of symptoms longer than 100 days, and in 6% of patients the symptoms had persisted after 1 year. Convalescent cases showed a trend toward reduced alcohol intake and, perhaps, reduced alcohol tolerance. IM involves excessive morbidity in a student community compared with URI that was other than EBV-induced, during both the acute and the postacute phases of infection.

The Upper Atmosphere Research Satellite microwave limb sounder instrument

NASA Astrophysics Data System (ADS)

Barath, F. T.; Chavez, M. C.; Cofield, R. E.; Flower, D. A.; Frerking, M. A.; Gram, M. B.; Harris, W. M.; Holden, J. R.; Jarnot, R. F.; Kloezeman, W. G.

1993-06-01

The microwave limb sounder (MLS) on the Upper Atmosphere Research Satellite (UARS) is the first satellite experiment using limb sounding techniques at microwave frequencies. Primary measurement objectives are stratospheric ClO, O3, H2O, temperature, and pressure. Measurements are of thermal emission: all are performed simultaneously and continuously and are not degraded by ice clouds or volcanic aerosols. The instrument has a 1.6-m mechanically scanning antenna system and contains heterodyne radiometers in spectral bands centred near 63, 183, and 205 GHz. The radiometers operate at ambient temperature and use Schottky-diode mixers with local oscillators derived from phase-locked Gunn oscillators. Frequency tripling by varactor multipliers generates the 183- and 205-GHz local oscillators, and quasi-optical techniques inject these into the mixers. Six 15-channel filter banks spectrally resolve stratospheric thermal emission lines and produce an output spectrum every 2 s. Thermal stability is sufficient for 'total power' measurements which do not require fast chopping. Radiometric calibration, consisting of measurements of cold space and an internal target, is performed every 65-s limb scan. Instrument in-orbit performance has been excellent, and all objectives are being met.

The Upper Atmosphere Research Satellite microwave limb sounder instrument

NASA Technical Reports Server (NTRS)

Barath, F. T.; Chavez, M. C.; Cofield, R. E.; Flower, D. A.; Frerking, M. A.; Gram, M. B.; Harris, W. M.; Holden, J. R.; Jarnot, R. F.; Kloezeman, W. G.

1993-01-01

The microwave limb sounder (MLS) on the Upper Atmosphere Research Satellite (UARS) is the first satellite experiment using limb sounding techniques at microwave frequencies. Primary measurement objectives are stratospheric ClO, O3, H2O, temperature, and pressure. Measurements are of thermal emission: all are performed simultaneously and continuously and are not degraded by ice clouds or volcanic aerosols. The instrument has a 1.6-m mechanically scanning antenna system and contains heterodyne radiometers in spectral bands centred near 63, 183, and 205 GHz. The radiometers operate at ambient temperature and use Schottky-diode mixers with local oscillators derived from phase-locked Gunn oscillators. Frequency tripling by varactor multipliers generates the 183- and 205-GHz local oscillators, and quasi-optical techniques inject these into the mixers. Six 15-channel filter banks spectrally resolve stratospheric thermal emission lines and produce an output spectrum every 2 s. Thermal stability is sufficient for 'total power' measurements which do not require fast chopping. Radiometric calibration, consisting of measurements of cold space and an internal target, is performed every 65-s limb scan. Instrument in-orbit performance has been excellent, and all objectives are being met.

Ergonomic stressors and upper extremity disorders in vehicle manufacturing: cross sectional exposure-response trends

PubMed Central

Punnett, L.

1998-01-01

OBJECTIVE: To evaluate the association between upper extremity soft tissue disorders and exposure to preventable ergonomic stressors in vehicle manufacturing operations. METHODS: A cross sectional study was conducted in one vehicle stamping plant and one engine assembly plant. A standardised physical examination of the upper extremities was performed on all subjects. An interviewer administered questionnaire obtained data on demographics, work history, musculoskeletal symptoms, non-occupational covariates, and psycho-physical (relative intensity) ratings of ergonomic stressors. The primary exposure score was computed by summing the responses to the psychophysical exposure items. Multivariate regression analysis was used to model the prevalence of disorders of the shoulders or upper arms, wrists or hands, and all upper extremity regions (each defined both by symptoms and by physical examination plus symptoms) as a function of exposure quartile. RESULTS: A total of 1315 workers (85% of the target population) was examined. The prevalence of symptom disorders was 22% for the wrists or hands and 15% for the shoulders or upper arms; cases defined on the basis of a physical examination were about 80% as frequent. Disorders of the upper extremities, shoulders, and wrists or hands all increased markedly with exposure score, after adjustment for plant, acute injury, sex, body mass index, systemic disease, and seniority. CONCLUSIONS: Musculoskeletal disorders of the upper extremities were strongly associated with exposure to combined ergonomic stressors. The exposure- response trend was very similar for symptom cases and for physical examination cases. It is important to evaluate all dimensions of ergonomic exposure in epidemiological studies, as exposures often occur in combination in actual workplaces.   PMID:9764102

The role of ZAP70 kinase in acute lymphoblastic leukemia infiltration into the central nervous system.

PubMed

Alsadeq, Ameera; Fedders, Henning; Vokuhl, Christian; Belau, Nele M; Zimmermann, Martin; Wirbelauer, Tim; Spielberg, Steffi; Vossen-Gajcy, Michaela; Cario, Gunnar; Schrappe, Martin; Schewe, Denis M

2017-02-01

Central nervous system infiltration and relapse are poorly understood in childhood acute lymphoblastic leukemia. We examined the role of zeta-chain-associated protein kinase 70 in preclinical models of central nervous system leukemia and performed correlative studies in patients. Zeta-chain-associated protein kinase 70 expression in acute lymphoblastic leukemia cells was modulated using short hairpin ribonucleic acid-mediated knockdown or ectopic expression. We show that zeta-chain-associated protein kinase 70 regulates CCR7/CXCR4 via activation of extracellular signal-regulated kinases. High expression of zeta-chain-associated protein kinase 70 in acute lymphoblastic leukemia cells resulted in a higher proportion of central nervous system leukemia in xenografts as compared to zeta-chain-associated protein kinase 70 low expressing counterparts. High zeta-chain-associated protein kinase 70 also enhanced the migration potential towards CCL19/CXCL12 gradients in vitro CCR7 blockade almost abrogated homing of acute lymphoblastic leukemia cells to the central nervous system in xenografts. In 130 B-cell precursor acute lymphoblastic leukemia and 117 T-cell acute lymphoblastic leukemia patients, zeta-chain-associated protein kinase 70 and CCR7/CXCR4 expression levels were significantly correlated. Zeta-chain-associated protein kinase 70 expression correlated with central nervous system disease in B-cell precursor acute lymphoblastic leukemia, and CCR7/CXCR4 correlated with central nervous system involvement in T-cell acute lymphoblastic leukemia patients. In multivariate analysis, zeta-chain-associated protein kinase 70 expression levels in the upper third and fourth quartiles were associated with central nervous system involvement in B-cell precursor acute lymphoblastic leukemia (odds ratio=7.48, 95% confidence interval, 2.06-27.17; odds ratio=6.86, 95% confidence interval, 1.86-25.26, respectively). CCR7 expression in the upper fourth quartile correlated with central

Influences of thermal acclimation and acute temperature change on the motility of epithelial wound-healing cells (keratocytes) of tropical, temperate and Antarctic fish.

PubMed

Ream, Rachael A; Theriot, Julie A; Somero, George N

2003-12-01

The ability to heal superficial wounds is an important element in an organism's repertoire of adaptive responses to environmental stress. In fish, motile cells termed keratocytes are thought to play important roles in the wound-healing process. Keratocyte motility, like other physiological rate processes, is likely to be dependent on temperature and to show adaptive variation among differently thermally adapted species. We have quantified the effects of acute temperature change and thermal acclimation on actin-based keratocyte movement in primary cultures of keratocytes from four species of teleost fish adapted to widely different thermal conditions: two eurythermal species, the longjaw mudsucker Gillichthys mirabilis (environmental temperature range of approximately 10-37 degrees C) and a desert pupfish, Cyprinodon salinus (10-40 degrees C), and two species from stable thermal environments, an Antarctic notothenioid, Trematomus bernacchii (-1.86 degrees C), and a tropical clownfish, Amphiprion percula (26-30 degrees C). For all species, keratocyte speed increased with increasing temperature. G. mirabilis and C. salinus keratocytes reached maximal speeds at 25 degrees C and 35 degrees C, respectively, temperatures within the species' normal thermal ranges. Keratocytes of the stenothermal species continued to increase in speed as temperature increased above the species' normal temperature ranges. The thermal limits of keratocyte motility appear to exceed those of whole-organism thermal tolerance, notably in the case of T. bernacchii. Keratocytes of T. bernacchii survived supercooling to -6 degrees C and retained motility at temperatures as high as 20 degrees C. Mean keratocyte speed was conserved at physiological temperatures for the three temperate and tropical species, which suggests that a certain rate of motility is advantageous for wound healing. However, there was no temperature compensation in speed of movement for keratocytes of the Antarctic fish, which

[Hepatic pseudotumor in acute fascioliasis].

PubMed

Castillo Contreras, Ofelia Brisaida; Frisancho Velarde, Oscar

2013-03-01

We report a 61-year-old woman who was hospitalized because of abdominal pain in the right upper quadrant related to a liver tumor (ultrasound and tomographic findings). A collection of blood was obtained by a biopsy and there were no tumor cells. With the suspicion of acute fascioliasis (liver stage), due to severe eosinophilia and recent travel to endemic area of Fasciola hepatica, arc II and ELISA Fas 2 we carried out and were positive. Parasitological stool examinations were negative. During hospitalization a hepatic subcapsular hematoma presented as a complication and the patient developed fever because of cholangiolitic microabscesses in the left hepatic lobe. Percutaneous drainage was performed and positive cultures of secretions were obtained She received antibiotic coverage with vancomycin and imipenem. Treatment for Fasciola hepatica was initiated with nitaxozanida but it was discontinued due to oral intolerance. Later, she received a single dose of 250 mg triclabendazole with clinical and laboratory improvement. We presented this case because it is an unusual pseudotumoral presentation in acute hepatic fascioliasis. This parasitic disease is an emerging zoonosis in Perú.

Heat up and failure of BWR upper internals during a severe accident

DOE Office of Scientific and Technical Information (OSTI.GOV)

Robb, Kevin R.

In boiling water reactors, the shroud dome, separators, and dryers above the core are made of approximately 100,000 kg of stainless steel. During a severe accident in which the coolant boils away and exothermic oxidation of zirconium occurs, gases (steam and hydrogen) are superheated in the core region and pass through the upper internals. In this scenario, the upper internals can also be heated by thermal radiation from the hot degrading core. Historically, models of the upper internals have been relatively simple in severe accident codes. The upper internals are typically modeled in MELCOR as two lumped volumes with simplifiedmore » heat transfer characteristics and no structural integrity considerations, and with limited ability to oxidize, melt, and relocate. The potential for and the subsequent impact of the upper internals to heat up, oxidize, fail, and relocate during a severe accident was investigated. A higher fidelity representation of the shroud dome, steam separators, and steam driers was developed in MELCOR v1.8.6 by extending the core region upwards. The MELCOR modeling effort entailed adding 45 additional core cells and control volumes, 98 flow paths, and numerous control functions. The model accounts for the mechanical loading and structural integrity, oxidation, melting, flow area blockage, and relocation of the various components. Consistent with a previous study, the results indicate that the upper internals can reach high temperatures during a severe accident sufficient to lose their structural integrity and relocate. Finally, the additional 100 metric tons of stainless steel debris influences the subsequent in-vessel and ex-vessel accident progression.« less

Heat up and failure of BWR upper internals during a severe accident

DOE PAGES

Robb, Kevin R.

2017-02-21

In boiling water reactors, the shroud dome, separators, and dryers above the core are made of approximately 100,000 kg of stainless steel. During a severe accident in which the coolant boils away and exothermic oxidation of zirconium occurs, gases (steam and hydrogen) are superheated in the core region and pass through the upper internals. In this scenario, the upper internals can also be heated by thermal radiation from the hot degrading core. Historically, models of the upper internals have been relatively simple in severe accident codes. The upper internals are typically modeled in MELCOR as two lumped volumes with simplifiedmore » heat transfer characteristics and no structural integrity considerations, and with limited ability to oxidize, melt, and relocate. The potential for and the subsequent impact of the upper internals to heat up, oxidize, fail, and relocate during a severe accident was investigated. A higher fidelity representation of the shroud dome, steam separators, and steam driers was developed in MELCOR v1.8.6 by extending the core region upwards. The MELCOR modeling effort entailed adding 45 additional core cells and control volumes, 98 flow paths, and numerous control functions. The model accounts for the mechanical loading and structural integrity, oxidation, melting, flow area blockage, and relocation of the various components. Consistent with a previous study, the results indicate that the upper internals can reach high temperatures during a severe accident sufficient to lose their structural integrity and relocate. Finally, the additional 100 metric tons of stainless steel debris influences the subsequent in-vessel and ex-vessel accident progression.« less

Stimulation of abdominal and upper thoracic muscles with surface electrodes for respiration and cough: Acute studies in adult canines.

PubMed

Walter, James S; Posluszny, Joseph; Dieter, Raymond; Dieter, Robert S; Sayers, Scott; Iamsakul, Kiratipath; Staunton, Christine; Thomas, Donald; Rabbat, Mark; Singh, Sanjay

2018-05-01

To optimize maximal respiratory responses with surface stimulation over abdominal and upper thorax muscles and using a 12-Channel Neuroprosthetic Platform. Following instrumentation, six anesthetized adult canines were hyperventilated sufficiently to produce respiratory apnea. Six abdominal tests optimized electrode arrangements and stimulation parameters using bipolar sets of 4.5 cm square electrodes. Tests in the upper thorax optimized electrode locations, and forelimb moment was limited to slight-to-moderate. During combined muscle stimulation tests, the upper thoracic was followed immediately by abdominal stimulation. Finally, a model of glottal closure for cough was conducted with the goal of increased peak expiratory flow. Optimized stimulation of abdominal muscles included three sets of bilateral surface electrodes located 4.5 cm dorsal to the lateral line and from the 8 th intercostal space to caudal to the 13 th rib, 80 or 100 mA current, and 50 Hz stimulation frequency. The maximal expired volume was 343 ± 23 ml (n=3). Optimized upper thorax stimulation included a single bilateral set of electrodes located over the 2 nd interspace, 60 to 80 mA, and 50 Hz. The maximal inspired volume was 304 ± 54 ml (n=4). Sequential stimulation of the two muscles increased the volume to 600 ± 152 ml (n=2), and the glottal closure maneuver increased the flow. Studies in an adult canine model identified optimal surface stimulation methods for upper thorax and abdominal muscles to induce sufficient volumes for ventilation and cough. Further study with this neuroprosthetic platform is warranted.

Management of acute variceal bleeding.

PubMed

Herrera, Jorge L

2014-05-01

Acute variceal bleeding (AVB) is the most common cause of upper gastrointestinal hemorrhage in patients with cirrhosis. Advances in the management of AVB have resulted in decreased mortality. To minimize mortality, a multidisciplinary approach addressing airway safety, prompt judicious volume resuscitation, vasoactive and antimicrobial pharmacotherapy, and early endoscopy to obliterate varices is necessary. Placement of a transjugular intrahepatic portosystemic shunt (TIPS) has been used as rescue therapy for patients failing initial attempts at hemostasis. Patients who have a high likelihood of failing initial attempts at hemostasis may benefit from a more aggressive approach using TIPS earlier in their management. Copyright © 2014 Elsevier Inc. All rights reserved.

Global Attenuation Tomography and Implications for Upper-Mantle Thermal Structure

NASA Astrophysics Data System (ADS)

Dalton, C. A.; Ekström, G.; Dziewonski, A. M.

2007-12-01

Observation of seismic-wave attenuation provides a direct measure of the Earth's anelasticity. The sensitivity of attenuation to temperature, composition, partial melt, and water content is different from that of seismic velocity, and joint interpretation of elastic and anelastic models may be used to improve constraints on these properties throughout the Earth. Historically, the development of attenuation models has lagged behind velocity models. However, the availability of large seismic datasets and improved techniques to treat these data have recently led to better and higher-resolution attenuation models. We have developed a new 3-D global model of shear attenuation in the upper mantle. This new model, QRFSI12, is derived from > 30,000 fundamental-mode Rayleigh wave amplitude measurements at each period (period range 50-250 s). The amplitudes are inverted simultaneously for the coefficients of the 3-D model as well as frequency-dependent amplitude correction factors for each source and receiver. We have found that focusing by elastic heterogeneity can significantly influence surface-wave amplitudes and that this effect can be modeled at long periods using ray-theoretical approximations. We therefore subtract focusing effects from the data prior to inversion by using phase-velocity maps determined from jointly inverting amplitude and phase-delay datasets. In the shallow mantle, QRFSI12 exhibits a strong correlation with tectonic features, and different tectonic provinces are characterized by distinct attenuative properties. At depths > 250 km, the model is dominated by high attenuation beneath the southeastern Pacific and eastern Africa and low attenuation associated with subduction zones in the western Pacific. Comparison of QRFSI12 with global shear-velocity models shows a strong anti-correlation throughout the upper mantle. At 100-km depth, a clear trend of increasing velocity and decreasing attenuation with increasing age of the seafloor is apparent, and

Thermal reactionomes reveal divergent responses to thermal extremes in warm and cool-climate ant species.

PubMed

Stanton-Geddes, John; Nguyen, Andrew; Chick, Lacy; Vincent, James; Vangala, Mahesh; Dunn, Robert R; Ellison, Aaron M; Sanders, Nathan J; Gotelli, Nicholas J; Cahan, Sara Helms

2016-03-02

The distributions of species and their responses to climate change are in part determined by their thermal tolerances. However, little is known about how thermal tolerance evolves. To test whether evolutionary extension of thermal limits is accomplished through enhanced cellular stress response (enhanced response), constitutively elevated expression of protective genes (genetic assimilation) or a shift from damage resistance to passive mechanisms of thermal stability (tolerance), we conducted an analysis of the reactionome: the reaction norm for all genes in an organism's transcriptome measured across an experimental gradient. We characterized thermal reactionomes of two common ant species in the eastern U.S, the northern cool-climate Aphaenogaster picea and the southern warm-climate Aphaenogaster carolinensis, across 12 temperatures that spanned their entire thermal breadth. We found that at least 2 % of all genes changed expression with temperature. The majority of upregulation was specific to exposure to low temperatures. The cool-adapted A. picea induced expression of more genes in response to extreme temperatures than did A. carolinensis, consistent with the enhanced response hypothesis. In contrast, under high temperatures the warm-adapted A. carolinensis downregulated many of the genes upregulated in A. picea, and required more extreme temperatures to induce down-regulation in gene expression, consistent with the tolerance hypothesis. We found no evidence for a trade-off between constitutive and inducible gene expression as predicted by the genetic assimilation hypothesis. These results suggest that increases in upper thermal limits may require an evolutionary shift in response mechanism away from damage repair toward tolerance and prevention.

Thermal insulating barrier and neutron shield providing integrated protection for a nuclear reactor vessel

DOEpatents

Schreiber, R.B.; Fero, A.H.; Sejvar, J.

1997-12-16

The reactor vessel of a nuclear reactor installation which is suspended from the cold leg nozzles in a reactor cavity is provided with a lower thermal insulating barrier spaced from the reactor vessel to form a chamber which can be flooded with cooling water through passive valving to directly cool the reactor vessel in the event of a severe accident. The passive valving also includes bistable vents at the upper end of the thermal insulating barrier for releasing steam. A removable, modular neutron shield extending around the upper end of the reactor cavity below the nozzles forms with the upwardly and outwardly tapered transition on the outer surface of the reactor vessel, a labyrinthine channel which reduces neutron streaming while providing a passage for the escape of steam during a severe accident, and for the cooling air which is circulated along the reactor cavity walls outside the thermal insulating barrier during normal operation of the reactor. 8 figs.

Thermal insulating barrier and neutron shield providing integrated protection for a nuclear reactor vessel

DOEpatents

Schreiber, Roger B.; Fero, Arnold H.; Sejvar, James

1997-01-01

The reactor vessel of a nuclear reactor installation which is suspended from the cold leg nozzles in a reactor cavity is provided with a lower thermal insulating barrier spaced from the reactor vessel to form a chamber which can be flooded with cooling water through passive valving to directly cool the reactor vessel in the event of a severe accident. The passive valving also includes bistable vents at the upper end of the thermal insulating barrier for releasing steam. A removable, modular neutron shield extending around the upper end of the reactor cavity below the nozzles forms with the upwardly and outwardly tapered transition on the outer surface of the reactor vessel, a labyrinthine channel which reduces neutron streaming while providing a passage for the escape of steam during a severe accident, and for the cooling air which is circulated along the reactor cavity walls outside the thermal insulating barrier during normal operation of the reactor.

Competition between Langmuir and upper-hybrid turbulence in a high-frequency-pumped ionosphere.

PubMed

Thidé, B; Sergeev, E N; Grach, S M; Leyser, T B; Carozzi, T D

2005-12-16

We show how the secondary escaping radiation, also known as stimulated electromagnetic emission (SEE), from the ionosphere irradiated by a high-intensity radio beam, can be used to study both reflection altitude ponderomotive parametric instabilities and upper-hybrid altitude thermal parametric instabilities. This has allowed us to observe the transfer of energy from smaller to higher sideband frequency offsets and to identify a new transient SEE feature.

Thermal escape from extrasolar giant planets

PubMed Central

Koskinen, Tommi T.; Lavvas, Panayotis; Harris, Matthew J.; Yelle, Roger V.

2014-01-01

The detection of hot atomic hydrogen and heavy atoms and ions at high altitudes around close-in extrasolar giant planets (EGPs) such as HD209458b implies that these planets have hot and rapidly escaping atmospheres that extend to several planetary radii. These characteristics, however, cannot be generalized to all close-in EGPs. The thermal escape mechanism and mass loss rate from EGPs depend on a complex interplay between photochemistry and radiative transfer driven by the stellar UV radiation. In this study, we explore how these processes change under different levels of irradiation on giant planets with different characteristics. We confirm that there are two distinct regimes of thermal escape from EGPs, and that the transition between these regimes is relatively sharp. Our results have implications for thermal mass loss rates from different EGPs that we discuss in the context of currently known planets and the detectability of their upper atmospheres. PMID:24664923

Can Thermal Bending Fracture Ice Shelves?

NASA Astrophysics Data System (ADS)

MacAyeal, D. R.; Sergienko, O. V.; Banwell, A. F.; Willis, I.; Macdonald, G. J.; Lin, J.

2017-12-01

Visco-elastic plates will bend if the temperature on one side is cooled. If the plate is constrained to float, as for sea ice floes, this bending will lead to tensile stresses that can fracture the ice. The hydroacoustic regime below sea ice displays increased fracture-sourced noise when air temperatures above the ice cools with the diurnal cycle. The McMurdo Ice Shelf, Antarctica, also displays a massive increase in seismicity during the cooling phase of the diurnal cycle, and this motivates the question: Can surface cooling (or other forcing with thermal consequences) drive through-thickness fracture leading to iceberg calving? Past study of this question for sea ice gives an upper limit of ice-plate thickness (order meters) for which diurnal-scale thermal bending fracture can occur; but could cooling with longer time scales induce fracture of thicker ice plates? Given the seismic evidence of thermal bending fracture on the McMurdo Ice Shelf, the authors examine this question further.

Differences in childhood adiposity influence upper limb fracture site

PubMed Central

Moon, Rebecca J; Lim, Adelynn; Farmer, Megan; Segaran, Avinash; Clarke, Nicholas MP; Dennison, Elaine M; Harvey, Nicholas C; Cooper, Cyrus; Davies, Justin H

2015-01-01

Introduction Although it has been suggested that overweight and obese children have an increased risk of fracture, recent studies in post-menopausal women have shown that the relationship between obesity and fracture risk varies by fracture site. We therefore assessed whether adiposity and overweight/obesity prevalence differed by upper limb fracture site in children. Methods Height, weight, BMI, triceps and subscapular skinfold thickness (SFT) were measured in children aged 3-18 years with an acute upper limb fracture. Data was compared across three fracture sites (hand, forearm and upper arm/shoulder [UA]), and to published reference data. Results 401 children (67.1% male, median age 11.71 years (range 3.54-17.27 years) participated. 34.2%, 50.6% and 15.2% had fractures of the hand, forearm and UA, respectively. Children with forearm fractures had higher weight, BMI and SFT z-scores than those with UA fractures (p<0.05 for all). SFT z-scores were also higher in children with forearm fractures compared to hand fractures, but children withor hand and UA fractures did not differ. Overweight and obesity prevalence was higher in children with forearm fractures (37.6%) than those with UA fractures (19.0%, p=0.009). This prevalence was also higher than the published United Kingdom population prevalence (27.9%, p=0.003), whereas that of children with either UA (p=0.13) or hand fractures (29.1%, p=0.76) did not differ. The differences in anthropometry and overweight/obesity were similar for boys, but not present in girls. Conclusion Measurements of adiposity and the prevalence of overweight/obesity differ by fracture site in children, and in particular boys, with upper limb fractures. PMID:26027507

Acute Toxic Neuropathy Mimicking Guillain Barre Syndrome

PubMed Central

Jalal, Muhammed Jasim Abdul; Fernandez, Shirley Joan; Menon, Murali Krishna

2015-01-01

Case: A 30 year old male presented with numbness of palms and soles followed by weakness of upper limbs and lower limbs of 5 days duration, which was ascending and progressive. Three months back he was treated for oral and genital ulcers with oral steroids. His ulcers improved and shifted to indigenous medication. His clinical examination showed polyneuropathy. CSF study did not show albuminocytological dissociation. Nerve conduction study showed demyelinating polyneuropathy. His blood samples and the ayurvedic drug samples were sent for toxicological analysis. Inference: Acute toxic neuropathy - Arsenic PMID:25811007

Removal of iron and manganese by artificial destratification in a tropical climate (Upper Layang Reservoir, Malaysia).

PubMed

Ismail, R; Kassim, M A; Inman, M; Baharim, N H; Azman, S

2002-01-01

Environmental monitoring was carried out at Upper Layang Reservoir situated in Masai, Johor, Malaysia. The study shows that thermal stratification and natural mixing of the water column do exist in the reservoir and the level of stratification varies at different times of the year. Artificial destratification via diffused air aeration techniques was employed at the reservoir for two months. The results show that thermal stratification was eliminated after a week of continuous aeration. The concentrations of iron and to a lesser extent manganese in the water column was also reduced during the aeration period.

Haemosuccus pancreaticus, an uncommon cause of upper gastro intestinal bleeding: Case report and review of the literature.

PubMed

Shah, Amir Ali; Charon, Jean Pierre

2015-06-01

Haemosuccus Pancreaticus is defined as upper gastro intestinal (GI) bleeding from the ampula of vater via the pancreatic duct. It is most commonly associated with pancreatic inflammation, erosion of the pancrease by aneurysm or pseudo-aneurysm of the splenic artery. We report a 69 year old man with previous history of acute pancreatitis who was admitted with recurrent haematemesis. Initial upper GI endocopy was normal, while admitted, he collapse with abdominal pain and hypotension. He was resuscitated with blood and intravenous fluid. Repeat upper GI endocopy showed fresh blood in the duodenum, but no active bleeding site was demonstrated. An urgent coeliac axis CT angiogram was done which showed an splenic artery pseudo-aneurysm, which was successfully embolized. Patient is well 9 months after the procedure. This case highlights the importance of considering coeliac axis CT angiogram as part of investigation for obscure GI bleeding.

Inclusion of thoracic spine thrust manipulation into an electro-therapy/thermal program for the management of patients with acute mechanical neck pain: a randomized clinical trial.

PubMed

González-Iglesias, Javier; Fernández-de-las-Peñas, Cesar; Cleland, Joshua A; Alburquerque-Sendín, Francisco; Palomeque-del-Cerro, Luis; Méndez-Sánchez, Roberto

2009-06-01

Our aim was to examine the effects of a seated thoracic spine distraction thrust manipulation included in an electrotherapy/thermal program on pain, disability, and cervical range of motion in patients with acute neck pain. This randomized controlled trial included 45 patients (20 males, 25 females) between 23 and 44 years of age presenting with acute neck pain. Patients were randomly divided into 2 groups: an experimental group which received a thoracic manipulation, and a control group which did not receive the manipulative procedure. Both groups received an electrotherapy program consisting of 6 sessions of TENS (frequency 100Hz; 20min), superficial thermo-therapy (15min) and soft tissue massage. The experimental group also received a thoracic manipulation once a week for 3 consecutive weeks. Outcome measures included neck pain (numerical pain rate scale; NPRS), level of disability (Northwick Park Neck Pain Questionnaire; NPQ) and neck mobility. These outcomes were assessed at baseline and 1 week after discharge. A 2-way repeated-measures ANOVA with group as between-subject variable and time as within-subject variable was used. Patients receiving thoracic manipulation experienced greater reductions in both neck pain, with between-group difference of 2.3 (95% CI 2-2.7) points on a 11-NPRS, and perceived disability with between-group differences 8.5 (95% CI 7.2-9.8) points. Further, patients receiving thoracic manipulation experienced greater increases in all cervical motions with between-group differences of 10.6 degrees (95% CI 8.8-12.5 degrees) for flexion; 9.9 degrees (95% CI 8.1-11.7 degrees) for extension; 9.5 degrees (95% CI 7.6-11.4 degrees) for right lateral-flexion; 8 degrees (95% CI 6.2-9.8 degrees) for left lateral-flexion; 9.6 degrees (95% CI 7.7-11.6 degrees) for right rotation; and 8.4 degrees (95% CI 6.5-10.3 degrees) for left rotation. We found that the inclusion of a thoracic manipulation into an electrotherapy/thermal program was effective in

Synthetic receiver function profiles through the upper mantle and the transition zone for upwelling scenarios

NASA Astrophysics Data System (ADS)

Nagel, Thorsten; Düsterhöft, Erik; Schiffer, Christian

2017-04-01

We investigate the signature relevant mantle lithologies leave in the receiver function record for different adiabatic thermal gradients down to 800 kilometers depth. The parameter space is chosen to target the visibility of upwelling mantle (a plume). Seismic velocities for depleted mantle, primitive mantle, and three pyroxenites are extracted from thermodynamically calculated phases diagrams, which also provide the adiabatic decompression paths. Results suggest that compositional variations, i.e. the presence or absence of considerable amounts of pyroxenites in primitive mantle should produce a clear footprint while horizontal differences in thermal gradients for similar compositions might be more subtle. Peridotites best record the classic discontinuities at around 410 and 650 kilometers depth, which are associated with the olivin-wadsleyite and ringwoodite-perovskite transitions, respectively. Pyroxenites, instead, show the garnet-perovskite transition below 700 kilometers depth and SiO2-supersaturated compositions like MORB display the coesite-stishovite transition between 300 and 340 kilometers depth. The latter shows the strongest temperature-depth dependency of all significant transitions potentially allowing to infer information about the thermal state if the mantle contains a sufficient fraction of MORB-like compositions. For primitive and depleted mantle compositions, the olivin-wadsleyite transition shows a certain temperature-depth dependency reflected in slightly larger delay times for higher thermal gradients. The lower-upper-mantle discontinuity, however, is predicted to display larger delay times for higher thermal gradients although the associated assemblage transition occurs at shallower depths thus requiring a very careful depth migration if a thermal anomaly should be recognized. This counterintuitive behavior results from the downward replacement of the assemblage wadsleyite+garnet with the assemblage garnet+periclase at high temperatures

Global warming-induced upper-ocean freshening and the intensification of super typhoons

DOE Office of Scientific and Technical Information (OSTI.GOV)

Balaguru, Karthik; Foltz, Gregory R.; Leung, L. Ruby

Here, super typhoons (STYs), intense tropical cyclones of the western North Pacific, rank among the most destructive natural hazards globally. The violent winds of these storms induce deep mixing of the upper ocean, resulting in strong sea surface cooling and making STYs highly sensitive to ocean density stratification. Although a few studies examined the potential impacts of changes in ocean thermal structure on future tropical cyclones, they did not take into account changes in near-surface salinity. Here, using a combination of observations and coupled climate model simulations, we show that freshening of the upper ocean, caused by greater rainfall inmore » places where typhoons form, tends to intensify STYs by reducing their ability to cool the upper ocean. We further demonstrate that the strengthening effect of this freshening over the period 1961–2008 is ~53% stronger than the suppressive effect of temperature, whereas under twenty-first century projections, the positive effect of salinity is about half of the negative effect of ocean temperature changes.« less

Global warming-induced upper-ocean freshening and the intensification of super typhoons

DOE PAGES

Balaguru, Karthik; Foltz, Gregory R.; Leung, L. Ruby; ...

2016-11-25

Here, super typhoons (STYs), intense tropical cyclones of the western North Pacific, rank among the most destructive natural hazards globally. The violent winds of these storms induce deep mixing of the upper ocean, resulting in strong sea surface cooling and making STYs highly sensitive to ocean density stratification. Although a few studies examined the potential impacts of changes in ocean thermal structure on future tropical cyclones, they did not take into account changes in near-surface salinity. Here, using a combination of observations and coupled climate model simulations, we show that freshening of the upper ocean, caused by greater rainfall inmore » places where typhoons form, tends to intensify STYs by reducing their ability to cool the upper ocean. We further demonstrate that the strengthening effect of this freshening over the period 1961–2008 is ~53% stronger than the suppressive effect of temperature, whereas under twenty-first century projections, the positive effect of salinity is about half of the negative effect of ocean temperature changes.« less

Hot leptogenesis from thermal Dark Matter

DOE PAGES

Bernal, Nicolas; Fong, Chee Sheng

2017-10-26

In this work, we investigate a scenario in which heavy Majorana Right-Handed Neutrinos (RHNs) are in thermal equilibrium with a dark sector with temperature higher than the Standard Model (SM) thermal bath. Specifically, we consider the scenario in which thermal Dark Matter (DM) abundance is fixed from the freeze-out of DM annihilations into RHNs. Due to the inert nature of the RHNs, we show that it is possible for the two sectors to remain thermally decoupled by having more than two generations of the RHNs. The hotter temperature implies higher abundances of DM and RHNs with the following consequences. Formore » leptogenesis, an enhancement in efficiency up to a factor of 51.6 can be obtained, though a resonant enhancement of CP violation is still required due to an upper mass bound of about 4 TeV for the RHNs. For the DM, an enhanced annihilation cross section up to a factor of 51.6 is required to obtain the correct DM abundance. This scenario can be probed via indirect detection of DM annihilating into RHNs, which then decay into hν, Zν and W ± ℓ ∓ with an enhanced annihilation cross section above the typical thermal value.« less

Role of Interventional Radiology in the Emergent Management of Acute Upper Gastrointestinal Bleeding

PubMed Central

Navuluri, Rakesh; Patel, Jay; Kang, Lisa

2012-01-01

Approximately 100,000 cases of upper gastrointestinal bleeding (UGIB) require inpatient admission annually in the United States. When medical management and endoscopic therapy are inadequate, endovascular intervention can be lifesaving. These emergent situations highlight the importance of immediate competence of the interventional radiologist in the preangiographic evaluation as well as the endovascular treatment of UGIB. We describe a case of UGIB managed with endovascular embolization and detail the angiographic techniques used. The case description is followed by a detailed discussion of the treatment approach to UGIB, with attention to both nonvariceal and variceal algorithms. PMID:23997408

Thermal structure of the Panama Basin by analysis of seismic attenuation

NASA Astrophysics Data System (ADS)

Vargas, Carlos A.; Pulido, José E.; Hobbs, Richard W.

2018-04-01

Using recordings of earthquakes on Oceanic Bottom Seismographs and onshore stations on the coastal margins of Colombia, Panama, and Ecuador, we estimate attenuation parameters in the upper lithosphere of the Panama Basin. The tomographic images of the derived coda-Q values are correlated with estimates of Curie Point Depth and measured and theoretical heat flow. Our study reveals three tectonic domains where magmatic/hydrothermal activity or lateral variations of the lithologic composition in the upper lithosphere can account for the modeled thermal structure and the anelasticity. We find that the Costa Rica Ridge and the Panama Fracture Zone are significant tectonic features probably related to thermal anomalies detected in the study area. We interpret a large and deep intrinsic attenuation anomaly as related to the heat source at the Costa Rica Ridge and show how interactions with regional fault systems cause contrasting attenuation anomalies.

Ground-state splitting of ultrashallow thermal donors with negative central-cell corrections in silicon

NASA Astrophysics Data System (ADS)

Hara, Akito; Awano, Teruyoshi

2017-06-01

Ultrashallow thermal donors (USTDs), which consist of light element impurities such as carbon, hydrogen, and oxygen, have been found in Czochralski silicon (CZ Si) crystals. To the best of our knowledge, these are the shallowest hydrogen-like donors with negative central-cell corrections in Si. We observed the ground-state splitting of USTDs by far-infrared optical absorption at different temperatures. The upper ground-state levels are approximately 4 meV higher than the ground-state levels. This energy level splitting is also consistent with that obtained by thermal excitation from the ground state to the upper ground state. This is direct evidence that the wave function of the USTD ground state is made up of a linear combination of conduction band minimums.

Intensified Training Period Increases Salivary IgA Responses But Does Not Affect the Severity of Upper Respiratory Tract Infection Symptoms in Prepuberal Rhythmic Gymnasts.

PubMed

Antualpa, Kizzy; Aoki, Marcelo Saldanha; Moreira, Alexandre

2018-05-01

This study examined the effect of a 4-week intensified training (IT) period, followed by a 2-week tapering period (TP), on salivary immunoglobulin A (SIgA), salivary cortisol, and the severity of upper respiratory tract infection symptoms in 23 rhythmic gymnasts [12.1 (2.6) y; 143.9 (13.7) cm; 37.2 (9.4) kg]. Saliva sampling was conducted at pre- and post-IT, and post-TP (analyzed using enzyme-linked immunosorbent assay). The Wisconsin Upper Respiratory Symptom Survey (WURSS-21) questionnaire was completed daily to analyze the severity of upper respiratory tract infection symptoms. The session rating of the perceived exertion was used to determine the internal training load and the acute:chronic workload ratio. A higher SIgA concentration [SIgA abs (μg/mL); F = 7.6; P = .001] for post-IT [234 (104)] versus pre-IT [173 (91)], and post-TP [182 (70)], and a higher SIgA secretion rate [SIgA rate (μg/min); F = 3.4; P = .04] for post-IT [69 (28)] versus pre-IT [55 (27)], and post-TP [58 (22)] were observed. No significant change was observed for cortisol (F = 0.81; P = .45) or for the severity of upper respiratory tract infection symptoms (χ 2  = 2.81; P = .24). Internal training load was higher during IT (vs TP; effect size = 2.37). The acute:chronic workload for the IT weeks varied from 1.2 (0.3) to 1.4 (0.3). These results suggest that a 4-week IT may temporarily augment the oral mucosal immunity, and an acute:chronic workload of 1.2-1.4 seems to be a safe approach to periodized training loads in youth rhythmic gymnasts.

Development of a high-resolution infrared thermographic imaging method as a diagnostic tool for acute undifferentiated limp in young children.

PubMed

Owen, R; Ramlakhan, S; Saatchi, R; Burke, D

2018-06-01

Acute limp is a common presenting condition in the paediatric emergency department. There are a number of causes of acute limp that include traumatic injury, infection and malignancy. These causes in young children are not easily distinguished. In this pilot study, an infrared thermographic imaging technique to diagnose acute undifferentiated limp in young children was developed. Following required ethics approval, 30 children (mean age = 5.2 years, standard deviation = 3.3 years) were recruited. The exposed lower limbs of participants were imaged using a high-resolution thermal camera. Using predefined regions of interest (ROI), any skin surface temperature difference between the healthy and affected legs was statistically analysed, with the aim of identifying limp. In all examined ROIs, the median skin surface temperature for the affected limb was higher than that of the healthy limb. The small sample size recruited for each group, however, meant that the statistical tests of significant difference need to be interpreted in this context. Thermal imaging showed potential in helping with the diagnosis of acute limp in children. Repeating a similar study with a larger sample size will be beneficial to establish reproducibility of the results. Graphical abstract A young child with an acute undifferentiated limp undergoes thermal imaging and the follow on image analysis assists the limp diagnosis.

Middle and upper Miocene natural gas sands in onshore and offshore Alabama

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mink, R.M.; Mancini, E.A.; Bearden, B.L.

1988-09-01

Thirty Miocene natural gas fields have been established in onshore and offshore Alabama since the discovery of Miocene gas in this area in 1979. These fields have produced over 16 bcf of natural gas from the middle Miocene Amos sand (24 fields) and upper Miocene Luce (3 fields), Escambia (1 field), and Meyer (3 fields) sands. Production from the Amos transgressive sands represents over 92% of the cumulative shallow Miocene natural gas produced in onshore and offshore Alabama. In addition, over 127 bcf of natural gas has been produced from upper Miocene sands in the Chandeleur area. The productive Miocenemore » section in onshore and coastal Alabama is interpreted to present transgressive marine shelf and regressive shoreface sands. The middle Miocene Amos sand bars are the most productive reservoirs of natural gas in onshore and coastal Alabama, principally due to the porous and permeable nature of these transgressive sands and their stratigraphic relationship to the underlying basinal clays in this area. In offshore Alabama the upper Miocene sands become thicker and are generally more porous and permeable than their onshore equivalents. Because of their deeper burial depth in offshore Alabama, these upper Miocene sands are associated with marine clays that are thermally more mature. The combination of reservoir grade lithologies associated with moderately mature petroleum source rocks enhances the natural gas potential of the upper Miocene sands in offshore Alabama.« less

[Does the antisecretory agent used affect the evolution of upper digestive hemorrhage?].

PubMed

Ortí, E; Canelles, P; Quiles, F; Zapater, R; Cuquerella, J; Ariete, V; Tomé, A; Medina, E

1995-06-01

To investigate whether omeprazole has improved morbidity-mortality among patients with upper gastrointestinal bleeding of non-variceal origin in comparison with ranitidine. Prospective, randomized and open study. We study 519 consecutive patients admitted to our Service between June 1991 and January 1993 for upper gastrointestinal bleeding of peptic origin, dividing the patients into two randomized groups that were homogeneous in terms of age, sex, previous history of gastric disease and upper gastrointestinal bleeding, intake of non-steroidal antiinflammatory drugs, and the severity of bleeding on admittance. Thus, Group A consisted of 252 patients treated immediately upon arrival at the emergency ward with 50 mg intravenous ranitidine, followed by a further 50 mg every 6 hours. Group B in turn consisted of 267 patients initially given a bolus dose of 80 mg omeprazole intravenously, followed by an additional 40 mg every 8 hours for 48 hours. Forty mg were subsequently administered every 12 hours until hospital discharge. Endoscopy was performed in all cases within the first 24 hours following admittance, those patients with active upper gastrointestinal bleeding resulted from Forrest-type ulcer of subjected to endoscopic sclerotherapy were excluded. Duodenal ulcer was the most common cause of bleeding, followed by gastric ulcer and acute lesions of the mucosa. Emphasis should be placed on the high incidence of previous non-steroidal antiinflammatory drug intake in our series (54.5%). We encountered no statistically significant differences between the two groups on comparing bleeding stigmata, transfusion requirements, recurrences, emergency surgery, the duration of hospital stay, and mortality. Both drugs were found to possess a similar efficacy in treating upper gastrointestinal bleeding of peptic origin.

Using GIA observables to constrain the thermal contribution to lateral variations in mantle viscosity

NASA Astrophysics Data System (ADS)

Wu, P.; Wang, H.; van der Wal, W.; Shum, C.; Lee, H.; Braun, A.

2009-05-01

Lateral heterogeneities in the mantle can be caused by thermal, chemical and non-isotropic pre-stress effects. Here, observations of the glacial isostatic adjustment (GIA) process are used to constrain the thermal contribution to lateral variations in upper and lower mantle viscosities. The Coupled Laplace-Finite Element method is used to predict the GIA response on a spherical, self-gravitating, compressible, viscoelastic earth with self-gravitating oceans, induced by either the ICE-5G or ICE-4G deglaciation models. GIA observations include global historic relative sea level data, GPS uplift rates in Laurentide and Fennoscandia, altimetry together with tide-gauge data in the Great Lakes area, and GRACE data in Laurentide. The lateral viscosity perturbations are inferred from the high resolution seismic tomography model of Grand (2002) by using a conversion relation that takes into account both anelastic and anharmonic effects (Karato 2008). To determine the contribution of thermal effects in the upper and lower mantle, the scaling factor b is also inserted into the conversion relation: For b = 1, lateral velocity variations are caused by thermal effects alone; while b < 1 indicates a decreasing contribution of thermal effects; eventually when b = 0, there is no lateral viscosity variations exist and the Earth is laterally homogeneous. The value of b in the upper mantle is b1 while that in the lower mantle is b2. The lateral viscosity variations computed this way are superposed on a reference model that is able to give a reasonably good fit to the GIA observations. The parameter space for (b1, b2) is then searched to find the combination that yields the best improvement in fitting the GIA data in Laurentide, Fennoscandia or globally.

Mycoplasma pneumoniae: an aetiological agent of acute haemorrhagic oedema of infancy.

PubMed

Di Lernia, Vito

2014-11-01

Acute haemorrhagic oedema of infancy (AHEI) is considered a separate clinical entity among cutaneous small vessel vasculitis of childhood. It usually occurs in children younger than 2 years of age, with spontaneous recovery occurring within a few weeks. A history of recent upper respiratory or urinary tract infections or immunisation is found in most patients. Although Mycoplasma pneumoniae has been linked to a wide array of skin eruptions or diseases, it is not recognised as a possible cause of acute haemorrhagic oedema of infancy. The authors report a child with AHEI and a concurrent M. pneumoniae infection. © 2013 The Author. Australasian Journal of Dermatology © 2013 The Australasian College of Dermatologists.

Reduced hemoglobin and increased C-reactive protein are associated with upper gastrointestinal bleeding.

PubMed

Tomizawa, Minoru; Shinozaki, Fuminobu; Hasegawa, Rumiko; Togawa, Akira; Shirai, Yoshinori; Ichiki, Noboru; Motoyoshi, Yasufumi; Sugiyama, Takao; Yamamoto, Shigenori; Sueishi, Makoto

2014-02-07

To investigate the early upper gastrointestinal endoscopy (endoscopy) significantly reduces mortality resulting from upper gastrointestinal (GI) bleeding. Upper GI bleeding was defined as 1a, 1b, 2a, and 2b according to the Forrest classification. The hemoglobin (Hb), and C-reactive protein (CRP) were examined at around the day of endoscopy and 3 mo prior to endoscopy. The rate of change was calculated as follows: (the result of blood examination on the day of endoscopy - the results of blood examination 3 mo prior to endoscopy)/(results of blood examination 3 mo prior to endoscopy). Receiver operating characteristic curves were created to determine threshold values. Seventy-nine men and 77 women were enrolled. There were 17 patients with upper GI bleeding: 12 with a gastric ulcer, 3 with a duodenal ulcer, 1 with an acute gastric mucosal lesion, and 1 with gastric cancer. The area under the curve (AUC), threshold, sensitivity, and specificity of Hb around the day of endoscopy were 0.902, 11.7 g/dL, 94.1%, and 77.1%, respectively, while those of CRP were 0.722, 0.5 mg/dL, 70.5%, and 73%, respectively. The AUC, threshold, sensitivity, and specificity of the rate of change of Hb were 0.851, -21.3%, 76.4%, and 82.6%, respectively, while those of CRP were 0.901, 100%, 100%, and 82.5%, respectively. Predictors for upper GI bleeding were Hb < 11.7 g/dL, reduction rate in the Hb > 21.3% and an increase in the CRP > 100%, 3 mo before endoscopy.

Upper tropospheric ice sensitivity to sulfate geoengineering

NASA Astrophysics Data System (ADS)

Visioni, Daniele; Pitari, Giovanni; Mancini, Eva

2017-04-01

In light of the Paris Agreement which aims to keep global warming under 2 °C in the next century and considering the emission scenarios produced by the IPCC for the same time span, it is likely that to remain below that threshold some kind of geoengineering technique will have to be deployed. Amongst the different methods, the injection of sulfur into the stratosphere has received much attention considering its effectiveness and affordability. Aside from the rather well established surface cooling sulfate geoengineering (SG) would produce, the investigation on possible side-effects of this method is still ongoing. For instance, some recent studies have investigated the effect SG would have on upper tropospheric cirrus clouds, expecially on the homogenous freezing mechanisms that produces the ice particles (Kuebbeler et al., 2012). The goal of the present study is to better understand the effect of thermal and dynamical anomalies caused by SG on the formation of ice crystals via homogeneous freezing by comparing a complete SG simulation with a RCP4.5 reference case and with a number of sensitivity studies where atmospheric temperature changes in the upper tropospheric region are specified in a schematic way as a function of the aerosol driven stratospheric warming and mid-lower tropospheric cooling. These changes in the temperature profile tend to increase atmospheric stabilization, thus decreasing updraft and with it the amount of water vapor available for homogeneous freezing in the upper troposphere. However, what still needs to be assessed is the interaction between this dynamical effect and the thermal effects of tropospheric cooling (which would increase ice nucleation rates) and stratospheric warming (which would probably extend to the uppermost troposphere via SG aerosol gravitational settling, thus reducing ice nucleation rates), in order to understand how they combine together. Changes in ice clouds coverage could be important for SG, because cirrus ice

Self-compensation of thermal lens in high-power diode pumped solid-state lasers

NASA Astrophysics Data System (ADS)

Wang, Xiao-Jun

2010-02-01

We present a comprehensive model to describe the optic-thermal coupling in the diode pumped solid-state lasers (DPSSL). The thermal transition of particles at the upper laser level leads the heat-generation of laser crystals to depend on shape of the laser beam, while the laser field is also influenced by the temperature because of the thermal excitation of doped particles among various Stark levels. These effects, together with the usual thermal-optic effect that induces a fluctuation of the refraction index by an inhomogeneous temperature distribution, cause a complicated coupling between the laser field and the temperature field. We show that the optic-thermal coupling plays an important role in high-power DPSSL with larger size beam. That effect may yield a self-compensation for the thermal lens and improve the beam quality.

Thermal stress, human performance, and physical employment standards.

PubMed

Cheung, Stephen S; Lee, Jason K W; Oksa, Juha

2016-06-01

Many physically demanding occupations in both developed and developing economies involve exposure to extreme thermal environments that can affect work capacity and ultimately health. Thermal extremes may be present in either an outdoor or an indoor work environment, and can be due to a combination of the natural or artificial ambient environment, the rate of metabolic heat generation from physical work, processes specific to the workplace (e.g., steel manufacturing), or through the requirement for protective clothing impairing heat dissipation. Together, thermal exposure can elicit acute impairment of work capacity and also chronic effects on health, greatly contributing to worker health risk and reduced productivity. Surprisingly, in most occupations even in developed economies, there are rarely any standards regarding enforced heat or cold safety for workers. Furthermore, specific physical employment standards or accommodations for thermal stressors are rare, with workers commonly tested under near-perfect conditions. This review surveys the major occupational impact of thermal extremes and existing employment standards, proposing guidelines for improvement and areas for future research.

Upper gastrointestinal bleeding in patients with hepatic cirrhosis: clinical course and mortality prediction.

PubMed

Afessa, B; Kubilis, P S

2000-02-01

We conducted this study to describe the complications and validate the accuracy of previously reported prognostic indices in predicting the mortality of cirrhotic patients hospitalized for upper GI bleeding. This prospective, observational study included 111 consecutive hospitalizations of 85 cirrhotic patients admitted for GI bleeding. Data obtained included intensive care unit (ICU) admission status, Child-Pugh score, the development of systemic inflammatory response syndrome (SIRS), organ failure, and inhospital mortality. The performances of Garden's, Gatta's, and Acute Physiology and Chronic Health Evaluation (APACHE) II prognostic systems in predicting mortality were assessed. Patients' mean age was 48.7 yr, and the median APACHE II and Child-Pugh scores were 17 and 9, respectively. Their ICU admission rate was 71%. Organ failure developed in 57%, and SIRS in 46% of the patients. Nine patients had acute respiratory distress syndrome, and three patients had hepatorenal syndrome. The inhospital mortality was 21%. The APACHE II, Garden's, and Gatta' s predicted mortality rates were 39%, 24%, and 20%, respectively, and their areas under the receiver operating characteristic curve (AUC) were 0.78, 0.70, and 0.71, respectively. The AUC for Child-Pugh score was 0.76. SIRS and organ failure develop in many patients with hepatic cirrhosis hospitalized for upper GI bleeding, and are associated with increased mortality. Although the APACHE II prognostic system overestimated the mortality of these patients, the receiver operating characteristic curves did not show significant differences between the various prognostic systems.

Furniture dimensions and postural overload for schoolchildren's head, upper back and upper limbs.

PubMed

Batistão, Mariana Vieira; Sentanin, Anna Cláudia; Moriguchi, Cristiane Shinohara; Hansson, Gert-Åke; Coury, Helenice Jane Cote Gil; de Oliveira Sato, Tatiana

2012-01-01

The aim of this study was to evaluate how the fixed furniture dimensions match with students' anthropometry and to describe head, upper back and upper limbs postures and movements. Evaluation was performed in 48 students from a Brazilian state school. Furniture dimensions were measured with metric tape, movements and postures by inclinometers (Logger Tecknologi, Åkarp, Sweden). Seat height was high for 21% and low for 36% of the students; seat length was short for 45% and long for 9% and table height was high for 53% and low for 28%. Regression analysis showed that seat/popliteal height quotient is explained by 90th percentile of upper back inclination (β=0.410) and 90th percentile of right upper arm elevation (β=-0.293). For seat/thigh length quotient the significant variables were 90th percentile of upper back velocity (β=-0.282) and 90th percentile of right upper arm elevation (β=0.410). This study showed a relationship between furniture mismatch and postural overload. When the seat height is low students increase upper back left inclination and right upper arm elevation; when the seat is short students decrease the upper back flexion velocity and increase right upper arm elevation.

Exploring the impact of visual and movement based priming on a motor intervention in the acute phase post-stroke in persons with severe hemiparesis of the upper extremity

PubMed Central

Patel, Jigna; Qiu, Qinyin; Yarossi, Mathew; Merians, Alma; Massood, Supriya; Tunik, Eugene; Adamovich, Sergei; Fluet, Gerard

2016-01-01

Purpose Explore the potential benefits of using priming methods prior to an active hand task in the acute phase post-stroke in persons with severe upper extremity hemiparesis. Methods Five individuals were trained using priming techniques including virtual reality (VR) based visual mirror feedback and contralaterally controlled passive movement strategies prior to training with an active pinch force modulation task. Clinical, kinetic, and neurophysiological measurements were taken pre and post the training period. Clinical measures were taken at six months post training. Results The two priming simulations and active training were well tolerated early after stroke. Priming effects were suggested by increased maximal pinch force immediately after visual and movement based priming. Despite having no clinically observable movement distally, the subjects were able to volitionally coordinate isometric force and muscle activity (EMG) in a pinch tracing task. The Root Mean Square Error (RMSE) of force during the pinch trace task gradually decreased over the training period suggesting learning may have occurred. Changes in motor cortical neurophysiology were seen in the unaffected hemisphere using Transcranial Magnetic Stimulation (TMS) mapping. Significant improvements in motor recovery as measured by the Action Research Arm Test (ARAT) and the Upper Extremity Fugl Meyer Assessment (UEFMA) were demonstrated at six months post training by three of the five subjects. Conclusion This study suggests that an early hand-based intervention using visual and movement based priming activities and a scaled motor task allows participation by persons without the motor control required for traditionally presented rehabilitation and testing. PMID:27636200

Antibiotics for the common cold and acute purulent rhinitis.

PubMed

Kenealy, Tim; Arroll, Bruce

2013-06-04

It has long been believed that antibiotics have no role in the treatment of common colds yet they are often prescribed in the belief that they may prevent secondary bacterial infections. To determine the efficacy of antibiotics compared with placebo for reducing general and specific nasopharyngeal symptoms of acute upper respiratory tract infections (URTIs) (common colds).To determine if antibiotics have any influence on the outcomes for acute purulent rhinitis and acute clear rhinitis lasting less than 10 days before the intervention.To determine whether there are significant adverse outcomes associated with antibiotic therapy for participants with a clinical diagnosis of acute URTI or acute purulent rhinitis. For this 2013 update we searched CENTRAL 2013, Issue 1, MEDLINE (March 2005 to February week 2, 2013), EMBASE (January 2010 to February 2013), CINAHL (2005 to February 2013), LILACS (2005 to February 2013) and Biosis Previews (2005 to February 2013). Randomised controlled trials (RCTs) comparing any antibiotic therapy against placebo in people with symptoms of acute upper respiratory tract infection for less than seven days, or acute purulent rhinitis less than 10 days in duration. Both review authors independently assessed trial quality and extracted data. This updated review included 11 studies. Six studies contributed to one or more analyses related to the common cold, with up to 1047 participants. Five studies contributed to one or more analyses relating to purulent rhinitis, with up to 791 participants. One study contributed only to data on adverse events and one met the inclusion criteria but reported only summary statistics without providing any numerical data that could be included in the meta-analyses. Interpretation of the combined data is limited because some studies included only children, or only adults, or only males; a wide range of antibiotics were used and outcomes were measured in different ways. There was a moderate risk of bias because of

Estimation of Thermal Sensation Based on Wrist Skin Temperatures.

PubMed

Sim, Soo Young; Koh, Myung Jun; Joo, Kwang Min; Noh, Seungwoo; Park, Sangyun; Kim, Youn Ho; Park, Kwang Suk

2016-03-23

Thermal comfort is an essential environmental factor related to quality of life and work effectiveness. We assessed the feasibility of wrist skin temperature monitoring for estimating subjective thermal sensation. We invented a wrist band that simultaneously monitors skin temperatures from the wrist (i.e., the radial artery and ulnar artery regions, and upper wrist) and the fingertip. Skin temperatures from eight healthy subjects were acquired while thermal sensation varied. To develop a thermal sensation estimation model, the mean skin temperature, temperature gradient, time differential of the temperatures, and average power of frequency band were calculated. A thermal sensation estimation model using temperatures of the fingertip and wrist showed the highest accuracy (mean root mean square error [RMSE]: 1.26 ± 0.31). An estimation model based on the three wrist skin temperatures showed a slightly better result to the model that used a single fingertip skin temperature (mean RMSE: 1.39 ± 0.18). When a personalized thermal sensation estimation model based on three wrist skin temperatures was used, the mean RMSE was 1.06 ± 0.29, and the correlation coefficient was 0.89. Thermal sensation estimation technology based on wrist skin temperatures, and combined with wearable devices may facilitate intelligent control of one's thermal environment.

Estimation of Thermal Sensation Based on Wrist Skin Temperatures

PubMed Central

Sim, Soo Young; Koh, Myung Jun; Joo, Kwang Min; Noh, Seungwoo; Park, Sangyun; Kim, Youn Ho; Park, Kwang Suk

2016-01-01

Thermal comfort is an essential environmental factor related to quality of life and work effectiveness. We assessed the feasibility of wrist skin temperature monitoring for estimating subjective thermal sensation. We invented a wrist band that simultaneously monitors skin temperatures from the wrist (i.e., the radial artery and ulnar artery regions, and upper wrist) and the fingertip. Skin temperatures from eight healthy subjects were acquired while thermal sensation varied. To develop a thermal sensation estimation model, the mean skin temperature, temperature gradient, time differential of the temperatures, and average power of frequency band were calculated. A thermal sensation estimation model using temperatures of the fingertip and wrist showed the highest accuracy (mean root mean square error [RMSE]: 1.26 ± 0.31). An estimation model based on the three wrist skin temperatures showed a slightly better result to the model that used a single fingertip skin temperature (mean RMSE: 1.39 ± 0.18). When a personalized thermal sensation estimation model based on three wrist skin temperatures was used, the mean RMSE was 1.06 ± 0.29, and the correlation coefficient was 0.89. Thermal sensation estimation technology based on wrist skin temperatures, and combined with wearable devices may facilitate intelligent control of one’s thermal environment. PMID:27023538

Playing piano can improve upper extremity function after stroke: case studies.

PubMed

Villeneuve, Myriam; Lamontagne, Anouk

2013-01-01

Music-supported therapy (MST) is an innovative approach that was shown to improve manual dexterity in acute stroke survivors. The feasibility of such intervention in chronic stroke survivors and its longer-term benefits, however, remain unknown. The objective of this pilot study was to estimate the short- and long-term effects of a 3-week piano training program on upper extremity function in persons with chronic stroke. A multiple pre-post sequential design was used, with measurements taken at baseline (week0, week3), prior to (week6) and after the intervention (week9), and at 3-week follow-up (week12). Three persons with stroke participated in the 3-week piano training program that combined structured piano lessons to home practice program. The songs, played on an electronic keyboard, involved all 5 digits of the affected hand and were displayed using a user-friendly MIDI program. After intervention, all the three participants showed improvements in their fine (nine hole peg test) and gross (box and block test) manual dexterity, as well as in the functional use of the upper extremity (Jebsen hand function test). Improvements were maintained at follow-up. These preliminary results support the feasibility of using an MST approach that combines structured lessons to home practice to improve upper extremity function in chronic stroke.

Playing Piano Can Improve Upper Extremity Function after Stroke: Case Studies

PubMed Central

Villeneuve, Myriam; Lamontagne, Anouk

2013-01-01

Music-supported therapy (MST) is an innovative approach that was shown to improve manual dexterity in acute stroke survivors. The feasibility of such intervention in chronic stroke survivors and its longer-term benefits, however, remain unknown. The objective of this pilot study was to estimate the short- and long-term effects of a 3-week piano training program on upper extremity function in persons with chronic stroke. A multiple pre-post sequential design was used, with measurements taken at baseline (week0, week3), prior to (week6) and after the intervention (week9), and at 3-week follow-up (week12). Three persons with stroke participated in the 3-week piano training program that combined structured piano lessons to home practice program. The songs, played on an electronic keyboard, involved all 5 digits of the affected hand and were displayed using a user-friendly MIDI program. After intervention, all the three participants showed improvements in their fine (nine hole peg test) and gross (box and block test) manual dexterity, as well as in the functional use of the upper extremity (Jebsen hand function test). Improvements were maintained at follow-up. These preliminary results support the feasibility of using an MST approach that combines structured lessons to home practice to improve upper extremity function in chronic stroke. PMID:23533954

Micro-Scalable Thermal Control Device

NASA Technical Reports Server (NTRS)

Moran, Matthew E. (Inventor)

2002-01-01

A microscalable thermal control module consists of a Stirling cycle cooler that can be manipulated to operate at a selected temperature within the heating and cooling range of the module. The microscalable thermal control module is particularly suited for controlling the temperature of devices that must be maintained at precise temperatures. It is particularly suited for controlling the temperature of devices that need to be alternately heated or cooled. The module contains upper and lower opposing diaphragms, with a regenerator region containing a plurality of regenerators interposed between the diaphragms. Gaps exist on each side of each diaphragm to permit it to oscillate freely. The gap on the interior side one diaphragm is in fluid connection with the gap on the interior side of the other diaphragm through regenerators. As the diaphragms oscillate working gas is forced through the regenerators. The surface area of each regenerator is sufficiently large to effectively transfer thermal energy to and from the working gas as it is passed through them. The phase and amplitude of the oscillations can be manipulated electronically to control the steady state temperature of the active thermal control surface, and to switch the operation of the module from cooling to heating, or vice versa. The ability of the microscalable thermal control module to heat and cool may be enhanced by operating a plurality of modules in series, in parallel, or in connection through a shared bottom layer.

Purtscher's retinopathy and renal cortical necrosis: two rare vaso-occlusive complications in a patient with acute pancreatitis: a case report.

PubMed

Haque, Wasim Md Mohosin Ul; Ananna, Mehruba Alam; Haque, Hasna Fahmima; Rahim, Muhammad Abdur; Samad, Tabassum; Iqbal, Sarwar

2016-11-15

Purtscher's retinopathy and renal cortical necrosis are two rare vaso-occlusive complications of acute pancreatitis. Purtscher's retinopathy causes sudden impairment of vision, which was first reported in a patient with head trauma. Subsequently, it was also reported as a complication of acute pancreatitis and few other clinical conditions. Acute pancreatitis also rarely causes renal cortical necrosis leading to acute kidney injury. However, the simultaneous presence of both complications is rarely reported. A 20-year-old Bengali man presented to our hospital with a history of acute upper abdominal pain, vomiting, anuria, and disorientation. He was ultimately found to have bilateral complete blindness due to Purtscher's retinopathy and acute kidney injury due to renal cortical necrosis, as sequelae of acute pancreatitis. He became dialysis-dependent, his vision did not recover, and he died 16 months after diagnosis. This case highlights Purtscher's retinopathy and renal cortical necrosis might be considered as a recognized pair complication of acute pancreatitis.

Non-variceal upper gastrointestinal bleeding in cirrhotic patients in Nile Delta.

PubMed

Gabr, Mamdouh Ahmed; Tawfik, Mohamed Abd El-Raouf; El-Sawy, Abd Allah Ahmed

2016-01-01

Acute upper gastrointestinal bleeding (AUGIB) in cirrhotic patients occurs mainly from esophageal and gastric varices; however, quite a large number of cirrhotic patients bleed from other sources as well. The aim of the present work is to determine the prevalence of non-variceal UGIB as well as its different causes among the cirrhotic portal hypertensive patients in Nile Delta. Emergency upper gastrointestinal (UGI) endoscopy for AUGIB was done in 650 patients. Out of these patients, 550 (84.6%) patients who were proved to have cirrhosis were the subject of the present study. From all cirrhotic portal hypertensive patients, 415 (75.5%) bled from variceal sources (esophageal and gastric) while 135 (24.5%) of them bled from non-variceal sources. Among variceal sources of bleeding, esophageal varices were much more common than gastric varices. Peptic ulcer was the most common non-variceal source of bleeding. Non-variceal bleeding in cirrhosis was not frequent, and sources included peptic ulcer, portal hypertensive gastropathy, and erosive disease of the stomach and duodenum.

Dose to organs at risk in the upper abdomen in patients treated with extended fields by helical tomotherapy: a dosimetric and clinical preliminary study

PubMed Central

2013-01-01

Background The aim of this work was to determine the technical feasibility and safety of extended-field radiotherapy (EF), performed by Helical TomoTherapy, in patients with positive pelvic and/or para-aortic nodes. Dosimetric data were collected and acute and sub-acute toxicities of the upper abdominal organs at risk (OAR) were evaluated. Methods Twenty-nine patients suitable for EF irradiation for local disease and/or nodal disease in the pelvic or para-aortic area were treated. The prescription dose was 50.4/54 Gy (1.7-1.8 Gy/fraction) for prophylactic lymph nodes (N-) and 60–70.5 Gy (2–2.35 Gy/fraction) for clinically evident gross disease (N+). Modulation factor (MF), pitch and field width (FW) were chosen to optimize dose distribution and treatment duration. Dose values of PTVs and OAR were analysed. The length of the treatment field, the N + and N- volumes, and treatment duration were reported. To evaluate the safety of treatment, haematological, hepatic, renal and pancreatic functions were assessed before, during and after treatment. The median follow-up time was 17.6 months (range: 6–22 months). Results The treatment was well tolerated and all patients but one completed treatment without interruption. Four of the 29 patients experienced G3 haematological acute toxicity (13.8%), but no patient experienced sub-acute grade G3 toxicity. Ten patients experienced G1 and three G2 acute gastrointestinal toxicity (nausea). No sub-acute gastrointestinal or renal toxicity was observed. Only one (3.7%) patient had a persistent slight increase of pancreatic enzymes and two (7.4%) patients a slight increase of hepatic enzymes six months after radiotherapy (G1 toxicity). Conclusions With our treatment design and dose regimen, we found that EF treatment by TomoTherapy could be safely and effectively delivered with minimal acute and sub-acute toxicities in the upper abdomen area. PMID:24160769

Inconsistent diagnosis of acute malnutrition by weight-for-height and mid-upper arm circumference: contributors in 16 cross-sectional surveys from South Sudan, the Philippines, Chad, and Bangladesh.

PubMed

Roberfroid, Dominique; Huybregts, Lieven; Lachat, Carl; Vrijens, France; Kolsteren, Patrick; Guesdon, Benjamin

2015-08-25

The two anthropometric indicators of acute malnutrition in children under 5 years, i.e. a Mid-Upper Arm Circumference < 125 mm (MUAC125) or a Weight-for-Height Z-score<-2 (WHZ-2), correlate poorly. We aimed at assessing the contribution of age, sex, stunting (Height-for-Age HAZ<-2), and low sitting-standing height ratio Z-score (SSRZ in the 1st tertile of the study population, called hereafter 'longer legs') to this diagnosis discrepancy. Data from 16 cross-sectional nutritional surveys carried out by Action Against Hunger International in South Sudan, the Philippines, Chad, and Bangladesh fed multilevel, multivariate regression models, with either WHZ-2 or MUAC125 as the dependent variable and age, sex, stunting, and 'longer legs' as the independent ones. We also compared how the performance of MUAC125 and WHZ-2 to detect slim children, i.e. children with a low Weight-for-Age (WAZ<-2) but no linear growth retardation (HAZ≥-2), was modified by the contributors. Overall 23.1% of the 14,409 children were identified as acutely malnourished by either WHZ-2 or MUAC125, but only 28.5% of those (949/3,328) were identified by both indicators. Being stunted (+17.8%; 95 % CI: 14.8%; 22.8%), being a female (+16.5%; 95 % CI: 13.5%; 19.5%) and being younger than 24 months (+33.6%; 95 % CI: 30.4%; 36.7%) were factors strongly associated with being detected as malnourished by MUAC125 and not by WHZ-2, whereas having 'longer legs' moderately increased the diagnosis by WHZ-2 (+4.2%; 95 % CI: 0.7%; 7.6%). The sensitivity to detect slim children by MUAC125 was 31.0% (95 % CI: 26.8%; 35.2%) whereas it was 70.6% (95 % CI: 65.4%; 75.9%) for WHZ-2. The sensitivity of MUAC125 was particularly affected by age (57.4% vs. 18.1% in children aged < 24 months vs. ≥ 24 months). Specificity was high for both indicators. MUAC125 should not be used as a stand-alone criterion of acute malnutrition given its strong association with age, sex and stunting, and its low sensitivity to detect slim

Effects of upper mantle heterogeneities on the lithospheric stress field and dynamic topography

NASA Astrophysics Data System (ADS)

Osei Tutu, Anthony; Steinberger, Bernhard; Sobolev, Stephan V.; Rogozhina, Irina; Popov, Anton A.

2018-05-01

The orientation and tectonic regime of the observed crustal/lithospheric stress field contribute to our knowledge of different deformation processes occurring within the Earth's crust and lithosphere. In this study, we analyze the influence of the thermal and density structure of the upper mantle on the lithospheric stress field and topography. We use a 3-D lithosphere-asthenosphere numerical model with power-law rheology, coupled to a spectral mantle flow code at 300 km depth. Our results are validated against the World Stress Map 2016 (WSM2016) and the observation-based residual topography. We derive the upper mantle thermal structure from either a heat flow model combined with a seafloor age model (TM1) or a global S-wave velocity model (TM2). We show that lateral density heterogeneities in the upper 300 km have a limited influence on the modeled horizontal stress field as opposed to the resulting dynamic topography that appears more sensitive to such heterogeneities. The modeled stress field directions, using only the mantle heterogeneities below 300 km, are not perturbed much when the effects of lithosphere and crust above 300 km are added. In contrast, modeled stress magnitudes and dynamic topography are to a greater extent controlled by the upper mantle density structure. After correction for the chemical depletion of continents, the TM2 model leads to a much better fit with the observed residual topography giving a good correlation of 0.51 in continents, but this correction leads to no significant improvement of the fit between the WSM2016 and the resulting lithosphere stresses. In continental regions with abundant heat flow data, TM1 results in relatively small angular misfits. For example, in western Europe the misfit between the modeled and observation-based stress is 18.3°. Our findings emphasize that the relative contributions coming from shallow and deep mantle dynamic forces are quite different for the lithospheric stress field and dynamic

Oncoplastic Surgery for Upper/Upper Inner Quadrant Breast Cancer.

PubMed

Lin, Joseph; Chen, Dar-Ren; Wang, Yu-Fen; Lai, Hung-Wen

2016-01-01

Tumors located in the upper/upper inner quadrant of the breast warrant more attention. A small lesion relative to the size of breast in this location may be resolved by performing a level I oncoplastic technique. However, a wide excision may significantly reduce the overall quality of the breast shape by distorting the visible breast line. From June 2012 to April 2015, 36 patients with breast cancer located in the upper/upper inner quadrant underwent breast-conservation surgery with matrix rotation mammoplasty. According to the size and location of the tumor relative to the nipple-areola complex, 11 patients underwent matrix rotation with periareolar de-epithelialization (donut group) and the other 25 underwent matrix rotation only (non-donut group). The cosmetic results were self-assessed by questionnaires. The average weights of the excised breast lumps in the donut and non-donut groups were 104.1 and 84.5 g, respectively. During the 3-year follow-up period, local recurrence was observed in one case and was managed with nipple-sparing mastectomy followed by breast reconstruction with prosthetic implants. In total, 31 patients (88.6%) ranked their postoperative result as either acceptable or satisfactory. The treated breasts were also self-evaluated by 27 patients (77.1%) to be nearly identical to or just slightly different from the untreated side. Matrix rotation is an easy breast-preserving technique for treating breast cancer located in the upper/upper inner quadrant of the breast that requires a relatively wide excision. With this technique, a larger breast tumor could be removed without compromising the breast appearance.

Aquifer Thermal Energy Storage: An Attempt to Counter Free Thermal Convection

NASA Astrophysics Data System (ADS)

Molz, F. J.; Melville, J. G.; Güven, O.; Parr, A. D.

1983-08-01

In previous Aquifer Thermal Energy Storage (ATES) experiments, appreciable free thermal convection was observed. In an attempt to counter the detrimental effects of convection, a dual recovery well system was constructed at the Mobile site and a third injection-storage-recovery cycle performed. Using a partially penetrating well, cycle 3-3 injection began on April 7, 1982. A total of 56,680 m3 of 79°C water were injected. After 57 days of storage, production began with a dual recovery well system. Due to the dominating effect of nonhomogeneities, the dual well system did not work particularly well, and a recovery factor of 0.42 was achieved. The degree of aquifer heterogeneity at the location of the present experiments was not apparent during previous experiments at a location only 109 m away, although pumping tests indicated similar values of transmissivity. Therefore aquifers with the same transmissivity can behave quite differently in a thermal sense. Heat conduction to the upper aquitard was a major energy loss mechanism. Water sample analyses indicated that there were no important changes in the chemical constituents during the third set of experiments. There was a 19% increase in total dissolved solids. At the end of injection, the land surface near the injection well had risen 1.39 cm with respect to bench marks located 70 m away.

A splenic artery aneurysm presenting with multiple episodes of upper gastrointestinal bleeding: a case report.

PubMed

De Silva, W S L; Gamlaksha, D S; Jayasekara, D P; Rajamanthri, S D

2017-05-03

Splenic artery aneurysm is rare and its diagnosis is challenging due to the nonspecific nature of the clinical presentation. We report a case of a splenic artery aneurysm in which the patient presented with chronic dyspepsia and multiple episodes of minor intragastric bleeding. A 60-year-old, previously healthy Sri Lankan man presented with four episodes of hematemesis and severe dyspeptic symptoms over a period of 6 months. The results of two initial upper gastrointestinal endoscopies and an abdominal ultrasound scan were unremarkable. A third upper gastrointestinal endoscopy detected a pulsatile bulge at the posterior wall of the gastric antrum. A contrast-enhanced computed tomogram of his abdomen detected a splenic artery aneurysm measuring 3 × 3 × 2.5 cm. While awaiting routine surgery, he developed a torrential upper gastrointestinal bleeding and shock, leading to emergency laparotomy. Splenectomy and en bloc resection of the aneurysm with the posterior stomach wall were performed. Histology revealed evidence for a true aneurysm without overt, acute, or chronic inflammation of the surrounding gastric mucosa. He became completely asymptomatic 2 weeks after the surgery. Splenic artery aneurysms can result in recurrent upper gastrointestinal bleeding. The possibility of impending catastrophic bleeding should be remembered when managing patients with splenic artery aneurysms after a minor bleeding. Negative endoscopy and ultrasonography should require contrast-enhanced computed tomography to look for the cause of recurrent upper gastrointestinal bleeding.

Bilateral upper limb trainer with virtual reality for post-stroke rehabilitation: case series report.

PubMed

Sampson, Michael; Shau, Yio-Wha; King, Marcus James

2012-01-01

Stroke is a leading cause of disability with many survivors having upper limb (UL) hemiparesis. UL rehabilitation using bilateral exercise enhances outcomes and the Bilateral Upper Limb Trainer (BUiLT) was developed to provide symmetrical, bilateral arm exercise in a 'forced' and self-assistive manner, incorporating virtual reality (VR) to provide direction and task specificity to users as well as action observation-execution and greater motivation to exercise. The BUiLT + VR system was trialled on five post-stroke participants with UL hemiparesis: one sub-acute and four chronic. The intervention was supplied for 45 min, 4 days/week for 6 weeks. The Fugl-Meyer Upper Extremity score (FMA-UE) was used as the primary outcome measure. Secondary outcome measures used were UL isometric strength and the Intrinsic Motivation Inventory (IMI) questionnaire. The BUiLT + VR therapy increased FMA-UE scores from 1 to 5 and overall strength in the shoulder and elbow. Motivation at the end of intervention was positive. Therapy using the BUiLT + VR system is reliable, can be administered safely and has a positive trend of benefit as measured by the FMA-UE, isometric strength testing and IMI questionnaire.

Sex, stress and sleep apnoea: Decreased susceptibility to upper airway muscle dysfunction following intermittent hypoxia in females.

PubMed

O'Halloran, Ken D; Lewis, Philip; McDonald, Fiona

2017-11-01

Obstructive sleep apnoea syndrome (OSAS) is a devastating respiratory control disorder more common in men than women. The reasons for the sex difference in prevalence are multifactorial, but are partly attributable to protective effects of oestrogen. Indeed, OSAS prevalence increases in post-menopausal women. OSAS is characterized by repeated occlusions of the pharyngeal airway during sleep. Dysfunction of the upper airway muscles controlling airway calibre and collapsibility is implicated in the pathophysiology of OSAS, and sex differences in the neuro-mechanical control of upper airway patency are described. It is widely recognized that chronic intermittent hypoxia (CIH), a cardinal feature of OSAS due to recurrent apnoea, drives many of the morbid consequences characteristic of the disorder. In rodents, exposure to CIH-related redox stress causes upper airway muscle weakness and fatigue, associated with mitochondrial dysfunction. Of interest, in adults, there is female resilience to CIH-induced muscle dysfunction. Conversely, exposure to CIH in early life, results in upper airway muscle weakness equivalent between the two sexes at 3 and 6 weeks of age. Ovariectomy exacerbates the deleterious effects of exposure to CIH in adult female upper airway muscle, an effect partially restored by oestrogen replacement therapy. Intriguingly, female advantage intrinsic to upper airway muscle exists with evidence of substantially greater loss of performance in male muscle during acute exposure to severe hypoxic stress. Sex differences in upper airway muscle physiology may have relevance to human OSAS. The oestrogen-oestrogen receptor α axis represents a potential therapeutic target in OSAS, particularly in post-menopausal women. Copyright © 2016 Elsevier B.V. All rights reserved.

Endoscopic management of acute peptic ulcer bleeding.

PubMed

Lu, Yidan; Chen, Yen-I; Barkun, Alan

2014-12-01

This review discusses the indications, technical aspects, and comparative effectiveness of the endoscopic treatment of upper gastrointestinal bleeding caused by peptic ulcer. Pre-endoscopic considerations, such as the use of prokinetics and timing of endoscopy, are reviewed. In addition, this article examines aspects of postendoscopic care such as the effectiveness, dosing, and duration of postendoscopic proton-pump inhibitors, Helicobacter pylori testing, and benefits of treatment in terms of preventing rebleeding; and the use of nonsteroidal anti-inflammatory drugs, antiplatelet agents, and oral anticoagulants, including direct thrombin and Xa inhibitors, following acute peptic ulcer bleeding. Copyright © 2014 Elsevier Inc. All rights reserved.

Thermally-Induced Structural Disturbances of Rigid Panel Solar Arrays

NASA Technical Reports Server (NTRS)

Johnston, John D.; Thornton, Earl A.

1997-01-01

The performance of a significant number of spacecraft has been impacted negatively by attitude disturbances resulting from thermally-induced motions of flexible structures. Recent examples of spacecraft affected by these disturbances include the Hubble Space Telescope (HST) and the Upper Atmosphere Research Satellite (UARS). Thermally-induced structural disturbances occur as the result of rapid changes in thermal loading typically initiated as a satellite exits or enters the Earth's shadow. Temperature differences in flexible appendages give rise to structural deformations, which in turn result in disturbance torques reacting back on the spacecraft. Structures which have proven susceptible to these disturbances include deployable booms and solar arrays. This paper investigates disturbances resulting from thermally-induced deformations of rigid panel solar arrays. An analytical model for the thermal-structural response of the solar array and the corresponding disturbance torque are presented. The effect of these disturbances on the attitude dynamics of a simple spacecraft is then investigated using a coupled system of governing equations which includes the effects of thermally-induced deformations. Numerical results demonstrate the effect of varying solar array geometry on the dynamic response of the system.

Effects of low-frequency repetitive transcranial magnetic stimulation and neuromuscular electrical stimulation on upper extremity motor recovery in the early period after stroke: a preliminary study.

PubMed

Tosun, Aliye; Türe, Sabiha; Askin, Ayhan; Yardimci, Engin Ugur; Demirdal, Secil Umit; Kurt Incesu, Tülay; Tosun, Ozgur; Kocyigit, Hikmet; Akhan, Galip; Gelal, Fazıl Mustafa

2017-07-01

To assess the efficacy of inhibitory repetitive transcranial magnetic stimulation (rTMS) and neuromuscular electrical stimulation (NMES) on upper extremity motor function in patients with acute/subacute ischemic stroke. Twenty-five ischemic acute/subacute stroke subjects were enrolled in this randomized controlled trial. Experimental group 1 received low frequency (LF) rTMS to the primary motor cortex of the unaffected side + physical therapy (PT) including activities to improve strength, flexibility, transfers, posture, balance, coordination, and activities of daily living, mainly focusing on upper limb movements; experimental group 2 received the same protocol combined with NMES to hand extensor muscles; and the control group received only PT. Functional magnetic resonance imaging (fMRI) scan was used to evaluate the activation or inhibition of the affected and unaffected primary motor cortex. No adverse effect was reported. Most of the clinical outcome scores improved significantly in all groups, however no statistically significant difference was found between groups due to the small sample sizes. The highest percent improvement scores were observed in TMS + NMES group (varying between 48 and 99.3%) and the lowest scores in control group (varying between 13.1 and 28.1%). Hand motor recovery was significant in both experimental groups while it did not change in control group. Some motor cortex excitability changes were also observed in fMRI. LF-rTMS with or without NMES seems to facilitate the motor recovery in the paretic hand of patients with acute/subacute ischemic stroke. TMS or the combination of TMS + NMES may be a promising additional therapy in upper limb motor training. Further studies with larger numbers of patients are needed to establish their effectiveness in upper limb motor rehabilitation of stroke.

Upper mantle P velocity structure beneath the Baikal Rift from modeling regional seismic data

NASA Astrophysics Data System (ADS)

Brazier, Richard A.; Nyblade, Andrew A.

2003-02-01

Uppermost mantle P wave velocity structure beneath the Baikal rift and southern margin of the Siberian Platform has been investigated by using a grid search method to model Pnl waveforms from two moderate earthquakes recorded by station TLY at the southwestern end of Lake Baikal. The results yielded a limited number of successful models which indicate the presence of upper mantle P wave velocities beneath the rift axis and the margin of the platform that are 2-5% lower than expected. The magnitude of the velocity anomalies and their location support the presence of a thermal anomaly that extends laterally beyond the rift proper, possibly created by small-scale convection or a plume-like, thermal upwelling.

Numerical modeling of the autumnal thermal bar

NASA Astrophysics Data System (ADS)

Tsydenov, Bair O.

2018-03-01

The autumnal riverine thermal bar of Kamloops Lake has been simulated using atmospheric data from December 1, 2015, to January 4, 2016. The nonhydrostatic 2.5D mathematical model developed takes into account the diurnal variability of the heat fluxes and wind on the lake surface. The average values for shortwave and longwave radiation and latent and sensible heat fluxes were 19.7 W/m2, - 95.9 W/m2, - 11.8 W/m2, and - 32.0 W/m2 respectively. Analysis of the wind regime data showed prevailing easterly winds and maximum speed of 11 m/s on the 8th and 19th days. Numerical experiments with different boundary conditions at the lake surface were conducted to evaluate effects of variable heat flux and wind stress. The results of modeling demonstrated that the variable heat flux affects the process of thermal bar evolution, especially during the lengthy night cooling. However, the wind had the greatest impact on the behavior of the autumnal thermal bar: The easterly winds contributed to an earlier appearance of the thermal bar, but the strong winds generating the intensive circulations (the velocity of the upper lake flow increased to 6 cm/s) may destroy the thermal bar front.

Thermal re-design of the Galileo spacecraft for a Venus-earth-earth-gravity assist (VEEGA) trajectory

NASA Technical Reports Server (NTRS)

Reeve, R.

1989-01-01

The cancellation of the Centaur upper stage program in the aftermath of the Challenger tragedy forced a redesign of the flight trajectory of the Galileo spacecraft to Jupiter, i.e., from a direct trajectory to the Venus-earth-earth-gravity-assist (VEEGA) trajectory on the lower energy two-stage inertial upper stage (IUS), with the result that the spacecraft would be exposed to more than twofold increase in peak solar irradiance. This paper describes the general system-level thermal redesign effort for the Galileo spacecraft, from the start of feasibility studies to its final implementation. Results indicate that the addition of sunshades and the generous utilization of second-surface aluminized Kapton surface material for reflecting high percentages of incident solar irradiation would 'harden' the spacecraft's existing thermal protection system adequately, provided that sun-pointing at the relatively higher solar irradiance levels could be maintained. The final miximum flight temperature predictions for the spacecraft's subsystem thermal designs are given.

Rapid laboratory investigation of the thermal properties of planetary analogues by using the EXTASE thermal probe.

NASA Astrophysics Data System (ADS)

Nadalini, R.; Extase Team

The thermal properties of the constituent materials of the upper meters of planets and planetary bodies are of extreme interest. During the design and the verification of various planetary missions, the need to model and test appropriate simulants in laboratory is often raised. To verify the thermal properties of deployed laboratory simulants, the EXTASE thermal probe is a fast, precise, and easy-to-use tool. EXTASE is a thermal profile probe, able to measure the temperature and inject heat into the selected material at 16 different locations along its 45cm long slender cylindrical body. It has been developed following the experience of MUPUS, with the purpose of observing such properties on Earth, in situ and in a short time. We have used EXTASE, under laboratory cold and standard conditions, on several sand mixtures, soils, granular and compact ices, under vacuum and at normal pressure levels, to collect a great number of time- and depth-dependent temperature curves that represent the thermal dynamical response of the material. At the same time, two independent models have been developed to verify the experimental results by reaching the same results with a simulation of the same process. The models, analytical and numerical, which account for all material parameters (conductivity, density, capacity), have been developed and fine tuned until their results are superposed to the experimental curves, thus allowing the determination of the distinct thermal properties. In addition, a test campaign is under planning to use EXTASE to determine, rapidly and efficiently, the thermal properties of various regolith simulants to be used in the simulation of planetary subsurface processes.

Thermal Impact of Medium Deep Borehole Thermal Energy Storage on the Shallow Subsurface

NASA Astrophysics Data System (ADS)

Welsch, Bastian; Schulte, Daniel O.; Rühaak, Wolfram; Bär, Kristian; Sass, Ingo

2017-04-01

Borehole heat exchanger arrays are a well-suited and already widely applied method for exploiting the shallow subsurface as seasonal heat storage. However, in most of the populated regions the shallow subsurface also comprises an important aquifer system used for drinking water production. Thus, the operation of shallow geothermal heat storage systems leads to a significant increase in groundwater temperatures in the proximity of the borehole heat exchanger array. The magnitude of the impact on groundwater quality and microbiology associated with this temperature rise is controversially discussed. Nevertheless, the protection of shallow groundwater resources has priority. Accordingly, water authorities often follow restrictive permission policies for building such storage systems. An alternative approach to avoid this issue is the application of medium deep borehole heat exchanger arrays instead of shallow ones. The thermal impact on shallow aquifers can be significantly reduced as heat is stored at larger depth. Moreover, it can be further diminished by the installation of a thermally insulating materials in the upper section of the borehole heat exchangers. Based on a numerical simulation study, the advantageous effects of medium deep borehole thermal energy storage are demonstrated and quantified. A finite element software is used to model the heat transport in the subsurface in 3D, while the heat transport in the borehole heat exchangers is solved analytically in 1D. For this purpose, an extended analytical solution is implemented, which also allows for the consideration of a thermally insulating borehole section.

Evaluating the behaviour of different thermal indices by investigating various outdoor urban environments in the hot dry city of Damascus, Syria

NASA Astrophysics Data System (ADS)

Yahia, Moohammed Wasim; Johansson, Erik

2013-07-01

Consideration of urban microclimate and thermal comfort is an absolute neccessity in urban development, and a set of guidelines for every type of climate must be elaborated. However, to develop guidelines, thermal comfort ranges need to be defined. The aim of this study was to evaluate the behaviour of different thermal indices by investigating different thermal environments in Damascus during summer and winter. A second aim was to define the lower and upper limits of the thermal comfort range for some of these indices. The study was based on comprehensive micrometeorological measurements combined with questionnaires. It was found that the thermal conditions of different outdoor environments vary considerably. In general, Old Damascus, with its deep canyons, is more comfortable in summer than modern Damascus where there is a lack of shade. Conversely, residential areas and parks in modern Damascus are more comfortable in winter due to more solar access. The neutral temperatures of both the physiologically equivalent temperature (PET) and the outdoor standard effective temperature (OUT_SET*) were found to be lower in summer than in winter. At 80 % acceptability, the study defined the lower comfort limit in winter to 21.0 °C and the upper limit in summer to 31.3 °C for PET. For OUT_SET*, the corresponding lower and upper limits were 27.6 °C and 31.3 °C respectively. OUT_SET* showed a better correlation with the thermal sensation votes than PET. The study also highlighted the influence of culture and traditions on people's clothing as well as the influence of air conditioning on physical adaptation.

Emergency percutaneous tracheostomy in a severely burned patient with upper airway obstruction and circulatory arrest.

PubMed

Schlossmacher, Pascal; Martinet, Olivier; Testud, Richard; Agesilas, Fabrice; Benhamou, Léon; Gauzëre, Bernard Alex

2006-02-01

We report the life-saving use of Griggs percutaneous tracheostomy in an arrested patient with complex upper airway obstruction, as a result of burns, smoke injuries and iterative tracheal intubation attempts. The technique was performed blindly at bedside to treat an acute episode of failed ventilation and intubation and cardiac arrest in a patient with altered neck anatomy. The intervention salvaged the situation, leaving a definitive airway. The feasibility of using an emergency Griggs percutaneous tracheostomy versus cricothyroidotomy is suggested in selected cases.

The burden of acute respiratory infections in Ecuador 2011-2015.

PubMed

Chicaiza-Ayala, Wilson; Henríquez-Trujillo, Aquiles R; Ortiz-Prado, Esteban; Douce, Richard W; Coral-Almeida, Marco

2018-01-01

Burden of disease studies intend to improve public health decision-making and to measure social and economic impact in population. The objective of this study was to describe the burden of acute respiratory infections (ARI) in Ecuador between 2011 and 2015. Five-year period morbidity and mortality data available from national agencies of statistics was analyzed to estimate the burden of disease attributable to acute respiratory infections. Cases and deaths registered were grouped according to their ICD-10 code into three diagnostic groups: Acute upper respiratory infections (J00-J06), Influenza and pneumonia (J09-J18), and Bronchitis and other acute lower respiratory infections (J20-J22, J85, J86). Disability-adjusted life years stratified by diagnostic and age group were calculated using the "DALY" package for R. The productivity loss in monetary terms was estimated using the human capital method. Over the 5-year period studied there were a total of 14.84 million cases of acute respiratory infections, with 17 757 deaths reported (0.12%). The yearly burden of disease ranged between 98 944 to 118 651 disability-adjusted life years, with an estimated average loss of productivity of US$152.16 million (±19.6) per year. Approximately 99% of the burden can be attributed to years life lost due to premature mortality in population under 5 years old and over 60 years-old. The burden of acute respiratory infections remained steady during the analyzed period. Evidence-based prevention and control policies to tackle acute respiratory infections in Ecuador should focus on the population at extreme ages of life.

The burden of acute respiratory infections in Ecuador 2011-2015

PubMed Central

2018-01-01

Background Burden of disease studies intend to improve public health decision-making and to measure social and economic impact in population. The objective of this study was to describe the burden of acute respiratory infections (ARI) in Ecuador between 2011 and 2015. Methods Five-year period morbidity and mortality data available from national agencies of statistics was analyzed to estimate the burden of disease attributable to acute respiratory infections. Cases and deaths registered were grouped according to their ICD-10 code into three diagnostic groups: Acute upper respiratory infections (J00-J06), Influenza and pneumonia (J09-J18), and Bronchitis and other acute lower respiratory infections (J20-J22, J85, J86). Disability-adjusted life years stratified by diagnostic and age group were calculated using the “DALY” package for R. The productivity loss in monetary terms was estimated using the human capital method. Results Over the 5-year period studied there were a total of 14.84 million cases of acute respiratory infections, with 17 757 deaths reported (0.12%). The yearly burden of disease ranged between 98 944 to 118 651 disability-adjusted life years, with an estimated average loss of productivity of US$152.16 million (±19.6) per year. Approximately 99% of the burden can be attributed to years life lost due to premature mortality in population under 5 years old and over 60 years-old. Conclusions The burden of acute respiratory infections remained steady during the analyzed period. Evidence-based prevention and control policies to tackle acute respiratory infections in Ecuador should focus on the population at extreme ages of life. PMID:29715314

Effects of variable thermal diffusivity on the structure of convection

NASA Astrophysics Data System (ADS)

Shcheritsa, O. V.; Getling, A. V.; Mazhorova, O. S.

2018-03-01

The structure of multiscale convection in a thermally stratified plane horizontal fluid layer is investigated by means of numerical simulations. The thermal diffusivity is assumed to produce a thin boundary sublayer convectively much more unstable than the bulk of the layer. The simulated flow is a superposition of cellular structures with three different characteristic scales. In contrast to the largest convection cells, the smaller ones are localised in the upper portion of the layer. The smallest cells are advected by the larger-scale convective flows. The simulated flow pattern qualitatively resembles that observed on the Sun.

The microwave limb sounder for the Upper Atmosphere Research Satellite

NASA Technical Reports Server (NTRS)

Waters, J. W.; Peckham, G. E.; Suttie, R. A.; Curtis, P. D.; Maddison, B. J.; Harwood, R. S.

1988-01-01

The Microwave Limb Sounder was designed to map the concentrations of trace gases from the stratosphere to the lower thermosphere, to improve understanding of the photochemical reactions which take place in this part of the atmosphere. The instrument will measure the intensity of thermal radiation from molecules in the atmosphere at frequencies corresponding to rotational absorption bands of chlorine monoxide, ozone, and water vapor. Molecular concentration profiles will be determined over a height range of 15 to 80 km (20 to 45 km for C10). The 57 deg inclination orbit proposed for the Upper Atmosphere Research Satellite will allow global coverage.

Demographic and clinical profiles in patients with acute urticaria.

PubMed

Sánchez-Borges, M; Capriles-Hulett, A; Caballero-Fonseca, F

2015-01-01

Urticaria is a common cause for consultation in general and specialised medical practices. There is scarce information on the characteristics of patients suffering acute urticaria in Latin America. To investigate demographic and clinical features of patients with acute urticaria attending two allergy clinics in Caracas, Venezuela. A prospective study of all new patients who consulted during a three-year period because of acute urticaria. Information on age, gender, symptom duration, previous medical history, body distribution of wheals and angio-oedema, laboratory investigations, skin prick tests, and pharmacological treatment, was collected. Patients were classified according to their age as children/adolescents and adults. Two hundred and forty eight patients (177 adults and 71 children) were studied. Acute urticaria was more frequent in middle-aged atopic female patients. Lesions more often involved upper and lower limbs and head, and 31% of patients exhibited generalised urticaria. Laboratory investigations, performed only in selected cases, did not contribute to the final diagnosis. Most frequent subtypes of acute urticaria were spontaneous, dermographic, papular, and drug-induced urticaria. Most patients were treated with non-sedating antihistamines, with increased use of cetirizine and levocetirizine in children, while 5.6% of children and 20.3% of adults required the addition of short courses of systemic corticosteroids. Acute urticaria is a frequent cause of consultation for allergists, affecting more often middle-aged female atopic patients. The use of extensive complementary tests does not seem to be cost-effective for this clinical condition. Spontaneous, dermographic, papular and drug-induced urticaria are the most common subtypes. Copyright © 2014 SEICAP. Published by Elsevier Espana. All rights reserved.

Polar Maps of Thermal and Epithermal Neutrons

NASA Technical Reports Server (NTRS)

2002-01-01

Observations by NASA's 2001 Mars Odyssey spacecraft show views of the polar regions of Mars in thermal neutrons (top) and epithermal neutrons (bottom). In these maps, deep blue indicates a low amount of neutrons, and red indicates a high amount. Thermal neutrons are sensitive to the presence of hydrogen and the presence of carbon dioxide, in this case 'dry ice' frost. The red area in the upper right map indicates that about one meter (three feet) of carbon dioxide frost covers the surface around the north pole, as it does every Mars winter in the polar regions. An enhancement of thermal neutrons close to the south pole, seen as a light green color on the upper left map, indicates the presence of residual carbon dioxide in the south polar cap, even though the annual frost dissipated from that region during southern summer. Soil enriched with hydrogen is indicated by the deep blue colors on the epithermal maps (bottom), showing a low intensity of epithermal neutrons. The deep blue areas in the polar regions are believed to contain up to 50 percent water ice in the upper one meter (three feet) of the soil. The views shown here are of measurements made during the first three months of mapping using the neutron spectrometer instrument, part of the gamma ray spectrometer instrument suite. Topographic features are superimposed on the map for geographic reference.

NASA's Jet Propulsion Laboratory manages the 2001 Mars Odyssey mission for NASA's Office of Space Science, Washington, D.C. Investigators at Arizona State University in Tempe, the University of Arizona in Tucson, and NASA's Johnson Space Center, Houston, operate the science instruments. The gamma-ray spectrometer was provided by the University of Arizona in collaboration with the Russian Aviation and Space Agency, which provided the high-energy neutron detector, and the Los Alamos National Laboratories, New Mexico, which provided the neutron spectrometer. Lockheed Martin Astronautics, Denver, is the prime

Acute Myocardial Infarction Risk in Patients with Coronary Artery Disease Doubled after Upper Gastrointestinal Tract Bleeding: A Nationwide Nested Case-Control Study.

PubMed

Wu, Chia-Jung; Lin, Hung-Jung; Weng, Shih-Feng; Hsu, Chien-Chin; Wang, Jhi-Joung; Su, Shih-Bin; Huang, Chien-Cheng; Guo, How-Ran

2015-01-01

Prior studies of upper gastrointestinal bleeding (UGIB) and acute myocardial infarction (AMI) are small, and long-term effects of UGIB on AMI have not been delineated. We investigated whether UGIB in patients diagnosed with coronary artery disease (CAD) increased their risk of subsequent AMI. This was a population-based, nested case-control study using Taiwan's National Health Insurance Research Database. After propensity-score matching for age, gender, comorbidities, CAD date, and follow-up duration, we identified 1,677 new-onset CAD patients with AMI (AMI[+]) between 2001 and 2006 as the case group and 10,062 new-onset CAD patients without (AMI[-]) as the control group. Conditional logistic regression was used to examine the association between UGIB and AMI. Compared with UGIB[-] patients, UGIB[+] patients had twice the risk for subsequent AMI (adjusted odds ratio [AOR] = 2.08; 95% confidence interval [CI], 1.72-2.50). In the subgroup analysis for gender and age, UGIB[+] women (AOR = 2.70; 95% CI, 2.03-3.57) and patients < 65 years old (AOR = 2.23; 95% CI, 1.56-3.18) had higher odds of an AMI. UGIB[+] AMI[+] patients used nonsignificantly less aspirin than did UGIB[-] AMI[+] patients (27.69% vs. 35.61%, respectively). UGIB increased the risk of subsequent AMI in CAD patients, especially in women and patients < 65. This suggests that physicians need to use earlier and more aggressive intervention to detect UGIB and prevent AMI in CAD patients.

Prospective, randomized comparison of 3 different hemoclips for the treatment of acute upper GI hemorrhage in an established experimental setting.

PubMed

Kato, Masayuki; Jung, Yunho; Gromski, Mark A; Chuttani, Ram; Matthes, Kai

2012-01-01

Recently, endoscopic clip application devices have undergone redesign and improvements to optimize their clinical use and effectiveness. Initially designed for the treatment of bleeding nonvariceal lesions, these devices are also increasingly used for the closure of perforations, fistulas, and anastomotic leaks. Several clinical studies, both randomized and nonrandomized, have used endoscopic hemoclips for hemostasis. However, no comparative studies have yet been reported in the literature comparing the latest endoscopic clip devices for usability and effectiveness for hemostasis of acute upper GI hemorrhage. We aimed to compare the usability and efficacy of 3 different types of endoscopic clip application devices in an established experimental setting by using a porcine ex-vivo simulator of upper GI hemorrhage. Randomized, controlled, ex-vivo study. Academic medical center. Spurting vessels were created within ex-vivo porcine stomachs as published in prior studies. The vessels were attached to a pressure transducer to record the pressure of the circulating blood replacement. Before the initiation of bleeding, each vessel was randomized to 1 of 3 endoscopic clipping devices: 2 different commonly used hemoclips deployed through the working channel and 1 novel clip deployed via an over-the-scope applications device. Two investigators treated 45 bleeding sites (15 bleeding sites for each device at various randomized locations in the stomach: fundus, body, and antrum). Usability was measured via the endpoints of procedure time and quantity of clips required to achieve hemostasis. Efficacy was measured via the endpoint of pressure increase (Δp) from baseline to after treatment. All of the 45 hemostasis treatments were carried out successfully. The mean procedure times were significantly different among the hemoclips, with the clip deployed in an over-the-scope fashion requiring significantly less time to attain hemostasis compared with the other 2 clips. For number of

ACUTE CHOLECYSTITIS AS AN UNUSUAL PRESENTATION OF SCRUB TYPHUS: A REPORT OF TWO CASES AND REVIEW OF THE LITERATURE.

PubMed