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Sample records for ad4bp includes severe

  1. Transgenic Expression of Ad4BP/SF-1 in Fetal Adrenal Progenitor Cells Leads to Ectopic Adrenal Formation

    PubMed Central

    Zubair, Mohamad; Oka, Sanae; Parker, Keith L.; Morohashi, Ken-ichirou

    2009-01-01

    Deficiency of adrenal 4 binding protein/steroidogenic factor 1 (Ad4BP/SF-1; NR5A1) impairs adrenal development in a dose-dependent manner, whereas overexpression of Ad4BP/SF-1 is associated with adrenocortical tumorigenesis. Despite its essential roles in adrenal development, the mechanism(s) by which Ad4BP/SF-1 regulates this process remain incompletely understood. We previously identified a fetal adrenal enhancer (FAdE) that stimulates Ad4BP/SF-1 expression in the fetal adrenal gland by a two-step mechanism in which homeobox proteins initiate Ad4BP/SF-1 expression, which then maintains FAdE activity in an autoregulatory loop. In the present study, we examined the effect of transgenic expression of Ad4BP/SF-1 controlled by FAdE on adrenal development. When Ad4BP/SF-1 was overexpressed using a FAdE-Ad4BP/SF-1 transgene, FAdE activity expanded outside of its normal field, resulting in increased adrenal size and the formation of ectopic adrenal tissue in the thorax. The increased size of the adrenal gland did not result from a corresponding increase in cell proliferation, suggesting rather that the increased levels of Ad4BP/SF-1 may divert uncommitted precursors to the steroidogenic lineage. The effects of FAdE-controlled Ad4BP/SF-1 overexpression in mice provide a novel model of ectopic adrenal formation that further supports the critical role of Ad4BP/SF-1 in the determination of steroidogenic cell fate in vivo. PMID:19628584

  2. Expression of 3β-hydroxysteroid dehydrogenase (hsd3b), star and ad4bp/sf-1 during gonadal development in medaka (Oryzias latipes).

    PubMed

    Nakamoto, Masatoshi; Fukasawa, Motoaki; Tanaka, Satomi; Shimamori, Kazusuke; Suzuki, Aya; Matsuda, Masaru; Kobayashi, Tohru; Nagahama, Yoshitaka; Shibata, Naoki

    2012-04-01

    In most vertebrates, sex steroids play a critical role in gonadal development, maturation of germ cells, and development of secondary sexual characteristics. Sex steroids are synthesized in steroid-producing cells (SPCs) in the testis known as Leydig cells, as well as in thecal and granulosa cells in the ovary. In SPCs, cholesterol is sequentially catalyzed by a set of steroidogenic factors and enzymes in order to produce sex steroids. Therefore, integrated expression of the genes involved in steroidogenesis is critical for the proper production of sex steroids. In the present study, regulatory mechanisms of steroidogenic factors and enzymes were examined. We focused on hsd3b, star and ad4bp/sf-1 as well as the description of temporal and spatial expression of these genes during gonadal development in medaka (Oryzias latipes). During testicular development, hsd3b, star and ad4bp/sf-1 were co-expressed in the interstitial somatic cells subsequent to the formation of the seminiferous tubule precursor, suggesting that ad4bp/sf-1 regulated the transcription of both hsd3b and star. During ovarian development, the expression pattern of hsd3b coincided with that of cyp11a1, but not with that of aromatase. Although ad4bp/sf-1 was mainly expressed in presumptive follicular cells, it was also detected in hsd3b positive interstitial cells in the developing ovary. Contrary to our expectations, the onset of star expression occurred during a later stage of ovarian development than the expression of other steroidogenic enzymes. Thus, the regulation mechanism of star transcription appears to differ from that of the other steroidogenic enzymes in the developing ovary, but not in the developing testis.

  3. A boundary for histone acetylation allows distinct expression patterns of the Ad4BP/SF-1 and GCNF loci in adrenal cortex cells

    SciTech Connect

    Ishihara, Satoru L.; Morohashi, Ken-ichirou . E-mail: moro@nibb.ac.jp

    2005-04-08

    Ad4BP/SF-1 is a nuclear receptor whose expression is restricted to tissues involved in steroid hormone synthesis such as the adrenal cortex and gonads. Recent sequence data analysis has shown that the Ad4BP/SF-1 gene is located only 13 kb downstream of the last exon of the neighboring GCNF gene that is expressed in some neurons and gonadal germ cells. Despite the close proximity of the two genes, regulatory elements from one do not interfere with the transcription of the neighboring gene, resulting in distinct expression patterns of Ad4BP/SF-1 and GCNF. This observation has led to the prediction that an insulator element must exist between the two loci to establish independent transcription units. We performed DNase I hypersensitivity assays on the adrenal cortex cell line, Y-1, to test for the existence of an insulator. Three hypersensitive sites were identified in the region spanning 2.1 kb between the last exon of GCNF and the first exon of Ad4BP/SF-1. The most upstream site contains a binding site for CTCF, a known insulator protein, while the other sites are predicted to associate with the nuclear matrix. Chromatin immunoprecipitation analysis using anti-acetylated histone H3 and H4 antibodies showed a discontinuous pattern of histone H3 and H4 acetylation upstream of these sites. Our data suggest that the chromatin architecture specialized by CTCF and the nuclear matrix contribute to the distinct pattern of transcriptional regulation of these genes.

  4. Analysis of DAX1 (NR0B1) and steroidogenic factor-1 (SF1/Ad4BP, NR5A1) in children and adults with primary adrenal failure: ten years' experience

    PubMed Central

    Lin, Lin; Gu, Wen-Xia; Ozisik, Gokhan; To, Wing S.; Owen, Catherine J.; Jameson, J. Larry; Achermann, John C.

    2007-01-01

    Context Primary adrenal failure is a life-threatening condition that can be caused by a range of etiologies, including autoimmune, metabolic, and developmental disorders. The nuclear receptors DAX1 (NR0B1) and steroidogenic factor-1 (SF1/Ad4BP, NR5A1) play an important role in adrenal development and function, and mutations in these transcription factors have been found in patients with adrenal hypoplasia. Objective To investigate the prevalence of DAX1 and SF1 mutations in children and adults with primary adrenal failure of unknown etiology (i.e., not caused by congenital adrenal hyperplasia, adrenoleukodystrophy, autoimmune disease). Patients One-hundred and seventeen patients were included. Eighty-eight individuals presented in infancy or childhood with adrenal hypoplasia or primary adrenal failure of unknown etiology (n=64, 46,XY phenotypic males; n=17, 46,XY gonadal dysgenesis/impaired androgenization; n=7, 46,XX females). Twenty-nine individuals presented in adulthood with “Addison disease” of unknown etiology. Methods Mutational analysis of DAX1 (NR0B1) (including exon 2α/1A) and SF1 (NR5A1) by direct sequencing. Results DAX1 mutations were found in 58% (37/64) of 46,XY phenotypic boys referred with adrenal hypoplasia, and in all boys (8/8) with hypogonadotropic hypogonadism and a family history suggestive of adrenal failure in males. SF1 mutations causing adrenal failure were found only in two patients with 46,XY gonadal dysgenesis. No DAX1 or SF1 mutations were identified in the adult-onset group. Conclusions DAX1 mutations are a relatively frequent cause of adrenal failure in this group of boys. SF1 mutations causing adrenal failure in humans are rare and are more likely to be associated with significant underandrogenization and gonadal dysfunction in 46,XY individuals. PMID:16684822

  5. Drugs (including oxygen) in severe COPD.

    PubMed

    Albert, P; Calverley, P M A

    2008-05-01

    Access to comprehensive guidelines on the management of chronic obstructive pulmonary disease (COPD) is now available, and several treatment goals of therapy have been identified from these guidelines, which have since been studied in clinical trials. Drug therapy is a key component of an individual patient's management plan, particularly in more severe disease. During the past few years, a number of new drug treatments have become available, although these are not always appropriately prescribed; this is particularly the case for oxygen. For patients with a history of exacerbations, there is good evidence for the use of inhaled long-acting anticholinergic agents or combined inhaled steroids and long-acting beta-agonists. Evidence for prophylactic antibiotics and antioxidant agents is lacking. Nutritional and calorie supplementation have not been shown to improve exercise capacity. Statins may improve outcomes in COPD, but prospective trials are needed to confirm this. The evidence for the use of long-term oxygen therapy in hypoxaemic patients is robust. Ambulatory oxygen improves exercise capacity, but whether it is used appropriately is in doubt. Overall, short burst oxygen therapy does not offer a benefit and therefore cannot be recommended.

  6. Long term results after multiple injuries including severe head injury.

    PubMed

    Lehmann, U; Pape, H C; Seekamp, A; Gobiet, W; Zech, S; Winny, M; Molitoris, U; Regel, G

    1999-12-01

    To describe the long term results in patients with multiple injuries including severe head injury. Retrospective and prospective clinical study. Level I trauma centre, Germany. Patients aged 16-60 years who had been injured more than 2 years before, whose Injury Severity Score was over 20 and whose cranial Abbreviated Injury Score (AIS) was over 3. Glasgow Outcome Scale (GOS), functional, neuropsychological, vocational and social outcomes. 58 patients, median age 24 (range 16-53, interquartile range (IQR) 21-32) years were investigated 5 (3-9; IQR 4-7) years after their injury. Median ISS was 34 (21-57; IQR 26-41) and GCS 6 (3-8; IQR 4-7). Duration of coma was 10 (2-51; IQR 7-22) days and neurological rehabilitation lasted 169 (10-830; IQR 80-300) days. Movements of the elbow and ankle was most impaired by injury. All psychometric tests showed deficits, particularly in speed of processing, concentration, recent memory, and learning performance. The social environment had been changed in half and vocational rehabilitation was dependent on age. 24 (42%) returned to their former profession, 18 (31%) were retrained to another profession, 16 (27%) were unemployed or retired on a pension. 31 (53%) made a good recovery with moderate disability, 19 (33%) had severe disability, and 8 (14%) remained in a persistent vegetative state assessed by the GOS. Early and concentrated rehabilitation facilitates functional, social, and neuropsychological reintegration.

  7. Prevalence of occupational asthma in spray painters exposed to several types of isocyanates, including polymethylene polyphenylisocyanate.

    PubMed

    Séguin, P; Allard, A; Cartier, A; Malo, J L

    1987-04-01

    The prevalence of occupational asthma was assessed in four paint shops of a large assembly plant where 51 employees were exposed to several types of isocyanates, including polymethylene polyphenylisocyanate (PPI). Three employees were first referred by their physician for asthma symptoms. A questionnaire was administered to the other 48 employees. Seven of these were suspected of having work-related asthma. Airway hyperexcitability to inhaled histamine was demonstrated in these ten subjects (three referred and seven screened). The diagnosis of occupational asthma was confirmed in six subjects (three referred and three screened) through specific inhalation challenges in the laboratory to a paint system component containing PPI. Thus, the prevalence of occupational asthma was 11.8% in these paint shops using several types of isocyanates, including PPI.

  8. Surveillance for Respiratory Infections, Including Severe Acute Respiratory, Syndrome (SARS), in Cobra Gold 2003

    DTIC Science & Technology

    2004-05-10

    to be causal. Respiratory illnesses caused by viruses in the family Coronaviridae have long been recognized.2-13 Two species known to cause human ...tested positive for influenza A, 2 (13%) for coronavirus OC43, 2 (13%) for respiratory syncytial virus , 1 (6%) rhinovirus, 9 and 4 (25%) were...NAVAL HEALTH RESEARCH CENTER SURVEILLANCE FOR RESPIRATORY INFECTIONS , INCLUDING SEVERE ACUTE RESPIRATORY SYNDROME (SARS), IN COBRA

  9. Fatal and severe box jellyfish stings, including Irukandji stings, in Malaysia, 2000-2010.

    PubMed

    Lippmann, John M; Fenner, Peter J; Winkel, Ken; Gershwin, Lisa-Ann

    2011-01-01

    Jellyfish are a common cause of injury throughout the world, with fatalities and severe systemic events not uncommon after tropical stings. The internet is a recent innovation to gain information on real-time health issues of travel destinations, including Southeast Asia. We applied the model of internet-based retrospective health data aggregation, through the Divers Alert Network Asia-Pacific (DAN AP), together with more conventional methods of literature and media searches, to document the health significance, and clinical spectrum, of box jellyfish stings in Malaysia for the period January 1, 2000 to July 30, 2010. Three fatalities, consistent with chirodropid envenomation, were identified for the period-all tourists to Malaysia. Non-fatal chirodropid stings were also documented. During 2010, seven cases consistent with moderately severe Irukandji syndrome were reported to DAN and two representative cases are discussed here. Photographs of chirodropid (multi-tentacled), carybdeid (four-tentacled) box jellyfish, and of severe sting lesions were also submitted to DAN during this period. This study suggests that the frequency and severity of jellyfish stings affecting tourists in Southeast Asia have been significantly underestimated. Severe and fatal cases of chirodropid-type stings occur in coastal waters off Peninsular Malaysia and Sabah, Borneo. Indeed, the first Malaysian cases consistent with Irukandji-like syndrome are reported here. Reports to DAN, a provider of emergency advice to divers, offer one method to address the historic lack of formalized reporting mechanisms for such events, for photo-documentation of the possible culprit species and treatment advice. The application of marine stinger prevention and treatment principles throughout the region may help reduce the incidence and severity of such stings. Meanwhile travelers and their medical advisors should be aware of the hazards of these stings throughout the Asia-Pacific. © 2011 International

  10. Clinical Outcomes in Patients with Severe Renal Dysfunction Including Dialysis Following Defibrillator Implantation.

    PubMed

    Bogdan, Stefan; Nof, Eyal; Eisen, Alon; Sela, Ron; Rosenheck, Shimon; Freedberg, Nahum; Geist, Michael; Ben-Zvi, Shlomit; Haim, Moti; Glikson, Michael; Goldenberg, Ilan; Suleiman, Mahmoud

    2015-01-01

    Renal dysfunction is associated with increased mortality in heart failure (HF) patients. However, there are limited data regarding clinical and arrhythmic outcomes associated with implantable cardioverter defibrillator (ICD) therapy in this population. We evaluated outcomes associated with the severity of renal dysfunction with or without dialysis among 2,289 patients who were enrolled and prospectively followed up in the Israeli ICD Registry. The primary endpoint of the study was all-cause mortality. Secondary endpoints included cardiac mortality, HF hospitalization, non-cardiac hospitalization, and appropriate and inappropriate ICD therapy. Severe renal dysfunction patients (estimated glomerular filtration rate<30 ml/min/1.73 m2; n=144 patients; 6%) were older, with higher comorbidities prevalence, and more likely to suffer from advanced HF. Among severe renal dysfunction patients, those on dialysis had a lower prevalence of wide QRS and complete left bundle branch morphology, resulting in lower cardiac resynchronization therapy defibrillator (CRTD) implantation rates. Dialysis was associated with an overall increased risk for all-cause mortality (hazard ratio (HR) 3.22; 95% CI 1.69-6.13; p<0.01) and for noncardiac hospitalizations (HR 2.80; p<0.001) compared to all other study patients. However, within the subgroup of patients with severe renal dysfunction, the presence of dialysis was not an independent risk factor for all-cause mortality (HR 0.99; p=0.97) as compared to non-dialysis. The rate of appropriate ICD therapy for ventricular tachyarrhythmias increased with declining renal function, with the highest rate observed among those undergoing dialysis. The present findings suggest that dialysis does not significantly modify the adverse outcomes associated with severe renal dysfunction following ICD/CRTD implantation. © 2015 S. Karger AG, Basel.

  11. Including students with moderate and severe intellectual disabilities in school extracurricular and community recreation activities.

    PubMed

    Kleinert, Harold L; Miracle, Sally; Sheppard-Jones, Kathy

    2007-02-01

    We conducted an online statewide survey of teachers of students with moderate and severe intellectual disabilities to determine the extent to which their students were included in school extracurricular and community recreation activities. For the 252 teacher respondents who indicated that their primary caseload consisted of students with significant intellectual disabilities, we report the numbers of students participating in school and community activities and the primary type of support students required to participate in each activity. Finally, we identify implications for practitioners who want to increase the participation of students with significant disabilities in school and community activities.

  12. A Call to Include Severe Combined Immunodeficiency in Newborn Screening Program

    PubMed Central

    Somech, Raz; Etzioni, Amos

    2014-01-01

    Quantification of the T cell receptor excision circles (TRECs) has recently emerged as a useful non-invasive clinical and research tool to investigate thymic activity. It allows the identification of T cell production by the thymus. Quantification of TREC copies has recently been implemented as the preferred test to screen neonates with severe combined immunodeficiency (SCID) or significant lymphopenia. Neonatal genetic screening for SCID is highly important in countries with high rates of consanguinous marriages, such as Israel, and can be used for early diagnosis, enabling prompt therapeutic intervention that will save lives and improve the outcome of these patients. TREC measurement is also applicable in clinical settings where T cell immunity is involved, including any T cell immunodeficiencies, HIV infection, the aging process, autoimmune diseases, and immune reconstitution after bone marrow transplantation. TAKE-HOME MESSAGES Severe combined immunodeficiency, a life-threatening condition, can be detected by neonatal screening. The earlier the detection and the quicker the implementation of appropriate treatment, the greater the likelihood for improved outcome, even cure, for the affected children. TRECs and KRECs quantification are useful screening tests for severe T and B cell immunodeficiency and can be used also to evaluate every medical condition involving T and B cell immunity. PMID:24498508

  13. Macrocyclic lactones: distribution in plasma lipoproteins of several animal species including humans.

    PubMed

    Bassissi, Mohamad Firas; Alvinerie, Michel; Lespine, Anne

    2004-08-01

    We studied the in vitro distribution of macrocyclic lactones (MLs), lipophilic anthelmintic drugs, in the plasma of several animal species including humans. First, in vitro spiking of goat plasma was performed with ivermectin, moxidectin, abamectin, doramectin, or eprinomectin. In parallel, goats were treated with subcutaneous injection of ivermectin. Then, cow, sheep, rabbit, pig, and human plasma were spiked with moxidectin. Four fractions were separated using KBr density gradient ultracentrifugation: very-low-density lipoprotein (VLDL), low-density lipoprotein (LDL), high-density lipoprotein (HDL), and lipoprotein-deficient fraction. Cholesterol was analyzed by enzymatic assay and MLs by high-performance liquid chromatography. An average of 96% of MLs was associated with lipoproteins. The five MLs studied distributed similarly into goat plasma fractions with a preferential association with HDL (80-90%). Ivermectin partitioning in goat plasma was similar after in vitro spiking and in vivo treatment. In species displaying various lipoprotein profiles, moxidectin was also mainly associated with HDL. However, in human plasma, moxidectin was associated with a lesser extent to HDL (70%) and more to LDL (22%) when compared to other animal species. A relation between the plasma cholesterol content and pharmacokinetics of the drug is suggested. Our finding will allow further exploration of intestinal lymphatic absorption and milk elimination of these compounds-mechanisms in which lipoproteins are involved. In addition, possible improvements of new drug delivery systems are suggested.

  14. Severe third molar complications including death-lessons from 100 cases requiring hospitalization.

    PubMed

    Kunkel, Martin; Kleis, Wilfried; Morbach, Thomas; Wagner, Wilfried

    2007-09-01

    In this study we investigated patients that were hospitalized due to third molar (M3) complications. Specifically we analyzed frequency, age distribution, and outcome with respect to the M3 clinical status. We set up a prospective cohort study and included 100 subjects admitted for management of acute M3-associated complications. The clinical status of the M3 was defined as 1) prophylactic M3 removal, 2) therapeutic (nonelective) M3 removal, or 3) M3 present at the time of admission. Outcome variables were clinical infection markers (C-reactive protein, leukocyte counts) and economic parameters (treatment costs, length of hospital stay, and days of disability). Nonparametric tests were used for comparison of subpopulations (surgical vs nonsurgical, prophylaxis-related vs nonprophylaxis-related). One third of the 100 patients were age 40 or older. Overall 80 severe infections, 11 mandibular fractures, 3 nerve injuries, 5 tooth/root luxations, and 1 postoperative hemorrhage were noticed. Twenty-seven complications resulted from prophylactic surgery, 44 from nonelective removal, and 29 from pericoronitis. Postoperatively, a 77-year-old male patient hospitalized with nonelective removal sustained fatal myocardial infarction. Treatment costs were 260,086 euro (mean 2,608 euro/case); total days of disability were 1,534. The postsurgical complications showed higher C-reactive protein values compared with pericoronitis-induced complications. Within the catchment area of our institution, the majority of complications requiring hospitalization resulted from diseased third molars or their removal. Side effects of observational strategies such as the shifting of complications to higher ages deserve future attention.

  15. Anesthetic Management of the Pediatric Patient with Multiple Congenital Anomalies Including Severe Hemifacial Hypertrophy*

    PubMed Central

    Trapp, Larry D.; Lee, ChingMuh; Troutman, Kenneth C.; Simon, Jeffrev E.

    1981-01-01

    An anesthesia induction technique not widely utilized is described for a pediatric patient presenting with severe hemifacial hypertrophy, severe mental retardation, as well as a seizure disorder and other congenital anomalies. The anatomically and/or pathologically altered airway as well as other anomalies increase the risks of anesthesia. ImagesFigure 1Figure 2Figure 3Figure 4 PMID:6211111

  16. Mainstreaming: A Model for Including Elementary Students in the Severely Handicapped Classroom.

    ERIC Educational Resources Information Center

    Almond, Patricia; And Others

    1979-01-01

    Using the concepts of normalization, mainstreaming, and individualized instruction, a big brother/big sister program was developed in which 16 severely handicapped autistic children (4 to 15 years old) were tutored by nonhandicapped and educable mentally retarded elementary students. (CL)

  17. An interesting case that included visual hallucinations in a patient with severe hypomagnesaemia and hypocalcaemia.

    PubMed

    Wilkinson, Andrea

    2011-12-05

    A 57-year-old man presenting with profound visual hallucinations was found to have severe hypomagnesaemia and hypocalcaemia with a normal level of parathyroid hormone (PTH). Magnesium is essential to the release of PTH so the suspected pathophysiology was thought to be: low Mg → inappropriately low PTH → low Ca. He commenced supplementation and his symptoms resolved. Causes of hypomagnesaemia are discussed.

  18. Integra artificial skin in the management of severe tissue defects, including bone exposure, in injured children.

    PubMed

    Violas, Philippe; Abid, Abdelazis; Darodes, Philippe; Galinier, Philippe; de Gauzy, Jérome Sales; Cahuzac, Jean-Philippe

    2005-09-01

    A dermal substitute, Integra (Integra Neurosciences Implants SA, Sophia Antipolis, France) artificial skin, was used for wound management on three children with lower limb injuries in our institutions. In one case this biosynthetic material was applied directly to a bony surface (patella). This technique allows an early wound coverage and provides a satisfactory preparation for autograft. It can be a useful adjunct in the treatment of severe tissue defects in child limb injuries.

  19. In Junior High You Take Earth Science: Including a Student with Severe Disabilities into an Academic Class.

    ERIC Educational Resources Information Center

    Siegel-Causey, Ellin; McMorris, Carol; McGowen, Susan; Sands-Buss, Sue

    1998-01-01

    This case study of a 14-year-old boy with severe disabilities describes the collaboration of a team of educators who sought to include him in eighth-grade general-education classes. His inclusion plan included four steps: planning, selecting classes, accommodating, and collaborating. The accomplishments of the student's inclusion in earth science…

  20. Curriculum Guidelines for Teaching Profound and Severely Retarded Students (I.Q. Under 40) Including Those with Physical Handicaps.

    ERIC Educational Resources Information Center

    Bailey, Constance

    1975-01-01

    Presented are curriculum guidelines for teaching severely and profoundly retarded students, including students with physical handicaps. In addition to a listing of aims and objectives (such as that the student should analyze the need for space for himself and others), guidelines are provided for the following areas: awareness (of such stimuli as…

  1. Xq28 duplications including MECP2 in five females: Expanding the phenotype to severe mental retardation.

    PubMed

    Bijlsma, E K; Collins, A; Papa, F T; Tejada, M I; Wheeler, P; Peeters, E A J; Gijsbers, A C J; van de Kamp, J M; Kriek, M; Losekoot, M; Broekma, A J; Crolla, J A; Pollazzon, M; Mucciolo, M; Katzaki, E; Disciglio, V; Ferreri, M I; Marozza, A; Mencarelli, M A; Castagnini, C; Dosa, L; Ariani, F; Mari, F; Canitano, R; Hayek, G; Botella, M P; Gener, B; Mínguez, M; Renieri, A; Ruivenkamp, C A L

    2012-06-01

    Duplications leading to functional disomy of chromosome Xq28, including MECP2 as the critical dosage-sensitive gene, are associated with a distinct clinical phenotype in males, characterized by severe mental retardation, infantile hypotonia, progressive neurologic impairment, recurrent infections, bladder dysfunction, and absent speech. Female patients with Xq duplications including MECP2 are rare. Only recently submicroscopic duplications of this region on Xq28 have been recognized in four females, and a triplication in a fifth, all in combination with random X-chromosome inactivation (XCI). Based on this small series, it was concluded that in females with MECP2 duplication and random XCI, the typical symptoms of affected boys are not present. We present clinical and molecular data on a series of five females with an Xq28 duplication including the MECP2 gene, both isolated and as the result of a translocation, and compare them with the previously reported cases of small duplications in females. The collected data indicate that the associated phenotype in females is distinct from males with similar duplications, but the clinical effects may be as severe as seen in males.

  2. Xq28 duplications including MECP2 in five females: Expanding the phenotype to severe mental retardation

    PubMed Central

    Bijlsma, E.K.; Collins, A.; Papa, F.T.; Tejada, M.I.; Wheeler, P.; Peeters, E.A.J.; Gijsbers, A.C.J.; van de Kamp, J.M.; Kriek, M.; Losekoot, M.; Broekma, A.J.; Crolla, J.A.; Pollazzon, M.; Mucciolo, M.; Katzaki, E.; Disciglio, V.; Ferreri, M.I.; Marozza, A.; Mencarelli, M.A.; Castagnini, C.; Dosa, L.; Ariani, F.; Mari, F.; Canitano, R.; Hayek, G.; Botella, M.P.; Gener, B.; Mínguez, M.; Renieri, A.; Ruivenkamp, C.A.L.

    2012-01-01

    Duplications leading to functional disomy of chromosome Xq28, including MECP2 as the critical dosage-sensitive gene, are associated with a distinct clinical phenotype in males, characterized by severe mental retardation, infantile hypotonia, progressive neurologic impairment, recurrent infections, bladder dysfunction, and absent speech. Female patients with Xq duplications including MECP2 are rare. Only recently submicroscopic duplications of this region on Xq28 have been recognized in four females, and a triplication in a fifth, all in combination with random X-chromosome inactivation (XCI). Based on this small series, it was concluded that in females with MECP2 duplication and random XCI, the typical symptoms of affected boys are not present. We present clinical and molecular data on a series of five females with an Xq28 duplication including the MECP2 gene, both isolated and as the result of a translocation, and compare them with the previously reported cases of small duplications in females. The collected data indicate that the associated phenotype in females is distinct from males with similar duplications, but the clinical effects may be as severe as seen in males. PMID:22522176

  3. Planet Hunters Update: Many New Planet Candidates Identified by Citizen Scientists from Kepler Data, Including Several in the Habitable Zone

    NASA Astrophysics Data System (ADS)

    Schmitt, Joseph; Wang, Ji

    2013-07-01

    Since December, 2010, more than 250,000 public volunteers have searched through more than 19 million Kepler light curves hunting for transiting planets. The Kepler light curves are shown in 30 day sections, and with ~160,000 Kepler target stars, the users have contributed the equivalent of 180 years of work hours. This vetting process has resulted in over 40 new planet candidates and two new confirmed planets, including several not identified through the Kepler pipeline. Many of our candidate planets lie within their host star's habitable zone. We review the recent large release of new PH candidates in Wang et al. (2013), including one confirmed planet, and give preliminary results for our next PH candidate release.

  4. The Clinical Profile of Subjects Included in the Swedish National Register on Individuals with Severe Alpha 1-Antitrypsin deficiency.

    PubMed

    Piitulainen, Eeva; Tanash, Hanan A

    2015-05-01

    The Swedish national register of severe alpha1-antitrypsin (AAT) deficiency was established in 1991. The main aims are to prospectively study the natural history of severe AAT deficiency, and to improve the knowledge of AAT deficiency. The inclusion criteria in the register are age ≥ 18 years, and the PiZ phenotype diagnosed by isoelectric focusing. The register is kept updated by means of repeated questionnaires providing data to allow analysis of the mode of identification, lung and liver function, smoking-habits, respiratory symptoms and diagnoses as reported by physicians. Until February 2014, a total of 1553 PiZZ individuals had been included in the register. The 1102 subjects still alive constituted about 20% of the adult PiZZ individuals in Sweden. Forty-three percent of the subjects had been identified during investigation of respiratory symptoms, 7% by an investigation of liver disease, 26% in an investigation of other pathological conditions, and 24% in a population or family screening. Forty five percent of the subjects had never smoked, 47% were ex-smokers, and 8% current smokers. Twenty-eight percent of the never-smokers, 72% of the ex-smokers, and 61% of the current smokers fulfilled the criteria for COPD with a FEV1/FVC ratio of <0.70. Among the 451 deceased, the most common cause of death was respiratory diseases (55%), followed by liver diseases (13%). We conclude that the detection rate of severe AAT deficiency is relatively high in Sweden. Large numbers of subjects are identified for other reasons than respiratory symptoms, and the majority of these have never smoked.

  5. Compound heterozygous TRPV4 mutations in two siblings with a complex phenotype including severe intellectual disability and neuropathy.

    PubMed

    Thibodeau, My Linh; Peters, Colin H; Townsend, Katelin N; Shen, Yaoqing; Hendson, Glenda; Adam, Shelin; Selby, Kathryn; Macleod, Patrick M; Gershome, Cynthia; Ruben, Peter; Jones, Steven J M; Friedman, Jan M; Gibson, William T; Horvath, Gabriella A

    2017-09-12

    TRPV4 encodes a polymodal calcium-permeable plasma membrane channel. Dominant pathogenic mutations in TRPV4 lead to a wide spectrum of abnormal phenotypes. This is the first report of biallelic TRPV4 mutations and we describe two compound heterozygous siblings presenting with a complex phenotype including severe neuromuscular involvement. In light of previously well described dominant inheritance for TRPV4-related neuromuscular disease, our study suggests a role for compound heterozygosity and loss-of-function as a potential novel disease mechanism for this group of disorders. Profound intellectual disability was also noted in both affected children, suggesting that TRPV4 may be necessary for normal brain development. © 2017 Wiley Periodicals, Inc.

  6. Double Xp11.22 deletion including SHROOM4 and CLCN5 associated with severe psychomotor retardation and Dent disease.

    PubMed

    Armanet, Narjes; Metay, Corinne; Brisset, Sophie; Deschenes, Georges; Pineau, Dominique; Petit, François M; Di Rocco, Federico; Goossens, Michel; Tachdjian, Gérard; Labrune, Philippe; Tosca, Lucie

    2015-01-01

    Here we report the clinical and molecular characterization of two Xp11.22 deletions including SHROOM4 and CLCN5 genes. These deletions appeared in the same X chromosome of the same patient. The patient is a six-year-old boy who presented hydrocephalus, severe psychomotor and growth retardation, facial dysmorphism and renal proximal tubulopathy associated with low-molecular-weight proteinuria, hypercalciuria, hyperaminoaciduria, hypophosphatemia and hyperuricemia. Standard and high resolution karyotypes showed a 46,XY formula. Array-CGH revealed two consecutive cryptic deletions in the region Xp11.22, measuring respectively 148 Kb and 2.6 Mb. The two deletions were inherited from the asymptomatic mother. Array-CGH allowed us to determine candidate genes in the deleted region. The disruption and partial loss of CLCN5 confirmed the diagnostic of Dent disease for this patient. Moreover, the previously described involvement of SHROOM4 in neuronal development is discussed.

  7. [Disability after stroke: a longitudinal study in moderate and severe stroke patients included in a multidisciplinary rehabilitation program].

    PubMed

    Noe-Sebastian, E; Balasch-Bernat, M; Colomer-Font, C; Moliner-Munoz, B; Rodriguez Sanchez-Leiva, C; Ugart, P; Llorens, R; Ferri-Campos, J

    2017-05-01

    Stroke is a recognized cause of disability among adults. However the impact that the deficits that occur after a moderate/severe stroke have on long-term disability, as well as the response of the resultant deficits to rehabilitation, are not completely understood. A total of 396 patients with a modified Rankin score >= 3 after an ischemic (n = 221) or hemorrhagic (n = 175) stroke were included in this study. All patients were assessed with cognitive, behavior, emotional, motor and functional domains. All patients were assessed at baseline and six months after inclusion in a multidisciplinary rehabilitation program. Risk of falling (Berg Balance Scale < 45 in 83.1% of the sample at baseline and 49.5% at follow-up) and functional problems (82.8% with a Barthel Index < 75 at baseline and 53% at follow-up) were the most prevalent deficits. Emotional disturbances were those that most improved while behavioral problems were those that did less. Although global disability improved during treatment among most patients, only 11% of our patients, especially those with preserved cognitive function at baseline, could be classified as patients with mild disability at follow-up. Stroke consequences are multidimensional. The symptoms that the stroke can cause in multiple domains, as well as the pattern of recovery are widely diverse, with prevalence of behavioral long-term disturbances.

  8. A Multiplex Immunoassay Using the Guthrie Specimen to Detect T-Cell Deficiencies Including Severe Combined Immunodeficiency Disease

    PubMed Central

    Janik, David K.; Lindau-Shepard, Barbara; Comeau, Anne Marie; Pass, Kenneth A.

    2011-01-01

    BACKGROUND Severe combined immunodeficiency (SCID) fulfills many of the requirements for addition to a newborn screening panel. Two newborn screening SCID pilot studies are now underway using the T-cell receptor excision circle (TREC) assay, a molecular technique. Here we describe an immunoassay with CD3 as a marker for T cells and CD45 as a marker for total leukocytes that can be used with the Guthrie specimen. METHODS The multiplexing capabilities of the Luminex platform were used. Antibody pairs were used to capture and detect CD3 and CD45 from a single 3-mm punch of the Guthrie specimen. The assay for each bio-marker was developed separately in identical buffers and then combined to create a multiplex assay. RESULTS Using calibrators made from known amounts of leukocytes, a detection limit of 0.25 × 106 cells/mL for CD3 and 0.125 × 106 cells/mL for CD45 was obtained. Affinity tests showed no cross-reactivity between the antibodies to CD3 and CD45. The multiplex assay was validated against 8 coded specimens of known clinical status and linked to results from the TREC assay that had identified them. All were correctly identified by the CD345 assay. CONCLUSIONS The performance parameters of the CD345 assay met the performance characteristics generally accepted for immunoassays. Our assay classifications of positive specimens concur with previous TREC results. This CD345 assay warrants evaluation as a viable alternative or complement to the TREC assay as a primary screening tool for detecting T-cell immunodeficiencies, including SCID, in Guthrie specimens. PMID:20660143

  9. How useful is the DSM-5 severity indicator in bulimia nervosa? A clinical study including a measure of impairment.

    PubMed

    Jenkins, Paul E; Luck, Amy; Cardy, Jessica; Staniford, Jessica

    2016-12-30

    The severity criterion used in DSM-5 for bulimia nervosa (BN) was investigated in 214 individuals referred for treatment at a regional eating disorders service in the UK. In addition to comparing eating disorder symptoms, impairment secondary to these symptoms was also assessed. According to guidance in DSM-5, 94 individuals were classified as mild (43.9%), 70 as moderate (32.7%), 32 as severe (15.0%), and 8 as extreme (3.7%) levels of BN severity. Due to small numbers in the latter two groups, it was necessary to combine these to form one 'severe/extreme' group. Analyses on these three groups suggested no group effect on demographic variables but differences were seen on measures of eating pathology, psychological distress, and psychosocial impairment between the mild group and other groups. Individuals in the moderate and severe/extreme groups scored comparably on most measures of pathology and impairment. The results are broadly consistent with past studies on community samples although together question the demarcation between moderate and more severe groups of individuals with BN.

  10. High Quality Power Supply Method for Islanding Microgrid by use of Several Types of DG Systems including Rotating Machines

    NASA Astrophysics Data System (ADS)

    Kikuchi, Takuro; Baba, Jumpei; Kawachi, Shunsuke; Shimoda, Eisuke; Numata, Shigeo; Yamane, Toshihiro; Masada, Eisuke; Nitta, Tanzo

    When a microgrid is operated in the islanding mode, the operator must satisfy the power quality demand by compensating the active and reactive power using several types of distributed power generation (DG) systems. In this paper, a method to stabilize the system frequency fluctuations and voltage fluctuations of the islanding microgrid is suggested. Extending the suggested “combined cascade control method” which can realize the power compensation without interferences between several types of DGs, “hybrid control” strucuture is proposed and negative effects of control and measurement signal delays on a control are reduced. Moreover, a control of the state of charge (SoC) of energy storage devices is added. For the stabilization of the system voltage, the energy storage is driven by “STATCOM model control”. Experiments have been carried out to confirm the effects of these methods by use of the model microgrid system, and satisfying results were received.

  11. The HER2 amplicon includes several genes required for the growth and survival of HER2 positive breast cancer cells.

    PubMed

    Sahlberg, Kristine Kleivi; Hongisto, Vesa; Edgren, Henrik; Mäkelä, Rami; Hellström, Kirsi; Due, Eldri U; Moen Vollan, Hans Kristian; Sahlberg, Niko; Wolf, Maija; Børresen-Dale, Anne-Lise; Perälä, Merja; Kallioniemi, Olli

    2013-06-01

    About 20% of breast cancers are characterized by amplification and overexpression of the HER2 oncogene. Although significant progress has been achieved for treating such patients with HER2 inhibitor trastuzumab, more than half of the patients respond poorly or become resistant to the treatment. Since the HER2 amplicon at 17q12 contains multiple genes, we have systematically explored the role of the HER2 co-amplified genes in breast cancer cell growth and their relation to trastuzumab resistance. We integrated aCGH data of the HER2 amplicon from 71 HER2 positive breast tumors and 10 cell lines with systematic functional RNA interference analysis of 23 core amplicon genes with several phenotypic endpoints in a panel of trastuzumab responding and non-responding HER2 positive breast cancer cells. Silencing of HER2 caused a greater growth arrest and apoptosis in the responding compared to the non-responding cell lines, indicating that the resistant cells are inherently less dependent on the HER2 pathway. Several other genes in the amplicon also showed a more pronounced effect when silenced; indicating that expression of HER2 co-amplified genes may be needed to sustain the growth of breast cancer cells. Importantly, co-silencing of STARD3, GRB7, PSMD3 and PERLD1 together with HER2 led to an additive inhibition of cell viability as well as induced apoptosis. These studies indicate that breast cancer cells may become addicted to the amplification of several genes that reside in the HER2 amplicon. The simultaneous targeting of these genes may increase the efficacy of the anti-HER2 therapies and possibly also counteract trastuzumab resistance. The observed additive effects seem to culminate to both apoptosis and cell proliferation pathways indicating that these pathways may be interesting targets for combinatorial treatment of HER2+ breast cancers.

  12. Oil body-associated hazelnut allergens including oleosins are underrepresented in diagnostic extracts but associated with severe symptoms.

    PubMed

    Zuidmeer-Jongejan, Laurian; Fernández-Rivas, Montserrat; Winter, Marcel Gt; Akkerdaas, Jaap H; Summers, Colin; Lebens, Ans; Knulst, André C; Schilte, Piet; Briza, Peter; Gadermaier, Gabriele; van Ree, Ronald

    2014-02-02

    Oil body-associated allergens such as oleosins have been reported for important allergenic foods such as peanut, sesame and hazelnut. Here we investigate whether oil body associated proteins (OAPs) are linked with specific clinical phenotypes and whether they are represented in skin prick test (SPT) reagents. A hazelnut OAP fraction was characterized by mass-spectrometry (MS) to identify its major constituents. Polyclonal rabbit antibodies were generated against hazelnut OAPs. The presence of OAPs in commercially available hazelnut SPTs was studied by immunoblot and spiking experiments. OAP-specific IgE antibodies were measured in sera from patients with a convincing history of hazelnut allergy by RAST (n = 91), immunoblot (n = 22) and basophil histamine release (BHR; n = 14). Hazelnut OAPs were analysed by MS and found to be dominated by oleosins at ~14 and ~17 kDa, and a 27 kDa band containing oleosin dimers and unidentified protein. In 36/91 sera specific IgE against hazelnut OAPs was detected, and confirmed to be biologically active by BHR (n = 14). The majority (21/22) recognized the oleosin bands at 17 kDa on immunoblot, of which 11 exclusively. These OAP-specific IgE responses dominated by oleosin were associated with systemic reactions to hazelnut (OR 4.24; p = 0.015) and negative SPT (χ2 6.3, p = 0.012). Immunoblot analysis using OAP-specific rabbit antiserum demonstrated that commercial SPT reagents are virtually devoid of OAPs, sometimes (3/9) resulting in false-negative SPT. Spiking of SPT reagents with OAP restored serum IgE binding of these false-negative patients on immunoblot at mainly 17 kDa. Hazelnut allergens found in oil bodies dominated by oleosin are associated with more severe systemic reactions and negative SPT. Defatted diagnostic extracts are virtually devoid of these allergens, resulting in poor sensitivity for detection of IgE antibodies against these clinically relevant molecules.

  13. Oil body-associated hazelnut allergens including oleosins are underrepresented in diagnostic extracts but associated with severe symptoms

    PubMed Central

    2014-01-01

    Background Oil body-associated allergens such as oleosins have been reported for important allergenic foods such as peanut, sesame and hazelnut. Here we investigate whether oil body associated proteins (OAPs) are linked with specific clinical phenotypes and whether they are represented in skin prick test (SPT) reagents. Methods A hazelnut OAP fraction was characterized by mass-spectrometry (MS) to identify its major constituents. Polyclonal rabbit antibodies were generated against hazelnut OAPs. The presence of OAPs in commercially available hazelnut SPTs was studied by immunoblot and spiking experiments. OAP-specific IgE antibodies were measured in sera from patients with a convincing history of hazelnut allergy by RAST (n = 91), immunoblot (n = 22) and basophil histamine release (BHR; n = 14). Results Hazelnut OAPs were analysed by MS and found to be dominated by oleosins at ~14 and ~17 kDa, and a 27 kDa band containing oleosin dimers and unidentified protein. In 36/91 sera specific IgE against hazelnut OAPs was detected, and confirmed to be biologically active by BHR (n = 14). The majority (21/22) recognized the oleosin bands at 17 kDa on immunoblot, of which 11 exclusively. These OAP-specific IgE responses dominated by oleosin were associated with systemic reactions to hazelnut (OR 4.24; p = 0.015) and negative SPT (χ2 6.3, p = 0.012). Immunoblot analysis using OAP-specific rabbit antiserum demonstrated that commercial SPT reagents are virtually devoid of OAPs, sometimes (3/9) resulting in false-negative SPT. Spiking of SPT reagents with OAP restored serum IgE binding of these false-negative patients on immunoblot at mainly 17 kDa. Conclusion Hazelnut allergens found in oil bodies dominated by oleosin are associated with more severe systemic reactions and negative SPT. Defatted diagnostic extracts are virtually devoid of these allergens, resulting in poor sensitivity for detection of IgE antibodies against these clinically relevant

  14. Gene-alcohol interactions identify several novel blood pressure loci including a promising locus near SLC16A9

    PubMed Central

    Simino, Jeannette; Sung, Yun Ju; Kume, Rezart; Schwander, Karen; Rao, D. C.

    2013-01-01

    Alcohol consumption is a known risk factor for hypertension, with recent candidate studies implicating gene-alcohol interactions in blood pressure (BP) regulation. We used 6882 (predominantly) Caucasian participants aged 20–80 years from the Framingham SNP Health Association Resource (SHARe) to perform a genome-wide analysis of SNP-alcohol interactions on BP traits. We used a two-step approach in the ABEL suite to examine genetic interactions with three alcohol measures (ounces of alcohol consumed per week, drinks consumed per week, and the number of days drinking alcohol per week) on four BP traits [systolic (SBP), diastolic (DBP), mean arterial (MAP), and pulse (PP) pressure]. In the first step, we fit a linear mixed model of each BP trait onto age, sex, BMI, and antihypertensive medication while accounting for the phenotypic correlation among relatives. In the second step, we conducted 1 degree-of-freedom (df) score tests of the SNP main effect, alcohol main effect, and SNP-alcohol interaction using the maximum likelihood estimates (MLE) of the parameters from the first step. We then calculated the joint 2 df score test of the SNP main effect and SNP-alcohol interaction using MixABEL. The effect of SNP rs10826334 (near SLC16A9) on SBP was significantly modulated by both the number of alcoholic drinks and the ounces of alcohol consumed per week (p-values of 1.27E-08 and 3.92E-08, respectively). Each copy of the G-allele decreased SBP by 3.79 mmHg in those consuming 14 drinks per week vs. a 0.461 mmHg decrease in non-drinkers. Index SNPs in 20 other loci exhibited suggestive (p-value ≤ 1E-06) associations with BP traits by the 1 df interaction test or joint 2 df test, including 3 rare variants, one low-frequency variant, and SNPs near/in genes ESRRG, FAM179A, CRIPT-SOCS5, KAT2B, ADCY2, GLI3, ZNF716, SLIT1, PDE3A, KERA-LUM, RNF219-AS1, CLEC3A, FBXO15, and IGSF5. SNP-alcohol interactions may enhance discovery of novel variants with large effects that can be

  15. A 7q31.33q32.1 microdeletion including LRRC4 and GRM8 is associated with severe intellectual disability and characteristics of autism.

    PubMed

    Sangu, Noriko; Shimojima, Keiko; Takahashi, Yuya; Ohashi, Tsukasa; Tohyama, Jun; Yamamoto, Toshiyuki

    2017-01-01

    A 4-year-old boy with severe intellectual disability (ID) and characteristics of autism was found to have a de novo 1.9-Mb microdeletion in 7q31.33q32.1, in which LRRC4, GRM8, and 11 other genes were included. GRM8 is associated with attention deficit hyperactivity disorder. LRRC4 is related to synaptic cell adhesion molecules, some of which are associated with autism. The deletion of LRRC4 may be responsible for the severe ID and characteristics of autism observed in the present patient.

  16. A 7q31.33q32.1 microdeletion including LRRC4 and GRM8 is associated with severe intellectual disability and characteristics of autism

    PubMed Central

    Sangu, Noriko; Shimojima, Keiko; Takahashi, Yuya; Ohashi, Tsukasa; Tohyama, Jun; Yamamoto, Toshiyuki

    2017-01-01

    A 4-year-old boy with severe intellectual disability (ID) and characteristics of autism was found to have a de novo 1.9-Mb microdeletion in 7q31.33q32.1, in which LRRC4, GRM8, and 11 other genes were included. GRM8 is associated with attention deficit hyperactivity disorder. LRRC4 is related to synaptic cell adhesion molecules, some of which are associated with autism. The deletion of LRRC4 may be responsible for the severe ID and characteristics of autism observed in the present patient. PMID:28224041

  17. Plasma ω-3 fatty acid levels negatively and ω-6 fatty acid levels positively associated with other cardiovascular risk factors including homocysteine in severe obese subjects.

    PubMed

    Mehmetoglu, Idris; Yerlikaya, F Hümeyra; Kurban, Sevil; Polat, Hakkı

    2012-01-01

    Obesity and homocysteine (tHcy) are important risk factors for cardiovascular diseases (CVD). Plasma omega-3 fatty acids (ω-3 FAs) and omega-6 fatty acids (ω-6 FAs) are essential fatty acids with diverse biological effects in human health and disease. We have investigated the relation of plasma ω-3 FAs and ω-6 FAs levels with other cardiovascular risk factors including tHcy in severe obese subjects. This study was performed on 96 severe obese and 65 normal weight subjects. Plasma fatty acid composition was measured by GC/MS and serum tHcy level was measured by HPLC methods. There were no differences between groups in terms of concentrations of serum tHcy, plasma ω-3 FAs, ω-6 FAs and ω-3/ω-6 ratio, whereas serum vitamin B-12 (p<0.01) and folic acid (p<0.05) levels were lower than those of the normal weight subjects. Homocysteine positively correlated with ω-6 FAs and negatively correlated with ω-3 FAs in severe obese and normal weight subjects. Serum vitamin B-12 positively correlated with ω-3 FAs (p<0.01) and ω-3/ω-6 ratio (p<0.01) and negatively correlated with ω-6 FAs (p<0.05) in severe obese subjects. Serum folic acid positively correlated with ω-3 FAs (p<0.01) in severe obese subjects. Our results suggest an association between the plasma ω-3 FAs and ω-6 FAs and serum tHcy concentrations in severe obese and normal weight subjects. Low levels vitamin B-12 and folic acid may have been responsible for the elevated tHcy levels in severe obese subjects, increasing the risk for future development of cardiovascular diseases.

  18. Deletion 16p13.11 uncovers NDE1 mutations on the non-deleted homolog and extends the spectrum of severe microcephaly to include fetal brain disruption

    PubMed Central

    Paciorkowski, Alex R; Keppler-Noreuil, Kim; Robinson, Luther; Sullivan, Christopher; Sajan, Samin; Christian, Susan L; Bukshpun, Polina; Gabriel, Stacy B; Gleeson, Joseph G; Sherr, Elliott H; Dobyns, William B

    2013-01-01

    Deletions of 16p13.11 have been associated with a variety of phenotypes, and have also been found in normal individuals. We report on two unrelated patients with severe microcephaly, agenesis of the corpus callosum, scalp rugae, and a fetal brain disruption (FBD)-like phenotype with inherited deletions of 16p13.11. The first patient was subsequently found on whole exome sequencing to have a nonsense mutation (p.R44X) in NDE1 on the non-deleted chromosome 16 homolog. We then undertook copy number studies of 16p13.11 and sequencing of NDE1 in nine additional patients with a similar severe microcephaly, agenesis of the corpus callosum, and FBD-like phenotype. The second patient was found to have an inherited deletion of the entire NDE1 gene combined with a frameshift mutation (c.1020-1021het_delGA) in the non-deleted NDE1. These observations broaden the phenotype seen in NDE1-related microcephaly to include FBD. These data also represent the second described syndrome, after Bernard-Soulier syndrome, where an autosomal recessive condition combines an inherited segmental duplication mediated deletion with a mutation in a gene within the non-deleted homolog. Finally, we performed informatics analysis of the 16p13.11 gene content, and found that there are many genes within the region with evidence for role(s) in brain development. Sequencing of other candidate genes in this region in patients with deletion 16p13.11 and more severe neurophenotypes may be warranted. PMID:23704059

  19. A Prospective Study of the Prevalence of Tuberculosis and Bacteraemia in Bangladeshi Children with Severe Malnutrition and Pneumonia Including an Evaluation of Xpert MTB/RIF Assay

    PubMed Central

    Chisti, Mohammod Jobayer; Graham, Stephen M.; Duke, Trevor; Ahmed, Tahmeed; Ashraf, Hasan; Faruque, Abu Syed Golam; La Vincente, Sophie; Banu, Sayera; Raqib, Rubhana; Salam, Mohammed Abdus

    2014-01-01

    Background Severe malnutrition is a risk factor for pneumonia due to a wide range of pathogens but aetiological data are limited and the role of Mycobacterium tuberculosis is uncertain. Methods We prospectively investigated severely malnourished young children (<5 years) with radiological pneumonia admitted over a 15-month period. Investigations included blood culture, sputa for microscopy and mycobacterial culture. Xpert MTB/RIF assay was introduced during the study. Study children were followed for 12 weeks following their discharge from the hospital. Results 405 eligible children were enrolled, with a median age of 10 months. Bacterial pathogens were isolated from blood culture in 18 (4.4%) children, of which 72% were Gram negatives. Tuberculosis was confirmed microbiologically in 7% (27/396) of children that provided sputum - 10 by culture, 21 by Xpert MTB/RIF assay, and 4 by both tests. The diagnostic yield from induced sputum was 6% compared to 3.5% from gastric aspirate. Sixty (16%) additional children had tuberculosis diagnosed clinically that was not microbiologically confirmed. Most confirmed tuberculosis cases did not have a positive contact history or positive tuberculin test. The sensitivity and specificity of Xpert MTB/RIF assay compared to culture was 67% (95% CI: 24–94) and 92% (95% CI: 87–95) respectively. Overall case-fatality rate was 17% and half of the deaths occurred in home following discharge from the hospital. Conclusion and Significance TB was common in severely malnourished Bangladeshi children with pneumonia. X-pert MTB/RIF assay provided higher case detection rate compared to sputum microscopy and culture. The high mortality among the study children underscores the need for further research aimed at improved case detection and management for better outcomes. PMID:24695758

  20. Risk of severe ovarian hyperstimulation syndrome in GnRH antagonist versus GnRH agonist protocol: RCT including 1050 first IVF/ICSI cycles.

    PubMed

    Toftager, M; Bogstad, J; Bryndorf, T; Løssl, K; Roskær, J; Holland, T; Prætorius, L; Zedeler, A; Nilas, L; Pinborg, A

    2016-06-01

    Is the risk of severe ovarian hyperstimulation syndrome (OHSS) similar in a short GnRH antagonist and long GnRH agonist protocol in first cycle IVF/ICSI patients less than 40 years of age?. There is an increased risk of severe OHSS in the long GnRH agonist group compared with the short GnRH antagonist protocol. WHAT IS KNOWN ALREADY?: In the most recent Cochrane review, the GnRH antagonist protocol was associated with a similar live birth rate (LBR), a similar on-going pregnancy rate (OPR), and a lower incidence of OHSS (odds ratio (OR) = 0.43 95% confidence interval (CI): 0.33-0.57) compared with the traditional GnRH agonist protocol. Previous trials comparing the two protocols mainly included selected patient populations, a limited number of patients and the applied OHSS criteria differed, making direct comparisons difficult. In two recent large meta-analyses, no significant differences in LBR (OR = 0.86; 95% CI: 0.72-1.02) or in the incidence of severe OHSS were reported, while others found a lower LBR (OR = 0.82; 95% CI: 0.68-0.97) and a reduced risk of severe OHSS using the GnRH antagonist protocol (OR = 0.60; 95% CI: 0.40-0.88). Phase IV, dual-centre, open-label, RCT including 1050 women allocated to either short GnRH antagonist or long GnRH agonist protocol in a 1:1 ratio and enrolled over a 5-year period using a web-based concealed randomization code. This is a superiority study designed to detect a difference in severe OHSS, the primary outcome, between the two groups with a power of 80% and stratified for age, assisted reproductive technology (ART) clinic and planned fertilization procedure (IVF/ICSI). The secondary aims were to compare rates of mild and moderate OHSS, positive plasma (p)-hCG, on-going pregnancy and live birth between the two arms. None of the women had undergone previous ART treatment. All infertile women referred for their first IVF/ICSI at two public fertility clinics, less than 40 years of age and with no uterine malformations were

  1. Therapeutic monitoring of opioids: a sensitive LC-MS/MS method for quantitation of several opioids including hydrocodone and its metabolites.

    PubMed

    Langman, Loralie J; Korman, Eric; Stauble, M Elaine; Boswell, Mark V; Baumgartner, Richard N; Jortani, Saeed A

    2013-06-01

    For pain management, opioid therapy is a mainstay for treating acute pain and relieving moderate to severe chronic pain. Quantitative measurement of opioids and their metabolites in urine is used mainly for confirmation of screened results obtained for clinical and forensic purposes. Due to limitations in interpretation of urine results for pain management testing purposes, the use of blood or serum to assess opioids and their metabolites may be of benefit. This report describes a sensitive liquid chromatography-tandem mass spectrometry method for the detection of hydrocodone and its metabolites hydromorphone, norhydrocodone, and dihydrocodeine, and other common opiates that patients may be taking, including morphine, codeine, oxycodone, and oxymorphone in a single extraction. The method uses solid-phase extraction of 500 µL of sample with quantitation by liquid chromatography-tandem mass spectrometry. The assay is linear from 1.0 to 100 ng/mL and has a between-day coefficient of variation of <10%. The major advantage of this method is that a single extraction can detect hydrocodone and its metabolites and other opiates or opioids that patients frequently use simultaneously with hydrocodone.

  2. The mammalian alcohol dehydrogenase genome shows several gene duplications and gene losses resulting in a large set of different enzymes including pseudoenzymes.

    PubMed

    Östberg, Linus J; Persson, Bengt; Höög, Jan-Olov

    2015-06-05

    Mammalian alcohol dehydrogenase (ADH) is a protein family divided into six classes and the number of known family members is increasing rapidly. Several primate genomes are completely analyzed for the ADH region, where higher primates (human and hominoids) have seven genes of classes ADH1-ADH5. Within the group of non-hominoids apes there have been further duplications and species with more than the typical three isozymic forms for ADH1 are present. In contrast there are few completely analyzed ADH genomes in the non-primate group of mammals, where an additional class has been identified, ADH6, that has been lost during the evolution of primates. In this study 85 mammalian genomes with at least one ADH gene have been compiled. In total more than 500 ADH amino acid sequences were analyzed for patterns that distinguish the different classes. For ADH1-ADH4 intensive investigations have been performed both at the functional and at structural levels. However, a corresponding functional protein to the ADH5 gene, which is found in most ADH genomes, has never been detected. The same is true for ADH6, which is only present in non-primates. The entire mammalian ADH family shows a broad spectrum of gene duplications and gene losses where the numbers differ from six genes (most non-primate mammals) up to ten genes (vole). Included in these sets are examples of pseudogenes and pseudoenzymes.

  3. Re-engineering Cytochrome P450 2B11dH for Enhanced Metabolism of Several Substrates Including the Anti-cancer Prodrugs Cyclophosphamide and Ifosfamide

    PubMed Central

    Sun, Ling; Chen, Chong S.; Waxman, David J.; Liu, Hong; Halpert, James R.; Kumar, Santosh

    2007-01-01

    Based on recent directed evolution of P450 2B1, six P450 2B11 mutants at three positions were created in an N-terminal modified construct termed P450 2B11dH and characterized for enzyme catalysis using five substrates. Mutant I209A demonstrated a 3.2-fold enhanced kcat/Km for 7-ethoxy-4-trifluoromethylcourmarin O-deethylation, largely due to a dramatic decrease in Km (0.72 vs. 18 μM). I209A also demonstrated enhanced selectivity for testosterone 16β-hydroxylation over 16α-hydroxylation. In contrast, V183L showed a 4-fold increased kcat for 7-benzyloxyresorufin debenzylation and a 4.7-fold increased kcat/Km for testosterone 16α-hydroxylation. V183L also displayed a 1.7-fold higher kcat/Km than P450 2B11dH with the anti-cancer prodrugs cyclophosphamide and ifosfamide, resulting from a ~4-fold decrease in Km. Introduction of the V183L mutation into full-length P450 2B11 did not enhance the kcat/Km. Overall, the re-engineered P450 2B11dH enzymes exhibited enhanced catalytic efficiency with several substrates including the anti-cancer prodrugs. PMID:17254539

  4. Two-stage bottom-up tiered approach combining several alternatives for identification of eye irritation potential of chemicals including insoluble or volatile substances.

    PubMed

    Hayashi, Kazuhiko; Mori, Taeko; Abo, Takayuki; Ooshima, Kenichi; Hayashi, Takumi; Komano, Tomoko; Takahashi, Yutaka; Sakaguchi, Hitoshi; Takatsu, Akihiko; Nishiyama, Naohiro

    2012-10-01

    For the assessment of eye irritation, one alternative test may not completely replace the rabbit Draize test. In the present study, we examined the predictive potential of a tiered approach analyzing the results from several alternatives (i.e., the Short Time Exposure (STE) test, the EpiOcular assay, the Hen's Egg Test-Chorioallantoic Membrane (HET-CAM) assay and the Bovine Corneal Opacity and Permeability (BCOP) assay) for assessing Globally Harmonized System (GHS) eye irritation categories. Fifty-six chemicals including alcohols, surfactants, and esters were selected with a balanced GHS category and a wide range of chemical classes. From a standpoint of both assessable sample numbers and predictive accuracy, the more favorable tiered approach was considered to be the two-stage bottom-up tiered approach combining the STE test, the EpiOcular assay followed by the BCOP assay (accuracy 69.6%, under prediction rate 8.9%). Moreover, a more favorable predictive capacity (accuracy 71.4%, under prediction rate 3.6%) was obtained when high volatile alcohols/esters with vapor pressures >6 kilopascal (kPa) at 25°C were evaluated with EpiOcular assay instead of the STE test. From these results, the two-stage bottom-up tiered approach combining the STE test, the EpiOcular assay followed by the BCOP assay might be a promising method for the classification of GHS eye irritation category (Not classified (NC), Category 2 (Cat. 2), and Category 1 (Cat. 1)) for a wide range of test chemicals regardless of solubility. Copyright © 2012 Elsevier Ltd. All rights reserved.

  5. Composition of Glycosaminoglycans in Elasmobranchs including Several Deep-Sea Sharks: Identification of Chondroitin/Dermatan Sulfate from the Dried Fins of Isurus oxyrinchus and Prionace glauca

    PubMed Central

    Higashi, Kyohei; Takeuchi, Yoshiki; Mukuno, Ann; Tomitori, Hideyuki; Miya, Masaki; Linhardt, Robert J.; Toida, Toshihiko

    2015-01-01

    Shark fin, used as a food, is a rich source of glycosaminoglyans (GAGs), acidic polysaccharides having important biological activities, suggesting their nutraceutical and pharmaceutical application. A comprehensive survey of GAGs derived from the fin was performed on 11 elasmobranchs, including several deep sea sharks. Chondroitin sulfate (CS) and hyaluronic acid (HA) were found in Isurus oxyrinchus, Prionace glauca, Scyliorhinus torazame, Deania calcea, Chlamydoselachus anguineus, Mitsukurina owatoni, Mustelus griseus and Dasyatis akajei, respectively. CS was only found from Chimaera phantasma, Dalatias licha, and Odontaspis ferox, respectively. Characteristic disaccharide units of most of the CS were comprised of C- and D-type units. Interestingly, substantial amount of CS/dermatan sulfate (DS) was found in the dried fin (without skin and cartilage) of Isurus oxyrinchus and Prionace glauca. 1H-NMR analysis showed that the composition of glucuronic acid (GlcA) and iduronic acid (IdoA) in shark CS/DS was 41.2% and 58.8% (Isurus oxyrinchus), 36.1% and 63.9% (Prionace glauca), respectively. Furthermore, a substantial proportion of this CS/DS consisted of E-, B- and D-type units. Shark CS/DS stimulated neurite outgrowth of hippocampal neurons at a similar level as DS derived from invertebrate species. Midkine and pleiotrophin interact strongly with CS/DS from Isurus oxyrinchus and Prionace glauca, affording Kd values of 1.07 nM, 6.25 nM and 1.70 nM, 1.88 nM, respectively. These results strongly suggest that the IdoA-rich domain of CS/DS is required for neurite outgrowth activity. A detailed examination of oligosaccharide residues, produced by chondroitinase ACII digestion, suggested that the IdoA and B-type units as well as A- and C-type units were found in clusters in shark CS/DS. In addition, it was discovered that the contents of B-type units in these IdoA-rich domain increased in a length dependent manner, while C- and D-type units were located particularly in the

  6. Composition of glycosaminoglycans in elasmobranchs including several deep-sea sharks: identification of chondroitin/dermatan sulfate from the dried fins of Isurus oxyrinchus and Prionace glauca.

    PubMed

    Higashi, Kyohei; Takeuchi, Yoshiki; Mukuno, Ann; Tomitori, Hideyuki; Miya, Masaki; Linhardt, Robert J; Toida, Toshihiko

    2015-01-01

    Shark fin, used as a food, is a rich source of glycosaminoglyans (GAGs), acidic polysaccharides having important biological activities, suggesting their nutraceutical and pharmaceutical application. A comprehensive survey of GAGs derived from the fin was performed on 11 elasmobranchs, including several deep sea sharks. Chondroitin sulfate (CS) and hyaluronic acid (HA) were found in Isurus oxyrinchus, Prionace glauca, Scyliorhinus torazame, Deania calcea, Chlamydoselachus anguineus, Mitsukurina owatoni, Mustelus griseus and Dasyatis akajei, respectively. CS was only found from Chimaera phantasma, Dalatias licha, and Odontaspis ferox, respectively. Characteristic disaccharide units of most of the CS were comprised of C- and D-type units. Interestingly, substantial amount of CS/dermatan sulfate (DS) was found in the dried fin (without skin and cartilage) of Isurus oxyrinchus and Prionace glauca. 1H-NMR analysis showed that the composition of glucuronic acid (GlcA) and iduronic acid (IdoA) in shark CS/DS was 41.2% and 58.8% (Isurus oxyrinchus), 36.1% and 63.9% (Prionace glauca), respectively. Furthermore, a substantial proportion of this CS/DS consisted of E-, B- and D-type units. Shark CS/DS stimulated neurite outgrowth of hippocampal neurons at a similar level as DS derived from invertebrate species. Midkine and pleiotrophin interact strongly with CS/DS from Isurus oxyrinchus and Prionace glauca, affording Kd values of 1.07 nM, 6.25 nM and 1.70 nM, 1.88 nM, respectively. These results strongly suggest that the IdoA-rich domain of CS/DS is required for neurite outgrowth activity. A detailed examination of oligosaccharide residues, produced by chondroitinase ACII digestion, suggested that the IdoA and B-type units as well as A- and C-type units were found in clusters in shark CS/DS. In addition, it was discovered that the contents of B-type units in these IdoA-rich domain increased in a length dependent manner, while C- and D-type units were located particularly in the

  7. An outbreak of acute Schistosoma mansoni Schistosomiasis in a nonendemic area of Brazil: a report on 50 cases, including 5 with severe clinical manifestations.

    PubMed

    Lambertucci, José Roberto; Drummond, Sandra Costa; Voieta, Izabela; de Queiróz, Leonardo Campos; Pereira, Pedro Paulo Nunes; Chaves, Bruna Assis; Botelho, Patrícia Passos; Prata, Pedro Henrique; Otoni, Alba; Vilela, José Fagundes; Antunes, Carlos Maurício

    2013-07-01

    Acute schistosomiasis is a systemic hypersensitivity reaction against the migrating schistosomula and eggs. In this report, we describe an atypical outbreak of the disease with severe cases. Transmission occurred in a nonendemic area of Brazil, which became a new focus of transmission due to the in-migration of infected workers. From December 2009 to March 2010, the 50 patients with acute schistosomiasis (group 1) bathed in a swimming pool supplied by a brook on a country estate in the outskirts of São João del Rei, Brazil. Thirty other subjects (group 2) living in the same area, who denied having contact with the swimming pool, volunteered to participate in the study. All participants were submitted to clinical, laboratory, and ultrasound examinations. Five of 50 (10%) patients were admitted to the hospital: 1 with myeloradiculopathy, 1 with diffuse pulmonary micronodules, and 3 with diarrhea and dehydration. All 5 had hypereosinophilia and prolonged fever. Group 1 patients more frequently had cercarial dermatitis (P = .01), blood in the stool (P = .04), and intra-abdominal lymph nodes (P = .001). All group 1 patients were treated with praziquantel; 1 patient with myeloradiculopathy also received oral prednisone (60 mg/day) for 6 months with complete recovery. This report describes the first time that patients from an outbreak of acute schistosomiasis have been compared to controls. Five subjects (10%) had severe manifestations of schistosomiasis. Diagnosis of the disease and its severity was delayed because physicians did not consider that an epidemic of schistosomiasis might emerge in a nonendemic area.

  8. A homozygous deletion of 8q24.3 including the NIBP gene associated with severe developmental delay, dysgenesis of the corpus callosum, and dysmorphic facial features.

    PubMed

    Koifman, Arie; Feigenbaum, Annette; Bi, Weimin; Shaffer, Lisa G; Rosenfeld, Jill; Blaser, Susan; Chitayat, David

    2010-05-01

    We have identified by microarray-based comparative genomic hybridization analysis (aCGH), a homozygous deletion of 8q24.3 [arr cgh 8q24.3(140,879,937 --> 141,021,392)x0 mat pat] in a patient with dysmorphic facial features, dysgenesis of the corpus callosum, and severe mental retardation. The deletion was inherited from asymptomatic, consanguineous parents, each of them being heterozygous for the same deletion. The only gene known to map to this segment is the NIBP gene, and so far no clinical manifestations have been found in association with this gene mutation in homozygous or heterozygous state in humans. Our findings suggest that a homozygous deletion in the NIBP gene results in an autosomal recessive condition with multiple abnormalities and severe delay. In addition, the child inherited a 781-kb deletion on 4q32.2 from the mother that contains the SPOCK3 gene. We suggest that this heterozygous deletion is likely to be non-contributory to the phenotype. Copyright 2010 Wiley-Liss, Inc.

  9. Senescence-associated β-galactosidase staining in fish cell lines and primary cultures from several tissues and species, including rainbow trout coelomic fluid and milt.

    PubMed

    Vo, Nguyen T K; Mikhaeil, Michael S; Lee, Lucy E J; Pham, Phuc H; Bols, Niels C

    2015-04-01

    Cell lines and primary cultures from several teleost tissues and species were stained for senescence-associated β-galactosidase (SA β-Gal), revealing four general outcomes. (1) For long-standing fish cell lines that can be considered immortal, little or no SA β-Gal staining was observed, regardless of the culture conditions. (2) For a new walleye cell line from the bulbus arteriosus (WEBA), most cells stained for SA β-Gal even after 40 passages. This suggested that high SA β-Gal activity was a unique property of WEBA, perhaps reflecting their endothelial character, rather than cellular senescence. (3) For cell lines developed from the walleye caudal fin and from somatic cells in rainbow trout coelomic fluid, no SA β-Gal staining was observed in the earliest cultures to over 70 passages later. This suggested that cells from these anatomical sites do not undergo senescence in vitro. (4) By contrast, for cell lines developed from the walleye brain and from somatic cells in rainbow trout milt, most cells in the early-stage cultures stained for SA β-Gal, but as these were developed into cell lines, SA β-Gal-negative cells became dominant. This suggested that if cellular senescence occurred in vitro, this happened early in these cultures and subsequently a few SA β-Gal-negative cells went onto to form the cell line. Overall, the presence of SA β-Gal-positive cells in cultures could be interpreted in several ways, whereas their absence predicted that in these cultures, cells would proliferate indefinitely.

  10. Molecular basis of severe factor XI deficiency in seven families from the west of France. Seven novel mutations, including an ancient Q88X mutation.

    PubMed

    Quélin, F; Trossaërt, M; Sigaud, M; Mazancourt, P D E; Fressinaud, E

    2004-01-01

    Inherited factor (F)XI deficiency is a rare disorder in the general population, though it is commonly found in individuals of Ashkenazi Jewish ancestry. In particular, two mutations--a stop mutation (type II) and a missense mutation (type III)--which are responsible for FXI deficiency, predominate. The bleeding tendency associated with plasma FXI deficiency in patients is variable, with approximately 50% of patients exhibiting excessive post-traumatic or postsurgical bleeding. In this study, we identified the molecular basis of FXI deficiency in 10 patients belonging to six unrelated families of the Nantes area in France and one family of Lebanese origin. As in Ashkenazi Jewish or in French Basque patients, we have identified a new ancient mutation in exon 4 resulting in Q88X, specific to patients from Nantes, that can result in a severely truncated polypeptide. Homozygous Q88X was found in a severely affected patient with an inhibitor to FXI and in three other unrelated families, either as homozygous, heterozygous or compound heterozygous states. Other identified mutations are two nonsense mutations in the FXI gene, in exon 7 and 15, resulting in R210X and C581X, respectively, which were identified in three families. A novel insertion in exon 3 (nucleotide 137 + G), which causes a stop codon, was characterized. Finally, sequence analysis of all 15 exons of the FXI gene revealed three missense mutations resulting in G336R and G350A (exon 10) and T575M (exon 15). Two mutations (T575M and G350A) with discrepant antigen and functional values are particularly interesting because most of the described mutations are associated with the absence of secreted protein.

  11. IVIG - A cure to severe refractory NAP-1 Clostridium difficile colitis? A case of successful treatment of severe infection, which failed standard therapy including fecal microbiota transplants and fidaxomicin.

    PubMed

    Coffman, Kelley; Chen, Xian Jie Cindy; Okamura, Charles; Louie, Eddie

    2017-01-01

    The mainstay treatment of Clostridium difficile infections (CDI) is antimicrobials with growing support for fecal microbiota transplants. We report the first case of an elderly man with severe refractory NAP-1 pseudomembranous CDI who failed all medical therapy and two fecal transplants with response only seen after administration of intravenous immunoglobulin.

  12. Exosome secretion, including the DNA damage-induced p53-dependent secretory pathway, is severely compromised in TSAP6/Steap3-null mice.

    PubMed

    Lespagnol, A; Duflaut, D; Beekman, C; Blanc, L; Fiucci, G; Marine, J-C; Vidal, M; Amson, R; Telerman, A

    2008-11-01

    TSAP6 (tumor suppressor-activated pathway 6), also known as Steap3, is a direct p53 transcriptional target gene. It regulates protein secretion, for example translationally controlled tumor protein (TCTP), which is implicated in tumor reversion. In keeping with the latter, we show herein that TSAP6 is a glycosylated protein present in the trans-Golgi network, endosomal-vesicular compartment and cytoplasmic membrane. To further investigate the physiological function of TSAP6, we have generated TSAP6-deficient mice. These mice exhibit microcytic anemia with abnormal reticulocyte maturation and deficient transferrin receptor downregulation, a process known to be dependent on exosomal secretion. Moreover, we provide direct evidence that exosome production is severely compromised in TSAP6-null cells. Finally, we show that the DNA damage-induced p53-dependent nonclassical exosomal secretory pathway is abrogated in TSAP6-null cells. Given the fact that exosomes are used as cell-free vaccines against cancer and that they could be involved in the biogenesis and spread of human immunodeficiency virus, it is important to understand their regulation. The results presented here provide the first genetic demonstration that exosome formation is a tightly controlled biological process dependent of TSAP6.

  13. Comparison of Inhibition Kinetics of Several Organophosphates, including Some Nerve Agent Surrogates, using Human Erythrocyte and Rat and Mouse Brain Acetylcholinesterase

    PubMed Central

    Coban, Alper; Carr, Russell L.; Chambers, Howard W.; Willeford, Kenneth O.; Chambers, Janice E.

    2016-01-01

    Because testing of nerve agents is limited to only authorized facilities, our laboratory developed several surrogates that resemble nerve agents because they phosphylate the acetylcholinesterase (AChE) with the same moiety as the actual nerve agents. The inhibition kinetic parameters were determined for AChE by surrogates of cyclosarin (NCMP), sarin (NIMP, PIMP and TIMP) and VX (NEMP and TEMP) and other organophosphorus compounds derived from insecticides. All compounds were tested with rat brain and a subset was tested with mouse brain and purified human erythrocyte AChE. Within the compounds tested on all AChE sources, chlorpyrifos-oxon had the highest molecular rate constant followed by NCMP and NEMP. This was followed by NIMP then paraoxon and DFP with rat and mouse brain AChE but DFP was a more potent inhibitor than NIMP and paraoxon with human AChE. With the additional compounds tested only in rat brain, TEMP was slightly less potent than NEMP but more potent than PIMP which was more potent than NIMP. Methyl paraoxon was slightly less potent than paraoxon but more potent than TIMP which was more potent than DFP. Overall, this study validates that the pattern of inhibitory potencies of our surrogates is comparable to the pattern of inhibitory potencies of actual nerve agents (i.e., cyclosarin>VX>sarin), and that these are more potent than insecticidal organophosphates. PMID:26965078

  14. Caffeine neuroprotective effects on 6-OHDA-lesioned rats are mediated by several factors, including pro-inflammatory cytokines and histone deacetylase inhibitions.

    PubMed

    Machado-Filho, João Ananias; Correia, Alyne Oliveira; Montenegro, Anyssa Brilhante Aires; Nobre, Maria Elizabeth Pereira; Cerqueira, Gilberto Santos; Neves, Kelly Rose Tavares; Naffah-Mazzacoratti, Maria da Graça; Cavalheiro, Esper Abrão; de Castro Brito, Gerly Anne; de Barros Viana, Glauce Socorro

    2014-05-01

    Several lines of evidences have shown the inversion association between coffee consumption and Parkinson's disease (PD) development. Caffeine is a methylxanthine known as a non-selective inhibitor of A2A and A1 adenosine receptors in the brain and shown to be a neuroprotective drug. The objectives were to study caffeine effects in a unilateral 6-OHDA model of PD in rats. Male rats were divided into the following groups: sham-operated (SO), striatal 6-OHDA-lesioned and 6-OHDA-lesioned and treated for 2 weeks with caffeine (10 and 20mg/kg, p.o.). Then, animals were subjected to behavioral (open field and apomorphine-induced rotations), neurochemical (striatal determinations of DA and DOPAC), histological (cresyl violet staining) and immunohistochemical (TH, TNF-α, IL-1β and HDAC) evaluations. The results showed that while the 6-OHDA group presented a decreased locomotor activity and a high number of apomorphine-induced rotations, these behaviors were partially blocked by caffeine. Caffeine itself increased DA contents and reversed the decrease in striatal DA observed in the 6-OHDA-lesioned group. Furthermore, it improved the hippocampal neuronal viability and significantly increased TH immunoreactivity in the striatum of the 6-OHDA-lesioned group. In addition, caffeine treatment also decreased the number of immunopositive cells for HDAC and pro-inflammatory cytokines TNF-α and IL-1β. All these effects points out to a neuroprotective effect of caffeine and its potential benefit in the prevention and treatment of PD.

  15. Effects of MK-801 treatment across several pre-clinical analyses including a novel assessment of brain metabolic function utilizing PET and CT fused imaging in live rats.

    PubMed

    Daya, R P; Bhandari, J K; Hui, P A; Tian, Y; Farncombe, T; Mishra, R K

    2014-02-01

    Functional imaging studies in schizophrenic patients have demonstrated metabolic brain abnormalities during cognitive tasks. This study aimed to 1) introduce a novel analysis of brain metabolic function in live animals to characterize the hypo- and hyperfrontality phenomena observed in schizophrenia and following NMDA antagonist exposure, and 2) identify a robust and representative MK-801 treatment regimen that effectively models brain metabolic abnormalities as well as a range of established behavioural abnormalities representative of schizophrenia. The validity of the MK-801 animal model was examined across several established pre-clinical tests, and a novel assessment of brain metabolic function using PET/CT fused imaging. In the present study, MK-801 was administered acutely at 0.1 mg/kg and 0.5 mg/kg, and sub-chronically at 0.5 mg/kg daily for 7 days. Acute treatment at 0.5 mg/kg-disrupted facets of memory measured through performance in the 8-arm radial maze task and generated abnormalities in sensorimotor gating, social interaction and locomotor activity. Furthermore, this treatment regimen induced hyperfrontality (increased brain metabolic function in the prefrontal area) observed via PET/CT fused imaging in the live rat. While PET and CT fused imaging in the live rat offers a functional representation of metabolic function, more advanced PET/CT integration is required to analyze more discrete brain regions. These findings provide insight on the effectiveness of the MK-801 pre-clinical model of schizophrenia and provide an optimal regimen to model schizophrenia. PET/CT fused imaging offers a highly translatable tool to assess hypo- and hyperfrontality in live animals. Copyright © 2013 Elsevier Ltd. All rights reserved.

  16. A non-leaky Artemis-deficient mouse that accurately models the human severe combined immune deficiency phenotype, including resistance to hematopoietic stem cell transplantation.

    PubMed

    Xiao, Zheng; Dunn, Elizabeth; Singh, Kanal; Khan, Imran S; Yannone, Steven M; Cowan, Morton J

    2009-01-01

    Two Artemis-deficient (mArt(-/-)) mouse models, generated independently on 129/SvJ backgrounds, have the expected T(-)B(-)NK(+) severe combined immune deficiency (SCID) phenotype but fail to mimic the human disease because of CD4(+) T cell leakiness. Moreover, immune reconstitution after hematopoietic stem cell transplantation is achieved more readily in these leaky mouse models than in Artemis-deficient humans. To develop a more clinically relevant animal model, we backcrossed the mArt(-/-) mutation onto the C57Bl/6 (B6) background (99.9%), which resulted in virtually no CD4(+) T cell leakiness compared with 129/SvJ mArt(+/-) mice (0.3% +/- 0.25% vs 19.5% +/- 15.1%, P < .001). The nonleaky mouse also was uniquely resistant to engraftment using allogeneic mismatched hematopoietic stem cells, comparable to what is seen in human Artemis deficiency. The genetic background also influenced Artemis-associated radiation sensitivity, with differing degrees of x-ray hypersensitivity evident in 129/SvJ and B6 backgrounds with both the mArt(-/-) and mArt(+/-) genotypes. Our results indicate that immunogenic and DNA repair phenotypes associated with Artemis deficiency are significantly altered by genetic background, which has important implications for the diagnosis and treatment of SCID. Moreover, the B6 mArt(-/-) mouse provides a more accurate model for the human disease and a more appropriate system for studying human Artemis deficiency and for developing improved transplantation and gene therapy regimens for the treatment of children with SCID.

  17. Bioinformatic analyses of the publicly accessible crustacean expressed sequence tags (ESTs) reveal numerous novel neuropeptide-encoding precursor proteins, including ones from members of several little studied taxa.

    PubMed

    Christie, Andrew E; Durkin, Christopher S; Hartline, Niko; Ohno, Paul; Lenz, Petra H

    2010-05-15

    ESTs have been generated for many crustacean species, providing an invaluable resource for peptide discovery in members of this arthropod subphylum. Here, these data were mined for novel peptide-encoding transcripts, with the mature peptides encoded by them predicted using a combination of online peptide prediction programs and homology to known arthropod sequences. In total, 70 mature full-length/partial peptides representing members of 16 families/subfamilies were predicted, the vast majority being novel; the species from which the peptides were identified included members of the Branchiopoda (Daphnia carinata and Triops cancriformis), Maxillopoda (Caligus clemensi, Caligus rogercresseyi, Lepeophtheirus salmonis and Lernaeocera branchialis) and Malacostraca (Euphausia superba, Marsupenaeus japonicus, Penaeus monodon, Homarus americanus, Petrolisthes cinctipes, Callinectes sapidus and Portunus trituberculatus). Of particular note were the identifications of an intermediate between the insect adipokinetic hormones and crustacean red pigment concentrating hormone and a modified crustacean cardioactive peptide from the daphnid D. carinata; Arg(7)-corazonin was also deduced from this species, the first identification of a corazonin from a non-decapod crustacean. Our data also include the first reports of members of the calcitonin-like diuretic hormone, FMRFamide-related peptide (neuropeptide F subfamily) and orcokinin families from members of the Copepoda. Moreover, the prediction of a bursicon alpha from the euphausid E. superba represents the first peptide identified from any member of the basal eucaridean order Euphausiacea. In addition, large collections of insect eclosion hormone- and neuroparsin-like peptides were identified from a variety of species, greatly expanding the number of known members of these families in crustaceans.

  18. A novel 2q37 microdeletion containing human neural progenitors genes including STK25 results in severe developmental delay, epilepsy, and microcephaly.

    PubMed

    Imitola, Jaime; Khurana, Divya S; Teplyuk, Nadiya M; Zucker, Mark; Jethva, Reena; Legido, Agustin; Krichevsky, Ana M; Frangieh, Michael; Walsh, Christopher A; Carvalho, Karen S

    2015-11-01

    2q37 microdeletion syndrome is a rare syndrome characterized by neurodevelopmental delay, bone, cardiovascular, and neurological alterations. This syndrome is typically associated with loss of genetic material of approximately 100 genes in the 2q37 band. However, the genes associated with neurodevelopmental phenotype in this syndrome are still unknown. We identified a deleted region of 496 kb by whole genome array CGH in a patient who fulfilled criteria for 2q37 microdeletion syndrome with developmental delay, microcephaly, hypoplasia of the corpus callosum, hand wringing, toe walking, and seizures. The deleted segment contains genes that are highly expressed in the developing human cortical plate and the subventricular zone (SVZ) in vivo and human neural progenitors in vitro, including SEPT2, THAP4, ATG4B, PPP1R7, and STK25. Network analysis revealed that STK25 was the most interacting gene associated with neural development in this deletion. Our report narrows the likely causative genomic region for microcephaly and neurodevelopmental delay in 2q37 microdeletion syndrome to a small genomic region enriched with neural progenitor genes that may represent an important locus for the development of the human cortex and corpus callosum. © 2015 Wiley Periodicals, Inc.

  19. Introduction to IEEE 841-1994, IEEE standard for petroleum and chemical industry: Severe duty totally enclosed fan-cooled (TEFC) squirrel cage induction motors -- up to and including 500 hp

    SciTech Connect

    Doughty, R.L.

    1995-12-31

    IEEE 841, Recommended Practice for Chemical Industry Severe Duty Squirrel-Cage Induction Motors--600 V and Below, first issued in 1986, has been significantly revised and reissued as a Standard. The scope has been increased to include severe duty TEFC squirrel-cage induction motors with antifriction bearings in sizes up to and including 500 horsepower. Motor rated voltages of 2,300 V and 4,000 V have been added. Changes to the standard are reviewed in detail. Requirements are identified that improve motor reliability and increase motor life.

  20. Delineation of a de novo 7q21.3q31.1 Deletion by CGH-SNP Arrays in a Girl with Multiple Congenital Anomalies Including Severe Glaucoma

    PubMed Central

    Martínez-Jacobo, L.; Córdova-Fletes, C.; Ortiz-López, R.; Rivas, F.; Saucedo-Carrasco, C.; Rojas-Martínez, A.

    2013-01-01

    In this study, we present a female patient with a constitutional de novo deletion in 7q21.3q31.1 as determined by G-banding and CGH-SNP arrays. She exhibited, among other features, psychomotor retardation, congenital severe bilateral glaucoma, a cleft palate, and heart defect. Microarray assay disclosed a deleted 12.5-Mb region roughly 88 kb downstream the ectrodactyly critical region; thus, the patient's final karyotype was 46,XX.arr 7q21.3q31.1(96,742,140-109,246,085)×1 dn. This girl represents the fourth patient described so far with congenital glaucoma and a deletion encompassing or overlapping the 7q21.3q31.1 region, and confirms the presence of a locus or loci related to such a clinical feature. According to our results, the proneness to ocular defects secondary to 7q intermediate deletions could be caused by co-deletion of TAC1, HBP1, and a small cluster of cytochrome P450 genes (subfamily 3A). This conclusion is supported by their functional roles and expression locations as well as because TAC1 is related to the functional pathway of the MYOC gene whose mutations are linked to glaucoma. Moreover, given that this girl is clinically reminiscent of several phenotypes related to diverse deletions within 7q21q32, our results and observations offer a general overview of the gene content of deletions/phenotypes overlapping 7q21.3q31.1 and confirm that loci distal to DLX genes including the CUX1 gene and potential regulatory elements downstream from DLX5 are unrelated to ectrodactyly. PMID:24167464

  1. Plasma granulocyte colony-stimulating factor and granulocyte-macrophage colony-stimulating factor levels in critical illness including sepsis and septic shock: relation to disease severity, multiple organ dysfunction, and mortality.

    PubMed

    Presneill, J J; Waring, P M; Layton, J E; Maher, D W; Cebon, J; Harley, N S; Wilson, J W; Cade, J F

    2000-07-01

    To define the circulating levels of granulocyte colony-stimulating factor (G-CSF) and granulocyte-macrophage colony-stimulating factor (GM-CSF) during critical illness and to determine their relationship to the severity of illness as measured by the Acute Physiology and Chronic Health Evaluation (APACHE) II score, the development of multiple organ dysfunction, or mortality. Prospective cohort study. University hospital intensive care unit. A total of 82 critically ill adult patients in four clinically defined groups, namely septic shock (n = 29), sepsis without shock (n = 17), shock without sepsis (n = 22), and nonseptic, nonshock controls (n = 14). None. During day 1 of septic shock, peak plasma levels of G-CSF, interleukin (IL)-6, and leukemia inhibitory factor (LIF), but not GM-CSF, were greater than in sepsis or shock alone (p < .001), and were correlated among themselves (rs = 0.44-0.77; p < .02) and with the APACHE II score (rs = 0.25-0.40; p = .03 to .18). G-CSF, IL-6, and UF, and sepsis, shock, septic shock, and APACHE II scores were strongly associated with organ dysfunction or 5-day mortality by univariate analysis. However, multiple logistic regression analysis showed that only septic shock remained significantly associated with organ dysfunction and only APACHE II scores and shock with 5-day mortality. Similarly, peak G-CSF, IL-6, and LIF were poorly predictive of 30-day mortality. Plasma levels of G-CSF, IL-6, and LIF are greatly elevated in critical illness, including septic shock, and are correlated with one another and with the severity of illness. However, they are not independently predictive of mortality, or the development of multiple organ dysfunction. GM-CSF was rarely elevated, suggesting different roles for G-CSF and GM-CSF in human septic shock.

  2. Less invasive corrective surgery using oblique lateral interbody fusion (OLIF) including L5-S1 fusion for severe lumbar kyphoscoliosis due to L4 compression fracture in a patient with Parkinson's disease: a case report.

    PubMed

    Wakita, Hiromasa; Shiga, Yasuhiro; Ohtori, Seiji; Kubota, Go; Inage, Kazuhide; Sainoh, Takeshi; Sato, Jun; Fujimoto, Kazuki; Yamauchi, Kazuyo; Nakamura, Junichi; Takahashi, Kazuhisa; Toyone, Tomoaki; Aoki, Yasuchika; Inoue, Gen; Miyagi, Masayuki; Orita, Sumihisa

    2015-04-07

    Corrective surgery for kyphoscoliosis patients tend to be highly invasive due to osteotomy. The present case introduce less invasive corrective surgery using anterior oblique lateral interbody fusion (OLIF) technique. An 80-year-old Japanese man with a history of Parkinson's disease presented to our hospital because of severe kyphoscoliosis and gait disturbance. Considering the postsurgical complications due to osteotomy, we performed an anterior-posterior combined corrective fusion surgery: OLIF of Lumbar (L) 2-3, L3-4, and L4-5 (Medtronic Sofamor Danek, Memphis, TN, USA) followed by L5-Sacral (S) 1 anterior lumbar fusion via the OLIF approach using an anterior intervertebral cage, and posterior L3-4 and L4-5 facetectomy and posterior fusion using percutaneous pedicle screws from Thoracic (T) 10 to S1 with a T-9 hook system. The surgery was performed in a less invasive manner with no osteotomy, and it improved the sagittal alignments with moderate restoration, which improved the patient's posture and gait disturbance. The patient showed transient muscle weakness of proximal lower extremity contralateral side to the surgical site, which fully recovered by physical rehabilitation 3 months after the surgery. The surgical corrective procedure using the minimally invasive OLIF method including L5-S1 fusion showed a great advantage in treating degenerative kyphoscoliosis in a Parkinson's disease patient in its less-invasive approac.

  3. Infliximab, adalimumab and golimumab for treating moderately to severely active ulcerative colitis after the failure of conventional therapy (including a review of TA140 and TA262): clinical effectiveness systematic review and economic model.

    PubMed

    Archer, Rachel; Tappenden, Paul; Ren, Shijie; Martyn-St James, Marrissa; Harvey, Rebecca; Basarir, Hasan; Stevens, John; Carroll, Christopher; Cantrell, Anna; Lobo, Alan; Hoque, Sami

    2016-05-01

    achieve clinical response and remission than those receiving placebo (PBO). Hospitalisation data were limited, but suggested more favourable outcomes for ADA- and IFX-treated patients. Data on the use of surgical intervention were sparse, with a potential benefit for intervention-treated patients. Data were available from one trial to support the use of IFX in paediatric patients. Safety issues identified included serious infections, malignancies and administration site reactions. Based on the NMA, in the induction phase, all biological treatments were associated with statistically significant beneficial effects relative to PBO, with the greatest effect associated with IFX. For patients in response following induction, all treatments except ADA and GOL 100 mg at 32-52 weeks were associated with beneficial effects when compared with PBO, although these were not significant. The greatest effects at 8-32 and 32-52 weeks were associated with 100 mg of GOL and 5 mg/kg of IFX, respectively. For patients in remission following induction, all treatments except ADA at 8-32 weeks and GOL 50 mg at 32-52 weeks were associated with beneficial effects when compared with PBO, although only the effect of ADA at 32-52 weeks was significant. The greatest effects were associated with GOL (at 8-32 weeks) and ADA (at 32-52 weeks). The economic analysis suggests that colectomy is expected to dominate drug therapies, but for some patients, colectomy may not be considered acceptable. In circumstances in which only drug options are considered, IFX and GOL are expected to be ruled out because of dominance, while the incremental cost-effectiveness ratio for ADA versus conventional treatment is approximately £50,300 per QALY gained. The health economic model is subject to several limitations: uncertainty associated with extrapolating trial data over a lifetime horizon, the model does not consider explicit sequential pathways of non-biological treatments, and evidence relating to

  4. A Kinome-Wide Small Interfering RNA Screen Identifies Proviral and Antiviral Host Factors in Severe Acute Respiratory Syndrome Coronavirus Replication, Including Double-Stranded RNA-Activated Protein Kinase and Early Secretory Pathway Proteins

    PubMed Central

    de Wilde, Adriaan H.; Wannee, Kazimier F.; Scholte, Florine E. M.; Goeman, Jelle J.; ten Dijke, Peter; Snijder, Eric J.

    2015-01-01

    ABSTRACT To identify host factors relevant for severe acute respiratory syndrome-coronavirus (SARS-CoV) replication, we performed a small interfering RNA (siRNA) library screen targeting the human kinome. Protein kinases are key regulators of many cellular functions, and the systematic knockdown of their expression should provide a broad perspective on factors and pathways promoting or antagonizing coronavirus replication. In addition to 40 proteins that promote SARS-CoV replication, our study identified 90 factors exhibiting an antiviral effect. Pathway analysis grouped subsets of these factors in specific cellular processes, including the innate immune response and the metabolism of complex lipids, which appear to play a role in SARS-CoV infection. Several factors were selected for in-depth validation in follow-up experiments. In cells depleted for the β2 subunit of the coatomer protein complex (COPB2), the strongest proviral hit, we observed reduced SARS-CoV protein expression and a >2-log reduction in virus yield. Knockdown of the COPB2-related proteins COPB1 and Golgi-specific brefeldin A-resistant guanine nucleotide exchange factor 1 (GBF1) also suggested that COPI-coated vesicles and/or the early secretory pathway are important for SARS-CoV replication. Depletion of the antiviral double-stranded RNA-activated protein kinase (PKR) enhanced virus replication in the primary screen, and validation experiments confirmed increased SARS-CoV protein expression and virus production upon PKR depletion. In addition, cyclin-dependent kinase 6 (CDK6) was identified as a novel antiviral host factor in SARS-CoV replication. The inventory of pro- and antiviral host factors and pathways described here substantiates and expands our understanding of SARS-CoV replication and may contribute to the identification of novel targets for antiviral therapy. IMPORTANCE Replication of all viruses, including SARS-CoV, depends on and is influenced by cellular pathways. Although

  5. Nature-assisted rehabilitation for reactions to severe stress and/or depression in a rehabilitation garden: long-term follow-up including comparisons with a matched population-based reference cohort.

    PubMed

    Währborg, Peter; Petersson, Ingemar F; Grahn, Patrik

    2014-03-01

    To determine the effect of a nature-assisted rehabilitation programme in a group of patients with reactions to severe stress and/or mild to moderate depression. Changes in sick-leave status and healthcare consumption in these patients were compared with those in a matched population-based reference cohort (treatment as usual). Retrospective cohort study with a matched reference group from the general population. A total of 118 participants referred to a nature-assisted rehabilitation programme, and 678 controls recruited from the Skåne Health Care Register. For both groups, information on sick leave was extracted from the National Social Insurance Register and on healthcare consumption data from the Skåne Health Care Register. The interventional rehabilitation programme was designed as a multimodal programme involving professionals from horticulture and medicine. The programme was conducted in a rehabilitation garden, designed especially for this purpose. A significant reduction in healthcare consumption was noted among participants in the programme compared with the reference population. The main changes were a reduction in outpatient visits to primary healthcare and a reduction in inpatient psychiatric care. No significant difference in sick-leave status was found. A structured, nature-based rehabilitation programme for patients with reactions to severe stress and/or depression could be beneficial, as reflected in reduced healthcare consumption.

  6. Stable Carbon Isotope Ratios and Mixing Ratios of Several VOC Including n-Hexane, Benzene, Toluene, p-Xylene, n-Octane, and n-Decane Measured During the Border Air Quality Study Campaign (June-July, 2007)

    NASA Astrophysics Data System (ADS)

    Kornilova, A.; Moukhtar, S.; Huang, L.; Rudolph, J.

    2008-12-01

    Many important secondary pollutants are formed during the oxidation of Volatile Organic Compounds (VOC) in the atmosphere. These organic compounds can contribute significant mass to atmospheric particulate matter (PM) and therefore impact physical properties and composition of aerosols. Despite numerous studies, the formation processes for atmospheric PM are still not well understood. While there have been very extensive laboratory investigations of PM formation, nearly all of these studies have been conducted at VOC concentrations which exceed ambient atmospheric levels by several orders of magnitude. Consequently there is substantial uncertainty in the extrapolation of laboratory results to the atmosphere. Recently it has been demonstrated that stable carbon isotopic composition measurements can be very valuable in providing increased insight into the chemical and transport processes of VOC in the troposphere. Studies showed that isotope ratio measurements could aid in the determination of photochemical processing of individual VOC. It is expected that applying isotope measurements to studies of VOC oxidation products in the atmosphere will allow to establish quantitative relationship between the amount of precursor oxidized and the concentration of secondary pollutants formed during this process. Thus, the yield of secondary organic aerosols (SOA) from this reaction can be calculated. A cartridge technique was developed for field sampling of VOC and subsequent laboratory analysis by gas chromatography coupled with isotope ratio mass spectrometry. It was first implemented during the BAQS field study (June-July, 2007) parallel to PM sampling. Stable carbon isotopic composition and concentrations of several VOC were determined and compared to those of PM. The results of these measurements will be presented and discussed.

  7. Investigation of Minimum Drag and Maximum Lift-drag Ratios of Several Wing-body Combinations Including a Cambered Triangular Wing at Low Reynolds Numbers and at Supersonic Speeds

    NASA Technical Reports Server (NTRS)

    Brown, Clinton E; Hargrave, L K

    1958-01-01

    Theoretical and experimental data for wing-body combinations with wings of triangular, arrow, and diamond plan form are presented for Mach numbers of 1.62, 1.93, and 2.41 and a Reynolds number range of 1.4 x 10 to the 6th power to 0.7 x 10 to the 6th power. Included are two each of triangular and arrow plan-form wings cambered for approximately uniform load at m = 1.62 and lift coefficients of 0.08 and 0.20. Liquid-film studies of the flow over the various configurations are also presented.

  8. Reduced difference of α₂-plasmin inhibitor levels between plasma and serum in patients with severe factor XIII deficiency, including autoimmune hemorrhaphilia due to anti-factor XIII antibodies.

    PubMed

    Ichinose, Akitada; Souri, Masayoshi

    2012-01-01

    Coagulation factor XIII/13 (FXIII/13) stabilizes fibrin molecules by creating crosslinks with other fibrin molecules as well as with α₂-plasmin inhibitor (α₂-PI). "Hemorrhagic acquired FXIII/13 deficiency" was formerly considered rare, but has been increasing recently in Japan. During the 10 months of our nationwide campaign, we diagnosed five new patients with "acquired hemorrhaphilia due to anti-FXIII/13 autoantibodies," after examining 20 newly suspected cases of "hemorrhagic acquired FXIII/13 deficiency." When FXIII/13 activity was reduced to less than 50% of normal, it was proportional to the difference in α₂-PI levels between plasma and serum (plasma-serum α₂-PI), likely due to its cross-linking to fibrin by activated FXIII/13. Accordingly, decreased amounts of the plasma-serum α₂-PI ex vivo may reflect reduced FXIII/13 activity in vivo. The plasma-serum α₂-PI may thus also be a useful diagnostic marker for severe FXIII/13 deficiency.

  9. 34 CFR 303.15 - Include; including.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 34 Education 2 2010-07-01 2010-07-01 false Include; including. 303.15 Section 303.15 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION EARLY INTERVENTION PROGRAM FOR INFANTS AND TODDLERS WITH...

  10. 34 CFR 303.15 - Include; including.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 34 Education 2 2011-07-01 2010-07-01 true Include; including. 303.15 Section 303.15 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION EARLY INTERVENTION PROGRAM FOR INFANTS AND TODDLERS WITH...

  11. Severe pneumonia.

    PubMed

    Harvey, J

    1982-03-01

    The successful management of severe pneumonia involves a logical approach to antibiotic therapy, based on selecting drugs active against the most likely pathogen in each individual case while awaiting possible identification of an organism. In patients who deteriorate, more invasive diagnostic procedures should be considered in combination with broader-spectrum antibiotic treatment. Controlled oxygen therapy monitored by arterial blood-gas tension measurements is essential and mechanical ventilation may be indicated in some cases. Other measures including physiotherapy, fluid replacement, and the relief of pleuritic pain should not be forgotten.

  12. Refraction, including prisms.

    PubMed

    Hiatt, R L

    1991-02-01

    The literature in the past year on refraction is replete with several isolated but very important topics that have been of interest to strabismologists and refractionists for many decades. The refractive changes in scleral buckling procedures include an increase in axial length as well as an increase in myopia, as would be expected. Tinted lenses in dyslexia show little positive effect in the nonasthmatic patients in one study. The use of spectacles or bifocals as a way to control increase in myopia is refuted in another report. It has been shown that in accommodative esotropia not all patients will be able to escape the use of bifocals in the teenage years, even though surgery might be performed. The hope that disposable contact lenses would cut down on the instance of giant papillary conjunctivitis and keratitis has been given some credence, and the conventional theory that sclerosis alone is the cause of presbyopia is attacked. Also, gas permeable bifocal contact lenses are reviewed and the difficulties of correcting presbyopia by this method outlined. The practice of giving an aphakic less bifocal addition instead of a nonaphakic, based on the presumption of increased effective power, is challenged. In the review of prisms, the majority of articles concern prism adaption. The most significant report is that of the Prism Adaptation Study Research Group (Arch Ophthalmol 1990, 108:1248-1256), showing that acquired esotropia in particular has an increased incidence of stable and full corrections surgically in the prism adaptation group versus the control group.(ABSTRACT TRUNCATED AT 250 WORDS)

  13. KENNEDY SPACE CENTER, FLA. - Dr. Dennis Morrison, NASA Johnson Space Center, processes one of the experiments carried on mission STS-107. Several experiments were found during the search for Columbia debris. Included in the Commercial ITA Biomedical Experiments payload on mission STS-107 are urokinase cancer research, microencapsulation of drugs, the Growth of Bacterial Biofilm on Surfaces during Spaceflight (GOBBSS), and tin crystal formation.

    NASA Image and Video Library

    2003-05-07

    KENNEDY SPACE CENTER, FLA. - Dr. Dennis Morrison, NASA Johnson Space Center, processes one of the experiments carried on mission STS-107. Several experiments were found during the search for Columbia debris. Included in the Commercial ITA Biomedical Experiments payload on mission STS-107 are urokinase cancer research, microencapsulation of drugs, the Growth of Bacterial Biofilm on Surfaces during Spaceflight (GOBBSS), and tin crystal formation.

  14. KENNEDY SPACE CENTER, FLA. - The crystals visible in this laboratory dish were part of an experiment carried on mission STS-107. Several experiments were found during the search for Columbia debris. Included in the Commercial ITA Biomedical Experiments payload on mission STS-107 are urokinase cancer research, microencapsulation of drugs, the Growth of Bacterial Biofilm on Surfaces during Spaceflight (GOBBSS), and tin crystal formation.

    NASA Image and Video Library

    2003-05-07

    KENNEDY SPACE CENTER, FLA. - The crystals visible in this laboratory dish were part of an experiment carried on mission STS-107. Several experiments were found during the search for Columbia debris. Included in the Commercial ITA Biomedical Experiments payload on mission STS-107 are urokinase cancer research, microencapsulation of drugs, the Growth of Bacterial Biofilm on Surfaces during Spaceflight (GOBBSS), and tin crystal formation.

  15. KENNEDY SPACE CENTER, FLA. - Valerie Cassanto (foreground), Instrumentation Technology Associates, Inc., examines one of the experiments carried on mission STS-107. Several experiments were found during the search for Columbia debris. Included in the Commercial ITA Biomedical Experiments payload on mission STS-107 are urokinase cancer research, microencapsulation of drugs, the Growth of Bacterial Biofilm on Surfaces during Spaceflight (GOBBSS), and tin crystal formation.

    NASA Image and Video Library

    2003-05-07

    KENNEDY SPACE CENTER, FLA. - Valerie Cassanto (foreground), Instrumentation Technology Associates, Inc., examines one of the experiments carried on mission STS-107. Several experiments were found during the search for Columbia debris. Included in the Commercial ITA Biomedical Experiments payload on mission STS-107 are urokinase cancer research, microencapsulation of drugs, the Growth of Bacterial Biofilm on Surfaces during Spaceflight (GOBBSS), and tin crystal formation.

  16. Severe Weather

    ERIC Educational Resources Information Center

    Forde, Evan B.

    2004-01-01

    Educating the public about safety issues related to severe weather is part of the National Oceanic and Atmospheric Administration's (NOAA) mission. This article deals with a poster entitled, "Severe Weather," that has been created by NOAA to help educate the public about hazardous weather conditions. The four types of severe weather highlighted in…

  17. Severe Weather

    ERIC Educational Resources Information Center

    Forde, Evan B.

    2004-01-01

    Educating the public about safety issues related to severe weather is part of the National Oceanic and Atmospheric Administration's (NOAA) mission. This month's insert, Severe Weather, has been created by NOAA to help educate the public about hazardous weather conditions. The four types of severe weather highlighted in this poster are hurricanes,…

  18. Severe Weather

    ERIC Educational Resources Information Center

    Forde, Evan B.

    2004-01-01

    Educating the public about safety issues related to severe weather is part of the National Oceanic and Atmospheric Administration's (NOAA) mission. This article deals with a poster entitled, "Severe Weather," that has been created by NOAA to help educate the public about hazardous weather conditions. The four types of severe weather highlighted in…

  19. Severe Weather

    ERIC Educational Resources Information Center

    Forde, Evan B.

    2004-01-01

    Educating the public about safety issues related to severe weather is part of the National Oceanic and Atmospheric Administration's (NOAA) mission. This month's insert, Severe Weather, has been created by NOAA to help educate the public about hazardous weather conditions. The four types of severe weather highlighted in this poster are hurricanes,…

  20. Pump apparatus including deconsolidator

    DOEpatents

    Sonwane, Chandrashekhar; Saunders, Timothy; Fitzsimmons, Mark Andrew

    2014-10-07

    A pump apparatus includes a particulate pump that defines a passage that extends from an inlet to an outlet. A duct is in flow communication with the outlet. The duct includes a deconsolidator configured to fragment particle agglomerates received from the passage.

  1. Optical modulator including grapene

    DOEpatents

    Liu, Ming; Yin, Xiaobo; Zhang, Xiang

    2016-06-07

    The present invention provides for a one or more layer graphene optical modulator. In a first exemplary embodiment the optical modulator includes an optical waveguide, a nanoscale oxide spacer adjacent to a working region of the waveguide, and a monolayer graphene sheet adjacent to the spacer. In a second exemplary embodiment, the optical modulator includes at least one pair of active media, where the pair includes an oxide spacer, a first monolayer graphene sheet adjacent to a first side of the spacer, and a second monolayer graphene sheet adjacent to a second side of the spacer, and at least one optical waveguide adjacent to the pair.

  2. Including Jews in Multiculturalism.

    ERIC Educational Resources Information Center

    Langman, Peter F.

    1995-01-01

    Discusses reasons for the lack of attention to Jews as an ethnic minority within multiculturalism both by Jews and non-Jews; why Jews and Jewish issues need to be included; and addresses some of the issues involved in the ethical treatment of Jewish clients. (Author)

  3. Sever's Disease

    MedlinePlus

    ... good flexibility while your child is growing. The stretching exercises pictured in the treatment section can lower ... your child has already recovered from Sever's disease, stretching and putting ice on the heel after activity ...

  4. Nutritional therapies (including fosteum).

    PubMed

    Nieves, Jeri W

    2009-03-01

    Nutrition is important in promoting bone health and in managing an individual with low bone mass or osteoporosis. In adult women and men, known losses of bone mass and microarchitecture occur, and nutrition can help minimize these losses. In every patient, a healthy diet with adequate protein, fruits, vegetables, calcium, and vitamin D is required to maintain bone health. Recent reports on nutritional remedies for osteoporosis have highlighted the importance of calcium in youth and continued importance in conjunction with vitamin D as the population ages. It is likely that a calcium intake of 1200 mg/d is ideal, and there are some concerns about excessive calcium intakes. However, vitamin D intake needs to be increased in most populations. The ability of soy products, particularly genistein aglycone, to provide skeletal benefit has been recently studied, including some data that support a new medical food marketed as Fosteum (Primus Pharmaceuticals, Scottsdale, AZ).

  5. [Severe asthma].

    PubMed

    González, Claudio D

    2016-01-01

    The objectives of this work were to investigate the frequency of severe asthma (SA) according to WHO definition and to compare SA patients' characteristics with those of non-severe asthma (NSA); secondly, to investigate the level of control reached throughout a period of regular treatment. Between 1-1-2005 and 12-31-2014, 471 medical records from patients with bronchial asthma assisted in Buenos Aires City were analyzed. SA frequency was 40.1% (189/471), being significantly higher among patients from the public health system (47.7%, 108/226 vs. 33%, 81/245, p = 0.001). SA patients were older than NSA ones (51.3 ± 17.4 vs. 42.6 ± 17.1 years, p = 0.000), presented longer time since onset of the disease (median 30 vs. 20 years, p = 0.000), lower educational levels (secondary level or higher 41.7% vs. 58.1%, p = 0.000), lower frequency of rhinitis (47% vs. 60.6%, p = 0.004), more severe levels of airway obstruction (FEV% 50.2 ± 13.7 vs. 77.7 ± 12.4, p = 0.000), more frequent antecedents of Near Fatal Asthma (11.1% vs. 2.8%, p = 0.000), higher levels of serum IgE (median of 410 vs. 279 UI/l, p = 0.01) and higher demand of systemic steroids requirements and hospitalizations (68.7% vs. 50.7%, p = 0.000 and 37.5% vs. 15.9%, p = 0.000, respectively). A 30.6% of SA patients (58/189) reached a follow-up period of 12 months, 13 (22.5%) of whom reached the controlled asthma level. The frequency of SA found seems to be considerable. Multicenter studies to investigate the levels of control reached by SA patients with access to proper treatment are recommended.

  6. Early life adversity and/or posttraumatic stress disorder severity are associated with poor diet quality, including consumption of trans fatty acids, and fewer hours of resting or sleeping in a US middle-aged population: A cross-sectional and prospective study

    PubMed Central

    Gavrieli, Anna; Farr, Olivia M; Davis, Cynthia R; Crowell, Judith A; Mantzoros, Christos S.

    2015-01-01

    Background Early life adversity (ELA) and post-traumatic stress disorder (PTSD) are associated with poorer psychological and physical health. Potential underlying mechanisms and mediators remain to be elucidated, and the lifestyle habits and characteristics of individuals with ELA and/or PTSD have not been fully explored. We investigated whether the presence of ELA and/or PTSD are associated with nutrition, physical activity, resting and sleeping and smoking. Methods A cross-sectional sample of 151 males and females (age: 45.6±3.5 y, BMI: 30.0±7.1kg/m2) underwent anthropometric measurements, as well as detailed questionnaires for dietary assessment, physical activity, resting and sleeping, smoking habits and psychosocial assessments. A prospective follow-up visit of 49 individuals was performed 2.5 years later and the same outcomes were assessed. ELA and PTSD were evaluated as predictors, in addition to a variable assessing the combined presence/severity of ELA–PTSD. Data were analyzed using analysis of covariance after adjusting for several socioeconomic, psychosocial and anthropometric characteristics. Results Individuals with higher ELA or PTSD severity were found to have a poorer diet quality (DASH score: p=0.006 and p=0.003, respectively; aHEI-2010 score: ELA p=0.009), including further consumption of trans fatty acids (ELA p=0.003); the differences were significantly attenuated null after adjusting mainly for education or income and/or race. Further, individuals with higher ELA severity reported less hours of resting and sleeping (p=0.043) compared to those with zero/lower ELA severity, and the difference remained significant in the fully adjusted model indicating independence from potential confounders. When ELA and PTSD were combined, an additive effect was observed on resting and sleeping (p=0.001); results remained significant in the fully adjusted model. They also consumed more energy from trans fatty acids (p=0.017) tended to smoke more (p=0

  7. KENNEDY SPACE CENTER, FLA. - Researchers conduct underwater acoustic research in the Launch Complex 39 turn basin. Several government agencies, including NASA, NOAA, the Navy, the Coast Guard, and the Florida Fish and Wildlife Commission are involved in the testing. The research involves demonstrations of passive and active sensor technologies, with applications in fields ranging from marine biological research to homeland security. The work is also serving as a pilot project to assess the cooperation between the agencies involved. Equipment under development includes a passive acoustic monitor developed by NASA’s Jet Propulsion Laboratory, and mobile robotic sensors from the Navy’s Mobile Diving and Salvage Unit.

    NASA Image and Video Library

    2003-08-18

    KENNEDY SPACE CENTER, FLA. - Researchers conduct underwater acoustic research in the Launch Complex 39 turn basin. Several government agencies, including NASA, NOAA, the Navy, the Coast Guard, and the Florida Fish and Wildlife Commission are involved in the testing. The research involves demonstrations of passive and active sensor technologies, with applications in fields ranging from marine biological research to homeland security. The work is also serving as a pilot project to assess the cooperation between the agencies involved. Equipment under development includes a passive acoustic monitor developed by NASA’s Jet Propulsion Laboratory, and mobile robotic sensors from the Navy’s Mobile Diving and Salvage Unit.

  8. Management of severe preeclampsia.

    PubMed

    Brichant, G; Dewandre, P Y; Foidart, J M; Brichant, J F

    2010-01-01

    Features of severe preeclampsia include severe proteinuric hypertension and symptoms of central nervous system dysfunction, hepatocellular injury, thrombocytopenia, oliguria, pulmonary oedema, cerebrovascular accident and severe intrauterine growth restriction. Women with severe preeclampsia must be hospitalized to confirm the diagnosis, to assess the severity of the disease, to monitor the progression of the disease and to try to stabilize the disease. Severe preeclampsia may be managed expectantly, in selected cases. The objective of expectant management in these patients is to improve neonatal outcome. Expectant management is based on antihypertensive treatment and prevention of end organ dysfunction. Antihypertensive treatment improves maternal outcome but has the potential to be deleterious for the foetus. Plasma volume expansion has been suggested for severe preeclampsia but trials failed to show any benefit. Magnesium sulfate is the anticonvulsivant of choice to treat or prevent eclampsia when indicated. Antenatal corticosteroids are recommended in severely preeclamptic women with 26-34 weeks gestation. Timing of delivery is based upon gestational age, severity of preeclampsia, maternal and foetal risks.

  9. Severe childhood malnutrition.

    PubMed

    Bhutta, Zulfiqar A; Berkley, James A; Bandsma, Robert H J; Kerac, Marko; Trehan, Indi; Briend, André

    2017-09-21

    The main forms of childhood malnutrition occur predominantly in children <5 years of age living in low-income and middle-income countries and include stunting, wasting and kwashiorkor, of which severe wasting and kwashiorkor are commonly referred to as severe acute malnutrition. Here, we use the term 'severe malnutrition' to describe these conditions to better reflect the contributions of chronic poverty, poor living conditions with pervasive deficits in sanitation and hygiene, a high prevalence of infectious diseases and environmental insults, food insecurity, poor maternal and fetal nutritional status and suboptimal nutritional intake in infancy and early childhood. Children with severe malnutrition have an increased risk of serious illness and death, primarily from acute infectious diseases. International growth standards are used for the diagnosis of severe malnutrition and provide therapeutic end points. The early detection of severe wasting and kwashiorkor and outpatient therapy for these conditions using ready-to-use therapeutic foods form the cornerstone of modern therapy, and only a small percentage of children require inpatient care. However, the normalization of physiological and metabolic functions in children with malnutrition is challenging, and children remain at high risk of relapse and death. Further research is urgently needed to improve our understanding of the pathophysiology of severe malnutrition, especially the mechanisms causing kwashiorkor, and to develop new interventions for prevention and treatment.

  10. Severe asthma in children

    PubMed Central

    Guilbert, TW; Bacharier, LB; Fitzpatrick, AM

    2015-01-01

    Severe asthma in children is characterized by sustained symptoms despite treatment with high doses of ICS or oral corticosteroids. Children with severe asthma may fall into two categories, difficult-to-treat asthma or severe therapy-resistant asthma. Difficult-to-treat asthma is defined as poor control due to an incorrect diagnosis or comorbidities, poor adherence due to adverse psychological or environmental factors. In contrast, treatment-resistant is defined as difficult asthma despite management of these factors. It is increasingly recognized that severe asthma is a highly heterogeneous disorder associated with a number of clinical and inflammatory phenotypes that have been described in children with severe asthma. Guideline based drug therapy of severe childhood asthma is based primarily on extrapolated data from adult studies. The recommendation is that children with severe asthma be treated with higher-dose inhaled or oral corticosteroids combined with long-acting beta-agonists and other add on therapies such as antileukotrienes and methylxanthines. It is important to identify and address the influences that make asthma difficult to control including reviewing the diagnosis and the removal of causal or aggravating factors. Better definition of the phenotypes and better targeting of therapy based upon individual patient phenotypes is likely to improve asthma treatment in the future. PMID:25213041

  11. Severe asthma in children.

    PubMed

    Guilbert, Theresa W; Bacharier, Leonard B; Fitzpatrick, Anne M

    2014-01-01

    Severe asthma in children is characterized by sustained symptoms despite treatment with high doses of inhaled corticosteroids or oral corticosteroids. Children with severe asthma may fall into 2 categories, difficult-to-treat asthma or severe therapy-resistant asthma. Difficult-to-treat asthma is defined as poor control due to an incorrect diagnosis or comorbidities, or poor adherence due to adverse psychological or environmental factors. In contrast, treatment resistant is defined as difficult asthma despite management of these factors. It is increasingly recognized that severe asthma is a highly heterogeneous disorder associated with a number of clinical and inflammatory phenotypes that have been described in children with severe asthma. Guideline-based drug therapy of severe childhood asthma is based primarily on extrapolated data from adult studies. The recommendation is that children with severe asthma be treated with higher-dose inhaled or oral corticosteroids combined with long-acting β-agonists and other add-on therapies, such as antileukotrienes and methylxanthines. It is important to identify and address the influences that make asthma difficult to control, including reviewing the diagnosis and removing causal or aggravating factors. Better definition of the phenotypes and better targeting of therapy based upon individual patient phenotypes is likely to improve asthma treatment in the future.

  12. KENNEDY SPACE CENTER, FLA. - Researchers utilize several types of watercraft to conduct underwater acoustic research in the Launch Complex 39 turn basin. Several government agencies, including NASA, NOAA, the Navy, the Coast Guard, and the Florida Fish and Wildlife Commission are involved in the testing. The research involves demonstrations of passive and active sensor technologies, with applications in fields ranging from marine biological research to homeland security. The work is also serving as a pilot project to assess the cooperation between the agencies involved. Equipment under development includes a passive acoustic monitor developed by NASA’s Jet Propulsion Laboratory, and mobile robotic sensors from the Navy’s Mobile Diving and Salvage Unit.

    NASA Image and Video Library

    2003-08-18

    KENNEDY SPACE CENTER, FLA. - Researchers utilize several types of watercraft to conduct underwater acoustic research in the Launch Complex 39 turn basin. Several government agencies, including NASA, NOAA, the Navy, the Coast Guard, and the Florida Fish and Wildlife Commission are involved in the testing. The research involves demonstrations of passive and active sensor technologies, with applications in fields ranging from marine biological research to homeland security. The work is also serving as a pilot project to assess the cooperation between the agencies involved. Equipment under development includes a passive acoustic monitor developed by NASA’s Jet Propulsion Laboratory, and mobile robotic sensors from the Navy’s Mobile Diving and Salvage Unit.

  13. KENNEDY SPACE CENTER, FLA. - Researchers utilize several types of watercraft to conduct underwater acoustic research in the Launch Complex 39 turn basin near Launch Pad 39A. Several government agencies, including NASA, NOAA, the Navy, the Coast Guard, and the Florida Fish and Wildlife Commission are involved in the testing. The research involves demonstrations of passive and active sensor technologies, with applications in fields ranging from marine biological research to homeland security. The work is also serving as a pilot project to assess the cooperation between the agencies involved. Equipment under development includes a passive acoustic monitor developed by NASA’s Jet Propulsion Laboratory, and mobile robotic sensors from the Navy’s Mobile Diving and Salvage Unit.

    NASA Image and Video Library

    2003-08-18

    KENNEDY SPACE CENTER, FLA. - Researchers utilize several types of watercraft to conduct underwater acoustic research in the Launch Complex 39 turn basin near Launch Pad 39A. Several government agencies, including NASA, NOAA, the Navy, the Coast Guard, and the Florida Fish and Wildlife Commission are involved in the testing. The research involves demonstrations of passive and active sensor technologies, with applications in fields ranging from marine biological research to homeland security. The work is also serving as a pilot project to assess the cooperation between the agencies involved. Equipment under development includes a passive acoustic monitor developed by NASA’s Jet Propulsion Laboratory, and mobile robotic sensors from the Navy’s Mobile Diving and Salvage Unit.

  14. Allergy in severe asthma.

    PubMed

    Del Giacco, S R; Bakirtas, A; Bel, E; Custovic, A; Diamant, Z; Hamelmann, E; Heffler, E; Kalayci, Ö; Saglani, S; Sergejeva, S; Seys, S; Simpson, A; Bjermer, L

    2017-02-01

    It is well recognized that atopic sensitization is an important risk factor for asthma, both in adults and in children. However, the role of allergy in severe asthma is still under debate. The term 'Severe Asthma' encompasses a highly heterogeneous group of patients who require treatment on steps 4-5 of GINA guidelines to prevent their asthma from becoming 'uncontrolled', or whose disease remains 'uncontrolled' despite this therapy. Epidemiological studies on emergency room visits and hospital admissions for asthma suggest the important role of allergy in asthma exacerbations. In addition, allergic asthma in childhood is often associated with severe asthma in adulthood. A strong association exists between asthma exacerbations and respiratory viral infections, and interaction between viruses and allergy further increases the risk of asthma exacerbations. Furthermore, fungal allergy has been shown to play an important role in severe asthma. Other contributing factors include smoking, pollution and work-related exposures. The 'Allergy and Asthma Severity' EAACI Task Force examined the current evidence and produced this position document on the role of allergy in severe asthma. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  15. ADIPONECTIN IN SEVERE PREECLAMPSIA

    PubMed Central

    Nien, Jyh Kae; Mazaki-Tovi, Shali; Romero, Roberto; Erez, Offer; Kusanovic, Juan Pedro; Gotsch, Francesca; Pineles, Beth L.; Gomez, Ricardo; Edwin, Samuel; Mazor, Moshe; Espinoza, Jimmy; Yoon, Bo Hyun; Hassan, Sonia S.

    2008-01-01

    Aims Adiponectin is an adipokine with insulin-sensitizing, anti-atherogenic, anti-inflammatory and angiogenic properties. The aims of this study were to determine whether maternal plasma adiponectin concentrations differ between patients with severe preeclampsia and those with normal pregnancies, and to explore the relationship between plasma adiponectin and the results of Doppler velocimetry of the uterine arteries. Methods This case-control study included two groups: (1) patients with severe preeclampsia (n=50) and (2) patients with normal pregnancies (n=150). Pulsed-wave and color Doppler ultrasound examination of the uterine arteries were performed. Plasma adiponectin concentrations were determined by ELISA. Non-parametric statistics were used for analysis. Results (1) Patients with severe preeclampsia had a higher median plasma concentration of adiponectin than that of normal pregnant women. (2) The median plasma adiponectin concentration did not differ between women with severe preeclampsia who had a high impedance to blood flow in the uterine arteries and those with normal impedance to blood flow. (3) Among patients with normal pregnancies, plasma adiponectin concentrations were negatively correlated with BMI in the first trimester and at sampling. Conclusions Women with severe preeclampsia have a higher median plasma concentration of adiponectin than that of normal pregnant women. This may reflect a compensatory feedback mechanism to the metabolically-altered, anti-angiogenic and pro-atherogenic state of severe preeclampsia. PMID:17919115

  16. KENNEDY SPACE CENTER, FLA. - Barry Perlman, Pembroke Pines Charter Middle School in Florida, prepares a computer to receive data from an experiment carried on mission STS-107. Several experiments were found during the search for Columbia debris. Included in the Commercial ITA Biomedical Experiments payload on mission STS-107 are urokinase cancer research, microencapsulation of drugs, the Growth of Bacterial Biofilm on Surfaces during Spaceflight (GOBBSS), and tin crystal formation. The latter was sponsored by the Pembroke Pines Charter Middle School.

    NASA Image and Video Library

    2003-05-07

    KENNEDY SPACE CENTER, FLA. - Barry Perlman, Pembroke Pines Charter Middle School in Florida, prepares a computer to receive data from an experiment carried on mission STS-107. Several experiments were found during the search for Columbia debris. Included in the Commercial ITA Biomedical Experiments payload on mission STS-107 are urokinase cancer research, microencapsulation of drugs, the Growth of Bacterial Biofilm on Surfaces during Spaceflight (GOBBSS), and tin crystal formation. The latter was sponsored by the Pembroke Pines Charter Middle School.

  17. KENNEDY SPACE CENTER, FLA. - From left, Bob McLean, Southwest Texas State University; Valerie Cassanto, Instrumentation Technology Associates, Inc.; and Dennis Morrison, NASA Johnson Space Center, process one of the experiments carried on mission STS-107. Several experiments were found during the search for Columbia debris. Included in the Commercial ITA Biomedical Experiments payload on mission STS-107 are urokinase cancer research, microencapsulation of drugs, the Growth of Bacterial Biofilm on Surfaces during Spaceflight (GOBBSS), and tin crystal formation.

    NASA Image and Video Library

    2003-05-07

    KENNEDY SPACE CENTER, FLA. - From left, Bob McLean, Southwest Texas State University; Valerie Cassanto, Instrumentation Technology Associates, Inc.; and Dennis Morrison, NASA Johnson Space Center, process one of the experiments carried on mission STS-107. Several experiments were found during the search for Columbia debris. Included in the Commercial ITA Biomedical Experiments payload on mission STS-107 are urokinase cancer research, microencapsulation of drugs, the Growth of Bacterial Biofilm on Surfaces during Spaceflight (GOBBSS), and tin crystal formation.

  18. KENNEDY SPACE CENTER, FLA. - Valerie Cassanto, Instrumentation Technology Associates, Inc., studies one of the experiments carried on mission STS-107. Several experiments were found during the search for Columbia debris. Included in the Commercial ITA Biomedical Experiments payload on mission STS-107 are urokinase cancer research, microencapsulation of drugs, the Growth of Bacterial Biofilm on Surfaces during Spaceflight (GOBBSS), and tin crystal formation. The latter was sponsored by the Pembroke Pines Charter Middle School.

    NASA Image and Video Library

    2003-05-07

    KENNEDY SPACE CENTER, FLA. - Valerie Cassanto, Instrumentation Technology Associates, Inc., studies one of the experiments carried on mission STS-107. Several experiments were found during the search for Columbia debris. Included in the Commercial ITA Biomedical Experiments payload on mission STS-107 are urokinase cancer research, microencapsulation of drugs, the Growth of Bacterial Biofilm on Surfaces during Spaceflight (GOBBSS), and tin crystal formation. The latter was sponsored by the Pembroke Pines Charter Middle School.

  19. KENNEDY SPACE CENTER, FLA. - Valerie Cassanto, with Instrumentation Technology Associates, Inc., examines closely the container containing one of the experiments carried on mission STS-107. Several experiments were found during the search for Columbia debris. Included in the Commercial ITA Biomedical Experiments payload on mission STS-107 are urokinase cancer research, microencapsulation of drugs, the Growth of Bacterial Biofilm on Surfaces during Spaceflight (GOBBSS), and tin crystal formation.

    NASA Image and Video Library

    2003-05-06

    KENNEDY SPACE CENTER, FLA. - Valerie Cassanto, with Instrumentation Technology Associates, Inc., examines closely the container containing one of the experiments carried on mission STS-107. Several experiments were found during the search for Columbia debris. Included in the Commercial ITA Biomedical Experiments payload on mission STS-107 are urokinase cancer research, microencapsulation of drugs, the Growth of Bacterial Biofilm on Surfaces during Spaceflight (GOBBSS), and tin crystal formation.

  20. KENNEDY SPACE CENTER, FLA. - Valerie Cassanto, with Instrumentation Technology Associates, Inc., and Bob McLean, from the Southwest Texas State University, transfer to a new container material from one of the experiments carried on mission STS-107. Several experiments were found during the search for Columbia debris. Included in the Commercial ITA Biomedical Experiments payload on mission STS-107 are urokinase cancer research, microencapsulation of drugs, the Growth of Bacterial Biofilm on Surfaces during Spaceflight (GOBBSS), and tin crystal formation.

    NASA Image and Video Library

    2003-05-06

    KENNEDY SPACE CENTER, FLA. - Valerie Cassanto, with Instrumentation Technology Associates, Inc., and Bob McLean, from the Southwest Texas State University, transfer to a new container material from one of the experiments carried on mission STS-107. Several experiments were found during the search for Columbia debris. Included in the Commercial ITA Biomedical Experiments payload on mission STS-107 are urokinase cancer research, microencapsulation of drugs, the Growth of Bacterial Biofilm on Surfaces during Spaceflight (GOBBSS), and tin crystal formation.

  1. KENNEDY SPACE CENTER, FLA. - From left, Bob McLean, Southwest Texas State University, and Valerie Cassanto, Instrumentation Technology Associates, Inc., study one of the experiments carried on mission STS-107. Several experiments were found during the search for Columbia debris. Included in the Commercial ITA Biomedical Experiments payload on mission STS-107 are urokinase cancer research, microencapsulation of drugs, the Growth of Bacterial Biofilm on Surfaces during Spaceflight (GOBBSS), and tin crystal formation.

    NASA Image and Video Library

    2003-05-07

    KENNEDY SPACE CENTER, FLA. - From left, Bob McLean, Southwest Texas State University, and Valerie Cassanto, Instrumentation Technology Associates, Inc., study one of the experiments carried on mission STS-107. Several experiments were found during the search for Columbia debris. Included in the Commercial ITA Biomedical Experiments payload on mission STS-107 are urokinase cancer research, microencapsulation of drugs, the Growth of Bacterial Biofilm on Surfaces during Spaceflight (GOBBSS), and tin crystal formation.

  2. KENNEDY SPACE CENTER, FLA. - The apparatus shown was designed to hold microcapsules for research on mission STS-107. It is one over several included in the Commercial ITA Biomedical Experiments payload. The box was recently recovered during the search for Columbia debris. The drug delivery system and spaceflight hardware was developed jointly by JSC, the Institute for Research Inc. and Instrumentation Technology Associates Inc. to conduct microencapsulation experiments under microgravity conditions.

    NASA Image and Video Library

    2003-05-06

    KENNEDY SPACE CENTER, FLA. - The apparatus shown was designed to hold microcapsules for research on mission STS-107. It is one over several included in the Commercial ITA Biomedical Experiments payload. The box was recently recovered during the search for Columbia debris. The drug delivery system and spaceflight hardware was developed jointly by JSC, the Institute for Research Inc. and Instrumentation Technology Associates Inc. to conduct microencapsulation experiments under microgravity conditions.

  3. KENNEDY SPACE CENTER, FLA. - From left, Valerie Cassanto, Instrumentation Technology Associates, Inc., and Dr. Dennis Morrison, NASA Johnson Space Center, analyze one of the experiments carried on mission STS-107. Several experiments were found during the search for Columbia debris. Included in the Commercial ITA Biomedical Experiments payload on mission STS-107 are urokinase cancer research, microencapsulation of drugs, the Growth of Bacterial Biofilm on Surfaces during Spaceflight (GOBBSS), and tin crystal formation.

    NASA Image and Video Library

    2003-05-07

    KENNEDY SPACE CENTER, FLA. - From left, Valerie Cassanto, Instrumentation Technology Associates, Inc., and Dr. Dennis Morrison, NASA Johnson Space Center, analyze one of the experiments carried on mission STS-107. Several experiments were found during the search for Columbia debris. Included in the Commercial ITA Biomedical Experiments payload on mission STS-107 are urokinase cancer research, microencapsulation of drugs, the Growth of Bacterial Biofilm on Surfaces during Spaceflight (GOBBSS), and tin crystal formation.

  4. KENNEDY SPACE CENTER, FLA. - Dr. Dennis Morrison, NASA Johnson Space Center, works with one of the experiments carried on mission STS-107. Several experiments were found during the search for Columbia debris. Included in the Commercial ITA Biomedical Experiments payload on mission STS-107 are urokinase cancer research, microencapsulation of drugs, the Growth of Bacterial Biofilm on Surfaces during Spaceflight (GOBBSS), and tin crystal formation.

    NASA Image and Video Library

    2003-05-07

    KENNEDY SPACE CENTER, FLA. - Dr. Dennis Morrison, NASA Johnson Space Center, works with one of the experiments carried on mission STS-107. Several experiments were found during the search for Columbia debris. Included in the Commercial ITA Biomedical Experiments payload on mission STS-107 are urokinase cancer research, microencapsulation of drugs, the Growth of Bacterial Biofilm on Surfaces during Spaceflight (GOBBSS), and tin crystal formation.

  5. [Severe depression : psychoanalysis].

    PubMed

    Bouvet de la Maisonneuve, O

    2009-12-01

    The indication for psychoanalysis in severe depression is not clear. And yet, demands for this type of intervention are increasing, despite the absence of any form of consensus on the subject. Freud considered depression as a failure of analytical efforts and, based on this observation, revised his theory, in particular to include the notions of narcissism and the death drive. Many analysts have been reluctant to follow his teachings on this last point and provide depressed patients with analytical-type therapies aimed at restoring narcissism. Melanie Klein pushed Freud's ideas about depression even further and brought such therapies back to the heart of analytical practice. Jacques Lacan took the debate to another level by proposing an overhaul of the principles on which analysis has been based. Today, while following certain precautionary rules, true psychoanalyses can be proposed to patients with severe depression, whether of the bipolar, recurring or even neurotic type that can reach this level of severity.

  6. Modelling runway incursion severity.

    PubMed

    Wilke, Sabine; Majumdar, Arnab; Ochieng, Washington Y

    2015-06-01

    Analysis of the causes underlying runway incursions is fundamental for the development of effective mitigation measures. However, there are significant weaknesses in the current methods to model these factors. This paper proposes a structured framework for modelling causal factors and their relationship to severity, which includes a description of the airport surface system architecture, establishment of terminological definitions, the determination and collection of appropriate data, the analysis of occurrences for severity and causes, and the execution of a statistical analysis framework. It is implemented in the context of U.S. airports, enabling the identification of a number of priority interventions, including the need for better investigation and causal factor capture, recommendations for airfield design, operating scenarios and technologies, and better training for human operators in the system. The framework is recommended for the analysis of runway incursions to support safety improvements and the methodology is transferable to other areas of aviation safety risk analysis.

  7. Predicting Severe Duststorms

    NASA Technical Reports Server (NTRS)

    Woicheshyn, P. M.

    1985-01-01

    Combined human/machine forecasting technique shows promise. Severe duststorms in Great Plains forecast with fair reliability. Forecasts derived from combination of human expertise and variety of meteorological information sources, including all current and recent weather observations, standard National Meteorological Center (NMC) computer analyses for surface and upper air, and NMC 12-, 24-, 36-, and 48-hour prognostication charts generated by Limited Fine Mesh computer model.

  8. Family Living, Including Sex Education.

    ERIC Educational Resources Information Center

    Forlano, George

    This volume describes and evaluates 21 selected New York City Board of Education Umbrella Programs for the 1974-1975 school year. The programs include: (1) the parent resource center, (2) the teacher self-help program, (3) the East Harlem pre-kindergarten center, (4) the Brooklyn College volunteer tutoring program, (5) the parent education for…

  9. Severe congenital neutropenias.

    PubMed

    Skokowa, Julia; Dale, David C; Touw, Ivo P; Zeidler, Cornelia; Welte, Karl

    2017-06-08

    Severe congenital neutropenias are a heterogeneous group of rare haematological diseases characterized by impaired maturation of neutrophil granulocytes. Patients with severe congenital neutropenia are prone to recurrent, often life-threatening infections beginning in their first months of life. The most frequent pathogenic defects are autosomal dominant mutations in ELANE, which encodes neutrophil elastase, and autosomal recessive mutations in HAX1, whose product contributes to the activation of the granulocyte colony-stimulating factor (G-CSF) signalling pathway. The pathophysiological mechanisms of these conditions are the object of extensive research and are not fully understood. Furthermore, severe congenital neutropenias may predispose to myelodysplastic syndromes or acute myeloid leukaemia. Molecular events in the malignant progression include acquired mutations in CSF3R (encoding G-CSF receptor) and subsequently in other leukaemia-associated genes (such as RUNX1) in a majority of patients. Diagnosis is based on clinical manifestations, blood neutrophil count, bone marrow examination and genetic and immunological analyses. Daily subcutaneous G-CSF administration is the treatment of choice and leads to a substantial increase in blood neutrophil count, reduction of infections and drastic improvement of quality of life. Haematopoietic stem cell transplantation is the alternative treatment. Regular clinical assessments (including yearly bone marrow examinations) to monitor treatment course and detect chromosomal abnormalities (for example, monosomy 7 and trisomy 21) as well as somatic pre-leukaemic mutations are recommended.

  10. [Severe psoriasis: 160 cases].

    PubMed

    Jalal, O; Houass, S; Laissaoui, K; Hocar, O; Charioui, S; Amal, S

    2005-02-01

    Psoriasis is a frequent dermatosis, its prevalence is estimated of between 1 and 3 p. 100. The severe forms may threaten the functional and life prognosis of patients. We conducted a retrospective study on 160 cases of severe psoriasis collected between 1990 and 2001. We included patients exhibiting severe psoriasis: pustular, erythrodermic or arthropathic psoriasis, the generalized forms that had developed for more than 6 months, without positive response to treatment and the forms with a PASI greater than 50. The patients' ages ranged from 6 to 85 years with a clear male predominance (96 men, 64 women). Nine familial cases were collected. Erythroderma was noted in 87 cases, pustular psoriasis in 31, generalized psoriasis in 31 and psoriatic rheumatism in 15 (4 of which were associated with pustular psoriasis). Local treatment with topical corticosteroids or a Vitamin D derivative was recommended in respectively 41.8 and 13.75 p. 100 of cases. The administration of general treated relied on methotrexate and was required in 68.75 p. 100 of cases. Progression was usually good, relapses were often noted when treatment was stopped. Four patients died. Although the diagnosis of psoriasis is often easy, the severe forms are still difficult to treat. Treatment is complicated, sometimes disappointing and often necessitates heavy and aggressive treatments that require strict surveillance.

  11. Clinical review: Severe asthma

    PubMed Central

    Papiris, Spyros; Kotanidou, Anastasia; Malagari, Katerina; Roussos, Charis

    2002-01-01

    Severe asthma, although difficult to define, includes all cases of difficult/therapy-resistant disease of all age groups and bears the largest part of morbidity and mortality from asthma. Acute, severe asthma, status asthmaticus, is the more or less rapid but severe asthmatic exacerbation that may not respond to the usual medical treatment. The narrowing of airways causes ventilation perfusion imbalance, lung hyperinflation, and increased work of breathing that may lead to ventilatory muscle fatigue and life-threatening respiratory failure. Treatment for acute, severe asthma includes the administration of oxygen, β2-agonists (by continuous or repetitive nebulisation), and systemic corticosteroids. Subcutaneous administration of epinephrine or terbutaline should be considered in patients not responding adequately to continuous nebulisation, in those unable to cooperate, and in intubated patients not responding to inhaled therapy. The exact time to intubate a patient in status asthmaticus is based mainly on clinical judgment, but intubation should not be delayed once it is deemed necessary. Mechanical ventilation in status asthmaticus supports gas-exchange and unloads ventilatory muscles until aggressive medical treatment improves the functional status of the patient. Patients intubated and mechanically ventilated should be appropriately sedated, but paralytic agents should be avoided. Permissive hypercapnia, increase in expiratory time, and promotion of patient-ventilator synchronism are the mainstay in mechanical ventilation of status asthmaticus. Close monitoring of the patient's condition is necessary to obviate complications and to identify the appropriate time for weaning. Finally, after successful treatment and prior to discharge, a careful strategy for prevention of subsequent asthma attacks is imperative. PMID:11940264

  12. Include heuristics in protection systems

    SciTech Connect

    Kobyakov, A.I. )

    1993-02-01

    Automatic systems based on interlock principles are the most popular method of protecting plants from hazards. Nevertheless, such systems have specific shortcomings. The major one comes from the fact that protection controls are activated at the stage of break down mode development, and not at the moments of pre-fault status origin. It is possible to design protection controls that account for information relating to pre-fault status, causes, locations, and potential danger severity. A method of recreating automatic protection systems (APS) with functioning and structural organization is based on the accepted strategy of potentially hazardous plant protection. APS features these basic functions: pre-fault status classification and diagnostic providing protection controls that depend on pre-fault status type and cause, and suppression process analysis and protection controls correction. The system functions as a parallel/series process. Pre-fault status location data with related classification and diagnostics are based on current startup information. A protection control vector is formed that guarantees pre-fault status suppression. This paper describes these features.

  13. FLUXNET2015 Dataset: Batteries included

    NASA Astrophysics Data System (ADS)

    Pastorello, G.; Papale, D.; Agarwal, D.; Trotta, C.; Chu, H.; Canfora, E.; Torn, M. S.; Baldocchi, D. D.

    2016-12-01

    The synthesis datasets have become one of the signature products of the FLUXNET global network. They are composed from contributions of individual site teams to regional networks, being then compiled into uniform data products - now used in a wide variety of research efforts: from plant-scale microbiology to global-scale climate change. The FLUXNET Marconi Dataset in 2000 was the first in the series, followed by the FLUXNET LaThuile Dataset in 2007, with significant additions of data products and coverage, solidifying the adoption of the datasets as a research tool. The FLUXNET2015 Dataset counts with another round of substantial improvements, including extended quality control processes and checks, use of downscaled reanalysis data for filling long gaps in micrometeorological variables, multiple methods for USTAR threshold estimation and flux partitioning, and uncertainty estimates - all of which accompanied by auxiliary flags. This "batteries included" approach provides a lot of information for someone who wants to explore the data (and the processing methods) in detail. This inevitably leads to a large number of data variables. Although dealing with all these variables might seem overwhelming at first, especially to someone looking at eddy covariance data for the first time, there is method to our madness. In this work we describe the data products and variables that are part of the FLUXNET2015 Dataset, and the rationale behind the organization of the dataset, covering the simplified version (labeled SUBSET), the complete version (labeled FULLSET), and the auxiliary products in the dataset.

  14. Neoclassical Transport Including Collisional Nonlinearity

    SciTech Connect

    Candy, J.; Belli, E. A.

    2011-06-10

    In the standard {delta}f theory of neoclassical transport, the zeroth-order (Maxwellian) solution is obtained analytically via the solution of a nonlinear equation. The first-order correction {delta}f is subsequently computed as the solution of a linear, inhomogeneous equation that includes the linearized Fokker-Planck collision operator. This equation admits analytic solutions only in extreme asymptotic limits (banana, plateau, Pfirsch-Schlueter), and so must be solved numerically for realistic plasma parameters. Recently, numerical codes have appeared which attempt to compute the total distribution f more accurately than in the standard ordering by retaining some nonlinear terms related to finite-orbit width, while simultaneously reusing some form of the linearized collision operator. In this work we show that higher-order corrections to the distribution function may be unphysical if collisional nonlinearities are ignored.

  15. Families classification including multiopposition asteroids

    NASA Astrophysics Data System (ADS)

    Milani, Andrea; Spoto, Federica; Knežević, Zoran; Novaković, Bojan; Tsirvoulis, Georgios

    2016-01-01

    In this paper we present the results of our new classification of asteroid families, upgraded by using catalog with > 500,000 asteroids. We discuss the outcome of the most recent update of the family list and of their membership. We found enough evidence to perform 9 mergers of the previously independent families. By introducing an improved method of estimation of the expected family growth in the less populous regions (e.g. at high inclination) we were able to reliably decide on rejection of one tiny group as a probable statistical fluke. Thus we reduced our current list to 115 families. We also present newly determined ages for 6 families, including complex 135 and 221, improving also our understanding of the dynamical vs. collisional families relationship. We conclude with some recommendations for the future work and for the family name problem.

  16. Bowling for the Severely Handicapped.

    ERIC Educational Resources Information Center

    Ankenbrand, Larry J.

    Instructions are given for constructing a bowling board to aid severely physically handicapped, and wheelchair-confined individuals in bowling. A list of materials needed for building the device is included and diagrams accompany the instructions. (JD)

  17. Percutaneous absorption of several chemicals, some pesticides included, in the red-winged blackbird

    USGS Publications Warehouse

    Rogers, J.G.; Cagan, R.H.; Kare, M.R.

    1974-01-01

    Percutaneous absorption in vivo through the skin of the feet of the red-winged blackbird (Agelaius phoeniceus) has been investigated. Absorption after 18-24 hours exposure to 0.01 M solutions of salicylic acid, caffeine, urea, 2,4-D, dieldrin, diethylstilbesterol, and DDT was measured. Of these, only DDT and diethylstilbesterol were not absorbed to a measurable degree. The solvents ethanol, dimethylsulfoxide (DMSO), and vegetable oil were compared with water in their effects on the absorption ofcaffeine, urea, and salicylic acid. Ethanol, DMSO,and oil each decreased percutaneous absorption of salicylic acid. DMSO increased absorption of caffeine, and ethanol had no effect on it. Neither DMSO nor ethanol affected penetration of urea. Partition coefficients (K) (epidermis/water) were determined for all seven penetrants. Compounds with higher values of K showed lower percutaneous absorption. These findings suggest that K may be useful to predict percutaneous absorption in vivo. It appears unlikely that percutaneous absorption contributes greatly to the body burden of 2,4-D and dieldrin in A. phoeniceus.

  18. Altitude response of several airplanes during landing approach. [including space shuttle

    NASA Technical Reports Server (NTRS)

    Phillips, W. H.

    1979-01-01

    The response in altitude and pitching velocity of the shuttle and of four other airplanes during the landing approach is compared. The effects of airplane type, pitch damping, center-of-gravity location, lift coefficient, and cockpit position are presented. The reasons for the differences observed and the effects of these differences on control characteristics are discussed.

  19. Severe hyponatremia and Schmidt's syndrome.

    PubMed

    Wehbe, Edgard; Grant, Michael E

    2008-06-01

    Severe hyponatremia, defined by a sodium concentration of below 115 meq/l, is rarely reported with Schmidt's syndrome. We report a 43-year-old woman diagnosed with Schmidt's syndrome during the workup for severe hyponatremia as well a review of all the reported cases. The Medline database from 1960 to 2007 and relevant references of selected articles were searched. Search terms included hyponatremia, hypothyroidism, autoimmune thyroid disease, adrenal insufficiency, adrenal failure, Schmidt's syndrome and autoimmune polyendocrine syndrome type 2. The search was restricted to the English language, human subjects, and patients with a serum sodium concentration of below 115 meq/l. Seven cases were reported including this report. Severe hyponatremia seems to be found more often in patients with severe hypothyroidism. To our knowledge this is the first case to describe the occurrence of severe hyponatremia with normal thyroid function test and normal baseline cortisol level.

  20. Nutrition in Severe Dementia

    PubMed Central

    Pivi, Glaucia Akiko Kamikado; Bertolucci, Paulo Henrique Ferreira; Schultz, Rodrigo Rizek

    2012-01-01

    An increasing proportion of older adults with Alzheimer's disease or other dementias are now surviving to more advanced stages of the illness. Advanced dementia is associated with feeding problems, including difficulty in swallowing and respiratory diseases. Patients become incompetent to make decisions. As a result, complex situations may arise in which physicians and families decide whether artificial nutrition and hydration (ANH) is likely to be beneficial for the patient. The objective of this paper is to present methods for evaluating the nutritional status of patients with severe dementia as well as measures for the treatment of nutritional disorders, the use of vitamin and mineral supplementation, and indications for ANH and pharmacological therapy. PMID:22645608

  1. Emerging Contaminant Issues, Including Management Of Emerging Contaminants In Wastewater

    EPA Science Inventory

    Emerging contaminants are receiving increasing media and scientific attention. These chemicals are sometimes referred to as compounds of emerging concern or trace organic compounds, and include several groups of chemicals including endocrine disrupting compounds (EDCs), and pha...

  2. Directory, Projects for Severely Handicapped.

    ERIC Educational Resources Information Center

    Yeshiva Univ., New York, NY. Curriculum Research and Development Center in Mental Retardation.

    Presented is a directory of 169 projects for severely handicapped persons. Descriptions include title of project, director's name, project address and telephone number, target population, designation of personnel (including teacher, medical personnel, and psychologist) involved in training, project areas (such as staff training, communication and…

  3. Current concepts of severe asthma.

    PubMed

    Ray, Anuradha; Raundhal, Mahesh; Oriss, Timothy B; Ray, Prabir; Wenzel, Sally E

    2016-07-01

    The term asthma encompasses a disease spectrum with mild to very severe disease phenotypes whose traditional common characteristic is reversible airflow limitation. Unlike milder disease, severe asthma is poorly controlled by the current standard of care. Ongoing studies using advanced molecular and immunological tools along with improved clinical classification show that severe asthma does not identify a specific patient phenotype, but rather includes patients with constant medical needs, whose pathobiologic and clinical characteristics vary widely. Accordingly, in recent clinical trials, therapies guided by specific patient characteristics have had better outcomes than previous therapies directed to any subject with a diagnosis of severe asthma. However, there are still significant gaps in our understanding of the full scope of this disease that hinder the development of effective treatments for all severe asthmatics. In this Review, we discuss our current state of knowledge regarding severe asthma, highlighting different molecular and immunological pathways that can be targeted for future therapeutic development.

  4. Severe Weather Forecast Decision Aid

    NASA Technical Reports Server (NTRS)

    Bauman, William H., III; Wheeler, Mark M.; Short, David A.

    2005-01-01

    This report presents a 15-year climatological study of severe weather events and related severe weather atmospheric parameters. Data sources included local forecast rules, archived sounding data, Cloud-to-Ground Lightning Surveillance System (CGLSS) data, surface and upper air maps, and two severe weather event databases covering east-central Florida. The local forecast rules were used to set threat assessment thresholds for stability parameters that were derived from the sounding data. The severe weather events databases were used to identify days with reported severe weather and the CGLSS data was used to differentiate between lightning and non-lightning days. These data sets provided the foundation for analyzing the stability parameters and synoptic patterns that were used to develop an objective tool to aid in forecasting severe weather events. The period of record for the analysis was May - September, 1989 - 2003. The results indicate that there are certain synoptic patterns more prevalent on days with severe weather and some of the stability parameters are better predictors of severe weather days based on locally tuned threat values. The results also revealed the stability parameters that did not display any skill related to severe weather days. An interactive web-based Severe Weather Decision Aid was developed to assist the duty forecaster by providing a level of objective guidance based on the analysis of the stability parameters, CGLSS data, and synoptic-scale dynamics. The tool will be tested and evaluated during the 2005 warm season.

  5. Severe Weather Research at the European Severe Storms Laboratory

    NASA Astrophysics Data System (ADS)

    Groenemeijer, Pieter

    2013-04-01

    The European Severe Storms Laboratory's (ESSL) aim is to increase understanding of high-impact weather, with a particular focus on phenomena with small spatial and temporal dimensions, such as large hail, convectively-driven severe wind gusts, tornadoes and extreme precipitation.The ESSL performs and supports research activities and contributes to enhancing forecasting and warning capabilities in several ways. First, ESSL supports research by providing quality-controlled point data on severe weather events in the European Severe Weather Database. These data are collected through collaborations with networks of voluntary observers, and National HydroMeteorological Institutes throughout Europe. Second, research carried out at ESSL includes modelling the present and future occurrence of severe weather phenomena. This is done by developing proxies for severe weather events for use with reanalysis and climate model data. Third, at the ESSL Testbed, new products to support forecasting and warning operations are tested and demonstrated. Among these tools are visualizations of NWP ensemble data as well as radar, satellite and lightning detection data. Testbed participants provide feedback to the products and receive training in forecasting severe convective weather. Last, every second year ESSL organizes or co-organizes the European Conferences on Severe Storms.

  6. [Severe rhabdomyolysis secondary to severe hypernatraemic dehydration].

    PubMed

    Mastro-Martínez, Ignacio; Montes-Arjona, Ana María; Escudero-Lirio, Margarita; Hernández-García, Bárbara; Fernández-Cantalejo Padial, José

    2015-01-01

    Rhabdomyolysis is a rare paediatric condition. The case is presented of a patient in whom this developed secondary to severe hypernatraemic dehydration following acute diarrhoea. Infant 11 months of age who presented with vomiting, fever, diarrhoea and anuria for 15 hours. Parents reported adequate preparation of artificial formula and oral rehydration solution. He was admitted with malaise, severe dehydration signs and symptoms, cyanosis, and low reactivity. The laboratory tests highlighted severe metabolic acidosis, hypernatraemia and pre-renal kidney failure (Sodium [Na] plasma 181 mEq/L, urine density> 1030). He was managed in Intensive Care Unit with gradual clinical and renal function improvement. On the third day, slight axial hypotonia and elevated cell lysis enzymes (creatine phosphokinase 75,076 IU/L) were observed, interpreted as rhabdomyolysis. He was treated with intravenous rehydration up to 1.5 times the basal requirements, and he showed a good clinical and biochemical response, being discharged 12 days after admission without motor sequelae. Severe hypernatraemia is described as a rare cause of rhabdomyolysis and renal failure. In critically ill patients, it is important to have a high index of suspicion for rhabdomyolysis and performing serial determinations of creatine phosphokinase for early detection and treatment. Copyright © 2015 Sociedad Chilena de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

  7. Dengue and Severe Dengue

    MedlinePlus

    ... serotypes increase the risk of developing severe dengue. Global burden of dengue The incidence of dengue has ... accumulation, respiratory distress, severe bleeding, or organ impairment. Warning signs occur 3–7 days after the first ...

  8. National Severe Storms Forecast Center

    NASA Technical Reports Server (NTRS)

    1977-01-01

    The principal mission of the National Severe Storms Forecast Center (NSSFC) is to maintain a continuous watch of weather developments that are capable of producing severe local storms, including tornadoes, and to prepare and issue messages designated as either Weather Outlooks or Tornado or Severe Thunderstorm Watches for dissemination to the public and aviation services. In addition to its assigned responsibility at the national level, the NSSFC is involved in a number of programs at the regional and local levels. Subsequent subsections and paragraphs describe the NSSFC, its users, inputs, outputs, interfaces, capabilities, workload, problem areas, and future plans in more detail.

  9. Severe Asthma in Children.

    PubMed

    Chipps, Bradley E; Parikh, Neil G; Maharaj, Sheena K

    2017-04-01

    The aim of this study is to characterize, diagnose, evaluate, and treat severe childhood asthma. Understanding the occurrence of the physiologic and clinical presentations of childhood severe asthma, the treatment and response may be predicted by biomarkers, but the patient's response is highly variable. The onset of severe asthma occurs early and is primarily predicted by severity of viral infection and coexistence of the atopic state.

  10. Severe storm electricity

    NASA Technical Reports Server (NTRS)

    Rust, W. D.; Macgorman, D. R.; Taylor, W.; Arnold, R. T.

    1984-01-01

    Severe storms and lightning were measured with a NASA U2 and ground based facilities, both fixed base and mobile. Aspects of this program are reported. The following results are presented: (1) ground truth measurements of lightning for comparison with those obtained by the U2. These measurements include flash type identification, electric field changes, optical waveforms, and ground strike location; (2) simultaneous extremely low frequency (ELF) waveforms for cloud to ground (CG) flashes; (3) the CG strike location system (LLP) using a combination of mobile laboratory and television video data are assessed; (4) continued development of analog-to-digital conversion techniques for processing lightning data from the U2, mobile laboratory, and NSSL sensors; (5) completion of an all azimuth TV system for CG ground truth; (6) a preliminary analysis of both IC and CG lightning in a mesocyclone; and (7) the finding of a bimodal peak in altitude lightning activity in some storms in the Great Plains and on the east coast. In the forms on the Great Plains, there was a distinct class of flash what forms the upper mode of the distribution. These flashes are smaller horizontal extent, but occur more frequently than flashes in the lower mode of the distribution.

  11. Severe Malnutrition: A Global Approach.

    ERIC Educational Resources Information Center

    Pelletier, Jean-Gerard

    1993-01-01

    This report examines the immediate and underlying causes of malnutrition in the developing world. The first section discusses the effects of malnutrition on childhood development and examines the efficacy of nutritional rehabilitation. The second section addresses the medical effects of severe malnutrition, including the onset of ponderostatural…

  12. Severe malarial anaemia.

    PubMed

    Casals-Pascual, C; Roberts, D J

    2006-03-01

    This review describes the importance of severe malarial anaemia as a public health problem, and the clinical and pathophysiological aspects of this syndrome. The review also highlights the recent advances in our understanding of the epidemiological, clinical, cellular and molecular aspects of severe malarial anaemia.

  13. Management of severe osteoporosis.

    PubMed

    Miller, Paul D

    2016-01-01

    Severe osteoporosis represents a disease of high mortality and morbidity. Recognition of what constitutes and causes severe osteoporosis and aggressive intervention with pharmacological agents with evidence to reduce fracture risk are outlined in this review. This review is a blend of evidence obtained from literature searches from PubMed and The National Library of Medicine (USA), clinical experience and the author's opinions. The review covers the recognition of what constitutes severe osteoporosis, and provides up-to-date references on this sub-set of high risk patients. Severe osteoporosis can be classified by using measurements of bone densitometry, identification of prevalent fractures, and, knowledge of what additional risk factors contribute to high fracture risk. Once recognized, the potential consequences of severe osteoporosis can be mitigated by appropriate selection of pharmacological therapies and modalities to reduce the risk for falling.

  14. [Severe multifactorial hyponatremia].

    PubMed

    Manes, Massimo; Radin, Elisabetta; Pellù, Valentina; Caputo, Donatella; Gabrielli, Danila; Molino, Andrea; Paternoster, Giuseppe; Parodi, Emanuele; Nebiolo, Pier Eugenio

    2017-01-01

    Hyponatremia is the most common electrolyte disorder observed in hospitalized patients. The most severe forms are neurological and potentially fatal emergencies; yet increased morbidity, length of hospital stay and costs associated with less severe forms are aspects of major concern. Nephrologists are frequently consulted regarding the therapeutic management and the key pathophysiological issues of hyponatremia, as this latter aspect represents a true challenge in an emergency setting. We report a case of a woman admitted to the emergency room for gait instability caused by a very severe multifactorial hyponatremia with a favourable clinical outcome.

  15. Optical design including characteristics of manufactured nanostructures

    NASA Astrophysics Data System (ADS)

    Wächter, Christoph; Müller, Martin; Förster, Erik; Oliva, Maria; Michaelis, Dirk

    2013-09-01

    Micro- and nanostructures enable specific optical functionalities, which rely on diffractive effects or effective medium features, depending on pattern dimension and wavelength. Performance predictions of optical systems which make use of nanostructured materials require having an accurate description of these materials ready to hand within the optical design. At the one hand, nanostructure characteristics which result from rigorous electromagnetic modeling can be used for the optical design. At the other hand, manufactured nanostructures may deviate from their idealized geometry, which will affect the performance of the optical system, wherein these artificial structures will be used. Thus, detailed optical characterization of the micro- or nanostructure functionality is prerequisite for accurate optical design and performance prediction. To this end, several characterization techniques can be applied depending on the scope of the optical design, finally. We report on a general route to include all accessible and required optical information about the nanostructured material within a corresponding model of the nanostructure as a specific optical component which can be used within a ray-trace engine, finally. This is illustrated by a meta-material with asymmetric transmission properties in some more detail.

  16. Design philosophy for reliable systems, including control

    SciTech Connect

    Gabriel, J.R.

    1984-04-01

    In the past, use of computers and software to manage physical plant has usually involved systems similar to the clockwork automata of the 17th century. The next generation of plant control will include intelligent systems - computer systems having knowledge of the plant and being capable of intelligent behavior, even though only some control functions will need such expertise. This report develops a framework for a universe of discourse usable by such non-human experts. It is based on the idea that a design has many features of a contract and may be described as a contract between humans and a machine, defining what each must do to attain a goal. Several points are discussed: the use of techniques in analytical redundancy and their place as analogues in administrative control for conventional techniques in physical control; the use of redundant computer systems to protect against hardware faults; the necessity to prove properties of software used in redundant hardware, because software faults are common modes across redundant hardware; and some issues in choosing a programming language for provable control software. Because proof of correctness is costly, it should be used only where necessary. This report concludes that the degree of reliability needed by the plant model used in analytic redundancy protection need not be nearly as reliable as the mechanism to detect discrepancy between plant and model.

  17. Dynamic stall simulation including turbulence modeling

    SciTech Connect

    Allet, A.; Halle, S.; Paraschivoiu, I.

    1995-09-01

    The objective of this study is to investigate the two-dimensional unsteady flow around an airfoil undergoing a Darrieus motion in dynamic stall conditions. For this purpose, a numerical solver based on the solution of the Reynolds-averaged Navier-Stokes equations expressed in a streamfunction-vorticity formulation in a non-inertial frame of reference was developed. The governing equations are solved by the streamline upwind Petrov-Galerkin finite element method (FEM). Temporal discretization is achieved by second-order-accurate finite differences. The resulting global matrix system is linearized by the Newton method and solved by the generalized minimum residual method (GMRES) with an incomplete triangular factorization preconditioning (ILU). Turbulence effects are introduced in the solver by an eddy viscosity model. The investigation centers on an evaluation of the possibilities of several turbulence models, including the algebraic Cebeci-Smith model (CSM) and the nonequilibrium Johnson-King model (JKM). In an effort to predict dynamic stall features on rotating airfoils, first the authors present some testing results concerning the performance of both turbulence models for the flat plate case. Then, computed flow structure together with aerodynamic coefficients for a NACA 0015 airfoil in Darrieus motion under stall conditions are presented.

  18. Extending Newtonian Dynamics to Include Stochastic Processes

    NASA Technical Reports Server (NTRS)

    Zak, Michail

    2009-01-01

    A paper presents further results of continuing research reported in several previous NASA Tech Briefs articles, the two most recent being Stochastic Representations of Chaos Using Terminal Attractors (NPO-41519), [Vol. 30, No. 5 (May 2006), page 57] and Physical Principle for Generation of Randomness (NPO-43822) [Vol. 33, No. 5 (May 2009), page 56]. This research focuses upon a mathematical formalism for describing post-instability motions of a dynamical system characterized by exponential divergences of trajectories leading to chaos (including turbulence as a form of chaos). The formalism involves fictitious control forces that couple the equations of motion of the system with a Liouville equation that describes the evolution of the probability density of errors in initial conditions. These stabilizing forces create a powerful terminal attractor in probability space that corresponds to occurrence of a target trajectory with probability one. The effect in configuration space (ordinary three-dimensional space as commonly perceived) is to suppress exponential divergences of neighboring trajectories without affecting the target trajectory. As a result, the post-instability motion is represented by a set of functions describing the evolution of such statistical quantities as expectations and higher moments, and this representation is stable.

  19. Severe Exoplanetary Storm

    NASA Image and Video Library

    2009-01-28

    These computer-generated images from NASA Spitzer Space Telescope chart the development of severe weather patterns on the highly eccentric exoplanet HD 80606b during the days after its closest approach to its parent star.

  20. Severe scoliosis in a patient with severe methylenetetrahydrofolate reductase deficiency.

    PubMed

    Munoz, Tatiana; Patel, Jinesh; Badilla-Porras, Ramses; Kronick, Jonathan; Mercimek-Mahmutoglu, Saadet

    2015-01-01

    Severe methylenetetrahydrofolate reductase (MTHFR) deficiency is a rare autosomal recessively inherited inborn error of folate metabolism. We report a new patient with severe MTHFR deficiency who presented at age 4 months with early onset severe scoliosis associated with severe hypotonia. Markedly decreased MTHFR enzyme activity (0.3 nmoles CHO/mg protein/h; reference range>9) and compound heterozygous mutations (c. 1304T>C; p.Phe435Ser and c.1539dup; p.Glu514Argfs∗24) in the MTHFR gene confirmed the diagnosis. She was treated with vitamin B12, folic acid and betaine supplementation and showed improvements in her developmental milestones and hypotonia. To the best of our knowledge, this is the first patient with MTHFR deficiency reported with severe early onset scoliosis. Despite the late diagnosis and treatment initiation, she showed favorable short-term neurodevelopmental outcome. This case suggests that homocysteine measurement should be included in the investigations of patients with developmental delay, hypotonia and scoliosis within first year of life prior to organizing genetic investigations.

  1. Severe cutaneous adverse drug reactions

    PubMed Central

    Verma, Rajesh; Vasudevan, Biju; Pragasam, Vijendran

    2013-01-01

    Severe cutaneous drug reactions are one of the commonest medical challenges presenting to an emergency room in any hospital. The manifestations range from maculopapular rash to severe systemic symptoms like renal failure and cardiovascular compromise. Toxic epidermal necrolysis, erythroderma, drug rash with eosinophilia and systemic symptoms, acute generalised exanthematous pustulosis and drug induced vasculitis are the common cutaneous drug reactions which can have severe morbidity and even mortality. Careful history taking of the lag period after drug intake and associated symptoms, along with detailed examination of the skin, mucosa and various systems, help in early diagnosis of these reactions. Early stoppage of the incriminating drug, specific therapy including corticosteroids, cyclosporine and intravenous immunoglobulin depending on the case along with supportive therapy and local measures help in salvaging most patients. An overview of these important cutaneous drug reactions along with their management is being reviewed in this article. PMID:24600147

  2. Severe Weather training

    NASA Astrophysics Data System (ADS)

    Ter Pelkwijk, H.

    2009-09-01

    Our environmental models, such as the models we use for weather prediction, are getting better and better. Within the operational meteorology there is a growing tendency to use models to produce automatic forecasts. For the forecaster this means more work is done on a weather dependent base and less routine work. An example of weather dependent work is the analysis of severe weather events. These will not occur very often, and when they occur different people will be on shift. This means a small chance to gain expertise in this field which becomes more and more complex. Within KNMI we have made a Severe Weather Catalogue which we can use to train the forecaster. In this presentation I will tell something about the ideas behind the Severe Weather Catalogue, how it works, the training of the forecasters and the problems we face.

  3. Environmental Sustainability - Including Land and Water Use

    EPA Science Inventory

    Assessments of environmental sustainability can be conducted in many ways with one of the most quantitative methods including Life Cycle Impact Assessment (LCIA). While historically LCIA has included a comprehensive list of impact categories including: ozone depletion, global c...

  4. Environmental Sustainability - Including Land and Water Use

    EPA Science Inventory

    Assessments of environmental sustainability can be conducted in many ways with one of the most quantitative methods including Life Cycle Impact Assessment (LCIA). While historically LCIA has included a comprehensive list of impact categories including: ozone depletion, global c...

  5. Severe Combined Immunodeficiency Disorders.

    PubMed

    Chinn, Ivan K; Shearer, William T

    2015-11-01

    Severe combined immunodeficiency disorders represent pediatric emergencies due to absence of adaptive immune responses to infections. The conditions result from either intrinsic defects in T-cell development (ie, severe combined immunodeficiency disease [SCID]) or congenital athymia (eg, complete DiGeorge anomaly). Hematopoietic stem cell transplant provides the only clinically approved cure for SCID, although gene therapy research trials are showing significant promise. For greatest survival, patients should undergo transplant before 3.5 months of age and before the onset of infections. Newborn screening programs have yielded successful early identification and treatment of infants with SCID and congenital athymia in the United States.

  6. Anemia in severe acute malnutrition.

    PubMed

    Thakur, Neha; Chandra, Jagdish; Pemde, Harish; Singh, Varinder

    2014-04-01

    India has the highest prevalence of severe acute malnutrition (SAM). Severe anemia is one of the comorbidities responsible for increased mortality in severely malnourished children, yet it has not received the attention it should. The aim of the present study was to determine the prevalence and type of anemia and to evaluate the possible etiologies for severe anemia, in these children. A cross-sectional study of patients with SAM in a tertiary care hospital in northern India over a period of 12 mo from Sept. 1, 2010 to Aug. 31, 2011 was conducted. We observed the prevalence of severe anemia (hemoglobin < 7 g/dL), morphologic type of anemia, number of patients requiring blood transfusion, hematologic profile of mothers, nature of feeding, duration of exclusive breastfeeding, and the demographic profile of these patients. Included in the study were 131 cases of SAM. The age group varied between 6 and to 59 mo. Of patients with SAM, 67.3% had severe anemia; 13.8% had moderate anemia. Of these patients, 25% required packed red blood cell transfusion. The most common type of anemia was microcytic (38.6%) followed by megaloblastic (30.5%). A high incidence of severe anemia in SAM with a large proportion (25%) requiring blood transfusion is a pointer toward nutritional anemia being a very common comorbidity of SAM requiring hospital admission. Because megaloblastic anemia closely followed microcytic anemia, supplementation with vitamin B12 in addition to iron and folic acid would be recommended. Copyright © 2014 Elsevier Inc. All rights reserved.

  7. Severe blastomycosis in infants.

    PubMed

    Pelly, Lorine; Al Juaid, Alaa; Fanella, Sergio

    2014-11-01

    Blastomycosis is a dimorphic fungal infection that can be manifested as pulmonary or extrapulmonary disease. Disease in infants is rare, even in endemic areas. We report a case of severe blastomycosis in a 4-month-old infant, as well as details of 2 other cases from our center and a brief review of infant blastomycosis.

  8. Severe storms forecast systems

    NASA Technical Reports Server (NTRS)

    Kaplan, M.; Zack, J.

    1980-01-01

    Two research tasks are described: (1) the improvement and enhancement of an existing mesoscale numerical simulation system, and (2) numerical diagnostic studies associated with an individual case of severe storm development (April 10, 1979 in the Red River Valley of Texas and Oklahoma).

  9. Severe low turnover osteoporosis.

    PubMed

    Pietrogrande, Luca

    2007-08-01

    Severe osteoporosis, a situation with fractures, can worsen in the case of poor response to usual therapies, such as bisphosphonates associated with calcium and vitamin D, especially if bone turnover is strongly suppressed. One way of inverting the poor evolution of non-responders is to use Teriparatide. The case of a non-responder is reported, with considerations about the possibility of detecting these patients before a new fracture takes place.

  10. Epidemiology of severe trauma.

    PubMed

    Alberdi, F; García, I; Atutxa, L; Zabarte, M

    2014-12-01

    Major injury is the sixth leading cause of death worldwide. Among those under 35 years of age, it is the leading cause of death and disability. Traffic accidents alone are the main cause, fundamentally in low- and middle-income countries. Patients over 65 years of age are an increasingly affected group. For similar levels of injury, these patients have twice the mortality rate of young individuals, due to the existence of important comorbidities and associated treatments, and are more likely to die of medical complications late during hospital admission. No worldwide, standardized definitions exist for documenting, reporting and comparing data on severely injured trauma patients. The most common trauma scores are the Abbreviated Injury Scale (AIS), the Injury Severity Score (ISS) and the Trauma and Injury severity Score (TRISS). Documenting the burden of injury also requires evaluation of the impact of post-trauma impairments, disabilities and handicaps. Trauma epidemiology helps define health service and research priorities, contributes to identify disadvantaged groups, and also facilitates the elaboration of comparable measures for outcome predictions.

  11. Children and Humane Behavior: Are Snakes Included?

    ERIC Educational Resources Information Center

    Nethery, Lauren B.

    1984-01-01

    Discusses the necessity for and development of a humane attitude in children, considering various factors that affect children's perception of animals. Also considers whether or not several children were right or wrong in their mistreatment of a snake. (JN)

  12. Coagulopathy after severe pediatric trauma.

    PubMed

    Christiaans, Sarah C; Duhachek-Stapelman, Amy L; Russell, Robert T; Lisco, Steven J; Kerby, Jeffrey D; Pittet, Jean-François

    2014-06-01

    Trauma remains the leading cause of morbidity and mortality in the United States among children aged 1 to 21 years. The most common cause of lethality in pediatric trauma is traumatic brain injury. Early coagulopathy has been commonly observed after severe trauma and is usually associated with severe hemorrhage and/or traumatic brain injury. In contrast to adult patients, massive bleeding is less common after pediatric trauma. The classical drivers of trauma-induced coagulopathy include hypothermia, acidosis, hemodilution, and consumption of coagulation factors secondary to local activation of the coagulation system after severe traumatic injury. Furthermore, there is also recent evidence for a distinct mechanism of trauma-induced coagulopathy that involves the activation of the anticoagulant protein C pathway. Whether this new mechanism of posttraumatic coagulopathy plays a role in children is still unknown. The goal of this review is to summarize the current knowledge on the incidence and potential mechanisms of coagulopathy after pediatric trauma and the role of rapid diagnostic tests for early identification of coagulopathy. Finally, we discuss different options for treating coagulopathy after severe pediatric trauma.

  13. Severe convective environments in Reanalyses

    NASA Astrophysics Data System (ADS)

    Gutierrez, G.; Kennedy, A. D.

    2014-12-01

    Climate change implies an altering of weather patterns that may change the frequency of high impact events such as severe thunderstorms and their associated dangers (damaging winds, torrential rains, hail, and tornadoes). Presently, very little is known about how climate change will impact these events. Since these phenomenon are not resolved by climate models, proxies are required to understand how these events may change in the future.Prior to investigating how convective environments change in the future, a reference must be obtained to understand the current climatology of convective environments. Studies such as Kennedy et al. (2011) have shown there are significant differences in reanalyses for regions prone to severe weather.Severe weather parameters such as Convective Available Potential Energy (CAPE), Lifted Index, K Index, Total Totals, 0-1 km shear, 0-3 km shear and 0-6 km shear are calculated using soundings from reanalyses for known severe convective environments. Reanalyses included in this study are the North American Regional Reanalysis (NARR), Modern-Era Retrospective Analysis for Research and Applications (MERRA), 20th Century Reanalysis (20CR), Climate Forecast System Reanalysis (CFSR), Japanese 25-year Reanalysis (JRA25), and Japanese 55-year Reanalysis (JRA55). Preliminary findings are presented. If time allows, multi-parameter indices such as Energy Helicity Index, Bunkers storm motion, Significant Tornado Parameter, and Supercell Composite Parameter will also be compared.

  14. Haemophilus influenzae Disease (Including Hib) Symptoms

    MedlinePlus

    ... Search The CDC Cancel Submit Search The CDC Haemophilus influenzae Disease (Including Hib) Note: Javascript is disabled or ... and Symptoms Recommend on Facebook Tweet Share Compartir Haemophilus influenzae , including Hib, disease causes different symptoms depending on ...

  15. Article Including Environmental Barrier Coating System

    NASA Technical Reports Server (NTRS)

    Lee, Kang N. (Inventor)

    2015-01-01

    An enhanced environmental barrier coating for a silicon containing substrate. The enhanced barrier coating may include a bond coat doped with at least one of an alkali metal oxide and an alkali earth metal oxide. The enhanced barrier coating may include a composite mullite bond coat including BSAS and another distinct second phase oxide applied over said surface.

  16. KENNEDY SPACE CENTER, FLA. - Research team members take their places on one of the watercraft being utilized to conduct underwater acoustic research in the Launch Complex 39 turn basin. Several government agencies, including NASA, NOAA, the Navy, the Coast Guard, and the Florida Fish and Wildlife Commission are involved in the testing. The research involves demonstrations of passive and active sensor technologies, with applications in fields ranging from marine biological research to homeland security. The work is also serving as a pilot project to assess the cooperation between the agencies involved. Equipment under development includes a passive acoustic monitor developed by NASA’s Jet Propulsion Laboratory, and mobile robotic sensors from the Navy’s Mobile Diving and Salvage Unit.

    NASA Image and Video Library

    2003-08-19

    KENNEDY SPACE CENTER, FLA. - Research team members take their places on one of the watercraft being utilized to conduct underwater acoustic research in the Launch Complex 39 turn basin. Several government agencies, including NASA, NOAA, the Navy, the Coast Guard, and the Florida Fish and Wildlife Commission are involved in the testing. The research involves demonstrations of passive and active sensor technologies, with applications in fields ranging from marine biological research to homeland security. The work is also serving as a pilot project to assess the cooperation between the agencies involved. Equipment under development includes a passive acoustic monitor developed by NASA’s Jet Propulsion Laboratory, and mobile robotic sensors from the Navy’s Mobile Diving and Salvage Unit.

  17. KENNEDY SPACE CENTER, FLA. - A research team member aboard one of the watercraft being utilized to conduct underwater acoustic research in the Launch Complex 39 turn basin releases some of the project's equipment into the water. Several government agencies, including NASA, NOAA, the Navy, the Coast Guard, and the Florida Fish and Wildlife Commission are involved in the testing. The research involves demonstrations of passive and active sensor technologies, with applications in fields ranging from marine biological research to homeland security. The work is also serving as a pilot project to assess the cooperation between the agencies involved. Equipment under development includes a passive acoustic monitor developed by NASA’s Jet Propulsion Laboratory, and mobile robotic sensors from the Navy’s Mobile Diving and Salvage Unit.

    NASA Image and Video Library

    2003-08-19

    KENNEDY SPACE CENTER, FLA. - A research team member aboard one of the watercraft being utilized to conduct underwater acoustic research in the Launch Complex 39 turn basin releases some of the project's equipment into the water. Several government agencies, including NASA, NOAA, the Navy, the Coast Guard, and the Florida Fish and Wildlife Commission are involved in the testing. The research involves demonstrations of passive and active sensor technologies, with applications in fields ranging from marine biological research to homeland security. The work is also serving as a pilot project to assess the cooperation between the agencies involved. Equipment under development includes a passive acoustic monitor developed by NASA’s Jet Propulsion Laboratory, and mobile robotic sensors from the Navy’s Mobile Diving and Salvage Unit.

  18. KENNEDY SPACE CENTER, FLA. - Research team members roll out acoustic cable to the water's edge during underwater acoustic research being conducted in the Launch Complex 39 turn basin. Several government agencies, including NASA, NOAA, the Navy, the Coast Guard, and the Florida Fish and Wildlife Commission are involved in the testing. The research involves demonstrations of passive and active sensor technologies, with applications in fields ranging from marine biological research to homeland security. The work is also serving as a pilot project to assess the cooperation between the agencies involved. Equipment under development includes a passive acoustic monitor developed by NASA’s Jet Propulsion Laboratory, and mobile robotic sensors from the Navy’s Mobile Diving and Salvage Unit.

    NASA Image and Video Library

    2003-08-18

    KENNEDY SPACE CENTER, FLA. - Research team members roll out acoustic cable to the water's edge during underwater acoustic research being conducted in the Launch Complex 39 turn basin. Several government agencies, including NASA, NOAA, the Navy, the Coast Guard, and the Florida Fish and Wildlife Commission are involved in the testing. The research involves demonstrations of passive and active sensor technologies, with applications in fields ranging from marine biological research to homeland security. The work is also serving as a pilot project to assess the cooperation between the agencies involved. Equipment under development includes a passive acoustic monitor developed by NASA’s Jet Propulsion Laboratory, and mobile robotic sensors from the Navy’s Mobile Diving and Salvage Unit.

  19. KENNEDY SPACE CENTER, FLA. - Research team members aboard one of the watercraft being utilized to conduct underwater acoustic research in the Launch Complex 39 turn basin prepare to release some of the project's equipment into the water. Several government agencies, including NASA, NOAA, the Navy, the Coast Guard, and the Florida Fish and Wildlife Commission are involved in the testing. The research involves demonstrations of passive and active sensor technologies, with applications in fields ranging from marine biological research to homeland security. The work is also serving as a pilot project to assess the cooperation between the agencies involved. Equipment under development includes a passive acoustic monitor developed by NASA’s Jet Propulsion Laboratory, and mobile robotic sensors from the Navy’s Mobile Diving and Salvage Unit.

    NASA Image and Video Library

    2003-08-19

    KENNEDY SPACE CENTER, FLA. - Research team members aboard one of the watercraft being utilized to conduct underwater acoustic research in the Launch Complex 39 turn basin prepare to release some of the project's equipment into the water. Several government agencies, including NASA, NOAA, the Navy, the Coast Guard, and the Florida Fish and Wildlife Commission are involved in the testing. The research involves demonstrations of passive and active sensor technologies, with applications in fields ranging from marine biological research to homeland security. The work is also serving as a pilot project to assess the cooperation between the agencies involved. Equipment under development includes a passive acoustic monitor developed by NASA’s Jet Propulsion Laboratory, and mobile robotic sensors from the Navy’s Mobile Diving and Salvage Unit.

  20. KENNEDY SPACE CENTER, FLA. - Justin Manley, of the National Oceanic and Atmospheric Administration, is a member of the research team conducting underwater acoustic research in the Launch Complex 39 turn basin near Launch Pad 39A. Several government agencies, including NASA, NOAA, the Navy, the Coast Guard, and the Florida Fish and Wildlife Commission are involved in the testing. The research involves demonstrations of passive and active sensor technologies, with applications in fields ranging from marine biological research to homeland security. The work is also serving as a pilot project to assess the cooperation between the agencies involved. Equipment under development includes a passive acoustic monitor developed by NASA’s Jet Propulsion Laboratory, and mobile robotic sensors from the Navy’s Mobile Diving and Salvage Unit.

    NASA Image and Video Library

    2003-08-18

    KENNEDY SPACE CENTER, FLA. - Justin Manley, of the National Oceanic and Atmospheric Administration, is a member of the research team conducting underwater acoustic research in the Launch Complex 39 turn basin near Launch Pad 39A. Several government agencies, including NASA, NOAA, the Navy, the Coast Guard, and the Florida Fish and Wildlife Commission are involved in the testing. The research involves demonstrations of passive and active sensor technologies, with applications in fields ranging from marine biological research to homeland security. The work is also serving as a pilot project to assess the cooperation between the agencies involved. Equipment under development includes a passive acoustic monitor developed by NASA’s Jet Propulsion Laboratory, and mobile robotic sensors from the Navy’s Mobile Diving and Salvage Unit.

  1. KENNEDY SPACE CENTER, FLA. - Research team members aboard one of the watercraft being utilized to conduct underwater acoustic research in the Launch Complex 39 turn basin monitor some of the project's equipment just released into the water. Several government agencies, including NASA, NOAA, the Navy, the Coast Guard, and the Florida Fish and Wildlife Commission are involved in the testing. The research involves demonstrations of passive and active sensor technologies, with applications in fields ranging from marine biological research to homeland security. The work is also serving as a pilot project to assess the cooperation between the agencies involved. Equipment under development includes a passive acoustic monitor developed by NASA’s Jet Propulsion Laboratory, and mobile robotic sensors from the Navy’s Mobile Diving and Salvage Unit.

    NASA Image and Video Library

    2003-08-19

    KENNEDY SPACE CENTER, FLA. - Research team members aboard one of the watercraft being utilized to conduct underwater acoustic research in the Launch Complex 39 turn basin monitor some of the project's equipment just released into the water. Several government agencies, including NASA, NOAA, the Navy, the Coast Guard, and the Florida Fish and Wildlife Commission are involved in the testing. The research involves demonstrations of passive and active sensor technologies, with applications in fields ranging from marine biological research to homeland security. The work is also serving as a pilot project to assess the cooperation between the agencies involved. Equipment under development includes a passive acoustic monitor developed by NASA’s Jet Propulsion Laboratory, and mobile robotic sensors from the Navy’s Mobile Diving and Salvage Unit.

  2. KENNEDY SPACE CENTER, FLA. - Research team members aboard one of the watercraft being utilized to conduct underwater acoustic research in the Launch Complex 39 turn basin retrieve some of the project's equipment from the water. Several government agencies, including NASA, NOAA, the Navy, the Coast Guard, and the Florida Fish and Wildlife Commission are involved in the testing. The research involves demonstrations of passive and active sensor technologies, with applications in fields ranging from marine biological research to homeland security. The work is also serving as a pilot project to assess the cooperation between the agencies involved. Equipment under development includes a passive acoustic monitor developed by NASA’s Jet Propulsion Laboratory, and mobile robotic sensors from the Navy’s Mobile Diving and Salvage Unit.

    NASA Image and Video Library

    2003-08-19

    KENNEDY SPACE CENTER, FLA. - Research team members aboard one of the watercraft being utilized to conduct underwater acoustic research in the Launch Complex 39 turn basin retrieve some of the project's equipment from the water. Several government agencies, including NASA, NOAA, the Navy, the Coast Guard, and the Florida Fish and Wildlife Commission are involved in the testing. The research involves demonstrations of passive and active sensor technologies, with applications in fields ranging from marine biological research to homeland security. The work is also serving as a pilot project to assess the cooperation between the agencies involved. Equipment under development includes a passive acoustic monitor developed by NASA’s Jet Propulsion Laboratory, and mobile robotic sensors from the Navy’s Mobile Diving and Salvage Unit.

  3. KENNEDY SPACE CENTER, FLA. - Research team members work with acoustic cable during underwater acoustic research being conducted in the Launch Complex 39 turn basin. Several government agencies, including NASA, NOAA, the Navy, the Coast Guard, and the Florida Fish and Wildlife Commission are involved in the testing. The research involves demonstrations of passive and active sensor technologies, with applications in fields ranging from marine biological research to homeland security. The work is also serving as a pilot project to assess the cooperation between the agencies involved. Equipment under development includes a passive acoustic monitor developed by NASA’s Jet Propulsion Laboratory, and mobile robotic sensors from the Navy’s Mobile Diving and Salvage Unit.

    NASA Image and Video Library

    2003-08-18

    KENNEDY SPACE CENTER, FLA. - Research team members work with acoustic cable during underwater acoustic research being conducted in the Launch Complex 39 turn basin. Several government agencies, including NASA, NOAA, the Navy, the Coast Guard, and the Florida Fish and Wildlife Commission are involved in the testing. The research involves demonstrations of passive and active sensor technologies, with applications in fields ranging from marine biological research to homeland security. The work is also serving as a pilot project to assess the cooperation between the agencies involved. Equipment under development includes a passive acoustic monitor developed by NASA’s Jet Propulsion Laboratory, and mobile robotic sensors from the Navy’s Mobile Diving and Salvage Unit.

  4. KENNEDY SPACE CENTER, FLA. - Researchers are positioned on one of the watercraft being utilized to conduct underwater acoustic research in the Launch Complex 39 turn basin. Several government agencies, including NASA, NOAA, the Navy, the Coast Guard, and the Florida Fish and Wildlife Commission are involved in the testing. The research involves demonstrations of passive and active sensor technologies, with applications in fields ranging from marine biological research to homeland security. The work is also serving as a pilot project to assess the cooperation between the agencies involved. Equipment under development includes a passive acoustic monitor developed by NASA’s Jet Propulsion Laboratory, and mobile robotic sensors from the Navy’s Mobile Diving and Salvage Unit.

    NASA Image and Video Library

    2003-08-19

    KENNEDY SPACE CENTER, FLA. - Researchers are positioned on one of the watercraft being utilized to conduct underwater acoustic research in the Launch Complex 39 turn basin. Several government agencies, including NASA, NOAA, the Navy, the Coast Guard, and the Florida Fish and Wildlife Commission are involved in the testing. The research involves demonstrations of passive and active sensor technologies, with applications in fields ranging from marine biological research to homeland security. The work is also serving as a pilot project to assess the cooperation between the agencies involved. Equipment under development includes a passive acoustic monitor developed by NASA’s Jet Propulsion Laboratory, and mobile robotic sensors from the Navy’s Mobile Diving and Salvage Unit.

  5. KENNEDY SPACE CENTER, FLA. - Research team members aboard one of the watercraft being utilized to conduct underwater acoustic research in the Launch Complex 39 turn basin release some of the project's equipment into the water. Several government agencies, including NASA, NOAA, the Navy, the Coast Guard, and the Florida Fish and Wildlife Commission are involved in the testing. The research involves demonstrations of passive and active sensor technologies, with applications in fields ranging from marine biological research to homeland security. The work is also serving as a pilot project to assess the cooperation between the agencies involved. Equipment under development includes a passive acoustic monitor developed by NASA’s Jet Propulsion Laboratory, and mobile robotic sensors from the Navy’s Mobile Diving and Salvage Unit.

    NASA Image and Video Library

    2003-08-19

    KENNEDY SPACE CENTER, FLA. - Research team members aboard one of the watercraft being utilized to conduct underwater acoustic research in the Launch Complex 39 turn basin release some of the project's equipment into the water. Several government agencies, including NASA, NOAA, the Navy, the Coast Guard, and the Florida Fish and Wildlife Commission are involved in the testing. The research involves demonstrations of passive and active sensor technologies, with applications in fields ranging from marine biological research to homeland security. The work is also serving as a pilot project to assess the cooperation between the agencies involved. Equipment under development includes a passive acoustic monitor developed by NASA’s Jet Propulsion Laboratory, and mobile robotic sensors from the Navy’s Mobile Diving and Salvage Unit.

  6. KENNEDY SPACE CENTER, FLA. - Research team members roll out acoustic cable to the water's edge as others stand by in a watercraft during underwater acoustic research being conducted in the Launch Complex 39 turn basin. Several government agencies, including NASA, NOAA, the Navy, the Coast Guard, and the Florida Fish and Wildlife Commission are involved in the testing. The research involves demonstrations of passive and active sensor technologies, with applications in fields ranging from marine biological research to homeland security. The work is also serving as a pilot project to assess the cooperation between the agencies involved. Equipment under development includes a passive acoustic monitor developed by NASA’s Jet Propulsion Laboratory, and mobile robotic sensors from the Navy’s Mobile Diving and Salvage Unit.

    NASA Image and Video Library

    2003-08-18

    KENNEDY SPACE CENTER, FLA. - Research team members roll out acoustic cable to the water's edge as others stand by in a watercraft during underwater acoustic research being conducted in the Launch Complex 39 turn basin. Several government agencies, including NASA, NOAA, the Navy, the Coast Guard, and the Florida Fish and Wildlife Commission are involved in the testing. The research involves demonstrations of passive and active sensor technologies, with applications in fields ranging from marine biological research to homeland security. The work is also serving as a pilot project to assess the cooperation between the agencies involved. Equipment under development includes a passive acoustic monitor developed by NASA’s Jet Propulsion Laboratory, and mobile robotic sensors from the Navy’s Mobile Diving and Salvage Unit.

  7. KENNEDY SPACE CENTER, FLA. - Joe Bartoszek, NASA, is a member of the research team conducting underwater acoustic research in the Launch Complex 39 turn basin near Launch Pad 39A. Several government agencies, including NASA, NOAA, the Navy, the Coast Guard, and the Florida Fish and Wildlife Commission are involved in the testing. The research involves demonstrations of passive and active sensor technologies, with applications in fields ranging from marine biological research to homeland security. The work is also serving as a pilot project to assess the cooperation between the agencies involved. Equipment under development includes a passive acoustic monitor developed by NASA’s Jet Propulsion Laboratory, and mobile robotic sensors from the Navy’s Mobile Diving and Salvage Unit.

    NASA Image and Video Library

    2003-08-18

    KENNEDY SPACE CENTER, FLA. - Joe Bartoszek, NASA, is a member of the research team conducting underwater acoustic research in the Launch Complex 39 turn basin near Launch Pad 39A. Several government agencies, including NASA, NOAA, the Navy, the Coast Guard, and the Florida Fish and Wildlife Commission are involved in the testing. The research involves demonstrations of passive and active sensor technologies, with applications in fields ranging from marine biological research to homeland security. The work is also serving as a pilot project to assess the cooperation between the agencies involved. Equipment under development includes a passive acoustic monitor developed by NASA’s Jet Propulsion Laboratory, and mobile robotic sensors from the Navy’s Mobile Diving and Salvage Unit.

  8. KENNEDY SPACE CENTER, FLA. - A research team member aboard one of the watercraft being utilized to conduct underwater acoustic research in the Launch Complex 39 turn basin lifts some of the project's equipment from the water. Several government agencies, including NASA, NOAA, the Navy, the Coast Guard, and the Florida Fish and Wildlife Commission are involved in the testing. The research involves demonstrations of passive and active sensor technologies, with applications in fields ranging from marine biological research to homeland security. The work is also serving as a pilot project to assess the cooperation between the agencies involved. Equipment under development includes a passive acoustic monitor developed by NASA’s Jet Propulsion Laboratory, and mobile robotic sensors from the Navy’s Mobile Diving and Salvage Unit.

    NASA Image and Video Library

    2003-08-19

    KENNEDY SPACE CENTER, FLA. - A research team member aboard one of the watercraft being utilized to conduct underwater acoustic research in the Launch Complex 39 turn basin lifts some of the project's equipment from the water. Several government agencies, including NASA, NOAA, the Navy, the Coast Guard, and the Florida Fish and Wildlife Commission are involved in the testing. The research involves demonstrations of passive and active sensor technologies, with applications in fields ranging from marine biological research to homeland security. The work is also serving as a pilot project to assess the cooperation between the agencies involved. Equipment under development includes a passive acoustic monitor developed by NASA’s Jet Propulsion Laboratory, and mobile robotic sensors from the Navy’s Mobile Diving and Salvage Unit.

  9. KENNEDY SPACE CENTER, FLA. - Research team members aboard one of the watercraft being utilized to conduct underwater acoustic research in the Launch Complex 39 turn basin secure some of the project's equipment back into the vessel. Several government agencies, including NASA, NOAA, the Navy, the Coast Guard, and the Florida Fish and Wildlife Commission are involved in the testing. The research involves demonstrations of passive and active sensor technologies, with applications in fields ranging from marine biological research to homeland security. The work is also serving as a pilot project to assess the cooperation between the agencies involved. Equipment under development includes a passive acoustic monitor developed by NASA’s Jet Propulsion Laboratory, and mobile robotic sensors from the Navy’s Mobile Diving and Salvage Unit.

    NASA Image and Video Library

    2003-08-19

    KENNEDY SPACE CENTER, FLA. - Research team members aboard one of the watercraft being utilized to conduct underwater acoustic research in the Launch Complex 39 turn basin secure some of the project's equipment back into the vessel. Several government agencies, including NASA, NOAA, the Navy, the Coast Guard, and the Florida Fish and Wildlife Commission are involved in the testing. The research involves demonstrations of passive and active sensor technologies, with applications in fields ranging from marine biological research to homeland security. The work is also serving as a pilot project to assess the cooperation between the agencies involved. Equipment under development includes a passive acoustic monitor developed by NASA’s Jet Propulsion Laboratory, and mobile robotic sensors from the Navy’s Mobile Diving and Salvage Unit.

  10. KENNEDY SPACE CENTER, FLA. - Dr. Grant Gilmore (left), Dynamac Corp., talks to another member of the research team conducting underwater acoustic research in the Launch Complex 39 turn basin. Several government agencies, including NASA, NOAA, the Navy, the Coast Guard, and the Florida Fish and Wildlife Commission are involved in the testing. The research involves demonstrations of passive and active sensor technologies, with applications in fields ranging from marine biological research to homeland security. The work is also serving as a pilot project to assess the cooperation between the agencies involved. Equipment under development includes a passive acoustic monitor developed by NASA’s Jet Propulsion Laboratory, and mobile robotic sensors from the Navy’s Mobile Diving and Salvage Unit.

    NASA Image and Video Library

    2003-08-18

    KENNEDY SPACE CENTER, FLA. - Dr. Grant Gilmore (left), Dynamac Corp., talks to another member of the research team conducting underwater acoustic research in the Launch Complex 39 turn basin. Several government agencies, including NASA, NOAA, the Navy, the Coast Guard, and the Florida Fish and Wildlife Commission are involved in the testing. The research involves demonstrations of passive and active sensor technologies, with applications in fields ranging from marine biological research to homeland security. The work is also serving as a pilot project to assess the cooperation between the agencies involved. Equipment under development includes a passive acoustic monitor developed by NASA’s Jet Propulsion Laboratory, and mobile robotic sensors from the Navy’s Mobile Diving and Salvage Unit.

  11. KENNEDY SPACE CENTER, FLA. - Dr. Grant Gilmore, Dynamac Corp., utilizes a laptop computer to explain aspects of the underwater acoustic research under way in the Launch Complex 39 turn basin. Several government agencies, including NASA, NOAA, the Navy, the Coast Guard, and the Florida Fish and Wildlife Commission are involved in the testing. The research involves demonstrations of passive and active sensor technologies, with applications in fields ranging from marine biological research to homeland security. The work is also serving as a pilot project to assess the cooperation between the agencies involved. Equipment under development includes a passive acoustic monitor developed by NASA’s Jet Propulsion Laboratory, and mobile robotic sensors from the Navy’s Mobile Diving and Salvage Unit.

    NASA Image and Video Library

    2003-08-18

    KENNEDY SPACE CENTER, FLA. - Dr. Grant Gilmore, Dynamac Corp., utilizes a laptop computer to explain aspects of the underwater acoustic research under way in the Launch Complex 39 turn basin. Several government agencies, including NASA, NOAA, the Navy, the Coast Guard, and the Florida Fish and Wildlife Commission are involved in the testing. The research involves demonstrations of passive and active sensor technologies, with applications in fields ranging from marine biological research to homeland security. The work is also serving as a pilot project to assess the cooperation between the agencies involved. Equipment under development includes a passive acoustic monitor developed by NASA’s Jet Propulsion Laboratory, and mobile robotic sensors from the Navy’s Mobile Diving and Salvage Unit.

  12. KENNEDY SPACE CENTER, FLA. - A research team member aboard one of the watercraft being utilized to conduct underwater acoustic research in the Launch Complex 39 turn basin prepares some of the project's equipment for placement in the water. Several government agencies, including NASA, NOAA, the Navy, the Coast Guard, and the Florida Fish and Wildlife Commission are involved in the testing. The research involves demonstrations of passive and active sensor technologies, with applications in fields ranging from marine biological research to homeland security. The work is also serving as a pilot project to assess the cooperation between the agencies involved. Equipment under development includes a passive acoustic monitor developed by NASA’s Jet Propulsion Laboratory, and mobile robotic sensors from the Navy’s Mobile Diving and Salvage Unit.

    NASA Image and Video Library

    2003-08-19

    KENNEDY SPACE CENTER, FLA. - A research team member aboard one of the watercraft being utilized to conduct underwater acoustic research in the Launch Complex 39 turn basin prepares some of the project's equipment for placement in the water. Several government agencies, including NASA, NOAA, the Navy, the Coast Guard, and the Florida Fish and Wildlife Commission are involved in the testing. The research involves demonstrations of passive and active sensor technologies, with applications in fields ranging from marine biological research to homeland security. The work is also serving as a pilot project to assess the cooperation between the agencies involved. Equipment under development includes a passive acoustic monitor developed by NASA’s Jet Propulsion Laboratory, and mobile robotic sensors from the Navy’s Mobile Diving and Salvage Unit.

  13. Rivastigmine in moderately severe-to-severe Alzheimer's disease: Severe Impairment Battery factor analysis.

    PubMed

    Ferris, Steven; Karantzoulis, Stella; Somogyi, Monique; Meng, Xiangyi

    2013-01-01

    The Severe Impairment Battery (SIB) is validated for assessing cognition in patients with severe dementia. The current analysis aimed to further investigate the cognitive efficacy of rivastigmine capsules, as assessed by SIB factor scores, in patients with moderately severe-to-severe Alzheimer's disease (AD). This was a retrospective analysis of a 26-week, multicenter, randomized, double-blind, placebo-controlled study of oral rivastigmine conducted in Spain. Previously reported outcome measures included the full SIB. Current analyses examined calculated scores and effect sizes for the change from baseline at Week 26 on: newly defined SIB subscales (derived by a factor analysis of the 40 SIB items, using the PROC FACTOR function (SAS)); previously defined memory, language and praxis subscales (derived by previous analysis of the nine SIB domains); and the individual SIB items. Treatment differences were assessed. SIB data were provided by 104 rivastigmine-treated patients and 106 patients receiving placebo (Intent-To-Treat Last Observation Carried Forward population). Significantly less decline was observed on the previously defined memory and language subscales, and the newly defined working memory/memory subscale in rivastigmine-treated patients (all P < 0.05 versus placebo). Calculation of effect sizes demonstrated numerically greater efficacy of rivastigmine versus placebo on each of the subscales, and a broad range of SIB items; greatest effect sizes were observed on SIB items assessing the current month (effect size = 0.30) and digit span series (effect size = 0.33). These data suggest the observed efficacy of rivastigmine in moderately severe-to-severe AD is likely a cumulative effect across a range of tasks. Rivastigmine demonstrates broad cognitive efficacy in this patient population.

  14. Rivastigmine in moderately severe-to-severe Alzheimer’s disease: Severe Impairment Battery factor analysis

    PubMed Central

    2013-01-01

    Introduction The Severe Impairment Battery (SIB) is validated for assessing cognition in patients with severe dementia. The current analysis aimed to further investigate the cognitive efficacy of rivastigmine capsules, as assessed by SIB factor scores, in patients with moderately severe-to-severe Alzheimer’s disease (AD). Methods This was a retrospective analysis of a 26-week, multicenter, randomized, double-blind, placebo-controlled study of oral rivastigmine conducted in Spain. Previously reported outcome measures included the full SIB. Current analyses examined calculated scores and effect sizes for the change from baseline at Week 26 on: newly defined SIB subscales (derived by a factor analysis of the 40 SIB items, using the PROC FACTOR function (SAS)); previously defined memory, language and praxis subscales (derived by previous analysis of the nine SIB domains); and the individual SIB items. Treatment differences were assessed. Results SIB data were provided by 104 rivastigmine-treated patients and 106 patients receiving placebo (Intent-To-Treat Last Observation Carried Forward population). Significantly less decline was observed on the previously defined memory and language subscales, and the newly defined working memory/memory subscale in rivastigmine-treated patients (all P < 0.05 versus placebo). Calculation of effect sizes demonstrated numerically greater efficacy of rivastigmine versus placebo on each of the subscales, and a broad range of SIB items; greatest effect sizes were observed on SIB items assessing the current month (effect size = 0.30) and digit span series (effect size = 0.33). Conclusions These data suggest the observed efficacy of rivastigmine in moderately severe-to-severe AD is likely a cumulative effect across a range of tasks. Rivastigmine demonstrates broad cognitive efficacy in this patient population. PMID:24351447

  15. [Severe edematous dermatomyositis].

    PubMed

    Goussot, R; Wettlé, C; Le Coz, C; Cribier, B; Lipsker, D

    2016-03-01

    Edematous dermatomyositis is a rare entity with localized or generalized subcutaneous edema and only 21 cases have been reported in the literature. It is considered to be a severe form of dermatomyositis which needs quick therapeutic decision. We report 2 cases with difficult therapeutic decisions. Two patients aged 23 and 80 years were admitted in hospital for DM with typical cutaneous and muscular involvement without any sign of gravity and which have been treated by steroids: methylprednisolone bolus and prednisone. They both then developed severe edema of the upper limbs as well as worsening of the cutaneous and muscular symptoms with dysphagia. The addition of mycophenolate mofetil and intravenous immunoglobulin has permitted in the case of the first patient the disappearance of the cutaneous symptoms in particular the edema with restitution of the muscular force and withdrawal of the dysphagia and swallowing symptoms. The therapeutic failure for the second patient was due to a refusal of the treatment and a probable paraneoplastic context. Subcutaneous edema localized or generalized must not be confused with periorbital erythematous edema, classically observed in DM, nor with DM with mucinosis. Potential marker of gravity, it is often associated to important muscular weakness and dysphagia. In this case, an aggressive treatment associating corticosteroids, immunosuppressive therapy and intravenous immunoglobulin is necessary. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  16. Composite Pressure Vessel Including Crack Arresting Barrier

    NASA Technical Reports Server (NTRS)

    DeLay, Thomas K. (Inventor)

    2013-01-01

    A pressure vessel includes a ported fitting having an annular flange formed on an end thereof and a tank that envelopes the annular flange. A crack arresting barrier is bonded to and forming a lining of the tank within the outer surface thereof. The crack arresting barrier includes a cured resin having a post-curing ductility rating of at least approximately 60% through the cured resin, and further includes randomly-oriented fibers positioned in and throughout the cured resin.

  17. LEAD SEVERING CONTRIVANCE

    DOEpatents

    Widmaier, W.

    1958-04-01

    A means for breaking an electrical circuit within an electronic tube during the process of manufacture is described. Frequently such circuits must be employed for gettering or vapor coating purposes, however, since an external pair of corector pins having no use after manufacture, is undesirable, this invention permits the use of existing leads to form a temporary circuit during manufacture, and severing it thereafter. One portion of the temporary circuit, made from a springy material such as tungsten, is spot welded to a fusable member. To cut the circuit an external radiant heat source melts the fusable member, allowing the tensed tungsten spring to contract and break the circuit. This inexpensive arrangement is particularly useful when the tube has a great many external leads crowded into the tube base.

  18. Severe storm electricity

    NASA Technical Reports Server (NTRS)

    Arnold, R. T.; Rust, W. D.

    1984-01-01

    Successful ground truth support of U-2 overflights was been accomplished. Data have been reduced for 4 June 1984 and some of the results have been integrated into some of MSFC's efforts. Staccato lightning (multiply branched, single stroke flash with no continuing current) is prevalent within the rainfree region around the main storm updraft and this is believed to be important, i.e., staccato flashes might be an important indicator of severe storm electrification. Results from data analysis from two stations appear to indicate that charge center heights can be estimated from a combination of intercept data with data from the fixed laboratory at NSSL. An excellent data base has been provided for determining the sight errors and efficiency of NSSL's LLP system. Cloud structures, observable in a low radar reflectivity region and on a scale smaller than is currently resolved by radar, which appear to be related to electrical activity are studied.

  19. Measurement by phase severance

    SciTech Connect

    Noyes, H.P.

    1987-03-01

    It is claimed that the measurement process is more accurately described by ''quasi-local phase severance'' than by ''wave function collapse''. The approach starts from the observation that the usual route to quantum mechanics starting from the Hamilton-Jacobi equations throws away half the degrees of freedom, namely, the classical initial state parameters. To overcome this difficulty, the full set of Hamilton-Jacobi equations is interpreted as operator equations acting on a state vector. The measurement theory presented is based on the conventional S-matrix boundary condition of N/sub A/ free particles in the distant past and N/sub B/ free particles in the distant future and taking the usual free particle wave functions, multiplied by phase factors.

  20. Age and injury severity.

    PubMed

    Brorsson, B

    1989-01-01

    This study aims at showing if and to what extent injury severity in frontal car crashes increases with the age of front seat occupants. Data on 2658 belted drivers and front seat passengers in Volvo private car series 140, 240 and 740/760, involved in frontal crashes were extracted from the Volvo Car Crash Register. The results show that the risk of injury resulting in "medical observation" does not increase systematically with age. However, the risk of fracture with any localization is more than three times higher among those aged 65-74 than in those aged 18-24, and the risk of fracture in the rib cage is nearly eleven times higher among the older than in the younger age group. It can be concluded that the incidence of specific types of injuries - as exemplified with fractures of any localization and fractures in the rib cage - increases with advancing age.

  1. Terlipressin Induced Severe Hyponatremia.

    PubMed

    Šíma, Martin; Pokorný, Miroslav; Paďour, František; Slanař, Ondřej

    2016-01-01

    Terlipressin is a vasopressin analogue used for its vasoconstrictor effect in the treatment of variceal bleeding. Despite its good safety profile compared to vasopressin, some adverse reactions may occur during its use - e.g. hyponatremia. We describe a case of a cirrhotic patient with active variceal bleeding treated during two separate hospitalizations with terlipressin. In both drug treatment periods, severe laboratory hyponatremia developed. After terlipressin discontinuation, mineral disbalance corrected rapidly. Positive dechallenge and rechallenge corresponding to the drug administration schedule confirms the causality between terlipressin administration and hyponatremia. Hyponatremia was preceded with substantial fluid retention in both episodes. In this case report we want to highlight the need for fluid balance monitoring immediately after first terlipressin dose, which may individually predict the patient risk for the development of hyponatremia as other risk factors have rather limited predictive value in real clinical settings.

  2. Inverse wing design in transonic flow including viscous interaction

    NASA Technical Reports Server (NTRS)

    Carlson, Leland A.; Ratcliff, Robert R.; Gally, Thomas A.; Campbell, Richard L.

    1989-01-01

    Several inverse methods were compared and initial results indicate that differences in results are primarily due to coordinate systems and fuselage representations and not to design procedures. Further, results from a direct-inverse method that includes 3-D wing boundary layer effects, wake curvature, and wake displacement are represented. These results show that boundary layer displacements must be included in the design process for accurate results.

  3. New technology recipes include horseradish, vinegar, mushrooms

    SciTech Connect

    Bishop, J.

    1995-08-01

    Technology development for more effective environmental management continues to abound. This article contains some recent innovations in the following areas: wastewater treatment; site remediation; and air pollution control. In addition several emerging technologies address solid and hazardous waste management with techniques designed to reduce waste volume, recycle valuable materials and create new energy sources.

  4. Severe accident simulation at Olkiuoto

    SciTech Connect

    Tirkkonen, H.; Saarenpaeae, T.; Cliff Po, L.C.

    1995-09-01

    A personal computer-based simulator was developed for the Olkiluoto nuclear plant in Finland for training in severe accident management. The generic software PCTRAN was expanded to model the plant-specific features of the ABB Atom designed BWR including its containment over-pressure protection and filtered vent systems. Scenarios including core heat-up, hydrogen generation, core melt and vessel penetration were developed in this work. Radiation leakage paths and dose rate distribution are presented graphically for operator use in diagnosis and mitigation of accidents. Operating on an graphically for operator use in diagnosis and mitigation of accidents. Operating on an 486 DX2-66, PCTRAN-TVO achieves a speed about 15 times faster than real-time. A convenient and user-friendly graphic interface allows full interactive control. In this paper a review of the component models and verification runs are presented.

  5. Planned reoperation for severe trauma.

    PubMed Central

    Hirshberg, A; Mattox, K L

    1995-01-01

    OBJECTIVE: The authors review the physiologic basis, indications, techniques, and results of the planned reoperation approach to severe trauma. SUMMARY BACKGROUND DATA: Multivisceral trauma and exsanguinating hemorrhage lead to hypothermia, coagulopathy, and acidosis. Formal resections and reconstructions in these unstable patients often result in irreversible physiologic insult. A new surgical strategy addresses these physiologic concerns by staged control and repair of the injuries. METHOD: The authors review the literature. RESULTS: Indications for planned reoperation include avoidance of irreversible physiologic insult and inability to obtain direct hemostasis or formal abdominal closure. The three phases of the strategy include initial control, stabilization, and delayed reconstruction. Various techniques are used to obtain rapid temporary control of bleeding and hollow visceral spillage. Hypothermia, coagulopathy, and the abdominal compartment syndrome are major postoperative concerns. Definitive repair of the injuries is undertaken after stabilization. CONCLUSION: Planned reoperation offers a simple and effective alternative to the traditional surgical management of complex or multiple injuries in critically wounded patients. PMID:7618965

  6. 28 CFR 20.32 - Includable offenses.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Judicial Administration DEPARTMENT OF JUSTICE CRIMINAL JUSTICE INFORMATION SYSTEMS Federal Systems and Exchange of Criminal History Record Information § 20.32 Includable offenses. (a) Criminal history record information maintained in the III System and the FIRS shall include serious and/or significant adult...

  7. 28 CFR 20.32 - Includable offenses.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Judicial Administration DEPARTMENT OF JUSTICE CRIMINAL JUSTICE INFORMATION SYSTEMS Federal Systems and Exchange of Criminal History Record Information § 20.32 Includable offenses. (a) Criminal history record information maintained in the III System and the FIRS shall include serious and/or significant adult...

  8. 28 CFR 20.32 - Includable offenses.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Judicial Administration DEPARTMENT OF JUSTICE CRIMINAL JUSTICE INFORMATION SYSTEMS Federal Systems and Exchange of Criminal History Record Information § 20.32 Includable offenses. (a) Criminal history record information maintained in the III System and the FIRS shall include serious and/or significant adult...

  9. 28 CFR 20.32 - Includable offenses.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Judicial Administration DEPARTMENT OF JUSTICE CRIMINAL JUSTICE INFORMATION SYSTEMS Federal Systems and Exchange of Criminal History Record Information § 20.32 Includable offenses. (a) Criminal history record information maintained in the III System and the FIRS shall include serious and/or significant adult...

  10. 28 CFR 20.32 - Includable offenses.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Judicial Administration DEPARTMENT OF JUSTICE CRIMINAL JUSTICE INFORMATION SYSTEMS Federal Systems and Exchange of Criminal History Record Information § 20.32 Includable offenses. (a) Criminal history record information maintained in the III System and the FIRS shall include serious and/or significant adult...

  11. 47 CFR 65.820 - Included items.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 3 2010-10-01 2010-10-01 false Included items. 65.820 Section 65.820 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES (CONTINUED) INTERSTATE RATE OF RETURN PRESCRIPTION PROCEDURES AND METHODOLOGIES Rate Base § 65.820 Included items....

  12. Server-Side Includes Made Simple.

    ERIC Educational Resources Information Center

    Fagan, Jody Condit

    2002-01-01

    Describes server-side include (SSI) codes which allow Webmasters to insert content into Web pages without programming knowledge. Explains how to enable the codes on a Web server, provides a step-by-step process for implementing them, discusses tags and syntax errors, and includes examples of their use on the Web site for Southern Illinois…

  13. 47 CFR 1.9005 - Included services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 47 Telecommunication 1 2013-10-01 2013-10-01 false Included services. 1.9005 Section 1.9005 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL PRACTICE AND PROCEDURE Grants by Random Selection Spectrum Leasing Scope and Authority § 1.9005 Included services. The spectrum leasing policies and rules...

  14. 47 CFR 1.9005 - Included services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 1 2010-10-01 2010-10-01 false Included services. 1.9005 Section 1.9005 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL PRACTICE AND PROCEDURE Spectrum Leasing Scope and Authority § 1.9005 Included services. The spectrum leasing policies and rules of this subpart apply to...

  15. 47 CFR 1.9005 - Included services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 47 Telecommunication 1 2011-10-01 2011-10-01 false Included services. 1.9005 Section 1.9005 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL PRACTICE AND PROCEDURE Spectrum Leasing Scope and Authority § 1.9005 Included services. The spectrum leasing policies and rules of this subpart apply to...

  16. 47 CFR 1.9005 - Included services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 47 Telecommunication 1 2012-10-01 2012-10-01 false Included services. 1.9005 Section 1.9005 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL PRACTICE AND PROCEDURE Grants by Random Selection Spectrum Leasing Scope and Authority § 1.9005 Included services. The spectrum leasing policies and rules...

  17. Novel antipsychotics and severe hyperlipidemia.

    PubMed

    Meyer, J M

    2001-08-01

    Newer atypical antipsychotics demonstrate superior effectiveness, with a diminished incidence of extrapyramidal side effects compared with older typical antipsychotics, but they have been associated with the development of obesity and new-onset diabetes. A small number of reports documenting modest hypertriglyceridemia related to newer antipsychotics have implicated fluperlapine, clozapine, and, most recently, olanzapine. This study summarizes the results of 14 cases of severe hypertriglyceridemia (>600 mg/dL) associated with olanzapine and quetiapine therapy occurring among inpatients at Oregon State Hospital, including 7 patients whose serum triglyceride levels exceeded 1,000 mg/ dL. Four of these patients also developed new-onset diabetes. Nine cases occurred during the first 8 months of treatment, with three cases identified within 3 months of commencing olanzapine or quetiapine therapy. Weight gain in olanzapine and quetiapine groups was modest (12.3 lb and 8.5 lb, respectively) and did not correlate with the severity of hypertriglyceridemia. Biochemical causes for severe hypertriglyceridemia associated with novel antipsychotics are unclear, but clinical monitoring of serum lipids must be added to the concerns about the metabolic consequences of therapy with certain newer antipsychotic agents.

  18. Severe adhesive small bowel obstruction.

    PubMed

    Di Saverio, Salomone; Catena, Fausto; Kelly, Michael D; Tugnoli, Gregorio; Ansaloni, Luca

    2012-12-01

    Adhesive small bowel obstruction is a frequent cause of hospital admission. Water soluble contrast studies may have diagnostic and therapeutic value and avoid challenging demanding surgical operations, but if bowel ischemia is suspected, prompt surgical intervention is mandatory. A 58-year-old patient was operated for extensive adhesive small bowel obstruction after having had two previous laparotomies for colorectal surgery, and had a complex clinical course with multiple operations and several complications. Different strategies of management have been adopted, including non-operative management with the use of hyperosmolar water soluble contrast medium, multiple surgical procedures, total parenteral nutrition (TPN) support, and finally use of antiadherences icodextrin solution. After 2 years follow-up the patient was doing well without presenting recurrent episodes of adhesive small bowel obstruction. For patients admitted several times for adhesive small bowel obstruction, the relative risk of recurring obstruction increases in relation to the number of prior episodes. Several strategies for non-operative conservative management of adhesive small bowel obstruction have already addressed diagnostic and therapeutic value of hyperosmolar water soluble contrast. According to the most recent evidence-based guidelines, open surgery is the preferred method for surgical treatment of strangulating adhesive small bowel obstruction as well as after failed conservative management. Research interest and clinical evidence are increasing in adhesions prevention. Hyaluronic acid-carboxycellulose membrane and icodextrin may reduce incidence of adhesions.

  19. [Severe form of herpes gestationis].

    PubMed

    Orsini, G; Loizzi, P; Morelli, L; Chiechi, L M; Sabatini, R; Distante, G

    2003-06-01

    We report a very severe form of herpers gestationis that arose at the 26(th) week of pregnancy and reached us for observation at the 30(th) week. Herpes gestationis in an autoimmune vesicobullous dermatosis characterised by skin eruptions, intense itching and consequent increase in fetal morbility, with delayed intrauterine growth and prematurity. Owing to its particular severity (involvement of the entire body surface including the face), between the 30th and the 32(nd) weeks we had to address a severe clinical condition characterised by anaemia, marked hypoproteinaemia, hypoalbuminaemia, hupertension and hyperglycaemia which led us to resort to the maximum dose of oral corticotherapy in association with topical therapy using clobetasol propionate. In our opinion the results obtained were highly statisfactory with the result that at the end of the 37(th) week, in consideration of the patient's obstetric history, podalic presentation and parity, we performed a Caesarean delivering a newborn of 3000 g in excellent condition. The patient was discharged symptom-free on the 6(th) day and the newborn was in full healt.

  20. Severe soccer injuries in amateurs

    PubMed Central

    Goga, I; Gongal, P

    2003-01-01

    Objectives: To ascertain the number and type of severe soccer injuries admitted to King Edward Hospital in South Africa over 42 months. Methods: This was a retrospective study of all patients admitted for treatment or observation to the orthopaedic unit only. Patients treated as outpatients, irrespective of severity, are also presented for comparison. Results: Thirty two patients were admitted with severe injuries. The injuries included 18 fractures of the tibial and femoral shaft. Two tibial shaft fractures were compound. Four tibial plateau fractures and five epiphyseal injuries were identified. One patient had a fracture-dislocation of the hip. One patient with a popliteal artery injury presented 48 hours after the injury had occurred. He had an above knee amputation. In the same period 122 patients were treated as outpatients. The types of injury in this group were similar to soccer injuries reported in other countries. Conclusions: Very serious injuries are sustained by casual soccer players in South Africa. Urgent measures need to be taken to prevent such injuries. PMID:14665587

  1. Storm severity detection (RF)

    NASA Technical Reports Server (NTRS)

    Johnson, R. L.; Goodman, S. J.

    1985-01-01

    Atmospheric electrical emissions occurring in association with Hurricane Alicia were observed by two crossed baseline phase linear interferometers. The sensors were located in San Antonio, Texas, and at Marshall Space Flight Center (MSFC), Huntsville, Alabama. An analysis of the data has indicated that the direction finding (DF) performance of the San Antonio site was extremely good while the DF performance at the MSFC site evidenced erratic behavior. A check of the data acquisition hardware revealed an intermitted problem in one of the radio receiver channels. Since the system has experienced several lightning strikes during the early spring of 1984, it was necessary to ship the entire rack of equipment back to SwRI for refurbishment. Analysis of the DF data from the interferometer site at San Antonio is being done. A limited subset of the MSFC data acquired during Hurricane Alicia has been found to be valid. These were data which satisfied the phase linearity criteria. Approximately 2,000 location estimates have been produced on the valid data. The results of the DF analysis and the location data are being correlated with the McIDAS data base at Marshall Space Flight Center, and with the radar summary data provided by the Hurricane Research Division using the National weather Service radar Facility at Galveston, Texas.

  2. Severe Exoplanetary Storm

    NASA Technical Reports Server (NTRS)

    2009-01-01

    These computer-generated images chart the development of severe weather patterns on the highly eccentric exoplanet HD 80606b during the days after its closest approach to its parent star. An exoplanet is a planet that orbits a star other than our sun.

    The images were produced by computer simulations that modeled NASA's Spitzer Space Telescope's measurements of heat radiating from the planet. The six frames are evenly spaced in time, starting from 4.4 days after the planet's close approach to the star, a moment known as 'periastron,' and running through 8.9 days after periastron. The blue glow of the crescent is starlight that has been scattered and reflected by the planet. The starlight appears blue because the planet is a very efficient absorber of red light. The night side appears reddish orange as it glows with its own internal heat.

    These theoretical models allow astronomers to better understand weather patterns on distant planets. While direct telescopic observations of the atmospheres of such worlds may be many decades away, such simulations give us a clue to what we may see when it becomes possible.

    The Spitzer observations themselves spanned the relatively brief period when the heating of the planet was most intense, running from 20 hours prior to 10 hours after periastron. The data were taken in Nov. of 2007.

    HD 80606b is located 190 light-years away in the constellation Ursa Major. Its star can be seen with binoculars.

  3. Storm severity detection (RF)

    NASA Technical Reports Server (NTRS)

    Johnson, R. L.; Goodman, S. J.

    1985-01-01

    Atmospheric electrical emissions occurring in association with Hurricane Alicia were observed by two crossed baseline phase linear interferometers. The sensors were located in San Antonio, Texas, and at Marshall Space Flight Center (MSFC), Huntsville, Alabama. An analysis of the data has indicated that the direction finding (DF) performance of the San Antonio site was extremely good while the DF performance at the MSFC site evidenced erratic behavior. A check of the data acquisition hardware revealed an intermitted problem in one of the radio receiver channels. Since the system has experienced several lightning strikes during the early spring of 1984, it was necessary to ship the entire rack of equipment back to SwRI for refurbishment. Analysis of the DF data from the interferometer site at San Antonio is being done. A limited subset of the MSFC data acquired during Hurricane Alicia has been found to be valid. These were data which satisfied the phase linearity criteria. Approximately 2,000 location estimates have been produced on the valid data. The results of the DF analysis and the location data are being correlated with the McIDAS data base at Marshall Space Flight Center, and with the radar summary data provided by the Hurricane Research Division using the National weather Service radar Facility at Galveston, Texas.

  4. 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.

  5. Include Passive Solar in Your Renovations.

    ERIC Educational Resources Information Center

    Bender, Gerald F.; Probasco, Jack F.

    1981-01-01

    A checklist covers potential energy saving modifications in a building scheduled for renovation, and includes suggestions for room utilization, landscaping, and building envelope, solar control, and active system modifications. (Author)

  6. Lung Disease Including Asthma and Adult Vaccination

    MedlinePlus

    ... Healthcare Professionals Lung Disease including Asthma and Adult Vaccination Language: English Español (Spanish) Recommend on Facebook Tweet ... more about health insurance options. Learn about adult vaccination and other health conditions Asplenia Diabetes Heart Disease, ...

  7. 47 CFR 1.9005 - Included services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Spectrum Leasing Scope and Authority § 1.9005 Included services. Link to an amendment published at 79 FR 48533, August 15, 2014. The spectrum leasing policies and rules of this subpart apply to the...

  8. KENNEDY SPACE CENTER, FLA. - Barry Perlman, Pembroke Pines Charter Middle School in Florida, examines one of the experiments carried on mission STS-107 as Bob McLean, Southwest Texas State University, looks on. Several experiments were found during the search for Columbia debris. Included in the Commercial ITA Biomedical Experiments payload on mission STS-107 are urokinase cancer research, microencapsulation of drugs, the Growth of Bacterial Biofilm on Surfaces during Spaceflight (GOBBSS), and tin crystal formation. The latter was sponsored by the Pembroke Pines Charter Middle School.

    NASA Image and Video Library

    2003-05-07

    KENNEDY SPACE CENTER, FLA. - Barry Perlman, Pembroke Pines Charter Middle School in Florida, examines one of the experiments carried on mission STS-107 as Bob McLean, Southwest Texas State University, looks on. Several experiments were found during the search for Columbia debris. Included in the Commercial ITA Biomedical Experiments payload on mission STS-107 are urokinase cancer research, microencapsulation of drugs, the Growth of Bacterial Biofilm on Surfaces during Spaceflight (GOBBSS), and tin crystal formation. The latter was sponsored by the Pembroke Pines Charter Middle School.

  9. KENNEDY SPACE CENTER, FLA. - From left, Barry Perlman, Pembroke Pines Charter Middle School in Florida, and Valerie Cassanto, Instrumentation Technology Associates, Inc., process one of the experiments carried on mission STS-107. Several experiments were found during the search for Columbia debris. Included in the Commercial ITA Biomedical Experiments payload on mission STS-107 are urokinase cancer research, microencapsulation of drugs, the Growth of Bacterial Biofilm on Surfaces during Spaceflight (GOBBSS), and tin crystal formation. The latter was sponsored by the Pembroke Pines Charter Middle School.

    NASA Image and Video Library

    2003-05-07

    KENNEDY SPACE CENTER, FLA. - From left, Barry Perlman, Pembroke Pines Charter Middle School in Florida, and Valerie Cassanto, Instrumentation Technology Associates, Inc., process one of the experiments carried on mission STS-107. Several experiments were found during the search for Columbia debris. Included in the Commercial ITA Biomedical Experiments payload on mission STS-107 are urokinase cancer research, microencapsulation of drugs, the Growth of Bacterial Biofilm on Surfaces during Spaceflight (GOBBSS), and tin crystal formation. The latter was sponsored by the Pembroke Pines Charter Middle School.

  10. KENNEDY SPACE CENTER, FLA. - From left, Barry Perlman, Pembroke Pines Charter Middle School in Florida, and Valerie Cassanto, Instrumentation Technology Associates, Inc., analyze one of the experiments carried on mission STS-107. Several experiments were found during the search for Columbia debris. Included in the Commercial ITA Biomedical Experiments payload on mission STS-107 are urokinase cancer research, microencapsulation of drugs, the Growth of Bacterial Biofilm on Surfaces during Spaceflight (GOBBSS), and tin crystal formation. The latter was sponsored by the Pembroke Pines Charter Middle School.

    NASA Image and Video Library

    2003-05-07

    KENNEDY SPACE CENTER, FLA. - From left, Barry Perlman, Pembroke Pines Charter Middle School in Florida, and Valerie Cassanto, Instrumentation Technology Associates, Inc., analyze one of the experiments carried on mission STS-107. Several experiments were found during the search for Columbia debris. Included in the Commercial ITA Biomedical Experiments payload on mission STS-107 are urokinase cancer research, microencapsulation of drugs, the Growth of Bacterial Biofilm on Surfaces during Spaceflight (GOBBSS), and tin crystal formation. The latter was sponsored by the Pembroke Pines Charter Middle School.

  11. KENNEDY SPACE CENTER, FLA. - From left, Barry Perlman, Pembroke Pines Charter Middle School in Florida; Valerie Cassanto, Instrumentation Technology Associates, Inc.; and Dr. Dennis Morrison, NASA Johnson Space Center, process one of the experiments carried on mission STS-107. Several experiments were found during the search for Columbia debris. Included in the Commercial ITA Biomedical Experiments payload on mission STS-107 are urokinase cancer research, microencapsulation of drugs, the Growth of Bacterial Biofilm on Surfaces during Spaceflight (GOBBSS), and tin crystal formation. The latter was sponsored by the Pembroke Pines Charter Middle School.

    NASA Image and Video Library

    2003-05-07

    KENNEDY SPACE CENTER, FLA. - From left, Barry Perlman, Pembroke Pines Charter Middle School in Florida; Valerie Cassanto, Instrumentation Technology Associates, Inc.; and Dr. Dennis Morrison, NASA Johnson Space Center, process one of the experiments carried on mission STS-107. Several experiments were found during the search for Columbia debris. Included in the Commercial ITA Biomedical Experiments payload on mission STS-107 are urokinase cancer research, microencapsulation of drugs, the Growth of Bacterial Biofilm on Surfaces during Spaceflight (GOBBSS), and tin crystal formation. The latter was sponsored by the Pembroke Pines Charter Middle School.

  12. Fire severity classification: Uses and abuses

    Treesearch

    Theresa B. Jain; Russell T. Graham

    2003-01-01

    Burn severity (also referred to as fire severity) is not a single definition, but rather a concept and its classification is a function of the measured units unique to the system of interest. The systems include: flora and fauna, soil microbiology and hydrologic processes, atmospheric inputs, fire management, and society. Depending on the particular system of interest...

  13. Gas storage materials, including hydrogen storage materials

    DOEpatents

    Mohtadi, Rana F; Wicks, George G; Heung, Leung K; Nakamura, Kenji

    2013-02-19

    A material for the storage and release of gases comprises a plurality of hollow elements, each hollow element comprising a porous wall enclosing an interior cavity, the interior cavity including structures of a solid-state storage material. In particular examples, the storage material is a hydrogen storage material such as a solid state hydride. An improved method for forming such materials includes the solution diffusion of a storage material solution through a porous wall of a hollow element into an interior cavity.

  14. Gas storage materials, including hydrogen storage materials

    DOEpatents

    Mohtadi, Rana F; Wicks, George G; Heung, Leung K; Nakamura, Kenji

    2014-11-25

    A material for the storage and release of gases comprises a plurality of hollow elements, each hollow element comprising a porous wall enclosing an interior cavity, the interior cavity including structures of a solid-state storage material. In particular examples, the storage material is a hydrogen storage material, such as a solid state hydride. An improved method for forming such materials includes the solution diffusion of a storage material solution through a porous wall of a hollow element into an interior cavity.

  15. Communications circuit including a linear quadratic estimator

    DOEpatents

    Ferguson, Dennis D.

    2015-07-07

    A circuit includes a linear quadratic estimator (LQE) configured to receive a plurality of measurements a signal. The LQE is configured to weight the measurements based on their respective uncertainties to produce weighted averages. The circuit further includes a controller coupled to the LQE and configured to selectively adjust at least one data link parameter associated with a communication channel in response to receiving the weighted averages.

  16. Eddy Resolving Global Ocean Prediction including Tides

    DTIC Science & Technology

    2013-09-30

    tensor scheme reduced at supercritical slopes, and their scalar sisters, a Nycander scalar limited in shallow water , and the Jayne and St. Laurent [2001...NAVOCEANO) starting in FY14. The model will include shallow water and provide boundary conditions to finer resolution coastal models that may use HYCOM or a...latter out to 30 days in many deep water regions, including regions of high Navy interest such as the Western Pacific and the Arabian Sea/Gulf of

  17. Ectasia and Severe Atherosclerosis

    PubMed Central

    Adiloglu, Ali K.; Can, Rabia; Nazli, Cem; Ocal, Ahmet; Ergene, Oktay; Tinaz, Gulgun; Kisioglu, Nesimi

    2005-01-01

    To date, there has been no convincing evidence for an association between Chlamydia pneumoniae or Helicobacter pylori and ectasia. In this case-control study, we have investigated the association of H. pylori and C. pneumoniae seropositivity with ectasia, severe coronary atherosclerosis, and normal vessels, which were so classified by coronary angiography. We have also evaluated the influence of these infections on inflammatory markers such as high-sensitive C-reactive protein (hsCRP) and interleukin 6 (IL-6). Of the 796 patients undergoing coronary angiography for suspected ischemic heart disease, 244 patients were recruited. Of these, 91 had normal vessels, 88 had 3 or more obstructed vessels, and 65 had ectatic vessels without atherosclerosis. Eighty-seven atherosclerotic patients (98.9%) were positive for C. pneumoniae IgG, as were 64 ectatic patients (98.5%) and 76 controls (83.5%) (P < 0.001). Forty-two atherosclerotic patients (47.7%) were positive for C. pneumoniae IgM, as were 43 ectatic patients (66.2%) and 43 controls (47.3%) (P = 0.036). Seventy-two atherosclerotic patients (81.8%) were positive for H. pylori IgA, as were 26 ectatic patients (40.0%) and 44 controls (48.4%) (P < 0.001). High-sensitive CRP levels were significantly higher in ectatic patients (5.639 mg/L) than in controls (4.390 mg/L) (P = 0.032), and IL-6 levels were significantly higher in atherosclerotic patients (33.92 U/L) than in controls (14.01 U/L) (P < 0.001). Interleukin-6 levels were higher in H. pylori seropositive patients, and hsCRP levels were higher in C. pneumoniae seropositive patients, when compared with seronegatives. We suggest that, as in atherosclerosis, C. pneumoniae infection is related to ectasia, with raised CRP levels. PMID:15902817

  18. Severe storm electricity

    NASA Technical Reports Server (NTRS)

    Rust, W. D.; Macgorman, D. R.

    1985-01-01

    During FY-85, Researchers conducted a field program and analyzed data. The field program incorporated coordinated measurements made with a NASA U2. Results include the following: (1) ground truth measurements of lightning for comparison with those obtained by the U2; (2) analysis of dual-Doppler radar and dual-VHF lightning mapping data from a supercell storm; (3) analysis of synoptic conditions during three simultaneous storm systems on 13 May 1983 when unusually large numbers of positive cloud-to-ground (+CG) flashes occurred; (4) analysis of extremely low frequency (ELF) wave forms; and (5) an assessment of a cloud -ground strike location system using a combination of mobile laboratory and fixed-base TV video data.

  19. Severe storm electricity

    NASA Technical Reports Server (NTRS)

    Rust, W. D.; Macgorman, D. R.

    1985-01-01

    During FY-85, Researchers conducted a field program and analyzed data. The field program incorporated coordinated measurements made with a NASA U2. Results include the following: (1) ground truth measurements of lightning for comparison with those obtained by the U2; (2) analysis of dual-Doppler radar and dual-VHF lightning mapping data from a supercell storm; (3) analysis of synoptic conditions during three simultaneous storm systems on 13 May 1983 when unusually large numbers of positive cloud-to-ground (+CG) flashes occurred; (4) analysis of extremely low frequency (ELF) wave forms; and (5) an assessment of a cloud -ground strike location system using a combination of mobile laboratory and fixed-base TV video data.

  20. Severe weather prediction studies

    NASA Technical Reports Server (NTRS)

    Chang, C.-B.; Kreitzberg, C. W.

    1977-01-01

    A numerical forecast model is described which uses three-dimensional primitive equations to predict the evolution of the wind, temperature and moisture fields along with the subsynoptic-scale convective activity. There are 15 vertical levels set on a longitude-latitude horizontal grid. In this study, the horizontal grid distance is 70 km (0.625 deg latitude and 0.816 deg longitude at 40 deg N) and the time step is 90 sec. Orography is included and terrain coordinates are adopted. The forecast model is used to test two tornado-producing storms with very different synoptic structures. A 12 hr forecast is carried out for both cases. The rms errors of the forecast indicate much smaller errors in the middle troposphere than in the lower troposphere. The results demonstrate that a rather fine-mesh limited-area numerical model is capable of providing a valuable short-range forecast of the circulation and the mesoscale precipitation features.

  1. An Integrated Biochemistry Laboratory, Including Molecular Modeling

    NASA Astrophysics Data System (ADS)

    Hall, Adele J. Wolfson Mona L.; Branham, Thomas R.

    1996-11-01

    The dilemma of designing an advanced undergraduate laboratory lies in the desire to teach and reinforce basic principles and techniques while at the same time exposing students to the excitement of research. We report here on a one-semester, project-based biochemistry laboratory that combines the best features of a cookbook approach (high success rate, achievement of defined goals) with those of an investigative, discovery-based approach (student involvement in the experimental design, excitement of real research). Individual modules may be selected and combined to meet the needs of different courses and different institutions. The central theme of this lab is protein purification and design. This laboratory accompanies the first semester of biochemistry (Structure and Function of Macromolecules, a course taken mainly by junior and senior chemistry and biological chemistry majors). The protein chosen as the object of study is the enzyme lysozyme, which is utilized in all projects. It is suitable for a student lab because it is easily and inexpensively obtained from egg white and is extremely stable, and its high isoelectric point (pI = 11) allows for efficient separation from other proteins by ion-exchange chromatography. Furthermore, a literature search conducted by the resourceful student reveals a wealth of information, since lysozyme has been the subject of numerous studies. It was the first enzyme whose structure was determined by crystallography (1). Hendrickson et al. (2) have previously described an intensive one-month laboratory course centered around lysozyme, although their emphasis is on protein stability rather than purification and engineering. Lysozyme continues to be the focus of much exciting new work on protein folding and dynamics, structure and activity (3 - 5). This lab course includes the following features: (i) reinforcement of basic techniques, such as preparation of buffers, simple enzyme kinetics, and absorption spectroscopy; (ii

  2. Severe paroxysmal hypertension (pseudopheochromocytoma).

    PubMed

    Mann, Samuel J

    2008-02-01

    Paroxysmal hypertension always engenders a search for a catecholamine-secreting pheochromocytoma. Yet 98% of people with paroxysmal hypertension do not have this tumor. The cause and management of paroxysmal hypertension remain a mystery, and the subject of remarkably few papers. This review presents an approach to understanding and successfully treating this disorder. Patients experience symptomatic blood pressure surges likely linked to sympathetic nervous system stimulation. A specific personality profile associated with this disorder suggests a psychological basis, attributable to repressed emotion related to prior emotional trauma or a repressive (nonemotional) coping style. Based on this understanding, three forms of intervention, alone or in combination, appear successful: antihypertensive therapy with agents directed at the sympathetically mediated blood pressure elevation (eg, combined alpha- and beta-blockade or central alpha-agonists such as clonidine); psychopharmacologic interventions including anxiolytic and/or antidepressant agents; and psychological intervention, particularly reassurance and increased psychological awareness. An appropriately selected intervention can reduce or eliminate attacks in most patients.

  3. Electric Power Monthly, August 1990. [Glossary included

    SciTech Connect

    Not Available

    1990-11-29

    The Electric Power Monthly (EPM) presents monthly summaries of electric utility statistics at the national, Census division, and State level. The purpose of this publication is to provide energy decisionmakers with accurate and timely information that may be used in forming various perspectives on electric issues that lie ahead. Data includes generation by energy source (coal, oil, gas, hydroelectric, and nuclear); generation by region; consumption of fossil fuels for power generation; sales of electric power, cost data; and unusual occurrences. A glossary is included.

  4. Isolators Including Main Spring Linear Guide Systems

    NASA Technical Reports Server (NTRS)

    Goold, Ryan (Inventor); Buchele, Paul (Inventor); Hindle, Timothy (Inventor); Ruebsamen, Dale Thomas (Inventor)

    2017-01-01

    Embodiments of isolators, such as three parameter isolators, including a main spring linear guide system are provided. In one embodiment, the isolator includes first and second opposing end portions, a main spring mechanically coupled between the first and second end portions, and a linear guide system extending from the first end portion, across the main spring, and toward the second end portion. The linear guide system expands and contracts in conjunction with deflection of the main spring along the working axis, while restricting displacement and rotation of the main spring along first and second axes orthogonal to the working axis.

  5. Transmission line including support means with barriers

    DOEpatents

    Cookson, Alan H.

    1982-01-01

    A gas insulated transmission line includes an elongated outer sheath, a plurality of inner conductors disposed within and extending along the outer sheath, and an insulating gas which electrically insulates the inner conductors from the outer sheath. A support insulator insulatably supports the inner conductors within the outer sheath, with the support insulator comprising a main body portion including a plurality of legs extending to the outer sheath, and barrier portions which extend between the legs. The barrier portions have openings therein adjacent the main body portion through which the inner conductors extend.

  6. Weather information network including graphical display

    NASA Technical Reports Server (NTRS)

    Leger, Daniel R. (Inventor); Burdon, David (Inventor); Son, Robert S. (Inventor); Martin, Kevin D. (Inventor); Harrison, John (Inventor); Hughes, Keith R. (Inventor)

    2006-01-01

    An apparatus for providing weather information onboard an aircraft includes a processor unit and a graphical user interface. The processor unit processes weather information after it is received onboard the aircraft from a ground-based source, and the graphical user interface provides a graphical presentation of the weather information to a user onboard the aircraft. Preferably, the graphical user interface includes one or more user-selectable options for graphically displaying at least one of convection information, turbulence information, icing information, weather satellite information, SIGMET information, significant weather prognosis information, and winds aloft information.

  7. Electrochemical cell structure including an ionomeric barrier

    DOEpatents

    Lambert, Timothy N.; Hibbs, Michael

    2017-06-20

    An apparatus includes an electrochemical half-cell comprising: an electrolyte, an anode; and an ionomeric barrier positioned between the electrolyte and the anode. The anode may comprise a multi-electron vanadium phosphorous alloy, such as VP.sub.x, wherein x is 1-5. The electrochemical half-cell is configured to oxidize the vanadium and phosphorous alloy to release electrons. A method of mitigating corrosion in an electrochemical cell includes disposing an ionomeric barrier in a path of electrolyte or ion flow to an anode and mitigating anion accumulation on the surface of the anode.

  8. Severe Vitamin D Deficiency Causing Kyphoscoliosis

    PubMed Central

    Singhai, Abhishek; Banzal, Subodh

    2013-01-01

    Vitamin D deficiency is common among Indian population. Women are especially at risk for severe vitamin D deficiency. The risk is higher for those who are multiparous and postmenopausal. Poor exposure to sunlight, higher latitude, winter season, inadequate diet, older age, obesity and malabsorption are also important risk factors. Symptoms of hypovitaminosis D, including diffuse or migratory pain affecting several sites (especially the shoulder, pelvis, ribcage and lower back) have also been misdiagnosed as musculoskeletal disorders, including fibromyalgia, polymyalgia rheumatica and ankylosing spondylitis. Here, we report two cases presented with kyphoscoliosis, diagnosed to have severe vitamin D deficiency. PMID:26664847

  9. Severe Vitamin D Deficiency Causing Kyphoscoliosis.

    PubMed

    Singhai, Abhishek; Banzal, Subodh

    2013-01-01

    Vitamin D deficiency is common among Indian population. Women are especially at risk for severe vitamin D deficiency. The risk is higher for those who are multiparous and postmenopausal. Poor exposure to sunlight, higher latitude, winter season, inadequate diet, older age, obesity and malabsorption are also important risk factors. Symptoms of hypovitaminosis D, including diffuse or migratory pain affecting several sites (especially the shoulder, pelvis, ribcage and lower back) have also been misdiagnosed as musculoskeletal disorders, including fibromyalgia, polymyalgia rheumatica and ankylosing spondylitis. Here, we report two cases presented with kyphoscoliosis, diagnosed to have severe vitamin D deficiency.

  10. 42 CFR 441.520 - Included services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... Community-Based Attendant Services and Supports State Plan Option (Community First Choice) § 441.520... facility for Individuals with Intellectual Disabilities to a home and community-based setting where the... 42 Public Health 4 2012-10-01 2012-10-01 false Included services. 441.520 Section 441.520 Public...

  11. 42 CFR 441.520 - Included services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Community-Based Attendant Services and Supports State Plan Option (Community First Choice) § 441.520... facility for Individuals with Intellectual Disabilities to a home and community-based setting where the... 42 Public Health 4 2013-10-01 2013-10-01 false Included services. 441.520 Section 441.520 Public...

  12. 42 CFR 441.520 - Included services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Community-Based Attendant Services and Supports State Plan Option (Community First Choice) § 441.520... facility for Individuals with Intellectual Disabilities to a home and community-based setting where the... 42 Public Health 4 2014-10-01 2014-10-01 false Included services. 441.520 Section 441.520 Public...

  13. Effects of Including Humor in Test Items.

    ERIC Educational Resources Information Center

    McMorris, Robert F.; And Others

    Two 50-item multiple-choice forms of a grammar test were developed differing only in humor being included in 20 items of one form. One hundred twenty-six (126) eighth graders received the test plus alternate forms of a questionnaire. Humor inclusion did not affect grammar scores on matched humorous/nonhumorous items nor on common post-treatment…

  14. 34 CFR 300.20 - Include.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 34 Education 2 2010-07-01 2010-07-01 false Include. 300.20 Section 300.20 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION ASSISTANCE TO STATES FOR THE EDUCATION OF CHILDREN WITH...

  15. Including Students with Visual Impairments: Softball

    ERIC Educational Resources Information Center

    Brian, Ali; Haegele, Justin A.

    2014-01-01

    Research has shown that while students with visual impairments are likely to be included in general physical education programs, they may not be as active as their typically developing peers. This article provides ideas for equipment modifications and game-like progressions for one popular physical education unit, softball. The purpose of these…

  16. Parachute Line Hook Includes Integral Loop Expander

    NASA Technical Reports Server (NTRS)

    Bayless, G. B.

    1983-01-01

    Parachute packing simplified with modified line hook. One person packs parachutes for test recovery vehicles faster than previously two-person team. New line hook includes expander that opens up two locking loops so parachute lines are pulled through them. Parachutes are packed at high pressure to be compressed into limited space available in test vehicles.

  17. 34 CFR 300.20 - Include.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 34 Education 2 2014-07-01 2013-07-01 true Include. 300.20 Section 300.20 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION ASSISTANCE TO STATES FOR THE EDUCATION OF CHILDREN WITH...

  18. 34 CFR 300.20 - Include.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 34 Education 2 2013-07-01 2013-07-01 false Include. 300.20 Section 300.20 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION ASSISTANCE TO STATES FOR THE EDUCATION OF CHILDREN WITH...

  19. Including Students with Visual Impairments: Softball

    ERIC Educational Resources Information Center

    Brian, Ali; Haegele, Justin A.

    2014-01-01

    Research has shown that while students with visual impairments are likely to be included in general physical education programs, they may not be as active as their typically developing peers. This article provides ideas for equipment modifications and game-like progressions for one popular physical education unit, softball. The purpose of these…

  20. Including the Excluded: One School for All.

    ERIC Educational Resources Information Center

    EFA 2000 Bulletin, 1998

    1998-01-01

    This issue of "EFA 2000" focuses on the theme of inclusive education, i.e., including children with disabilities in general education classrooms. The cover story discusses a 1995 UNESCO survey of 63 countries that showed that integration of children with disabilities in regular schools is a declared policy in almost every country.…

  1. Foil bearing lubrication theory including compressibility effects

    NASA Technical Reports Server (NTRS)

    Gorla, Rama Subba Reddy; Catalano, Daniel A.

    1987-01-01

    An analysis is presented to determine the film thickness in a foil bearing. Using the Reynolds equation and including the compressibility effects of the gas, an equation was developed applicable to the film thickness in a foil bearing. The bearing was divided into three regions, namely, the entrance region, middle region and exit region. Solutions are obtained for the film thickness in each region.

  2. Nuclear Chemistry: Include It in Your Curriculum.

    ERIC Educational Resources Information Center

    Atwood, Charles H.; Sheline, R. K.

    1989-01-01

    Some of the topics that might be included in a nuclear chemistry section are explored. Offers radioactivity, closed shells in nuclei, energy of nuclear processes, nuclear reactions, and fission and fusion as topics of interest. Provided are ideas and examples for each. (MVL)

  3. Nuclear Chemistry: Include It in Your Curriculum.

    ERIC Educational Resources Information Center

    Atwood, Charles H.; Sheline, R. K.

    1989-01-01

    Some of the topics that might be included in a nuclear chemistry section are explored. Offers radioactivity, closed shells in nuclei, energy of nuclear processes, nuclear reactions, and fission and fusion as topics of interest. Provided are ideas and examples for each. (MVL)

  4. Second Language Teaching 75 (Including Linguistics).

    ERIC Educational Resources Information Center

    Hammerly, Hector, Ed.; Sawyer, Isabel, Ed.

    This volume contains the second part of the proceedings of the twenty-sixth annual meeting of the Pacific Northwest Council on Foreign Languages. The focus is on second language teaching, and relevant linguistic research is included. The proceedings are divided into six major sections. Following the major addresses, which concern audiolingual…

  5. A group of VIPs, including Orville Wright

    NASA Technical Reports Server (NTRS)

    1939-01-01

    A group of VIPs, including Orville Wright, center. Left to right bottom row ?, Walter Reiser, Elton Miller, Orville Wright, Starr Truscutt, Addison Rothrock, Eastman Jacobs, Dr. Lewis Top row Gus Crowley, Ernie Johnson, Carlton Kemper, H.J.E. Reid, Smith DeFrance, Theodore Theodorsen.

  6. [Ergotherapy of severely burned patients].

    PubMed

    Nickerl, U; Resag, I

    1995-04-01

    Occupational therapy for severely burned patients includes individual exercise programmes, activities of daily living (ADL), assessment of the need for technical aids, splinting and pressure bandages, as well as psychological and social support. There are different focal points in the three stages of treatment. In the burn-care unit (first stage), if necessary, the patient is provided with splints. At this time the first contact is made. In the burn-care ward (second stage), the occupational therapy is focused on individual exercise programmes, dynamic splinting, ADL, and preparation for discharge from hospital. In the outpatient department (third stage), the aims of occupational therapy are: providing the patients with pressure bandages, checking of splints, assessment of the need for technical aids and special support if the patients have difficulties at home and work.

  7. [PHARMACONUTRITION IN SEVERELY ILL PATIENT].

    PubMed

    Burgos Peláez, Rosa; Escudero Álvarez, Elena; García Almeida, Jose Manuel; García de Lorenzo, Abelardo; García Luna, Pedro Pablo; Gil Hernández, Angel; Matos Adames, Alfredo; Molina Soria, Juan Bautista; Montejo González, Juan Carlos; Sánchez Alvarez, Carmen; Perez de la Cruz, Antonio

    2015-08-01

    "Pharmaconutrient" is a term applicable to those compounds which. in addition to their nutritional function, play a role as aids in the treatment of patients with severe pathologies, including sepsis, trauma, burns and major surgery, In general, enrichment of enteral an parenteral formulas with pharmaconutrients contribute to positively modulate the inflammatory response, infection and controlling the internal milieu, which in turn can be evaluated through lower mortality, hospital and intensive care units stay, days of mechanical ventilation and other parameters allowing to asses their effects. Arginine, glutamine, nucleotides, omega-3 fatty acids and antioxidant micronutrients, make up the nucleus of pharmaconutrients used with that aim, usually as mixtures of them. In the present review current evidence about the effects, indications, limitations, doses, potential adverse risks and even counter-indications is analysed.

  8. [Difficult to control severe asthma].

    PubMed

    Magnan, Antoine; Pipet, Anaïs

    2011-03-01

    Difficult to control severe asthma is characterized by the persistence of inacceptable symptoms of asthma despite a continuous treatment with at least high doses of inhaled steroids and long acting bronchodilators. The diagnosis is done after a period of observation and some investigations that will allow confirm the diagnosis of asthma, eliminate alternative diagnosis and etiological forms that would be difficult to treat intrinsically (allergic broncho-pulmonary aspergillosis, Churg and Strauss disease, chronic eosinophilic pneumonia, occupational asthma). At the end of this period devoted to diagnosis a systematic approach is set up to take care of these patients. Therapeutic education includes action plans and measures for triggering factors avoidance in order to prevent exacerbations. Comorbidities such as rhinitis, nasal polyposis, gastro-oesophageal reflux and obesity are taken into account. Lastly, the treatment must be adapted according to the patient's preferences and aims, and to the asthma severity. Ultimately in steroid-dependent asthma, the lowest efficient dose is tracked continuously. For these patients, new molecules are needed.

  9. Severe tomato allergy (Lycopersicon esculentum).

    PubMed

    Zacharisen, Michael C; Elms, Nancy P; Kurup, Viswanath P

    2002-01-01

    Although tomatoes are a commonly consumed food, severe allergic reactions to tomatoes are unusual or rarely reported. Previously reported allergic manifestations to tomato include urticaria/angioedema, dermatitis, oral allergy syndrome, rhinitis, and abdominal pain. The aim of this study was to report two patients with significant immediate hypersensitivity reactions to tomato and characterize the responsible allergen. We reviewed the history and documentation of tomato-specific immunoglobulin E (IgE) of two patients with adverse symptoms after ingesting tomato. Fresh tomato extracts prepared from the skin, seeds, and flesh of red, ripe tomatoes were evaluated for total protein content and sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) was performed to characterize the tomato protein. IgE enzyme-linked immunosorbent assay (ELISA) using the patients' serum against the various tomato extracts was accomplished and IgE immunoblot was performed. Percutaneous skin tests or radioallergosorbent tests (RASTs) were positive to tomato in both patients. Both adults experienced laryngeal edema and one had anaphylaxis. Similar total protein contents were found in each of the tomato extracts and gel electrophoresis revealed similar protein profile for skin and seed extracts with protein bands discernible at molecular weights of 21, 33, and 43 kDa. One patient reacted specifically to a 43-kDa protein band on IgE immunoblot. The two cases show that severe allergic reactions to tomato occur in adults and one is associated with IgE binding to a 43-kDa protein.

  10. Spider behaviors include oral sexual encounters

    PubMed Central

    Gregorič, Matjaž; Šuen, Klavdija; Cheng, Ren-Chung; Kralj-Fišer, Simona; Kuntner, Matjaž

    2016-01-01

    Several clades of spiders whose females evolved giant sizes are known for extreme sexual behaviors such as sexual cannibalism, opportunistic mating, mate-binding, genital mutilation, plugging, and emasculation. However, these behaviors have only been tested in a handful of size dimorphic spiders. Here, we bring another lineage into the picture by reporting on sexual behavior of Darwin’s bark spider, Caerostris darwini. This sexually size dimorphic Madagascan species is known for extreme web gigantism and for producing the world’s toughest biomaterial. Our field and laboratory study uncovers a rich sexual repertoire that predictably involves cannibalism, genital mutilation, male preference for teneral females, and emasculation. Surprisingly, C. darwini males engage in oral sexual encounters, rarely reported outside mammals. Irrespective of female’s age or mating status males salivate onto female genitalia pre-, during, and post-copulation. While its adaptive significance is elusive, oral sexual contact in spiders may signal male quality or reduce sperm competition. PMID:27126507

  11. Severe hyponatraemia: complications and treatment.

    PubMed

    Ellis, S J

    1995-12-01

    To observe the incidence of complications in severely hyponatraemic hospitalized patients and relate outcome to rate of correction, all patients admitted to a tertiary referral hospital in New York City, USA or a group of hospitals in Oxford, UK with a sodium < or = 120 mmol/l were studied. Review of the notes and prospective evaluation were used to ascertain cause of hyponatraemia, method of management and outcome. There were 84 episodes in New York and 100 in Oxford, over 9.5 months and one year, respectively; 79% had chronic hyponatraemia ( > 3 days duration). During hyponatraemia, 76% of patients had clouding of consciousness with 11% in coma. Other hyponatraemic complications included long track signs (including hemiparesis) (6.0%), seizures (3.3%), hallucinations (0.5%), tremor (1.0%), intellectual impairment without clouding of consciousness (0.5%), and acute psychosis (0.5%). 4.3% died as a direct result of their electrolyte disturbance. After correction, central pontine myelinolysis (0.5%), post-correction seizures (1.0%), intellectual impairment (2.2%), tremor (0.5%), paraesthesiae (0.5%), and striatal syndrome (0.5%) were observed. Correction of hyponatraemia was started in 158 patients, and the mean maximum rate of correction in 24 h was 8.4 mmol/l (SD 5.6, range 2-42). The maximum rate of correction was higher in those who developed neurological sequelae (12.1 mmol/l/24 h vs. 8.2 mmol/l/24 h; p = 0.0125, t-test, separate variance, two-tail). Neurological sequelae were associated with faster rates of correction, and correction of chronic severe hyponatraemia should be < 10 mmol/l in 24 h.

  12. Dynamic Analyses Including Joints Of Truss Structures

    NASA Technical Reports Server (NTRS)

    Belvin, W. Keith

    1991-01-01

    Method for mathematically modeling joints to assess influences of joints on dynamic response of truss structures developed in study. Only structures with low-frequency oscillations considered; only Coulomb friction and viscous damping included in analysis. Focus of effort to obtain finite-element mathematical models of joints exhibiting load-vs.-deflection behavior similar to measured load-vs.-deflection behavior of real joints. Experiments performed to determine stiffness and damping nonlinearities typical of joint hardware. Algorithm for computing coefficients of analytical joint models based on test data developed to enable study of linear and nonlinear effects of joints on global structural response. Besides intended application to large space structures, applications in nonaerospace community include ground-based antennas and earthquake-resistant steel-framed buildings.

  13. Photoactive devices including porphyrinoids with coordinating additives

    DOEpatents

    Forrest, Stephen R; Zimmerman, Jeramy; Yu, Eric K; Thompson, Mark E; Trinh, Cong; Whited, Matthew; Diev, Vlacheslav

    2015-05-12

    Coordinating additives are included in porphyrinoid-based materials to promote intermolecular organization and improve one or more photoelectric characteristics of the materials. The coordinating additives are selected from fullerene compounds and organic compounds having free electron pairs. Combinations of different coordinating additives can be used to tailor the characteristic properties of such porphyrinoid-based materials, including porphyrin oligomers. Bidentate ligands are one type of coordinating additive that can form coordination bonds with a central metal ion of two different porphyrinoid compounds to promote porphyrinoid alignment and/or pi-stacking. The coordinating additives can shift the absorption spectrum of a photoactive material toward higher wavelengths, increase the external quantum efficiency of the material, or both.

  14. SKIRT: Stellar Kinematics Including Radiative Transfer

    NASA Astrophysics Data System (ADS)

    Baes, Maarten; Dejonghe, Herwig; Davies, Jonathan

    2011-09-01

    SKIRT is a radiative transfer code based on the Monte Carlo technique. The name SKIRT, acronym for Stellar Kinematics Including Radiative Transfer, reflects the original motivation for its creation: it has been developed to study the effects of dust absorption and scattering on the observed kinematics of dusty galaxies. In a second stage, the SKIRT code was extended with a module to self-consistently calculate the dust emission spectrum under the assumption of local thermal equilibrium. This LTE version of SKIRT has been used to model the dust extinction and emission of various types of galaxies, as well as circumstellar discs and clumpy tori around active galactic nuclei. A new, extended version of SKIRT code can perform efficient 3D radiative transfer calculations including a self-consistent calculation of the dust temperature distribution and the associated FIR/submm emission with a full incorporation of the emission of transiently heated grains and PAH molecules.

  15. Electric power monthly, September 1990. [Glossary included

    SciTech Connect

    Not Available

    1990-12-17

    The purpose of this report is to provide energy decision makers with accurate and timely information that may be used in forming various perspectives on electric issues. The power plants considered include coal, petroleum, natural gas, hydroelectric, and nuclear power plants. Data are presented for power generation, fuel consumption, fuel receipts and cost, sales of electricity, and unusual occurrences at power plants. Data are compared at the national, Census division, and state levels. 4 figs., 52 tabs. (CK)

  16. Temporary agency contracts: what should they include?

    PubMed

    Sferrella, Sheila M

    2002-01-01

    The AHRA Board committed to provide some tools to help our members with agency contracts. This article provides the sections for a contract and what they should include. Of course, the language will have to comply with your organization's requirements. To comply with HIPAA regulations for contracts, I've also included language for business associates. JCAHO requires that the following documentation be on file for all contracted personnel: 1. Hospital job description or formal contract outlining the job responsibilities. 2. All licenses, certifications and registrations are reviewed and a process is developed to ensure that they remain current. 3. Competency is evaluated and maintained. 4. Evidence that personnel received a general orientation. 5. Evidence that personnel received a departmental orientation. 6. Safety and infection control standards must be met. In order to aid with compliance when utilizing contracted personnel, my organization developed a Contractor Personnel Administrative Compliance Checklist, which identifies requirements for compliance, a reference for assistance, and places to record that the requirement has been met for each of the areas listed in the previous item. Our standard contract includes sections on general definition of engagement, credentials and work experience; health, including immunization and drug testing; corporation; JCAHO; terms of the contract; and, non-disclosure of information. A business associate agreement may be necessary to comply with HIPAA regulations. Using the template has made my job much easier than trying to read each contract that crosses my desk. If an agency refuses to sign our contract, then we do not conduct business with that company. If an agency requests changes to the contract, depending on the language, we may or may not agree to it. This information is not intended to be legal advice, but rather an educational overview. As with any contract, the reader should consult with legal counsel at his or her

  17. Rotor assembly including superconducting magnetic coil

    DOEpatents

    Snitchler, Gregory L.; Gamble, Bruce B.; Voccio, John P.

    2003-01-01

    Superconducting coils and methods of manufacture include a superconductor tape wound concentrically about and disposed along an axis of the coil to define an opening having a dimension which gradually decreases, in the direction along the axis, from a first end to a second end of the coil. Each turn of the superconductor tape has a broad surface maintained substantially parallel to the axis of the coil.

  18. Nuclear reactor shield including magnesium oxide

    DOEpatents

    Rouse, Carl A.; Simnad, Massoud T.

    1981-01-01

    An improvement in nuclear reactor shielding of a type used in reactor applications involving significant amounts of fast neutron flux, the reactor shielding including means providing structural support, neutron moderator material, neutron absorber material and other components as described below, wherein at least a portion of the neutron moderator material is magnesium in the form of magnesium oxide either alone or in combination with other moderator materials such as graphite and iron.

  19. Power generation method including membrane separation

    DOEpatents

    Lokhandwala, Kaaeid A.

    2000-01-01

    A method for generating electric power, such as at, or close to, natural gas fields. The method includes conditioning natural gas containing C.sub.3+ hydrocarbons and/or acid gas by means of a membrane separation step. This step creates a leaner, sweeter, drier gas, which is then used as combustion fuel to run a turbine, which is in turn used for power generation.

  20. Nutritional Considerations for Severely Handicapped Children.

    ERIC Educational Resources Information Center

    Sobsey, Dick

    Children and adults with severe disabilities may have nutritional problems due to the effects of the primary disability (including such syndromes as phenylketonuria, galactosemia, and Hurler's Disease), effects related to medications (including anticonvulsants, tranquilizers, and laxatives), effects of food preferences (restrictive food…

  1. Opioid dependence treatment, including buprenorphine/naloxone.

    PubMed

    Raisch, Dennis W; Fye, Carol L; Boardman, Kathy D; Sather, Mike R

    2002-02-01

    To review opioid dependence (OD) and its treatment. Pharmacologic treatments, including the use of buprenorphine/naloxone, are presented. Pharmaceutical care functions for outpatient OD treatment are discussed. Primary and review articles were identified by MEDLINE and HEALTHSTAR searches (from 1966 to November 2000) and through secondary sources. Tertiary sources were also reviewed regarding general concepts of OD and its treatment. Relevant articles were reviewed after identification from published abstracts. Articles were selected based on the objectives for this article. Studies of the treatment of OD with buprenorphine were selected based on the topic (pharmacology, pharmacokinetics, adverse reactions) and study design (randomized, controlled clinical trials in patients with OD with active/placebo comparisons and/or comparisons of active OD treatments). Articles regarding pharmacists' activities in the treatment and prevention of OD were reviewed for the pharmaceutical care section. OD is considered a medical disorder with costly adverse health outcomes. Although methadone maintenance treatment (MMT) is cost-effective for OD, only about 12% of individuals with OD receive this treatment. Psychological and pharmacologic modalities are used to treat OD, but patients often relapse. Drug therapy includes alpha 2-agonists for withdrawal symptoms, detoxification regimens with or without opioids, opioid antagonists, and opioid replacement including methadone, levomethadyl acetate, and buprenorphine. The Drug Addiction Treatment Act of 1999 allows for office-based opioid replacement therapies. Sublingual buprenorphine with naloxone can be used in this milieu. Buprenorphine with naloxone is currently under new drug application review with the Food and Drug Administration. Clinical research shows buprenorphine to be equal in effectiveness to methadone, but safer in overdose due to its ceiling effect on respiratory depression. It has lower abuse potential and fewer

  2. Molecular cloning of chicken FTZ-F1-related orphan receptors.

    PubMed

    Kudo, T; Sutou, S

    1997-09-15

    FTZ-F1 is a member of the orphan nuclear receptors, which belongs to the steroid hormone receptor superfamily, and plays a role in the blastoderm and nervous system development in Drosophila. Recently, several FTZ-F1 family genes have been cloned in several species. SF-1/Ad4BPs have been identified as master regulators controlling steroidogenic P-450 genes in mammals and are considered to be the mammalian homologues of FTZ-F1. Moreover, SF-1/Ad4BP plays a critical role in the sexual differentiation of gonads in mammals. In vertebrates, except for mammals, the functional homologue of SF-1/Ad4BP has not been identified before. Herein, we cloned two chicken cDNAs (OR2.0 and OR2.1), which encode putative FTZ-F1 family receptors, by reverse transcriptase-polymerase chain reaction (RT-PCR) and rapid amplification of cDNA ends (RACE). OR2.1 consists of 3255 bp, is expressed in the adrenal glands and gonads, and is considered to be the chicken counterpart of mammalian SF-1/Ad4BP. However, OR2.0 consists of 2945 bp, is expressed in the livers and the adrenal glands, and is considered to be the chicken counterpart of mouse LRH-1, which is a member of the FTZ-F1 family in mammals.

  3. Severe Weather Planning for Schools

    ERIC Educational Resources Information Center

    Watson, Barbara McNaught; Strong, Christopher; Bunting, Bill

    2008-01-01

    Flash floods, severe thunderstorms, and tornadoes occur with rapid onset and often no warning. Decisions must be made quickly and actions taken immediately. This paper provides tips for schools on: (1) Preparing for Severe Weather Emergencies; (2) Activating a Severe Weather Plan; (3) Severe Weather Plan Checklist; and (4) Periodic Drills and…

  4. [Renal patient's diet: Can fish be included?].

    PubMed

    Castro González, M I; Maafs Rodríguez, A G; Galindo Gómez, C

    2012-01-01

    Medical and nutritional treatment for renal disease, now a major public health issue, is highly complicated. Nutritional therapy must seek to retard renal dysfunction, maintain an optimal nutritional status and prevent the development of underlying pathologies. To analyze ten fish species to identify those that, because of their low phosphorus content, high biological value protein and elevated n-3 fatty acids EPA and DHA, could be included in renal patient's diet. The following fish species (Litte tunny, Red drum, Spotted eagleray, Escolar, Swordfish, Big-scale pomfret, Cortez flounder, Largemouth blackbass, Periche mojarra, Florida Pompano) were analyzed according to the AOAC and Keller techniques to determine their protein, phosphorus, sodium, potassium, cholesterol, vitamins D(3) and E, and n-3 EPA+DHA content. These results were used to calculate relations between nutrients. The protein in the analyzed species ranged from 16.5 g/100 g of fillet (Largemouth black bass) to 27.2 g/100 g (Red drum); the lowest phosphorus value was 28.6 mg/100 g (Periche mojarra) and the highest 216.3 mg/100 g (Spotted eagle ray). 80% of the fish presented > 100 mg EPA + DHA in 100 g of fillet. By its Phosphorus/gProtein ratio, Escolar and Swordfish could not be included in the renal diet; Little tunny, Escolar, Big-scale pomfret, Largemouth black-bass, Periche mojarra and Florida Pompano presented a lower Phosphorus/EPA + DHA ratio. Florida pompano is the most recommended specie for renal patients, due to its optimal nutrient relations. However, all analyzed species, except Escolar and Swordfish, could be included in renal diets.

  5. Rehabilitation of a triple amputee including a hip disarticulation.

    PubMed

    Shin, J C; Park, C I; Kim, Y C; Jang, S H; Bang, I K; Shin, J S

    1998-12-01

    A multiple amputee more severe than a triple amputee is uncommon. There have been no reports on the rehabilitation outcome of a triple amputee, including hip disarticulation and transtibial amputation. The authors report the rehabilitation of a patient with left hip disarticulation, right trans-tibial amputation, and left trans-humeral amputation due to a train accident. He has successfully completed the rehabilitation programme and has become independent in prosthetic ambulation, activities of daily living, and driving.

  6. Multiverse rate equation including bubble collisions

    NASA Astrophysics Data System (ADS)

    Salem, Michael P.

    2013-03-01

    The volume fractions of vacua in an eternally inflating multiverse are described by a coarse-grain rate equation, which accounts for volume expansion and vacuum transitions via bubble formation. We generalize the rate equation to account for bubble collisions, including the possibility of classical transitions. Classical transitions can modify the details of the hierarchical structure among the volume fractions, with potential implications for the staggering and Boltzmann-brain issues. Whether or not our vacuum is likely to have been established by a classical transition depends on the detailed relationships among transition rates in the landscape.

  7. View of northeastern Italy including Venice

    NASA Technical Reports Server (NTRS)

    1973-01-01

    A near vertical view of northeastern Italy including the Venice (Venezia) area is seen in this Skylab 3 Earth Resources Experiments Package S190-B (five-inch earth terrain camera) infrared photograph taken from the Skylab space station in Earth orbit. The mountainous area is the Dolomite Alps. The most conspicuous stream northeast of Venice is the Piave River. The city near the center of the picture on the Brenta River is Bassano del Grappa. The large city of Padua (Padova) is on the western bank of the Grenta near the clock.

  8. Including absorption in Gordon's optical metric

    NASA Astrophysics Data System (ADS)

    Chen, B.; Kantowski, R.

    2009-05-01

    We show that Gordon’s optical metric on a curved spacetime can be generalized to include absorption by allowing the metric to become complex. We demonstrate its use in the realm of geometrical optics by giving three simple examples. We use one of these examples to compute corrected distance-redshift relations for Friedman-Lemaître-Robertson-Walker models in which the cosmic fluid has an associated complex index of refraction that represents grey extinction. We then fit this corrected Hubble curve to the type Ia supernovae data and provide a possible explanation (other than dark energy) of the deviation of these observations from dark matter predictions.

  9. View of northeastern Italy including Venice

    NASA Technical Reports Server (NTRS)

    1973-01-01

    A near vertical view of northeastern Italy including the Venice (Venezia) area is seen in this Skylab 3 Earth Resources Experiments Package S190-B (five-inch earth terrain camera) infrared photograph taken from the Skylab space station in Earth orbit. The mountainous area is the Dolomite Alps. The most conspicuous stream northeast of Venice is the Piave River. The city near the center of the picture on the Brenta River is Bassano del Grappa. The large city of Padua (Padova) is on the western bank of the Grenta near the clock.

  10. Fuel delivery system including heat exchanger means

    NASA Technical Reports Server (NTRS)

    Coffinberry, G. A. (Inventor)

    1978-01-01

    A fuel delivery system is presented wherein first and second heat exchanger means are each adapted to provide the transfer of heat between the fuel and a second fluid such as lubricating oil associated with the gas turbine engine. Valve means are included which are operative in a first mode to provide for flow of the second fluid through both first and second heat exchange means and further operative in a second mode for bypassing the second fluid around the second heat exchanger means.

  11. Inverse transonic airfoil design including viscous interaction

    NASA Technical Reports Server (NTRS)

    Carlson, L. A.

    1976-01-01

    A numerical technique was developed for the analysis of specified transonic airfoils or for the design of airfoils having a prescribed pressure distribution, including the effect of weak viscous interaction. The method uses the full potential equation, a stretched Cartesian coordinate system, and the Nash-MacDonald turbulent boundary layer method. Comparisons with experimental data for typical transonic airfoils show excellent agreement. An example shows the application of the method to design a thick aft-cambered airfoil, and the effects of viscous interaction on its performance are discussed.

  12. Including Language Access into Medicaid ACO Design.

    PubMed

    Gershon, Rachel; Morris, Lisa; Ferguson, Warren

    2016-09-01

    Quality health care relies upon communication in a patient's preferred language. Language access in health care occurs when individuals are: (1) Welcomed by providers regardless of language ability; and (2) Offered quality language services as part of their care. Federal law generally requires access to health care and quality language services for deaf and Limited English Proficient (LEP) patients in health care settings, but these patients still find it hard to access health care and quality language services.Meanwhile, several states are implementing Medicaid Accountable Care Organization (ACO) initiatives to reduce health care costs and improve health care quality. Alternative payment methods used in these initiatives can give Accountable Care Organizations more flexibility to design linguistically accessible care, but they can also put ACOs at increased financial risk for the cost of care. If these new payment methods do not account for differences in patient language needs, ACO initiatives could have the unintended consequence of rewarding ACOs who do not reach out to deaf and LEP communities or offer quality language services.We reviewed public documents related to Medicaid ACO initiatives in six states. Some of these documents address language access. More could be done, however, to pay for language access efforts. This article describes Medicaid ACO initiatives and explores how different payment tools could be leveraged to reward ACOs for increased access to care and quality language services. We find that a combination of payment tools might be helpful to encourage both access and quality.

  13. Aerosol simulation including chemical and nuclear reactions

    SciTech Connect

    Marwil, E.S.; Lemmon, E.C.

    1985-01-01

    The numerical simulation of aerosol transport, including the effects of chemical and nuclear reactions presents a challenging dynamic accounting problem. Particles of different sizes agglomerate and settle out due to various mechanisms, such as diffusion, diffusiophoresis, thermophoresis, gravitational settling, turbulent acceleration, and centrifugal acceleration. Particles also change size, due to the condensation and evaporation of materials on the particle. Heterogeneous chemical reactions occur at the interface between a particle and the suspending medium, or a surface and the gas in the aerosol. Homogeneous chemical reactions occur within the aersol suspending medium, within a particle, and on a surface. These reactions may include a phase change. Nuclear reactions occur in all locations. These spontaneous transmutations from one element form to another occur at greatly varying rates and may result in phase or chemical changes which complicate the accounting process. This paper presents an approach for inclusion of these effects on the transport of aerosols. The accounting system is very complex and results in a large set of stiff ordinary differential equations (ODEs). The techniques for numerical solution of these ODEs require special attention to achieve their solution in an efficient and affordable manner. 4 refs.

  14. Treatment for pulmonary hypertension including lung transplantation.

    PubMed

    Kusano, Kengo F

    2011-08-01

    Pulmonary hypertension (PH) is a progressive disease characterized by sustained elevation in pulmonary arterial pressure and increased pulmonary vascular resistance, leading to right-sided ventricular failure. The untreated median survival period is 2-3 years from the time of diagnosis, with the cause of death usually being right-sided ventricular failure. However, outcomes have dramatically changed in recent years because of great advances in medical management of PH, including early diagnosis and new drugs such as prostaglandins, endothelin receptor antagonists, and phosphodiesterase type 5 inhibitors. Long-term continuous intravenous prostacyclin therapy has shown excellent results in patients with PH. More recently, a molecular-targeted agent, imatinib mesylate, that acts by specifically inhibiting a certain enzyme that is characteristic of a particular cancer cell, rather than nonspecifically inhibiting and killing all rapidly dividing cells, has also been shown to have a potential role in the treatment of PH. This drug has been shown to reduce both pulmonary arterial smooth muscle cell hypertrophy and hyperplasia in a variety of disease processes. We summarize here recent topics regarding PH and advances in treatments for PH, particularly pulmonary arterial hypertension, including lung transplantation.

  15. Including supplementary elements in a compositional biplot

    NASA Astrophysics Data System (ADS)

    Daunis-i-Estadella, J.; Thió-Henestrosa, S.; Mateu-Figueras, G.

    2011-05-01

    The biplot is a widely and powerful methodology used with multidimensional data sets to describe and display the relationships between observations and variables in an easy way. Compositional data are vectors with positive components, whose sum is constant because they represent a relative contribution of different parts to a whole; due to this property standard biplots cannot be performed with compositional data, instead of a previous transformation of the data is performed. In this paper, we extend the compositional biplot defined by Aitchison and Greenacre (2002), in order to include in the display supplementary elements which are not used in the definition of the compositional biplot. Different types of supplementary elements are considered: supplementary parts of the composition, supplementary continuous variables external to the composition, supplementary categorical variables and supplementary observations. The projection of supplementary parts of the composition is done by means of the equivalence of clr and lr biplots. The other supplementary projections are done by classical methodology. An application example with a real geological data is included.

  16. Should family planning include STD services?

    PubMed

    Finger, W R

    1994-05-01

    Recent reviews suggest that the addition of programs aimed at preventing and controlling sexually transmitted diseases (STDs), specifically human immunodeficiency virus (HIV), to existing family planning programs does not necessarily dilute overall program effectiveness. In Colombia, Mexico, and Jamaica, where condom distribution and/or information to prevent HIV transmission was integrated into the activities of family planning field workers, no negative effect on the image of condoms as a pregnancy prevention method was observed and there was a great demand on the part of family planning clients for information about acquired immunodeficiency syndrome (AIDS). In Brazil, family planning staff are receiving training in HIV risk assessment and the counseling of women in partner negotiation skills. However, steps must be taken to reach men since it is their high-risk behavior that puts most women at risk of HIV. Both separate STD clinics for men and condom social marketing projects have yielded promising results. Obstacles to the addition of STD services to family planning programs include the need to treat male partners as well as female clients, a shortage of diagnostic tools and antibiotics for treatment, and the fact that the majority of women with STDs are asymptomatic. Indicative of the increased attention being given this approach, however, is the recent release of guidelines by the US Agency for International Development Office of Population on how family planning programs should approach integration. Suggested activities include condom promotion, behavior change, counseling, information, contraceptive development, and selected efforts at STD treatment.

  17. Including Students with Severe Disabilities in School-Wide Positive Behavioral Interventions and Supports: Perceptions of State Coordinators

    ERIC Educational Resources Information Center

    Landers, Eric; Courtade, Ginevra; Ryndak, Diane

    2012-01-01

    The purpose of this study was to determine how the needs of students with disabilities are addressed by state coordinators of school-wide positive behavioral interventions and supports (PBIS) during professional development activities on positive behavioral strategies, school-wide systems, and school-wide commitment to the PBIS approach.…

  18. Special Education Coding Criteria 2009/2010: ECS to Grade 12 Mild/Moderate (Including Gifted and Talented) Severe

    ERIC Educational Resources Information Center

    Alberta Education, 2009

    2009-01-01

    Alberta Education provides programming support and funding to school authorities to develop and implement special education programming for ECS children and students in grades 1 to 12. "Special Education Coding Criteria 2009/2010" outlines criteria within specific categories to help school authorities identify those children and students…

  19. Simple model of membrane proteins including solvent.

    PubMed

    Pagan, D L; Shiryayev, A; Connor, T P; Gunton, J D

    2006-05-14

    We report a numerical simulation for the phase diagram of a simple two-dimensional model, similar to the one proposed by Noro and Frenkel [J. Chem. Phys. 114, 2477 (2001)] for membrane proteins, but one that includes the role of the solvent. We first use Gibbs ensemble Monte Carlo simulations to determine the phase behavior of particles interacting via a square-well potential in two dimensions for various values of the interaction range. A phenomenological model for the solute-solvent interactions is then studied to understand how the fluid-fluid coexistence curve is modified by solute-solvent interactions. It is shown that such a model can yield systems with liquid-liquid phase separation curves that have both upper and lower critical points, as well as closed loop phase diagrams, as is the case with the corresponding three-dimensional model.

  20. Optical panel system including stackable waveguides

    DOEpatents

    DeSanto, Leonard; Veligdan, James T.

    2007-03-06

    An optical panel system including stackable waveguides is provided. The optical panel system displays a projected light image and comprises a plurality of planar optical waveguides in a stacked state. The optical panel system further comprises a support system that aligns and supports the waveguides in the stacked state. In one embodiment, the support system comprises at least one rod, wherein each waveguide contains at least one hole, and wherein each rod is positioned through a corresponding hole in each waveguide. In another embodiment, the support system comprises at least two opposing edge structures having the waveguides positioned therebetween, wherein each opposing edge structure contains a mating surface, wherein opposite edges of each waveguide contain mating surfaces which are complementary to the mating surfaces of the opposing edge structures, and wherein each mating surface of the opposing edge structures engages a corresponding complementary mating surface of the opposite edges of each waveguide.

  1. Optical panel system including stackable waveguides

    SciTech Connect

    DeSanto, Leonard; Veligdan, James T.

    2007-11-20

    An optical panel system including stackable waveguides is provided. The optical panel system displays a projected light image and comprises a plurality of planar optical waveguides in a stacked state. The optical panel system further comprises a support system that aligns and supports the waveguides in the stacked state. In one embodiment, the support system comprises at least one rod, wherein each waveguide contains at least one hole, and wherein each rod is positioned through a corresponding hole in each waveguide. In another embodiment, the support system comprises at least two opposing edge structures having the waveguides positioned therebetween, wherein each opposing edge structure contains a mating surface, wherein opposite edges of each waveguide contain mating surfaces which are complementary to the mating surfaces of the opposing edge structures, and wherein each mating surface of the opposing edge structures engages a corresponding complementary mating surface of the opposite edges of each waveguide.

  2. DEVELOPMENT OF WATER CIRCULATION MODEL INCLUDING IRRIGATION

    NASA Astrophysics Data System (ADS)

    Kotsuki, Shunji; Tanaka, Kenji; Kojiri, Toshiharu; Hamaguchi, Toshio

    It is well known that since agricultural water withdrawal has much affect on water circulation system, accurate analysis of river discharge or water balance are difficult with less regard for it. In this study, water circulation model composed of land surface model and distributed runoff model is proposed at 10km 10km resolution. In this model, irrigation water, which is estimated with land surface model, is introduced to river discharge analysis. The model is applied to the Chao Phraya River in Thailand, and reproduced seasonal water balance. Additionally, the discharge on dry season simulated with the model is improved as a result of including irrigation. Since the model, which is basically developed from global data sets, simulated seasonal change of river discharge, it can be suggested that our model has university to other river basins.

  3. Should Broca's area include Brodmann area 47?

    PubMed

    Ardila, Alfredo; Bernal, Byron; Rosselli, Monica

    2017-02-01

    Understanding brain organization of speech production has been a principal goal of neuroscience. Historically, brain speech production has been associated with so-called Broca’s area (Brodmann area –BA- 44 and 45), however, modern neuroimaging developments suggest speech production is associated with networks rather than with areas. The purpose of this paper was to analyze the connectivity of BA47 ( pars orbitalis) in relation to language . A meta-analysis was conducted to assess the language network in which BA47 is involved. The Brainmap database was used. Twenty papers corresponding to 29 experimental conditions with a total of 373 subjects were included. Our results suggest that BA47 participates in a “frontal language production system” (or extended Broca’s system). The BA47  connectivity found is also concordant with a minor role in language semantics. BA47 plays a central role in the language production system.

  4. Education Program on Fossil Resources Including Coal

    NASA Astrophysics Data System (ADS)

    Usami, Masahiro

    Fossil fuels including coal play a key role as crucial energies in contributing to economic development in Asia. On the other hand, its limited quantity and the environmental problems causing from its usage have become a serious global issue and a countermeasure to solve such problems is very much demanded. Along with the pursuit of sustainable development, environmentally-friendly use of highly efficient fossil resources should be therefore, accompanied. Kyushu-university‧s sophisticated research through long years of accumulated experience on the fossil resources and environmental sectors together with the advanced large-scale commercial and empirical equipments will enable us to foster cooperative research and provide internship program for the future researchers. Then, this program is executed as a consignment business from the Ministry of Economy, Trade and Industry from 2007 fiscal year to 2009 fiscal year. The lecture that uses the textbooks developed by this program is scheduled to be started a course in fiscal year 2010.

  5. Massachusetts proposes widening Medicaid to include HIV.

    PubMed

    1999-03-19

    In a move to expand Medicaid protection to low-income uninsured people soon after they test positive from HIV, Massachusetts Gov. Paul Cellucci has proposed using $10 million from an expected tobacco settlement to provide health care for 2,000 people. The pilot program would include primary care, diagnostics, and prescription medicines. The AIDS Action Committee of Massachusetts and other policy advocates are supporting the Governor's recommendation. The program would cost more than it saves initially, but as health care improves, people would require fewer costly hospital stays. These budget projections are expected to enable the proposal to meet the Federal requirement of a budget neutral Medical program. Contact information is provided.

  6. Models of bovine babesiosis including juvenile cattle.

    PubMed

    Saad-Roy, C M; Shuai, Zhisheng; van den Driessche, P

    2015-03-01

    Bovine Babesiosis in cattle is caused by the transmission of protozoa of Babesia spp. by ticks as vectors. Juvenile cattle (<9 months of age) have resistance to Bovine Babesiosis, rarely show symptoms, and acquire immunity upon recovery. Susceptibility to the disease varies between breeds of cattle. Models of the dynamics of Bovine Babesiosis transmitted by the cattle tick that include these factors are formulated as systems of ordinary differential equations. Basic reproduction numbers are calculated, and it is proved that if these numbers are below the threshold value of one, then Bovine Babesiosis dies out. However, above the threshold number of one, the disease may approach an endemic state. In this case, control measures are suggested by determining target reproduction numbers. The percentage of a particular population (for example, the adult bovine population) needed to be controlled to eradicate the disease is evaluated numerically using Columbia data from the literature.

  7. Including eddies in global ocean models

    NASA Astrophysics Data System (ADS)

    Semtner, Albert J.; Chervin, Robert M.

    The ocean is a turbulent fluid that is driven by winds and by surface exchanges of heat and moisture. It is as important as the atmosphere in governing climate through heat distribution, but so little is known about the ocean that it remains a “final frontier” on the face of the Earth. Many ocean currents are truly global in extent, such as the Antarctic Circumpolar Current and the “conveyor belt” that connects the North Atlantic and North Pacific oceans by flows around the southern tips of Africa and South America. It has long been a dream of some oceanographers to supplement the very limited observational knowledge by reconstructing the currents of the world ocean from the first principles of physics on a computer. However, until very recently, the prospect of doing this was thwarted by the fact that fluctuating currents known as “mesoscale eddies” could not be explicitly included in the calculation.

  8. Drapery assembly including insulated drapery liner

    DOEpatents

    Cukierski, Gwendolyn

    1983-01-01

    A drapery assembly is disclosed for covering a framed wall opening, the assembly including drapery panels hung on a horizontal traverse rod, the rod having a pair of master slides and means for displacing the master slides between open and closed positions. A pair of insulating liner panels are positioned behind the drapery, the remote side edges of the liner panels being connected with the side portions of the opening frame, and the adjacent side edges of the liner panels being connected with a pair of vertically arranged center support members adapted for sliding movement longitudinally of a horizontal track member secured to the upper horizontal portion of the opening frame. Pivotally arranged brackets connect the center support members with the master slides of the traverse rod whereby movement of the master slides to effect opening and closing of the drapery panels effects simultaneous opening and closing of the liner panels.

  9. Thermovoltaic semiconductor device including a plasma filter

    DOEpatents

    Baldasaro, Paul F.

    1999-01-01

    A thermovoltaic energy conversion device and related method for converting thermal energy into an electrical potential. An interference filter is provided on a semiconductor thermovoltaic cell to pre-filter black body radiation. The semiconductor thermovoltaic cell includes a P/N junction supported on a substrate which converts incident thermal energy below the semiconductor junction band gap into electrical potential. The semiconductor substrate is doped to provide a plasma filter which reflects back energy having a wavelength which is above the band gap and which is ineffectively filtered by the interference filter, through the P/N junction to the source of radiation thereby avoiding parasitic absorption of the unusable portion of the thermal radiation energy.

  10. PLUTINO DETECTION BIASES, INCLUDING THE KOZAI RESONANCE

    SciTech Connect

    Lawler, S. M.; Gladman, B.

    2013-07-01

    Because of their relative proximity within the trans-Neptunian region, the plutinos (objects in the 3:2 mean-motion resonance with Neptune) are numerous in flux-limited catalogs, and well-studied theoretically. We perform detailed modeling of the on-sky detection biases for plutinos, with special attention to those that are simultaneously in the Kozai resonance. In addition to the normal 3:2 resonant argument libration, Kozai plutinos also show periodic oscillations in eccentricity and inclination, coupled to the argument of perihelion ({omega}) oscillation. Due to the mean-motion resonance, plutinos avoid coming to pericenter near Neptune's current position in the ecliptic plane. Because Kozai plutinos are restricted to certain values of {omega}, perihelion always occurs out of the ecliptic plane, biasing ecliptic surveys against finding these objects. The observed Kozai plutino fraction f{sub koz}{sup obs} has been measured by several surveys, finding values between 8% and 25%, while the true Kozai plutino fraction f{sub koz}{sup true} has been predicted to be between 10% and 30% by different giant planet migration simulations. We show that f{sub koz}{sup obs} varies widely depending on the ecliptic latitude and longitude of the survey, so debiasing to find the true ratio is complex. Even a survey that covers most or all of the sky will detect an apparent Kozai fraction that is different from f{sub koz}{sup true}. We present a map of the on-sky plutino Kozai fraction that would be detected by all-sky flux-limited surveys. This will be especially important for the Panoramic Survey Telescope and Rapid Response System and Large Synoptic Survey Telescope projects, which may detect large numbers of plutinos as they sweep the sky. f{sub koz}{sup true} and the distribution of the orbital elements of Kozai plutinos may be a diagnostic of giant planet migration; future migration simulations should provide details on their resonant Kozai populations.

  11. Analysis of Smart Composite Structures Including Debonding

    NASA Technical Reports Server (NTRS)

    Chattopadhyay, Aditi; Seeley, Charles E.

    1997-01-01

    Smart composite structures with distributed sensors and actuators have the capability to actively respond to a changing environment while offering significant weight savings and additional passive controllability through ply tailoring. Piezoelectric sensing and actuation of composite laminates is the most promising concept due to the static and dynamic control capabilities. Essential to the implementation of these smart composites are the development of accurate and efficient modeling techniques and experimental validation. This research addresses each of these important topics. A refined higher order theory is developed to model composite structures with surface bonded or embedded piezoelectric transducers. These transducers are used as both sensors and actuators for closed loop control. The theory accurately captures the transverse shear deformation through the thickness of the smart composite laminate while satisfying stress free boundary conditions on the free surfaces. The theory is extended to include the effect of debonding at the actuator-laminate interface. The developed analytical model is implemented using the finite element method utilizing an induced strain approach for computational efficiency. This allows general laminate geometries and boundary conditions to be analyzed. The state space control equations are developed to allow flexibility in the design of the control system. Circuit concepts are also discussed. Static and dynamic results of smart composite structures, obtained using the higher order theory, are correlated with available analytical data. Comparisons, including debonded laminates, are also made with a general purpose finite element code and available experimental data. Overall, very good agreement is observed. Convergence of the finite element implementation of the higher order theory is shown with exact solutions. Additional results demonstrate the utility of the developed theory to study piezoelectric actuation of composite

  12. Imaging of axial spondyloarthritis including ankylosing spondylitis.

    PubMed

    Braun, J; Baraliakos, X

    2011-03-01

    New bone formation of the vertebral column is pathognomonic for ankylosing spondylitis (AS), while acute and/or chronic changes in the sacroiliac joints are relevant for diagnosis. The 'gold standard' for assessment of structural changes in AS are conventional radiographs, while MRI is useful to assess inflammation. Recent MRI studies have shown that the lower half of the thoracic spine is most commonly affected in AS. Scoring tools for spinal inflammation such as the ASspiMRI-a have been proposed, successfully used in large clinical trials and compared in a multireader experiment; none was finally preferred by OMERACT. Quantification of structural spinal AS changes is performed by the modified Stokes AS Spine Score (mSASSS), which evaluates lateral cervical and lumbar radiographs. Two years was identified as the shortest possible follow-up time based on the reliability and sensitivity to change of the mSASSS. A potential disadvantage of the mSASSS is that the thoracic spine is not included. Recent data based on the mSASSS have suggested that tumour necrosis factor blockers do not inhibit radiographic progression in AS. Since the mean radiographic change is reported to be less than 1 syndesmophyte over 2 years, the sensitivity to change of the mSASSS has been questioned. However, in one study where continuous non-steroidal anti-inflammatory drugs use was compared with on-demand use, a difference between these two methods of drug intake was reported. The face and construct validity of the mSASSS has been criticised because a score of ´1´ contains a mixture of osteodestructive (erosions) and osteoproliferative changes (squaring and sclerosis). A new scoring system, the RASSS, which concentrates only on bone formation and which includes the lower part of the thoracic spine is currently being evaluated. The relationship between inflammation and new bone formation in AS has recently been investigated. Low sclerostin and DKK-1 serum levels, both inhibitors of bone

  13. Antimatter-matter scattering including rearrangement

    NASA Astrophysics Data System (ADS)

    Kadyrov, Alisher

    2014-10-01

    Two distinct versions of the convergent close coupling (CCC) approach to ion-atom and ion-molecule collisions have been developed in the impact parameter representation. The first method starts from the exact three-body Schrödinger equation for the total scattering wave function and leads to coupled-channel Lippmann-Schwinger type integral equations for the transition amplitudes, with the relative motion of the heavy particles treated fully quantum mechanically. The second approach utilises a traditional semi-classical approximation. It is based on the time-dependent Schrödinger equation for the electronic part of the scattering wave function and leads to a system of coupled differential equations. This allows one to test the quality of approximations used in standard approaches to the problem. Both methods are applied to calculate antiproton collisions with inert gases and simple molecular targets in the energy range from 1 keV to 1 MeV. The methods are also applied to proton collisions including rearrangement channels. Interplay of direct ionisation and electron capture to continuum in target breakup is investigated. The first CCC calculations of the antiproton and proton stopping power in atomic and molecular hydrogen are presented. The work was supported by the Australian Research Council.

  14. Engine lubrication circuit including two pumps

    DOEpatents

    Lane, William H.

    2006-10-03

    A lubrication pump coupled to the engine is sized such that the it can supply the engine with a predetermined flow volume as soon as the engine reaches a peak torque engine speed. In engines that operate predominately at speeds above the peak torque engine speed, the lubrication pump is often producing lubrication fluid in excess of the predetermined flow volume that is bypassed back to a lubrication fluid source. This arguably results in wasted power. In order to more efficiently lubricate an engine, a lubrication circuit includes a lubrication pump and a variable delivery pump. The lubrication pump is operably coupled to the engine, and the variable delivery pump is in communication with a pump output controller that is operable to vary a lubrication fluid output from the variable delivery pump as a function of at least one of engine speed and lubrication flow volume or system pressure. Thus, the lubrication pump can be sized to produce the predetermined flow volume at a speed range at which the engine predominately operates while the variable delivery pump can supplement lubrication fluid delivery from the lubrication pump at engine speeds below the predominant engine speed range.

  15. Articles including thin film monolayers and multilayers

    DOEpatents

    Li, DeQuan; Swanson, Basil I.

    1995-01-01

    Articles of manufacture including: (a) a base substrate having an oxide surface layer, and a multidentate ligand, capable of binding a metal ion, attached to the oxide surface layer of the base substrate, (b) a base substrate having an oxide surface layer, a multidentate ligand, capable of binding a metal ion, attached to the oxide surface layer of the base substrate, and a metal species attached to the multidentate ligand, (c) a base substrate having an oxide surface layer, a multidentate ligand, capable of binding a metal ion, attached to the oxide surface layer of the base substrate, a metal species attached to the multidentate ligand, and a multifunctional organic ligand attached to the metal species, and (d) a base substrate having an oxide surface layer, a multidentate ligand, capable of binding a metal ion, attached to the oxide surface layer of the base substrate, a metal species attached to the multidentate ligand, a multifunctional organic ligand attached to the metal species, and a second metal species attached to the multifunctional organic ligand, are provided, such articles useful in detecting the presence of a selected target species, as nonliear optical materials, or as scavengers for selected target species.

  16. Reconsidering remineralization strategies to include nanoparticle hydroxyapatite.

    PubMed

    Kutsch, V Kim; Chaiyabutr, Yada; Milicich, Graeme

    2013-03-01

    Dental caries is a transmissible biofilm-mediated disease of the teeth that is defined by prolonged periods of low pH resulting in net mineral loss from the teeth. Hydroxyapatite, fluorapatite, and the carbonated forms of calcium phosphate form the main mineral content of dental hard tissues: enamel, dentin, and cementum. Active dental caries results when the biofilm pH on the tooth surface drops below the dissolution threshold for hydroxyapatite and fluorapatite. The clinical evidence of this net mineral loss is porosity, whitespot lesions, caries lesions, and/or cavitation. The potential to reverse this mineral loss through remineralization has been well documented, although previous remineralization strategies for dental hard tissues have focused on the use of fluorides and forms of calcium phosphate. This in-vitro study documented the deposition of nanoparticle hydroxyapatite on demineralized enamel surfaces after treatment with an experimental remineralization gel. This finding supports consideration of an additional approach to remineralization that includes pH neutralization strategies and nanoparticle hydroxyapatite crystals.

  17. Prognostic biological factors in severe acute pancreatitis

    PubMed Central

    Popa, CC

    2014-01-01

    Acute pancreatitis is a serious disease. Many clinical and laboratory prognostic scores for the severity of acute pancreatitis have been proposed over the years. The aim was to identify the biological factors of prognostic severity. The study was prospective, including a four-year period between 2007 and 2010. 103 patients were diagnosed with severe acute pancreatitis and treated in a surgical clinic in Bucharest. 58 were males, accounting for 56.31%, and 45 were women, 43.69% respectively. Numerous biochemical analyses of blood, especially the number of leukocytes, glucose, urea and bilirubin were monitored. They proposed generic profiles for patients with severe acute pancreatitis. Conclusions: There is no single biological prognostic factor, but a combination of different markers may contribute to a more precise prediction of severity, as confirmed by international literature. PMID:25713614

  18. Prognostic biological factors in severe acute pancreatitis.

    PubMed

    Popa, C C

    2014-01-01

    Acute pancreatitis is a serious disease. Many clinical and laboratory prognostic scores for the severity of acute pancreatitis have been proposed over the years. The aim was to identify the biological factors of prognostic severity. The study was prospective, including a four-year period between 2007 and 2010. 103 patients were diagnosed with severe acute pancreatitis and treated in a surgical clinic in Bucharest. 58 were males, accounting for 56.31%, and 45 were women, 43.69% respectively. Numerous biochemical analyses of blood, especially the number of leukocytes, glucose, urea and bilirubin were monitored. They proposed generic profiles for patients with severe acute pancreatitis. There is no single biological prognostic factor, but a combination of different markers may contribute to a more precise prediction of severity, as confirmed by international literature.

  19. Including Tidal Effects in Tsunami Forecasting

    NASA Astrophysics Data System (ADS)

    Arcas, D.

    2015-12-01

    Recently a new tsunami forecast system SIFT (Short-term Inundation and Forecasting of Tsunamis) has been declared operational by the National Weather Service (NWS) Tsunami Warning Centers. The SIFT system assimilates real-time information from a network of observing systems deployed in the open ocean, to produce on-the-fly estimates of tsunami impact at specific coastal communities. These estimates are computed via the tsunami simulation code MOST (Method of Splitting Tsunami) and include forecast products such as tsunami arrival time, duration of the event, predicted tsunami currents, maximum sea surface elevation and expected inundation areas. These computations are performed under the assumption that the mean sea level remains constant at Mean High Water (MHW) during the entire tsunami event. This assumption produces conservative tsunami forecasts that tend to err on the side of caution with the possibility of substantial overestimates of the inundation areas. To avoid this problem and produce more accurate, operational tsunami forecasts, we investigate the effects of tsunami interaction with tides. The nonlinear dynamic interaction is simulated by first, simulating tidal elevations and currents with Oregon State University tidal model, to obtain boundary and initial conditions to force the MOST tsunami model. Tsunami boundary and initial conditions can be added to those for the tide to study the combined effect. Our results show that even at locations with strong tidal forcing, the tsunami/tide interaction effect has a weakly non-linear effect on the tsunami elevation waveform. This interaction, however, will have a significant effect on the extent of the inundation area. Based on these findings we propose a simple, linear correction to the standard MHW forecast for tsunami time series and inundation area, that can be performed on-the-fly by the SIFT system without the need for complex tidal models.

  20. [Contracts including performance and management of uncertainty].

    PubMed

    Duru, G; Garassus, P; Auray, J-P

    2013-09-01

    Since many decades in France, the most important part of ambulatory health care expenditure is represented by drug consumption. By the fact, French patient is indeed the greatest world consumer of pharmaceuticals treatments. Therefore, the regulation authorities by successive strategies, attempt to limit or even restrict market access for new drugs in the health care sector secured by public social insurance coverage. Common objectives are to assess the reimbursement to scientific studies and to fix the price of therapeutics at an acceptable level for both industries and government. New trends try then to determine recently the drug price in a dual approach, as a component of global and effective contract, including performance and outcome. The first diffusion authorization is diffusion concerned, but this concept takes into account the eventual success of new produces in long-term survey. Signed for a fixed period as reciprocal partnership between regulation authorities and pharmaceutics industries, the contract integrates two dimensions of incertitude. The first one is represented by the strategy of new treatments development according to efficacy and adapted price, and the second one is linked to the result of diffusion and determines adapted rules if eventual non-respects of the previous engagement are registered. This paper discusses problems related to this new dimension of incertitude affected by conditional drug prices in market access strategy and the adapted follow-up of new treatment diffusion fixed by "outcome" contract between French regulation administration and pharmaceutics industries in our recent economic context. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  1. The quality of lactation studies including antipsychotics.

    PubMed

    Hummels, Hazel; Bertholee, Daphne; van der Meer, Douwe; Smit, Jan Pieter; Wilffert, Bob; Ter Horst, Peter

    2016-12-01

    The aim of this study is to determine the quality of lactation studies that investigated antipsychotics in breast milk according to the Food and Drug Administration (FDA) and International Lactation Consultant Association (ILCA) draft guidelines. We used the draft FDA and ILCA guidelines to review the quality of articles including antipsychotic use during breastfeeding. We used PubMed and Lactmed for the literature search. Furthermore, cross references were searched for additional studies. Of the 51 studies, only one olanzapine and one quetiapine study calculated the milk to plasma ratio (M:P ratio), the Absolute Infant Dose (AID), and the Relative Infant Dose (RID) correctly. In the remaining studies, at least one of the three endpoints was not determined properly. No correct endpoints were calculated in studies containing chlorpromazine, chlorprothixene, clozapine, haloperidol, sulpiride, trifluoperazine, ziprasidone, zonisamide, and zuclopenthixol. This review investigated that there was a lack of information on the sampling methods of breast milk. Furthermore, the concentrations needed for the calculations of the three endpoints were mainly based on single measurements instead of at least five measurements during one dose interval. In many studies, the RID was not calculated correctly due to the fact that the RID was not normalized by the maternal weight or an average maternal weight of 70 kg was used as a standard. Except for two studies, most studies about the safety of antipsychotic use during lactation did not meet the criteria of the draft FDA and ILCA guidelines. Further research is mandatory to assess the safety of using antipsychotics while breastfeeding.

  2. Including lifestyle medicine in undergraduate medical curricula

    PubMed Central

    Phillips, Edward; Pojednic, Rachele; Polak, Rani; Bush, Jennifer; Trilk, Jennifer

    2015-01-01

    Purpose Currently, there is no model to integrate the discipline of lifestyle medicine (LM) into undergraduate medical education. Furthermore, there are no guidelines, validated assessment tools, or evaluation or implementation plans in place. Background The World Health Organization predicts that by 2020, two-thirds of disease worldwide will be the result of poor lifestyle choices. Fewer than 50% of US primary care physicians routinely provide specific guidance on nutrition, physical activity, or weight control. Methods We are establishing a plan to integrate LM into medical school education in collaboration with the investing stakeholders, including medical school deans and students, medical curriculum developers and researchers, medical societies, governing bodies, and policy institutes. Three planning and strategy meetings are being held to address key areas of focus – with a particular interest in nutrition, physical activity, student self-care, and behavior change – to develop specific implementation guidelines and landmarks. Results After the first two meetings, the proposed areas of focus were determined to be: 1) supporting of deans and key personnel, 2) creation of federal and state policy commitments, 3) use of assessment as a driver of LM, 4) provision of high-quality evidence-based curricular material on an easily navigated site, and 5) engaging student interest. Implementation strategies for each focus area will be addressed in an upcoming planning meeting in early 2015. Conclusion This initiative is expected to have important public health implications by efficiently promoting the prevention and treatment of non-communicable chronic disease with a scalable and sustainable model to educate physicians in training and practice. PMID:25652118

  3. The National Severe Storms Laboratory's contribution to severe weather warning improvement: multiple-sensor severe weather applications

    NASA Astrophysics Data System (ADS)

    Stumpf, Gregory J.; Smith, Travis M.; Thomas, Claire

    The National Severe Storms Laboratory (NSSL) has played the primary role in the development and evaluation of U.S. National Weather Service (NWS) severe weather applications for the Weather Surveillance Radar-1988 Doppler (WSR-88D). NSSL developed many of the primary detection algorithms for the radar, and is currently developing improvements to these algorithms. The traditional WSR-88D severe weather algorithms have been designed for use with a single-radar data source. Although the algorithm guidance has led to an improvement of the NWS severe weather warning statistics, it is understood that effective warning decisions can only be made via the integration of information from many sources, including input from multiple remote sensors (multiple radars, mesoscale models, satellite, lightning, etc.). Therefore, these traditional single-radar severe weather algorithms have been updated to take advantage of additional data sources in order to reduce the uncertainty of the measurements and increase the accuracy of the diagnoses of severe weather. The NSSL Warning Decision Support System-Integrated Information (WDSS-II) has provided an invaluable development environment to facilitate the development of these new applications. In just 1 year (2002), NSSL has converted its suite of single-radar severe weather detection algorithms to operate using multiple radars. NSSL has also developed a host of new radar diagnostic derivatives, including high-resolution gridded fields of vertically integrated liquid (VIL), probability of severe hail, maximum expected hail size, velocity-derived rotation, and velocity-derived divergence. Time-integrated gridded fields of some of the above have also been developed, including hail swath information (maximum size and hail damage potential) and velocity-derived rotation tracks.

  4. Compact Radar Transceiver with Included Calibration

    NASA Technical Reports Server (NTRS)

    McLinden, Matthew; Rincon, Rafael

    2013-01-01

    The Digital Beamforming Synthetic Aperture Radar (DBSAR) is an eight-channel phased array radar system that employs solid-state radar transceivers, a microstrip patch antenna, and a reconfigurable waveform generator and processor unit. The original DBSAR transceiver design utilizes connectorized electronic components that tend to be physically large and heavy. To achieve increased functionality in a smaller volume, PCB (printed circuit board) transceivers were designed to replace the large connectorized transceivers. One of the most challenging problems designing the transceivers in a PCB format was achieving proper performance in the calibration path. For a radar loop-back calibration path, a portion of the transmit signal is coupled out of the antenna feed and fed back into the receiver. This is achieved using passive components for stability and repeatability. Some signal also leaks through the receive path. As these two signal paths are correlated via an unpredictable phase, the leakage through the receive path during transmit must be 30 dB below the calibration path. For DBSAR s design, this requirement called for a 100-dB isolation in the receiver path during transmit. A total of 16 solid-state L-band transceivers on a PCB format were designed. The transceivers include frequency conversion stages, T/R switching, and a calibration path capable of measuring the transmit power-receiver gain product during transmit for pulse-by-pulse calibration or matched filtering. In particular, this calibration path achieves 100-dB isolation between the transmitted signal and the low-noise amplifier through the use of a switching network and a section of physical walls achieving attenuation of radiated leakage. The transceivers were designed in microstrip PCBs with lumped elements and individually packaged components for compactness. Each transceiver was designed on a single PCB with a custom enclosure providing interior walls and compartments to isolate transceiver

  5. Intensive intravenous regime for acute severe colitis.

    PubMed

    Banerjee, Rupa; Philip, Matthew; Bhatia, Shobna

    2014-08-01

    Acute severe exacerbation of ulcerative colitis is a potentially life threatening medical emergency. The management of acute severe ulcerative colitis depends on early recognition and prompt initiation of intensive intravenous treatment along with continuous objective monitoring for possible medical failure. The intensive regime is the accepted standard of care. This includes primarily a) intravenous corticosteroids, b) intravenous supportive management, and d) intravenous antibiotics in instances. This review discusses the timing, duration and dosage of the intensive intravenous treatment including the evidence based protocol for effective monitoring to enable timely escalation to second line therapy & colectomy.

  6. Genotyping for Severe Drug Hypersensitivity

    PubMed Central

    Karlin, Eric; Phillips, Elizabeth

    2014-01-01

    Over the past decade, there have been significant advances in our understanding of the immunopathogenesis and pharmacogenomics of severe immunologically-mediated adverse drug reactions. Such T-cell-mediated adverse drug reactions such as Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN), drug-induced liver disease (DILI) and other drug hypersensitivity syndromes have more recently been shown to be mediated through interactions with various class I and II HLA alleles. Key examples have included the associations of HLA-B*15:02 and carbamazepine induced SJS/TEN in Southeast Asian populations and HLA-B*57:01 and abacavir hypersensitivity. HLA-B*57:01 screening to prevent abacavir hypersensitivity exemplifies a successful translational roadmap from pharmacogenomic discovery through to widespread clinical implementation. Ultimately, our increased understanding of the interaction between drugs and the MHC could be used to inform drug design and drive pre-clinical toxicity programs to improve drug safety. PMID:24429903

  7. Guidelines for severe uncontrolled asthma.

    PubMed

    Cisneros Serrano, Carolina; Melero Moreno, Carlos; Almonacid Sánchez, Carlos; Perpiñá Tordera, Miguel; Picado Valles, César; Martínez Moragón, Eva; Pérez de Llano, Luis; Soto Campos, José Gregorio; Urrutia Landa, Isabel; García Hernández, Gloria

    2015-05-01

    Since the publication, 9 years ago, of the latest SEPAR (Spanish Society of Pulmonology and Thoracic Surgery) Guidelines on Difficult-to-Control Asthma (DCA), much progress has been made in the understanding of asthmatic disease. These new data need to be reviewed, analyzed and incorporated into the guidelines according to their level of evidence and recommendation. Recently, consensus documents and clinical practice guidelines (CPG) addressing this issue have been published. In these guidelines, specific mention will be made of what the previous DCA guidelines defined as "true difficult-to-control asthma". This is asthma that remains uncontrolled after diagnosis and a systematic evaluation to rule out factors unrelated to the disease itself that lead to poor control ("false difficult-to-control asthma"), and despite an appropriate treatment strategy (Spanish Guidelines for the Management of Asthma [GEMA] steps 5 and 6): severe uncontrolled asthma. In this respect, the guidelines propose a revised definition, an attempt to classify the various manifestations of this type of asthma, a proposal for a stepwise diagnostic procedure, and phenotype-targeted treatment. A specific section has also been included on DCA in childhood, aimed at assisting healthcare professionals to improve the care of these patients.

  8. Radiosensitive Severe Combined Immunodeficiency Disease

    PubMed Central

    Dvorak, Christopher C.; Cowan, Morton J.

    2009-01-01

    Synopsis Inherited defects in components of the non-homologous end joining DNA repair mechanism produce a T-B-NK+ severe combined immunodeficiency disease (SCID) characterized by heightened sensitivity to ionizing radiation. Patients with the radiosensitive form of SCID may also have increased short- and long-term sensitivity to the alkylator-based chemotherapy regimens traditionally utilized for conditioning prior to allogeneic hematopoietic cell transplantation (HCT). Known etiologies of radiosensitive SCID include deficiencies of Artemis, DNA Ligase IV, DNA-dependent protein kinase catalytic subunit (DNA-PKcs), and Cernunnos-XLF, all of which have been treated with HCT. Because of their sensitivity to certain forms of chemotherapy, the approach to donor selection and type of conditioning regimen utilized for a radiosensitive SCID patient requires careful consideration. Significantly more research needs to be done in order to determine the long-term outcomes of radiosensitive SCID patients following HCT, as well as to discover novel non-toxic approaches to HCT that might benefit those with intrinsic radio- and chemo-sensitivity, as well as potentially all patients undergoing an HCT. PMID:20113890

  9. Statistics of severe tornadoes and severe tornado outbreaks

    NASA Astrophysics Data System (ADS)

    Malamud, B. D.; Turcotte, D. L.

    2012-09-01

    The standard measures of the intensity of a tornado in the USA and many other countries are the Fujita and Enhanced Fujita scales. These scales are based on the damage that a tornado causes. Another measure of the strength of a tornado is its path length of touchdown, L. In this study we consider severe tornadoes, which we define as L≥10 km, in the continental USA (USA Storm Prediction Center Severe Weather Database). We find that for the period 1982-2011, for individual severe tornadoes (L≥10 km): (i) There is a strong linear scaling between the number of severe tornadoes in a year and their total path length in that year. (ii) The cumulative frequency path length data suggests that, not taking into account any changing trends over time, we would expect in a given year (on average) one severe tornado with a path length L≥115 km and in a decade (on average) one severe tornado with a path length L≥215 km. (iii) The noncumulative frequency-length statistics of severe tornado touchdown path lengths, 20severe tornadoes in a convective day (12:00-12:00 UTC), LD, as a measure of the strength of a 24-h USA tornado outbreak. We find that: (i) For 1982-2011, the number of severe tornadoes in a USA convective day outbreak has a strong power-law relationship (exponent 0.80) on the convective day total path length, LD. (ii) For 1952-2011, the cumulative frequency path length data for severe tornado outbreaks suggests that we would expect in a given year (on average) one daily severe tornado outbreak with total path length LD≥480 km and in a decade (on average) one daily severe tornado outbreak with a total path length LD≥1200 km. (iii) For 1982-2011, the noncumulative frequency-length statistics of tornado outbreaks, 10

  10. Severe asthma: lessons learned from the National Heart, Lung, and Blood Institute Severe Asthma Research Program.

    PubMed

    Jarjour, Nizar N; Erzurum, Serpil C; Bleecker, Eugene R; Calhoun, William J; Castro, Mario; Comhair, Suzy A A; Chung, Kian Fan; Curran-Everett, Douglas; Dweik, Raed A; Fain, Sean B; Fitzpatrick, Anne M; Gaston, Benjamin M; Israel, Elliot; Hastie, Annette; Hoffman, Eric A; Holguin, Fernando; Levy, Bruce D; Meyers, Deborah A; Moore, Wendy C; Peters, Stephen P; Sorkness, Ronald L; Teague, W Gerald; Wenzel, Sally E; Busse, William W

    2012-02-15

    The National Heart, Lung, and Blood Institute Severe Asthma Research Program (SARP) has characterized over the past 10 years 1,644 patients with asthma, including 583 individuals with severe asthma. SARP collaboration has led to a rapid recruitment of subjects and efficient sharing of samples among participating sites to conduct independent mechanistic investigations of severe asthma. Enrolled SARP subjects underwent detailed clinical, physiologic, genomic, and radiological evaluations. In addition, SARP investigators developed safe procedures for bronchoscopy in participants with asthma, including those with severe disease. SARP studies revealed that severe asthma is a heterogeneous disease with varying molecular, biochemical, and cellular inflammatory features and unique structure-function abnormalities. Priorities for future studies include recruitment of a larger number of subjects with severe asthma, including children, to allow further characterization of anatomic, physiologic, biochemical, and genetic factors related to severe disease in a longitudinal assessment to identify factors that modulate the natural history of severe asthma and provide mechanistic rationale for management strategies.

  11. Prognostic intraoperative factors in severe acute pancreatitis

    PubMed Central

    Popa, CC

    2014-01-01

    Acute pancreatitis is a serious disease. Triggered by the local inflammation of the pancreas, it can cause inflammation in various organs and systems in the body. It is important to identify severe forms of acute pancreatitis with an increased morbidity and mortality rate. Lately, internationally, numerous clinical and paraclinical factors predicting the severity of acute pancreatitis have been proposed. The purpose of the study is to identify the prognostic intraoperative factors of severity. The prospective study was conducted over a period of four years, between 2007 and 2010 and included 238 patients treated in a surgical clinic in Bucharest. 103 patients experienced a severe form of acute pancreatitis, which means 67.95% of all operations practiced. We monitored intraoperative factors, in particular: the presence and/ or the extent of pancreatic necrosis, common bile duct lithiasis and intraperitoneal fluid, parameters proposed to become statistically prognostic factors in the development and long-term morbidity of acute pancreatitis. The presence and/ or extension of necrosis was identified in the histopathology only in patients with severe acute pancreatitis. 71.43% of the patients with common bile duct lithiasis and 73.91% of the patients with inflammatory intraperitoneal fluid had severe acute pancreatitis. Most patients who developed postoperative complications (86.49%) or who required a surgical intervention (85.71%), presented a severe form of the disease. Conclusions: pancreatic necrosis, common bile duct lithiasis and intraperitoneal fluid may contribute to a more precise prediction of severity, as confirmed by international literature. PMID:25870691

  12. Promoting Social Inclusion Counting with Everyone: Learning Communities and INCLUD-ED

    ERIC Educational Resources Information Center

    Gatt, Suzanne; Ojala, Mikko; Soler, Marta

    2011-01-01

    The scientific community has provided a wide range of evidence that family and community involvement in schools benefits not only students' learning but also their surrounding community. The INCLUD-ED project has conducted case studies of successful schools around Europe that have strong community participation. Some of them are engaged in the…

  13. 76 FR 35026 - Hutchinson Technology, Inc., Including On-Site Workers Leased From Doherty, Including Workers...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-15

    ... Doherty, Including Workers Whose Unemployment Insurance (UI) Wages Are Paid Through Aramark Business..., Including Workers Whose Unemployment Insurance (UI) Wages Are Paid Through Aramark Business Facilities, LLC... wages reported under a separate unemployment insurance (UI) tax account under the name Aramark Business...

  14. A Method To Compare Rater Severity across Several Administrations.

    ERIC Educational Resources Information Center

    O'Neill, Thomas R.; Lunz, Mary E.

    This paper illustrates a method to study rater severity across exam administrations. A multi-facet Rasch model defined the ratings as being dominated by four facets: examinee ability, rater severity, project difficulty, and task difficulty. Ten years of data from administrations of a histotechnology performance assessment were pooled and analyzed…

  15. Statistics of Severe Tornadoes and Severe Tornado Outbreaks

    NASA Astrophysics Data System (ADS)

    Malamud, B. D.; Turcotte, D. L.

    2012-04-01

    The standard measures of the intensity of a tornado in the USA and many other countries are the Fujita and Enhanced Fujita scales. These scales are based on the damage that a tornado causes. Another measure of the strength of a tornado is its path length of touchdown, L. In this study we consider 4,061 severe tornadoes (defined as L≥ 10 km) in the continental USA for the time period 1981-2010 (USA Storm Prediction Center Severe Weather Database). We find for individual severe tornadoes: (i) The noncumulative frequency-length statistics of severe tornado touchdown path lengths, 20 < L < 200 km, is well approximated by an inverse power-law relationship with exponent near 3. (ii) There is a strong linear scaling between the number of severe tornadoes in a year and their total path lengths in that year. We then take the total path length of severe tornadoes in a day, LD, as a measure of the strength of a 24-hour USA tornado outbreak. We find that: (i) On average, the number of days per year with at least one continental USA severe tornado (path length L≥ 10 km) has increased 16% in the 30-year period 1981-2010. (ii) The daily numbers of severe tornadoes in a USA outbreak have a strong power-law relationship (exponent 0.87) on their daily total path lengths, LD, over the range 20 < LD

  16. Statistical Scaling of Severe Tornadoes and Severe Tornado Outbreaks

    NASA Astrophysics Data System (ADS)

    Turcotte, D. L.; Malamud, B. D.

    2012-12-01

    The standard measures of the intensity of a tornado in the USA and many other countries are the Fujita and Enhanced Fujita scales. These scales are based on the damage that a tornado causes. Another measure of the strength of a tornado is its path length of touchdown, L. Here we consider severe tornadoes, which we define as L ≥ 10 km, in the continental USA (USA Storm Prediction Center Severe Weather Database). We find that for the period 1982-2011, for individual severe tornadoes (L ≥ 10 km): (i) There is a strong linear scaling between the number of severe tornadoes in a year and their total path lengths in that year. (ii) The cumulative path length data suggests that the longest severe tornado path length (or greater) expected in a year (on average) is L = 115 km and in a decade (on average) is L = 215 km. (iii) The noncumulative frequency-length statistics of severe tornado touchdown path lengths, 20 < L < 200 km, is well approximated by an inverse power-law relationship with exponent near 3. We then take the total path length of severe tornadoes in a convective day (12:00-12:00 UTC), LD, as a measure of the strength of a 24-hour USA tornado outbreak. We find that: (i) For 1982-2011, the numbers of severe tornadoes in a USA convective day outbreak have a strong power-law relationship (exponent 0.80) with their convective day total path lengths, LD, over the range 20 < LD < 1000 km/dy. (ii) For 1952-2011, the cumulative severe tornado outbreak path length data suggests that the longest daily outbreak path length total (or greater) expected in a year (on average) is LD = 480 km and in a decade (on average) is LD = 120 km. (iii) For 1982-2011, the noncumulative frequency-length statistics of tornado outbreaks, 10 < LD <1000 km/dy, is well approximated by an inverse power-law relationship with exponent near 1.8. Finally, we consider the frequency path-length scaling of severe tornadoes (L ≥ 10 km) during two tornado outbreaks, 27 April 2011 (67 severe

  17. Upgrade Summer Severe Weather Tool

    NASA Technical Reports Server (NTRS)

    Watson, Leela

    2011-01-01

    The goal of this task was to upgrade to the existing severe weather database by adding observations from the 2010 warm season, update the verification dataset with results from the 2010 warm season, use statistical logistic regression analysis on the database and develop a new forecast tool. The AMU analyzed 7 stability parameters that showed the possibility of providing guidance in forecasting severe weather, calculated verification statistics for the Total Threat Score (TTS), and calculated warm season verification statistics for the 2010 season. The AMU also performed statistical logistic regression analysis on the 22-year severe weather database. The results indicated that the logistic regression equation did not show an increase in skill over the previously developed TTS. The equation showed less accuracy than TTS at predicting severe weather, little ability to distinguish between severe and non-severe weather days, and worse standard categorical accuracy measures and skill scores over TTS.

  18. Severity grading in radial dysplasia.

    PubMed

    Vilkki, S K

    2014-11-01

    A functional scoring method to grade the usefulness and quality of the upper limbs in congenital radial dysplasia is presented. It is based on the author's examinations of 44 arms with congenital deficiency of the radius. The hand (H), wrist (W) and proximal parts (P) of the extremity are each scored from 0 to 10 points for severity. The scoring is expressed similarly to the TNM (tumour, nodes, metastasis) tumour classification, for example as H5W4P2. The maximum severity index is 30 points. A severity grade of mild is between 1 and 8 points, moderate between 9 and 16 points and severe 17 points and over. In the author's series, the grades were mild in eight, moderate in 21 and severe in 15 cases. The functional severity grading should allow better comparison of radially deficient limbs and the results of treatment between groups of patients. © The Author(s) 2014.

  19. Statistics of severe tornadoes and severe tornado outbreaks

    NASA Astrophysics Data System (ADS)

    Malamud, B. D.; Turcotte, D. L.

    2012-03-01

    The standard measures of the intensity of a tornado in the USA and many other countries are the Fujita and Enhanced Fujita scales. These scales are based on the damage that a tornado causes. Another measure of the strength of a tornado is its path length of touchdown, L. In this study we consider 4061 severe tornadoes (defined as L≥10 km) in the continental USA for the time period 1981-2010 (USA Storm Prediction Center Severe Weather Database). We find for individual severe tornadoes: (i) The noncumulative frequency-length statistics of severe tornado touchdown path lengths, 20 < L < 200 km, is well approximated by an inverse power-law relationship with exponent near 3. (ii) There is a strong linear scaling between the number of severe tornadoes in a year and their total path lengths in that year. We then take the total path length of severe tornadoes in a day, LD, as a measure of the strength of a 24-hour USA tornado outbreak. We find that: (i) On average, the number of days per year with at least one continental USA severe tornado (path length L≥10 km) has increased 16% in the 30-year period 1981-2010. (ii) The daily numbers of severe tornadoes in a USA outbreak have a strong power-law relationship (exponent 0.87) on their daily total path lengths, LD, over the range 20 < LD < 1000 km dy-1. (iii) The noncumulative frequency-length statistics of tornado outbreaks, 10 < LD < 1000 km dy-1, is well approximated by an inverse power-law relationship with exponent near 1.7. We believe that our robust scaling results provide evidence that touchdown path lengths can be used as quantitative measures of the systematic properties of severe tornadoes and severe tornado outbreaks.

  20. Statistics of Severe Tornadoes and Severe Tornado Outbreaks

    NASA Astrophysics Data System (ADS)

    Malamud, B. D.; Turcotte, D. L.

    2011-12-01

    The standard measure of the intensity of a tornado in the USA and many other countries are the Fujita and Enhanced Fujita scales. These scales are based on the damage that a tornado causes. Another measure of the strength of a tornado is its path length of touchdown, L. In this study we consider 4,061 severe tornadoes, with L ≥ 10 km, in the continental USA for the period 1981-2010 (Storm Prediction Center Severe Weather Database). We find for individual severe tornadoes: (i) The noncumulative frequencies, f(L), have a strong power-law relationship on severe tornado path lengths, L. (ii) The dependence of the number of severe tornadoes in a year on the total length in that year also exhibits strong power-law scaling. We then take the total path length of severe tornadoes in a day, LD, as a measure of the strength of a 24-hour USA tornado outbreak. We find that: (i) The number of days on which USA outbreaks occur has increased 15% in the 30-year period considered over the continental USA. (ii) The numbers of severe tornadoes in a USA outbreak, ND, have a strong power-law relationship on total 24-hour path lengths, LD. (iii) The noncumulative frequencies, f(LD), have a strong power-law relationship on severe tornado path lengths, LD. We believe that our robust scaling results provide evidence that touchdown lengths might be used as quantitative measures of the systematic properties of severe tornadoes and severe tornado outbreaks.

  1. Indexes of severity: conceptual development.

    PubMed Central

    Krischer, J P

    1979-01-01

    A discussion of severity index development is presented in relation to conceptual issues in index definition, analytic issues in index formulation and validation issues in index application. The CHOP index is discussed along with six severity indexes described in an earlier paper dealing with underlying concepts to illustrate the material presented. Replies are provided to specific questions raised in an accompanying paper discussing the Injury Severity Score. This conceptual material is presented to provide a foundation for severity index development, to suggest criteria to be used in their formulation and testing, and to identify analyses that can lead to the successful selection and application of an index for a defined purpose. PMID:468553

  2. Genetics Home Reference: MECP2-related severe neonatal encephalopathy

    MedlinePlus

    ... related severe neonatal encephalopathy have severe to profound intellectual disability. Affected males have breathing problems, with some having ... syndrome , which has signs and symptoms that include intellectual disability, seizures, and movement problems. In some cases, males ...

  3. MODEL OF THE TOKAMAK EDGE DENSITY PEDESTAL INCLUDING DIFFUSIVE NEUTRALS

    SciTech Connect

    BURRELL.KH

    2003-01-01

    OAK-B135 Several previous analytic models of the tokamak edge density pedestal have been based on diffusive transport of plasma plus free-streaming of neutrals. This latter neutral model includes only the effect of ionization and neglects charge exchange. The present work models the edge density pedestal using diffusive transport for both the plasma and the neutrals. In contrast to the free-streaming model, a diffusion model for the neutrals includes the effect of both charge exchange and ionization and is valid when charge exchange is the dominant interaction. Surprisingly, the functional forms for the electron and neutral density profiles from the present calculation are identical to the results of the previous analytic models. There are some differences in the detailed definition of various parameters in the solution. For experimentally relevant cases where ionization and charge exchange rate are comparable, both models predict approximately the same width for the edge density pedestal.

  4. Early Childhood Programs for the Severely Handicapped.

    ERIC Educational Resources Information Center

    Coordinating Office for Regional Resource Centers, Lexington, KY.

    Reference material obtained from responses to questionnaires is presented on 25 early childhood programs for severely handicapped children. Each program report consists of components which include a program abstract; program summary; identification and screening procedures; diagnostic procedures; prescriptive procedures; child progress evaluation;…

  5. The Assessment of Severely Intellectually Disabled Students

    ERIC Educational Resources Information Center

    Kontu, Elina; Pirttimaa, Raija

    2008-01-01

    The aim of this study was to gather information on the tools used by special education teachers for the assessment of severely intellectually disabled students (SID), preparing an individual education plan, and about the methodology used for monitoring their learning progress. The survey included all Finnish special education teachers working with…

  6. Diagnosing and treating severe aplastic anemia.

    PubMed

    McKee, Natasha

    2015-09-01

    Severe aplastic anemia is a disorder of stem cell failure, leading to pancytopenia. The condition is characterized by an impairment of the function of hematopoietic stem cells. Patients typically have fatigue, infections, and increased or unusual bleeding. A bone marrow biopsy establishes the diagnosis. Treatment includes hematopoietic stem cell transplant or immunosuppressive therapy.

  7. Ionic liquids, electrolyte solutions including the ionic liquids, and energy storage devices including the ionic liquids

    DOEpatents

    Gering, Kevin L.; Harrup, Mason K.; Rollins, Harry W.

    2015-12-08

    An ionic liquid including a phosphazene compound that has a plurality of phosphorus-nitrogen units and at least one pendant group bonded to each phosphorus atom of the plurality of phosphorus-nitrogen units. One pendant group of the at least one pendant group comprises a positively charged pendant group. Additional embodiments of ionic liquids are disclosed, as are electrolyte solutions and energy storage devices including the embodiments of the ionic liquid.

  8. Lightning and severe thunderstorms in event management.

    PubMed

    Walsh, Katie M

    2012-01-01

    There are a few national position stands/guidelines that address environmental conditions in athletics, yet they do not govern all outdoor sports. Extreme heat and cold, lightning, and severe wind can all be fatal, yet the majority of outdoor sports have no published guidelines addressing these conditions in relation to activity. Available research on extreme heat and cold conditions in athletics provides prevention strategies, to include acclimatization. Lightning and severe wind are two environmental conditions to which humans cannot accommodate, and they both can be deadly. There are strong positions on extreme heat/cold and lightning safety in athletics, but none affiliated with severe winds. Medical personnel involved in planning large outdoor sporting events must know of the presence of nationally published weather-related documents and apply them to their event. In addition, research needs to be expanded in the realm of establishing guidelines for safety to participants and spectators in severe wind conditions.

  9. Delirium and severe illness: Etiologies, severity of delirium and phenomenological differences.

    PubMed

    Boettger, Soenke; Jenewein, Josef; Breitbart, William

    2015-08-01

    Our aim was to examine the characteristics of delirium in the severely medically ill cancer population on the basis of sociodemographic and medical variables, delirium severity, and phenomenology, as well as severity of medical illness. All subjects in the database were recruited from psychiatric referrals at Memorial Sloan Kettering Cancer Center (MSKCC). Sociodemographic and medical variables, as well as the Karnofsky Performance Status (KPS) scale and Memorial Delirium Assessment Scale (MDAS) scores were recorded at baseline. Subsequently, these variables were analyzed with respect to the severity of the medical illness. Out of 111 patients, 67 qualified as severely medically ill. KPS scores were 19.7 and 30.7 in less severe illness. There were no significant differences with respect to age, history of dementia, and MDAS scores. Although the severity of delirium did not differ, an increased frequency and severity of consciousness disturbance, disorientation, and inability to maintain and shift attention did exist. With respect to etiologies contributing to delirium, hypoxia and infection were commonly associated with severe illness. In contrast, corticosteroid administration was more often associated with less severe illness. There were no differences with respect to opiate administration, dehydration, and CNS disease, including brain metastasis. Delirium in the severely medically ill cancer population has been characterized by an increased disturbance of consciousness, disorientation, and an inability to maintain and shift attention. However, the severity of illness did not predict severity of delirium. Furthermore, hypoxia and infection were etiologies more commonly associated with delirium in severe illness, whereas the administration of corticosteroids was associated with less severe illness.

  10. Delirium and severe illness: Etiologies, severity of delirium and phenomenological differences

    PubMed Central

    BOETTGER, SOENKE; JENEWEIN, JOSEF; BREITBART, WILLIAM

    2017-01-01

    Objective Our aim was to examine the characteristics of delirium in the severely medically ill cancer population on the basis of sociodemographic and medical variables, delirium severity, and phenomenology, as well as severity of medical illness. Method All subjects in the database were recruited from psychiatric referrals at Memorial Sloan Kettering Cancer Center (MSKCC). Sociodemographic and medical variables, as well as the Karnofsky Performance Status (KPS) scale and Memorial Delirium Assessment Scale (MDAS) scores were recorded at baseline. Subsequently, these variables were analyzed with respect to the severity of the medical illness. Results Out of 111 patients, 67 qualified as severely medically ill. KPS scores were 19.7 and 30.7 in less severe illness. There were no significant differences with respect to age, history of dementia, and MDAS scores. Although the severity of delirium did not differ, an increased frequency and severity of consciousness disturbance, disorientation, and inability to maintain and shift attention did exist. With respect to etiologies contributing to delirium, hypoxia and infection were commonly associated with severe illness. In contrast, corticosteroid administration was more often associated with less severe illness. There were no differences with respect to opiate administration, dehydration, and CNS disease, including brain metastasis. Significance of Results Delirium in the severely medically ill cancer population has been characterized by an increased disturbance of consciousness, disorientation, and an inability to maintain and shift attention. However, the severity of illness did not predict severity of delirium. Furthermore, hypoxia and infection were etiologies more commonly associated with delirium in severe illness, whereas the administration of corticosteroids was associated with less severe illness. PMID:25191904

  11. [Severe hypertension: definition and patients profiles].

    PubMed

    Mourad, Jean-Jacques

    2013-05-01

    Severe arterial hypertension gathers relatively different clinical situations explained by the heterogeneity of the definitions of this clinical setting. From a medical point of view, severe hypertension is a short course situation defined by very high values of blood pressure corresponding to grade 3 hypertension. In France, until 2011, the social security also included in the definition of severe HTA chronic situations characterized by moderate blood pressure values requiring at least triple anthihypertensive therapies associated with a clinical or infraclinical target organ damages. These clinical profiles, much more frequent than grade 3 hypertension, allowed the full reimbursement of care costs for these patients. In France, it is estimated that 10% of hypertensive patients present a severe form with an annual incidence of 50,000 patients. The patients with severe hypertension have an increased cardiovascular morbidity justifying a closer clinical monitoring. From an economic point of view, these severe forms of hypertension have a higher cost of care, explained primarily by a more frequent need of specialized referrals, radiological exams and hospitalizations. This excess cost justified the existence of a full coverage of induced costs by the social security, since the incidence of severe hypertension is more frequent in the low social categories, and in patients with economic fragility.

  12. Cogeneration handbook for the textile industry. [Includes glossary

    SciTech Connect

    Not Available

    1984-02-01

    The US Department of Energy (DOE) contracted with Pacific Northwest Laboratory (PNL) to provide the textile plant manager or company energy coordinator with a framework for making a preliminary assessment of the feasibility and viability of cogeneration at a particular plant. The handbook is intended to provide an understanding of the potential of several standardized cogeneration systems, as well as their limitations. However, because the deicision to cogenerate is very site specific, the handbook cannot provide all of the answers. It does attempt, however, to bring to light the major issues that should be addressed in the decision-making process. The decision of whether to cogenerate involves several considerations, including technical, economic, environmental, legal, and regulatory issues. Each of these issues is addressed separately in this handbook. In addition, a chapter is included on preparing a three-phase work statement, which is needed to guide the design of a cogeneration system. Experience has shown that a well-defined work statement can be the key to a rapid and cost-effective design effort. Discussion is presented under the headings: Data Base Development; Matching Cogeneration System Designs; Economic Analysis; Financial Strategies; Environmental Issues; Legal and Contractual Issues; and Three-Phase Work Statements. 18 references, 36 figures, 30 tables.

  13. Addressing questions about including environmental effects in the DMSO HLA

    SciTech Connect

    Hummel, J.R.

    1996-10-01

    The Defense Modeling and Simulation Office (DMSO) is developing a High Level Architecture (HLA) to support the DOD Modeling and Simulation (M and S) community. Many, if not all, of the simulations involve the environment in some fashion. In some applications, the simulation takes place in an acknowledged environment without any environmental functionality being taken into account. The Joint Training Federation Prototype (JTFp) is one of several prototype efforts that have been created to provide a test of the DMSO HLA. In addition to addressing the applicability of the HLA to a training community, the JTFp is also one of two prototype efforts that is explicitly including environmental effects in their simulation effort. These two prototyping efforts are examining the issues associated with the inclusion of the environment in an HLA federation. In deciding whether or not to include an environmental federation in the JTFp effort, a number of questions have been raised about the environment and the HLA. These questions have raised the issue of incompatibility between the environment and the HLA and also shown that there is something unique about including the environment in simulations. The purpose of this White Paper, which was developed with inputs from the National Air and Space [Warfare] Model Program among others, is to address the various questions that have been posed about including environmental effects in an HLA simulation.

  14. Current treatment of severe asthma.

    PubMed

    Hashimoto, S; Bel, E H

    2012-05-01

    Severe asthma is considered a heterogeneous disease in which a variety of clinical, physiological and inflammatory markers determine disease severity. Pivotal studies in the last 5 years have led to substantial progress in many areas, ranging from a more accurate definition of truly severe, refractory asthma, to classification of the disease into distinct clinical phenotypes, and introduction of new therapies. This review focuses on three common clinical phenotypes of severe asthma in adults (early onset severe allergic asthma, late onset non-atopic eosinophilic asthma, late onset non-eosinophilic asthma with obesity), and provides an overview of recent developments regarding treatment options that are best suited for each of these phenotypes. © 2012 Blackwell Publishing Ltd.

  15. Parthenium Dermatitis Severity Score to Assess Clinical Severity of Disease

    PubMed Central

    Verma, Kaushal K; Bansal, Arika; Bhari, Neetu; Sethuraman, Gomathy

    2017-01-01

    Background: Parthenium dermatitis is the most common type of airborne contact dermatitis in India. It is a chronic disease of a remitting and relapsing course with significant morbidity and distress, but there is no scoring system to assess its severity. Aim: To design a scoring system for the assessment of clinical severity of disease in Parthenium dermatitis and to use this scoring system in various studies to determine its sensitivity, specificity, and reproducibility. Methods and Results: In our first few studies on Parthenium dermatitis, we designed and used a basic clinical severity scoring system based on itching, morphology of the lesions, and areas involved. However, in subsequent studies, we modified it to the present scoring system as Parthenium dermatitis severity score (PDSS). Our studies showed the high sensitivity of PDSS in characterization of the disease severity at the given point of time, as well as to determine the efficacy of a prescribed treatment modality which was reliable and reproducible. Conclusion: Thus, PDSS may be used by clinicians for appropriate scoring of the clinical severity of Parthenium dermatitis and in monitoring the disease response to therapy. PMID:28216730

  16. Asthma severity and exposure to occupational asthmogens

    PubMed Central

    Le Moual, Nicole; Siroux, Valérie; Pin, Isabelle; Kauffmann, Francine; Kennedy, Susan

    2005-01-01

    Rationale Severe asthma is a public health problem with limited information regarding preventable causes. Although occupational exposures have been implicated as important risk factors for asthma and asthma exacerbations, associations between occupational exposures and asthma severity have not been reported. Objective To examine associations between occupational exposures and asthma severity. Methods The Epidemiological study on the Genetics and Environment of Asthma combines a case control study with a family study of relatives of asthmatic cases. Adult cases (n=148) were recruited in chest clinics and non-asthmatic controls (n=228) were population-based. Occupational exposures to non-asthmagenic irritants and asthmagens (classified as ‘any asthmagen’ and 3 broad groups (high molecular weight agents, low molecular weight agents, mixed environments)) were assessed by an asthma-specific job exposure matrix. Asthma severity was defined from a 7-grade clinical score (frequency of attacks, persistent symptoms and hospitalisation). Severe (score ≥ 2) and mild asthmatics were compared to controls using nominal logistic regression. Main Results Significant associations were observed between severe adult onset asthma and exposure to any occupational asthmagen (odds ratio 4.0 [95% CI 2.0–8.1]); high molecular weight agents (3.7 [1.3–11.1]); low molecular weight agents (4.4 [1.9–10.1]), including industrial cleaning agents (7.2 [1.3–39.9]); and mixed environments (7.5 [2.4–23.5]). No significant associations were found between non-asthmagenic irritants and asthma severity, nor between asthmagens and childhood onset asthma or mild adult onset asthma. Conclusions Our results suggested a strong deleterious role of occupational asthmagens in severe asthma. Clinicians should consider occupational exposures in patients with moderate to severe asthma. PMID:15961697

  17. Catalyst support structure, catalyst including the structure, reactor including a catalyst, and methods of forming same

    DOEpatents

    Van Norman, Staci A.; Aston, Victoria J.; Weimer, Alan W.

    2017-05-09

    Structures, catalysts, and reactors suitable for use for a variety of applications, including gas-to-liquid and coal-to-liquid processes and methods of forming the structures, catalysts, and reactors are disclosed. The catalyst material can be deposited onto an inner wall of a microtubular reactor and/or onto porous tungsten support structures using atomic layer deposition techniques.

  18. Who pays the severance tax

    SciTech Connect

    Weinstein, B.L.

    1984-03-01

    Over the past four years, taxes levied by states on energy production have become a source of contention between the ''energy have'' and ''energy have-not'' regions of the nation. The popular notion that the taxes are shifted forward to consumers has gone virtually unchallenged in the policy debate. This paper examines the incidence and burden of severance taxes and also assesses the impact of severance taxation on production, investment, and land use. The author concludes that severance taxes are not shifted forward to consumers but are borne by producers and resources owners in the form of reduced profits and rents. 5 references.

  19. Fracture/Severance of Materials

    NASA Technical Reports Server (NTRS)

    Schimmel, Morry L. (Inventor); Bement, Laurence J. (Inventor); DuBrucq, Glenn F., Jr. (Inventor); Klein, Edward A. (Inventor)

    1998-01-01

    A method for severing or weakening materials is discussed. Explosive cords are placed in grooves on the upper surface of the material to be severed or weakened. The explosive cords are initiated simultaneously to introduce explosive shock waves into the material. These shock waves progress toward the centerline between the explosive cords and the lower surface of the material. Intersecting and reflected waves produce a rarefaction zone on the centerline to fail the material in tension. A groove may also be cut in the lower surface of the material to aid in severing or weakening the material.

  20. Spontaneous pnemomedastinum in acute severe asthma

    PubMed Central

    Aleemuddin, N. M.; Bahmed, Farah

    2010-01-01

    Spontaneous medastinal emphysema, as a complication of acute severe asthma, is an uncommon entity. It usually runs a benign course and resolves spontaneously without any surgical intervention. Recognition of this complication is critical, as it has to be differentiated from other life threatening ones including oesophageal rupture, Boerhave’s syndrome, acute coronary syndrome and pulmonary embolism. This case is being presented to emphasize its recognition in the differential diagnosis of complications arising from acute severe asthma and to present its management strategy in detail. PMID:20859494

  1. Severe acute malnutrition in Asia.

    PubMed

    Ahmed, Tahmeed; Hossain, Muttaquina; Mahfuz, Mustafa; Choudhury, Nuzhat; Hossain, Mir Mobarak; Bhandari, Nita; Lin, Maung Maung; Joshi, Prakash Chandra; Angdembe, Mirak Raj; Wickramasinghe, V Pujitha; Hossain, S M Moazzem; Shahjahan, Mohammad; Irianto, Sugeng Eko; Soofi, Sajid; Bhutta, Zulfiqar

    2014-06-01

    Severe acute malnutrition (SAM) is a common condition that kills children and intellectually maims those who survive. Close to 20 million children under the age of 5 years suffer from SAM globally, and about 1 million of them die each year. Much of this burden takes place in Asia. Six countries in Asia together have more than 12 million children suffering from SAM: 0.6 million in Afghanistan, 0.6 million in Bangladesh, 8.0 million in India, 1.2 million in Indonesia, 1.4 million in Pakistan, and 0.6 million in Yemen. This article is based on a review of SAM burden and intervention programs in Asian countries where, despite the huge numbers of children suffering from the condition, the coverage of interventions is either absent on a national scale or poor. Countries in Asia have to recognize SAM as a major problem and mobilize internal resources for its management. Screening of children in the community for SAM and appropriate referral and back referral require good health systems. Improving grassroots services will not only contribute to improving management of SAM, it will also improve infant and young child feeding and nutrition in general. Ready-to-use therapeutic food (RUTF), the key to home management of SAM without complications, is still not endorsed by many countries because of its unavailability in the countries and its cost. It should preferably be produced locally from locally available food ingredients. Countries in Asia that do not have the capacity to produce RUTF from locally available food ingredients can benefit from other countries in the region that can produce it. Health facilities in all high-burden countries should be staffed and equipped to treat children with SAM. A continuous cascade of training of health staff on management of SAM can offset the damage that results from staff attrition or transfers. The basic nutrition interventions, which include breastfeeding, appropriate complementary feeding, micronutrient supplementation, and

  2. Microtubule Severing Stymied by Free Tubulin

    NASA Astrophysics Data System (ADS)

    Ross, Jennifer; Bailey, Megan

    2015-03-01

    Proper organization of the microtubule cytoskeletal network is required to perform many necessary cellular functions including mitosis, cell development, and cell motility. Network organization is achieved through filament remodeling by microtubule-associated proteins (MAPs) that control microtubule dynamics. MAPs that stabilize are relatively well understood, while less is known about destabilizing MAPs, such as severing enzymes. Katanin, the first-discovered microtubule-severing enzyme, is a AAA + enzyme that oligomerizes into hexamers and uses ATP hydrolysis to sever microtubules. Using quantitative fluorescence imaging on reconstituted microtubule severing assays in vitro we investigate how katanin can regulate microtubule dynamics. Interestingly, we find microtubule dynamics inhibits katanin severing activity; dynamic microtubules are not severed. Using systematic experiments introducing free tubulin into the assays we find that free tubulin can compete for microtubule filaments for the katanin proteins. Our work indicates that katanin could function best on stabile microtubules or stabile regions of microtubules in cells in regions where free tubulin is sequesters, low, or depleted.

  3. Immunocompromised Children with Severe Adenoviral Respiratory Infection

    PubMed Central

    Tylka, Joanna C.; McCrory, Michael C.; Gertz, Shira J.; Custer, Jason W.; Spaeder, Michael C.

    2016-01-01

    Purpose. To investigate the impact of severe respiratory adenoviral infection on morbidity and case fatality in immunocompromised children. Methods. Combined retrospective-prospective cohort study of patients admitted to the intensive care unit (ICU) in four children's hospitals with severe adenoviral respiratory infection and an immunocompromised state between August 2009 and October 2013. We performed a secondary case control analysis, matching our cohort 1 : 1 by age and severity of illness score with immunocompetent patients also with severe respiratory adenoviral infection. Results. Nineteen immunocompromised patients were included in our analysis. Eleven patients (58%) did not survive to hospital discharge. Case fatality was associated with cause of immunocompromised state (p = 0.015), multiple organ dysfunction syndrome (p = 0.001), requirement of renal replacement therapy (p = 0.01), ICU admission severity of illness score (p = 0.011), and treatment with cidofovir (p = 0.005). Immunocompromised patients were more likely than matched controls to have multiple organ dysfunction syndrome (p = 0.01), require renal replacement therapy (p = 0.02), and not survive to hospital discharge (p = 0.004). One year after infection, 43% of immunocompromised survivors required chronic mechanical ventilator support. Conclusions. There is substantial case fatality as well as short- and long-term morbidity associated with severe adenoviral respiratory infection in immunocompromised children. PMID:27242924

  4. Phenotypes of refractory/severe asthma.

    PubMed

    Bush, Andrew; Fleming, Louise

    2011-09-01

    The acid test of phenotyping is that it leads either to a clinically useful or mechanistically important insight. Phenotypes may change over time, but the exact definition of a phenotype shift is unclear. Methods of phenotyping are either investigator driven, in which a priori prejudices are applied to the data, or (semi) objective, in which mathematical techniques or systems biology approaches are applied to the dataset. However, the composition of the dataset is driven by investigator prejudice. Phenotyping is likely most useful in severe asthma, because mild and moderate asthma responds to simple treatments, and no great subtlety is required. Our non-evidence based approach is to define the subpopulation of genuine severe, therapy-resistant asthmatics from the generality of problematic severe asthma. We then investigate them invasively with bronchoscopy and a steroid trial using intramuscular triamcinolone to determine the nature of any inflammatory process; whether inflammation and symptoms are concordant or discordant; whether the inflammatory process is steroid resistant or sensitive; and whether the child has persistent airflow limitation. Other possibly relevant phenotypes include the child with severe exacerbations; brittle asthma; and severe asthma with fungal sensitization. Severe, therapy resistant asthma is a disparate disease, and only international uniform approaches, carefully characterising the children as a prelude to focussed clinical trials will allow progress to be made, and vindicate (or otherwise) our suggested approach.

  5. Use of biologics in severe food allergies.

    PubMed

    Fiocchi, Alessandro; Pecora, Valentina; Valluzzi, Rocco L; Fierro, Vincenzo; Mennini, Maurizio

    2017-06-01

    Severe cases of food allergy account for the majority of the burden in terms of risks, quality of life, and resource expenditure. The traditional approach to these forms has been strict avoidance. More recently, Oral ImmunoTherapy (OIT) has gained a role in their management. However, in severe food allergies OIT is often infeasible. Case reports, observational, and prospective studies have recently proposed different approaches to severe food allergy. The majority of them include the use of biologics. Omalizumab has been the most studied drug for severe food allergies, and its role as adjuvant treatment to OIT is well established. Interest has been raised on other biologics, as dupilumab, reslizumab, and mepolizumab. Toll-like receptor agonists, and gene therapy using adeno-associated virus coding for Omalizumab are promising alternatives. The recent studies are deeply influencing the clinical practice. We review the modifications of the clinical approach to severe food allergies so far available. We indicate the possible evolutions of treatment with biologics in severe food allergies.

  6. Severe Brachial Plexus Injuries in American Football.

    PubMed

    Daly, Charles A; Payne, S Houston; Seiler, John G

    2016-11-01

    This article reports a series of severe permanent brachial plexus injuries in American football players. The authors describe the mechanisms of injury and outcomes from a more contemporary treatment approach in the form of nerve transfer tailored to the specific injuries sustained. Three cases of nerve transfer for brachial plexus injury in American football players are discussed in detail. Two of these patients regained functional use of the extremity, but 1 patient with a particularly severe injury did not regain significant function. Brachial plexus injuries are found along a spectrum of brachial plexus stretch or contusion that includes the injuries known as "stingers." Early identification of these severe brachial plexus injuries allows for optimal outcomes with timely treatment. Diagnosis of the place of a given injury along this spectrum is difficult and requires a combination of imaging studies, nerve conduction studies, and close monitoring of physical examination findings over time. Although certain patients may be at higher risk for stingers, there is no evidence to suggest that this correlates with a higher risk of severe brachial plexus injury. Unfortunately, no equipment or strengthening program has been shown to provide a protective effect against these severe injuries. Patients with more severe injuries likely have less likelihood of functional recovery. In these patients, nerve transfer for brachial plexus injury offers the best possibility of meaningful recovery without significant morbidity. [ Orthopedics. 2016; 39(6):e1188-e1192.].

  7. Severe ocular self-injury.

    PubMed

    Field, H L; Waldfogel, S

    1995-05-01

    To further delineate the clinical characteristics of patients who deliberately, severely mutilate their eyes, we reviewed the medical records of a specialty eye hospital and found nine cases of intentional, severe, self-inflicted eye injuries. We identified two groups of patients. Most were young psychotic individuals with severe psychopathology often involving sexual and religious delusions, command hallucinations, and the propensity to act on delusions. The second group was comprised of patients with organic disabilities, either dementia or severe mental retardation, where a lack of impulse control and preexisting eye irritation or surgical operation may have contributed to the act. One patient was a recidivist. Two-thirds of the patients were confined at the time of the act. That self-mutilation may occur frequently in confined patients calls for active vigilance from caretakers; that it may recur calls for caution by the psychiatrist.

  8. [The cost of severe dementia].

    PubMed

    Joël, Marie-Eve

    2005-03-01

    The aim of the present article is to analyse the methodological difficulties to assess the economic cost of severe dementia from the available data, and the shortcomings of an exclusively economic approach. It is very difficult to provide a reliable account of the cost of severe dementia, when ignoring the initial assessment of the severity and the socio-economic context of the care given to demented persons. When assessing the cost of severe dementia, one needs to know who are the affected individuals, and what medical care they are given - whether at home or inside an institution. While the direct cost can be easily assessed, the indirect cost is more difficult to calculate, and particularly the productivity loss for the caring persons, when they are in occupational activity. Setting up reliable indicators for the cost of dementia is a long process, which needs a clear definition of the target population of the measurement.

  9. Comparison of shock severity measures

    SciTech Connect

    Baca, T.J.

    1989-01-01

    In an effort to clarify the issues associated with quantifying shock severity, this paper compares the merits of two measures of shock severity. The first measure is the widely used absolute acceleration shock response spectrum (SAA). The second measure of shock severity is relatively new and is known as the shock intensity spectrum (SIS). Overall information content of SAA and SIS spectra are compared and discussed in the context of two shock excitations having known amplitude, duration, and frequency content. The first is a burst of band-limited white noise and the second is a classical haversine pulse. After describing both the SAA and SIS shock measures, numerous examples are described which emphasize the strengths and limitations of each shock characterization method. This discussion reveals how the use of different shock measures may alter an engineer's conclusions about relative shock severity between two shock environments. 8 refs., 15 figs.

  10. Launch Lock Assemblies Including Axial Gap Amplification Devices and Spacecraft Isolation Systems Including the Same

    NASA Technical Reports Server (NTRS)

    Barber, Tim Daniel (Inventor); Hindle, Timothy (Inventor); Young, Ken (Inventor); Davis, Torey (Inventor)

    2014-01-01

    Embodiments of a launch lock assembly are provided, as are embodiments of a spacecraft isolation system including one or more launch lock assemblies. In one embodiment, the launch lock assembly includes first and second mount pieces, a releasable clamp device, and an axial gap amplification device. The releasable clamp device normally maintains the first and second mount pieces in clamped engagement; and, when actuated, releases the first and second mount pieces from clamped engagement to allow relative axial motion there between. The axial gap amplification device normally residing in a blocking position wherein the gap amplification device obstructs relative axial motion between the first and second mount pieces. The axial gap amplification device moves into a non-blocking position when the first and second mount pieces are released from clamped engagement to increase the range of axial motion between the first and second mount pieces.

  11. [Severe hyponatremia revealing Sheehan's syndrome].

    PubMed

    Jousten, E; Legros, J J

    2009-01-01

    We describe the case of a young woman admitted for severe hyponatremia due to hypopituitarism caused by a Sheehan's syndrome. Sheehan's syndrome is a rare disorder. It develops after obstetrical hemorrhage that causes ischemic necrosis of the pituitary gland. In most cases, illness appears progressively and diagnosis is made after variable delay. Acute syndrome may develop immediately after delivery in some rare cases. Hyponatremia is a frequent manifestation and may be severe. It is principally caused by secondary adrenal failure.

  12. Fire intensity, fire severity and burn severity: A brief review and suggested usage

    USGS Publications Warehouse

    Keeley, J.E.

    2009-01-01

    Several recent papers have suggested replacing the terminology of fire intensity and fire severity. Part of the problem with fire intensity is that it is sometimes used incorrectly to describe fire effects, when in fact it is justifiably restricted to measures of energy output. Increasingly, the term has created confusion because some authors have restricted its usage to a single measure of energy output referred to as fireline intensity. This metric is most useful in understanding fire behavior in forests, but is too narrow to fully capture the multitude of ways fire energy affects ecosystems. Fire intensity represents the energy released during various phases of a fire, and different metrics such as reaction intensity, fireline intensity, temperature, heating duration and radiant energy are useful for different purposes. Fire severity, and the related term burn severity, have created considerable confusion because of recent changes in their usage. Some authors have justified this by contending that fire severity is defined broadly as ecosystem impacts from fire and thus is open to individual interpretation. However, empirical studies have defined fire severity operationally as the loss of or change in organic matter aboveground and belowground, although the precise metric varies with management needs. Confusion arises because fire or burn severity is sometimes defined so that it also includes ecosystem responses. Ecosystem responses include soil erosion, vegetation regeneration, restoration of community structure, faunal recolonization, and a plethora of related response variables. Although some ecosystem responses are correlated with measures of fire or burn severity, many important ecosystem processes have either not been demonstrated to be predicted by severity indices or have been shown in some vegetation types to be unrelated to severity. This is a critical issue because fire or burn severity are readily measurable parameters, both on the ground and with

  13. [Treatment of severe Rhesus erythroblastosis].

    PubMed

    Bichler, A; Frisch, H

    1977-01-01

    Report about the management of cases of severe Rhesus erythroblastosis. One case is specially discussed because of it's actuality. This was a patient with severe Rh-sensitization (OOD at 450 mm from the beginning of the 30th week of gestation in zone III according to Liley). Because of the haemolytic disease and the chronic fetal distress the Caesarean section was already performed in the 32nd week of gestation after Betamethason treatment of the mother. The Lecithin-Sphingomyelin (L/S) ratio in the amniotic fluid as a criterium of fetal lung maturity raised almost twicefold (from 0.9 to 1.6) after Cortison treatment. The intensive care (assisted ventilation with PEEP, correction of the acidosis and transfusion of packed red cells) of the severely anaemic (Hb 3.5 g%, Hk 15 vol.%) and hydropic newborn was already started in the delivery room. The newborn developed no RDS and was discharged healthy. With reference to this and other cases the management of severe Rh-sensitization before the 34th week of gestation is discussed. Premature infants are mainly susceptable to the development of a Respiratory Distress syndrome (RDS). After antepartum Cortison treatment for prevention of an RDS the date of confinement should be arranged earlier. The value of an early Caesarian section after antepartum Glucocorticoid treatment as compared to the application of intrauterine transfusions in cases of severe erythroblastosis is discussed. It is also reported about recent methods of treatment of severe conditions of hydrops fetalis.

  14. Severity assessment of acute pancreatitis using CT severity index and modified CT severity index: Correlation with clinical outcomes and severity grading as per the Revised Atlanta Classification.

    PubMed

    Sahu, Biswanath; Abbey, Pooja; Anand, Rama; Kumar, Ashok; Tomer, Shaili; Malik, Ekta

    2017-01-01

    To assess the severity of acute pancreatitis (AP) using computed tomography (CT) severity index (CTSI) and modified CT severity index (MCTSI), to correlate with clinical outcome measures, and to assess concordance with severity grading, as per the revised Atlanta classification (RAC). In this prospective study approved by the Institutional Review Board (November 2014 to March 2016), sixty patients with AP (as per the RAC definition) underwent contrast-enhanced computed tomography (CECT) 5-11 days (median 6 days) after symptom onset. Two radiologists, blinded to clinical parameters, independently assessed CTSI and MCTSI (differences were resolved by consensus). Clinical outcome parameters included duration of stay in the hospital and intensive care unit (ICU), presence of persistent organ failure (OF), evidence of infection, need for intervention, and mortality. We included 60 cases [36 males, age range 19-65 (mean 37) years]. As per the RAC, 26 patients had mild AP, 12 moderately severe, and 22 severe AP. According to CTSI and MCTSI, mild, moderate, and severe cases were 27 (45%), 19 (31.7%), 14 (23.3%) and 24 (40%), 10 (16.7%), 26 (43.3%), respectively. MCTSI was concordant with the RAC grading in 54 (90.0%), CTSI was concordant in 47 (78.3%), and both were concordant in 43 (71.7%) cases. Area under the receiver-operating characteristic (ROC) curves (AUROC) was compared by the Hanley and McNeil method. Both CTSI and MCTSI were significantly associated with outcome parameters (P < 0.001), except duration of ICU stay. Sensitivity, specificity, positive predictive value (PPV), and accuracy of CTSI for detecting moderate/severe disease were 97.1%, 100%, 100%, and 98.3% respectively, and of MCTSI were 100%, 92.3%, 94.4%, and 96.7% respectively. Both CTSI and MCTSI showed significant correlation with clinical outcome parameters, and good concordance with RAC grading of severity. MCTSI showed a higher sensitivity but lower specificity than CTSI in differentiating mild

  15. Sex differences in motor characteristics of elementary school children included/not included in swimming training.

    PubMed

    Pavić, Renata; Trninić, Viktorija; Katić, Ratko

    2008-09-01

    The aim of the study was to assess the development of motor abilities in elementary school fifth- to eighth-graders (age 11-14 years) according to sex, age and physical activity. Study sample included 312 subjects divided according to age and sex into four groups: male subjects aged 11-12 (n = 93) and 13-14 years (n = 84); and female subjects aged 11-12 (n = 65) and 13-14 years (n = 70). Then, differences in basic motor abilities between children included (experimental group) and those not included (control group) in swimming training were analyzed. In male fifth- and sixth-graders, experimental group was superior to control group in the variables of trunk repetitive strength, sprint, flexibility and coordination, while in male seventh- and eighth-graders experimental group showed better performance than control group in agility, aerobic endurance and explosive throw and jump strength. In female fifth- and sixth-graders, experimental group proved superior to control group in the variables of explosive strength, coordination, trunk strength and aerobic endurance, whereas in female seventh- and eighth-graders experimental group had better performance in coordination, endurance, explosive strength, speed and flexibility. Discriminative analysis of motor variables between male and female subjects revealed male subjects to be superior in explosive strength, throw strength in particular, coordination and aerobic endurance, whereas female subjects showed better performance in the variables of flexibility and movement frequency, leg movement in particular. Study results showed the formation of appropriate motor system determining achievement of top results in swimming to be influenced by swimming training from age 11 to 14. In male children, motor system was found to integrate coordination/agility, aerobic endurance and explosive strength, whereas in female children it integrated coordination in terms of cortical movement regulation, aerobic endurance, explosive strength

  16. Electrolyte solutions including a phosphoranimine compound, and energy storage devices including same

    DOEpatents

    Klaehn, John R.; Dufek, Eric J.; Rollins, Harry W.; Harrup, Mason K.; Gering, Kevin L.

    2017-09-12

    An electrolyte solution comprising at least one phosphoranimine compound and a metal salt. The at least one phosphoranimine compound comprises a compound of the chemical structure ##STR00001## where X is an organosilyl group or a tert-butyl group and each of R.sup.1, R.sup.2, and R.sup.3 is independently selected from the group consisting of an alkyl group, an aryl group, an alkoxy group, or an aryloxy group. An energy storage device including the electrolyte solution is also disclosed.

  17. [Severe cholestatic hepatitis revealing a DRESS syndrome].

    PubMed

    Droz, N; Thiebaut, M; Terrier, B; Bérézné, A; Sogni, P; Beuvon, F; Guillevin, L; Mouthon, L

    2013-10-01

    Drug Rash with Eosinophilia and Systemic Symptoms (DRESS) syndrome is a drug-induced hypersensitivity syndrome, characterized by rash, hyereosinophilia and multiorgan failure, including cytolytic hepatitis. A 75-year-old man, treated with amoxicillin/clavulanic acid, presented with jaundice and disabling pruritus associated with severe cholestatic hepatitis, related to a DRESS syndrome. Because of the persistence of cholestasis and the severity of pruritus, a treatment with corticosteroids and plasma exchanges was initiated, allowing a rapid and complete remission. Amoxicillin/clavulanic acid, although rarely described in the literature, is a rare cause of DRESS syndrome. Severe cholestatic hepatitis associated with disabling pruritus may be one of the systemic manifestations, with a good prognosis using corticosteroids and plasma exchanges. Copyright © 2013 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

  18. Severe eyelid oedema in Graves' ophthalmopathy.

    PubMed

    Anagnostis, Panagiotis; Adamidou, Fotini; Poulasouchidou, Maria; Karras, Spyridon

    2013-07-13

    We report a case of severe eyelid oedema due to Graves' ophthalmopathy (GO). The aim was to present a case report and review of the literature about eyelid oedema due to GO. The case report includes a history of patient data and literature review. The patient was offered intravenous methylprednisolone and gave consent. A dosage of 500 mg intravenous methylprednisolone once weekly for 6 weeks, followed by 250 mg intravenous methylprednisolone once weekly for 6 weeks, with a total treatment period of 12 weeks was given. Up to day, minor improvement has been observed. Severe eyelid oedema due to GO is a rare manifestation of Graves' disease. In cases of active and moderate-to-severe disease, treatment with intravenous glucorticoids is recommended alone or with orbital radiotherapy, followed by rehabilitative surgery.

  19. Severe alpha1-antitrypsin deficiency and pregnancy.

    PubMed

    Dempsey, O J; Godden, D J; Martin, P D; Danielian, P J

    1999-06-01

    This case study describes a successful pregnancy in a 27-yr-old patient with severe emphysema, secondary to alpha1-antitrypsin deficiency, genotype PiZZ. Despite significant respiratory compromise, more severe than previously reported, no complications ensued. Maternal pulmonary function did not deteriorate significantly until the 32nd week of pregnancy, with an elective Caesarean section being performed during the 37th week. This experience suggests that even severe maternal airflow obstruction is, in itself, not an absolute contra-indication to pregnancy. Pre-pregnancy multidisciplinary counselling is likely to be helpful in these patients, including frank discussion on the risks of pregnancy, the prospects of successful completion and the mother's future prognosis in relation to caring for the child.

  20. Measurement of stratospheric HOCl - Concentration profiles, including diurnal variation

    NASA Technical Reports Server (NTRS)

    Chance, K. V.; Johnson, D. G.; Traub, W. A.

    1989-01-01

    Determinations have been made of concentration profiles of HOCl in the earth's stratosphere, including the diurnal variation. Measurements of the rotational Q2 branch at 99.5/cm and of five RR(J3) transitions between 143 and 159/cm were made using far-infrared thermal emission spectroscopy. The spectra were obtained during a balloon flight of the FIRS 2 far-infrared Fourier-transform spectrometer and telescope from Palestine, Texas on May 12-13, 1988. From these measurements, altitude profiles of HOCl from 23 to 42 km are obtained. Daytime and nighttime average profiles of HOCl, as well as measurements on a 30-min time scale through the sunset transition at a single (35 km) altitude are presented. The measured profiles are lower than the current predictions from several modeling groups by a factor of approximately 0.6.

  1. Meson-exchange currents including energy transfer effects

    SciTech Connect

    Hwang, W.P.; Walker, G.E.

    1985-01-01

    The standard formalism of meson-exchange currents is extended to incorporate energy transfer effects. It is possible to make such an extension, in a chirally invariant way, for several exchange currents including those involving an intermediate isobar. It is found that the ''extended'' currents still satisfy conservation of the polar vector current (CVC) and partial conservation of the axial vector current (PCAC) where appropriate. The hypothesis of axial locality is found to be valid for the currents considered. Deuteron photodisintegration at intermediate energies is then used to illustrate the numerical importance of the energy transfer effects. A brief survey is carried out for other reactions where the inclusion of energy transfer effects in the evaluation of selected meson-exchange currents is believed important.

  2. Numerical Simulation of Liquid Jet Atomization Including Turbulence Effects

    NASA Technical Reports Server (NTRS)

    Trinh, Huu P.; Chen, C. P.; Balasubramanyam, M. S.

    2005-01-01

    This paper describes numerical implementation of a newly developed hybrid model, T-blob/T-TAB, into an existing computational fluid dynamics (CFD) program for primary and secondary breakup simulation of liquid jet atomization. This model extend two widely used models, the Kelvin-Helmholtz (KH) instability of Reitz (blob model) and the Taylor-Analogy-Breakup (TAB) secondary droplet breakup by O'Rourke and Amsden to include turbulence effects. In the primary breakup model, the level of the turbulence effect on the liquid breakup depends on the characteristic scales and the initial flow conditions. For the secondary breakup, an additional turbulence force acted on parent drops is modeled and integrated into the TAB governing equation. Several assessment studies are presented and the results indicate that the existing KH and TAB models tend to under-predict the product drop size and spray angle, while the current model provides superior results when compared with the measured data.

  3. Numerical Modeling of Electroacoustic Logging Including Joule Heating

    NASA Astrophysics Data System (ADS)

    Plyushchenkov, Boris D.; Nikitin, Anatoly A.; Turchaninov, Victor I.

    It is well known that electromagnetic field excites acoustic wave in a porous elastic medium saturated with fluid electrolyte due to electrokinetic conversion effect. Pride's equations describing this process are written in isothermal approximation. Update of these equations, which allows to take influence of Joule heating on acoustic waves propagation into account, is proposed here. This update includes terms describing the initiation of additional acoustic waves excited by thermoelastic stresses and the heat conduction equation with right side defined by Joule heating. Results of numerical modeling of several problems of propagation of acoustic waves excited by an electric field source with and without consideration of Joule heating effect in their statements are presented. From these results, it follows that influence of Joule heating should be taken into account at the numerical simulation of electroacoustic logging and at the interpretation of its log data.

  4. Evaluation of several finishes on severely weathered wood

    Treesearch

    R. Sam. Williams; Peter. Sotos; William. Feist

    1999-01-01

    Alkyd-, oil-modified-latex-, and latex-based finishes were applied to severely weathered western redcedar and redwood boards that did not have any surface treatment to ameliorate the weathered surface prior to painting. Six finishes were evaluated annually for 11 years for cracking, flaking, erosion, mildew growth, discoloration, and general appearance. Low-solids-...

  5. Severe Childhood Autism: The Family Lived Experience.

    PubMed

    Bessette Gorlin, Jocelyn; McAlpine, Cynthia Peden; Garwick, Ann; Wieling, Elizabeth

    This research examined the experiences of families living with a child with severe autism. There is limited literature on the experiences of families when a child has severe autism as distinct from milder autism and includes the voices of multiple family members. Van Manen's phenomenological approach was used for data collection and analysis. This approach allowed for the use of innovative data sources, including unstructured individual and family interviews, observations, and family lifelines (a pictorial, temporal picture with comments of the families lives). This study included 29 interviews with 22 participants from 11 families. All data were creatively triangulated and interpreted. Six essential themes were identified. First, families experienced autism as mysterious and complex because it is an invisible and unpredictable condition with diagnostic challenges. Second, families described severe autism behaviors that often caused self-injury, harm to others and damaged homes. Third, profound communication deficits resulted in isolation between the family and child. Fourth, families discussed the unrelenting stress from lack of sleep, managing the child's developmental delays, coordinating and financing services, and concern for the child's future. Fifth, families described consequences of isolation from friends, school, the public, and health providers. Sixth, families portrayed their need for compassionate support and formed 'hybrid families' (nuclear, extended families and friends) to gain support. Study results can be utilized to educate nurses/other providers about the unique needs of families with children with severe autism and could influence health care policies to improve the care for families caring for children with severe autism. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Severe forms of food allergy.

    PubMed

    Sarinho, Emanuel; Lins, Maria das Graças Moura

    2017-09-21

    To guide the diagnostic and therapeutic management of severe forms of food allergy. Search in the Medline database using the terms "severe food allergy," "anaphylaxis and food allergy," "generalized urticaria and food allergy," and "food protein-induced enterocolitis syndrome" in the last ten years, searching in the title, abstract, or keyword fields. Food allergy can be serious and life-threatening. Milk, eggs, peanuts, nuts, walnuts, wheat, sesame seeds, shrimp, fish, and fruit can precipitate allergic emergencies. The severity of reactions will depend on associated cofactors such as age, drug use at the onset of the reaction, history and persistence of asthma and/or severe allergic rhinitis, history of previous anaphylaxis, exercise, and associated diseases. For generalized urticaria and anaphylaxis, intramuscular epinephrine is the first and fundamental treatment line. For the treatment in acute phase of food-induced enterocolitis syndrome in the emergency setting, prompt hydroelectrolytic replacement, administration of methylprednisolone and ondansetron IV are necessary. It is important to recommend to the patient with food allergy to maintain the exclusion diet, seek specialized follow-up and, in those who have anaphylaxis, to emphasize the need to carry epinephrine. Severe food allergy may occur in the form of anaphylaxis and food-protein-induced enterocolitis syndrome, which are increasingly observed in the pediatric emergency room; hence, pediatricians must be alert so they can provide the immediate diagnosis and treatment. Copyright © 2017 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  7. Factors influencing severity of peri-implantitis.

    PubMed

    Saaby, Martin; Karring, Eva; Schou, Søren; Isidor, Flemming

    2016-01-01

    To retrospectively assess the influence of potential risk factors, primarily smoking and a prior history of periodontitis, on the severity of peri-implantitis in patients referred for treatment of peri-implantitis. Among 98 patients referred for treatment of peri-implantitis, 34 patients fulfilled the inclusion criteria: one or several implants with peri-implant marginal bone loss ≥2 mm concomitant with bleeding and/or pus on probing. Information about health status, smoking habits, reason for tooth loss, and performed implant treatment were obtained from the patient charts and interviews. Moreover, a detailed extra- and intraoral examination was performed, including intraoral radiographs of all implants. Risk factors were evaluated by a two-way anova at patient level. Smoking and a prior history of periodontitis were significant risk factors for increased severity of peri-implantitis. Furthermore, the presence of both smoking and a prior history of periodontitis did not further increase the severity of peri-implantitis, as compared to either of these two factors alone. Poor marginal fit of the suprastructure and extensive gingival imitations on implant-supported fixed full prostheses may also be potential risk factors. The study indicated that smoking and a prior history of periodontitis were important risk factors for increased severity of peri-implantitis, while concomitant presence of these two risk factors did not further increase the severity of peri-implantitis, as compared to either of these two risk factors alone. Therefore, early diagnosis and adequate treatment of peri-implantitis are important in patients with a prior history of periodontitis and in smokers to minimize the risk of advanced peri-implantitis in conjunction with focus on known risk factors, including meticulous infection control before implant treatment and a systematic maintenance care program. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  8. Severe hypokalemia probably associated with sertraline use.

    PubMed

    Izgi, Cemil; Erdem, Guliz; Mansuroglu, Denyan; Kurtoglu, Nuri; Kara, Mujdat; Gunesdogdu, Fusun

    2014-02-01

    To report a case of ventricular fibrillation caused by severe hypokalemia probably associated with sertraline use. A 48-year-old male patient experienced ventricular fibrillation and cardiac arrest 2 hours after an uneventful coronary angiography procedure, which revealed normal, unobstructed coronary arteries. Blood chemistry was immediately obtained, revealing a very low potassium (K+) level of 2.44 mEq/L. Other blood electrolytes, including magnesium, ECG, and corrected QT intervals, were all within normal limits. A thorough search for an etiology of hypokalemia, including adrenal gland causes, herbal product consumption, and toxic exposure, did not reveal any identifiable cause. This led us to consider the only drug he was on--sertraline 50 mg per day--as the possible culprit. There has been no clear identification of severe hypokalemia associated with sertraline use in the literature. However, there have been a considerable number of self-reported cases of hypokalemia in patients on sertraline therapy. Scoring according to the Naranjo adverse drug reaction scale revealed a probable relationship between severe hypokalemia and sertraline use in our patient. No clear pathogenic mechanism for the effect of sertraline on serum K equilibrium is known. However, considering the number of self-reported incidences and this case report, the effect of sertraline on serum K levels warrants consideration. This is the first documented case report of severe hypokalemia probably associated with sertraline use.

  9. Management of severe asthma in children

    PubMed Central

    Bush, Andrew; Saglani, Sejal

    2012-01-01

    Children who are referred to specialist care with asthma that does not respond to treatment (problematic severe asthma) are a heterogeneous group, with substantial morbidity. The evidence base for management is sparse, and is mostly based on data from studies in children with mild and moderate asthma and on extrapolation of data from studies in adults with severe asthma. In many children with severe asthma, the diagnosis is wrong or adherence to treatment is poor. The first step is a detailed diagnostic assessment to exclude an alternative diagnosis (“not asthma at all”), followed by a multidisciplinary approach to exclude comorbidities (“asthma plus”) and to assess whether the child has difficult asthma (improves when the basic management needs, such as adherence and inhaler technique, are corrected) or true, therapy-resistant asthma (still symptomatic even when the basic management needs are resolved). In particular, environmental causes of secondary steroid resistance should be identified. An individualised treatment plan should be devised depending on the clinical and pathophysiological characterisation. Licensed therapeutic approaches include high-dose inhaled steroids, the Symbicort maintenance and reliever (SMART) regimen (with budesonide and formoterol fumarate), and anti-IgE therapy. Unlicensed treatments include methotrexate, azathioprine, ciclosporin, and subcutaneous terbutaline infusions. Paediatric data are needed on cytokine-specific monoclonal antibody therapies and bronchial thermoplasty. However, despite the interest in innovative approaches, getting the basics right in children with apparently severe asthma will remain the foundation of management for the foreseeable future. PMID:20816548

  10. Management of severe asthma in children.

    PubMed

    Bush, Andrew; Saglani, Sejal

    2010-09-04

    Children who are referred to specialist care with asthma that does not respond to treatment (problematic severe asthma) are a heterogeneous group, with substantial morbidity. The evidence base for management is sparse, and is mostly based on data from studies in children with mild and moderate asthma and on extrapolation of data from studies in adults with severe asthma. In many children with severe asthma, the diagnosis is wrong or adherence to treatment is poor. The first step is a detailed diagnostic assessment to exclude an alternative diagnosis ("not asthma at all"), followed by a multidisciplinary approach to exclude comorbidities ("asthma plus") and to assess whether the child has difficult asthma (improves when the basic management needs, such as adherence and inhaler technique, are corrected) or true, therapy-resistant asthma (still symptomatic even when the basic management needs are resolved). In particular, environmental causes of secondary steroid resistance should be identified. An individualised treatment plan should be devised depending on the clinical and pathophysiological characterisation. Licensed therapeutic approaches include high-dose inhaled steroids, the Symbicort maintenance and reliever (SMART) regimen (with budesonide and formoterol fumarate), and anti-IgE therapy. Unlicensed treatments include methotrexate, azathioprine, ciclosporin, and subcutaneous terbutaline infusions. Paediatric data are needed on cytokine-specific monoclonal antibody therapies and bronchial thermoplasty. However, despite the interest in innovative approaches, getting the basics right in children with apparently severe asthma will remain the foundation of management for the foreseeable future.

  11. Ethical Issues in Withholding Care from Severely Handicapped Infants.

    ERIC Educational Resources Information Center

    Cohen, Libby

    1981-01-01

    Ethical issues are examined that involve withholding medical treatment from severely handicapped infants. Although current laws do not sanction euthanasia, severely handicapped infants are often assisted in dying. Discussion includes society's apparent acceptance of this practice and several solutions to the problems. (Author)

  12. Spotter's Guide for Identifying and Reporting Severe Local Storms.

    ERIC Educational Resources Information Center

    National Oceanic and Atmospheric Administration (DOC), Rockville, MD.

    This guide is designed to assist personnel working in the National Weather Service's Severe Local Storm Spotter Networks in identifying and reporting severe local storms. Provided are pictures of cloud types for severe storms including tornadoes, hail, thunder, lightning, heavy rains, and waterspouts. Instructions for key indications to watch for…

  13. Ethical Issues in Withholding Care from Severely Handicapped Infants.

    ERIC Educational Resources Information Center

    Cohen, Libby

    1981-01-01

    Ethical issues are examined that involve withholding medical treatment from severely handicapped infants. Although current laws do not sanction euthanasia, severely handicapped infants are often assisted in dying. Discussion includes society's apparent acceptance of this practice and several solutions to the problems. (Author)

  14. Preliminary Model of Acute Mountain Sickness Severity

    DTIC Science & Technology

    2010-10-01

    variance, the Akaike information criterion (AIC) and Bayesian information criterion (BIC) were utilized in selecting the final model using the... information and completed an Environmental Symptoms Questionnaire (ESQ). The ESQ assessed AMS severity using the validated AMS-Cerebral (AMS-C) factor...reporting burden for the collection of information is estimated to average 1 hour per response, including the time for reviewing instructions, searching

  15. Hemolytic Disorders Causing Severe Neonatal Hyperbilirubinemia.

    PubMed

    Christensen, Robert D; Yaish, Hassan M

    2015-09-01

    A shortened erythrocyte life span, because of hemolytic disorders, is a common cause of extreme neonatal hyperbilirubinemia. Clinical and laboratory examinations can frequently identify the underlying cause of extreme neonatal hyperbilirubinemia. In this article, several tests, techniques, and approaches have been reviewed, including red blood cell morphology assessment, end-tidal carbon monoxide quantification, eosin-5-maleimide flow cytometry, as well as next-generation DNA sequencing using neonatal jaundice panels. Copyright © 2015 Elsevier Inc. All rights reserved.

  16. Severe aortic stenosis: forgotten associations.

    PubMed

    Godinho, Ana Rita; Amorim, Sandra; Campelo, Manuel; Martins, Elisabete; Lopez Rodriguez, Elisa; Coelho, Rosa; Macedo, Guilherme; Maciel, Maria Júlia

    2014-09-01

    The authors present the case of a 68-year-old man with predominantly right heart failure in the context of severe aortic stenosis associated with pulmonary hypertension. Anemia was diagnosed which, after endoscopic study, was considered to be secondary to angiodysplasia and a diagnosis of Heyde syndrome was made. After valve replacement surgery the patient's heart failure improved and hemoglobin levels stabilized. We present this case to show the need to recognize less common associations of severe aortic stenosis, in order to provide immediate and appropriate treatment.

  17. [Severe sepsis and septic shock].

    PubMed

    Tønnesen, Else; Larsen, Kim

    2014-07-07

    Sepsis, severe sepsis and septic shock are syndromes. The incidence of sepsis is as high as 35% and with mortality rates in the intensive care unit from 27% to 54% in sepsis and septic shock, respectively. Many new treatments have been tested but only few have been implemented in clinical practise. The treatment of severe sepsis and septic shock is based on the Surviving Sepsis Campaign guidelines developed by an international expert panel. Early diagnosis, optimization of haemodynamics, rapid identification of focus and adequate antibiotic treatment are the most important strategies.

  18. Treatment of severe orthopedic infections.

    PubMed

    Dernell, W S

    1999-09-01

    Severe infections are uncommon following orthopedic surgery, yet they can be frustrating for the veterinarian and owner to treat and can result in devastating consequences for the patient. This article reviews the common causes for postoperative infection, reviews established treatment, and introduces newer methods for treatment and control. A thorough understanding of the pathogenesis, application of appropriate diagnostic procedures, the institution of aggressive treatment regimens, with adherence to established principles, will often result in satisfactory outcomes even with severe orthopedic infections. For those more refractory to treatment, the use of newer treatment methods, specifically locally implantable materials for sustained release of antimicrobials can improve success in the treatment of these more difficult cases.

  19. Fluid Resuscitation in Severe Sepsis.

    PubMed

    Loflin, Rob; Winters, Michael E

    2017-02-01

    Since its original description in 1832, fluid resuscitation has become the cornerstone of early and aggressive treatment of severe sepsis and septic shock. However, questions remain about optimal fluid composition, dose, and rate of administration for critically ill patients. This article reviews pertinent physiology of the circulatory system, pathogenesis of septic shock, and phases of sepsis resuscitation, and then focuses on the type, rate, and amount of fluid administration for severe sepsis and septic shock, so providers can choose the right fluid, for the right patient, at the right time.

  20. Classification of Rollovers According to Crash Severity

    PubMed Central

    Digges, K.; Eigen, A.

    2006-01-01

    NASS/CDS 1995–2004 was used to classify rollovers according to severity. The rollovers were partitioned into two classes – rollover as the first event and rollover preceded by an impact with a fixed or non-fixed object. The populations of belted and unbelted were examined separately and combined. The average injury rate for the unbelted was five times that for the belted. Approximately 21% of the severe injuries suffered by belted occupants were in crashes with harmful events prior to the rollover that produced severe damage to the vehicle. This group carried a much higher injury risk than the average. A planar damage measure in addition to the rollover measure was required to adequately capture the crash severity of this population. For rollovers as the first event, approximately 1% of the serious injuries to belted occupants occurred during the first quarter-turn. Rollovers that were arrested during the 1st quarter-turn carried a higher injury rate than average. The number of quarter-turns were grouped in various ways including the number of times the vehicle roof faces the ground (number of vehicle inversions). The number of vehicle inversions was found to be a statistically significant injury predictor for 78% of the belted and unbelted populations with MAIS 3+F injuries in rollovers. The remaining 22% required crash severity metrics in addition to the number of vehicle inversions. PMID:16968634

  1. Sex Differences in Severe Pulmonary Emphysema

    PubMed Central

    Martinez, Fernando J.; Curtis, Jeffrey L.; Sciurba, Frank; Mumford, Jeanette; Giardino, Nicholas D.; Weinmann, Gail; Kazerooni, Ella; Murray, Susan; Criner, Gerard J.; Sin, Donald D.; Hogg, James; Ries, Andrew L.; Han, MeiLan; Fishman, Alfred P.; Make, Barry; Hoffman, Eric A.; Mohsenifar, Zab; Wise, Robert

    2007-01-01

    Rationale: Limited data on sex differences in advanced COPD are available. Objectives: To compare male and female emphysema patients with severe disease. Methods: One thousand fifty-three patients (38.8% female) evaluated for lung volume reduction surgery as part of the National Emphysema Treatment Trial were analyzed. Measurements and Main Results: Detailed clinical, physiological, and radiological assessment, including quantitation of emphysema severity and distribution from helical chest computed tomography, was completed. In a subgroup (n = 101), airway size and thickness was determined by histological analyses of resected tissue. Women were younger and exhibited a lower body mass index (BMI), shorter smoking history, less severe airflow obstruction, lower Dlco and arterial Po2, higher arterial Pco2, shorter six-minute walk distance, and lower maximal wattage during oxygen-supplemented cycle ergometry. For a given FEV1% predicted, age, number of pack-years, and proportion of emphysema, women experienced greater dyspnea, higher modified BODE, more depression, lower SF-36 mental component score, and lower quality of well-being. Overall emphysema was less severe in women, with the difference from men most evident in the outer peel of the lung. Females had thicker small airway walls relative to luminal perimeters. Conclusions: In patients with severe COPD, women, relative to men, exhibit anatomically smaller airway lumens with disproportionately thicker airway walls, and emphysema that is less extensive and characterized by smaller hole size and less peripheral involvement. PMID:17431226

  2. Antecedents of Severe and Nonsevere Medication Errors

    PubMed Central

    Chang, Yun-Kyung; Mark, Barbara A.

    2017-01-01

    Purpose To investigate if differences in antecedents of severe and nonsevere medication errors exist. Design A longitudinal study of 6 months of data from 279 nursing units in 146 randomly selected hospitals in the United States (US). Methods Antecedents of severe and nonsevere medication errors included work environment factors (work dynamics and RN hours), team factors (communication with physicians and nurses’ expertise), person factors (nurses’ education and experience), patient factors (age, health status, and previous hospitalization), and medication-related support services. Generalized estimating equations with a negative binomial distribution were used with nursing units as the unit of analysis. Findings None of the antecedents allowed predicting both types of medication errors. Nurses’ expertise had a negative and medication-related support services had a positive association with nonsevere medication errors. Nurses’ educational level had a significant nonlinear relationship with severe medication errors only: As the percentage of unit BSN-prepared nurses increased, severe medication errors decreased until the percentage of BSN-prepared nurses reached 54%. In contrast, RN experience had a statistically significant relationship with nonsevere medication errors only and nursing units with more experienced nurses reported more nonsevere medication errors. Conclusions Severe and nonsevere medication errors might have different antecedents. Clinical Relevance Error prevention and management strategies should be targeted to specific types of medication errors for best results. PMID:19335680

  3. Sex differences in severe pulmonary emphysema.

    PubMed

    Martinez, Fernando J; Curtis, Jeffrey L; Sciurba, Frank; Mumford, Jeanette; Giardino, Nicholas D; Weinmann, Gail; Kazerooni, Ella; Murray, Susan; Criner, Gerard J; Sin, Donald D; Hogg, James; Ries, Andrew L; Han, MeiLan; Fishman, Alfred P; Make, Barry; Hoffman, Eric A; Mohsenifar, Zab; Wise, Robert

    2007-08-01

    Limited data on sex differences in advanced COPD are available. To compare male and female emphysema patients with severe disease. One thousand fifty-three patients (38.8% female) evaluated for lung volume reduction surgery as part of the National Emphysema Treatment Trial were analyzed. Detailed clinical, physiological, and radiological assessment, including quantitation of emphysema severity and distribution from helical chest computed tomography, was completed. In a subgroup (n = 101), airway size and thickness was determined by histological analyses of resected tissue. Women were younger and exhibited a lower body mass index (BMI), shorter smoking history, less severe airflow obstruction, lower Dl(co) and arterial Po(2), higher arterial Pco(2), shorter six-minute walk distance, and lower maximal wattage during oxygen-supplemented cycle ergometry. For a given FEV(1)% predicted, age, number of pack-years, and proportion of emphysema, women experienced greater dyspnea, higher modified BODE, more depression, lower SF-36 mental component score, and lower quality of well-being. Overall emphysema was less severe in women, with the difference from men most evident in the outer peel of the lung. Females had thicker small airway walls relative to luminal perimeters. In patients with severe COPD, women, relative to men, exhibit anatomically smaller airway lumens with disproportionately thicker airway walls, and emphysema that is less extensive and characterized by smaller hole size and less peripheral involvement.

  4. [Invasive yeast infections in severely burned patients].

    PubMed

    Renau, Ana Isabel; García-Vidal, Carolina; Salavert, Miguel

    2016-01-01

    Currently, there are few studies on candidaemia in the severely burned patient. These patients share the same risk factors for invasive fungal infections as other critically ill patients, but have certain characteristics that make them particularly susceptible. These include the loss of skin barrier due to extensive burns, fungal colonisation of the latter, and the use of hydrotherapy or other topical therapies (occasionally with antimicrobials). In addition, the increased survival rate achieved in recent decades in critically burned patients due to the advances in treatment has led to the increase of invasive Candida infections. This explains the growing interest in making an earlier and more accurate diagnosis, as well as more effective treatments to reduce morbidity and mortality of candidaemia in severe burned patients. A review is presented on all aspects of the burned patient, including the predisposition and risk factors for invasive candidiasis, pathogenesis of candidaemia, underlying immunodeficiency, local epidemiology and antifungal susceptibility, evolution and prognostic factors, as well as other non-Candida yeast infections. Finally, we include specific data on our local experience in the management of candidaemia in severe burned patients, which may serve to quantify the problem, place it in context, and offer a realistic perspective. Copyright © 2016 Asociación Española de Micología. Publicado por Elsevier España, S.L.U. All rights reserved.

  5. Severe accident testing of electrical penetration assemblies

    SciTech Connect

    Clauss, D.B. )

    1989-11-01

    This report describes the results of tests conducted on three different designs of full-size electrical penetration assemblies (EPAs) that are used in the containment buildings of nuclear power plants. The objective of the tests was to evaluate the behavior of the EPAs under simulated severe accident conditions using steam at elevated temperature and pressure. Leakage, temperature, and cable insulation resistance were monitored throughout the tests. Nuclear-qualified EPAs were produced from D. G. O'Brien, Westinghouse, and Conax. Severe-accident-sequence analysis was used to generate the severe accident conditions (SAC) for a large dry pressurized-water reactor (PWR), a boiling-water reactor (BWR) Mark I drywell, and a BWR Mark III wetwell. Based on a survey conducted by Sandia, each EPA was matched with the severe accident conditions for a specific reactor type. This included the type of containment that a particular EPA design was used in most frequently. Thus, the D. G. O'Brien EPA was chosen for the PWR SAC test, the Westinghouse was chosen for the Mark III test, and the Conax was chosen for the Mark I test. The EPAs were radiation and thermal aged to simulate the effects of a 40-year service life and loss-of-coolant accident (LOCA) before the SAC tests were conducted. The design, test preparations, conduct of the severe accident test, experimental results, posttest observations, and conclusions about the integrity and electrical performance of each EPA tested in this program are described in this report. In general, the leak integrity of the EPAs tested in this program was not compromised by severe accident loads. However, there was significant degradation in the insulation resistance of the cables, which could affect the electrical performance of equipment and devices inside containment at some point during the progression of a severe accident. 10 refs., 165 figs., 16 tabs.

  6. Brief Report: Concurrent Validity of Autism Symptom Severity Measures

    ERIC Educational Resources Information Center

    Reszka, Stephanie S.; Boyd, Brian A.; McBee, Matthew; Hume, Kara A.; Odom, Samuel L.

    2014-01-01

    The autism spectrum disorder (ASD) diagnostic classifications, according to the DSM-5, include a severity rating. Several screening and/or diagnostic measures, such as the autism diagnostic and observation schedule (ADOS), Childhood Autism Rating Scale (CARS) and social responsiveness scale (SRS) (teacher and parent versions), include an…

  7. Brief Report: Concurrent Validity of Autism Symptom Severity Measures

    ERIC Educational Resources Information Center

    Reszka, Stephanie S.; Boyd, Brian A.; McBee, Matthew; Hume, Kara A.; Odom, Samuel L.

    2014-01-01

    The autism spectrum disorder (ASD) diagnostic classifications, according to the DSM-5, include a severity rating. Several screening and/or diagnostic measures, such as the autism diagnostic and observation schedule (ADOS), Childhood Autism Rating Scale (CARS) and social responsiveness scale (SRS) (teacher and parent versions), include an…

  8. Remote Observations of Reentering Spacecraft Including the Space Shuttle Orbiter

    NASA Technical Reports Server (NTRS)

    Horvath, Thomas J.; Cagle, Melinda F.; Grinstead, jay H.; Gibson, David

    2013-01-01

    Flight measurement is a critical phase in development, validation and certification processes of technologies destined for future civilian and military operational capabilities. This paper focuses on several recent NASA-sponsored remote observations that have provided unique engineering and scientific insights of reentry vehicle flight phenomenology and performance that could not necessarily be obtained with more traditional instrumentation methods such as onboard discrete surface sensors. The missions highlighted include multiple spatially-resolved infrared observations of the NASA Space Shuttle Orbiter during hypersonic reentry from 2009 to 2011, and emission spectroscopy of comparatively small-sized sample return capsules returning from exploration missions. Emphasis has been placed upon identifying the challenges associated with these remote sensing missions with focus on end-to-end aspects that include the initial science objective, selection of the appropriate imaging platform and instrumentation suite, target flight path analysis and acquisition strategy, pre-mission simulations to optimize sensor configuration, logistics and communications during the actual observation. Explored are collaborative opportunities and technology investments required to develop a next-generation quantitative imaging system (i.e., an intelligent sensor and platform) with greater capability, which could more affordably support cross cutting civilian and military flight test needs.

  9. Risk factors for breast cancer, including occupational exposures.

    PubMed

    Weiderpass, Elisabete; Meo, Margrethe; Vainio, Harri

    2011-03-01

    The knowledge on the etiology of breast cancer has advanced substantially in recent years, and several etiological factors are now firmly established. However, very few new discoveries have been made in relation to occupational risk factors. The International Agency for Research on Cancer has evaluated over 900 different exposures or agents to-date to determine whether they are carcinogenic to humans. These evaluations are published as a series of Monographs (www.iarc.fr). For breast cancer the following substances have been classified as "carcinogenic to humans" (Group 1): alcoholic beverages, exposure to diethylstilbestrol, estrogen-progestogen contraceptives, estrogen-progestogen hormone replacement therapy and exposure to X-radiation and gamma-radiation (in special populations such as atomic bomb survivors, medical patients, and in-utero exposure). Ethylene oxide is also classified as a Group 1 carcinogen, although the evidence for carcinogenicity in epidemiologic studies, and specifically for the human breast, is limited. The classification "probably carcinogenic to humans" (Group 2A) includes estrogen hormone replacement therapy, tobacco smoking, and shift work involving circadian disruption, including work as a flight attendant. If the association between shift work and breast cancer, the most common female cancer, is confirmed, shift work could become the leading cause of occupational cancer in women.

  10. Risk Factors for Breast Cancer, Including Occupational Exposures

    PubMed Central

    Meo, Margrethe; Vainio, Harri

    2011-01-01

    The knowledge on the etiology of breast cancer has advanced substantially in recent years, and several etiological factors are now firmly established. However, very few new discoveries have been made in relation to occupational risk factors. The International Agency for Research on Cancer has evaluated over 900 different exposures or agents to-date to determine whether they are carcinogenic to humans. These evaluations are published as a series of Monographs (www.iarc.fr). For breast cancer the following substances have been classified as "carcinogenic to humans" (Group 1): alcoholic beverages, exposure to diethylstilbestrol, estrogen-progestogen contraceptives, estrogen-progestogen hormone replacement therapy and exposure to X-radiation and gamma-radiation (in special populations such as atomic bomb survivors, medical patients, and in-utero exposure). Ethylene oxide is also classified as a Group 1 carcinogen, although the evidence for carcinogenicity in epidemiologic studies, and specifically for the human breast, is limited. The classification "probably carcinogenic to humans" (Group 2A) includes estrogen hormone replacement therapy, tobacco smoking, and shift work involving circadian disruption, including work as a flight attendant. If the association between shift work and breast cancer, the most common female cancer, is confirmed, shift work could become the leading cause of occupational cancer in women. PMID:22953181

  11. Remote observations of reentering spacecraft including the space shuttle orbiter

    NASA Astrophysics Data System (ADS)

    Horvath, Thomas J.; Cagle, Melinda F.; Grinstead, Jay H.; Gibson, David M.

    Flight measurement is a critical phase in development, validation and certification processes of technologies destined for future civilian and military operational capabilities. This paper focuses on several recent NASA-sponsored remote observations that have provided unique engineering and scientific insights of reentry vehicle flight phenomenology and performance that could not necessarily be obtained with more traditional instrumentation methods such as onboard discrete surface sensors. The missions highlighted include multiple spatially-resolved infrared observations of the NASA Space Shuttle Orbiter during hypersonic reentry from 2009 to 2011, and emission spectroscopy of comparatively small-sized sample return capsules returning from exploration missions. Emphasis has been placed upon identifying the challenges associated with these remote sensing missions with focus on end-to-end aspects that include the initial science objective, selection of the appropriate imaging platform and instrumentation suite, target flight path analysis and acquisition strategy, pre-mission simulations to optimize sensor configuration, logistics and communications during the actual observation. Explored are collaborative opportunities and technology investments required to develop a next-generation quantitative imaging system (i.e., an intelligent sensor and platform) with greater capability, which could more affordably support cross cutting civilian and military flight test needs.

  12. Improving DTI Tractography by including Diagonal Tract Propagation

    PubMed Central

    Taylor, Paul A.; Cho, Kuan-Hung; Lin, Ching-Po; Biswal, Bharat B.

    2012-01-01

    Tractography algorithms have been developed to reconstruct likely WM pathways in the brain from diffusion tensor imaging (DTI) data. In this study, an elegant and simple means for improving existing tractography algorithms is proposed by allowing tracts to propagate through diagonal trajectories between voxels, instead of only rectilinearly to their facewise neighbors. A series of tests (using both real and simulated data sets) are utilized to show several benefits of this new approach. First, the inclusion of diagonal tract propagation decreases the dependence of an algorithm on the arbitrary orientation of coordinate axes and therefore reduces numerical errors associated with that bias (which are also demonstrated here). Moreover, both quantitatively and qualitatively, including diagonals decreases overall noise sensitivity of results and leads to significantly greater efficiency in scanning protocols; that is, the obtained tracts converge much more quickly (i.e., in a smaller amount of scanning time) to those of data sets with high SNR and spatial resolution. Importantly, the inclusion of diagonal propagation adds essentially no appreciable time of calculation or computational costs to standard methods. This study focuses on the widely-used streamline tracking method, FACT (fiber assessment by continuous tracking), and the modified method is termed “FACTID” (FACT including diagonals). PMID:22970125

  13. PTSD and cognitive functioning: importance of including performance validity testing.

    PubMed

    Wisdom, Nick M; Pastorek, Nicholas J; Miller, Brian I; Booth, Jane E; Romesser, Jennifer M; Linck, John F; Sim, Anita H

    2014-01-01

    Many studies have observed an association between post-traumatic stress disorder (PTSD) and cognitive deficits across several domains including memory, attention, and executive functioning. The inclusion of response bias measures in these studies, however, remains largely unaddressed. The purpose of this study was to identify possible cognitive impairments correlated with PTSD in returning OEF/OIF/OND veterans after excluding individuals failing a well-validated performance validity test. Participants included 126 men and 8 women with a history of mild traumatic brain injury (TBI) referred for a comprehensive neuropsychological evaluation as part of a consortium of five Veterans Affairs hospitals. The PTSD CheckList (PCL) and Word Memory Test (WMT) were used to establish symptoms of PTSD and invalid performance, respectively. Groups were categorized as follows: Control (PCL < 50, pass WMT), PTSD-pass (PCL ≥ 50, pass WMT), and PTSD-fail (PCL ≥ 50, fail WMT). As hypothesized, failure on the WMT was associated with significantly poorer performance on almost all cognitive tests administered; however, no significant differences were detected between individuals with and without PTSD symptoms after separating out veterans failing the WMT. These findings highlight the importance of assessing respondent validity in future research examining cognitive functioning in psychiatric illness and warrant further consideration of prior studies reporting PTSD-associated cognitive deficits.

  14. Community Assessment Tool for Public Health Emergencies Including Pandemic Influenza

    SciTech Connect

    ORAU's Oak Ridge Institute for Science Education

    2011-04-14

    The Community Assessment Tool (CAT) for Public Health Emergencies Including Pandemic Influenza (hereafter referred to as the CAT) was developed as a result of feedback received from several communities. These communities participated in workshops focused on influenza pandemic planning and response. The 2008 through 2011 workshops were sponsored by the Centers for Disease Control and Prevention (CDC). Feedback during those workshops indicated the need for a tool that a community can use to assess its readiness for a disaster - readiness from a total healthcare perspective, not just hospitals, but the whole healthcare system. The CAT intends to do just that - help strengthen existing preparedness plans by allowing the healthcare system and other agencies to work together during an influenza pandemic. It helps reveal each core agency partners (sectors) capabilities and resources, and highlights cases of the same vendors being used for resource supplies (e.g., personal protective equipment [PPE] and oxygen) by the partners (e.g., public health departments, clinics, or hospitals). The CAT also addresses gaps in the community's capabilities or potential shortages in resources. This tool has been reviewed by a variety of key subject matter experts from federal, state, and local agencies and organizations. It also has been piloted with various communities that consist of different population sizes, to include large urban to small rural communities.

  15. Chronic lymphocytic leukemia: a clinical review including Korean cohorts

    PubMed Central

    Jeon, Young-Woo; Cho, Seok-Goo

    2016-01-01

    Only 5th decade ago, chronic lymphocytic leukemia (CLL) was only recognized as disease group of presenting features like peripheral lymphocytosis, organomegaly including of splenomegaly. As understanding of disease biology and molecular diagnostic tools are getting improved gradually, characterization of variation in CLL’s clinical courses was facilitated, resulting in better risk stratification and targeted treatments. Consequently multiple new targeted agents have been used in treatment of CLL, it makes improved clinical outcome. Rituximab containing chemoimmunotherapy (combination of rituximab, fludarabine, and cyclophosphamide) have shown better overall response rate and progression-free survival on fit patients’ group in front-line setting, result in standard first-line therapeutic option for CLL. Furthermore, after introducing that the B-cell receptor is crucial for the evolution and progression of CLL, emerging treatments targeting highly activated surface antigens and oncogenic signaling pathways have been associated with several successes in recent decades. These include new anti-CD 20 monoclonal antibody (obinutuzumab), the bruton tyrosine kinase inhibitor (ibrutinib), the phosphatidylinositol 3-kinase inhibitor (idelalisib), and B-cell CLL/lymphoma 2 inhibitor (ABT-199 and ABT-263). So, we discuss not only general pathophysiology of CLL, but also rapidly advancing treatment strategies that are being studied or approved for treatment of CLL. PMID:27044858

  16. Restoration of severely weathered wood

    Treesearch

    R. Sam. Williams; Mark. Knaebe

    2000-01-01

    Severely weathered window units were used to test various restoration methods and pretreatments. Sanded and unsanded units were pretreated with a consolidant or water repellent preservative, finished with an oil- or latex-based paint system, and exposed outdoors near Madison, WI, for five years. Pretreatments were applied to both window sashes (stiles and rails) and...

  17. Polyradiculopathy secondary to severe hypertriglyceridemia.

    PubMed

    Nesbitt, Cassie; Wong, Daniel; Batchelor, Peter

    2015-05-08

    A 74-year-old man presented with a subacute severe thoracic polyradiculopathy affecting the T4-T8 dermatomes bilaterally. Extensive investigation demonstrated markedly raised triglyceride levels of 44 mmol/L (<1.7). The patient's unique presentation is discussed alongside a review of triglyceride-induced neurotoxicity and therapeutic management.

  18. Severe Weather Forecast Decision Aid

    NASA Technical Reports Server (NTRS)

    Bauman, William H., III; Wheeler, Mark

    2005-01-01

    The Applied Meteorology Unit developed a forecast tool that provides an assessment of the likelihood of local convective severe weather for the day in order to enhance protection of personnel and material assets of the 45th Space Wing Cape Canaveral Air Force Station (CCAFS), and Kennedy Space Center (KSC).

  19. Stuttering Severity and Educational Attainment

    ERIC Educational Resources Information Center

    O'Brian, Sue; Jones, Mark; Packman, Ann; Menzies, Ross; Onslow, Mark

    2011-01-01

    Purpose: This study investigated the relationship between self-reported stuttering severity ratings and educational attainment. Method: Participants were 147 adults seeking treatment for stuttering. At pretreatment assessment, each participant reported the highest educational level they had attained and rated their typical and worst stuttering…

  20. Severe thunderstorms and climate change

    NASA Astrophysics Data System (ADS)

    Brooks, H. E.

    2013-04-01

    As the planet warms, it is important to consider possible impacts of climate change on severe thunderstorms and tornadoes. To further that discussion, the current distribution of severe thunderstorms as a function of large-scale environmental conditions is presented. Severe thunderstorms are much more likely to form in environments with large values of convective available potential energy (CAPE) and deep-tropospheric wind shear. Tornadoes and large hail are preferred in high-shear environments and non-tornadic wind events in low shear. Further, the intensity of tornadoes and hail, given that they occur, tends to be almost entirely a function of the shear and only weakly depends on the thermodynamics. Climate model simulations suggest that CAPE will increase in the future and the wind shear will decrease. Detailed analysis has suggested that the CAPE change will lead to more frequent environments favorable for severe thunderstorms, but the strong dependence on shear for tornadoes, particularly the strongest ones, and hail means that the interpretation of how individual hazards will change is open to question. The recent development of techniques to use higher-resolution models to estimate the occurrence of storms of various kinds is discussed. Given the large interannual variability in environments and occurrence of events, caution is urged in interpreting the observational record as evidence of climate change.

  1. Water Recreation and Illness Severity

    EPA Science Inventory

    Abstract Background: The health endpoint of prior studies of water recreation has been the occurrence gastrointestinal (GI) of illness. The use of this dichotomous health outcome fails to take into account the range of symptom severity among those with GI illness, as well as thos...

  2. Severe allergic reaction to Dermabond.

    PubMed

    Perry, Arthur W; Sosin, Michael

    2009-01-01

    The use of 2-octyl cyanoacrylate (Dermabond; Ethicon, Somerville, NJ) for wound closure is increasingly popular. Problems with Dermabond are generally related to application techniques and rarely relate to the chemical nature of the adhesive. This article describes a severe allergic reaction to Dermabond following breast augmentation/mastopexy.

  3. Stuttering Severity and Educational Attainment

    ERIC Educational Resources Information Center

    O'Brian, Sue; Jones, Mark; Packman, Ann; Menzies, Ross; Onslow, Mark

    2011-01-01

    Purpose: This study investigated the relationship between self-reported stuttering severity ratings and educational attainment. Method: Participants were 147 adults seeking treatment for stuttering. At pretreatment assessment, each participant reported the highest educational level they had attained and rated their typical and worst stuttering…

  4. Water Recreation and Illness Severity

    EPA Science Inventory

    Abstract Background: The health endpoint of prior studies of water recreation has been the occurrence gastrointestinal (GI) of illness. The use of this dichotomous health outcome fails to take into account the range of symptom severity among those with GI illness, as well as thos...

  5. [Management of severe arterial hypertension].

    PubMed

    Leeman, M

    2015-09-01

    Severe arterial hypertension is defined as a systolic blood pressure (BP) ≥180 mmHg and/or a diastolic BP ≥ 110 mmHg. Initial assessment is to identify acute, ongoing, target-organ damage such as pulmonary edema, aortic dissection, ... (hypertensive emergency). If so, the patient requires urgent and specific management in a hospital setting. More commonly, however, BP in the severe range is relatively asymptomatic and not associated with end-organ damage (hypertensive urgency). Management can usually be carried out in the ambulatory setting. Severe hypertension should first be confirmed after a period of rest in a quiet room. If BP remains in the severe range, an antihypertensive drug can be initiated. Otherwise, the patient should be referred for further evaluation within a few days ; however, an antihypertensive treatment could be started immediately if there is concern that urgent outpatient follow-up cannot be ensured or if the patient is at high cardiovascular risk. The choice of the first drug should be tailored according to associated conditions and possible contraindications. Some guidelines recommend starting therapy with an antihypertensive combination of two drugs. In all cases, rapid and excessive reduction in BP, which could compromise organ perfusion, must be avoided, especially in elderly patients. In the short-term (days), BP should be progressively lowered to < 160/100 mmHg. In the long term, a BP < 140/90 mmHg should be obtained.

  6. Predicting eczema severity beyond childhood.

    PubMed

    Hon, Kam Lun; Tsang, Yin-Ching K; Poon, Terence Chuen W; Pong, Nga Hin; Kwan, Matthew; Lau, Shirley; Chiu, Yuen-Chun; Wong, Hin-Hei; Leung, Ting-Fan

    2016-02-01

    We evaluated factors associated with eczema severity in adolescence. Nottingham Eczema Severity Score (NESS), family and personal history of atopy, skin prick test for common food and aeroallergens, highest serum IgE level and eosinophil count were evaluated. Patients with paired NESSs (childhood-NESS is NESS performed at <10 years of age; adolescence-NESS is NESS performed at age >10 years) were further analyzed. Adolescence-NESS (n=383 patients) was associated with eczema onset in infancy, dust mite and food allergen sensitization, dietary avoidance, use of wet wrap, traditional Chinese medicine, immunomodulant (azathioprine or cyclosporine), high IgE level, eosinophil count, but not with family/personal history of atopy. Eighty-two patients had both childhood-NESS and adolescence-NESS (mean follow-up of 6.8 years) showing that adolescence-NESS was associated with childhood- NESS severity grades (P=0.034). Of these patients, 48% remained in the same severity grades, whereas 39% improved, and 13% deteriorated from childhood to adolescence. It is not possible to assure parents that their child can outgrow eczema. In eczema prognosis research, long-term follow-up is warranted.

  7. Positive lightning and severe weather

    NASA Astrophysics Data System (ADS)

    Price, C.; Murphy, B.

    2003-04-01

    In recent years researchers have noticed that severe weather (tornados, hail and damaging winds) are closely related to the amount of positive lightning occurring in thunderstorms. On 4 July 1999, a severe derecho (wind storm) caused extensive damage to forested regions along the United States/Canada border, west of Lake Superior. There were 665,000 acres of forest destroyed in the Boundary Waters Canoe Area Wilderness (BWCAW) in Minnesota and Quetico Provincial Park in Canada, with approximately 12.5 million trees blown down. This storm resulted in additional severe weather before and after the occurrence of the derecho, with continuous cloud-to-ground (CG) lightning occurring for more than 34 hours during its path across North America. At the time of the derecho the percentage of positive cloud-to-ground (+CG) lightning measured by the Canadian Lightning Detection Network (CLDN) was greater than 70% for more than three hours, with peak values reaching 97% positive CG lightning. Such high ratios of +CG are rare, and may be useful indicators for short-term forecasts of severe weather.

  8. Severe congenital RYR1-associated myopathy

    PubMed Central

    Bharucha-Goebel, Diana Xerxes; Santi, Mariarita; Medne, Līvija; Zukosky, Kristin; Dastgir, Jahannaz; Shieh, Perry B.; Winder, Thomas; Tennekoon, Gihan; Finkel, Richard S.; Dowling, James J.; Monnier, Nicole

    2013-01-01

    Objective: To report a series of 11 patients on the severe end of the spectrum of ryanodine receptor 1 (RYR1) gene–related myopathy, in order to expand the clinical, histologic, and genetic heterogeneity associated with this group of patients. Methods: Eleven patients evaluated in the neonatal period with severe neonatal-onset RYR1-associated myopathy confirmed by genetic testing were ascertained. Clinical features, molecular testing results, muscle imaging, and muscle histology are reviewed. Results: Clinical features associated with the severe neonatal presentation of RYR1-associated myopathy included decreased fetal movement, hypotonia, poor feeding, respiratory involvement, arthrogryposis, and ophthalmoplegia in 3 patients, and femur fractures or hip dislocation at birth. Four patients had dominant RYR1 mutations, and 7 had recessive RYR1 mutations. One patient had a cleft palate, and another a congenital rigid spine phenotype—findings not previously described in the literature in patients with early-onset RYR1 mutations. Six patients who underwent muscle ultrasound showed relative sparing of the rectus femoris muscle. Histologically, all patients with dominant mutations had classic central cores on muscle biopsy. Patients with recessive mutations showed great histologic heterogeneity, including fibrosis, variation in fiber size, skewed fiber typing, very small fibers, and nuclear internalization with or without ill-defined cores. Conclusions: This series confirms and expands the clinical and histologic variability associated with severe congenital RYR1-associated myopathy. Both dominant and recessive mutations of the RYR1 gene can result in a severe neonatal-onset phenotype, but more clinical and histologic heterogeneity has been seen in those with recessive RYR1 gene mutations. Central cores are not obligatory histologic features in recessive RYR1 mutations. Sparing of the rectus femoris muscle on imaging should prompt evaluation for RYR1-associated

  9. Midodrine for severe orthostatic hypotension.

    PubMed

    2016-05-01

    Midodrine (Bramox-Brancaster Pharma Limited) was authorised in the UK by the Medicines and Healthcare products Regulatory Agency (MHRA) in March 2015 for "the treatment of severe orthostatic hypotension due to autonomic dysfunction in adults when corrective factors have been ruled out and other forms of treatment are inadequate".(1) Previously, midodrine had only been available in the UK as an unlicensed product used on a named-patient basis. It is the first drug to be licensed in the UK for the treatment of orthostatic hypotension. Here we consider the evidence for midodrine in the treatment of severe orthostatic hypotension and how it fits with current management strategies. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  10. Accidental hypothermia in severe trauma.

    PubMed

    Vardon, Fanny; Mrozek, Ségolène; Geeraerts, Thomas; Fourcade, Olivier

    2016-10-01

    Hypothermia, along with acidosis and coagulopathy, is part of the lethal triad that worsen the prognosis of severe trauma patients. While accidental hypothermia is easy to identify by a simple measurement, it is no less pernicious if it is not detected or treated in the initial phase of patient care. It is a multifactorial process and is a factor of mortality in severe trauma cases. The consequences of hypothermia are many: it modifies myocardial contractions and may induce arrhythmias; it contributes to trauma-induced coagulopathy; from an immunological point of view, it diminishes inflammatory response and increases the chance of pneumonia in the patient; it inhibits the elimination of anaesthetic drugs and can complicate the calculation of dosing requirements; and it leads to an over-estimation of coagulation factor activities. This review will detail the pathophysiological consequences of hypothermia, as well as the most recent principle recommendations in dealing with it.

  11. [Severe limitation of mouth opening].

    PubMed

    Reiter, S; Winocur, E; Gavish, A; Eli, I

    2004-10-01

    Limitation of mouth opening is a common source of referral to an orofacial pain clinic with a proposed diagnosis of Temporomandibular Joint Dysfunction (TMD). The word "trismus" is defined by the American academy of orofacial pain as: "Myospasm of masticatory muscles specifically causing limited jaw opening; early symptom of tetanus". Therefore, once trismus is suspected, TMD should be ruled out. However, it is not uncommon to find the usage of this term to describe severe limitation of opening by causes other than myospasm, therefore posing the risk of misdiagnosis. The purpose of this article is to describe the differential diagnosis of hard end limitation of opening with emphasis on the clinical tools used to differentiate between muscle source of hard end limitation and other sources of hard end limitation. Several cases of hard end limitation of mouth opening are presented and through them major principles of orofacial diagnosis are discussed.

  12. Memory and head injury severity.

    PubMed

    Dikmen, S; Temkin, N; McLean, A; Wyler, A; Machamer, J

    1987-12-01

    One hundred and two consecutive head injured patients were studied at 1 and 12 months after injury. Their performances were compared with a group of uninjured friends. The results indicate that impairment in memory depends on the type of task used, time from injury to testing, and on the severity of head injury (that is, degree of impaired consciousness). Head injury severity indices are more closely related to behavioural outcome early as compared with later after injury. At 1 year, only those with deep or prolonged impaired consciousness (as represented by greater than 1 day of coma, Glasgow Coma Scale of 8 or less, and post traumatic amnesia of 2 weeks or greater) are performing significantly worse than comparison subjects.

  13. Severe acute malnutrition and infection

    PubMed Central

    Jones, Kelsey D J; Berkley, James A

    2014-01-01

    Severe acute malnutrition (SAM) is associated with increased severity of common infectious diseases, and death amongst children with SAM is almost always as a result of infection. The diagnosis and management of infection are often different in malnourished versus well-nourished children. The objectives of this brief are to outline the evidence underpinning important practical questions relating to the management of infectious diseases in children with SAM and to highlight research gaps. Overall, the evidence base for many aspects covered in this brief is very poor. The brief addresses antimicrobials; antipyretics; tuberculosis; HIV; malaria; pneumonia; diarrhoea; sepsis; measles; urinary tract infection; nosocomial Infections; soil transmitted helminths; skin infections and pharmacology in the context of SAM. The brief is structured into sets of clinical questions, which we hope will maximise the relevance to contemporary practice. PMID:25475887

  14. Severe acute malnutrition and infection.

    PubMed

    Jones, Kelsey D J; Berkley, James A

    2014-12-01

    Severe acute malnutrition (SAM) is associated with increased severity of common infectious diseases, and death amongst children with SAM is almost always as a result of infection. The diagnosis and management of infection are often different in malnourished versus well-nourished children. The objectives of this brief are to outline the evidence underpinning important practical questions relating to the management of infectious diseases in children with SAM and to highlight research gaps. Overall, the evidence base for many aspects covered in this brief is very poor. The brief addresses antimicrobials; antipyretics; tuberculosis; HIV; malaria; pneumonia; diarrhoea; sepsis; measles; urinary tract infection; nosocomial Infections; soil transmitted helminths; skin infections and pharmacology in the context of SAM. The brief is structured into sets of clinical questions, which we hope will maximise the relevance to contemporary practice.

  15. Severe acute pancreatitis and pregnancy.

    PubMed

    Robertson, K W; Stewart, I S; Imrie, C W

    2006-01-01

    For most patients with pregnancy-associated pancreatitis there is little maternal survival threat and only occasionally are there foetal deaths. We describe 4 young women with pregnancy-associated severe acute pancreatitis who each had gallstones. Their ages were 17, 18, 20 and 24 years. Each was a tertiary referral to our unit in Glasgow and each pursued a life-threatening course with hospital stays ranging from 37 to 90 days. One patient required pancreatic necrosectomy for infected necrosis, another had percutaneous management of a pancreatic abscess and 2 had cystogastrostomy as treatment for pancreatic pseudocyst. All underwent early endoscopic sphincterotomy and later cholecystectomy. It is important to be aware that pregnancy-associated acute pancreatitis may be severe, posing a survival threat even in the youngest patients. Gallstones, as we reported almost 20 years ago, are the most common aetiological factor in such patients. Copyright (c) 2006 S. Karger AG, Basel and IAP.

  16. [A severely disturbed lipid profile].

    PubMed

    Mignard, S; Calon, E; Hespel, J-P; Le Treut, A

    2004-01-01

    We report here the case of a 30-year-old woman presenting a disturbed lipid profile since her childhood. The rarity of this pathology (Anderson' disease or chylomicron retention disease) and its recent recognition explain its late detection in this case. The description of the biochemical profile is interesting especially the low level of vitamin A and E which explains the severity of the disease. A vitamin enriched-diet may be useful.

  17. Severe sepsis in older adults.

    PubMed

    Umberger, Reba; Callen, Bonnie; Brown, Mary Lynn

    2015-01-01

    Severe sepsis may be underrecognized in older adults. Therefore, the purpose of this article is to review special considerations related to early detection of severe sepsis in older adults. Normal organ changes attributed to aging may delay early detection of sepsis at the time when interventions have the greatest potential to improve patient outcomes. Systems are reviewed for changes. For example, the cardiovascular system may have a limited or absent compensatory response to inflammation after an infectious insult, and the febrile response and recruitment of white blood cells may be blunted because of immunosenescence in aging. Three of the 4 hallmark responses (temperature, heart rate, and white blood cell count) to systemic inflammation may be diminished in older adults as compared with younger adults. It is important to consider that older adults may not always manifest the typical systemic inflammatory response syndrome. Atypical signs such as confusion, decreased appetite, and unsteady gait may occur before sepsis related organ failure. Systemic inflammatory response syndrome criteria and a comparison of organ failure criteria were reviewed. Mortality rates in sepsis and severe sepsis remain high and are often complicated by multiple organ failures. As the numbers of older adults increase, early identification and prompt treatment is crucial in improving patient outcomes.

  18. Gender differences in addiction severity.

    PubMed

    Díaz-Mesa, Eva M; García-Portilla, Paz; Fernández-Artamendi, Sergio; Sáiz, Pilar A; Bobes Bascarán, Teresa; Casares, María José; Fonseca, Eduardo; Al-Halabí, Susana; Bobes, Julio

    2016-06-14

    Gender has been associated with substance use disorders (SUD). However, there are few studies that have evaluated gender differences in a global and a standardized way, and with a large sample of patients with SUD. Our goal is to analyze the role of gender in addiction severity throughout multiple life domains, using the Addiction Severity Index-6 (ASI-6). A naturalistic, multicenter and prospective study was conducted. A total of 221 patients with SUD (80.1% men) were interviewed with the ASI-6. Our results indicate that the Recent Summary Scores (RSSs) of men and women are similar, with the exception of Psychiatric and Partner- Problems, where women showed higher severity (p = .017 and p = .013, respectively). Statistically significant gender differences were found in certain aspects of the ASI-6 domains: men have more problems of physical health, legal issues, and alcohol and other substance use; and woman score higher in problems of mental health, social network, subjective evaluations of SUD consequences, and treatment needs. These results should be taken into account to improve the identification, prevention, and treatment of SUD.

  19. Immune thrombocytopenia in severe neonatal infections.

    PubMed

    Tate, D Y; Carlton, G T; Johnson, D; Sorenson, R L; Nesbit, M; White, J; Thompson, T; Krivit, W

    1981-03-01

    Thrombocytopenia occurs frequently in newborn infants with sepsis, but the exact mechanism remains obscure in those infants who do not have evidence of disseminated intravascular coagulation. Since recent work has suggested a possible immune mechanism for thrombocytopenia observed in adults with sepsis, we have investigated the role of platelet-associated immunoglobulin in severe neonatal infections. To detect PAIgG we use a method employing protein A and peroxidase-antiperoxidase as a labeled antibody. PAIgG was quantitated by phase contrast microscopy and expressed as a reactive index. Our control group included 16 normal newborn infants whose mean RI was 0.65 +/- 0.01 SE. In addition to the control group, five infants with nonimmune thrombocytopenia were included; their mean RI was 0.66 +/- 0.01 SE. Seventeen newborn infants with severe infections were assayed for PAIgG. Eight of nine infants with bacterial infections had increased RI, with a mean of 1.16 +/- 0.03 SE (P less than 0.01). Six of the eight infants with viral infections had elevated RI, with a mean of 1.23 +/- 0.03 SE (P less than 0.01). These findings suggest that an immune mechanism may be involved in the thrombocytopenia of severe neonatal infection.

  20. Emergency health impact of a severe storm.

    PubMed

    Geehr, E C; Salluzzo, R; Bosco, S; Braaten, J; Wahl, T; Wallenkampf, V

    1989-11-01

    A severe, premature snow storm resulted in widespread loss of power, communications, and transportation in a populous region of the Northeast. Staff in hospital emergency departments centered in the path of the storm reported a large number of injuries and many unexpected health effects related to the storm. A retrospective survey of the five major hospital emergency departments serving the most heavily affected urban and suburban areas was undertaken to determine the emergency health impact of the storm and resulting operational problems. Expected findings included a decrease in emergency department visits the day of the storm, followed by a sharp increase the day after. Clean-up activities accounted for a large number of the injuries, most of which were preventable. Unexpected findings include a large number of carbon monoxide poisonings and disposition and staffing problems created by caring for many patients who lost access to customary home health care services. Emergency department staff are encouraged to engage in public education efforts that may reduce serious illness or injury related to severe weather and its aftermath. Moreover, traditional disaster plans may need to be supplemented in anticipation of the disposition and staffing problems created by a growing population of elderly patients who will be cut off from vital home health care services by severe weather.

  1. 76 FR 23812 - Reliability and Continuity of Communications Networks, Including Broadband Technologies; Effects...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-28

    ... COMMISSION Reliability and Continuity of Communications Networks, Including Broadband Technologies; Effects on Broadband Communications Networks of Damage or Failure of Network Equipment or Severe Overload; Independent Panel Reviewing the Impact of Hurricane Katrina on Communications Networks AGENCY: Federal...

  2. Upgrade Summer Severe Weather Tool in MIDDS

    NASA Technical Reports Server (NTRS)

    Wheeler, Mark M.

    2010-01-01

    The goal of this task was to upgrade the severe weather database from the previous phase by adding weather observations from the years 2004 - 2009, re-analyze the data to determine the important parameters, make adjustments to the index weights depending on the analysis results, and update the MIDDS GUI. The added data increased the period of record from 15 to 21 years. Data sources included local forecast rules, archived sounding data, surface and upper air maps, and two severe weather event databases covering east-central Florida. Four of the stability indices showed increased severe weather predication. The Total Threat Score (TTS) of the previous work was verified for the warm season of 2009 with very good skill. The TTS Probability of Detection (POD) was 88% and the False alarm rate (FAR) of 8%. Based on the results of the analyses, the MIDDS Severe Weather Worksheet GUI was updated to assist the duty forecaster by providing a level of objective guidance based on the analysis of the stability parameters and synoptic-scale dynamics.

  3. Coagulopathy after severe pediatric trauma: A review

    PubMed Central

    Russell, Robert T.; Lisco, Steven J.; Kerby, Jeffrey D.; Pittet, Jean-François

    2014-01-01

    Trauma remains the leading cause of morbidity and mortality in the United States among children from the age 1 year to 21 years old. The most common cause of lethality in pediatric trauma is traumatic brain injury (TBI). Early coagulopathy has been commonly observed after severe trauma and is usually associated with severe hemorrhage and/or traumatic brain injury. In contrast to adult patients, massive bleeding is less common after pediatric trauma. The classical drivers of trauma-induced coagulopathy (TIC) include hypothermia, acidosis, hemodilution and consumption of coagulation factors secondary to local activation of the coagulation system following severe traumatic injury. Furthermore, there is also recent evidence for a distinct mechanism of TIC that involves the activation of the anticoagulant protein C pathway. Whether this new mechanism of posttraumatic coagulopathy plays a role in children is still unknown. The goal of this review is to summarize the current knowledge on the incidence and potential mechanisms of coagulopathy after pediatric trauma and the role of rapid diagnostic tests for early identification of coagulopathy. Finally, we discuss different options for treating coagulopathy after severe pediatric trauma. PMID:24569507

  4. Urine ethanol concentration and alcohol hangover severity.

    PubMed

    Van de Loo, Aurora; Mackus, Marlou; Korte-Bouws, Gerdien; Brookhuis, Karel; Garssen, Johan; Verster, Joris

    2017-01-01

    The aim of this study was to examine the relationship between urine ethanol concentration and alcohol hangover severity. N = 36 healthy social drinkers participated in a naturalistic study, comprising a hangover day and a control day. N = 18 of them have regular hangovers (the hangover group), while the other N = 18 claim to be hangover immune (hangover-immune group). On each test day at 9.30 am, urine samples were collected. Participants rated their overall hangover severity on a scale from 0 (absent) to 10 (extreme), as well as 18 individual hangover symptoms. Urine ethanol concentration was significantly higher on the hangover day when compared to the control day (p = 0.006). On the hangover day, urine ethanol concentration was significantly lower in the hangover-immune group when compared to the hangover group (p = 0.027). In the hangover-immune group, none of the correlations of urine ethanol concentration with individual hangover symptoms was significant. In contrast, in the hangover group, significant correlations were found with a variety of hangover symptoms, including nausea, concentration problems, sleepiness, weakness, apathy, sweating, stomach pain, thirst, heart racing, anxiety, and sleep problems. Urine ethanol levels are significantly associated with the presence and severity of several hangover symptoms.

  5. A validated photonumeric cellulite severity scale.

    PubMed

    Hexsel, D M; Dal'forno, T; Hexsel, C L

    2009-05-01

    With recent advances in the treatment of cellulite and localized fat, a comprehensive objective method of measuring cellulite can be potentially useful, especially since important morphological aspects of cellulite are not part of the current classification. Objective To develop and to validate a new photonumeric cellulite severity. Based on standardized photographs of 55 patients with cellulite, five key morphological aspects of cellulite were identified. A new photonumeric severity scale was developed and validated. The five key morphological features of cellulite were identified and included the number of depressions, depth of depressions, clinical appearance of evident raised lesions, and presence of flaccidity and the grade of cellulite. Each item was graded from 0 to 3, allowing final classification of cellulite as mild, moderate, and severe. Results for validation of the scale are statistically significant (P < 0.05) and are as follows: intraclass correlation coefficient > 0.7; correlation item-total > 0.7, with the exception of the right buttock; intraclass correlation coefficients 0.881-0.922; Cronbach's alpha 0.851-0.989 and factor analysis 68-76%. The proposed photonumeric scale is a consistent, comprehensive, reliable, and reproducible tool for the standardized and objective assessment of the severity of cellulite. Conflicts of interest The authors hereby affirm that neither the manuscript nor any part of it has been published or is being considered for publication elsewhere.

  6. Global anthropogenic emissions of particulate matter including black carbon

    NASA Astrophysics Data System (ADS)

    Klimont, Zbigniew; Kupiainen, Kaarle; Heyes, Chris; Purohit, Pallav; Cofala, Janusz; Rafaj, Peter; Borken-Kleefeld, Jens; Schöpp, Wolfgang

    2017-07-01

    was the most important sector, contributing about 60 % for BC and OC, 45 % for PM2. 5, and less than 40 % for PM10, where large combustion sources and industrial processes are equally important. Global anthropogenic emissions of BC were estimated at about 6.6 and 7.2 Tg in 2000 and 2010, respectively, and represent about 15 % of PM2. 5 but for some sources reach nearly 50 %, i.e. for the transport sector. Our global BC numbers are higher than previously published owing primarily to the inclusion of new sources. This PM estimate fills the gap in emission data and emission source characterization required in air quality and climate modelling studies and health impact assessments at a regional and global level, as it includes both carbonaceous and non-carbonaceous constituents of primary particulate matter emissions. The developed emission dataset has been used in several regional and global atmospheric transport and climate model simulations within the ECLIPSE (Evaluating the Climate and Air Quality Impacts of Short-Lived Pollutants) project and beyond, serves better parameterization of the global integrated assessment models with respect to representation of black carbon and organic carbon emissions, and built a basis for recently published global particulate number estimates.

  7. IV thrombolysis in very severe and severe ischemic stroke

    PubMed Central

    Lees, Kennedy R.; Collas, David; Rand, Viiu-Marika; Mikulik, Robert; Toni, Danilo; Wahlgren, Nils; Ahmed, Niaz

    2015-01-01

    Objective: To study the safety of off-label IV thrombolysis in patients with very severe stroke (NIH Stroke Scale [NIHSS] scores >25) compared with severe stroke (NIHSS scores 15–25), where treatment is within European regulations. Methods: Data were analyzed from 57,247 patients with acute ischemic stroke receiving IV tissue plasminogen activator in 793 hospitals participating in the Safe Implementation of Thrombolysis in Stroke (SITS) International Stroke Thrombolysis Registry (2002–2013). Eight hundred sixty-eight patients (1.5%) had NIHSS scores >25 and 19,995 (34.9%) had NIHSS scores 15–25. Outcome measures were parenchymal hemorrhage, symptomatic intracerebral hemorrhage, mortality, and functional outcome. Results: Parenchymal hemorrhage occurred in 10.7% vs 11.0% (p = 0.79), symptomatic intracerebral hemorrhage per SITS-MOST (SITS–Monitoring Study) in 1.4% vs 2.5% (p = 0.052), death at 3 months in 50.4% vs 26.9% (p < 0.001), and functional independence at 3 months in 14.0% vs 29.0% (p < 0.001) of patients with NIHSS scores >25 and NIHSS scores 15–25, respectively. Multivariate adjustment did not change findings from univariate comparisons. Posterior circulation stroke was more common in patients with NIHSS scores >25 (36.2% vs 7.4%, p < 0.001), who were also more often obtunded or comatose on presentation (58.4% vs 7.1%, p < 0.001). Of patients with NIHSS scores >25, 26.2% were treated >3 hours from symptom onset vs 14.5% with NIHSS scores of 15–25. Conclusions: Our data show no excess risk of cerebral hemorrhage in patients with NIHSS score >25 compared to score 15–25, suggesting that the European contraindication to IV tissue plasminogen activator treatment at NIHSS levels >25 may be unwarranted. Increased mortality and lower rates of functional independence in patients with NIHSS score >25 are explained by higher stroke severity, impaired consciousness on presentation due to posterior circulation ischemia, and longer treatment delays. PMID

  8. Severe teenage acne and risk of endometriosis

    PubMed Central

    Xie, Jing; Kvaskoff, Marina; Li, Yunhui; Zhang, Mingfeng; Qureshi, Abrar A.; Missmer, Stacey A.; Han, Jiali

    2014-01-01

    STUDY QUESTION Is there a relationship between severe teenage acne and endometriosis? SUMMARY ANSWER Endometriosis is positively associated with severe teenage acne. WHAT IS KNOWN ALREADY No studies have specifically explored a possible association between severe acne in adolescence and risk of endometriosis. STUDY DESIGN, SIZE, DURATION This prospective cohort study used data collected from 88 623 female nurses from September 1989 to June 2009 as part of the Nurses' Health Study II (NHS II) cohort. PARTICIPANTS/MATERIALS, SETTING, METHODS Regression models were used to calculate hazard ratios (HRs) and confidence intervals (CIs) for endometriosis among women with and without severe teenage acne. Multivariate models were adjusted for established risk factors of endometriosis. MAIN RESULTS AND THE ROLE OF CHANCE A total of 4 382 laparoscopically confirmed endometriosis cases were documented during 1 132 272 woman-years of follow-up. Compared with women without a history of severe teenage acne, women who had severe teenage acne had a 20% increased risk of endometriosis (HR = 1.20, 95% CI: 1.08–1.32). The association was not affected by adjusting for use of tetracycline or isotretinoin. LIMITATIONS AND REASONS FOR CAUTION The HR is likely to be underestimated since we only included endometriosis cases confirmed by laparoscopy. Although geographically diverse, the NHS II cohort is primarily Caucasian, which may limit generalization to more ethnically diverse populations. WIDER IMPLICATIONS OF THE STUDY The results of this study suggest that severe teenage acne is associated with an increased risk of endometriosis. As a visible and non-invasive clinical indicator, severe teenage acne may be useful for early detection of endometriosis. We bring this counter-intuitive association to the attention of clinicians for the benefit of the patient and an early diagnosis of endometriosis. STUDY FUNDING/COMPETING INTEREST This study was funded by research grant CA176726 from the

  9. Severe teenage acne and risk of endometriosis.

    PubMed

    Xie, Jing; Kvaskoff, Marina; Li, Yunhui; Zhang, Mingfeng; Qureshi, Abrar A; Missmer, Stacey A; Han, Jiali

    2014-11-01

    Is there a relationship between severe teenage acne and endometriosis? Endometriosis is positively associated with severe teenage acne. No studies have specifically explored a possible association between severe acne in adolescence and risk of endometriosis. This prospective cohort study used data collected from 88 623 female nurses from September 1989 to June 2009 as part of the Nurses' Health Study II (NHS II) cohort. Regression models were used to calculate hazard ratios (HRs) and confidence intervals (CIs) for endometriosis among women with and without severe teenage acne. Multivariate models were adjusted for established risk factors of endometriosis. A total of 4 382 laparoscopically confirmed endometriosis cases were documented during 1 132 272 woman-years of follow-up. Compared with women without a history of severe teenage acne, women who had severe teenage acne had a 20% increased risk of endometriosis (HR = 1.20, 95% CI: 1.08-1.32). The association was not affected by adjusting for use of tetracycline or isotretinoin. The HR is likely to be underestimated since we only included endometriosis cases confirmed by laparoscopy. Although geographically diverse, the NHS II cohort is primarily Caucasian, which may limit generalization to more ethnically diverse populations. The results of this study suggest that severe teenage acne is associated with an increased risk of endometriosis. As a visible and non-invasive clinical indicator, severe teenage acne may be useful for early detection of endometriosis. We bring this counter-intuitive association to the attention of clinicians for the benefit of the patient and an early diagnosis of endometriosis. This study was funded by research grant CA176726 from the National Institute of Health. M.K. is supported by a Marie Curie International Outgoing Fellowship within the 7th European Community Framework Programme (#PIOF-GA-2011-302078). The funding agencies had no role in the design of the study, in the analysis and

  10. Personalized medicine in severe influenza.

    PubMed

    Valenzuela-Sánchez, F; Valenzuela-Méndez, B; Rodríguez-Gutiérrez, J F; Rello, J

    2016-06-01

    Existing therapies against infectious diseases may only be effective in limited subpopulations during specific phases of diseases, incorporating theranostics, and there is a clear need to individualize different therapeutic approaches depending on the host. Influenza A virus infection evolves into a severe respiratory failure in some young adult patients, related to an exaggerated inflammatory response. Mortality rates remain high despite antiviral treatment and aggressive respiratory support. The influenza A virus (IAV) infection will induce a proinflammatory innate immune response through recognition of viral RNA by Toll-like receptor (TLR) 7 and retinoic acid-inducible gene 1 (RIG-I) molecules by nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB route). Anti-inflammatory therapies focused on modulating this inflammatory response to "all patients" have not been satisfactory. Steroids should be avoided because they do not improve survival and promote superinfections. Since clinical judgment has often been proven inadequate, interest in the use of biomarkers to monitor host response and to assess severity and complications is growing. It is well known that, if used appropriately, these can be helpful tools to predict not only severity but also mortality. We need more biomarkers that predict host response: it is time to change lactate measurement to proteomics and transcriptomics. Theranostics describes an approach covering both diagnosis and coupled therapy. Death is usually a fatal complication of a dysregulated immune response more than the acute virulence of the infectious agent. Future research demonstrating the usefulness of adjunctive therapy in a subset of critically ill patients with IAV pneumonia is an unmet clinical need.

  11. [Respiratory problems in severe scoliosis].

    PubMed

    Barois, A

    1999-01-01

    In kyphoscoliosis restrictive ventilatory defect occurs. In idiopathic scoliosis vital capacity failure is significantly correlated with Cobb angle, vertebral rotation, and thoracic lordosis. Maximum voluntary ventilation is the most affected measurement. Forced expiratory volume in 1 second is reduced. Residual volume remains longtime normal. Hypoxemia due to decrease of diffusing capacity occurs, with initially reflex hyperventilation hypocapnia, and secondary hypercapnia. Pulmonary hypertension and cor pulmonale is related to hypoventilation and hypoxia. The lung situated on the concave side of the scoliosis curve shows a more functional derangement. Ventilatory pattern consists of low tidal volume and high respiratory rate with increase of ventilatory work. Scoliosis that appears in the earlier stage of the life has the worst respiratory prognosis (before 5 years of age) with impairement of lung and thoracic growth. To stimulate pulmonary and thoracic growth, intermittent ventilatory assistance by pressure preset ventilator should be performed as soon as possible and pursued up to 8 years of age, at least, more if necessity. In over 60 degrees angle idiopathic scoliosis, respiratory failure appears after 40 to 50 years of age. Non invasive ventilatory assistance with preset pressure ventilator by oral way in moderate cases and nocturnal nasal ventilation by volume ventilator or inspiratory assistance ventilator, in the most severe cases are efficient. In very severe and acute respiratory insufficiency (scoliosis over 90 degrees) ventilation by intubation then tractheostomy may be required. Earlier orthopedic management and surgical procedure to correct and stabilize spinal deformities is the best to prevent respiratory insufficiency. For scoliosis below 60 degrees, post operative pulmonary complications are very low, with no requirement of post operative ventilatory support. In very severe respiratory insufficiency treatment of respiratory failure precedes, and

  12. Suggestions for revised definitions of noise quantities, including quantum effects

    NASA Astrophysics Data System (ADS)

    Kerr, A. R.

    1999-03-01

    Recent advances in millimeter- and submillimeter-wavelength receivers and the development of low-noise optical amplifiers focus attention on inconsistencies and ambiguities in the standard definitions of noise quantities and the procedures for measuring them. The difficulty is caused by the zero-point (quantum) noise hf/2 W/Hz, which is present even at absolute zero temperature, and also by the nonlinear dependence at low temperature of the thermal noise power of a resistor on its physical temperature, as given by the Planck law. Until recently, these effects were insignificant in all but the most exotic experiments, and the familiar Rayleigh-Jeans noise formula P=kT W/Hz could safely be used in most situations, Now, particularly in low-noise millimeter-wave and photonic devices, the quantum noise is prominent and the nonlinearity of the Planck law can no longer be neglected. The IEEE Standard Dictionary of Electrical and Electronics Terms gives several definitions of the noise temperature of a resistor or a port, which include: 1) the physical temperature of the resistor and 2) its available noise power density divided by Boltzmann's constant-definitions which are incompatible because of the nature of the Planck radiation law. In addition, there is no indication of whether the zero-point noise should be included as part of the noise temperature. Revised definitions of the common noise quantities are suggested, which resolve the shortcomings of the present definitions. The revised definitions have only a small effect on most RF and microwave measurements, but they provide a common consistent noise terminology from dc to light frequencies.

  13. Diagnosis and investigation in the severe asthma clinic.

    PubMed

    Wark, Peter A B; Hew, Mark; Maltby, Steven; McDonald, Vanessa M; Gibson, Peter G

    2016-01-01

    Severe asthma is recognised as an important and emerging area of unmet need in asthma. The assessment of severe asthma should include three steps; (1) determining the diagnosis of asthma, including verification that the disease is severe asthma, (2) assessing comorbidities and contributing factors that will impact on clinical severity, as well as (3) assessing asthma phenotypes. These steps recognize the importance of heterogeneity in asthma as a key factor that determines the disease course and increasingly the choice of successful therapy. This assessment should be undertaken systematically and is best done by an expert multidisciplinary team. Here, we will outline the important aspects that should be included in the clinical assessment of the patient in the severe asthma clinic, including diagnosis, clinical history, the assessment of important comorbidities and the key investigations needed to support them.

  14. Global planning of several plants

    NASA Technical Reports Server (NTRS)

    Bescos, Sylvie

    1992-01-01

    This paper discusses an attempt to solve the problem of planning several pharmaceutical plants at a global level. The interest in planning at this level is to increase the global control over the production process, to improve its overall efficiency, and to reduce the need for interaction between production plants. In order to reduce the complexity of this problem and to make it tractable, some abstractions were made. Based on these abstractions, a prototype is being developed within the framework of the EUREKA project PROTOS, using Constraint Logic Programming techniques.

  15. Gravity waves in severe weather

    NASA Technical Reports Server (NTRS)

    Bowhill, S. A.; Gnanalingam, S.

    1986-01-01

    With a view to determining the role of severe weather in producing gravity waves, two tests were made. In the first, the wind speed measured at two nearby radiosonde stations, Peoria and Salem, was correlated with the stratosphere gravity-wave intensity at Urbana. Although the gravity-wave intensity fluctuated greatly from day to day, these is little if any correlation with the stratospheric wind speed. This suggests that orographic forcing is not a factor in generating gravity waves in Urbana. On the other hand, a clear correlation is found between cloud to heights exceeding 20,000 ft and an increased gravity-wave amplitude in the stratosphere.

  16. Ageostrophic winds in the severe strom environment

    NASA Technical Reports Server (NTRS)

    Moore, J. T.

    1982-01-01

    The period from 1200 GMT 10 April to 0000 GMT 11 April 1979, during which time several major tornadoes and severe thunderstorms, including the Wichita Falls tornado occurred was studied. A time adjusted, isentropic data set was used to analyze key parameters. Fourth order centered finite differences were used to compute the isallobaric, inertial advective, tendency, inertial advective geostrophic and ageostrophic winds. Explicit isentropic trajectories were computed through the isentropic, inviscid equations of motion using a 15 minute time step. Ageostrophic, geostrophic and total vertical motion fields were computed to judge the relative importance of ageostrophy in enhancing the vertical motion field. It is found that ageostrophy is symptomatic of those mass adjustments which take place during upper level jet streak propagation and can, in a favorable environment, act to increase and release potential instability over meso alpha time periods.

  17. Severe cutaneous adverse reaction to telaprevir.

    PubMed

    Shuster, Marina; Do, Daihung; Nambudiri, Vinod

    2015-01-15

    A 50-year-old woman presented with diffuse, intensely pruritic pink-red papules on her trunk and extremities three weeks after starting combination therapy with ribavirin, telaprevir, and interferon. She also had cervical lymphadenopathy, fever, eosinophilia, and transaminitis consistent with a severe drug reaction to telaprevir. She was started on high potency topical steroids under inpatient observation and recovered within two weeks. Severe cutaneous eruptions secondary to telaprevir have resulted in black-box warnings for potentially fatal skin reactions, including Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) and Stevens-Johnson Syndrome (SJS), and Toxic Epidermal Necrolysis (TEN). Because these reactions carry acute mortality rates of 10%, prompt detection and treatment with steroids are important. As such, physicians should be aware of these potentially lethal side effects.

  18. Dyschromia related to severe combined immunodeficiency.

    PubMed

    Maldonado-Cid, Paola; Noguera-Morel, Lucero; Moreno-Alonso-de-Celada, Ricardo; De-Lucas-Laguna, Raúl; Feito-Rodríguez, Marta; Beato-Merino, Maria José; Casado-Jiménez, Mariano

    2013-12-01

    Severe combined immunodeficiency includes a group of diseases characterized by different inherited immunological defects. A 4-month-old girl diagnosed with Omenn syndrome, a subtype of severe combined immunodeficiency presenting with generalized erythroderma, was referred to our hospital for an allogeneic stem cell transplantation. Days before transplantation, she developed hyperpigmented macules that increased in number in the following months. As the erythroderma resolved after transplantation, diffuse hypopigmentation was simultaneously noted together with the expansion of hyperpigmented lesions. Cutaneous biopsy samples were taken at different moments, showing features of Omenn syndrome at first, and 2 months later changes consistent with hypopigmentation and repigmentation were observed. Although pigmentary disorders are rarely described in this context, these must be taken into account as a possible alternative diagnosis to graft-versus-host disease and toxicoderma in immunosuppressed patients.

  19. cDNA encoding a polypeptide including a hevein sequence

    DOEpatents

    Raikhel, N.V.; Broekaert, W.F.; Chua, N.H.; Kush, A.

    1999-05-04

    A cDNA clone (HEV1) encoding hevein was isolated via polymerase chain reaction (PCR) using mixed oligonucleotides corresponding to two regions of hevein as primers and a Hevea brasiliensis latex cDNA library as a template. HEV1 is 1018 nucleotides long and includes an open reading frame of 204 amino acids. The deduced amino acid sequence contains a putative signal sequence of 17 amino acid residues followed by a 187 amino acid polypeptide. The amino-terminal region (43 amino acids) is identical to hevein and shows homology to several chitin-binding proteins and to the amino-termini of wound-induced genes in potato and poplar. The carboxyl-terminal portion of the polypeptide (144 amino acids) is 74--79% homologous to the carboxyl-terminal region of wound-inducible genes of potato. Wounding, as well as application of the plant hormones abscisic acid and ethylene, resulted in accumulation of hevein transcripts in leaves, stems and latex, but not in roots, as shown by using the cDNA as a probe. A fusion protein was produced in E. coli from the protein of the present invention and maltose binding protein produced by the E. coli. 12 figs.

  20. CDNA encoding a polypeptide including a hevein sequence

    DOEpatents

    Raikhel, Natasha V.; Broekaert, Willem F.; Chua, Nam-Hai; Kush, Anil

    1995-03-21

    A cDNA clone (HEV1) encoding hevein was isolated via polymerase chain reaction (PCR) using mixed oligonucleotides corresponding to two regions of hevein as primers and a Hevea brasiliensis latex cDNA library as a template. HEV1 is 1018 nucleotides long and includes an open reading frame of 204 amino acids. The deduced amino acid sequence contains a putative signal sequence of 17 amino acid residues followed by a 187 amino acid polypeptide. The amino-terminal region (43 amino acids) is identical to hevein and shows homology to several chitin-binding proteins and to the amino-termini of wound-induced genes in potato and poplar. The carboxyl-terminal portion of the polypeptide (144 amino acids) is 74-79% homologous to the carboxyl-terminal region of wound-inducible genes of potato. Wounding, as well as application of the plant hormones abscisic acid and ethylene, resulted in accumulation of hevein transcripts in leaves, stems and latex, but not in roots, as shown by using the cDNA as a probe. A fusion protein was produced in E. coli from the protein of the present invention and maltose binding protein produced by the E. coli.

  1. cDNA encoding a polypeptide including a hevein sequence

    DOEpatents

    Raikhel, Natasha V.; Broekaert, Willem F.; Chua, Nam-Hai; Kush, Anil

    1999-05-04

    A cDNA clone (HEV1) encoding hevein was isolated via polymerase chain reaction (PCR) using mixed oligonucleotides corresponding to two regions of hevein as primers and a Hevea brasiliensis latex cDNA library as a template. HEV1 is 1018 nucleotides long and includes an open reading frame of 204 amino acids. The deduced amino acid sequence contains a putative signal sequence of 17 amino acid residues followed by a 187 amino acid polypeptide. The amino-terminal region (43 amino acids) is identical to hevein and shows homology to several chitin-binding proteins and to the amino-termini of wound-induced genes in potato and poplar. The carboxyl-terminal portion of the polypeptide (144 amino acids) is 74-79% homologous to the carboxyl-terminal region of wound-inducible genes of potato. Wounding, as well as application of the plant hormones abscisic acid and ethylene, resulted in accumulation of hevein transcripts in leaves, stems and latex, but not in roots, as shown by using the cDNA as a probe. A fusion protein was produced in E. coli from the protein of the present invention and maltose binding protein produced by the E. coli.

  2. Allogeneic transplantation strategies including haploidentical transplantation in sickle cell disease.

    PubMed

    Gluckman, Eliane

    2013-01-01

    Sickle cell disease (SCD) is the most common inherited hemoglobinopathy. Despite antenatal counseling and neonatal screening programs implemented in higher income countries, SCD is still associated with multiple morbidities and early mortality. To date, the only curative approach to SCD is hematopoietic stem cell transplantation, but this therapy is not yet established worldwide. The registries of the European Blood and Marrow Transplant (EBMT) and the Centre for International Blood and Marrow Transplant Research (CIBMTR) account, respectively, for 611 and 627 patients receiving transplantations for SCD. Most of these patients were transplanted with grafts from an HLA-identical sibling donor. The main obstacles to increasing the number of transplantations are a lack of awareness on the part of physicians and families, the absence of reliable prognostic factors for severity, and the perceived risk that transplantation complications may outweigh the benefits of early transplantation. Results show that more than 90% of patients having undergone an HLA-identical sibling transplantation after myeloablative conditioning are cured, with very limited complications. Major improvement is expected from the use of new reduced-toxicity conditioning regimens and the use of alternative donors, including unrelated cord blood transplantations and related haploidentical bone marrow or peripheral blood stem cell transplantations.

  3. cDNA encoding a polypeptide including a hevein sequence

    DOEpatents

    Raikhel, N.V.; Broekaert, W.F.; Chua, N.H.; Kush, A.

    1995-03-21

    A cDNA clone (HEV1) encoding hevein was isolated via polymerase chain reaction (PCR) using mixed oligonucleotides corresponding to two regions of hevein as primers and a Hevea brasiliensis latex cDNA library as a template. HEV1 is 1,018 nucleotides long and includes an open reading frame of 204 amino acids. The deduced amino acid sequence contains a putative signal sequence of 17 amino acid residues followed by a 187 amino acid polypeptide. The amino-terminal region (43 amino acids) is identical to hevein and shows homology to several chitin-binding proteins and to the amino-termini of wound-induced genes in potato and poplar. The carboxyl-terminal portion of the polypeptide (144 amino acids) is 74--79% homologous to the carboxyl-terminal region of wound-inducible genes of potato. Wounding, as well as application of the plant hormones abscisic acid and ethylene, resulted in accumulation of hevein transcripts in leaves, stems and latex, but not in roots, as shown by using the cDNA as a probe. A fusion protein was produced in E. coli from the protein of the present invention and maltose binding protein produced by the E. coli. 11 figures.

  4. Analysis of wing truss stresses including the effect of redundancies

    NASA Technical Reports Server (NTRS)

    Warner, E P; Miller, R G

    1921-01-01

    Airplane wing trusses are generally designed to contain redundant members (stagger wires and external drag wires) which, according to common practice, are not taken into account in calculations, so as to simplify the stress analysis by rendering the structure statically determinate. A more accurate method, in which the redundancies are included, involves a solution by means of Castigliano's method of least work. For the purpose of demonstrating the practical application of the method of least work this report presents examples for stresses of several cases of loading worked out for a structure similar to that of the Curtiss JN-4h. Case 1 was taken as the condition of velocity of 100 miles per hour combined with the angle of attack of maximum lift. Case 1a assumed the same loading but neglected the distortion of wooden members in the least-work analysis. So little error was involved in case 1a that this simplified method was employed for each succeeding case. Case 2 assumed a diving speed of 120 miles per hour and an angle of attack of no lift. Case 3 was worked out for the conditions imposed by the sand load recommended in NACA technical note no. 6.

  5. cDNA encoding a polypeptide including a hevein sequence

    SciTech Connect

    Raikhel, N.V.; Broekaert, W.F.; Chua, N.H.; Kush, A.

    2000-07-04

    A cDNA clone (HEV1) encoding hevein was isolated via polymerase chain reaction (PCR) using mixed oligonucleotides corresponding to two regions of hevein as primers and a Hevea brasiliensis latex cDNA library as a template. HEV1 is 1018 nucleotides long and includes an open reading frame of 204 amino acids. The deduced amino acid sequence contains a putative signal sequence of 17 amino acid residues followed by a 187 amino acid polypeptide. The amino-terminal region (43 amino acids) is identical to hevein and shows homology to several chitin-binding proteins and to the amino-termini of wound-induced genes in potato and poplar. The carboxyl-terminal portion of the polypeptide (144 amino acids) is 74--79% homologous to the carboxyl-terminal region of wound-inducible genes of potato. Wounding, as well as application of the plant hormones abscisic acid and ethylene, resulted in accumulation of hevein transcripts in leaves, stems and latex, but not in roots, as shown by using the cDNA as a probe. A fusion protein was produced in E. coli from the protein of the present invention and maltose binding protein produced by the E. coli.

  6. Severe Local Storms Cultural Heritage

    NASA Astrophysics Data System (ADS)

    Gladich, I.; Gallai, I.; Giaiotti, D. B.; Morgan, G. M.; Stel, F.

    2009-09-01

    Local storms always had a deep impact on people communities, mainly because of the severe damage caused, because of their unpredictability and, up to a few years ago, even because of the lack of knowledge and awareness on their physical origin. Because of this large impact on real life and on imagination, people needed and wanted to describe and report the occurrence of these events, giving them suited names. Often, these nouns are related to the myth developed to explain the cause of the events. In this work, a short presentation and description of the popular nouns used to describe severe local storm events in different areas of the World is given. Countries taken into account span from Italy, moving toward Africa and reaching a few communities of Native Americans. The etymology of the names gives interesting information, useful even under the anthropological point of view, on the Culture and Believes of the peoples who adopted them. This research work is the result of an underground activity carried out in the last ten years by the authors, during their contacts with students and researchers coming from different Countries and mainly met at the International Center for Theoretical Physics in Trieste.

  7. Infections in severe alcoholic hepatitis

    PubMed Central

    Karakike, Eleni; Moreno, Christophe; Gustot, Thierry

    2017-01-01

    Severe alcoholic hepatitis (sAH), defined by a modified discriminant function ≥32, is the most severe form of alcohol-induced liver disease and is associated with a 1-month mortality rate of around 30%. Corticosteroid treatment remains the only therapeutic option that improves short-term survival. Infectious complications, occurring in approximately 50% of patients, are the main causes of death, even in patients who benefit from corticosteroids. Liver failure, recent alcohol consumption and immunosuppressive drugs contribute to this infectious risk. Although infection is a well-described feature of cirrhosis, little is known about the characteristics of infections in sAH. Infection is mainly of bacterial origin and frequently affects the respiratory tract. Pathogens classically observed in cirrhosis, such as gram-negative bacilli, are frequently involved, but opportunistic pathogens, such as fungi (Aspergillus fumigatus, Pneumocystis jirovecii) or viruses (Cytomegalovirus, Herpes simplex) may appear, mainly related to corticosteroid treatment. A high level of suspicion with systematic screening and prompt, adequate treatment are warranted to improve outcomes in these patients. Prophylactic strategies in this high-risk population should be assessed in well-designed trials. PMID:28243035

  8. [Development of treatment of severe thoracic injuries].

    PubMed

    Le Brigand, H

    1975-11-01

    About 25 p. 100 of cases of closed trauma of the thorax may be classified as severe, for they rapidly endanger life. Their treatment has made considerable progress since the report of J. Dor and H. Le Brigand in 1960. However, when severe trauma is treated, the mortality has remained unchanged over the last ten years. The treatment of fractures of the sternum includes respiratory assistance and internal fixation of the fractured bones, these two methods together, when correctly applied, give good results. Endothoracic lesions are now better recognised. Hemothorax and pneumothorax are now treated by a well recognised method. Visceral lesions, such as bronchial rupture, or major vascular ruptures, e.g. aorta, and heart lesions may be diagnosed at an early stage and be operated on more often. On the other hand, it is now better recognised that diffuse pulmonary lesions, e.g. pulmonary contusions or "shock lung", which is usually treated by artificial respiration alone, still may have a poor prognosis in some cases. From this it results that many surgical teams have enlarged the indications for early thoracotomy in the same way as laparotomy is more often carried out in abdominal trauma. In fact, these indications require circumspection and thoracotomy should only be carried out in specialised thoracic surgery units. If this is not available, aspiration, drainage, tracheotomy, continuous extension, are still applicable, but it is also necessary for them to be carried out correctly; if not, failures and complications of these minor measures are frequent. The use of these methods has shown the existence of therapeutic failures, including major bilateral bony lesions, diffuse severe lung injuries with resistant anoxia, complex multiple injuries with thoracic involvement and, finally, combined thoracic and cranial lesions, the mortality of which is about 50 p. 100. These facts explain why treatment of severe thoracic trauma gives variable results. The mortality varies from

  9. Following My Severance: A Reprise.

    ERIC Educational Resources Information Center

    Lovitt, Thomas C.

    2000-01-01

    This article provides 10 recommendations for new special education faculty, including: keep and file your papers, be wary of busy colleagues, don't recycle your publications, keep data on your publications, learn to take and give criticism, see the sights when you travel, schedule time with your colleagues, and be quantitative. (CR)

  10. Association between Family History and Keratoconus Severity.

    PubMed

    Naderan, Mohammad; Rajabi, Mohammad Taher; Zarrinbakhsh, Parviz; Naderan, Morteza; Bakhshi, Anahita

    2016-11-01

    The high prevalence of positive family history of keratoconus (KC) in KC patients is well-known. However, the results regarding the association between family history of KC and disease severity are controversial. The aim of this study was to evaluate the possible association between family history and severity of KC. Clinical data of 1496 KC patients were evaluated. All participants were asked if they had had a family member with KC. Topographic and keratometric measurements of KC patients, including central corneal thickness (CCT), thinnest corneal thickness (TCT), mean, flat, and steep keratometry values (K) by the use of Pentacam, best-spectacle corrected visual acuity (BCVA), spherical equivalent (SE), and astigmatism were recorded and compared according to patients with and without a family history of KC, first- or second-degree family members, and the number of family members with KC. Severity of KC was classified according to the Amsler-Krumeich classification. Family history of KC was present in 292 (19.5%) patients. Of those 292 patients who had a family history of KC, 159 (54.5%) had one family member with KC and 133 (45.5%) had two or more family members with KC. There was not a significant difference between corneal pachymetry and K values of the patients with and without a family history of KC (p > 0.05). However, those with a positive family history of KC had more severe disease, according to the Amsler-Krumeich classification (p < 0.05). KC patients who had more family members with KC had significantly lower TCT and significantly higher steep K and astigmatism (p < 0.05), and had more severe disease, according to the Amsler-Krumeich classification (p < 0.05). We suggest that patients with more family members with KC should be subject to screening to identify early disease.

  11. Social networking for adolescents with severe haemophilia.

    PubMed

    Khair, K; Holland, M; Carrington, S

    2012-05-01

    Access to modern treatments allows adolescents with haemophilia to manage their haemophilia at home, with improved treatment outcomes and quality of life, but has reduced peer support and the potential for experiential learning from older peers. Social networking, aided by modern communication technologies, may offer health benefits through peer support. We sought to assess whether or not disease-specific social networking could benefit adolescents with severe haemophilia. A total of 150 adolescents (aged 10-18) with severe haemophilia A or B from 11 UK treatment centres or those who had attended focus groups to explore the potential for a social network designed specifically for their use were surveyed. Teenage boys with severe haemophilia in the UK who responded to an online and paper questionnaire (n = 47; 31% response rate) rarely knew of or socialized with others with haemophilia outside their families. Two-thirds of respondents said they would like to meet others. For 70% of boys, parents were the major source of information about haemophilia, yet more than half said they often had trouble finding answers to their questions. These boys frequently used online social networks to chat with friends. Adolescents with severe haemophilia frequently have limited contact with others and many wish to have greater contact. They may benefit from peer support and experiential learning gained through online social networking. The SixVibe restricted access social network is to be launched in 2011. It includes features designed to promote and facilitate the development of peer-to peer disease management skills for adolescents with severe haemophilia.

  12. Exploratory evaluation of several teratogen warning symbols.

    PubMed

    Goldsworthy, Richard; Kaplan, Brian

    2006-06-01

    Previous research has noted potential inadequacies in the warning labels and symbols used with some teratogenic medications. A clear teratogen warning symbol represents an important component of risk mitigation for accidental teratogen exposure. Several teratogen warning symbols were developed through rapid prototyping and focus groups. A nationally distributed field trial (n = 300) examined the relative effectiveness of 6 candidate symbols, including the symbol in use at the time of the study. Measures included open-ended interpretation, closed-ended preference, and demographic surveys. Each participant was shown a single symbol and asked what it meant, to whom it applied, and what that person should do. Text statements were added to the symbol and participants were asked to reinterpret the warning. Participants were told the intended message of the warning, shown all 6 symbols, and asked to choose the most effective symbol. Four of 6 symbols achieved levels of correct interpretation close to or exceeding the American National Standards Institute (ANSI) benchmark of 85% and none exceeded the ANSI limit of 5% critical confusion. Symbols elicited varying conceptual responses. Respondents considered 1 symbol to be the most effective, by a 4 to 1 margin. Several outcomes varied by age and by ethnicity. Several symbols emerged as viable alternatives to the current symbol; however, no 1 symbol was clearly found to be the most effective. Instead, the symbol considered "best" depends on the messages that are considered most essential to the warning. Additionally, it appears a symbol without the addition of text can convey most, but possibly not all, of the meaning required of the warning label. Next steps should include further symbol refinement, closer examination of text additions to symbols, and validation of the candidate symbols and warnings through a large-scale field trial. (c) 2006 Wiley-Liss, Inc.

  13. Observations of severe turbulence near thunderstorm tops

    NASA Technical Reports Server (NTRS)

    Pantley, K. C.; Lester, Peter F.

    1990-01-01

    Data derived from the flight tapes of two airliners that experienced severe turbulence near thunderstorm tops are used to produce quantitative descriptions of the turbulence and its environment. The likely turbulence-producing processes include a three-dimensional turbulent wake in the lee of a squall line and an updraft in the top of a thunderstorm. Results suggest that current procedures for using surface and airborne weather radar for routing aircraft near thunderstorm tops should be reexamined. Also, although useful rules for safe flight near thunderstorm tops already exist, there is evidence that they are not universally applied.

  14. Severe rhabdomyolysis after excessive bodybuilding.

    PubMed

    Finsterer, J; Zuntner, G; Fuchs, M; Weinberger, A

    2007-12-01

    A 46-year-old male subject performed excessive physical exertion during 4-6 h in a studio for body builders during 5 days. He was not practicing sport prior to this training and denied the use of any aiding substances. Despite muscle aching already after 1 day, he continued the exercises. After the last day, he recognized tiredness and cessation of urine production. Two days after discontinuation of the training, a Herpes simplex infection occurred. Because of acute renal failure, he required hemodialysis. There were absent tendon reflexes and creatine kinase (CK) values up to 208 274 U/L (normal: <170 U/L). After 2 weeks, CK had almost normalized and, after 4 weeks, hemodialysis was discontinued. Excessive muscle training may result in severe, hemodialysis-dependent rhabdomyolysis. Triggering factors may be prior low fitness level, viral infection, or subclinical metabolic myopathy.

  15. Severe scurvy: an underestimated disease.

    PubMed

    Levavasseur, M; Becquart, C; Pape, E; Pigeyre, M; Rousseaux, J; Staumont-Sallé, D; Delaporte, E

    2015-09-01

    Scurvy is one of the oldest diseases in human history. Nowadays, although scurvy tends to become a forgotten disease in developed country, rare cases still occur, especially in people undergoing extreme diet, old people or children with poor diet and patients with malabsorption. We describe three cases of scurvy. The first case is a patient diagnosed with Crohn's disease, the second one is in a context of anorexia nervosa and drug addiction, and the third case is in a context of social isolation. Early recognition of scurvy can be difficult because symptoms may appear nonspecific and can mimic more common conditions. In any patient with spontaneous hematoma and purpura, in the context of nutritional disorder, scurvy should be systematically considered. As this disease can lead to severe complications, such as bone pain, heart failure or gastrointestinal symptoms, nothing should delay vitamin C supplementation, which is a simple and rapidly effective treatment.

  16. [ICSI treatment in severe asthenozoospermia].

    PubMed

    Mitchell, V; Sigala, J; Jumeau, F; Ballot, C; Peers, M C; Decanter, C; Rives, N; Perdrix, A; Rigot, J-M; Escalier, D

    2012-12-01

    In the management of asthenozoospermia, the spermogram-spermocytogram plays an important role during diagnosis. It is of major importance to distinguish between necrozoospermia and sperm vitality. An ultrastructural study of spermatozoa is processed in the case of primary infertility without female implication, severe, unexplained and irreversible asthenozoospermia, sperm vitality at least 50 % and normal concentration of spermatozoa. Ultrastructural flagellar abnormalities are numerous and involve most spermatozoa. ICSI provides a suitable solution for patients with sperm flagellar defects to conceive children with their own gametes but the rate of ICSI success may be influenced by the type of flagellar abnormality. Some fertilization and birth rate failures which are related to some flagellar abnormalities might occur.

  17. Therapeutic interventions in severe asthma.

    PubMed

    Canonica, Giorgio Walter; Senna, Gianenrico; Mitchell, Patrick D; O'Byrne, Paul M; Passalacqua, Giovanni; Varricchi, Gilda

    2016-01-01

    The present paper addresses severe asthma which is limited to 5-10% of the overall population of asthmatics. However, it accounts for 50% or more of socials costs of the disease, as it is responsible for hospitalizations and Emergency Department accesses as well as expensive treatments. The recent identification of different endotypes of asthma, based on the inflammatory pattern, has led to the development of tailored treatments that target different inflammatory mediators. These are major achievements in the perspective of Precision Medicine: a leading approach to the modern treatment strategy. Omalizumab, an anti-IgE antibody, has been the only biologic treatment available on the market for severe asthma during the last decade. It prevents the linkage of the IgE and the receptors, thereby inhibiting mast cell degranulation. In clinical practice omalizumab significantly reduced the asthma exacerbations as well as the concomitant use of oral glucocorticoids. In the "Th2-high asthma" phenotype, the hallmarks are increased levels of eosinophils and other markers (such as periostin). Because anti-IL-5 in this condition plays a crucial role in driving eosinophil inflammation, this cytokine or its receptors on the eosinophil surface has been studied as a potential target for therapy. Two different anti-IL-5 humanized monoclonal antibodies, mepolizumab and reslizumab, have been proven effective in this phenotype of asthma (recently they both came on the market in the United States), as well as an anti-IL-5 receptor alpha (IL5Rα), benralizumab. Other monoclonal antibodies, targeting different cytokines (IL-13, IL-4, IL-17 and TSLP) are still under evaluation, though the preliminary results are encouraging. Finally, AIT, Allergen Immunotherapy, a prototype of Precision Medicine, is considered, also in light of the recent evidences of Sublingual Immunotherapy (SLIT) tablet efficacy and safety in mite allergic asthma patients. Given the high costs of these therapies

  18. SPICE: Simulation Package for Including Flavor in Collider Events

    NASA Astrophysics Data System (ADS)

    Engelhard, Guy; Feng, Jonathan L.; Galon, Iftah; Sanford, David; Yu, Felix

    2010-01-01

    supersymmetric particles in theories with lepton flavor violation. The inputs are the parameters of any of several standard flavor-conserving supersymmetric models, supplemented by flavor-violating parameters determined, for example, by horizontal flavor symmetries. The output are files that may be used for detailed simulation of supersymmetric events at particle colliders. Solution method: Simpson's rule integrator, basic algebraic computation. Additional comments: SPICE interfaces with SOFTSUSY and SUSYHIT to produce the low energy sparticle spectrum. Flavor mixing for sleptons and sneutrinos is fully implemented; flavor mixing for squarks is not included. Running time: <1 minute. Running time is dominated by calculating the possible and relevant three-body flavor-violating decays of sleptons, which is usually 10-15 seconds per slepton. References:B.C. Allanach, Comput. Phys. Commun. 143 (2002) 305, arXiv:hep-ph/0104145. B.C. Allanach, M.A. Bernhardt, arXiv:0903.1805 [hep-ph]. A. Djouadi, M.M. Muhlleitner, M. Spira, Acta Phys. Pol. B 38 (2007) 635, arXiv:hep-ph/0609292.

  19. U.S. and European severe asthma cohorts: what can they teach us about severe asthma?

    PubMed

    Kupczyk, M; Wenzel, S

    2012-08-01

    Asthma is a global health problem affecting around 300 million patients of all ages and ethnic groups in all countries around the world. In the majority of subjects with persistent, mild-to-moderate asthma (MA), the disease can be relatively well controlled by the use of currently available medications; however, five to ten per cent of patients suffer from a particularly severe disease that is poorly controlled clinically and often refractory to usual treatment. Improved care of severe asthma (SA) is a major unmet medical need and several international consortia aim at improving our understanding of mechanisms in SA. To manage SA better, standardized definitions and concepts of asthma severity, risk and level of control are critical. In the following sections, we present several guidelines approaches and definitions followed by an overview of U.S. (SARP) and European (ENFUMOSA, BIOAIR, U-BIOPRED) SA networks. Key findings regarding SA phenotypes, risk factors and pathophysiology are discussed. International cooperation in the area of respiratory diseases, including SA, across the Atlantic Ocean, will lead to a better understanding of asthma pathology, especially of those severe, not well controlled or difficult-to-treat cases. © 2012 The Association for the Publication of the Journal of Internal Medicine.

  20. Practical uses for ecdysteroids in mammals including humans: an update

    PubMed Central

    Lafont, R.; Dinan, L.

    2003-01-01

    Ecdysteroids are widely used as inducers for gene-switch systems based on insect ecdysteroid receptors and genes of interest placed under the control of ecdysteroid-response elements. We review here these systems, which are currently mainly used in vitro with cultured cells in order to analyse the role of a wide array of genes, but which are expected to represent the basis for future gene therapy strategies. Such developments raise several questions, which are addressed in detail. First, the metabolic fate of ecdysteroids in mammals, including humans, is only poorly known, and the rapid catabolism of ecdysteroids may impede their use as in vivo inducers. A second set of questions arose in fact much earlier with the pioneering “heterophylic” studies of Burdette in the early sixties on the pharmacological effects of ecdysteroids on mammals. These and subsequent studies showed a wide range of effects, most of them being beneficial for the organism (e.g. hypoglycaemic, hypocholesterolaemic, anabolic). These effects are reviewed and critically analysed, and some hypotheses are proposed to explain the putative mechanisms involved. All of these pharmacological effects have led to the development of a wide array of ecdysteroid-containing preparations, which are primarily used for their anabolic and/or “adaptogenic” properties on humans (or horses or dogs). In the same way, increasing numbers of patents have been deposited concerning various beneficial effects of ecdysteroids in many medical or cosmetic domains, which make ecdysteroids very attractive candidates for several practical uses. It may be questioned whether all these pharmacological actions are compatible with the development of ecdysteroid-inducible gene switches for gene therapy, and also if ecdysteroids should be classified among doping substances. Abbreviation: 20E 20-hydroxyecdysone 2d20E 2-deoxy-20-hydroxyecdysone 2dE 2-deoxyecdysone BAH bisacylhydrazine BmEcR Bombyx mori EcR CfEcR Choristoneura

  1. Severe storms observing satellite study

    NASA Technical Reports Server (NTRS)

    Iwens, R. P.; Stern, D. A.

    1976-01-01

    Payload distribution and the attitude control system for the multi-mission modular spacecraft/StormSat configuration are discussed. The design of the advanced atmospheric sounder and imaging radiometer (AASIR) gimbal drive and its servomechanism is described. Onboard data handling, data downlink communications, and ground data handling systems are developed. Additional topics covered include: magnetic unloading at synchronous altitude, north-south stationkeeping, and the feasibility and impact of flying the microwave atmospheric sounding radiometer (MASR) as an additional payload.

  2. The Risk Factors for Moderately Severe and Severe Post-Endoscopic Retrograde Cholangiopancreatography Pancreatitis According to the Revised Atlanta Classification.

    PubMed

    Kim, Eui Joo; Cho, Jae Hee; Oh, Kyong Yong; Kim, Su Young; Kim, Yeon Suk

    2017-10-01

    The aim of this study was to confirm the value of the revised Atlanta classification for predicting the severity of post-endoscopic retrograde choloangiopancreatography pancreatitis (PEP) and to validate the risk factors for moderately severe and severe PEP. Among 2672 patients, 86 with PEP and 172 randomly selected control patients were included in this study. Post-endoscopic retrograde choloangiopancreatography pancreatitis was evaluated according to Cotton criteria and the revised Atlanta classification. The agreements between the 2 sets of criteria were compared, and the risk factors for moderately severe and severe PEP were identified. According to the revised Atlanta classification, 72 patients (83.7%) had mild, 11 (12.8%) had moderately severe, and 3 (3.5%) had severe disease. The agreement between the revised Atlanta classification and Cotton criteria was fair (κ = 0.285). Statistically significant risk factors for PEP were difficult cannulation and dye injection in the pancreatic duct, including acinarization. For moderately severe or severe PEP, obesity (hazard ratio, 3.384 [95% confidence interval, 1.023-11.191]) was the only statistically significant risk factor. The revised Atlanta classification of acute pancreatitis is an effective and feasible classification system for predicting PEP severity. Obesity was identified as an important risk factor predicting moderately severe and severe PEP.

  3. Childhood trauma exposure and alcohol dependence severity in adulthood: mediation by emotional abuse severity and neuroticism.

    PubMed

    Schwandt, Melanie L; Heilig, Markus; Hommer, Daniel W; George, David T; Ramchandani, Vijay A

    2013-06-01

    Childhood trauma has been linked with a number of negative outcomes later in life, including alcohol dependence (AD). Previous studies have suggested a mediating role for neuroticism in the relationship between childhood trauma and psychopathology. In this study, we investigate the prevalence of multiple types of childhood trauma in treatment-seeking alcohol-dependent patients, and the associations between childhood trauma and AD severity using multiple mediation analysis. The prevalence of 5 types of childhood trauma-emotional abuse, sexual abuse, physical abuse, emotional neglect, and physical neglect-was assessed in treatment-seeking alcohol-dependent patients (n = 280) and healthy controls (n = 137) using the Childhood Trauma Questionnaire. Multiple mediation analyses were used to model associations between childhood trauma measures and alcohol-related outcomes, primarily the severity of AD in the alcohol-dependent sample. Childhood trauma was significantly more prevalent and more severe in the alcohol-dependent subjects. In addition, childhood trauma was found to influence AD severity, an effect that was mediated by neuroticism. When individual trauma types were examined, emotional abuse was found to be the primary predictor of AD severity, both directly and through the mediating effects of the impulsivity subfacet of neuroticism. Physical abuse also had a moderate direct effect on AD severity. Mediation analysis did not reveal any association between childhood trauma and Alcohol Use Disorders Identification Test score in the nondependent control sample. Childhood trauma is highly prevalent in treatment-seeking alcoholics and may play a significant role in the development and severity of AD through an internalizing pathway involving negative affect. Our findings suggest that alcoholics with a history of childhood emotional abuse may be particularly vulnerable to severe dependence. Copyright © 2012 by the Research Society on Alcoholism.

  4. Allergic rhinitis severity can be assessed using a visual analogue scale in mild, moderate and severe.

    PubMed

    Del Cuvillo, A; Santos, V; Montoro, J; Bartra, J; Davila, I; Ferrer, M; Jauregui, I; Sastre, J; Mullol, J; Valero, A

    2017-03-01

    Allergic rhinitis is a global healthcare problem due to its high prevalence, impact on individuals and socioeconomic burden for the nations. Allergic rhinitis severity evaluation is the key to a correct treatment, prevention of comorbidities and improving the quality of life of patients. This evaluation should be made with a simple, easy, fast but accurate and reliable methodology, both in a primary care and specialist setting. The visual analogue scale (VAS) meets all requirements to be the ideal tool to assess allergic rhinitis severity and has already been validated by using a single cut-off point, but this classification in two degrees of severity suffer from not allocating the patients uniformly and from giving a blind interval to classify the patients when the score is between 5 to 6 cm. The main objective of our study is to describe the optimal cut-off points by using a VAS to discriminate between three degrees of allergic rhinitis severity (mild, moderate, and severe) following the ARIA modified severity criteria that has been previously validated. Sensitivity, specificity, positive and negative predictive values just like receiver operating characteristic curves were used to select the best cut-off values. In a cross-sectional multicentre study with 3,572 patients included we have found that VAS has a significant correlation with nasal symptom score and quality of life and that the best cut-off points to differentiate between mild, moderate an severe allergic rhinitis are a VAS score of 4 and 7, respectively. Allergic rhinitis severity could be assessed in three degrees by using VAS in a simple, easy, and accurate method.

  5. [Severe eye involvement in pemphigus vulgaris].

    PubMed

    Baykal, H E; Pleyer, U; Sönnichsen, K; Thiel, H J; Zierhut, M

    1995-12-01

    Pemphigus vulgaris (PV) is an immune-mediated vesiculobullous disease of the skin and mucous membranes. Generally, patients with PV present first with oral lesions, which may precede the cutaneous lesions, such as bullae and erosions, by several months. An ocular manifestation is unusual. The most common ophthalmologic involvement in pemphigus is conjunctivitis, but without progressive scarring such as occurs in ocular cictricial pemphigoid. Corneal involvement is very rare. CASE REPORT. We report on severe ocular involvement in a 56-year-old male Turkish patient with PV. Ophthalmologic findings included conjunctival cicatrization, corneal ulceration and corneal perforation, despite immunosuppressive therapy with azathioprine and corticosteroids. A penetrating keratoplasty was performed, but rapidly failed because of corneal vascularization. CONCLUSION. If a chronic bullous dermatosis leads to severe eye involvement, PV should be considered in the differential diagnosis besides ocular cicatricial pemphigoid. Pemphigus vulgaris can be differentiated on the basis of clinical findings and histopathological and immunohistological features. Generally, PV can be treated with steroids or with a combination of an immunosuppressant and steroids. However, the combination of prednisone and azathioprine could not prevent corneal perforation in our patient.

  6. Nonpharmacologic Therapy for Severe Persistent Asthma.

    PubMed

    Hall, Chase; Nici, Linda; Sood, Shweta; ZuWallack, Richard; Castro, Mario

    The treatment of asthma largely depends on guideline-based pharmacologic therapies. However, nonpharmacologic therapies for asthma such as pulmonary rehabilitation, focused breathing techniques, and bronchial thermoplasty have an important, yet underappreciated, role. Structured pulmonary rehabilitation programs can reduce dyspnea and increase cardiopulmonary fitness. The educational component of these programs can ensure that therapies are being used appropriately, increase compliance, and decrease health care utilization. Studies have demonstrated a reduction in inflammatory mediators in patients with asthma who are engaged in an exercise program. Focused breathing techniques are commonly used by patients with asthma, yet benefit has not been clearly shown in randomized controlled trials. For the patients with severe asthma who are unresponsive to maximum medical therapy and have evidence of airway remodeling, bronchial thermoplasty has demonstrated long-term improvement in quality of life and reduction in severe exacerbations and health care utilization. Recent airway biopsy studies have demonstrated bronchial thermoplasty's disease-modifying effect on smooth muscle, inflammatory mediators, and bronchial nerve endings. These nonpharmacologic therapies are complementary to current guideline-based treatment, including the use of biologic modifiers, for severe asthma. Copyright © 2017 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  7. Long-Term Aripiprazole in Youth with Developmental Disabilities Including Autism

    ERIC Educational Resources Information Center

    Hellings, Jessica A.; Boehm, Danna; Yeh, Hung Wen; Butler, Merlin G.; Schroeder, Stephen R.

    2011-01-01

    We retrospectively reviewed clinic charts of 21 children and adolescents with developmental disabilities including autism spectrum disorders (ASD) treated consecutively with aripiprazole (ARI) for irritability and severe challenging behaviors. Data extracted include age, sex, and race; level of intellectual disability (ID); "Diagnostic and…

  8. Long-Term Aripiprazole in Youth with Developmental Disabilities Including Autism

    ERIC Educational Resources Information Center

    Hellings, Jessica A.; Boehm, Danna; Yeh, Hung Wen; Butler, Merlin G.; Schroeder, Stephen R.

    2011-01-01

    We retrospectively reviewed clinic charts of 21 children and adolescents with developmental disabilities including autism spectrum disorders (ASD) treated consecutively with aripiprazole (ARI) for irritability and severe challenging behaviors. Data extracted include age, sex, and race; level of intellectual disability (ID); "Diagnostic and…

  9. Smoking and periodontal disease severity.

    PubMed

    Martinez-Canut, P; Lorca, A; Magán, R

    1995-10-01

    This study was performed to assess the influence of smoking on periodontal disease severity. Data concerning periodontal status and smoking habits were collected from 889 periodontal patients: 340 male and 549 female, 21 to 76 years of age, 47.4% being non smokers and 52.6% smokers. Periodontal parameters, recorded by the same examiner (PMC), were: gingival recession (GR), Pocket depth (PD), Probing attachment level (PAL), and mobility (M). The influence of age, sex and tobacco consumption on these periodontal parameters was statistically evaluated using an analysis of variance (ANOVA) with covariates. A non-linear effect model was also fitted by taking the natural logarithms of the response variables (GR, PD, PAL) closer to biomedical phenomena. Mobility was analyzed by a chi2-test. The effect of smoking on periodontitis showed no association with age or with sex. Smoking, age and sex were shown to be statistically significant for periodontitis, by performing both univariate (t-test for equal means) and multivariate tests. p-values for smoking and periodontitis were: GR (p=0.000), PD (p=0.000), PAL (p=0.000) and M (P=0.015). Smoking one cigarette per day, up to 10, and up to 20, increased PAL by 0.5%, 5% and 10%, respectively. The impact of tobacco is comparable to the impact resulting from the factor of age in this sample, increasing PAL by 0.7% for each year of life. Comparison between smokers of less than 10 cigarettes per day (PAL mean 3.72 mm +/-0.86) and non-smokers (PAL mean 3.84 +/- 0.89) showed no differences in PAL (p=0.216), while comparison for smokers from 11 to 20 cigarettes (PAL mean 4.36 +/- 1.23) and for more than 20 cigarettes (PAL mean 4.50 +/- 1.04) demonstrated significant differences (p=0.000). These findings suggest that: (1) tobacco increases periodontal disease severity; (2) this effect is clinically evident above consumption of a certain quantity of tobacco.

  10. Predicting severe injury using vehicle telemetry data.

    PubMed

    Ayoung-Chee, Patricia; Mack, Christopher D; Kaufman, Robert; Bulger, Eileen

    2013-01-01

    In 2010, the National Highway Traffic Safety Administration standardized collision data collected by event data recorders, which may help determine appropriate emergency medical service (EMS) response. Previous models (e.g., General Motors ) predict severe injury (Injury Severity Score [ISS] > 15) using occupant demographics and collision data. Occupant information is not automatically available, and 12% of calls from advanced automatic collision notification providers are unanswered. To better inform EMS triage, our goal was to create a predictive model only using vehicle collision data. Using the National Automotive Sampling System Crashworthiness Data System data set, we included front-seat occupants in late-model vehicles (2000 and later) in nonrollover and rollover crashes in years 2000 to 2010. Telematic (change in velocity, direction of force, seat belt use, vehicle type and curb weight, as well as multiple impact) and nontelematic variables (maximum intrusion, narrow impact, and passenger ejection) were included. Missing data were multiply imputed. The University of Washington model was tested to predict severe injury before application of guidelines (Step 0) and for occupants who did not meet Steps 1 and 2 criteria (Step 3) of the Centers for Disease Control and Prevention Field Triage Guidelines. A probability threshold of 20% was chosen in accordance with Centers for Disease Control and Prevention recommendations. There were 28,633 crashes, involving 33,956 vehicles and 52,033 occupants, of whom 9.9% had severe injury. At Step 0, the University of Washington model sensitivity was 40.0% and positive predictive value (PPV) was 20.7%. At Step 3, the sensitivity was 32.3 % and PPV was 10.1%. Model analysis excluding nontelematic variables decreased sensitivity and PPV. The sensitivity of the re-created General Motors model was 38.5% at Step 0 and 28.1% at Step 3. We designed a model using only vehicle collision data that was predictive of severe injury at

  11. A study of helicopter stability and control including blade dynamics

    NASA Technical Reports Server (NTRS)

    Zhao, Xin; Curtiss, H. C., Jr.

    1988-01-01

    A linearized model of rotorcraft dynamics has been developed through the use of symbolic automatic equation generating techniques. The dynamic model has been formulated in a unique way such that it can be used to analyze a variety of rotor/body coupling problems including a rotor mounted on a flexible shaft with a number of modes as well as free-flight stability and control characteristics. Direct comparison of the time response to longitudinal, lateral and directional control inputs at various trim conditions shows that the linear model yields good to very good correlation with flight test. In particular it is shown that a dynamic inflow model is essential to obtain good time response correlation, especially for the hover trim condition. It also is shown that the main rotor wake interaction with the tail rotor and fixed tail surfaces is a significant contributor to the response at translational flight trim conditions. A relatively simple model for the downwash and sidewash at the tail surfaces based on flat vortex wake theory is shown to produce good agreement. Then, the influence of rotor flap and lag dynamics on automatic control systems feedback gain limitations is investigated with the model. It is shown that the blade dynamics, especially lagging dynamics, can severly limit the useable values of the feedback gain for simple feedback control and that multivariable optimal control theory is a powerful tool to design high gain augmentation control system. The frequency-shaped optimal control design can offer much better flight dynamic characteristics and a stable margin for the feedback system without need to model the lagging dynamics.

  12. Community Assessment Tool for Public Health Emergencies Including Pandemic Influenza

    SciTech Connect

    HCTT-CHE

    2011-04-14

    The Community Assessment Tool (CAT) for Public Health Emergencies Including Pandemic Influenza (hereafter referred to as the CAT) was developed as a result of feedback received from several communities. These communities participated in workshops focused on influenza pandemic planning and response. The 2008 through 2011 workshops were sponsored by the Centers for Disease Control and Prevention (CDC). Feedback during those workshops indicated the need for a tool that a community can use to assess its readiness for a disaster—readiness from a total healthcare perspective, not just hospitals, but the whole healthcare system. The CAT intends to do just that—help strengthen existing preparedness plans by allowing the healthcare system and other agencies to work together during an influenza pandemic. It helps reveal each core agency partners' (sectors) capabilities and resources, and highlights cases of the same vendors being used for resource supplies (e.g., personal protective equipment [PPE] and oxygen) by the partners (e.g., public health departments, clinics, or hospitals). The CAT also addresses gaps in the community's capabilities or potential shortages in resources. While the purpose of the CAT is to further prepare the community for an influenza pandemic, its framework is an extension of the traditional all-hazards approach to planning and preparedness. As such, the information gathered by the tool is useful in preparation for most widespread public health emergencies. This tool is primarily intended for use by those involved in healthcare emergency preparedness (e.g., community planners, community disaster preparedness coordinators, 9-1-1 directors, hospital emergency preparedness coordinators). It is divided into sections based on the core agency partners, which may be involved in the community's influenza pandemic influenza response.

  13. [Crush syndrome in severe trauma].

    PubMed

    Poznanović, Marija Rakarić; Sulen, Nina

    2007-01-01

    Crush injury or traumatic rhabdomyolysis is caused by crushing of large muscule mass, usually of the femoral and gluteal compartment. Crush syndrome is general manifestation of crush injury with renal failure (ARF). ARF is caused by deposition of myoglobin in distal tubules. The concentration of serum creatin phosphokinase is an indicator of the extent of injured muscule. The serum concentration of myoglobin is an indicator of the extent of injured muscule and the main cause of development of crush syndrome. In a prospective study the concentration of myoglobin and CPK was measured in 81 patients with injuries of lower extremities and pelvis as a part of severe trauma. The increase of CPK concentration above 1000 U/L was measured in all patients. The increase of CPK concentration above 2000 U/L was measured in 78 (96.3%) patients. The increase of myoglobin concentration of >700 mcg/L was measured in 19 (23.5%) patients. In the group of 19 patients with CPK concentration of >2000 U/L and myoglobin concentration of >700 mcg/L crush syndrome developed in 6 (7.4%) patients with oliguria (urin output <50 ml/h) and the increase of serum potassium, phosphate and creatinine concentrations. The decrease of CPK and myoglobin concentrations was achieved in 5 patients during 10-12 days and 1 patient with associated craniocrebral injury died.

  14. Meal type affects heartburn severity.

    PubMed

    Rodriguez, S; Miner, P; Robinson, M; Greenwood, B; Maton, P N; Pappa, K

    1998-03-01

    This study compared heartburn severity, number of episodes, and changes in esophageal pH induced by three meals. Symptomatic volunteers consumed the following on different occasions: McDonald's Quarter Pounder, french fries, and chocolate shake; McDonald's Sausage Biscuit with Egg, cheese, raw onion, and chocolate milk; and Wendy's Chili and red wine. Increases in reflux episodes over baseline for the hamburger, sausage biscuit, and chili meals were 28.8 +/- 5.7, 36 +/- 5.5 and 43.7 +/- 8.8, respectively. The sausage biscuit and chili increased reflux compared to the hamburger (P < 0.05), but the chili did not differ statistically from the sausage biscuit meal. Onset and peak heartburn for the hamburger, sausage biscuit, and chili meals were 45 and 90, 30 and 120, and 15 and 150 min, respectively. Despite lower fat content, chili and red wine promoted more reflux and heartburn pain than the other meals, demonstrating the importance of meal selection in provocative meal studies.

  15. Severe Hypokalemia Masquerading Myocardial Ischemia

    PubMed Central

    Petrov, Daniel Bogdanov; Sardovski, Svetlozar Ivanov; Milanova, Maria Hristova

    2012-01-01

    An advanced degree of body potassium deficit may produce striking changes in the electrocardiogram (ECG). These changes can result in incidental findings on the 12-lead ECG or precipitate potentially life-threatening dysrhythmias. Although usually readily recognized, at times these abnormalities may be confused with myocardial ischemia. The object was to report a case of severe hypokalemia mimicking myocardial ischemia. A 33-year-old, previously healthy man, presented to the Emergency Department (ED) with a progressive weakness and chest discomfort. The electrocardiogram showed a marked ST-segment depression in leads II, III, aVF, V1-V6. The initial diagnosis was non ST-elevation myocardial infarction. Echocardiography was normal and troponin levels were within normal limits. A more detailed history revealed that the patient had an episode of acute gastroenteritis with diarrhea and vomiting. Serum chemistries were notable for a potassium concentration of 1,8 mmol per liter. With aggressive electrolyte correction, the ECG abnormalities reverted as potassium levels normalized. Hypokalemia induced ST-segment depression may simulate myocardial ischemia. The differential diagnosis might be difficult, especially in the cases when ST changes are accompanied with chest discomfort.

  16. Night eating syndrome: implications for severe obesity

    PubMed Central

    Cleator, J; Abbott, J; Judd, P; Sutton, C; Wilding, J P H

    2012-01-01

    Night eating syndrome (NES) was first identified in 1955 by Stunkard, a psychiatrist specialising in eating disorders (ED). Over the last 20 years considerable progress has been made in defining NES as a significant clinical entity in its own right and it has now been accepted for inclusion in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) due for publication in 2013. NES is considered a dysfunction of circadian rhythm with a disassociation between eating and sleeping. Core criteria include a daily pattern of eating with a significantly increased intake in the evening and/or night time, as manifested by one or both of the following: at least 25% of food intake is consumed after the evening meal or at least two episodes of nocturnal eating per week. An important recent addition to core criteria includes the presence of significant distress and/or impairment in functioning. Stunkard's team recommend further investigation on the pathogenesis of NES, in particular its relationship with traumatic life events, psychiatric comorbidity, the age of onset of NES and course of NES over time. The relationship between NES and other ED also requires further clarification as night-eaters exhibit some features of other ED; previous guidance to separate NES from other ED may have hindered earlier characterisation of NES. Evidence from European and American studies suggests NES features strongly in populations with severe obesity. The complex interplay between depression, impaired sleep and obesity-related comorbidity in severely obese individuals makes understanding NES in this context even more difficult. This review examines evidence to date on the characterisation of NES and concludes by examining the applicability of current NES criteria to individuals with severe obesity. PMID:23446659

  17. CME front and severe space weather

    NASA Astrophysics Data System (ADS)

    Balan, N.; Skoug, R.; Tulasi Ram, S.; Rajesh, P. K.; Shiokawa, K.; Otsuka, Y.; Batista, I. S.; Ebihara, Y.; Nakamura, T.

    2014-12-01

    Thanks to the work of a number of scientists who made it known that severe space weather can cause extensive social and economic disruptions in the modern high-technology society. It is therefore important to understand what determines the severity of space weather and whether it can be predicted. We present results obtained from the analysis of coronal mass ejections (CMEs), solar energetic particle (SEP) events, interplanetary magnetic field (IMF), CME-magnetosphere coupling, and geomagnetic storms associated with the major space weather events since 1998 by combining data from the ACE and GOES satellites with geomagnetic parameters and the Carrington event of 1859, the Quebec event of 1989, and an event in 1958. The results seem to indicate that (1) it is the impulsive energy mainly due to the impulsive velocity and orientation of IMF Bz at the leading edge of the CMEs (or CME front) that determine the severity of space weather. (2) CMEs having high impulsive velocity (sudden nonfluctuating increase by over 275 km s-1 over the background) caused severe space weather (SvSW) in the heliosphere (failure of the solar wind ion mode of Solar Wind Electron Proton Alpha Monitor in ACE) probably by suddenly accelerating the high-energy particles in the SEPs ahead directly or through the shocks. (3) The impact of such CMEs which also show the IMF Bz southward from the leading edge caused SvSW at the Earth including extreme geomagnetic storms of mean DstMP < -250 nT during main phases, and the known electric power outages happened during some of these SvSW events. (4) The higher the impulsive velocity, the more severe the space weather, like faster weather fronts and tsunami fronts causing more severe damage through impulsive action. (5) The CMEs having IMF Bz northward at the leading edge do not seem to cause SvSW on Earth, although, later when the IMF Bz turns southward, they can lead to super geomagnetic storms of intensity (Dstmin) less than even -400 nT.

  18. Obesity and severe obesity forecasts through 2030.

    PubMed

    Finkelstein, Eric A; Khavjou, Olga A; Thompson, Hope; Trogdon, Justin G; Pan, Liping; Sherry, Bettylou; Dietz, William

    2012-06-01

    Previous efforts to forecast future trends in obesity applied linear forecasts assuming that the rise in obesity would continue unabated. However, evidence suggests that obesity prevalence may be leveling off. This study presents estimates of adult obesity and severe obesity prevalence through 2030 based on nonlinear regression models. The forecasted results are then used to simulate the savings that could be achieved through modestly successful obesity prevention efforts. The study was conducted in 2009-2010 and used data from the 1990 through 2008 Behavioral Risk Factor Surveillance System (BRFSS). The analysis sample included nonpregnant adults aged ≥ 18 years. The individual-level BRFSS variables were supplemented with state-level variables from the U.S. Bureau of Labor Statistics, the American Chamber of Commerce Research Association, and the Census of Retail Trade. Future obesity and severe obesity prevalence were estimated through regression modeling by projecting trends in explanatory variables expected to influence obesity prevalence. Linear time trend forecasts suggest that by 2030, 51% of the population will be obese. The model estimates a much lower obesity prevalence of 42% and severe obesity prevalence of 11%. If obesity were to remain at 2010 levels, the combined savings in medical expenditures over the next 2 decades would be $549.5 billion. The study estimates a 33% increase in obesity prevalence and a 130% increase in severe obesity prevalence over the next 2 decades. If these forecasts prove accurate, this will further hinder efforts for healthcare cost containment. Copyright © 2012 Elsevier Inc. All rights reserved.

  19. Severe sepsis and septic shock in pregnancy.

    PubMed

    Barton, John R; Sibai, Baha M

    2012-09-01

    Pregnancies complicated by severe sepsis and septic shock are associated with increased rates of preterm labor, fetal infection, and preterm delivery. Sepsis onset in pregnancy can be insidious, and patients may appear deceptively well before rapidly deteriorating with the development of septic shock, multiple organ dysfunction syndrome, or death. The outcome and survivability in severe sepsis and septic shock in pregnancy are improved with early detection, prompt recognition of the source of infection, and targeted therapy. This improvement can be achieved by formulating a stepwise approach that consists of early provision of time-sensitive interventions such as: aggressive hydration (20 mL/kg of normal saline over the first hour), initiation of appropriate empiric intravenous antibiotics (gentamicin, clindamycin, and penicillin) within 1 hour of diagnosis, central hemodynamic monitoring, and the involvement of infectious disease specialists and critical care specialists familiar with the physiologic changes in pregnancy. Thorough physical examination and imaging techniques or empiric exploratory laparotomy are suggested to identify the septic source. Even with appropriate antibiotic therapy, patients may continue to deteriorate unless septic foci (ie, abscess, necrotic tissue) are surgically excised. The decision for delivery in the setting of antepartum severe sepsis or septic shock can be challenging but must be based on gestational age, maternal status, and fetal status. The natural inclination is to proceed with emergent delivery for a concerning fetal status, but it is imperative to stabilize the mother first, because in doing so the fetal status will likewise improve. Aggressive [corrected] treatment of sepsis can be expected to reduce the progression to severe sepsis and septic shock and prevention strategies can include preoperative skin preparations and prophylactic antibiotic therapy as well as appropriate immunizations.

  20. Teaching Associated Work Skills to Adolescents with Severe Handicaps.

    ERIC Educational Resources Information Center

    Egan, Isabelle; And Others

    1985-01-01

    Five adolescents with moderate to severe mental retardation, including one with hearing impairments and blindness, were taught 12 associated work skills through an approach featuring reinforcement for desirable behavior and negative consequences and cueing for undesirable behavior. (CL)

  1. Management of Severe Pancreatic Fistula After Pancreatoduodenectomy.

    PubMed

    Smits, F Jasmijn; van Santvoort, Hjalmar C; Besselink, Marc G; Batenburg, Marilot C T; Slooff, Robbert A E; Boerma, Djamila; Busch, Olivier R; Coene, Peter P L O; van Dam, Ronald M; van Dijk, David P J; van Eijck, Casper H J; Festen, Sebastiaan; van der Harst, Erwin; de Hingh, Ignace H J T; de Jong, Koert P; Tol, Johanna A M G; Borel Rinkes, Inne H M; Molenaar, I Quintus

    2017-06-01

    Postoperative pancreatic fistula is a potentially life-threatening complication after pancreatoduodenectomy. Evidence for best management is lacking. To evaluate the clinical outcome of patients undergoing catheter drainage compared with relaparotomy as primary treatment for pancreatic fistula after pancreatoduodenectomy. A multicenter, retrospective, propensity-matched cohort study was conducted in 9 centers of the Dutch Pancreatic Cancer Group from January 1, 2005, to September 30, 2013. From a cohort of 2196 consecutive patients who underwent pancreatoduodenectomy, 309 patients with severe pancreatic fistula were included. Propensity score matching (based on sex, age, comorbidity, disease severity, and previous reinterventions) was used to minimize selection bias. Data analysis was performed from January to July 2016. First intervention for pancreatic fistula: catheter drainage or relaparotomy. Primary end point was in-hospital mortality; secondary end points included new-onset organ failure. Of the 309 patients included in the analysis, 209 (67.6%) were men, and mean (SD) age was 64.6 (10.1) years. Overall in-hospital mortality was 17.8% (55 patients): 227 patients (73.5%) underwent primary catheter drainage and 82 patients (26.5%) underwent primary relaparotomy. Primary catheter drainage was successful (ie, survival without relaparotomy) in 175 patients (77.1%). With propensity score matching, 64 patients undergoing primary relaparotomy were matched to 64 patients undergoing primary catheter drainage. Mortality was lower after catheter drainage (14.1% vs 35.9%; P = .007; risk ratio, 0.39; 95% CI, 0.20-0.76). The rate of new-onset single-organ failure (4.7% vs 20.3%; P = .007; risk ratio, 0.15; 95% CI, 0.03-0.60) and new-onset multiple-organ failure (15.6% vs 39.1%; P = .008; risk ratio, 0.40; 95% CI, 0.20-0.77) were also lower after primary catheter drainage. In this propensity-matched cohort, catheter drainage as first intervention for severe

  2. Reliability and Validity of the Yale Global Tic Severity Scale

    ERIC Educational Resources Information Center

    Storch, Eric A.; Murphy, Tanya K.; Geffken, Gary R.; Sajid, Muhammad; Allen, Pam; Roberti, Jonathan W.; Goodman, Wayne K.

    2005-01-01

    To investigate the reliability and validity of the Yale Global Tic Severity Scale (YGTSS), 28 youth aged 6 to 17 years with Tourette's syndrome (TS) participated in the study. Data included clinician reports of tics and obsessive-compulsive disorder (OCD) severity, parent reports of tics, internalizing and externalizing problems, and child reports…

  3. The Autism Diagnostic Observation Schedule, Toddler Module: Standardized Severity Scores

    ERIC Educational Resources Information Center

    Esler, Amy N.; Bal, Vanessa Hus; Guthrie, Whitney; Wetherby, Amy; Weismer, Susan Ellis; Lord, Catherine

    2015-01-01

    Standardized calibrated severity scores (CSS) have been created for Autism Diagnostic Observation Schedule, 2nd edition (ADOS-2) Modules 1-4 as a metric of the relative severity of autism-specific behaviors. Total and domain CSS were created for the Toddler Module to facilitate comparison to other modules. Analyses included 388 children with ASD…

  4. Systematic Instruction of the Severely Handicapped: Teaching Sequences.

    ERIC Educational Resources Information Center

    McCormack, James E., Jr.; And Others

    Intended for teachers of severely handicapped students, the volume provides suggestions on systematic instruction based on individual assessment and curriculum development with sample detailed instructional sequences included. Explained in introductory chapters are the need for systematic instruction of the severely handicapped, major components…

  5. Reliability and Validity of the Yale Global Tic Severity Scale

    ERIC Educational Resources Information Center

    Storch, Eric A.; Murphy, Tanya K.; Geffken, Gary R.; Sajid, Muhammad; Allen, Pam; Roberti, Jonathan W.; Goodman, Wayne K.

    2005-01-01

    To investigate the reliability and validity of the Yale Global Tic Severity Scale (YGTSS), 28 youth aged 6 to 17 years with Tourette's syndrome (TS) participated in the study. Data included clinician reports of tics and obsessive-compulsive disorder (OCD) severity, parent reports of tics, internalizing and externalizing problems, and child reports…

  6. A comparison of different category scales for estimating disease severity

    USDA-ARS?s Scientific Manuscript database

    Plant pathologists most often obtain quantitative information on disease severity using visual assessments. Category scales are widely used for assessing disease severity, including for screening germplasm. The most widely used category scale is the Horsfall-Barratt (H-B) scale, but reports show tha...

  7. Autism Severity and Qualities of Parent-Child Relations

    ERIC Educational Resources Information Center

    Beurkens, Nicole M.; Hobson, Jessica A.; Hobson, R. Peter

    2013-01-01

    The aim of this study was to examine how severity of autism affects children's interactions (relatedness) and relationships with their parents. Participants were 25 parent-child dyads that included offspring who were children with autism aged from 4 to 14 years. The severity of the children's autism was assessed using the calibrated severity…

  8. 7 CFR 1400.6 - Joint and several liability.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 10 2013-01-01 2013-01-01 false Joint and several liability. 1400.6 Section 1400.6... AND SUBSEQUENT CROP, PROGRAM, OR FISCAL YEARS General Provisions § 1400.6 Joint and several liability. (a) Any legal entity, including joint operations, and any member of a legal entity determined to have...

  9. 7 CFR 1400.6 - Joint and several liability.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 10 2011-01-01 2011-01-01 false Joint and several liability. 1400.6 Section 1400.6... AND SUBSEQUENT CROP, PROGRAM, OR FISCAL YEARS General Provisions § 1400.6 Joint and several liability. (a) Any legal entity, including joint operations, and any member of a legal entity determined to have...

  10. 7 CFR 1400.6 - Joint and several liability.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 10 2012-01-01 2012-01-01 false Joint and several liability. 1400.6 Section 1400.6... AND SUBSEQUENT CROP, PROGRAM, OR FISCAL YEARS General Provisions § 1400.6 Joint and several liability. (a) Any legal entity, including joint operations, and any member of a legal entity determined to have...

  11. 7 CFR 1400.6 - Joint and several liability.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 10 2014-01-01 2014-01-01 false Joint and several liability. 1400.6 Section 1400.6... AND SUBSEQUENT CROP, PROGRAM, OR FISCAL YEARS General Provisions § 1400.6 Joint and several liability. (a) Any legal entity, including joint operations, and any member of a legal entity determined to have...

  12. [Management of severe accidental hypothermia].

    PubMed

    Avellanas, M L; Ricart, A; Botella, J; Mengelle, F; Soteras, I; Veres, T; Vidal, M

    2012-04-01

    Accidental hypothermia is an environmental condition with basic principles of classification and resuscitation that apply to mountain, sea or urban scenarios. Along with coagulopathy and acidosis, hypothermia belongs to the lethal triad of trauma victims requiring critical care. A customized healthcare chain is involved in its management, extending from on site assistance to intensive care, cardiac surgery and/or the extracorporeal circulation protocols. A good classification of the degree of hypothermia preceding admission contributes to improve management and avoids inappropriate referrals between hospitals. The most important issue is to admit hypothermia victims in asystolia or ventricular fibrillation to those hospitals equipped with the medical technology which these special clinical scenarios require. This study attempts to establish the foundations for optimum management of accidental hypothermia from first emergency care on site to treatment in hospital including, resuscitation and rewarming with extracorporeal circulation. Copyright © 2011 Elsevier España, S.L. and SEMICYUC. All rights reserved.

  13. Gambling disorder, DSM-5 criteria and symptom severity.

    PubMed

    Grant, Jon E; Odlaug, Brian L; Chamberlain, Samuel R

    2017-05-01

    Gambling disorder (GD) is a prevalent psychiatric condition whose severity is typically defined by the number of DSM-5 criteria met out of a maximum of nine. The relationships between the levels of gambling severity, thus defined, and other measures of psychopathology and everyday functioning are clinically important. Baseline data were collected in patients with GD, conducted from 2001 to 2016. Participants completed clinical interviews and questionnaires. The impact of disease severity (mild, moderate, and severe) on clinical measures was characterized using analysis of variance models. The sample included 574 adults with GD, of whom 73 (12.7%) had mild, 184 (32.1%) moderate, and 317 (55.2%) severe GD. The moderate and severe cases, compared to mild severity group tended be older, had later age of onset, lost more money to gambling in the preceding year, had worse quality of life, had higher state anxiety and depressive scores, consumed more nicotine via smoking per day, and had lower venturesomeness scores. The moderate and severe groups did not differ significantly on these measures, however. The Yale-Brown Obsessive Compulsive Scale modified for Pathological Gambling (PG-YBOCS) discriminated significantly between all three groups. Several measures of psychopathology and functional impact of gambling symptoms appear similar between moderate and severe GD cases, while mild cases are clearly differentiated from moderate and severe cases. Thus, the current working definition of GD symptom severity boundaries has important limitations in terms of potential clinical utility. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. Congenital Anorectal Malformation Severity Does Not Predict Severity of Congenital Heart Defects.

    PubMed

    Jonker, Jara E; Liem, Eryn T; Elzenga, Nynke J; Molenbuur, Bouwe; Trzpis, Monika; Broens, Paul M A

    2016-12-01

    To determine the prevalence of congenital heart defects (CHDs) in patients with mild or severe congenital anorectal malformations (CARMs), and whether all patients with CARM need pediatric cardiology screening. We included 129 patients with CARM born between 2004 and 2013, and referred to University Medical Center Groningen. Recto-perineal and recto-vestibular fistulas were classified as mild CARMs, all others as severe. Significant patent foramen ovale, secundum atrial septal defect, and small ventricular septum defect were classified as minor CHDs, all others as major. Of 129 patients with CARM, 67% had mild CARM, 33% severe CARM, and 17% were additionally diagnosed with CHD. CHDs were distributed equally in patients with mild or severe CARMs. Patients with multiple congenital abnormalities were more frequently diagnosed with CHD (n = 16, 36%) than patients without multiple congenital malformations (n = 5, 9%, P = .001). Patients with CARM diagnosed with CHD using pediatric cardiac echo screening were younger than 3 months of age at diagnosis. Earlier general pediatric examinations missed 7 (50%) children with mild and 4 (50%) with severe CHDs. The severity of CARM could predict neither prevalence nor severity of CHD. More than one-half of CHDs were missed during the first physical examination. No new CHDs were found in patients older than 3 months of age at the time CARMs were diagnosed. We recommend screening all patients with CARM younger than 3 months of age for CHD at the time CARM is diagnosed. Preoperative echocardiography should be the rule in children younger than 3 months of age and with multiple congenital anomalies. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Several Developments in Space Tethers

    NASA Technical Reports Server (NTRS)

    Santangelo, Andrew; Sturmfels, Rich; Rothwell, Neal

    2007-01-01

    Five reports address different aspects of development of tethers to be deployed from spacecraft in orbit around the Earth. The first report discusses proposed optoelectronic tracking of retroreflective objects located at intervals or of retroreflective coats along the entire length of a tether to measure lateral motions. The second report describes digitally controlled spooling machinery that retracts or extends a tape tether at controlled speed and tension in the spool isolated from uncontrolled tension on the outside. The third report discusses part of this machinery that pivots to accommodate misalignments between the deployed and spooled portions of the tether and contains rollers used to exert tension and speed control. The fourth report discusses aspects of designs of proposed electrodynamic tethers, which would be electrically conductive and would interact with the magnetic field of the Earth to exert forces to modify orbits of deploying spacecraft. The fifth report discusses electrical aspects of designs of electrodynamic tape tethers, including the use of solar cells or motional electromagnetic force to generate currents in tethers and the use of electron emitters and electron and ion collectors at opposite ends of tethers to make electrical contact with the thin plasma in surrounding space.

  16. [Photodynamic therapy for severe myopia].

    PubMed

    Krebs, I; Binder, S; Stolba, U; Abri, A

    2004-01-01

    In the modern western world quality of life depends on the ability of reading. Our study was designed to prove the possibility of stabilization of reading acuity, central visual field and multifocal electroretinogram (mERG) after photodynamic therapy (PDT) in cases of pathologic myopia. In our study 20 eyes were included. At baseline, after 6 weeks,3 months and afterwards every 3 months we investigated distance acuity, reading acuity, 10 degrees static threshold perimetry, mERG, optical coherence tomography and fluorescence angiograophy. After 1 year 85% of eyes lost less than 1.5 lines of distance acuity, the reading acuity could be stabilized in 80%, the central visual field in 60% and the ERG in 55%. Patients less than 60 years old showed better results than older patients. PDT was found to be very effective because the membranes were classic without any occult parts in 100%. They were small and superficially located and the scotomas were small. There was a good correlation between functional and morphological results.

  17. Subjectivity and Severe Psychiatric Disorders

    PubMed Central

    Strauss, John

    2011-01-01

    To have a complete human science in the mental health field it is essential to give adequate attention to both the objective and the subjective data related to people with psychiatric disorders. The tendency in the past has been to ignore or discount one or the other of these data sources. Subjective data are particularly neglected, sometimes considered (only) part of the “art” of medicine since the usual methodologies of the physical sciences in themselves are not adequate to reflect the nature, elusiveness, and complexity of human subjective experience. The complete experience of hallucinated voices, for instance, often includes not only the voices themselves but also terrible anguish and terrifying inability to concentrate. But even such descriptors fall unnecessarily short of reflecting the data of the experience, thus leaving research, theory, and treatment with incomplete information. To represent adequately the subjective data it is essential to recognize that besides the usual discursive knowledge and methods of traditional physical science, a second kind of knowledge and method is required to reflect the depth of human experience. To accomplish this, we must employ approaches to narrative and the arts that are uniquely capable of capturing the nature of these experiences. Only by attending seriously in our research, training, theory, and practice to the unique nature of subjective data is it possible to have a true human science for our field. PMID:20961994

  18. Including data quality concepts into the GEOSS Portal

    NASA Astrophysics Data System (ADS)

    Masó, Joan; Nust, Daniel; Diaz, Daniel; Closa, Guillem; Lush, Victoria; Zabala, Alaitz; Nativi, Stefano

    2014-05-01

    The EC FP7 GeoViQua project has focussed in including quality information into the GEO Portal to increase the visibility of it and increase trust in the GEOSS data products. GeoViQua has fully adopted and extended the ISO19115 metadata model and the XML encoding, incorporating the ISO19157 concepts as new XML elements (pending the official XML encoding) but adding new elements detected as missing aspects in the model. This makes possible an easy transition and coexistence of both models in the GEO portal. The GEOSS Portal enables the user to discover data introducing keywords and other filtering criteria. Once the list of results is returned, the user can read more about each result based on the metadata available in the GEOSS catalogues. In GeoViQua, we developed several metadata-based visualization tools through applying an XSLT allowing specialized visualization focused in different aspects. A provenance-based visualization tool emphasising the sequence of processes and data sources and its detailed description, has been integrated. It is also possible to assess the completeness of the metadata records using an extension of an initially developed by NOAA tool that is now enriched with quality indicators assessment. A metadata comparison tool is able to present metadata document side-by-side allowing parallel reading of the different metadata tags. Furthermore, numerical values are automatically compared and the best one is illuminated in green background colour, and a star plot and a parallel coordinates plot are used to easily show a graph with the best dataset as the large polygon and the highest line. Each summary result combines both producer metadata with the possibility for the user to submit feedback consisting in ratings, comments, expert reviews, links to documentation and new quality indicators. Previous feedback items, coming for other users are shown next to the summary producer metadata. Also the both summaries and extended descriptions of each

  19. A framework for the assessment of severe accident management strategies

    SciTech Connect

    Kastenberg, W.E.; Apostolakis, G.; Dhir, V.K.

    1993-09-01

    Severe accident management can be defined as the use of existing and/or altemative resources, systems and actors to prevent or mitigate a core-melt accident. For each accident sequence and each combination of severe accident management strategies, there may be several options available to the operator, and each involves phenomenological and operational considerations regarding uncertainty. Operational uncertainties include operator, system and instrumentation behavior during an accident. A framework based on decision trees and influence diagrams has been developed which incorporates such criteria as feasibility, effectiveness, and adverse effects, for evaluating potential severe accident management strategies. The framework is also capable of propagating both data and model uncertainty. It is applied to several potential strategies including PWR cavity flooding, BWR drywell flooding, PWR depressurization and PWR feed and bleed.

  20. Should Relational Aggression Be Included in DSM-V?

    ERIC Educational Resources Information Center

    Keenan, Kate; Coyne, Claire; Lahey, Benjamin B.

    2008-01-01

    The study examines whether relational aggression should be included in DSM-V disruptive behavior disorders. The results conclude that some additional information is gathered from assessing relational aggression but not enough to be included in DSM-V.