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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. CREM confers cAMP responsiveness in human steroidogenic acute regulatory protein expression in NCI-H295R cells rather than SF-1/Ad4BP.

    PubMed

    Sugawara, Teruo; Sakuragi, Noriaki; Minakami, Hisanori

    2006-10-01

    Steroidogenic acute regulatory (StAR) protein plays a critical role in steroid hormone synthesis. Tropic hormones induce human StAR gene expression by a cAMP-dependent pathway. Steroidogenic factor-1/adrenal-4-binding protein (SF-1/Ad4BP) plays an important role in the expression of human StAR gene. We investigated the mechanism of cAMP responsiveness in human StAR gene expression in NCI-H295R cells. The StAR promoter activity and protein levels in cells subjected to various treatments were examined. Anti-SF-1/Ad4BP IgG transfection treatment resulted in decreases in the basal StAR promoter activity and StAR protein levels, but did not affect cAMP-stimulated promoter activity and protein levels. The basal and cAMP-stimulated StAR promoter activity levels were reduced in SF-1/Ad4BP mutant (G35E)-transfected cells, but the cAMP induction of StAR promoter activity in response to 1 mM 8-Br-cAMP was not inhibited when G35E SF-1/Ad4BP mutant expression vectors were co-transfected with cAMP-response element-binding (CREB) expression vectors. Although the basal StAR mRNA expression and protein levels were decreased by SF-1/Ad4BP-siRNA treatment, the cAMP-stimulated StAR mRNA expression and protein levels did not change. The basal StAR promoter activity level was not decreased by cAMP-response element modulator (CREM)-siRNA treatment, but the cAMP-stimulated StAR promoter activity level, the magnitude of cAMP induction of StAR promoter, and the cAMP-stimulated StAR protein level were decreased. The cAMP induction of StAR promoter activity in cells was inhibited when S117ACREM mutant expressionvectors were transfected. We conclude that inhibition of the function of SF-1/Ad4BP does not reduce the cAMP induction of StAR promoter activity and protein level. CREM is needed to confer cAMP responsiveness in human StAR protein expression.

  3. 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.

  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. 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.

  7. 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

  8. 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

  9. Models that include supercoiling of topological domains reproduce several known features of interphase chromosomes.

    PubMed

    Benedetti, Fabrizio; Dorier, Julien; Burnier, Yannis; Stasiak, Andrzej

    2014-03-01

    Understanding the structure of interphase chromosomes is essential to elucidate regulatory mechanisms of gene expression. During recent years, high-throughput DNA sequencing expanded the power of chromosome conformation capture (3C) methods that provide information about reciprocal spatial proximity of chromosomal loci. Since 2012, it is known that entire chromatin in interphase chromosomes is organized into regions with strongly increased frequency of internal contacts. These regions, with the average size of ∼1 Mb, were named topological domains. More recent studies demonstrated presence of unconstrained supercoiling in interphase chromosomes. Using Brownian dynamics simulations, we show here that by including supercoiling into models of topological domains one can reproduce and thus provide possible explanations of several experimentally observed characteristics of interphase chromosomes, such as their complex contact maps.

  10. 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…

  11. 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…

  12. 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.

  13. 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

  14. 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.

  15. 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.

  16. Infection with Chlamydia trachomatis alters the tyrosine phosphorylation and/or localization of several host cell proteins including cortactin.

    PubMed Central

    Fawaz, F S; van Ooij, C; Homola, E; Mutka, S C; Engel, J N

    1997-01-01

    Infection of epithelial cells by two biovars of Chlamydia trachomatis results in the tyrosine phosphorylation of several host proteins. The most prominent change in host protein tyrosine phosphorylation involves a complex of proteins with molecular masses of 75 to 85 kDa (pp75/85) and 100 kDa (pp100). The C. trachomatis-induced tyrosine phosphorylation of pp75/85 and pp100 is observed in several cell lines, including epithelial cells, fibroblasts, and macrophages. Subcellular fractionation and detergent solubility properties of pp75/85 are consistent with its association with the cytoskeleton. Phosphoamino acid analysis demonstrates that the pp75/85 complex is phosphorylated on both tyrosine and serine residues. Immunofluorescence studies of chlamydia-infected cells by using fluorescein isothiocyanate-phalloidin and antibodies to phosphotyrosine and cortactin demonstrate that tyrosine-phosphorylated proteins, as well as cortactin, are localized to the chlamydial vacuole and that this process is facilitated by actin. PMID:9393830

  17. 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

  18. 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.

  19. 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.

  20. 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

  1. 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

  2. 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.

  3. 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

  4. 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

  5. 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.

  6. 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.

  7. 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

  8. 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

  9. 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.

  10. 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.

  11. 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.

  12. 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

  13. 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.

  14. 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.

  15. 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.

  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 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,…

  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 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…

  18. 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)

  19. 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 ...

  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. [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.

  3. 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)

  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. 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

  6. 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.

  7. 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.

  8. 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

  9. 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

  10. [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.

  11. 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.

  12. 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.

  13. 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

  14. 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.

  15. 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.

  16. 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.

  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. 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.

  20. 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.

  1. 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…

  2. 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.

  3. [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.

  4. Dengue and Severe Dengue

    MedlinePlus

    ... can significantly reduce mortality rates from severe dengue. Global Strategy for dengue prevention and control, 2012–2020, Chapter ... vaccine: WHO position paper – July 2016 pdf, 437kb Global Strategy for dengue prevention and control, 2012–2020 Global ...

  5. 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.

  6. 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.

  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. 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.

  9. 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.

  10. 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.

  11. 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.

  12. 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.

  13. 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.

  14. 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.

  15. 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.

  16. 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.

  17. 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

  18. 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...

  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 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.

  1. 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.

  2. 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.

  3. 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.

  4. 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.

  5. 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)

  6. 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 ...

  7. 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.

  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. 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.

  10. [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.

  11. [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.

  12. 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.

  13. 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.

  14. 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…

  15. 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.

  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. 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…

  18. 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.

  19. 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...

  20. 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...

  1. 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...

  2. 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...

  3. 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...

  4. 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...

  5. 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...

  6. 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...

  7. 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...

  8. 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…

  9. 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...

  10. 42 CFR 410.100 - Included services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... function or dysfunction of the neuromuscular, musculoskeletal, cardiovascular and respiratory systems; and... create difficulties in communication. (e) Respiratory therapy services. (1) Respiratory therapy services... cardiopulmonary function. (2) Respiratory therapy services include the following: (i) Application of...

  11. 42 CFR 410.100 - Included services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... function or dysfunction of the neuromuscular, musculoskeletal, cardiovascular and respiratory systems; and... create difficulties in communication. (e) Respiratory therapy services. (1) Respiratory therapy services... cardiopulmonary function. (2) Respiratory therapy services include the following: (i) Application of...

  12. 42 CFR 410.100 - Included services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... function or dysfunction of the neuromuscular, musculoskeletal, cardiovascular and respiratory systems; and... create difficulties in communication. (e) Respiratory therapy services. (1) Respiratory therapy services... cardiopulmonary function. (2) Respiratory therapy services include the following: (i) Application of...

  13. 42 CFR 410.100 - Included services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... function or dysfunction of the neuromuscular, musculoskeletal, cardiovascular and respiratory systems; and... create difficulties in communication. (e) Respiratory therapy services. (1) Respiratory therapy services... cardiopulmonary function. (2) Respiratory therapy services include the following: (i) Application of...

  14. 42 CFR 410.100 - Included services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... function or dysfunction of the neuromuscular, musculoskeletal, cardiovascular and respiratory systems; and... create difficulties in communication. (e) Respiratory therapy services. (1) Respiratory therapy services... cardiopulmonary function. (2) Respiratory therapy services include the following: (i) Application of...

  15. 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)

  16. 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, ...

  17. 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.

  18. 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.

  19. 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.

  20. 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

  1. 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.

  2. 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

  3. 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

  4. 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

  5. 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.

  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. 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.

  8. 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.

  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. 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…

  12. 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...) Cash working capital. The average amount of investor-supplied capital needed to provide funds for...

  13. 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.

  14. 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…

  15. 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.…

  16. 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…

  17. 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)

  18. 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...

  19. 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...

  20. 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...

  1. 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.

  2. 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

  3. 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.

  4. 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.

  5. 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.

  6. 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.

  7. 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.

  8. 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.

  9. 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)

  10. 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.

  11. 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

  12. 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

  13. 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.

  14. 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.

  15. 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.

  16. 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

  17. 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;…

  18. 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.

  19. 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.

  20. 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.

  1. 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.

  2. Ocean management plan includes array of recommendations

    NASA Astrophysics Data System (ADS)

    Showstack, Randy

    When U.S. President Bill Clinton and Vice President Al Gore appeared in Monterey, California in June 1998 for a National Oceans Conference, some of the salt water spray from the Pacific Ocean must have clung to them.As a follow-up to the conference, the Clinton Administration on September 2 issued an interagency report to help guide federal efforts in establishing a comprehensive ocean policy.The report, which touches upon a number of global issues including the United Nations Convention on the Law of the Sea, contains nearly 150 recommendations.

  3. 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.

  4. 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.

  5. 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.

  6. 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.

  7. 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.

  8. 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.

  9. 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.

  10. 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.

  11. 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.

  12. Eigenstates of Moebius nanostructures including curvature effects

    SciTech Connect

    Gravesen, J.; Willatzen, M.

    2005-09-15

    Moebius-shell structures and their physical properties have recently received considerable attention experimentally and theoretically. In this work, eigenstates and associated eigenenergies are determined for a quantum-mechanical particle bounded to a Moebius shell including curvature contributions to the kinetic-energy operator. This is done using a parametrization of the Moebius shell-found by minimizing the elastic energy of the full structure-and employing differential-geometry methods. It is shown that inclusion of curvature contributions to the kinetic energy leads to splitting of the otherwise doubly degenerate groundstate and significantly alters the form of the groundstate and excited-state wavefunctions. Hence, we anticipate qualitative changes in the physical properties of Moebius-shell structures due to surface confinement and curvature effects.

  13. 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.

  14. 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.

  15. Optical panel system including stackable waveguides

    DOEpatents

    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.

  16. 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.

  17. 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.

  18. 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

  19. 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.

  20. 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

  1. 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

  2. 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.

  3. 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.

  4. [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.

  5. 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.

  6. 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.

  7. 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.

  8. 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

  9. 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.

  10. 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.

  11. [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.

  12. 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.

  13. 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.].

  14. 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.

  15. 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.

  16. 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

  17. [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.

  18. [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.

  19. 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

  20. 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

  1. 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.

  2. 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.

  3. 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...

  4. 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…

  5. 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.

  6. [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.

  7. 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.

  8. 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.

  9. 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.

  10. 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…

  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. 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

  13. 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

  14. 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.

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

    SciTech Connect

    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.

  16. 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.

  17. 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...

  18. 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.

  19. 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.

  20. 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…

  1. 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).

  2. 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…

  3. 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.

  4. 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

  5. [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.

  6. 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.

  7. 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.

  8. 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

  9. 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.

  10. 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.

  11. 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.

  12. 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.

  13. 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.

  14. 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.

  15. 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

  16. [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

  17. 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.

  18. 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.

  19. 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.

  20. 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.

  1. 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.

  2. 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.

  3. 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

  4. 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.

  5. 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.

  6. 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.

  7. 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)

  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. 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.

  10. [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.

  11. 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.

  12. 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.

  13. 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.

  14. 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.

  15. 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.

  16. 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

  17. 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.

  18. [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.

  19. 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.

  20. 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

  1. 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.

  2. 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)

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

    MedlinePlus

    ... protein called MeCP2 that is critical for normal brain function. Researchers believe that this protein has several functions, including regulating other genes in the brain by switching them on or off as they ...

  4. A comparison of different category scales for estimating disease severity

    Technology Transfer Automated Retrieval System (TEKTRAN)

    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...

  5. 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…

  6. 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…

  7. 7 CFR 1400.6 - Joint and several liability.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 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 ventures and general partnerships, and any member of a...

  8. 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...

  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...

  10. 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...

  11. 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...

  12. 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…

  13. 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

  14. 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.

  15. 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.

  16. 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.

  17. 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.

  18. 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.

  19. 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.

  20. 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.

  1. 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.

  2. 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.

  3. Mycophenolate mofetil therapy for severe immune thrombocytopenia.

    PubMed

    Taylor, Alice; Neave, Lucy; Solanki, Shalini; Westwood, John Paul; Terrinonive, Ilaria; McGuckin, Siobhan; Kothari, Jaimal; Cooper, Nichola; Stasi, Roberto; Scully, Marie

    2015-11-01

    Severe immune thrombocytopenia purpura (ITP) presents a clinical challenge. Second-line treatment options are variable without a precise protocol. We present 46 severe ITP patients treated with mycophenolate mofetil (MMF), retrospectively identified from three London teaching hospitals. Data was collected on patient demographics, co-morbidities and previous treatment strategies. Our key interest was whether there was a sustained response in platelet count to MMF. Patients included 27 males and 19 females whose ages ranged from 19 to 93 years old (median 52·5 years). Twenty-nine had primary ITP and 17 had secondary ITP, a third of whom had viral-associated disease. The standard dose of MMF was 1 g/day. Twenty-four patients (52%) responded with 15 (33%) achieving a complete response. No active viral-associated ITP patients demonstrated a response to MMF, although numbers were small (n = 4). We were not able to demonstrate a difference between responders and non-responders based on gender, age, previous therapies or time since diagnosis of ITP. Three of four previously splenectomized patients responded, two achieving complete response. We conclude that MMF is a useful steroid-sparing immunosuppressant to be considered in the second-line or later treatment of ITP.

  4. Performance of several low-cost accelerometers

    USGS Publications Warehouse

    Evans, J.R.; Allen, R.M.; Chung, A. I.; Cochran, E.S.; Guy, R.; Hellweg, M.; Lawrence, J. F.

    2014-01-01

    Several groups are implementing low‐cost host‐operated systems of strong‐motion accelerographs to support the somewhat divergent needs of seismologists and earthquake engineers. The Advanced National Seismic System Technical Implementation Committee (ANSS TIC, 2002), managed by the U.S. Geological Survey (USGS) in cooperation with other network operators, is exploring the efficacy of such systems if used in ANSS networks. To this end, ANSS convened a working group to explore available Class C strong‐motion accelerometers (defined later), and to consider operational and quality control issues, and the means of annotating, storing, and using such data in ANSS networks. The working group members are largely coincident with our author list, and this report informs instrument‐performance matters in the working group’s report to ANSS. Present examples of operational networks of such devices are the Community Seismic Network (CSN; csn.caltech.edu), operated by the California Institute of Technology, and Quake‐Catcher Network (QCN; Cochran et al., 2009; qcn.stanford.edu; November 2013), jointly operated by Stanford University and the USGS. Several similar efforts are in development at other institutions. The overarching goals of such efforts are to add spatial density to existing Class‐A and Class‐B (see next paragraph) networks at low cost, and to include many additional people so they become invested in the issues of earthquakes, their measurement, and the damage they cause.

  5. A case report of severe external resorption.

    PubMed

    Ford, G S; Baisden, M; Hoen, M; Quigley, N; Camp, L

    1994-06-01

    External root resorption is a multifactorial process with many causes. Except for transient surface resorption, it is usually considered an irreversible process. Treatment can arrest or retard the resorptive process. Many factors that have been associated with this process include physiologic resorption, local factors, systemic conditions, and idiopathic resorption. This case report documents a 29-year-old white male who suffered a motor vehicle accident and dental trauma nine years ago. The accident resulted in the lateral displacement of the maxillary right canine. The maxillary right lateral incisor, right central incisor and left central incisors were avulsed. The right central incisor was never recovered from the accident site. The other teeth were replanted 90 minutes after the accident and rigidly splinted for six months. They then received root canal treatment, approximately one month after the splint was removed (seven months from time of the trauma). On annual examination, the patient complained of a loose maxillary fixed prosthesis. He was diagnosed with severe external resorption on the right lateral and left central incisors, and severe external replacement resorption on the right canine. This case report reviews the current trends in the treatment of avulsed teeth and the resorptive process.

  6. Elucidating novel disease mechanisms in severe asthma

    PubMed Central

    Kim, Richard Y; Rae, Brittany; Neal, Rachel; Donovan, Chantal; Pinkerton, James; Balachandran, Lohis; Starkey, Malcolm R; Knight, Darryl A; Horvat, Jay C; Hansbro, Philip M

    2016-01-01

    Corticosteroids are broadly active and potent anti-inflammatory agents that, despite the introduction of biologics, remain as the mainstay therapy for many chronic inflammatory diseases, including inflammatory bowel diseases, nephrotic syndrome, rheumatoid arthritis, chronic obstructive pulmonary disease and asthma. Significantly, there are cohorts of these patients with poor sensitivity to steroid treatment even with high doses, which can lead to many iatrogenic side effects. The dose-limiting toxicity of corticosteroids, and the lack of effective therapeutic alternatives, leads to substantial excess morbidity and healthcare expenditure. We have developed novel murine models of respiratory infection-induced, severe, steroid-resistant asthma that recapitulate the hallmark features of the human disease. These models can be used to elucidate novel disease mechanisms and identify new therapeutic targets in severe asthma. Hypothesis-driven studies can elucidate the roles of specific factors and pathways. Alternatively, 'Omics approaches can be used to rapidly generate new targets. Similar approaches can be used in other diseases. PMID:27525064

  7. How I treat severe combined immunodeficiency.

    PubMed

    Gaspar, H Bobby; Qasim, Waseem; Davies, E Graham; Rao, Kanchan; Amrolia, Persis J; Veys, Paul

    2013-11-28

    Severe combined immunodeficiency (SCID) arises from different genetic defects associated with lymphocyte development and function and presents with severe infections. Allogeneic hematopoietic stem cell transplantation is an extremely effective way of restoring immunity in these individuals. Numerous multicenter studies have identified the factors determining successful outcome, and survival for SCID has shown great improvement. Advances in understanding the genetic basis of disease also mean that we increasingly tailor transplant protocols to the specific SCID form. Wherever possible, we attempt to transplant SCID patients without the use of cytoreductive conditioning, but it is clear that this is only successful for specific SCID forms and, although survival is good, in specific patients there are ongoing humoral defects. We aim to use matched related and unrelated donors (including cord blood) whenever possible and have limited the use of mismatched haploidentical donors. The development of autologous hematopoietic stem cell gene therapy provides another treatment of the X-linked and adenosine deaminase-deficient forms of SCID, and we discuss how we have integrated gene therapy into our treatment strategy. These developments together with the advent of universal newborn screening for SCID should allow for a highly favorable outcome for this otherwise lethal condition.

  8. The Severe Thunderstorm Electrification and Precipitation Study.

    NASA Astrophysics Data System (ADS)

    Lang, Timothy J.; Miller, L. Jay; Weisman, Morris; Rutledge, Steven A.; Barker, Llyle J., III; Bringi, V. N.; Chandrasekar, V.; Detwiler, Andrew; Doesken, Nolan; Helsdon, John; Knight, Charles; Krehbiel, Paul; Lyons, Walter A.; Macgorman, Don; Rasmussen, Erik; Rison, William; Rust, W. David; Thomas, Ronald J.

    2004-08-01

    During May July 2000, the Severe Thunderstorm Electrification and Precipitation Study (STEPS) occurred in the High Plains, near the Colorado Kansas border. STEPS aimed to achieve a better understanding of the interactions between kinematics, precipitation, and electrification in severe thunderstorms. Specific scientific objectives included 1) understanding the apparent major differences in precipitation output from super-cells that have led to them being classified as low precipitation (LP), classic or medium precipitation, and high precipitation; 2) understanding lightning formation and behavior in storms, and how lightning differs among storm types, particularly to better understand the mechanisms by which storms produce predominantly positive cloud-to-ground (CG) lightning; and 3) verifying and improving microphysical interpretations from polarimetric radar. The project involved the use of a multiple-Doppler polarimetric radar network, as well as a time-of-arrival very high frequency (VHF) lightning mapping system, an armored research aircraft, electric field meters carried on balloons, mobile mesonet vehicles, instruments to detect and classify transient luminous events (TLEs; e.g., sprites and blue jets) over thunderstorms, and mobile atmospheric sounding equipment. The project featured significant collaboration with the local National Weather Service office in Goodland, Kansas, as well as outreach to the general public. The project gathered data on a number of different cases, including LP storms, supercells, and mesoscale convective systems, among others. Many of the storms produced mostly positive CG lightning during significant portions of their lifetimes and also exhibited unusual electrical structures with opposite polarity to ordinary thunderstorms. The field data from STEPS is expected to bring new advances to understanding of supercells, positive CG lightning, TLEs, and precipitation formation in convective storms.

  9. 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.

  10. 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…

  11. 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

  12. Severe Asthma in Children: Lessons Learned and Future Directions.

    PubMed

    Fitzpatrick, Anne M

    2016-01-01

    Severe asthma in children is a complicated and heterogeneous disorder that is extremely challenging to treat. Although most children with asthma derive clinical benefit from daily administration of low-to-medium-dose inhaled corticosteroid (ICS) therapy, a small subset of children with "severe" or "refractory" asthma require high doses of ICS and even systemic corticosteroids to maintain symptom control. These children with severe asthma are at increased risk for adverse outcomes including medication-related side effects and recurrent and life-threatening exacerbations that significantly impair quality of life. This review highlights findings on severe asthma in school-age children (age 6-17 years) from the National Heart, Lung and Blood Institute's Severe Asthma Research Program (SARP) over a 10-year period, between 2001 and 2011. Although SARP has advanced knowledge of the unique clinical, biological, and molecular attributes of severe asthma in children, considerable gaps remain for which additional studies are needed.

  13. Hurricane Isabel gives accelerators a severe test

    SciTech Connect

    Swapan Chattopadhyay

    2004-01-01

    Hurricane Isabel was at category five--the most violent on the Saffir-Simpson scale of hurricane strength--when it began threatening the central Atlantic seaboard of the US. Over the course of several days, precautions against the extreme weather conditions were taken across the Jefferson Lab site in south-east Virginia. On 18 September 2003, when Isabel struck North Carolina's Outer Banks and moved northward, directly across the region around the laboratory, the storm was still quite destructive, albeit considerably reduced in strength. The flood surge and trees felled by wind substantially damaged or even devastated buildings and homes, including many belonging to Jefferson Lab staff members. For the laboratory itself, Isabel delivered an unplanned and severe challenge in another form: a power outage that lasted nearly three-and-a-half days, and which severely tested the robustness of Jefferson Lab's two superconducting machines, the Continuous Electron Beam Accelerator Facility (CEBAF) and the superconducting radiofrequency ''driver'' accelerator of the laboratory's free-electron laser. Robustness matters greatly for science at a time when microwave superconducting linear accelerators (linacs) are not only being considered, but in some cases already being built for projects such as neutron sources, rare-isotope accelerators, innovative light sources and TeV-scale electron-positron linear colliders. Hurricane Isabel interrupted a several-week-long maintenance shutdown of CEBAF, which serves nuclear and particle physics and represents the world's pioneering large-scale implementation of superconducting radiofrequency (SRF) technology. The racetrack-shaped machine is actually a pair of 500-600 MeV SRF linacs interconnected by recirculation arc beamlines. CEBAF delivers simultaneous beams at up to 6 GeV to three experimental halls. An imminent upgrade will double the energy to 12 GeV and add an extra hall for ''quark confinement'' studies. On a smaller scale

  14. Anchoring the Panic Disorder Severity Scale

    ERIC Educational Resources Information Center

    Keough, Meghan E.; Porter, Eliora; Kredlow, M. Alexandra; Worthington, John J.; Hoge, Elizabeth A.; Pollack, Mark H.; Shear, M. Katherine; Simon, Naomi M.

    2012-01-01

    The Panic Disorder Severity Scale (PDSS) is a clinician-administered measure of panic disorder symptom severity widely used in clinical research. This investigation sought to provide clinically meaningful anchor points for the PDSS both in terms of clinical severity as measured by the Clinical Global Impression-Severity Scale (CGI-S) and to extend…

  15. The determinants of fishing vessel accident severity.

    PubMed

    Jin, Di

    2014-05-01

    The study examines the determinants of fishing vessel accident severity in the Northeastern United States using vessel accident data from the U.S. Coast Guard for 2001-2008. Vessel damage and crew injury severity equations were estimated separately utilizing the ordered probit model. The results suggest that fishing vessel accident severity is significantly affected by several types of accidents. Vessel damage severity is positively associated with loss of stability, sinking, daytime wind speed, vessel age, and distance to shore. Vessel damage severity is negatively associated with vessel size and daytime sea level pressure. Crew injury severity is also positively related to the loss of vessel stability and sinking.

  16. 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.

  17. 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.

  18. Evaluation of the DSM-5 severity indicator for bulimia nervosa.

    PubMed

    Grilo, Carlos M; Ivezaj, Valentina; White, Marney A

    2015-04-01

    This study examined the DSM-5 severity criterion for bulimia nervosa (BN) based on the frequency of inappropriate weight compensatory behaviors. 199 community volunteers classified with BN were categorized using DSM-5 severity levels and compared on demographic and clinical variables. 77 (39%) participants were categorized as mild, 68 (34%) as moderate, 32 (16%) as severe, and 22 (11%) as extreme. The severity groups did not differ significantly in demographic variables or body mass index. Shape and Weight concerns did not differ significantly across severity groups. Binge eating differed with the extreme group having significantly higher frequency than the severe, moderate, and mild groups, which did not differ from each other. Restraint differed with the extreme group having significantly higher levels than the mild group. Eating concerns differed with the extreme group having significantly higher levels than moderate and mild groups. Depression differed with the extreme group having significantly higher levels than severe, moderate, and mild groups, which did not differ from each other. Findings from this non-clinical group provide new, albeit modest, support for DSM-5 severity rating for BN based on frequency of inappropriate weight compensatory behaviors. Statistical findings indicate that differences in collateral clinical variables associated with the DSM-5 severity ratings reflect small effect sizes. Further research is needed with treatment-seeking patient groups with BN to establish the validity of the DSM-5 severity specifier and should include broader clinical and functional validators.

  19. Evaluation of the DSM-5 Severity Indicator for Bulimia Nervosa

    PubMed Central

    Grilo, Carlos M.; Ivezaj, Valentina; White, Marney A.

    2015-01-01

    This study examined the DSM-5 severity criterion for bulimia nervosa (BN) based on the frequency of inappropriate weight compensatory behaviors. 199 community volunteers classified with BN were categorized using DSM-5 severity levels and compared on demographic and clinical variables. 77 (39%) participants were categorized as mild, 68 (34%) as moderate, 32 (16%) as severe, and 22 (11%) as extreme. The severity groups did not differ significantly in demographic variables or body mass index. Shape and Weight concerns did not differ significantly across severity groups. Binge eating differed with the extreme group having higher frequency than the severe, moderate, and mild groups, which did not differ from each other. Restraint differed with the extreme group having significantly higher levels than the mild group. Eating concerns differed with the extreme group having higher levels than moderate and mild groups. Depression differed with the extreme group having higher levels than severe, moderate, and mild groups, which did not differ from each other. Findings from this non-clinical group provide new, albeit modest, support for DSM-5 severity rating for BN based on frequency of inappropriate weight compensatory behaviors. Statistical findings indicate that differences in collateral clinical variables associated with the DSM-5 severity ratings reflect small effect sizes. Further research is needed with treatment-seeking patient groups with BN to establish the validity of the DSM-5 severity specifier and should include broader clinical and functional validators. PMID:25744910

  20. Streptozotocin, Type I Diabetes Severity and Bone

    PubMed Central

    2009-01-01

    As many as 50% of adults with type I (T1) diabetes exhibit bone loss and are at increased risk for fractures. Therapeutic development to prevent bone loss and/or restore lost bone in T1 diabetic patients requires knowledge of the molecular mechanisms accounting for the bone pathology. Because cell culture models alone cannot fully address the systemic/metabolic complexity of T1 diabetes, animal models are critical. A variety of models exist including spontaneous and pharmacologically induced T1 diabetic rodents. In this paper, we discuss the streptozotocin (STZ)-induced T1 diabetic mouse model and examine dose-dependent effects on disease severity and bone. Five daily injections of either 40 or 60 mg/kg STZ induce bone pathologies similar to spontaneously diabetic mouse and rat models and to human T1 diabetic bone pathology. Specifically, bone volume, mineral apposition rate, and osteocalcin serum and tibia messenger RNA levels are decreased. In contrast, bone marrow adiposity and aP2 expression are increased with either dose. However, high-dose STZ caused a more rapid elevation of blood glucose levels and a greater magnitude of change in body mass, fat pad mass, and bone gene expression (osteocalcin, aP2). An increase in cathepsin K and in the ratio of RANKL/OPG was noted in high-dose STZ mice, suggesting the possibility that severe diabetes could increase osteoclast activity, something not seen with lower doses. This may contribute to some of the disparity between existing studies regarding the role of osteoclasts in diabetic bone pathology. Examination of kidney and liver toxicity indicate that the high STZ dose causes some liver inflammation. In summary, the multiple low-dose STZ mouse model exhibits a similar bone phenotype to spontaneous models, has low toxicity, and serves as a useful tool for examining mechanisms of T1 diabetic bone loss. PMID:19495918

  1. Severe Fever with Thrombocytopenia Syndrome Presenting with Rhabdomyolysis

    PubMed Central

    Hong, Sang-Bum; Lee, Sang-Oh; Choi, Sang-Ho; Kim, Yang Soo; Woo, Jun Hee

    2017-01-01

    Severe fever with thrombocytopenia syndrome (SFTS) is an emerging febrile illness. While many kinds of severe complications including acute renal failure have been reported, rhabdomyolysis is rarely reported in association with SFTS. A 54-year-old female farmer was admitted with fever and diffuse myalgia. Laboratory finding showed thrombocytopenia, leukopenia, azotemia, extremely elevated muscle enzyme levels and myoglobinuria. We describe a fatal case of rhabdomyolysis with acute renal failure complicated by SFTS. PMID:28271645

  2. Treatment Approach to Patients With Severe Insulin Resistance

    PubMed Central

    Church, Timothy J.

    2016-01-01

    In Brief Patients with severe insulin resistance require >2 units/kg of body weight or 200 units/day of insulin. Yet, many patients do not achieve glycemic targets despite using very high doses of insulin. Insulin can cause weight gain, which further contributes to worsening insulin resistance. This article describes the pharmacological options for managing patients with severe insulin resistance, including the use of U-500 insulin and newer agents in combination with insulin. PMID:27092020

  3. Severe psychomotor delay in a severe presentation of cat-eye syndrome.

    PubMed

    Jedraszak, Guillaume; Receveur, Aline; Andrieux, Joris; Mathieu-Dramard, Michèle; Copin, Henri; Morin, Gilles

    2015-01-01

    Cat-eye syndrome is a rare genetic syndrome of chromosomal origin. Individuals with cat-eye syndrome are characterized by the presence of preauricular pits and/or tags, anal atresia, and iris coloboma. Many reported cases also presented with variable congenital anomalies and intellectual disability. Most patients diagnosed with CES carry a small supernumerary bisatellited marker chromosome, resulting in partial tetrasomy of 22p-22q11.21. There are two types of small supernumerary marker chromosome, depending on the breakpoint site. In a very small proportion of cases, other cytogenetic anomalies are reportedly associated with the cat-eye syndrome phenotype. Here, we report a patient with cat-eye syndrome caused by a type 1 small supernumerary marker chromosome. The phenotype was atypical and included a severe developmental delay. The use of array comparative genomic hybridization ruled out the involvement of another chromosomal imbalance in the neurological phenotype. In the literature, only a few patients with cat-eye syndrome present with a severe developmental delay, and all of the latter carried an atypical partial trisomy 22 or an uncharacterized small supernumerary marker chromosome. Hence, this is the first report of a severe neurological phenotype in cat-eye syndrome with a typical type 1 small supernumerary marker chromosome. Our observation clearly complicates prognostic assessment, particularly when cat-eye syndrome is diagnosed prenatally.

  4. Effectiveness of panretinal photocoagulation in severe diabetic retinopathy

    NASA Astrophysics Data System (ADS)

    Astakhov, Yuri S.; Shadrichev, Fedor Y.; Lisochkina, Alla B.

    1999-02-01

    Diabetic Retinopathy (DR) is one of the most severe complications of diabetes mellitus. In 1994, in St. Petersburg, a new system of ophthalmologic care for diabetic patients was set up. For Russia, this system represents an example of adequate care for subjects with DM, including screening strategies, documentation and education of patients and general ophthalmologists. According to our data, about one half of examined patients had DR, and about 20% of patients were in need of laser treatment. The aim of present study was to evaluate the effectiveness of panretinal photocoagulation (PRP) in cases of severe DR, including advanced nonproliferative DR (preproliferative DR) and proliferative DR. Data concerning 1073 diabetics are included in this study. PRP was performed in 736 cases (1163 eyes). DR stabilization was estimated after one year follow-up PRP enabled preventing severe visual loss in patients with preproliferative DR and proliferative DR. Our system of specialized ophthalmic care for diabetic patients proved to be effective.

  5. Men More Prone to Severe Psoriasis

    MedlinePlus

    ... fullstory_164498.html Men More Prone to Severe Psoriasis: Study Researchers say this may explain why more ... 2017 THURSDAY, April 6, 2017 (HealthDay News) -- Severe psoriasis is much more common in men than women, ...

  6. Recognizing and managing severe sepsis: a common and deadly threat.

    PubMed

    Schlichting, Douglas; McCollam, Jill Shwed

    2007-06-01

    Through a literature review, the epidemiology and pathophysiology, including alterations in inflammation, coagulation, and impaired fibrinolysis that occur in the course of severe sepsis, is presented. Treatment guidelines that are evidence-based and endorsed by 11 professional societies representing multispecialty groups are described. Severe sepsis is common; 750,000 cases are estimated to occur annually in the United States. The mortality rate for severe sepsis still ranges from 30 to 50%, and is as high as 80 to 90% for septic shock and multiple organ dysfunction. Severe sepsis exists along a continuum initiated by a localized infection that triggers a systemic response. A cascade of inflammation and activation of the coagulation system associated with impaired fibrinolysis leads to alterations in microvascular circulation associated with organ dysfunction, severe sepsis, multiple organ dysfunction syndrome, and death. In an attempt to improve care and reduce mortality, the Surviving Sepsis Campaign and The Institute for Healthcare Improvement (IHI) have created two sepsis treatment bundles.

  7. 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

  8. [Treatment of severe ulcerative colitis flares].

    PubMed

    Aceituno, Montserrat; Montserrat, Aceituno; Zabana, Yamile; Yamile, Zabana; Esteve, Maria; Maria, Esteve

    2014-10-01

    The treatment of severe ulcerative colitis remains a challenge for gastroenterologists. A not inconsiderable number of patients will experience severe flares throughout their lives and will require hospitalization. Mortality in severe ulcerative colitis is still high and consequently treatment must be aggressive, avoiding delays in rescue therapies or even surgery. The aim of this review was to describe the medical treatment of severe ulcerative colitis, highlighting recent therapeutic advances.

  9. [Children severe OSAHS with pectus excavatum: a case report].

    PubMed

    Ma, Wei; Wang, Jinfeng; Xie, Yuping

    2016-03-01

    The primary etiopathology of pediatric OSAHS includes tonsil or adenoid hypertrophy. Severe OSAHS contributes to or aggravates thoracic deformity, which is rarely reported. In the current report, This children sleep snoring more than 4 years, increasing with thoracic severe depression during sleep 2 days. Clinical examination indicated tonsil and adenoid hypertrophy, and polysomnography revealed OSAHS . The symptoms of OSAHS and severe inhalation-related sternum depression disappeared rapidly after tonsillectomy. Our findings indicated that OSAHS were the major causes underlying funnel chest in children. The rarity of the incidence may result in missed diagnosis or misdiagnosis. Polysomnography was recommended for the child diagnosed with funnel chest accompanied by upper airway stenosis.

  10. Primary lysis of eosinophils in severe desquamative asthma.

    PubMed

    Persson, C

    2014-02-01

    Primary lysis of eosinophils liberates free eosinophil granules (FEGs) releasing toxic proteins in association with bronchial epithelial injury repair. Eosinophil lysis may be significantly pathogenic. Bronchial mucosal FEGs are associated with uncontrolled asthma, severe asthma, aspirin-sensitive asthma, and lethal asthma. FEGs in the bronchial wall may characterize severe asthma without sputum eosinophilia. Excessive numbers of sputum FEGs occur in severe exacerbations of asthma and are reduced along with clinical improvement. Occurrence of FEGs affects interpretation of other sputum biomarkers including numbers of eosinophils, ECP, and eosinophil-stained macrophages. Thus, eosinophil lysis produces FEGs as bronchial biomarkers of severe asthma. Blood eosinophils in severe asthma seem primed exhibiting a propensity to lyse that is greater the more severe the asthma. Proclivity of blood eosinophils to lyse also distinguished three levels of severity among children with exacerbations of asthma. Numerous FEGs releasing toxic proteins occur in association with grave derangement and shedding of epithelium in severe asthma. Subepithelial FEGs correlate negatively with intact bronchial epithelium in clinically uncontrolled asthma. Significant correlations between sputum ECP, Creola bodies, and severity of asthma exacerbations have also been demonstrated. Hence, eosinophil lysis apparently causes epithelial desquamation in severe asthma. Exaggerated epithelial repair in turn would contribute to inflammatory and remodelling features of severe asthma. Perseverance of FEGs together with maintained disease activity, despite treatment with 'eosinophil-depleting' steroids and anti-IL5 biologicals, agrees with the possibility that eosinophil lysis is worthy target for novel anti-asthma drugs. Priming and lysis of eosinophils, and protein release from FEGs, are regulated and can be targeted. Eosinophil lysis and FEGs belong to the disease picture of severe asthma and need

  11. Etiology of severe pneumonia in Ecuadorian children

    PubMed Central

    Jonnalagadda, Sivani; Rodríguez, Oswaldo; Estrella, Bertha; Sabin, Lora L.; Sempértegui, Fernando

    2017-01-01

    Background In Latin America, community-acquired pneumonia remains a major cause of morbidity and mortality among children. Few studies have examined the etiology of pneumonia in Ecuador. Methods This observational study was part of a randomized, double blind, placebo-controlled clinical trial conducted among children aged 2–59 months with severe pneumonia in Quito, Ecuador. Nasopharyngeal and blood samples were tested for bacterial and viral etiology by polymerase chain reaction. Risk factors for specific respiratory pathogens were also evaluated. Results Among 406 children tested, 159 (39.2%) had respiratory syncytial virus (RSV), 71 (17.5%) had human metapneumovirus (hMPV), and 62 (15.3%) had adenovirus. Streptococcus pneumoniae was identified in 37 (9.2%) samples and Mycoplasma pneumoniae in three (0.74%) samples. The yearly circulation pattern of RSV (P = 0.0003) overlapped with S. pneumoniae, (P = 0.03) with most cases occurring in the rainy season. In multivariable analysis, risk factors for RSV included younger age (adjusted odds ratio [aOR] = 1.9, P = 0.01) and being underweight (aOR = 1.8, P = 0.04). Maternal education (aOR = 0.82, P = 0.003), pulse oximetry (aOR = 0.93, P = 0.005), and rales (aOR = 0.25, P = 0.007) were associated with influenza A. Younger age (aOR = 3.5, P = 0.007) and elevated baseline respiratory rate were associated with HPIV-3 infection (aOR = 0.94, P = 0.03). Conclusion These results indicate the importance of RSV and influenza, and potentially modifiable risk factors including undernutrition and future use of a RSV vaccine, when an effective vaccine becomes available. Trial registration ClinicalTrials.gov NCT 00513929 PMID:28182741

  12. 16 CFR 312.12 - Severability.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Severability. 312.12 Section 312.12 Commercial Practices FEDERAL TRADE COMMISSION REGULATIONS UNDER SPECIFIC ACTS OF CONGRESS CHILDREN'S ONLINE PRIVACY PROTECTION RULE § 312.12 Severability. The provisions of this part are separate and severable...

  13. 16 CFR 316.6 - Severability.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 16 Commercial Practices 1 2011-01-01 2011-01-01 false Severability. 316.6 Section 316.6 Commercial Practices FEDERAL TRADE COMMISSION REGULATIONS UNDER SPECIFIC ACTS OF CONGRESS CAN-SPAM RULE § 316.6 Severability. The provisions of this Part are separate and severable from one another. If any provision...

  14. 16 CFR 316.6 - Severability.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 16 Commercial Practices 1 2013-01-01 2013-01-01 false Severability. 316.6 Section 316.6 Commercial Practices FEDERAL TRADE COMMISSION REGULATIONS UNDER SPECIFIC ACTS OF CONGRESS CAN-SPAM RULE § 316.6 Severability. The provisions of this Part are separate and severable from one another. If any provision...

  15. 16 CFR 316.6 - Severability.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Severability. 316.6 Section 316.6 Commercial Practices FEDERAL TRADE COMMISSION REGULATIONS UNDER SPECIFIC ACTS OF CONGRESS CAN-SPAM RULE § 316.6 Severability. The provisions of this Part are separate and severable from one another. If any provision...

  16. 16 CFR 316.6 - Severability.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 16 Commercial Practices 1 2014-01-01 2014-01-01 false Severability. 316.6 Section 316.6 Commercial Practices FEDERAL TRADE COMMISSION REGULATIONS UNDER SPECIFIC ACTS OF CONGRESS CAN-SPAM RULE § 316.6 Severability. The provisions of this Part are separate and severable from one another. If any provision...

  17. 16 CFR 316.6 - Severability.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 16 Commercial Practices 1 2012-01-01 2012-01-01 false Severability. 316.6 Section 316.6 Commercial Practices FEDERAL TRADE COMMISSION REGULATIONS UNDER SPECIFIC ACTS OF CONGRESS CAN-SPAM RULE § 316.6 Severability. The provisions of this Part are separate and severable from one another. If any provision...

  18. 16 CFR 315.10 - Severability.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 16 Commercial Practices 1 2011-01-01 2011-01-01 false Severability. 315.10 Section 315.10 Commercial Practices FEDERAL TRADE COMMISSION REGULATIONS UNDER SPECIFIC ACTS OF CONGRESS CONTACT LENS RULE § 315.10 Severability. The provisions of this part are separate and severable from one another. If...

  19. 16 CFR 315.10 - Severability.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Severability. 315.10 Section 315.10 Commercial Practices FEDERAL TRADE COMMISSION REGULATIONS UNDER SPECIFIC ACTS OF CONGRESS CONTACT LENS RULE § 315.10 Severability. The provisions of this part are separate and severable from one another. If...

  20. 16 CFR 315.10 - Severability.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 16 Commercial Practices 1 2013-01-01 2013-01-01 false Severability. 315.10 Section 315.10 Commercial Practices FEDERAL TRADE COMMISSION REGULATIONS UNDER SPECIFIC ACTS OF CONGRESS CONTACT LENS RULE § 315.10 Severability. The provisions of this part are separate and severable from one another. If...

  1. 16 CFR 315.10 - Severability.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 16 Commercial Practices 1 2012-01-01 2012-01-01 false Severability. 315.10 Section 315.10 Commercial Practices FEDERAL TRADE COMMISSION REGULATIONS UNDER SPECIFIC ACTS OF CONGRESS CONTACT LENS RULE § 315.10 Severability. The provisions of this part are separate and severable from one another. If...

  2. 16 CFR 315.10 - Severability.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 16 Commercial Practices 1 2014-01-01 2014-01-01 false Severability. 315.10 Section 315.10 Commercial Practices FEDERAL TRADE COMMISSION REGULATIONS UNDER SPECIFIC ACTS OF CONGRESS CONTACT LENS RULE § 315.10 Severability. The provisions of this part are separate and severable from one another. If...

  3. 16 CFR 322.11 - Severability.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 16 Commercial Practices 1 2011-01-01 2011-01-01 false Severability. 322.11 Section 322.11 Commercial Practices FEDERAL TRADE COMMISSION REGULATIONS UNDER SPECIFIC ACTS OF CONGRESS MORTGAGE ASSISTANCE RELIEF SERVICES § 322.11 Severability. The provisions of this rule are separate and severable from...

  4. 16 CFR 317.5 - Severability.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 16 Commercial Practices 1 2012-01-01 2012-01-01 false Severability. 317.5 Section 317.5 Commercial Practices FEDERAL TRADE COMMISSION REGULATIONS UNDER SPECIFIC ACTS OF CONGRESS PROHIBITION OF ENERGY MARKET MANIPULATION RULE § 317.5 Severability. The provisions of this Rule are separate and severable from one...

  5. 16 CFR 317.5 - Severability.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 16 Commercial Practices 1 2011-01-01 2011-01-01 false Severability. 317.5 Section 317.5 Commercial Practices FEDERAL TRADE COMMISSION REGULATIONS UNDER SPECIFIC ACTS OF CONGRESS PROHIBITION OF ENERGY MARKET MANIPULATION RULE § 317.5 Severability. The provisions of this Rule are separate and severable from one...

  6. 16 CFR 317.5 - Severability.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Severability. 317.5 Section 317.5 Commercial Practices FEDERAL TRADE COMMISSION REGULATIONS UNDER SPECIFIC ACTS OF CONGRESS PROHIBITION OF ENERGY MARKET MANIPULATION RULE § 317.5 Severability. The provisions of this Rule are separate and severable from one...

  7. 16 CFR 317.5 - Severability.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 16 Commercial Practices 1 2013-01-01 2013-01-01 false Severability. 317.5 Section 317.5 Commercial Practices FEDERAL TRADE COMMISSION REGULATIONS UNDER SPECIFIC ACTS OF CONGRESS PROHIBITION OF ENERGY MARKET MANIPULATION RULE § 317.5 Severability. The provisions of this Rule are separate and severable from one...

  8. 16 CFR 317.5 - Severability.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 16 Commercial Practices 1 2014-01-01 2014-01-01 false Severability. 317.5 Section 317.5 Commercial Practices FEDERAL TRADE COMMISSION REGULATIONS UNDER SPECIFIC ACTS OF CONGRESS PROHIBITION OF ENERGY MARKET MANIPULATION RULE § 317.5 Severability. The provisions of this Rule are separate and severable from one...

  9. 25 CFR 20.309 - What does unearned income include?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... include? Unearned income includes, but is not limited to: (a) Income from interest; oil and gas and other... statute; (d) Income from sale of trust land and real or personal property that is set aside...

  10. Haemophilus influenzae Disease (Including Hib) Diagnosis and Treatment

    MedlinePlus

    ... Search The CDC Cancel Submit Search The CDC Haemophilus influenzae Disease (Including Hib) Note: Javascript is disabled or ... Compartir On this Page Diagnosis Treatment Complications Diagnosis Haemophilus influenzae , including Hib, disease is usually diagnosed with one ...

  11. 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.

  12. Including Alternate Assessment Results in Accountability Decisions. NCEO Policy Directions.

    ERIC Educational Resources Information Center

    Quenemoen, Rachel; Thurlow, Martha

    Alternate assessments provide a mechanism for students with complex disabilities to be included in assessment systems. An integral part of maximizing the benefits of assessing students is to include the results of alternate assessments in school accountability systems. This report addresses policy options for including the results of alternate…

  13. 29 CFR 780.616 - Operations included in raising livestock.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 3 2010-07-01 2010-07-01 false Operations included in raising livestock. 780.616 Section... Employment in Agriculture and Livestock Auction Operations Under the Section 13(b)(13) Exemption Requirements for Exemption § 780.616 Operations included in raising livestock. Raising livestock includes...

  14. 20 CFR 220.114 - Evaluation of symptoms, including pain.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 20 Employees' Benefits 1 2012-04-01 2012-04-01 false Evaluation of symptoms, including pain. 220... RETIREMENT ACT DETERMINING DISABILITY Medical Considerations § 220.114 Evaluation of symptoms, including pain...'s symptoms, including pain, and the extent to which the claimant's symptoms can reasonably...

  15. 20 CFR 220.114 - Evaluation of symptoms, including pain.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Evaluation of symptoms, including pain. 220... RETIREMENT ACT DETERMINING DISABILITY Medical Considerations § 220.114 Evaluation of symptoms, including pain...'s symptoms, including pain, and the extent to which the claimant's symptoms can reasonably...

  16. 20 CFR 220.114 - Evaluation of symptoms, including pain.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 20 Employees' Benefits 1 2014-04-01 2012-04-01 true Evaluation of symptoms, including pain. 220... RETIREMENT ACT DETERMINING DISABILITY Medical Considerations § 220.114 Evaluation of symptoms, including pain...'s symptoms, including pain, and the extent to which the claimant's symptoms can reasonably...

  17. 20 CFR 220.114 - Evaluation of symptoms, including pain.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 20 Employees' Benefits 1 2011-04-01 2011-04-01 false Evaluation of symptoms, including pain. 220... RETIREMENT ACT DETERMINING DISABILITY Medical Considerations § 220.114 Evaluation of symptoms, including pain...'s symptoms, including pain, and the extent to which the claimant's symptoms can reasonably...

  18. 20 CFR 220.114 - Evaluation of symptoms, including pain.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 20 Employees' Benefits 1 2013-04-01 2012-04-01 true Evaluation of symptoms, including pain. 220... RETIREMENT ACT DETERMINING DISABILITY Medical Considerations § 220.114 Evaluation of symptoms, including pain...'s symptoms, including pain, and the extent to which the claimant's symptoms can reasonably...

  19. 26 CFR 1.1013-1 - Property included in inventory.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 26 Internal Revenue 11 2011-04-01 2011-04-01 false Property included in inventory. 1.1013-1... included in inventory. The basis of property required to be included in inventory is the last inventory... an inventory are stated in subpart D (section 471 and following), part II, subchapter E, chapter 1...

  20. Development of New Therapies for Severe Asthma

    PubMed Central

    Fajt, Merritt L.

    2017-01-01

    Persistent asthma has long been treated with inhaled corticosteroids (CSs), as the mainstay of therapy. However, their efficacy in patients with more severe disease is limited, which led to the incorporation of poor response to ICSs (and thereby use of high doses of ICS) into recent definitions of severe asthma. Several studies have suggested that severe asthma might consist of several different phenotypes, each with ongoing symptoms and health care utilization, despite the use of high doses of ICS, usually in combination with a second or third controller. Several new therapies have been approved for severe asthma. Long-acting muscarinic agents have recently been approved as an additional controller agent and appear to improve lung function, although their effect on symptoms and exacerbations is less. Although bronchial thermoplasty (BT) has emerged as a therapy for severe asthma, little is understood regarding the appropriate selection of these patients. Considerable data have emerged to support the presence of a group of patients with severe asthma who have ongoing Type 2 inflammation. These patients appear to respond to targeted biologic approaches which are at the current time mostly investigational. In contrast, few effective therapies for patients with less or no evidence for Type 2 inflammation have emerged. Many new and exciting therapies are at the forefront for severe asthma therapy and, in conjunction with precision medicine approaches to identify the group of patients likely to respond to these approaches, will change the way we think about treating severe asthma. PMID:27826957

  1. Severe acquired anaemia in Africa: new concepts.

    PubMed

    van Hensbroek, Michael B; Jonker, Femkje; Bates, Imelda

    2011-09-01

    Severe anaemia is common in Africa. It has a high mortality and particularly affects young children and pregnant women. Recent research provides new insights into the mechanisms and causes of severe acquired anaemia and overturns accepted dogma. Deficiencies of vitamin B12 and vitamin A, but not of iron or folic acid, are associated with severe anaemia. Bacterial infections and, in very young children, hookworm infections are also common in severe anaemia. Irrespective of the aetiology, the mechanism causing severe anaemia is often red cell production failure. Severe anaemia in Africa is therefore a complex multi-factorial syndrome, which, even in an individual patient, is unlikely to be amenable to a single intervention. Policies and practices concerning anaemia diagnosis, treatment and prevention need to be substantially revised if we are to make a significant impact on the huge burden of severe anaemia in Africa.

  2. Characterising Cytokine Gene Expression Signatures in Patients with Severe Sepsis

    PubMed Central

    Grealy, Robert; White, Mary; Stordeur, Patrick; Kelleher, Dermot; Doherty, Derek G.; McManus, Ross; Ryan, Thomas

    2013-01-01

    Introduction. Severe sepsis in humans may be related to an underlying profound immune suppressive state. We investigated the link between gene expression of immune regulatory cytokines and the range of illness severity in patients with infection and severe sepsis. Methods. A prospective observational study included 54 ICU patients with severe sepsis, 53 patients with infection without organ failure, and 20 healthy controls. Gene expression in peripheral blood mononuclear cells (PBMC) was measured using real-time polymerase chain reaction. Results. Infection differed from health by decreased expression of the IL2, and IL23 and greater expression of IL10 and IL27. Severe sepsis differed from infection by having decreased IL7, IL23, IFNγ, and TNFα gene expression. An algorithm utilising mRNA copy number for TNFα, IFNγ, IL7, IL10, and IL23 accurately distinguished sepsis from severe sepsis with a receiver operator characteristic value of 0.88. Gene expression was similar with gram-positive and gram-negative infection and was similar following medical and surgical severe sepsis. Severity of organ failure was associated with serum IL6 protein levels but not with any index of cytokine gene expression in PBMCs. Conclusions. Immune regulatory cytokine gene expression in PBMC provides a robust method of modelling patients' response to infection. PMID:23935244

  3. Insufficient treatment of severe depression in neuromyelitis optica spectrum disorder

    PubMed Central

    Chavarro, Velina S.; Mealy, Maureen A.; Simpson, Alexandra; Lacheta, Anna; Pache, Florence; Ruprecht, Klemens; Gold, Stefan M.; Brandt, Alexander Ulrich; Levy, Michael

    2016-01-01

    Objective: To investigate depression frequency, severity, current treatment, and interactions with somatic symptoms among patients with neuromyelitis optica spectrum disorder (NMOSD). Methods: In this dual-center observational study, we included 71 patients diagnosed with NMOSD according to the International Panel for NMO Diagnosis 2015 criteria. The Beck Depression Inventory (BDI) was classified into severe, moderate, or minimal/no depressive state category. We used the Fatigue Severity Scale to evaluate fatigue. Scores from the Brief Pain Inventory and the PainDETECT Questionnaire were normalized to estimate neuropathic pain. Psychotropic, pain, and immunosuppressant medications were tabulated by established classes. Results: Twenty-eight percent of patients with NMOSD (n = 20) had BDI scores indicative of moderate or severe depression; 48% of patients (n = 34) endorsed significant levels of neuropathic pain. Severity of depression was moderately associated with neuropathic pain (r = 0.341, p < 0.004) but this relationship was confounded by levels of fatigue. Furthermore, only 40% of patients with moderate or severe depressive symptoms received antidepressant medical treatment. Fifty percent of those treated reported persistent moderate to severe depressive symptoms under treatment. Conclusions: Moderate and severe depression in patients with NMOSD is associated with neuropathic pain and fatigue and is insufficiently treated. These results are consistent across 2 research centers and continents. Future research needs to address how depression can be effectively managed and treated in NMOSD. PMID:27800532

  4. Severe asthma and the omalizumab option

    PubMed Central

    Miller, Christopher WT; Krishnaswamy, Narayanaswamy; Johnston, Chambless; Krishnaswamy, Guha

    2008-01-01

    Atopic diseases and asthma are increasing at a remarkable rate on a global scale. It is now well recognized that asthma is a chronic inflammatory disease of the airways. The inflammatory process in many patients is driven by an immunoglobulin E (IgE)-dependent process. Mast cell activation and release of mediators, in response to allergen and IgE, results in a cascade response, culminating in B lymphocyte, T lymphocyte, eosinophil, fibroblast, smooth muscle cell and endothelial activation. This complex cellular interaction, release of cytokines, chemokines and growth factors and inflammatory remodeling of the airways leads to chronic asthma. A subset of patients develops severe airway disease which can be extremely morbid and even fatal. While many treatments are available for asthma, it is still a chronic and incurable disease, characterized by exacerbation, hospitalizations and associated adverse effects of medications. Omalizumab is a new option for chronic asthma that acts by binding to and inhibiting the effects of IgE, thereby interfering with one aspect of the asthma cascade reviewed earlier. This is a humanized monoclonal antibody against IgE that has been shown to have many beneficial effects in asthma. Use of omalizumab may be influenced by the cost of the medication and some reported adverse effects including the rare possibility of anaphylaxis. When used in selected cases and carefully, omalizumab provides a very important tool in disease management. It has been shown to have additional effects in urticaria, angioedema, latex allergy and food allergy, but the data is limited and the indications far from clear. In addition to decreasing exacerbations, it has a steroid sparing role and hence may decrease adverse effects in some patients on high-dose glucocorticoids. Studies have shown improvement in quality of life measures in asthma following the administration of omalizumab, but the effects on pulmonary function are surprisingly small, suggesting a

  5. Hybrid Concurrent Constraint Simulation Models of Several Systems

    NASA Technical Reports Server (NTRS)

    Sweet, Adam

    2003-01-01

    This distribution contains several simulation models created for the hybrid simulation language, Hybrid Concurrent Constraint (HCC). An HCC model contains the information specified in the widely-accepted academic definition of a hybrid system: this includes expressions for the modes of the systems to be simulated and the differential equations that apply in each mode. These expressions are written in the HCC syntax. The models included here were created by either applying basic physical laws or implementing equations listed in previously published papers.

  6. Aeroelastic Tailoring of Transport Wings Including Transonic Flutter Constraints

    NASA Technical Reports Server (NTRS)

    Stanford, Bret K.; Wieseman, Carol D.; Jutte, Christine V.

    2015-01-01

    Several minimum-mass optimization problems are solved to evaluate the effectiveness of a variety of novel tailoring schemes for subsonic transport wings. Aeroelastic stress and panel buckling constraints are imposed across several trimmed static maneuver loads, in addition to a transonic flutter margin constraint, captured with aerodynamic influence coefficient-based tools. Tailoring with metallic thickness variations, functionally graded materials, balanced or unbalanced composite laminates, curvilinear tow steering, and distributed trailing edge control effectors are all found to provide reductions in structural wing mass with varying degrees of success. The question as to whether this wing mass reduction will offset the increased manufacturing cost is left unresolved for each case.

  7. Carpal tunnel syndrome severity staging using sonographic and clinical measures

    PubMed Central

    Roll, Shawn C.; Volz, Kevin R.; Fahy, Christine M.; Evans, Kevin D.

    2014-01-01

    Introduction Ultrasonography may be valuable in staging carpal tunnel syndrome severity, especially by combining multiple measures. This study aimed to develop a preliminary severity staging model using multiple sonographic and clinical measures. Methods Measures were obtained in 104 participants. Multiple categorization structures for each variable were correlated to diagnostic severity based on nerve conduction. Goodness-of-fit was evaluated for models using iterative combinations of highly correlated variables. Using the best-fit model, a preliminary scoring system was developed, and frequency of misclassification was calculated. Results The severity staging model with best fit (Rho 0.90) included patient-reported symptoms, functional deficits, provocative testing, nerve cross-sectional area, and nerve longitudinal appearance. An 8-point scoring scale classified severity accurately for 79.8% of participants. Discussion This severity staging model is a novel approach to carpal tunnel syndrome evaluation. Including more sensitive measures of nerve vascularity, nerve excursion, or other emerging techniques may refine this preliminary model. PMID:25287477

  8. Looking Northwest at Office Building Boiler Room, Including Cinderblock Walls, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Looking Northwest at Office Building Boiler Room, Including Cinderblock Walls, Fuel Tank and Scale Weights - Hematite Fuel Fabrication Facility, Office, 3300 State Road P, Festus, Jefferson County, MO

  9. WEST (FRONT) OF FURNACE COMPLEX, INCLUDING STACKS, WITH CHARGING BRIDGE ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    WEST (FRONT) OF FURNACE COMPLEX, INCLUDING STACKS, WITH CHARGING BRIDGE AND TRESSLE, LOOKING SOUTHEAST. - Tannehill Furnace, 12632 Confederate Parkway, Tannehill Historical State Park, Bucksville, Tuscaloosa County, AL

  10. 21. DETAIL VIEW OF MARSICAL WORKS CONDENSERS INCLUDING QUICKSILVER COLLECTION ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    21. DETAIL VIEW OF MARSICAL WORKS CONDENSERS INCLUDING QUICKSILVER COLLECTION CHANNEL AND COLLECTION BOX, CENTER FOREGROUND, LOOKING SOUTH, SOUTHEAST. - Mariscal Quicksilver Mine & Reduction Works, Terlingua, Brewster County, TX

  11. 10. PHOTOCOPY OF 1875 WOODCUT OF THE BRIDGE INCLUDING THE ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    10. PHOTOCOPY OF 1875 WOODCUT OF THE BRIDGE INCLUDING THE MANUFACTURERS ADVERTISING - Callowhill Street Bridge, Schuylkill River at Spring Garden & Callowhill Streets, Philadelphia, Philadelphia County, PA

  12. DETAIL VIEW OF MARISCAL WORKS CONDENSERS INCLUDING QUICKSILVER COLLECTION CHANNEL ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    DETAIL VIEW OF MARISCAL WORKS CONDENSERS INCLUDING QUICKSILVER COLLECTION CHANNEL AND COLLECTION BOX, CENTER FOREGROUND, LOOKING SOUTH, SOUTHEAST. - Mariscal Quicksilver Mine & Reduction Works, Terlingua, Brewster County, TX

  13. VIEW OF MARISCAL WORKS INCLUDING (POSSIBLE SOOT FURNACE), FOREGROUND, CONDENSERS ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    VIEW OF MARISCAL WORKS INCLUDING (POSSIBLE SOOT FURNACE), FOREGROUND, CONDENSERS AND ORE BIN FOUNDATION ABOVE, LOOKING NORTHWEST. - Mariscal Quicksilver Mine & Reduction Works, Terlingua, Brewster County, TX

  14. 18. VIEW OF MARISCAL WORKS INCLUDING (POSSIBLE SOOT FURNACE), FOREGROUND, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    18. VIEW OF MARISCAL WORKS INCLUDING (POSSIBLE SOOT FURNACE), FOREGROUND, CONDENSERS, AND ORE BIN FOUNDATION ABOVE, LOOKING NORTHWEST. - Mariscal Quicksilver Mine & Reduction Works, Terlingua, Brewster County, TX

  15. South side elevation view includes small buildings for communications equipment ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    South side elevation view includes small buildings for communications equipment and cellular communications tower in background. - Chelan Butte Lookout, Summit of Chelan Butte, Chelan, Chelan County, WA

  16. West side elevation view includes small buildings for communications equipment ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    West side elevation view includes small buildings for communications equipment and cellular communications tower in background. - Chelan Butte Lookout, Summit of Chelan Butte, Chelan, Chelan County, WA

  17. General education teachers' relationships with included students with autism.

    PubMed

    Robertson, Kristen; Chamberlain, Brandt; Kasari, Connie

    2003-04-01

    In this study, we examine the relationship between general education teachers and second- and third-grade included students with autism. We also examine the effect of childrens' behavior problems on these relationships, as well as inclusion within the social environment of the classroom. Included students with autism form multidimensional relationships with their general education teachers. These relationships are associated with student's display of behavior problems and level of inclusion in the class. Specifically, when teachers perceived their relationships with included students with autism to be more positive, children's levels of behavioral problems were lower and they were more socially included in the class.

  18. Screening for severe combined immunodeficiency in neonates

    PubMed Central

    Kelly, Brian T; Tam, Jonathan S; Verbsky, James W; Routes, John M

    2013-01-01

    Severe combined immunodeficiency (SCID) is a rare disease that severely affects the cellular and humoral immune systems. Patients with SCID present with recurrent or severe infections and often with chronic diarrhea and failure to thrive. The disease is uniformly fatal, making early diagnosis essential. Definitive treatment is hematopoietic stem cell transplantation, with best outcomes prior to 3.5 months of age. Newborn screening for SCID using the T-cell receptor excision circle assay has revolutionized early identification of infants with SCID or severe T-cell lymphopenia. PMID:24068875

  19. Development of Dengue Infection Severity Score

    PubMed Central

    Pongpan, Surangrat; Tawichasri, Chamaiporn; Namwongprom, Sirianong

    2013-01-01

    Objectives. To develop a simple scoring system to predict dengue infection severity based on patient characteristics and routine clinical profiles. Methods. Retrospective data of children with dengue infection from 3 general hospitals in Thailand were reviewed. Dengue infection was categorized into 3 severity levels: dengue infection (DF), dengue hemorrhagic fever (DHF), and dengue shock syndrome (DSS). Coefficients of significant predictors of disease severity under ordinal regression analysis were transformed into item scores. Total scores were used to classify patients into 3 severity levels. Results. Significant clinical predictors of dengue infection severity were age >6 years, hepatomegaly, hematocrit ≥40%, systolic pressure <90 mmHg, white cell count >5000 /μL, and platelet ≤50000 /μL. The derived total scores, which ranged from 0 to 18, classified patients into 3 severity levels: DF (scores <2.5, n = 451, 58.1%), DHF (scores 2.5–11.5, n = 276, 35.5%), and DSS (scores >11.5, n = 50, 6.4%). The derived score correctly classified patients into their original severity levels in 60.7%. An under-estimation of 25.7% and an over-estimation of 13.5% were clinically acceptable. Conclusions. The derived dengue infection severity score classified patients into DF, DHF, or DSS, correctly into their original severity levels. Validation of the score should be reconfirmed before application of routine practice. PMID:24324896

  20. Characterization of Samples from the 3H Evaporator System Including Effects of Recycle

    SciTech Connect

    Wilmarth, W.R.

    2001-05-15

    Analysis of several series of samples from the 3H Evaporator System have been completed. The goal of this work was to determine the effects of 3H operation including recycle of concentrated supernate from Tank 30H into the sludge layer of Tank 32H.

  1. Designing Research to Include Racial/Ethnic Diversity and Marginalized Voices

    ERIC Educational Resources Information Center

    James, Katherine

    2003-01-01

    Environmental education research designs will either exclude or include voices outside the dominant culture. Examining the questions we ask and the data collection techniques we use may enable us to design research that is more sensitive to marginalized voices. This article puts forward several methodological considerations that either draw out…

  2. Trouble in Paradise: A Study of Who Is Included in an Inclusion Classroom

    ERIC Educational Resources Information Center

    Zindler, Rachel

    2009-01-01

    Background/Context: This study is based on prior research regarding the need for explicit social instruction for children with special needs, cooperative educational models, and the goals and relative successes of inclusive educational practices. The author refers to several studies on these subjects, including those by Kavale and Forness; Salend;…

  3. Positive Behavioral Support: Including People with Difficult Behavior in the Community.

    ERIC Educational Resources Information Center

    Koegel, Lynn Kern, Ed.; And Others

    Twenty papers on positive behavioral support for people with difficult behavior are grouped into four sections: (1) family issues and family support; (2) education issues; (3) social inclusion; and (4) community inclusion. Papers include: "Parent Education for Prevention and Reduction of Severe Problem Behaviors" (Lynn Kern Koegel et…

  4. 20 CFR 410.454 - Determining the existence of pneumoconiosis, including statutory presumption-survivor's claim.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... SECURITY ADMINISTRATION FEDERAL COAL MINE HEALTH AND SAFETY ACT OF 1969, TITLE IV-BLACK LUNG BENEFITS (1969... (although less than 15) as well as a severe lung impairment, such evidence may be considered, in the... evidence includes medical tests such as blood gas studies, electrocardiogram, pulmonary function...

  5. 20 CFR 410.414 - Determining the existence of pneumoconiosis, including statutory presumption.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... FEDERAL COAL MINE HEALTH AND SAFETY ACT OF 1969, TITLE IV-BLACK LUNG BENEFITS (1969- ) Total Disability or... (although less than 15), as well as a severe lung impairment, such evidence may be considered, in the... relevant evidence includes medical tests such as blood gas studies, electrocardiogram, pulmonary...

  6. 20 CFR 410.414 - Determining the existence of pneumoconiosis, including statutory presumption.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... FEDERAL COAL MINE HEALTH AND SAFETY ACT OF 1969, TITLE IV-BLACK LUNG BENEFITS (1969- ) Total Disability or... (although less than 15), as well as a severe lung impairment, such evidence may be considered, in the... relevant evidence includes medical tests such as blood gas studies, electrocardiogram, pulmonary...

  7. 20 CFR 410.454 - Determining the existence of pneumoconiosis, including statutory presumption-survivor's claim.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... SECURITY ADMINISTRATION FEDERAL COAL MINE HEALTH AND SAFETY ACT OF 1969, TITLE IV-BLACK LUNG BENEFITS (1969... (although less than 15) as well as a severe lung impairment, such evidence may be considered, in the... evidence includes medical tests such as blood gas studies, electrocardiogram, pulmonary function...

  8. Developing Skills in Severely and Profoundly Handicapped Children.

    ERIC Educational Resources Information Center

    Thomas, M. Angele, Ed.

    Included in the publication are 10 articles on developing basic skills in severely and profoundly handicapped children. The first paper focuses on the development of object permanence, a basic cognitive skill, while the second and third review procedures for developing self care skills (toileting and eating). A fourth paper discusses an…

  9. DIESEL EXHAUST EXPOSURE INCREASES SEVERITY OF AN ONGOING INFLUENZA INFECTION

    EPA Science Inventory

    Numerous studies have shown that air pollutants including diesel exhaust (DE) alter host defense responses, resulting in decreased resistance to respiratory infection. The purpose of this study was to evaluate the effects of DE exposure on the severity of an ongoing influenza in...

  10. The School and Home Enrichment Program for Severely Handicapped Children.

    ERIC Educational Resources Information Center

    Gleason, Joni J.

    1987-01-01

    The School and Home Enrichment Program for Severely Handicapped Children includes 332 activities. Focus is on the development of sensory responsiveness, eating skills, fine motor skills, gross motor skills, expressive language, receptive language, personal hygiene, dressing, and social interaction that can be used by parents or teachers as a…

  11. Educational Technology for the Severely Handicapped: A Comprehensive Bibliography.

    ERIC Educational Resources Information Center

    Gaines, Debby, Comp.; And Others

    The bibliography presents approximately 650 references (1955-1975) on educational programs for the severely handicapped. Citations are listed alphabetically by author's name in the following areas: behavior management, curriculum guides, medico-prosthetic aids, motor development, parent training (including aspects of parent involvement in school…

  12. 26 CFR 26.2642-6 - Qualified severance.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... holds two parcels of real estate, Property A and Property B, stock in Company X, a publicly traded...-6 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) ESTATE AND GIFT... severance may result in a gift subject to gift tax, may cause any trust to be included in the gross...

  13. Strategic Planning under Severe Constraints in a State College

    ERIC Educational Resources Information Center

    Geisler, Jerry L.; Gilliard, Debbie J.

    2007-01-01

    This paper examines the difficulties of strategic planning under severe constraints in a state college. Constraints include the planning models available, the governance structure of the college and other externalities, and a not-for-profit model of constraints by Newman and Wallender. After presenting the planning challenges, we discuss…

  14. Physical Activities for Children with Severe Multiple Impairments.

    ERIC Educational Resources Information Center

    Grosse, Susan J.

    1981-01-01

    Intended for teachers of students with severe multiple impairments, the booklet examines the role of physical activities in the education of this population and suggests approaches to exhancing their motor development. Suggestions are offered for stimulating movement in preschool, elementary, and secondary immobile children, including tactile…

  15. Helping Individuals with Severe Disabilities Find Leisure Activities.

    ERIC Educational Resources Information Center

    Demchak, Mary Ann

    1994-01-01

    Guidelines for selecting leisure activities for individuals with severe disabilities include integration with nondisabled peers, age appropriateness, choice/preference, adaptations and partial participation, and feasibility. A form is presented for systematically evaluating potential recreational activities to determine the level to which they…

  16. 5 CFR 337.204 - Severe shortage of candidates.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... EXAMINING SYSTEM Direct-Hire Authority § 337.204 Severe shortage of candidates. (a) OPM will determine when... geographic locations. OPM may decide independently that such a shortage exists, or may make this decision in..., information about: (1) The results of workforce planning and analysis; (2) Employment trends including...

  17. Altered thyroid function in severely injured patients

    PubMed Central

    Grill, Elena; Strong, Michelle; Sonnad, Seema S.; Sarani, Babak; Pascual, Jose; Collins, Heather; Sims, Carrie A.

    2013-01-01

    Background Hemorrhagic shock profoundly affects the neuroendocrine profile of trauma patients, and we hypothesized that massive resuscitation would negatively impact thyroid function. Methods A prospective, observational study investigating thyroid function in hypotensive trauma patients (systolic blood pressure <90 mm Hg × 2) who survived >48 h was conducted at a Level I center over a 6-mo period. Blood samples for thyroid function were collected at time of presentation to the trauma bay and serially for 48 h. Collected data included demographics, injury data, vital signs, transfusion needs, crystalloid use, and vasopressor requirements. Patients receiving >5 units packed red blood cells (PRBC) within 12 h were compared with those receiving ≥ 5 units. Results Patients who required >5 units of PRBC/12 h had significantly lower total and free T4 levels on initial presentation, and levels remained significantly depressed over the next 48 h when compared with patients who required a less aggressive resuscitative effort. T3 values were markedly suppressed during the initial 48 h post trauma in all patients, but were significantly lower in patients requiring >5 units PRBC. TSH levels remained within the normal range for all time points. Lower trauma admission T4 levels were associated with the need for greater crystalloid resuscitation within the first 24 h. Conclusion Measurements of thyroid function are significantly altered in severely injured patients on initial presentation, and low T4 levels predict the need for large resuscitation. Further research investigating the profile and impact of thyroid function in trauma patients during resuscitation and recovery is warranted. PMID:23043865

  18. Severe Accident Test Station Design Document

    SciTech Connect

    Snead, Mary A.; Yan, Yong; Howell, Michael; Keiser, James R.; Terrani, Kurt A.

    2015-09-01

    The purpose of the ORNL severe accident test station (SATS) is to provide a platform for evaluation of advanced fuels under projected beyond design basis accident (BDBA) conditions. The SATS delivers the capability to map the behavior of advanced fuels concepts under accident scenarios across various temperature and pressure profiles, steam and steam-hydrogen gas mixtures, and thermal shock. The overall facility will include parallel capabilities for examination of fuels and irradiated materials (in-cell) and non-irradiated materials (out-of-cell) at BDBA conditions as well as design basis accident (DBA) or loss of coolant accident (LOCA) conditions. Also, a supporting analytical infrastructure to provide the data-needs for the fuel-modeling components of the Fuel Cycle Research and Development (FCRD) program will be put in place in a parallel manner. This design report contains the information for the first, second and third phases of design and construction of the SATS. The first phase consisted of the design and construction of an out-of-cell BDBA module intended for examination of non-irradiated materials. The second phase of this work was to construct the BDBA in-cell module to test irradiated fuels and materials as well as the module for DBA (i.e. LOCA) testing out-of-cell, The third phase was to build the in-cell DBA module. The details of the design constraints and requirements for the in-cell facility have been closely captured during the deployment of the out-of-cell SATS modules to ensure effective future implementation of the in-cell modules.

  19. Experience with partial cholecystectomy in severe cholecystitis

    PubMed Central

    2013-01-01

    Backgrounds/Aims Partial cholecystectomy (PC) is often an inevitable operative procedure when Calot triangle is severely inflamed and fibrosed with conglomerated structures. We reviewed our clinical outcomes of PC to compare its feasibility with conventional total cholecystectomy (TC), especially for its possible application to laparoscopic procedure. Methods From Aug. 2000 to July 2008, 20 cases of PC by laparotomy were performed, including converted cases during laparoscopic cholecystectomy. Sixty-eight cases of TC by open method during the same period were compared in a mean follow-up period of 108 months. Results Bile fistula was observed in 3 cases of PC; one case needed endoscopic biliary stent for management and a second case showed fistula that closed by supportive care in 2 months. The last patient died from peritonitis. No bile fistula was observed in PC. Morbidities were found in 9 cases of PC (45%) and in 11 cases of TC (16.2%). Bile fistula (n=3) and wound infection (n=3) were prominent in the PC group, and wound infection (n=7) in the TC group. Reoperations were necessary for 5 (25.0%) and 4 (5.9%) patients from PC and TC, respectively. Mortality occurred in 2 (2/10 10%) and 4 cases (4/68 5.9%) of PC and TC, respectively. Two mortalities in each group resulted from direct extension of cholecystitis. Conclusions Considering the higher risks of complications and mortality, PC should be avoided as long as possible, and patients should always be informed of its clinical outcomes postoperatively. Further elaboration of a safer operative plan should be sought. PMID:26155235

  20. Bringing Street Art to School: Open to Include

    ERIC Educational Resources Information Center

    Santos, Graça Duarte; Varandas, Elisabete

    2016-01-01

    Inclusive Education values differences by reducing barriers to learning and promoting active participation and positive interactions between all members of school community. Nowadays, school faces numerous children/adolescents who for several reasons have developed challenging behaviours and high risk of dropping out school. They come often from…

  1. Citrus diseases with global ramifications including citrus canker and huanglongbing

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Although there are a number of diseases that plague citrus production worldwide, two bacterial diseases are particularly problematic. Both are of Asian origin and currently cause severe economic damage: Asiatic citrus canker (ACC) and citrus huanglongbing (HLB). Although ACC has been found in the ...

  2. Top 10 Threats to Computer Systems Include Professors and Students

    ERIC Educational Resources Information Center

    Young, Jeffrey R.

    2009-01-01

    In this article, the author presents the top-10 list of campus computer-security risks he compiled based on several recent computing surveys and interviews with more than a dozen college-technology leaders. The list, ordered from least to most serious, is by no means scientific, but it gives a sense of where today's battle lines are--and why…

  3. Solar Energy Education. Reader, Part II. Sun story. [Includes glossary

    SciTech Connect

    Not Available

    1981-05-01

    Magazine articles which focus on the subject of solar energy are presented. The booklet prepared is the second of a four part series of the Solar Energy Reader. Excerpts from the magazines include the history of solar energy, mythology and tales, and selected poetry on the sun. A glossary of energy related terms is included. (BCS)

  4. 40 CFR 1502.14 - Alternatives including the proposed action.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 34 2012-07-01 2012-07-01 false Alternatives including the proposed action. 1502.14 Section 1502.14 Protection of Environment COUNCIL ON ENVIRONMENTAL QUALITY ENVIRONMENTAL IMPACT STATEMENT § 1502.14 Alternatives including the proposed action. This section is the heart of...

  5. 40 CFR 1502.14 - Alternatives including the proposed action.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 32 2010-07-01 2010-07-01 false Alternatives including the proposed action. 1502.14 Section 1502.14 Protection of Environment COUNCIL ON ENVIRONMENTAL QUALITY ENVIRONMENTAL IMPACT STATEMENT § 1502.14 Alternatives including the proposed action. This section is the heart of...

  6. 40 CFR 1502.14 - Alternatives including the proposed action.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 33 2011-07-01 2011-07-01 false Alternatives including the proposed action. 1502.14 Section 1502.14 Protection of Environment COUNCIL ON ENVIRONMENTAL QUALITY ENVIRONMENTAL IMPACT STATEMENT § 1502.14 Alternatives including the proposed action. This section is the heart of...

  7. 40 CFR 1502.14 - Alternatives including the proposed action.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 33 2014-07-01 2014-07-01 false Alternatives including the proposed action. 1502.14 Section 1502.14 Protection of Environment COUNCIL ON ENVIRONMENTAL QUALITY ENVIRONMENTAL IMPACT STATEMENT § 1502.14 Alternatives including the proposed action. This section is the heart of...

  8. 2 CFR 200.470 - Taxes (including Value Added Tax).

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 2 Grants and Agreements 1 2014-01-01 2014-01-01 false Taxes (including Value Added Tax). 200.470... Cost § 200.470 Taxes (including Value Added Tax). (a) For states, local governments and Indian tribes... Federal government for the taxes, interest, and penalties. (c) Value Added Tax (VAT) Foreign taxes...

  9. Microfluidic devices and methods including porous polymer monoliths

    DOEpatents

    Hatch, Anson V; Sommer, Gregory J; Singh, Anup K; Wang, Ying-Chih; Abhyankar, Vinay V

    2014-04-22

    Microfluidic devices and methods including porous polymer monoliths are described. Polymerization techniques may be used to generate porous polymer monoliths having pores defined by a liquid component of a fluid mixture. The fluid mixture may contain iniferters and the resulting porous polymer monolith may include surfaces terminated with iniferter species. Capture molecules may then be grafted to the monolith pores.

  10. 14 CFR 29.1181 - Designated fire zones: regions included.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Designated fire zones: regions included. 29... Protection § 29.1181 Designated fire zones: regions included. (a) Designated fire zones are— (1) The engine power section of reciprocating engines; (2) The engine accessory section of reciprocating engines;...

  11. 14 CFR 25.1181 - Designated fire zones; regions included.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Designated fire zones; regions included. 25... Protection § 25.1181 Designated fire zones; regions included. (a) Designated fire zones are— (1) The engine power section; (2) The engine accessory section; (3) Except for reciprocating engines, any...

  12. 14 CFR 23.1181 - Designated fire zones; regions included.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Designated fire zones; regions included. 23... Powerplant Powerplant Fire Protection § 23.1181 Designated fire zones; regions included. Designated fire zones are— (a) For reciprocating engines— (1) The power section; (2) The accessory section; (3)...

  13. 7 CFR 1437.303 - Aquaculture, including ornamental fish.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false Aquaculture, including ornamental fish. 1437.303... ASSISTANCE PROGRAM Determining Coverage Using Value § 1437.303 Aquaculture, including ornamental fish. (a) Aquaculture is a value loss crop and is compensable only in accord with restrictions set in this...

  14. 7 CFR 1437.303 - Aquaculture, including ornamental fish.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 10 2011-01-01 2011-01-01 false Aquaculture, including ornamental fish. 1437.303... ASSISTANCE PROGRAM Determining Coverage Using Value § 1437.303 Aquaculture, including ornamental fish. (a) Aquaculture is a value loss crop and is compensable only in accord with restrictions set in this...

  15. 7 CFR 1437.303 - Aquaculture, including ornamental fish.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 10 2013-01-01 2013-01-01 false Aquaculture, including ornamental fish. 1437.303... ASSISTANCE PROGRAM Determining Coverage Using Value § 1437.303 Aquaculture, including ornamental fish. (a) Aquaculture is a value loss crop and is compensable only in accord with restrictions set in this...

  16. 7 CFR 1437.303 - Aquaculture, including ornamental fish.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 10 2012-01-01 2012-01-01 false Aquaculture, including ornamental fish. 1437.303... ASSISTANCE PROGRAM Determining Coverage Using Value § 1437.303 Aquaculture, including ornamental fish. (a) Aquaculture is a value loss crop and is compensable only in accord with restrictions set in this...

  17. 7 CFR 1437.303 - Aquaculture, including ornamental fish.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 10 2014-01-01 2014-01-01 false Aquaculture, including ornamental fish. 1437.303... ASSISTANCE PROGRAM Determining Coverage Using Value § 1437.303 Aquaculture, including ornamental fish. (a) Aquaculture is a value loss crop and is compensable only in accord with restrictions set in this...

  18. Making Way and Making Sense: Including Newcomers in Interaction

    ERIC Educational Resources Information Center

    Pillet-Shore, Danielle

    2010-01-01

    In our everyday interactions as they unfold in real time, how do we do including? This article examines a specific set of interactional moments when the potential to be included (or not) recurs: when a newcomer arrives to some social scene where two or more already-present persons are actively engaged in some activity and that newcomer displays…

  19. 20 CFR 404.1312 - World War II service included.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false World War II service included. 404.1312... DISABILITY INSURANCE (1950- ) Wage Credits for Veterans and Members of the Uniformed Services World War II Veterans § 404.1312 World War II service included. Your service was in the active service of the...

  20. Microfluidic devices and methods including porous polymer monoliths

    SciTech Connect

    Hatch, Anson V.; Sommer, Gregory j.; Singh, Anup K.; Wang, Ying-Chih; Abhyankar, Vinay

    2015-12-01

    Microfluidic devices and methods including porous polymer monoliths are described. Polymerization techniques may be used to generate porous polymer monoliths having pores defined by a liquid component of a fluid mixture. The fluid mixture may contain iniferters and the resulting porous polymer monolith may include surfaces terminated with iniferter species. Capture molecules may then be grafted to the monolith pores.

  1. 43 CFR 3902.24 - Associations, including partnerships.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 43 Public Lands: Interior 2 2012-10-01 2012-10-01 false Associations, including partnerships. 3902... Qualification Requirements § 3902.24 Associations, including partnerships. Associations that are applicants must... members of the association who own or control 10 percent or more of the association or partnership,...

  2. 43 CFR 3902.24 - Associations, including partnerships.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 43 Public Lands: Interior 2 2014-10-01 2014-10-01 false Associations, including partnerships. 3902... Qualification Requirements § 3902.24 Associations, including partnerships. Associations that are applicants must... members of the association who own or control 10 percent or more of the association or partnership,...

  3. 43 CFR 3902.24 - Associations, including partnerships.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 43 Public Lands: Interior 2 2013-10-01 2013-10-01 false Associations, including partnerships. 3902... Qualification Requirements § 3902.24 Associations, including partnerships. Associations that are applicants must... members of the association who own or control 10 percent or more of the association or partnership,...

  4. 43 CFR 3902.24 - Associations, including partnerships.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 43 Public Lands: Interior 2 2011-10-01 2011-10-01 false Associations, including partnerships. 3902... Qualification Requirements § 3902.24 Associations, including partnerships. Associations that are applicants must... members of the association who own or control 10 percent or more of the association or partnership,...

  5. 31 CFR 103.51 - Dollars as including foreign currency.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Dollars as including foreign currency... RECORDKEEPING AND REPORTING OF CURRENCY AND FOREIGN TRANSACTIONS General Provisions § 103.51 Dollars as including foreign currency. Wherever in this part an amount is stated in dollars, it shall be deemed to...

  6. 142. ARAIII General plan of GCRE area, including electrical distribution ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    142. ARA-III General plan of GCRE area, including electrical distribution plan for power and lighting. Includes detail of floodlight and security lighting poles and fixtures. Aerojet-general 880-area/GCRE-406-1. Date: February 1958. Ineel index code no. 063-0406-00-013-102539. - Idaho National Engineering Laboratory, Army Reactors Experimental Area, Scoville, Butte County, ID

  7. 25 CFR 20.403 - What do protective services include?

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... AND SOCIAL SERVICES PROGRAMS Services to Children, Elderly, and Families § 20.403 What do protective services include? Protective services provided to a child, family or elderly person will be documented in... protective services; (2) Providing services to children, elderly, and families, including referrals...

  8. 7 CFR 201.7 - Purity (including variety).

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 3 2010-01-01 2010-01-01 false Purity (including variety). 201.7 Section 201.7 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Standards... REGULATIONS Records for Agricultural and Vegetable Seeds § 201.7 Purity (including variety). The...

  9. 32 CFR 165.7 - Waivers (including reductions).

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 32 National Defense 1 2011-07-01 2011-07-01 false Waivers (including reductions). 165.7 Section... RECOUPMENT OF NONRECURRING COSTS ON SALES OF U.S. ITEMS § 165.7 Waivers (including reductions). (a) The “Arms... consideration of reductions or waivers for particular sales which, if made, significantly advance...

  10. 26 CFR 1.642(g)-2 - Deductions included.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 26 Internal Revenue 8 2010-04-01 2010-04-01 false Deductions included. 1.642(g)-2 Section 1.642(g... (CONTINUED) INCOME TAXES Estates, Trusts, and Beneficiaries § 1.642(g)-2 Deductions included. It is not required that the total deductions, or the total amount of any deduction, to which section 642(g)...

  11. 20 CFR 408.710 - What must your report include?

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 20 Employees' Benefits 2 2013-04-01 2013-04-01 false What must your report include? 408.710 Section 408.710 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SPECIAL BENEFITS FOR CERTAIN WORLD WAR II VETERANS Reporting Requirements § 408.710 What must your report include? When you make a...

  12. 20 CFR 408.710 - What must your report include?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false What must your report include? 408.710 Section 408.710 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SPECIAL BENEFITS FOR CERTAIN WORLD WAR II VETERANS Reporting Requirements § 408.710 What must your report include? When you make a...

  13. 20 CFR 408.710 - What must your report include?

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 20 Employees' Benefits 2 2011-04-01 2011-04-01 false What must your report include? 408.710 Section 408.710 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SPECIAL BENEFITS FOR CERTAIN WORLD WAR II VETERANS Reporting Requirements § 408.710 What must your report include? When you make a...

  14. 20 CFR 408.710 - What must your report include?

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 20 Employees' Benefits 2 2014-04-01 2014-04-01 false What must your report include? 408.710 Section 408.710 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SPECIAL BENEFITS FOR CERTAIN WORLD WAR II VETERANS Reporting Requirements § 408.710 What must your report include? When you make a...

  15. 20 CFR 408.710 - What must your report include?

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 20 Employees' Benefits 2 2012-04-01 2012-04-01 false What must your report include? 408.710 Section 408.710 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SPECIAL BENEFITS FOR CERTAIN WORLD WAR II VETERANS Reporting Requirements § 408.710 What must your report include? When you make a...

  16. 26 CFR 1.1013-1 - Property included in inventory.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 26 Internal Revenue 11 2010-04-01 2010-04-01 true Property included in inventory. 1.1013-1 Section... inventory. The basis of property required to be included in inventory is the last inventory value of such property in the hands of the taxpayer. The requirements with respect to the valuation of an inventory...

  17. Including All Children in Standards-Based Physical Education.

    ERIC Educational Resources Information Center

    Johnson, Lynn V.; Kasser, Susan L.; Nichols, Beverly A.

    2002-01-01

    Discusses the inclusion of students with and without disabilities in physical education as the movement toward standards-based education progresses, examining whether standards should be applied to all students, obstacles to including all students, ways to include all students, and the importance of standards for teachers. An example of inclusive…

  18. 20 CFR 404.1312 - World War II service included.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 20 Employees' Benefits 2 2012-04-01 2012-04-01 false World War II service included. 404.1312... DISABILITY INSURANCE (1950- ) Wage Credits for Veterans and Members of the Uniformed Services World War II Veterans § 404.1312 World War II service included. Your service was in the active service of the...

  19. 20 CFR 404.1312 - World War II service included.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 20 Employees' Benefits 2 2011-04-01 2011-04-01 false World War II service included. 404.1312... DISABILITY INSURANCE (1950- ) Wage Credits for Veterans and Members of the Uniformed Services World War II Veterans § 404.1312 World War II service included. Your service was in the active service of the...

  20. 20 CFR 404.1312 - World War II service included.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 20 Employees' Benefits 2 2013-04-01 2013-04-01 false World War II service included. 404.1312... DISABILITY INSURANCE (1950- ) Wage Credits for Veterans and Members of the Uniformed Services World War II Veterans § 404.1312 World War II service included. Your service was in the active service of the...

  1. 20 CFR 404.1312 - World War II service included.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 20 Employees' Benefits 2 2014-04-01 2014-04-01 false World War II service included. 404.1312... DISABILITY INSURANCE (1950- ) Wage Credits for Veterans and Members of the Uniformed Services World War II Veterans § 404.1312 World War II service included. Your service was in the active service of the...

  2. Articles which include chevron film cooling holes, and related processes

    SciTech Connect

    Bunker, Ronald Scott; Lacy, Benjamin Paul

    2014-12-09

    An article is described, including an inner surface which can be exposed to a first fluid; an inlet; and an outer surface spaced from the inner surface, which can be exposed to a hotter second fluid. The article further includes at least one row or other pattern of passage holes. Each passage hole includes an inlet bore extending through the substrate from the inlet at the inner surface to a passage hole-exit proximate to the outer surface, with the inlet bore terminating in a chevron outlet adjacent the hole-exit. The chevron outlet includes a pair of wing troughs having a common surface region between them. The common surface region includes a valley which is adjacent the hole-exit; and a plateau adjacent the valley. The article can be an airfoil. Related methods for preparing the passage holes are also described.

  3. Allogeneic Transplant in ELANE and MEFV Mutation Positive Severe Cyclic Neutropenia: Review of Prognostic Factors for Secondary Severe Events

    PubMed Central

    2017-01-01

    Objective and Importance. Cyclic neutropenia (CyN) is a rare autosomal dominant inherited disorder due to the mutation ELANE primarily affecting bone marrow stem cells and is characterized by recurrent neutropenia every 2 to 4 weeks. Symptoms vary from benign to severe, including death. Postulations on the cause of wide spectrum in symptom presentation include the possibility of other genetic mutations, such as MEFV. Recommended treatment for CyN is G-CSF to keep ANC higher to minimize risk of infection. Case. A 25-year-old male diagnosed with CyN, on G-CSF but worsening quality of life. Pretransplant investigations revealed ELANE mutation positive severe CyN along with familial Mediterranean fever (MEFV) mutation. Intervention. Bone marrow transplantation as treatment for dual mutation (ELANE and MEFV mutation) positive severe CyN. Conclusion. BMT may be considered as an alternative treatment for severe CyN in patients who are refractory to G-CSF. It is postulated that in our patient the combined mutations (CyN and MEFV) may have contributed to the severity of this individual's symptoms. We suggest CyN patients who present with severe symptoms have evaluation with ELANE mutation testing, Periodic Fever Syndromes Panel, and routine marrow assessment with FISH, conventional cytogenetics, and morphological evaluation for MDS/AML. PMID:28197346

  4. Determination of potassium in several plants and study of potassium transfer to different beverages, including tequila, by measurement of 40K

    NASA Astrophysics Data System (ADS)

    Navarrete, J. M.; Muller, G.; Cabrera, L.; Martinez, T.

    2006-01-01

    Measurement of 40K was used for determination of potassium concentrations in leaves of agave and maguey cactus leaves, and coffee beans of various origins. The procedure was also used to study potassium transfer to tequila (alcoholic drink made of agave cactus), and the cactus and coffee infusions using 40K as a natural radioactive tracer. Counting of 40K in Marinelli containers with the aid of a low background NaI(Ti) scintillation detection system for 12 24 hours was employed. The method appeared to be simple and suitable for determination of potassium concentrations in large samples, which eliminates homogeneity problems.

  5. Determination of the optical properties of La2-xBaxCuO₄ for several dopings, including the anomalous x=1/8 phase

    DOE PAGES

    Homes, C. C.; Hücker, M.; Li, Q.; ...

    2012-04-11

    The optical properties of single crystals of the high-temperature superconductor La2-xBaxCuO₄ have been measured over a wide frequency and temperature range for light polarized in the a-b planes and along the c axis. Three different Ba concentrations have been examined, x=0.095 with a critical temperature Tc=32 K, x=0.125 where the superconductivity is dramatically weakened with Tc≅2.4 K, and x=0.145 with Tc≅24 K. The in-plane behavior of the optical conductivity for these materials at high temperature is described by a Drude-like response with a scattering rate that decreases with temperature. Below Tc in the x=0.095 and 0.145 materials there is amore » clear signature of the formation of a superconducting state in the optical properties allowing the superfluid density (ρs0) and the penetration depth to be determined. In the anomalous 1/8 phase, some spectral weight shifts from lower to higher frequency (≳300 cm⁻¹) on cooling below the spin-ordering temperature Tso≅42 K, associated with the onset of spin-stripe order; we discuss alternative interpretations in terms of a conventional density-wave gap versus the response to pair-density-wave superconductivity. The two dopings for which a superconducting response is observed both fall on the universal scaling line ρs0/8≅4.4σdcTc, which is consistent with the observation of strong dissipation within the a-b planes. The optical properties for light polarized along the c axis reveal an insulating character dominated by lattice vibrations, superimposed on a weak electronic background. No Josephson plasma edge is observed in the low-frequency reflectance along the c axis for x=1/8; however, sharp plasma edges are observed for x=0.095 and 0.145 below Tc.« less

  6. Mental Health Needs and Services for Severely Troubled and Troubling Young People Including Young Offenders in an N.H.S. Region.

    ERIC Educational Resources Information Center

    Nicol, Rory; Stretch, David; Whitney, Irene; Jones, Karin; Garfield, Paul; Turner, Keith; Stanion, Bryan

    2000-01-01

    Screens penal, social services, and special education agencies in one region to determine the need for mental health services among adolescents. Determines that the need for mental health care greatly outstrips the supply. Discusses the effectiveness of treatment for the problems of these youth and a possible structure for service delivery.…

  7. Determination of the optical properties of La2-xBaxCuO4 for several dopings, including the anomalous x=(1)/(8) phase

    NASA Astrophysics Data System (ADS)

    Homes, C. C.; Hücker, M.; Li, Q.; Xu, Z. J.; Wen, J. S.; Gu, G. D.; Tranquada, J. M.

    2012-04-01

    The optical properties of single crystals of the high-temperature superconductor La2-xBaxCuO4 have been measured over a wide frequency and temperature range for light polarized in the a-b planes and along the c axis. Three different Ba concentrations have been examined, x=0.095 with a critical temperature Tc=32 K, x=0.125 where the superconductivity is dramatically weakened with Tc≃2.4 K, and x=0.145 with Tc≃24 K. The in-plane behavior of the optical conductivity for these materials at high temperature is described by a Drude-like response with a scattering rate that decreases with temperature. Below Tc in the x=0.095 and 0.145 materials there is a clear signature of the formation of a superconducting state in the optical properties allowing the superfluid density (ρs0) and the penetration depth to be determined. In the anomalous 1/8 phase, some spectral weight shifts from lower to higher frequency (≳300 cm-1) on cooling below the spin-ordering temperature Tso≃42 K, associated with the onset of spin-stripe order; we discuss alternative interpretations in terms of a conventional density-wave gap versus the response to pair-density-wave superconductivity. The two dopings for which a superconducting response is observed both fall on the universal scaling line ρs0/8≃4.4σdcTc, which is consistent with the observation of strong dissipation within the a-b planes. The optical properties for light polarized along the c axis reveal an insulating character dominated by lattice vibrations, superimposed on a weak electronic background. No Josephson plasma edge is observed in the low-frequency reflectance along the c axis for x=1/8; however, sharp plasma edges are observed for x=0.095 and 0.145 below Tc.

  8. Kynurenine Pathway Pathologies: do Nicotinamide and Other Pathway Co-Factors have a Therapeutic Role in Reduction of Symptom Severity, Including Chronic Fatigue Syndrome (CFS) and Fibromyalgia (FM)

    PubMed Central

    Blankfield, Adele

    2013-01-01

    The definition of dual tryptophan pathways has increased the understanding of the mind-body, body-mind dichotomy. The serotonergic pathway highlights the primary (endogenous) psychiatric disorders. The up-regulation of the kynurenine pathway by physical illnesses can cause neuropathic and immunological disorders1 associated with secondary neuropsychiatric symptoms. Tryptophan and nicotinamide deficiencies fall within the protein energy malnutrition (PEM) spectrum. They can arise if the kynurenine pathway is stressed by primary or secondary inflammatory conditions and the consequent imbalance of available catabolic/anabolic substrates may adversely influence convalescent phase efficiency. The replacement of depleted or reduced NAD+ levels and other cofactors can perhaps improve the clinical management of these disorders. Chronic fatigue syndrome (CFS) and fibromyalgia (FM) appear to meet the criteria of a tryptophan-kynurenine pathway disorder with potential neuroimmunological sequelae. Aspects of some of the putative precipitating factors have been previously outlined.2,3 An analysis of the areas of metabolic dysfunction will focus on future directions for research and management. PMID:23922501

  9. Preserved Visual Language Identification Despite Severe Alexia

    ERIC Educational Resources Information Center

    Di Pietro, Marie; Ptak, Radek; Schnider, Armin

    2012-01-01

    Patients with letter-by-letter alexia may have residual access to lexical or semantic representations of words despite severely impaired overt word recognition (reading). Here, we report a multilingual patient with severe letter-by-letter alexia who rapidly identified the language of written words and sentences in French and English while he had…

  10. [A man with severe traumatic brain injury].

    PubMed

    Oudeman, Eline A; Martins Jarnalo, Carine O; van Ouwerkerk, Willem J R

    2013-01-01

    We present a 41-year-old man with severe traumatic brain injury. Cranial imaging studies revealed cerebral contusion and a longitudinal fracture of the temporal bone. Several days later brain herniated into the left external auditory canal. Imaging studies showed the known skull fracture with a direct connection between the external acoustic meatus and the intracranial structures.

  11. 6 CFR 27.125 - Severability.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 6 Domestic Security 1 2010-01-01 2010-01-01 false Severability. 27.125 Section 27.125 Domestic Security DEPARTMENT OF HOMELAND SECURITY, OFFICE OF THE SECRETARY CHEMICAL FACILITY ANTI-TERRORISM STANDARDS General § 27.125 Severability. If a court finds any portion of this Part to have been...

  12. 40 CFR 1603.14 - Severability.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 32 2010-07-01 2010-07-01 false Severability. 1603.14 Section 1603.14 Protection of Environment CHEMICAL SAFETY AND HAZARD INVESTIGATION BOARD RULES IMPLEMENTING THE GOVERNMENT IN THE SUNSHINE ACT § 1603.14 Severability. If any provision of this part or the application of...

  13. 36 CFR 28.4 - Severability.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 36 Parks, Forests, and Public Property 1 2010-07-01 2010-07-01 false Severability. 28.4 Section 28.4 Parks, Forests, and Public Property NATIONAL PARK SERVICE, DEPARTMENT OF THE INTERIOR FIRE ISLAND NATIONAL SEASHORE: ZONING STANDARDS General Provisions § 28.4 Severability. The invalidation of...

  14. Zika Virus Infection Associated With Severe Thrombocytopenia.

    PubMed

    Sharp, Tyler M; Muñoz-Jordán, Jorge; Perez-Padilla, Janice; Bello-Pagán, Melissa I; Rivera, Aidsa; Pastula, Daniel M; Salinas, Jorge L; Martínez Mendez, Jose H; Méndez, Mónica; Powers, Ann M; Waterman, Stephen; Rivera-García, Brenda

    2016-11-01

    We report two patients that developed severe thrombocytopenia after Zika virus (ZIKV) infection. The first patient had 1000 platelets/μL and died after multiple hemorrhages. The second patient had 2000 platelets/μL, had melena and ecchymoses, and recovered after receiving intravenous immunoglobulin. ZIKV may be associated with immune-mediated severe thrombocytopenia.

  15. 6 CFR 27.125 - Severability.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 6 Domestic Security 1 2011-01-01 2011-01-01 false Severability. 27.125 Section 27.125 Domestic Security DEPARTMENT OF HOMELAND SECURITY, OFFICE OF THE SECRETARY CHEMICAL FACILITY ANTI-TERRORISM STANDARDS General § 27.125 Severability. If a court finds any portion of this part to have been...

  16. 6 CFR 27.125 - Severability.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 6 Domestic Security 1 2012-01-01 2012-01-01 false Severability. 27.125 Section 27.125 Domestic Security DEPARTMENT OF HOMELAND SECURITY, OFFICE OF THE SECRETARY CHEMICAL FACILITY ANTI-TERRORISM STANDARDS General § 27.125 Severability. If a court finds any portion of this part to have been...

  17. 6 CFR 27.125 - Severability.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 6 Domestic Security 1 2014-01-01 2014-01-01 false Severability. 27.125 Section 27.125 Domestic Security DEPARTMENT OF HOMELAND SECURITY, OFFICE OF THE SECRETARY CHEMICAL FACILITY ANTI-TERRORISM STANDARDS General § 27.125 Severability. If a court finds any portion of this part to have been...

  18. Quality Education for the Severely Handicapped.

    ERIC Educational Resources Information Center

    Wilcox, Barbara, Ed.; York, Robert, Ed.

    Eleven papers given at a conference on issues in educational services for severely handicapped students are presented. R. Thompson, B. Wilcox, and R. York begin with "The Federal Program for the Severely Handicapped: Historical Perspective, Analysis, and Review." Six program elements in quality education are then addressed in the following papers:…

  19. Authentic Pedagogy and Students with Severe Disabilities

    ERIC Educational Resources Information Center

    Stephenson, Jennifer; Bo, Tony; Chavez, Deborah; Fayle, Leanne; Gavel, Julie

    2007-01-01

    This paper describes a project carried out by the first author, an academic in special education, with the other authors, teachers of students with severe disabilities. It aimed to explore the application of the New South Wales (NSW) model of pedagogy, derived from authentic pedagogy, to the education of students with severe intellectual…

  20. 16 CFR 436.11 - Severability.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Severability. 436.11 Section 436.11 Commercial Practices FEDERAL TRADE COMMISSION TRADE REGULATION RULES DISCLOSURE REQUIREMENTS AND PROHIBITIONS CONCERNING FRANCHISING Other Provisions § 436.11 Severability. If any provision of this part is stayed...

  1. 16 CFR 436.11 - Severability.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 16 Commercial Practices 1 2011-01-01 2011-01-01 false Severability. 436.11 Section 436.11 Commercial Practices FEDERAL TRADE COMMISSION TRADE REGULATION RULES DISCLOSURE REQUIREMENTS AND PROHIBITIONS CONCERNING FRANCHISING Other Provisions § 436.11 Severability. If any provision of this part is stayed...

  2. Severe weather phobia: an exploratory study.

    PubMed

    Westefeld, J S

    1996-09-01

    Eighty-one persons with an intense fear of severe thunderstorms and tornadoes were interviewed to learn more about the phenomenon of "severe weather phobia," a term introduced for the first time in this investigation. Possible causes and methods of treatment are discussed, as well as implications for future research.

  3. Severe Mental Retardation: From Theory to Practice.

    ERIC Educational Resources Information Center

    Bricker, Diane, Ed.; Filler, John, Ed.

    Fourteen papers examine current issues and practices in the education of students with severe mental retardation (SMR). Papers touch upon the broad context of education for SMR students, programs for the SMR population, and critical issues. The following papers are presented: "The Severely Mentally Retarded Individual: Philosophical and…

  4. Euthanasia of Severely Handicapped Infants: Ethical Issues.

    ERIC Educational Resources Information Center

    Cohen, Libby

    Ethical decisions are involved in life and death decisions for severely handicapped infants. Although it has become common practice for physicians not to treat severely handicapped infants, the ethical considerations involved in euthanasia are complex. A review of the literature reveals that concerns center around the quality of life of the…

  5. Trajectories of Autism Severity in Early Childhood

    ERIC Educational Resources Information Center

    Venker, Courtney E.; Ray-Subramanian, Corey E.; Bolt, Daniel M.; Weismer, Susan Ellis

    2014-01-01

    Relatively little is known about trajectories of autism severity using calibrated severity scores (CSS) from the Autism Diagnostic Observation Schedule, but characterizing these trajectories has important theoretical and clinical implications. This study examined CSS trajectories during early childhood. Participants were 129 children with autism…

  6. 36 CFR 294.18 - Severability.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 36 Parks, Forests, and Public Property 2 2010-07-01 2010-07-01 false Severability. 294.18 Section 294.18 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT OF AGRICULTURE SPECIAL AREAS State Petitions for Inventoried Roadless Area Management § 294.18 Severability. In the event that...

  7. Severe Histoplasmosis in Travelers to Nicaragua

    PubMed Central

    Weeks, Julia; Lance-Parker, Susan; Traeger, Marc; Wiersma, Steven; Phan, Quyen; Dennison, David; MacDonald, Pia; Lindsley, Mark; Guarner, Jeannette; Connolly, Patricia; Cetron, Martin; Hajjeh, Rana

    2003-01-01

    We investigated an outbreak of unexpectedly severe histoplasmosis among 14 healthy adventure travelers from the United States who visited a bat-infested cave in Nicaragua. Although histoplasmosis has rarely been reported to cause serious illness among travelers, this outbreak demonstrates that cases may be severe among travelers, even young, healthy persons. PMID:14609473

  8. 10 CFR 1704.10 - Severability.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 4 2011-01-01 2011-01-01 false Severability. 1704.10 Section 1704.10 Energy DEFENSE NUCLEAR FACILITIES SAFETY BOARD RULES IMPLEMENTING THE GOVERNMENT IN THE SUNSHINE ACT § 1704.10 Severability. If any provision of this part or the application of such provision to any person or...

  9. 10 CFR 1704.10 - Severability.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 4 2012-01-01 2012-01-01 false Severability. 1704.10 Section 1704.10 Energy DEFENSE NUCLEAR FACILITIES SAFETY BOARD RULES IMPLEMENTING THE GOVERNMENT IN THE SUNSHINE ACT § 1704.10 Severability. If any provision of this part or the application of such provision to any person or...

  10. 10 CFR 1704.10 - Severability.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Severability. 1704.10 Section 1704.10 Energy DEFENSE NUCLEAR FACILITIES SAFETY BOARD RULES IMPLEMENTING THE GOVERNMENT IN THE SUNSHINE ACT § 1704.10 Severability. If any provision of this part or the application of such provision to any person or...

  11. 10 CFR 1704.10 - Severability.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 4 2014-01-01 2014-01-01 false Severability. 1704.10 Section 1704.10 Energy DEFENSE NUCLEAR FACILITIES SAFETY BOARD RULES IMPLEMENTING THE GOVERNMENT IN THE SUNSHINE ACT § 1704.10 Severability. If any provision of this part or the application of such provision to any person or...

  12. 10 CFR 1704.10 - Severability.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 4 2013-01-01 2013-01-01 false Severability. 1704.10 Section 1704.10 Energy DEFENSE NUCLEAR FACILITIES SAFETY BOARD RULES IMPLEMENTING THE GOVERNMENT IN THE SUNSHINE ACT § 1704.10 Severability. If any provision of this part or the application of such provision to any person or...

  13. 17 CFR 4.17 - Severability.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 17 Commodity and Securities Exchanges 1 2014-04-01 2014-04-01 false Severability. 4.17 Section 4.17 Commodity and Securities Exchanges COMMODITY FUTURES TRADING COMMISSION COMMODITY POOL OPERATORS AND COMMODITY TRADING ADVISORS General Provisions, Definitions and Exemptions § 4.17 Severability....

  14. Diet-induced obesity, gut microbiota and bone, including alveolar bone loss.

    PubMed

    Eaimworawuthikul, Sathima; Thiennimitr, Parameth; Chattipakorn, Nipon; Chattipakorn, Siriporn C

    2017-02-07

    Obesity is a major risk factor for several pathologies, including jaw bone resorption. The underlying mechanisms involved in pathological conditions resulting from obesity include chronic systemic inflammation and the development of insulin resistance. Although numerous studies have indicated the importance of the role of gut microbiota in the pathogenesis of inflammation and insulin resistance in obesity, only a few studies have established a relationship between obesity, gut microbiota and status of the jaw bone. This review aims to summarize current findings relating to these issues, focusing on the role of obesity and gut microbiota on jaw bone health, including possible mechanisms which can explain this link.

  15. Intensive case management for severe mental illness

    PubMed Central

    Dieterich, Marina; Irving, Claire B; Park, Bert; Marshall, Max

    2014-01-01

    Background Intensive Case Management (ICM) is a community based package of care, aiming to provide long term care for severely mentally ill people who do not require immediate admission. ICM evolved from two original community models of care, Assertive Community Treatment (ACT) and Case Management (CM), where ICM emphasises the importance of small caseload (less than 20) and high intensity input. Objectives To assess the effects of Intensive Case Management (caseload <20) in comparison with non-Intensive Case Management (caseload > 20) and with standard community care in people with severe mental illness. To evaluate whether the effect of ICM on hospitalisation depends on its fidelity to the ACT model and on the setting. Search methods For the current update of this review we searched the Cochrane Schizophrenia Group Trials Register (February 2009), which is compiled by systematic searches of major databases, hand searches and conference proceedings. Selection criteria All relevant randomised clinical trials focusing on people with severe mental illness, aged 18 to 65 years and treated in the community-care setting, where Intensive Case Management, non-Intensive Case Management or standard care were compared. Outcomes such as service use, adverse effects, global state, social functioning, mental state, behaviour, quality of life, satisfaction and costs were sought. Data collection and analysis We extracted data independently. For binary outcomes we calculated relative risk (RR) and its 95% confidence interval (CI), on an intention-to-treat basis. For continuous data we estimated mean difference (MD) between groups and its 95% confidence interval (CI). We employed a random-effects model for analyses. We performed a random-effects meta-regression analysis to examine the association of the intervention’s fidelity to the ACT model and the rate of hospital use in the setting where the trial was conducted with the treatment effect. Main results We included 38 trials

  16. Severe stroke: which medicine for which results?

    PubMed

    Woimant, F; Biteye, Y; Chaine, P; Crozier, S

    2014-02-01

    In face of any severe stroke, the questions for health professionals in charge of the patient are: will the handicap be acceptable for the patient? But can we predict an acceptable handicap for the patient? For his family? When we know that the cognitive disorders, consequences of severe stroke often modify, in a major way, the behaviour of these patients? Given these difficulties for estimate vital and functional prognosis and even more the quality of life of patients with severe stroke, collective reflexions between physicians and nurses are essential, reflexions taking into account preferences and values of patients. Use of resuscitation resources for severe stroke patients implies to offer them the best rehabilitation. So, questions about health pathways for severe stroke are essential: which structures for these patients, which technologies, which medical, medico-social and social supports, which human accompaniment the society can propose to the patients and to their family, so that they have an acceptable quality of life.

  17. Turbomachine injection nozzle including a coolant delivery system

    DOEpatents

    Zuo, Baifang [Simpsonville, SC

    2012-02-14

    An injection nozzle for a turbomachine includes a main body having a first end portion that extends to a second end portion defining an exterior wall having an outer surface. A plurality of fluid delivery tubes extend through the main body. Each of the plurality of fluid delivery tubes includes a first fluid inlet for receiving a first fluid, a second fluid inlet for receiving a second fluid and an outlet. The injection nozzle further includes a coolant delivery system arranged within the main body. The coolant delivery system guides a coolant along at least one of a portion of the exterior wall and around the plurality of fluid delivery tubes.

  18. Electric drive systems including smoothing capacitor cooling devices and systems

    DOEpatents

    Dede, Ercan Mehmet; Zhou, Feng

    2017-02-28

    An electric drive system includes a smoothing capacitor including at least one terminal, a bus bar electrically coupled to the at least one terminal, a thermoelectric device including a first side and a second side positioned opposite the first side, where the first side is thermally coupled to at least one of the at least one terminal and the bus bar, and a cooling element thermally coupled to the second side of the thermoelectric device, where the cooling element dissipates heat from the thermoelectric device.

  19. High performance, durable polymers including poly(phenylene)

    DOEpatents

    Fujimoto, Cy; Pratt, Harry; Anderson, Travis Mark

    2017-02-28

    The present invention relates to functionalized polymers including a poly(phenylene) structure. In some embodiments, the polymers and copolymers of the invention include a highly localized concentration of acidic moieties, which facilitate proton transport and conduction through networks formed from these polymers. In addition, the polymers can include functional moieties, such as electron-withdrawing moieties, to protect the polymeric backbone, thereby extending its durability. Such enhanced proton transport and durability can be beneficial for any high performance platform that employs proton exchange polymeric membranes, such as in fuel cells or flow batteries.

  20. Air pollution and asthma severity in adults

    PubMed Central

    Rage, Estelle; Siroux, Valérie; Künzli, Nino; Pin, Isabelle; Kauffmann, Francine

    2009-01-01

    Objectives There is evidence that exposure to air pollution affects asthma, but the effect of air pollution on asthma severity has not been addressed. The aim was to assess the relation between asthma severity during the past 12 months and home outdoor concentrations of air pollution. Methods Asthma severity over the last 12 months was assessed in two complementary ways among 328 adult asthmatics from the French Epidemiological study on the Genetics and Environment of Asthma (EGEA) examined between 1991 and 1995. The 4-class severity score integrated clinical events and type of treatment. The 5-level asthma score is based only on the occurrence of symptoms. Nitrogen dioxide (NO2), sulphur dioxide (SO2) and ozone (O3) concentrations were assigned to each residence using two different methods. The first was based on the closest monitor data from 1991–1995. The second consisted in spatial models that used geostatistical interpolations and then assigned air pollutants to the geo-coded residences (1998). Results Higher asthma severity score was significantly related to the 8-hour average of ozone during April-September (O3-8hr) and the number of days (O3-days) with 8-hour ozone averages above 110 μg.m−3 (for a 36-day increase, equivalent to the inter quartile range, in O3-days, odds ratio (95% confidence interval) 2.22 (1.61–3.07) for one class difference in score). Adjustment for age, sex, smoking habits, occupational exposure, and educational level did not alter results. Asthma severity was unrelated to NO2. Both exposure assessment methods and severity scores resulted in very similar findings. SO2 correlated with severity but reached statistical significance only for the model based assignment of exposure. Conclusions The observed associations between asthma severity and air pollution, in particular O3, support the hypothesis that air pollution at levels far below current standards increases asthma severity. PMID:19017701

  1. An unusual case of generalized severe gingival enlargement during pregnancy.

    PubMed

    McIntosh, Crystal L; Kolhatkar, Shilpa; Winkler, James R; Ojha, Junu; Bhola, Monish

    2010-01-01

    Increased hormone levels that are present during puberty and pregnancy are associated with localized or generalized gingival enlargement. This article reviews the gingival alterations that can occur during pregnancy and describes a case of generalized severe gingival enlargement associated with pregnancy and its management. A 36-year-old woman had severe bilateral gingival enlargement of short duration. The patient denied taking any medications. The laboratory report revealed no systemic abnormalities; however, the report disclosed that she was pregnant. Surgical therapy for the gingival enlargement included gingivectomy and gingivoplasty of all quadrants, which reduced the size of the enlarged gingiva. Postoperative visits demonstrated uneventful healing, with no recurrence seen at the one-year follow-up appointment. It appears that the English literature includes only one other case report that discusses generalized gingival enlargement during pregnancy. Pregnancy-related gingival enlargement should be included as a differential diagnosis in women who have non-drug-induced generalized gingival enlargement.

  2. A reversible posterior leucoencephalopathy syndrome including blindness caused by preeclampsia

    PubMed Central

    Vandenbossche, G; Maquet, J; Vroonen, P; Lambert, G; Nisolle, M; Kridelka, F; Emonts, E

    2016-01-01

    Complications of (pre)eclampsia may involve multiple systems and organs. Neurological symptoms may occur. Visual symptoms concern up to 25% the of patients with severe preeclampsia and 50% of the patients with eclampsia. An uncommon effect of severe preeclampsia is sudden blindness. Blindness may be part of a clinical and radiological presentation named Posterior Reversible Encephalopathy Syndrome (PRES). PRES may lead to permanent neurological deficit, recurrences or death. We report the case of a 24-year-old Caucasian patient, gravida 5 para 2 who developed preeclampsia and PRES complicated with blindness at 32 weeks of gestation. Optimal care allowed visual symptoms to resolve within 24 hours and a favourable maternal outcome and no long- term sequelae. We describe different causes and manifestations of PRES and highlight the need for immediate care in order to optimize the chance of symptoms reversibility. PMID:28003872

  3. Contextual view including south (rear) of building 925, exercise in ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Contextual view including south (rear) of building 925, exercise in foreground, and modern buildings in background. Facing northwest. - Travis Air Force Base, Building No. 925, W Street, Fairfield, Solano County, CA

  4. 1. AERIAL VIEW OF BRIDGE IN CONTEXT INCLUDING VICTORY CIRCLE ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    1. AERIAL VIEW OF BRIDGE IN CONTEXT INCLUDING VICTORY CIRCLE FROM SOUTH. LOOKING NORTH. - Rue Road Bridge, Rue Road, spanning Matchaponix Brook, .35 mile east of intersection with Route 613, Jamesburg, Middlesex County, NJ

  5. 13. EQUIPMENT USED IN CLEAN ROOM (102), INCLUDING ROYCO PARTICLE ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    13. EQUIPMENT USED IN CLEAN ROOM (102), INCLUDING ROYCO PARTICLE COUNTER (LEFT) AND STEREOSCOPE FOR MANUAL PARTICLE COUNTING (RIGHT) - Vandenberg Air Force Base, Space Launch Complex 3, Vehicle Support Building, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

  6. Looking East on Third Floor of Pellet Plant Including Tops ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Looking East on Third Floor of Pellet Plant Including Tops of Line One and Blenders One, Two, and Three - Hematite Fuel Fabrication Facility, Pellet Plant, 3300 State Road P, Festus, Jefferson County, MO

  7. Looking South at North End of Rod Loading Line Including ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Looking South at North End of Rod Loading Line Including Welding Area Within Rod Loading building - Hematite Fuel Fabrication Facility, Rod Loading Building, 3300 State Road P, Festus, Jefferson County, MO

  8. Looking Northwest Along South End of Rod Loading Building Including ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Looking Northwest Along South End of Rod Loading Building Including Mezzanine and Gad Loading Area - Hematite Fuel Fabrication Facility, Rod Loading Building, 3300 State Road P, Festus, Jefferson County, MO

  9. Modeling Emergent Macrophyte Distributions: Including Sub-dominant Species

    EPA Science Inventory

    Mixed stands of emergent vegetation are often present following drawdowns but models of wetland plant distributions fail to include subdominant species when predicting distributions. Three variations of a spatial plant distribution cellular automaton model were developed to explo...

  10. 8. VIEW OF RADIOGRAPHY EQUIPMENT, TEST METHODS INCLUDED RADIOGRAPHY AND ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    8. VIEW OF RADIOGRAPHY EQUIPMENT, TEST METHODS INCLUDED RADIOGRAPHY AND BETA BACKSCATTERING. (7/13/56) - Rocky Flats Plant, Non-Nuclear Production Facility, South of Cottonwood Avenue, west of Seventh Avenue & east of Building 460, Golden, Jefferson County, CO

  11. Elevation view of front (east) side of milk barn includes ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Elevation view of front (east) side of milk barn includes portion of creamery on left and main barn on right. - Kosai Farm, Milk Barn, B Street north of Northwest Twenty-ninth Street, Auburn, King County, WA

  12. Reduced Toxicity Fuel Satellite Propulsion System Including Plasmatron

    NASA Technical Reports Server (NTRS)

    Schneider, Steven J. (Inventor)

    2003-01-01

    A reduced toxicity fuel satellite propulsion system including a reduced toxicity propellant supply for consumption in an axial class thruster and an ACS class thruster. The system includes suitable valves and conduits for supplying the reduced toxicity propellant to the ACS decomposing element of an ACS thruster. The ACS decomposing element is operative to decompose the reduced toxicity propellant into hot propulsive gases. In addition the system includes suitable valves and conduits for supplying the reduced toxicity propellant to an axial decomposing element of the axial thruster. The axial decomposing element is operative to decompose the reduced toxicity propellant into hot gases. The system further includes suitable valves and conduits for supplying a second propellant to a combustion chamber of the axial thruster. whereby the hot gases and the second propellant auto-ignite and begin the combustion process for producing thrust.

  13. Interior view looking SW includes map hanging from ceiling and ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Interior view looking SW includes map hanging from ceiling and edge of fire finder stand on right. - Badger Mountain Lookout, .125 mile northwest of Badger Mountain summit, East Wenatchee, Douglas County, WA

  14. 4. Band Wheel and Walking Beam Mechanism, Including Remains of ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    4. Band Wheel and Walking Beam Mechanism, Including Remains of Frame Belt House, Looking Southeast - David Renfrew Oil Rig, East side of Connoquenessing Creek, 0.4 mile North of confluence with Thorn Creek, Renfrew, Butler County, PA

  15. Crane 55 at Drydock No. 2. View includes entire bone. ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Crane 55 at Drydock No. 2. View includes entire bone. Building 43 is in background - Puget Sound Naval Shipyard, Portal Gantry Crane No. 55, Central Industrial Area, Farragut Avenue, Bremerton, Kitsap County, WA

  16. 5. EAST SPAN, FROM SOUTH, SHOWING STRUCTURAL CONFIGURATION, INCLUDING POLYGONAL ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    5. EAST SPAN, FROM SOUTH, SHOWING STRUCTURAL CONFIGURATION, INCLUDING POLYGONAL TOP CHORD, TRUSS PANELS, EAST ABUTMENT, AND CENTRAL PIER - Glendale Road Bridge, Spanning Deep Creek Lake on Glendale Road, McHenry, Garrett County, MD

  17. Initiatives to Develop Web Sites Including Information about Brownfields Properties

    EPA Pesticide Factsheets

    This web site was created to assist in planning, designing, and operating web sites that include information about individual brownfields properties. The report is of value to parties designing or managing such sites.

  18. 21 CFR 870.5300 - DC-defibrillator (including paddles).

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... heart or to terminate other cardiac arrhythmias. This generic type of device includes low energy... defibrillating the atria or ventricles of the heart or to terminate other cardiac arrhythmias. The device...

  19. 21 CFR 870.5300 - DC-defibrillator (including paddles).

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... heart or to terminate other cardiac arrhythmias. This generic type of device includes low energy... defibrillating the atria or ventricles of the heart or to terminate other cardiac arrhythmias. The device...

  20. 21 CFR 870.5300 - DC-defribrillator (including paddles).

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... heart or to terminate other cardiac arrhythmias. This generic type of device includes low energy... defibrillating the atria or ventricles of the heart or to terminate other cardiac arrhythmias. The device...

  1. 21 CFR 870.5300 - DC-defribrillator (including paddles).

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... heart or to terminate other cardiac arrhythmias. This generic type of device includes low energy... defibrillating the atria or ventricles of the heart or to terminate other cardiac arrhythmias. The device...

  2. 21 CFR 870.5300 - DC-defribrillator (including paddles).

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... heart or to terminate other cardiac arrhythmias. This generic type of device includes low energy... defibrillating the atria or ventricles of the heart or to terminate other cardiac arrhythmias. The device...

  3. View looking south from sidewalk includes halfthrough west girder on ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    View looking south from sidewalk includes half-through west girder on left and raging river (upstream) on right. - Raging River Bridge No. 234A, Preston-Fall City Road & Southeast Forty-fourth Place, Fall City, King County, WA

  4. 24. POWER ROOM INTERIOR, DC WESTINGHOUSE EXCITER UNIT INCLUDING A ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    24. POWER ROOM INTERIOR, DC WESTINGHOUSE EXCITER UNIT INCLUDING A SHUNT WOUND GENERATOR AND FIELD RHEOSTAT, 1500 RPM, 85 VNL TO 15 VOLT 90 SFL - Death Valley Ranch, Power House, Death Valley Junction, Inyo County, CA

  5. Building No. 902, detail of Mechanical Room door, including vent ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Building No. 902, detail of Mechanical Room door, including vent and conduit - Presidio of San Francisco, Enlisted Men's Barracks Type, West end of Crissy Field, between Pearce & Maudlin Streets, San Francisco, San Francisco County, CA

  6. 21 CFR 886.1840 - Simulatan (including crossed cylinder).

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... given object is clearly in focus, as the examiner uses different lenses). (b) Classification. Class I... cylinder). (a) Identification. A simulatan (including crossed cylinder) is a device that is a set of...

  7. 21 CFR 886.1840 - Simulatan (including crossed cylinder).

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... given object is clearly in focus, as the examiner uses different lenses). (b) Classification. Class I... cylinder). (a) Identification. A simulatan (including crossed cylinder) is a device that is a set of...

  8. 12. SW corner of seating in Original Grandstand, including TV ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    12. SW corner of seating in Original Grandstand, including TV Center booth and reserved seating areas. Stairway above booth leads to turret on roof. Camera pointed SW. (May 1993) - Longacres, Original Grandstand, 1621 Southwest Sixteenth Street, Renton, King County, WA

  9. When Should Zero Be Included on a Scale Showing Magnitude?

    ERIC Educational Resources Information Center

    Kozak, Marcin

    2011-01-01

    This article addresses an important problem of graphing quantitative data: should one include zero on the scale showing magnitude? Based on a real time series example, the problem is discussed and some recommendations are proposed.

  10. View of North End of Oxide Building Interior Including Roof ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    View of North End of Oxide Building Interior Including Roof and Wall Juncture and Crane Trolley - Hematite Fuel Fabrication Facility, Oxide Building & Oxide Loading Dock, 3300 State Road P, Festus, Jefferson County, MO

  11. Looking West From rear (East) End of Office Building Including ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Looking West From rear (East) End of Office Building Including Recycle Storage Area, Loading Docks, and Decontamination Zone - Hematite Fuel Fabrication Facility, Office, 3300 State Road P, Festus, Jefferson County, MO

  12. Looking South at south End of Green Room Including Scrubber ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Looking South at south End of Green Room Including Scrubber for Incinerator within Recycle Recovery Building - Hematite Fuel Fabrication Facility, Recycle Recovery Building, 3300 State Road P, Festus, Jefferson County, MO

  13. 41. OPERATING CORRIDOR PLAN AND SECTIONS, INCLUDING SOME ISOMETRIC DETAILS. ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    41. OPERATING CORRIDOR PLAN AND SECTIONS, INCLUDING SOME ISOMETRIC DETAILS. INEEL DRAWING NUMBER 200-0633-00-287-106455. FLUOR NUMBER 5775-CPP-633-P-60 - Idaho National Engineering Laboratory, Old Waste Calcining Facility, Scoville, Butte County, ID

  14. Stages of Plasma Cell Neoplasms (Including Multiple Myeloma)

    MedlinePlus

    ... Health Professional Plasma Cell Neoplasms Treatment Research Plasma Cell Neoplasms (Including Multiple Myeloma) Treatment (PDQ®)–Patient Version General Information About Plasma Cell Neoplasms Go to Health Professional Version Key Points ...

  15. Treatment Options for Plasma Cell Neoplasms (Including Multiple Myeloma)

    MedlinePlus

    ... Health Professional Plasma Cell Neoplasms Treatment Research Plasma Cell Neoplasms (Including Multiple Myeloma) Treatment (PDQ®)–Patient Version General Information About Plasma Cell Neoplasms Go to Health Professional Version Key Points ...

  16. 17. View of disassembled reduction gear parts including bull and ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    17. View of disassembled reduction gear parts including bull and intermediate gears and pedestal bearing. - Hacienda Azucarera La Esperanza, Steam Engine & Mill, 2.65 Mi. N of PR Rt. 2 Bridge over Manati River, Manati, Manati Municipio, PR

  17. Pets: Your Plan Should Include All Family Members

    MedlinePlus

    ... Emergencies › Pets Pets Your Plan Should Include All Family Members The best way to protect your household ... Cabinet Red Cross Stories Governance Career Opportunities Military Families Disaster Relief What We Do Disaster Relief Health ...

  18. View of west end of Childs Powerhouse, including transformer station ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    View of west end of Childs Powerhouse, including transformer station and associated sheds. Looking downstream (east) - Childs-Irving Hydroelectric Project, Childs System, Childs Powerhouse, Forest Service Road 708/502, Camp Verde, Yavapai County, AZ

  19. 25 CFR 20.308 - What does earned income include?

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... profit, from activities by an employee or self-employed individual. Earned income includes: (a) Any one... self-employment, total profit from a business enterprise (i.e., gross receipts less expenses...

  20. 25 CFR 20.308 - What does earned income include?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... profit, from activities by an employee or self-employed individual. Earned income includes: (a) Any one... self-employment, total profit from a business enterprise (i.e., gross receipts less expenses...