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Sample records for additional ldl-c lowering

  1. PREVENTION OF ATHEROSCLEROSIS WITH LDL-C LOWERING – LIPOPROTEIN CHANGES AND INTERACTIONS: THE SANDS STUDY

    PubMed Central

    Howard, Wm. James; Russell, Marie; Fleg, Jerome L.; Mete, Mihriye; Ali, Tauqeer; Devereux, Richard B.; Galloway, James M.; Otvos, James D.; Ratner, Robert E.; Roman, Mary J.; Silverman, Angela; Umans, Jason G.; Weissman, Neil J.; Wilson, Charlton; Howard, Barbara V.

    2009-01-01

    Background Lowering low-density lipoprotein cholesterol (LDL-C) with statins reduces atherosclerosis. LDL and high-density lipoprotein (HDL) are commonly measured by their cholesterol content, but non-HDL cholesterol, LDL particle number (LDL-P), or total apolipoprotein B (apoB) may better predict cardiovascular risk. Few studies have examined relations among lipoprotein levels and composition before and after interventions to lower LDL-C and non-HDL-C. Objective To measure changes in carotid artery intimal media thickness (CIMT) and lipid concentration and composition during 36 months of statin therapy. Methods Analyses were conducted on 418 diabetic individuals, with complete data and no prior cardiovascular events, who were randomized to aggressive (AG) versus standard (STD) treatment for LDL-C, non-HDL-C, and systolic blood pressure (SBP) as part of the Stop Atherosclerosis in Native Diabetics Study (SANDS). Results The AG group achieved average LDL-C and non-HDL-C of 71mg/dL and 100mg/dL and a decrease in CIMT. No significant interactions were observed between treatment effect and initial levels of LDL-C, non-HDL-C, HDL-C, triglycerides, apoB, or LDL-P. Decreases in LDL-C (p<.005) and non-HDL-C (p<.001) were independently correlated with CIMT regression in the AG group. Changes in apoB and LDL-P showed borderline correlations with CIMT regression (p=.07 and p=.09). Conclusions In diabetic adults with no prior cardiovascular events, treatment to current targets for lipids and SBP reduces atherosclerosis progression and when more aggressive targets are met, atherosclerosis regresses. The aggressive targets for LDL-C and non-HDL-C appeared to be the main determinants of CIMT regression and were more predictive of this outcome than changes in LDL-P or apoB. PMID:20161568

  2. Unmet Needs in LDL-C Lowering: When Statins Won't Do!

    PubMed

    Krähenbühl, Stephan; Pavik-Mezzour, Ivana; von Eckardstein, Arnold

    2016-08-01

    The use of low-density lipoprotein cholesterol (LDL-C)-lowering medications has led to a significant reduction of cardiovascular risk in both primary and secondary prevention. Statin therapy, one of the cornerstones for the prevention and treatment of cardiovascular disease (CVD), has been demonstrated to be effective in lowering LDL-C levels and in reducing the risk for CVD and is generally well-tolerated. However, compliance with statins remains suboptimal. One of the main reasons is limitations by adverse events, notably myopathies, which can lead to non-compliance with the prescribed statin regimen. Reducing the burden of elevated LDL-C levels is critical in patients with CVD as well as in patients with very high baseline levels of LDL-C (e.g. patients with familial hypercholesterolaemia), as statin therapy is insufficient for optimally reducing LDL-C below target values. In this review, we discuss alternative treatment options after maximally tolerated doses of statin therapy, including ezetimibe, proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors, and cholesteryl ester transfer protein (CETP) inhibitors. Difficult-to-treat patients may benefit from combination therapy with ezetimibe or a PCSK9 inhibitor (evolocumab or alirocumab, which are now available). Updates of treatment guidelines are needed to guide the management of patients who will best benefit from these new treatments. PMID:27456066

  3. Cost-Effectiveness of LDL-C Lowering With Evolocumab in Patients With High Cardiovascular Risk in the United States.

    PubMed

    Gandra, Shravanthi R; Villa, Guillermo; Fonarow, Gregg C; Lothgren, Mickael; Lindgren, Peter; Somaratne, Ransi; van Hout, Ben

    2016-06-01

    Randomized trials have shown marked reductions in low-density lipoprotein cholesterol (LDL-C), a risk factor for cardiovascular disease (CVD), when evolocumab is administered. We hypothesized that evolocumab added to standard of care (SOC) vs SOC alone is cost-effective in the treatment of patients with heterozygous familial hypercholesterolemia (HeFH) or atherosclerotic CVD (ASCVD) with or without statin intolerance and LDL-C >100 mg/dL. Using a Markov cohort state transition model, primary and recurrent CVD event rates were predicted considering population-specific trial-based mean risk factors and calibrated against observed rates in the real world. The LDL-C-lowering effect from population-specific phase 3 randomized studies for evolocumab was used together with estimated LDL-C-lowering effect on CVD event rates per 38.67-mg/dL LDL-C lowering from a statin-trial meta-analysis. Costs and utilities were included from published sources. Evolocumab treatment was associated with both increased cost and improved quality-adjusted life-years (QALY): HeFH (incremental cost: US$153 289, incremental QALY: 2.02, incremental cost-effectiveness ratio: US$75 863/QALY); ASCVD (US$158 307, 1.12, US$141 699/QALY); and ASCVD with statin intolerance (US$136 903, 1.36, US$100 309/QALY). Evolocumab met both the American College of Cardiology/American Heart Association (ACC/AHA) and World Health Organization (WHO) thresholds in each population evaluated. Sensitivity and scenario analyses confirmed that model results were robust to changes in model parameters. Among patients with HeFH and ASCVD with or without statin intolerance, evolocumab added to SOC may provide a cost-effective treatment option for lowering LDL-C using ACC/AHA intermediate/high value and WHO cost-effectiveness thresholds. More definitive information on the clinical and economic value of evolocumab will be available from the forthcoming CVD outcomes study.

  4. NEW CLASS OF DRUGS: THERAPEUTIC RNAi INHIBITION OF PCSK9 AS A SPECIFIC LDL-C LOWERING THERAPY.

    PubMed

    Strat, A L; Ghiciuc, Cristina Mihaela; Lupuşoru, Cătălina Elena; Mitu, F

    2016-01-01

    Hyperlipidemia is a well-known risk factor for coronary heart disease, the leading cause of death for both men and women. Current lipid-lowering treatment is not always efficient, therefore new pharmacological interventions that reduce LDL cholesterol (LDL-C) have been developed. This paper presents new class of specific LDL lipid-lowering drugs under investigation in phase II or III clinical trials. The inhibition of proprotein convertase subtilisin/kexin type 9 (PCSK9), a key enzyme in cholesterol homeostasis, improve the liver's ability to clear LDL from the plasma, reducing LDL-C levels. Currently, three monoclonal antibodies PCSK9 inhibitors (alirocumab, evolocumab and bococizumab) are evaluated in clinical outcome trials. ALN-PCSsc, the new first-in- class therapeutic RNA interference (RNAi) inhibitor of proprotein convertase subtilisin/kexin type 9 (PCSK9) is also the first-in-class investigational medicine that acts by turning off PCSK9 synthesis in the liver. The development leadership of ALN-PCSsc has now transferred from Alnylam Pharmaceuticals to The Medicines Company, who has initiated the ORION-1 Phase II study at the beginning of 2016. ALN-PCSsc has significant potential given its highly competitive profile as compared with monoclonal antibodies anti-PCSK9 MAbs, a recently approved class of LDL-C lowering drugs.

  5. NEW CLASS OF DRUGS: THERAPEUTIC RNAi INHIBITION OF PCSK9 AS A SPECIFIC LDL-C LOWERING THERAPY.

    PubMed

    Strat, A L; Ghiciuc, Cristina Mihaela; Lupuşoru, Cătălina Elena; Mitu, F

    2016-01-01

    Hyperlipidemia is a well-known risk factor for coronary heart disease, the leading cause of death for both men and women. Current lipid-lowering treatment is not always efficient, therefore new pharmacological interventions that reduce LDL cholesterol (LDL-C) have been developed. This paper presents new class of specific LDL lipid-lowering drugs under investigation in phase II or III clinical trials. The inhibition of proprotein convertase subtilisin/kexin type 9 (PCSK9), a key enzyme in cholesterol homeostasis, improve the liver's ability to clear LDL from the plasma, reducing LDL-C levels. Currently, three monoclonal antibodies PCSK9 inhibitors (alirocumab, evolocumab and bococizumab) are evaluated in clinical outcome trials. ALN-PCSsc, the new first-in- class therapeutic RNA interference (RNAi) inhibitor of proprotein convertase subtilisin/kexin type 9 (PCSK9) is also the first-in-class investigational medicine that acts by turning off PCSK9 synthesis in the liver. The development leadership of ALN-PCSsc has now transferred from Alnylam Pharmaceuticals to The Medicines Company, who has initiated the ORION-1 Phase II study at the beginning of 2016. ALN-PCSsc has significant potential given its highly competitive profile as compared with monoclonal antibodies anti-PCSK9 MAbs, a recently approved class of LDL-C lowering drugs. PMID:27483697

  6. Effect of Ezetimibe on LDL-C Lowering and Atherogenic Lipoprotein Profiles in Type 2 Diabetic Patients Poorly Controlled by Statins

    PubMed Central

    Sakamoto, Kentaro; Kawamura, Mitsunobu; Kohro, Takahide; Omura, Masao; Watanabe, Takayuki; Ashidate, Keiko; Horiuchi, Toshiyuki; Hara, Hidehiko; Sekine, Nobuo; Chin, Rina; Tsujino, Motoyoshi; Hiyoshi, Toru; Tagami, Motoki; Tanaka, Akira; Mori, Yasumichi; Inazawa, Takeshi; Hirano, Tsutomu; Yamazaki, Tsutomu; Shiba, Teruo

    2015-01-01

    Background There exists a subpopulation of T2DM in whom first-line doses of statin are insufficient for optimally reducing LDL-C, representing a major risk of CVD. The RESEARCH study focuses on LDL-C reduction in this population along with modifications of the lipid profiles leading to residual risks. Methods Lipid changes were assessed in a randomized, multicenter, 12-week, open-label study comparing a high-potency statin (10mg of atorvastatin or 1mg of pitavastatin) plus ezetimibe (EAT: n = 53) with a double dose of statin (20mg of atorvastatin or 2mg of pitavastatin) (DST: n = 56) in DM subjects who had failed to achieve the optimal LDL-C targets. Lipid variables were compared with a primary focus on LDL-C and with secondary focuses on the percentage of patients who reached the LDL-C targets and changes in the levels of RLP-C (remnant like particle cholesterol) and sd-LDL-C, two characteristic atherogenic risks of DM. Results The reduction of LDL-C (%), the primary endpoint, differed significantly between the two groups (-24.6 in EAT vs. -10.9 in DST). In the analyses of the secondary endpoints, EAT treatment brought about significantly larger reductions in sd-LDL-C (-20.5 vs. -3.7) and RLP-C (-19.7 vs. +5.5). In total, 89.4% of the patients receiving EAT reached the optimized treatment goal compared to 51.0% of the patients receiving DST. The changes in TC (-16.3 vs. -6.3) and non-HDL-C (-20.7 vs. -8.3) differed significantly between the two groups. Conclusion Ezetimibe added to high-potency statin (10 mg of atorvastatin or 1 mg of pitavastatin) was more effective than the intensified-dose statin (20 mg of atorvastatin or 2 mg of pitavastatin) treatment not only in helping T2DM patients attain more LDL-C reduction, but also in improving their atherogenic lipid profiles, including their levels of sd-LDL-C and RLP-C. We thus recommend the addition of ezetimibe to high-potency statin as a first line strategy for T2DM patients with insufficient statin response

  7. Evolocumab lowers LDL-C safely and effectively when self-administered in the at-home setting.

    PubMed

    Dent, Ricardo; Joshi, Raju; Stephen Djedjos, C; Legg, Jason; Elliott, Mary; Geller, Michelle; Meyer, Dawn; Somaratne, Ransi; Recknor, Chris; Weiss, Robert

    2016-01-01

    Evolocumab has been shown to consistently reduce low-density lipoprotein cholesterol (LDL-C) across populations. The phase 3 studies included administration in the home-use and in-clinic settings but did not specifically evaluate the feasibility of home-use administration. Two clinical studies enrolled patients with hypercholesterolemia or mixed dyslipidemia on statin therapy and with/without ezetimibe received evolocumab in the home-use setting. Patients were randomized to self-administer evolocumab using one of two injection devices biweekly over 6 weeks (autoinjector or prefilled syringe; n = 149; ClinicalTrials.gov, NCT01849497) or monthly over 12 weeks (autoinjector or automated minidoser; n = 164; NCT01879319). The first self-administration occurred in the in-clinic setting, and two more were performed in the at-home setting. Patients were successful in self-administering evolocumab in the home-use setting in approximately 95 % of attempts and experienced LDL-C reductions from baseline to week 6 or the mean of weeks 10 and 12 of approximately 65 %. Rates of successful self-administration and LDL-C reduction were similar across dosing schedules and study devices. Adverse events were similar between randomized groups and generally mild in severity. In two clinical studies, therefore, patients were able to successfully self-administer evolocumab in both the in-clinic and at-home settings regardless of which dosing schedule or device they used.

  8. Fixed-dose combination ezetimibe+atorvastatin lowers LDL-C equivalent to co-administered components in randomized trials: use of a dose-response model.

    PubMed

    Bays, Harold E; Chen, Erluo; Tomassini, Joanne E; McPeters, Gail; Polis, Adam B; Triscari, Joseph

    2015-04-01

    Co-administration of ezetimibe with atorvastatin is a generally well-tolerated treatment option that reduces LDL-C levels and improves other lipids with greater efficacy than doubling the atorvastatin dose. The objective of the study was to demonstrate the equivalent lipid-modifying efficacy of fixed-dose combination (FDC) ezetimibe/atorvastatin compared with the component agents co-administered individually in support of regulatory filing. Two randomized, 6-week, double-blind cross-over trials compared the lipid-modifying efficacy of ezetimibe/atorvastatin 10/20 mg (n = 353) or 10/40 mg (n = 280) vs. separate co-administration of ezetimibe 10 mg plus atorvastatin 20 mg (n = 346) or 40 mg (n = 280), respectively, in hypercholesterolemic patients. Percent changes from baseline in LDL-C (primary endpoint) and other lipids (secondary endpoints) were assessed by analysis of covariance; triglycerides were evaluated by longitudinal-data analysis. Expected differences between FDC and the corresponding co-administered doses were predicted from a dose-response relationship model; sample size was estimated given the expected difference and equivalence margins (±4%). LDL-C-lowering equivalence was based on 97.5% expanded confidence intervals (CI) for the difference contained within the margins; equivalence margins for other lipids were not prespecified. Ezetimibe/atorvastatin FDC 10/20 mg was equivalent to co-administered ezetimibe+atorvastatin 20 mg in reducing LDL-C levels (54.0% vs. 53.8%) as was FDC 10/40 mg and ezetimibe+atorvastatin 40 mg (58.9% vs. 58.7%), as predicted by the model. Changes in other lipids were consistent with equivalence (97.5% expanded CIs <±3%, included 0); triglyceride changes varied more. All treatments were generally well tolerated. Hypercholesterolemic patients administered ezetimibe/atorvastatin 10/20 and 10/40 mg FDC had equivalent LDL-C lowering. This FDC formulation proved to be an efficacious and generally well

  9. Innovative pharmaceutical interventions in cardiovascular disease: Focusing on the contribution of non-HDL-C/LDL-C-lowering versus HDL-C-raising: A systematic review and meta-analysis of relevant preclinical studies and clinical trials.

    PubMed

    Kühnast, Susan; Fiocco, Marta; van der Hoorn, José W A; Princen, Hans M G; Jukema, J Wouter

    2015-09-15

    Non-HDL-cholesterol is well recognised as a primary causal risk factor in cardiovascular disease. However, despite consistent epidemiological evidence for an inverse association between HDL-C and coronary heart disease, clinical trials aimed at raising HDL-C (AIM-HIGH, HPS2-THRIVE, dal-OUTCOMES) failed to meet their primary goals. This systematic review and meta-analysis investigated the effects of established and novel treatment strategies, specifically targeting HDL, on inhibition of atherosclerosis in cholesteryl ester transfer protein-expressing animals, and the prevention of clinical events in randomised controlled trials. Linear regression analyses using data from preclinical studies revealed associations for TC and non-HDL-C and lesion area (R(2)=0.258, P=0.045; R(2)=0.760, P<0.001), but not for HDL-C (R(2)=0.030, P=0.556). In clinical trials, non-fatal myocardial infarction risk was significantly less in the treatment group with pooled odd ratios of 0.87 [0.81; 0.94] for all trials and 0.85 [0.78; 0.93] after excluding some trials due to off-target adverse events, whereas all-cause mortality was not affected (OR 1.05 [0.99-1.10]). Meta-regression analyses revealed a trend towards an association between between-group differences in absolute change from baseline in LDL-C and non-fatal myocardial infarction (P=0.066), whereas no correlation was found for HDL-C (P=0.955). We conclude that the protective role of lowering LDL-C and non-HDL-C is well-established. The contribution of raising HDL-C on inhibition of atherosclerosis and the prevention of cardiovascular disease remains undefined and may be dependent on the mode of action of HDL-C-modification. Nonetheless, treatment strategies aimed at improving HDL function and raising apolipoprotein A-I may be worth exploring. PMID:25989133

  10. Interleukin 28B polymorphisms are the only common genetic variants associated with low-density lipoprotein cholesterol (LDL-C) in genotype-1 chronic hepatitis C and determine the association between LDL-C and treatment response.

    PubMed

    Clark, P J; Thompson, A J; Zhu, M; Vock, D M; Zhu, Q; Ge, D; Patel, K; Harrison, S A; Urban, T J; Naggie, S; Fellay, J; Tillmann, H L; Shianna, K; Noviello, S; Pedicone, L D; Esteban, R; Kwo, P; Sulkowski, M S; Afdhal, N; Albrecht, J K; Goldstein, D B; McHutchison, J G; Muir, A J

    2012-05-01

    Low-density lipoprotein cholesterol (LDL-C) levels and interleukin 28B (IL28B) polymorphism are associated with sustained viral response (SVR) to peginterferon/ribavirin (pegIFN/RBV) for chronic hepatitis C (CHC) infection. IL28B has been linked with LDL-C levels using a candidate gene approach, but it is not known whether other genetic variants are associated with LDL-C, nor how these factors definitively affect SVR. We assessed genetic predictors of serum lipid and triglyceride levels in 1604 patients with genotype 1 (G1) chronic hepatitis C virus (HCV) infection by genome-wide association study and developed multivariable predictive models of SVR. IL28B polymorphisms were the only common genetic variants associated with pretreatment LDL-C level in Caucasians (rs12980275, P = 4.7 × 10(-17), poor response IL28B variants associated with lower LDL-C). The association was dependent on HCV infection, IL28B genotype was no longer associated with LDL-C in SVR patients after treatment, while the association remained significant in non-SVR patients (P < 0.001). LDL-C was significantly associated with SVR for heterozygous IL28B genotype patients (P < 0.001) but not for homozygous genotypes. SVR modelling suggested that IL28B heterozygotes with LDL-C > 130 mg/dL and HCV RNA ≤600 000 IU/mL may anticipate cure rates >80%, while the absence of these two criteria was associated with an SVR rate of <35%. IL28B polymorphisms are the only common genetic variants associated with pretreatment LDL-C in G1-HCV. LDL-C remains significantly associated with SVR for heterozygous IL28B genotype patients, where LDL-C and HCV RNA burden may identify those patients with high or low likelihood of cure with pegIFN/RBV therapy. PMID:22497812

  11. Association of Apolipoprotein B, LDL-C and vascular stiffness in Adolescents with Type 1 Diabetes

    PubMed Central

    Bjornstad, Petter; Nguyen, Nhung; Reinick, Christina; Maahs, David M.; Bishop, Franziska K.; Clements, Scott A.; Snell-Bergeon, Janet K.; Lieberman, Rachel; Pyle, Laura P.; Daniels, Stephen R.; Wadwa, R. Paul

    2014-01-01

    Objective LDL cholesterol (LDL-C) is the current lipid standard for cardiovascular disease (CVD) risk assessment in type 1 diabetes. Apolipoprotein B (apoB) may be helpful to further stratify CVD-risk. We explored the association between apoB and pulse wave velocity (PWV) to determine if apoB would improve CVD-risk stratification, especially in type 1 diabetes adolescents with borderline LDL-C (100-129mg/dL). We hypothesized that type 1 diabetes adolescents with borderline LDL-C and elevated apoB (≥90mg/dL) would have increased PWV compared to those with borderline LDL-C and normal apoB (<90mg/dL), and that apoB would explain more of the variability of PWV than alternative lipid indices. Methods Fasting lipids, including apoB, were collected in 267 adolescents, age 12-19 years, with diabetes-duration >5 years and HbA1c 8.9±1.6%. Triglyceride to HDL-C ratio (TG/HDL-C) and nonHDL-cholesterol (nonHDL-C) were calculated. PWV was measured in the carotid-femoral segment. Results ApoB, nonHDL-C and TG/HDL-C correlated with PWV (p<0.0001). ApoB, nonHDL-C and TG/HDL-C remained significantly associated with PWV in fully-adjusted models. In adolescents with borderline LDL-C (n=61), PWV was significantly higher in those with elevated apoB than in those with normal apoB (5.6±0.6 vs. 5.2±0.6m/s, p<0.01), and also remained significant after adjustment for CVD-risk factors (p=0.0002). Moreover, in those with borderline LDL-C, apoB explained more of the variability of PWV than nonHDL-C and TG/HDL-C. Conclusion Elevated apoB is associated with increased arterial stiffness in type 1 diabetes adolescents. Measurement of apoB in addition to LDL-C may be helpful in stratifying CVD-risk in type 1 diabetes adolescents, especially in those with borderline LDL-C. PMID:25539881

  12. Refinement of variant selection for the LDL-C genetic risk score in the diagnosis of the polygenic form of clinical Familial Hypercholesterolemia and replication in samples from six countries

    PubMed Central

    Futema, Marta; Shah, Sonia; Cooper, Jackie A; Li, KaWah; Whittall, Ros A; Sharifi, Mahtab; Goldberg, Olivia; Drogari, Euridiki; Mollaki, Vasiliki; Wiegman, Albert; Defesche, Joep; D’Agostino, Maria N; D’Angelo, Antonietta; Rubba, Paolo; Fortunato, Giuliana; Walus-Miarka, Małgorzata; Hegele, Robert A; Bamimore, Mary Aderayo; Durst, Ronen; Leitersdorf, Eran; Mulder, Monique T; Roeters van Lennep, Janine E; Sijbrands, Eric J G; Whittaker, John C; Talmud, Philippa J; Humphries, Steve E

    2016-01-01

    Background Familial Hypercholesterolemia (FH) is an autosomal-dominant disorder caused by mutations in one of three genes. In the 60% of patients who are mutation-negative we have recently shown that the clinical phenotype can be associated with an accumulation of common small-effect LDL-C-raising alleles using a 12-SNP score. The aims of the study were to improve the selection of SNPs, and to replicate the results in additional samples. Methods Receiver-operating characteristic curves were used to determine the optimum number of LDL-C SNPs. For replication analysis, we genotyped patients with a clinical diagnosis of FH from six countries for six LDL-C-associated alleles. We compared the weighted SNP score among patients with no confirmed mutation (FH/M-), those with a mutation (FH/M+), and controls from an UK population sample (WHII). Results Increasing the number of SNPs to 33 did not improve the ability of the score to discriminate between FH/M- and controls, while sequential removal of SNPs with smaller effects/lower frequency showed a weighted score of six SNPs performed as well as the 12-SNP score. Meta-analysis of the weighted 6-SNP score, based on polymorphisms in CELSR2, APOB, ABCG5/8, LDLR and APOE loci, in the independent FH/M- cohorts showed a consistently higher score in comparison to the WHII population (P<2.2×10-16). Modeling in individuals with a 6-SNP score in the top three quarters of the score distribution, indicated a >95% likelihood of a polygenic explanation of their increased LDL-C. Conclusion A 6-SNP LDL-C score consistently distinguishes FH/M- patients from healthy subjects. The hypercholesterolemia in 88% of mutation-negative patients is likely to have a polygenic basis. PMID:25414277

  13. Genome-wide association study of genetic determinants of LDL-c response to atorvastatin therapy: importance of Lp(a) [S

    PubMed Central

    Deshmukh, Harshal A.; Colhoun, Helen M.; Johnson, Toby; McKeigue, Paul M.; Betteridge, D. John; Durrington, Paul N.; Fuller, John H.; Livingstone, Shona; Charlton-Menys, Valentine; Neil, Andrew; Poulter, Neil; Sever, Peter; Shields, Denis C.; Stanton, Alice V.; Chatterjee, Aurobindo; Hyde, Craig; Calle, Roberto A.; DeMicco, David A.; Trompet, Stella; Postmus, Iris; Ford, Ian; Jukema, J. Wouter; Caulfield, Mark; Hitman, Graham A.

    2012-01-01

    We carried out a genome-wide association study (GWAS) of LDL-c response to statin using data from participants in the Collaborative Atorvastatin Diabetes Study (CARDS; n = 1,156), the Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT; n = 895), and the observational phase of ASCOT (n = 651), all of whom were prescribed atorvastatin 10 mg. Following genome-wide imputation, we combined data from the three studies in a meta-analysis. We found associations of LDL-c response to atorvastatin that reached genome-wide significance at rs10455872 (P = 6.13 × 10−9) within the LPA gene and at two single nucleotide polymorphisms (SNP) within the APOE region (rs445925; P = 2.22 × 10−16 and rs4420638; P = 1.01 × 10−11) that are proxies for the ϵ2 and ϵ4 variants, respectively, in APOE. The novel association with the LPA SNP was replicated in the PROspective Study of Pravastatin in the Elderly at Risk (PROSPER) trial (P = 0.009). Using CARDS data, we further showed that atorvastatin therapy did not alter lipoprotein(a) [Lp(a)] and that Lp(a) levels accounted for all of the associations of SNPs in the LPA gene and the apparent LDL-c response levels. However, statin therapy had a similar effect in reducing cardiovascular disease (CVD) in patients in the top quartile for serum Lp(a) levels (HR = 0.60) compared with those in the lower three quartiles (HR = 0.66; P = 0.8 for interaction). The data emphasize that high Lp(a) levels affect the measurement of LDL-c and the clinical estimation of LDL-c response. Therefore, an apparently lower LDL-c response to statin therapy may indicate a need for measurement of Lp(a). However, statin therapy seems beneficial even in those with high Lp(a). PMID:22368281

  14. Genome-wide association study of genetic determinants of LDL-c response to atorvastatin therapy: importance of Lp(a).

    PubMed

    Deshmukh, Harshal A; Colhoun, Helen M; Johnson, Toby; McKeigue, Paul M; Betteridge, D John; Durrington, Paul N; Fuller, John H; Livingstone, Shona; Charlton-Menys, Valentine; Neil, Andrew; Poulter, Neil; Sever, Peter; Shields, Denis C; Stanton, Alice V; Chatterjee, Aurobindo; Hyde, Craig; Calle, Roberto A; Demicco, David A; Trompet, Stella; Postmus, Iris; Ford, Ian; Jukema, J Wouter; Caulfield, Mark; Hitman, Graham A

    2012-05-01

    We carried out a genome-wide association study (GWAS) of LDL-c response to statin using data from participants in the Collaborative Atorvastatin Diabetes Study (CARDS; n = 1,156), the Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT; n = 895), and the observational phase of ASCOT (n = 651), all of whom were prescribed atorvastatin 10 mg. Following genome-wide imputation, we combined data from the three studies in a meta-analysis. We found associations of LDL-c response to atorvastatin that reached genome-wide significance at rs10455872 (P = 6.13 × 10(-9)) within the LPA gene and at two single nucleotide polymorphisms (SNP) within the APOE region (rs445925; P = 2.22 × 10(-16) and rs4420638; P = 1.01 × 10(-11)) that are proxies for the ε2 and ε4 variants, respectively, in APOE. The novel association with the LPA SNP was replicated in the PROspective Study of Pravastatin in the Elderly at Risk (PROSPER) trial (P = 0.009). Using CARDS data, we further showed that atorvastatin therapy did not alter lipoprotein(a) [Lp(a)] and that Lp(a) levels accounted for all of the associations of SNPs in the LPA gene and the apparent LDL-c response levels. However, statin therapy had a similar effect in reducing cardiovascular disease (CVD) in patients in the top quartile for serum Lp(a) levels (HR = 0.60) compared with those in the lower three quartiles (HR = 0.66; P = 0.8 for interaction). The data emphasize that high Lp(a) levels affect the measurement of LDL-c and the clinical estimation of LDL-c response. Therefore, an apparently lower LDL-c response to statin therapy may indicate a need for measurement of Lp(a). However, statin therapy seems beneficial even in those with high Lp(a). PMID:22368281

  15. Higher prevalence of elevated LDL-C than non-HDL-C and low statin treatment rate in elderly community-dwelling Chinese with high cardiovascular risk

    PubMed Central

    Kuang, YaShu; Li, Xiaolin; Chen, Xiaoli; Sun, Huimin; Tomlinson, Brian; Chan, Paul; Zheng, Liang; Pi, Jinjiang; Peng, Sheng; Wu, Hong; Ding, Xugang; Qian, Dingguang; Shen, Yixin; Yu, Zuoren; Fan, Lieying; Chen, Ming; Fan, Huimin; Liu, Zhongmin; Zhang, Yuzhen

    2016-01-01

    Lipid levels are increasing in all age groups in the Chinese population, but the use of statin treatment in the elderly is not well documented. We examined serum lipids, statin usage and achievement of lipid goals in 3950 subjects aged ≥65 years. Established CVD was present in 7.77% of participants and increased CVD risk was common. Elevated LDL-C according to CVD risk level was present in 46.70% of all subjects and was more frequent (p < 0.01) than elevated non-HDL-C at 32.58%. With increasing age, LDL-C was unchanged but triglycerides and non-HDL-C decreased and HDL-C increased. Individuals at moderate risk for CVD had higher TC, LDL-C, and non-HDL-C than low-risk subjects, but the values were lower in high- and very-high-risk individuals, probably because of the use of statin which was 28.57% in high-risk subjects with established CVD and 37.60% in very-high-risk individuals, but only 2.62% in those with estimated high-risk and 3.75% in those with high-risk from diabetes. More subjects in each risk group reached the non-HDL-C goal than the LDL-C goal because of the relatively low triglycerides and VLDL-C levels. These findings demonstrate a high prevalence of elevated LDL-C but low rate of statin treatment in elderly community-dwelling Chinese. PMID:27686151

  16. Emerging innovative therapeutic approaches targeting PCSK9 to lower lipids.

    PubMed

    Shantha, G P S; Robinson, J G

    2016-01-01

    Statins are established therapies for cardiovascular disease prevention and ezetimibe has recently been shown to modestly reduce cardiovascular events when added to background statin therapy. Yet here remains a clear unmet need for additional therapies aimed at lowering low density lipoprotein cholesterol (LDL-C) to further reduce cardiovascular risk. Multiple strategies targeting proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibition have emerged as effective modalities for LDL-C lowering. PCSK9 monoclonal antibodies are the farthest along in clinical development and alirocumab and evolocumab were approved for clinical use by regulatory agencies in 2015. In addition to robust LDL-C lowering (nearly 50-65% from baseline), they improve other lipid parameters as well. Adverse events associated with these medications are minimal. Importantly, they improve clinical cardiovascular disease outcomes, although long-term study results are awaited. Cost may be an important limiting factor in their use and we propose two possible solutions which can potentially curtail cost.

  17. [Differences in Measured Values among Homogenous Assay Reagents of LDL-C in LP-X Positive Serum Samples].

    PubMed

    Abe, Misako; Kurosawa, Hideo; Sato, Ryo; Ito, Kumie; Tomono, Yoshiharu; Manita, Daisuke; Hirowatari, Yuji; Yoshida, Hiroshi

    2015-03-01

    The LDL-C level measures with homogeneous (direct) assays in almost of clinical laboratories. Several reports however showed differences in measured values among the assay reagents. We investigated the differences in LDL-C values among direct assays and Friedewald formula (F-f) in 58 LP-X positive serum samples from jaundice patients by comparing LDL-C values measured by anion-exchange chromatography (AEX-HPLC), largely comparable to ultracentrifugation method. Changes in LDL-C values during the treatment of 8 patients were also investigated. Direct assay reagents from Sekisui Medical (S-r), Denka-Seiken (D-r), Wako Chemical (W-r), and Kyowa Medics (K-r) were used for comparison. F-f, S-r, and D-r correlated with AEX-HPLC with r values < 0.6 while W-r and K-r correlated with AEX-HPLC with r-vales > 0.6. Two samples in which F-f values provided 500 mg/dL plus bias to AEX-HPLC (LDL-C value of 220 mg/dL) demonstrated increased levels of IDL-C before treatment. LDL-C values (S-r and D-r) of the 2 samples were relatively high and near to F-f data while LDL-C values (W-r and K-r) were relatively low and close to AEX-HPLC data. The jaundice treatment decreased LDL-C values (S-r and D-r) and converged to 220 mg/dL, indicating that S-r and D-r might react markedly to IDL. These changes were consistent with decreases in serum free cholesterol and phospholipid in support of LP-X. By contrast, W-r and K-r data showed upward tendency and also converged to 220 mg/dL. These results suggest that LDL-C direct assay reagents would be classified into 2 groups with respect to the reagent reactivity to LP-X. PMID:26524853

  18. Nutraceutical pill containing berberine versus ezetimibe on plasma lipid pattern in hypercholesterolemic subjects and its additive effect in patients with familial hypercholesterolemia on stable cholesterol-lowering treatment

    PubMed Central

    2012-01-01

    Background Although statins (STs) are drugs of first choice in hypercholesterolemic patients, especially in those at high cardiovascular risk, some of them are intolerant to STs or refuse treatment with these drugs. In view of this, we have evaluated the lipid-lowering effect of a nutraceutical pill containing berberine (BBR) and of ezetimibe, as alternative treatments, in monotherapy or in combination, in 228 subjects with primary hypercholesterolemia (HCH), with history of STs intolerance or refusing STs treatment. In addition, since PCSK9 was found up-regulated by STs dampening their effect through an LDL receptors (LDLRs) degradation, and BBR suppressed PCSK9 expression in cellular studies, we supplemented the stable lipid-lowering therapy of 30 genotype-confirmed Familial Hypercholesterolemia heterozygotes (HeFH) with BBR, searching for a further plasma cholesterol reduction. Plasma lipid pattern was evaluated at baseline and during treatments. Results In HCH subjects the nutraceutical pill resulted more effective than EZE in lowering LDL cholesterol (−31.7% vs −25.4%, P < 0.001) and better tolerated. On treatment, LDL-C level below 3.36 mmol/L (≤130 mg/dl) was observed in 28.9% of subjects treated with the nutraceutical pill and 11.8% of those treated with EZE (P <0.007). In the group treated with EZE the subjects carrying the G allele of the g.1679 C > G silent polymorphism of NPC1L1 gene showed a higher response to EZE than homozygous for the common allele (GG + CG: LDL-C −29.4±5.0%, CC −23.6±6.5%, P <0.001). Combined treatment with these drugs was as effective as STs in moderate doses (LDL cholesterol −37%, triglycerides −23%). In HeFH patients the addition of BBR resulted in LDL cholesterol reductions inversely related to those induced by the stable therapy (r = −0.617, P <0.0001), with mean 10.5% further decrease. Conclusions The alternative treatments tested in our HCH subjects were rather effective and safe. The findings in

  19. Differential microRNA response to a high-cholesterol, high-fat diet in livers of low and high LDL-C baboons

    PubMed Central

    2012-01-01

    Background Dysregulation of microRNA (miRNA) expression has been implicated in molecular genetic events leading to the progression and development of atherosclerosis. We hypothesized that miRNA expression profiles differ between baboons with low and high serum low-density lipoprotein cholesterol (LDL-C) concentrations in response to diet, and that a subset of these miRNAs regulate genes relevant to dyslipidemia and risk of atherosclerosis. Results Using Next Generation Illumina sequencing methods, we sequenced hepatic small RNA libraries from baboons differing in their LDL-C response to a high-cholesterol, high-fat (HCHF) challenge diet (low LDL-C, n = 3; high LDL-C, n = 3), resulting in 517 baboon miRNAs: 490 were identical to human miRNAs and 27 were novel. We compared miRNA expression profiles from liver biopsies collected before and after the challenge diet and observed that HCHF diet elicited expression of more miRNAs compared to baseline (chow) diet for both low and high LDL-C baboons. Eighteen miRNAs exhibited differential expression in response to HCHF diet in high LDL-C baboons compared to 10 miRNAs in low LDL-C baboons. We used TargetScan/Base tools to predict putative miRNA targets; miRNAs expressed in high LDL-C baboons had significantly more gene targets than miRNAs expressed in low LDL-C responders. Further, we identified miRNA isomers and other non-coding RNAs that were differentially expressed in response to the challenge diet in both high LDL-C and low LDL-C baboons. Conclusions We sequenced and annotated baboon liver miRNAs from low LDL-C and high LDL-C responders using high coverage Next Gen sequencing methods, determined expression changes in response to a HCHF diet challenge, and predicted target genes regulated by the differentially expressed miRNAs. The identified miRNAs will enrich the database for non-coding small RNAs including the extent of variation in these sequences. Further, we identified other small non-coding RNAs

  20. Emergent Biomarkers of Residual Cardiovascular Risk in Patients with Low HDL-c and/or High Triglycerides and Average LDL-c Concentrations: Focus on HDL Subpopulations, Oxidized LDL, Adiponectin, and Uric Acid

    PubMed Central

    Mascarenhas-Melo, Filipa; Sereno, José; Freitas, Isabel; Isabel-Mendonça, Maria; Pinto, Rui; Teixeira, Frederico

    2013-01-01

    This study intended to determine the impact of HDL-c and/or TGs levels on patients with average LDL-c concentration, focusing on lipidic, oxidative, inflammatory, and angiogenic profiles. Patients with cardiovascular risk factors (n = 169) were divided into 4 subgroups, combining normal and low HDL-c with normal and high TGs patients. The following data was analyzed: BP, BMI, waist circumference and serum glucose, Total-c, TGs, LDL-c, oxidized-LDL, total HDL-c and HDL subpopulations, paraoxonase-1 (PON1) activity, hsCRP, uric acid, TNF-α, adiponectin, VEGF, and iCAM1. The two populations with increased TGs levels, regardless of the normal or low HDL-c, presented obesity and higher waist circumference, Total-c, LDL-c, Ox-LDL, and uric acid. Adiponectin concentration was significantly lower and VEGF was higher in the population with cumulative low values of HDL-c and high values of TGs, while HDL quality was reduced in the populations with impaired values of HDL-c and/or TGs, viewed by reduced large and increased small HDL subfractions. In conclusion, in a population with cardiovascular risk factors, low HDL-c and/or high TGs concentrations seem to be associated with a poor cardiometabolic profile, despite average LDL-c levels. This condition, often called residual risk, is better evidenced by using both traditional and nontraditional CV biomarkers, including large and small HDL subfractions, Ox-LDL, adiponectin, VEGF, and uric acid. PMID:24319364

  1. Emerging innovative therapeutic approaches targeting PCSK9 to lower lipids.

    PubMed

    Shantha, G P S; Robinson, J G

    2016-01-01

    Statins are established therapies for cardiovascular disease prevention and ezetimibe has recently been shown to modestly reduce cardiovascular events when added to background statin therapy. Yet here remains a clear unmet need for additional therapies aimed at lowering low density lipoprotein cholesterol (LDL-C) to further reduce cardiovascular risk. Multiple strategies targeting proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibition have emerged as effective modalities for LDL-C lowering. PCSK9 monoclonal antibodies are the farthest along in clinical development and alirocumab and evolocumab were approved for clinical use by regulatory agencies in 2015. In addition to robust LDL-C lowering (nearly 50-65% from baseline), they improve other lipid parameters as well. Adverse events associated with these medications are minimal. Importantly, they improve clinical cardiovascular disease outcomes, although long-term study results are awaited. Cost may be an important limiting factor in their use and we propose two possible solutions which can potentially curtail cost. PMID:26492546

  2. Presence of elevated non-HDL among patients with T2DM with CV events despite of optimal LDL-C - A report from South India.

    PubMed

    Kumpatla, Satyavani; Soni, Anju; Narasingan, S N; Viswanathan, Vijay

    2016-01-01

    Elevated non-high density lipoprotein cholesterol (non-HDL-C) was the commonest lipid abnormality among T2DM patients with cardiovascular events (CV) events. Prevalence of elevated non-HDL-C was 21.6% among patients who were on statin therapy and with optimal low density lipoprotein-cholesterol (LDL-C) levels. Despite an optimal LDL-C level, 47% of the T2DM patients with CV events had elevated non-HDL-C.

  3. Colesevelam hydrochloride: usefulness of a specifically engineered bile acid sequestrant for lowering LDL-cholesterol.

    PubMed

    Corsini, Alberto; Windler, Eberhard; Farnier, Michel

    2009-02-01

    Several recent meta-analyses of numerous lipid-lowering outcome trials confirm the direct relationship between low-density lipoprotein-cholesterol (LDL-C) lowering and cardiovascular risk reduction. As a consequence, LDL-C goals are continuously being set lower. To achieve lipid lowering, several efficient drugs are available, however, the current pharmacopoeia remains limited for some critical patient situations. Colesevelam hydrochloride is a specifically engineered bile acid sequestrant that features a more favourable tolerability and drug interaction profile than traditional bile acid sequestrants, because of a better affinity and binding capacity to bile acids. In addition, colesevelam retains the nonsystemic mode of action of bile acid sequestrants. Moreover, colesevelam lowers LDL-C by 15-19% and 10-16%, respectively, in monotherapy and in combination to various lipid-lowering drugs, such as statins, ezetimibe and fenofibrates. Along with an efficient and sustainable effect on lipid profiles, colesevelam - as other bile acid sequestrants - has been shown to lower the glycosylated haemoglobin HbA1c by 0.5% on average in patients with type 2 diabetes. Overall, colesevelam represents an interesting add-on treatment to be used in high-risk patients with hypercholesterolaemia for whom standard lipid-lowering therapies are not enough or not well tolerated.

  4. Ezetimibe's effect on platelet aggregation and LDL tendency to peroxidation in hypercholesterolaemia as monotherapy or in addition to simvastatin

    PubMed Central

    Hussein, Osamah; Minasian, LiLia; Itzkovich, Yaroslav; Shestatski, Karina; Solomon, Lizora; Zidan, Jamal

    2008-01-01

    AIMS To investigate the effect of lowering low-density lipoprotein-cholesterol (LDL-C) on platelet aggregation and LDL tendency to peroxidation by ezetimibe alone or with simvastatin in hypercholesterolaemia. METHODS Sixteen patients with LDL-C >3.4 mmol l−1 received ezetimibe for 3 months (Part I). Twenty-two patients on fixed simvastatin dose with LDL-C >2.6 mmol l−1 were enrolled (Part II). Part II patients continued simvastatin treatment 20 mg day−1 for 6 weeks, then received 20 mg day−1 simvastatin combined with ezetimibe 10 mg day−1 for another 6 weeks. The tendency of LDL to peroxidation measured by lag time in minutes required for initiation of LDL oxidation and by LDL oxidation at maximal point (plateau) was measured before and after ezetimibe treatment. RESULTS Part I: Ezetimibe 10 mg daily for 3 months decreased plasma LDL-C level 16% (P = 0.002), prolonged lag time to LDL oxidation from 144 ± 18 min to 195 ± 16 min (P < 0.001), decreasing maximal aggregation from 83 ± 15% to 60 ± 36% (P = 0.04). Part II: Serum level LDL-C decreased 23% (P = 0.02) and lag time in minutes to LDL oxidation was prolonged from 55.9 ± 16.5 to 82.7 ± 11.6 (P < 0.0001) using combined simvastatin–ezetimibe therapy. There were no differences in platelet aggregation. CONCLUSIONS Ezetimibe was associated with decreased platelet aggregation and LDL tendency to peroxidation. Treatment with ezetimibe in addition to simvastatin has an additive antioxidative effect on LDL. WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT Statins demonstrate a pleiotropic effect which contributes beyond the hypocholesterolaemic effect to prevent atherosclerosis. WHAT THIS STUDY ADDS Ezetimibe has an antioxidative effect when given as monotherapy or as an add-on to the statin, simvastatin. PMID:18241285

  5. PCSK9 inhibitors: an overview on a new promising lipid-lowering therapy.

    PubMed

    Denegri, Andrea; Petrova-Slater, Iveta; Pasotti, Elena; Rossi, Maria Grazia; Pedrazzini, Giovanni Battista; Moccetti, Tiziano; Moccetti, Marco

    2016-04-01

    Atherosclerosis is characterized by cholesterol deposition in the arterial intima, with subsequent plaque formation and arterial disease. Low-density lipoprotein cholesterol (LDL-C) plays the most important role in the atherogenesis process, which is the substrate of cardiovascular disease and is the leading cause of death worldwide. Several studies show that a strict control of risk factors, particularly the reduction of LDL-C levels, is a cornerstone in primary and secondary prevention of coronary heart disease. Statins are currently the most effective drugs for lowering LDL-C, but the discovery of proprotein convertase subtilisin kexin 9 (PCSK9) has opened up new therapeutic options in lipid management. PCSK9 reduces LDL-receptors' recycling resulting in a decrease of LDL-C receptors on the surface of hepatocytes and an increase of LDL-C levels in plasma. Obviously, inhibition of PCSK9 has been associated with an increase of LDL-C receptors with subsequent lowering of plasma levels of LDL-C. The clinical development of monoclonal antibodies against PCSK9 has been achieved through phase I and II studies, and nowadays there are many ongoing phase III trials with promising preliminary results. The aim of this review is to update the evidence for PCSK9 monoclonal antibodies, such as evolocumab, alirocumab and bococizumab, in LDL-C management and to discuss their therapeutic perspectives based on the most recent clinical studies, with attention to side-effects. PMID:26855411

  6. Lipid-lowering therapy: who can benefit?

    PubMed Central

    Lewis, Sandra J

    2011-01-01

    Cardiovascular disease (CVD) is the leading cause of death in the US. Despite the decline in CVD-associated mortality rates in recent years, coronary heart disease (CHD) still causes one in every six deaths in this country. Because most CHD risk factors are modifiable (eg, smoking, hypertension, obesity, onset of type 2 diabetes, and dyslipidemia), cardiovascular risk can be reduced by timely and appropriate interventions, such as smoking cessation, diet and lifestyle changes, and lipid-modifying therapy. Dyslipidemia, manifested by elevated low-density lipoprotein cholesterol (LDL-C), is central to the development and progression of atherosclerosis, which can be silent for decades before triggering a first major cardiovascular event. Consequently, dyslipidemia has become a primary target of intervention in strategies for the prevention of cardiovascular events. The guidelines of the Adult Treatment Panel (ATP) III, updated in 2004, recommend therapeutic lifestyle changes and the use of lipid-lowering medications, such as statins, to achieve specific LDL-C goals based on a person’s global cardiovascular risk. For high-risk individuals, such as patients with CHD and diabetic patients without CHD, an LDL-C target of < 100 mg/dL is recommended, and statin therapy should be considered to help patients achieve this goal. If correctly dosed in appropriate patients, currently approved statins are generally safe and provide significant cardiovascular benefits in diverse populations, including women, the elderly, and patients with diabetes. A recent primary prevention trial also showed that statins benefit individuals traditionally not considered at high risk of CHD, such as those with no hyperlipidemia but elevated C-reactive protein. Additional evidence suggests that statins may halt or slow atherosclerotic disease progression. Recent evidence confirms the pivotal role of statins in primary and secondary prevention. PMID:21915170

  7. Genetic loci associated with plasma concentration of LDL-C, HDL-C, triglycerides, ApoA1, and ApoB among 6382 Caucasian women in genome-wide analysis with replication

    PubMed Central

    Chasman, Daniel I.; Paré, Guillaume; Zee, Robert Y. L.; Parker, Alex N.; Cook, Nancy R.; Buring, Julie E.; Kwiatkowski, David J.; Rose, Lynda M.; Smith, Joshua D.; Williams, Paul T.; Rieder, Mark J.; Rotter, Jerome I.; Nickerson, Deborah A.; Krauss, Ronald M.; Miletich, Joseph P.; Ridker, Paul M

    2009-01-01

    Background Genome-wide genetic association analysis represents an opportunity for comprehensive survey of genes governing lipid metabolism, potentially revealing new insights or even therapeutic strategies for cardiovascular disease and related metabolic disorders. Methods and Results We have performed large-scale, genome-wide genetic analysis among 6382 Caucasian women with replication in two cohorts of 970 additional Caucasian men and women for associations between common SNPs and LDL-C, HDL-C, triglycerides, apolipoprotein A1 (ApoA1), and apolipoprotein B (ApoB). Genome-wide associations (P<5×10−8) were found at the PCSK9 gene, the APOB gene, the LPL gene, the APOA1-APOA5 locus, the LIPC gene, the CETP gene, the LDLR gene, and the APOE locus. In addition, genome-wide associations with triglycerides at the GCKR gene confirm and extend emerging links between glucose and lipid metabolism. Still other genome-wide associations at the 1p13.3 locus are consistent with emerging biological properties for a region of the genome, possibly related to the SORT1 gene. Below genome-wide significance, our study provides confirmatory evidence for associations at five novel loci with LDL-C, HDL-C, or triglycerides reported recently in separate genome-wide association studies. The total proportion of variance explained by common variation at the genome-wide candidate loci ranges from 4.3% for triglycerides to 12.6% for ApoB. Conclusions Genome-wide associations at the GCKR gene and near the SORT1 gene as well as confirmatory associations at five additional novel loci suggest emerging biological pathways for lipid metabolism among Caucasian women. PMID:19802338

  8. Effect of statins on HDL-C: a complex process unrelated to changes in LDL-C: analysis of the VOYAGER Database.

    PubMed

    Barter, Philip J; Brandrup-Wognsen, Gunnar; Palmer, Mike K; Nicholls, Stephen J

    2010-06-01

    The relationship between statin-induced increases in HDL cholesterol (HDL-C) concentration and statin-induced decreases in LDL cholesterol (LDL-C) is unknown. The effects of different statins on HDL-C levels, relationships between changes in HDL-C and changes in LDL-C, and predictors of statin-induced increases in HDL-C have been investigated in an individual patient meta-analysis of 32,258 dyslipidemic patients included in 37 randomized studies using rosuvastatin, atorvastatin, and simvastatin. The HDL-C raising ability of rosuvastatin, and simvastatin was comparable, with both being superior to atorvastatin. Increases in HDL-C were positively related to statin dose with rosuvastatin and simvastatin but inversely related to dose with atorvastatin. There was no apparent relationship between reduction in LDL-C and increase in HDL-C, whether analyzed overall for all statins (correlation coefficient = 0.005) or for each statin individually. Percentage increase in apolipoprotein A-I was virtually identical to that of HDL-C at all doses of the three statins. Baseline concentrations of HDL-C and triglyceride (TG) and presence of diabetes were strong, independent predictors of statin-induced elevations of HDL-C. Statins vary in their HDL-C raising ability. The HDL-C increase achieved by all three statins was independent of LDL-C decrease. However, baseline HDL-C and TGs and the presence of diabetes were predictors of statin-induced increases in HDL-C.

  9. [Lipid-lowering therapy in Europe and the United States - treat to target or fire and forget?].

    PubMed

    Pfetsch, Vanessa; Sanin, Veronika; Koenig, Wolfgang

    2016-06-01

    The 2013 AHA/ ACC guidelines on the assessment of cardiovascular risk recommend high-dose statin treatment to reduce LDL-cholesterol (LDL-C) by at least 30-50% without suggesting a specific target value 1. Favoring a strict Evidence Based Medicine approach the authors focus on randomized clinical trials only and neglect a target value since none of the randomized trials has titrated statin therapy to a specific LDL-C concentration. This is in contrast to current European guidelines. This paradigm shift has created a lot of controversy and confusion due to the lacking opportunity to assess medication adherence and the addition of further lipid lowering therapy. Moreover, these new guidelines might discourage clinicians to individualize patient care. PMID:27305301

  10. PROVE-IT proved it: lower is better--pro.

    PubMed

    Leiter, Lawrence A

    2006-02-01

    Data from prospective epidemiological studies and randomized controlled trials have clearly demonstrated that lower low density lipoprotein cholesterol (LDL-C) concentrations are associated with the greatest reduction in cardiovascular events. Coronary artery disease mortality is lowest in epidemiological studies in those individuals with the lowest cholesterol concentrations. In angiographic studies, patients who had their cholesterol lowered had less angiographic worsening of their atherosclerosis, with those trials that had the lowest on-treatment LDL-C, and especially those that had the greatest percentage of LDL-C lowering, showed the least progression of atherosclerosis. Clinical trials have also highlighted the fact that lower LDL-C concentrations are associated with reduced risk for both a first and a subsequent coronary event with analyses showing that event rates in both primary and secondary prevention trials are directly proportional to on-treatment LDL-C concentrations. An aggressive approach to LDL-C lowering, especially in the high-risk patient, seems warranted.

  11. Goal attainments and their discrepancies for low density lipoprotein cholesterol (LDL-C) and apolipoprotein B (apo B) in over 2,000 Chinese patients with known coronary artery disease or type 2 diabetes

    PubMed Central

    Yang, Xiang-Jun; Zhao, Xin; Xu, Hai-Feng

    2015-01-01

    Purpose Low density lipoprotein cholesterol (LDL-C) is primary treatment target for patients with dislipidemia. The apolipoprotein B (apo B), an emerging biomarker for cardiovascular risk prediction, appears to be superior to the LDL-C. However, little is known about goal attainments and their discrepancies for LDL-C and apo B in Chinese patients with known CAD or DM. Methods A total of 2,172 hospitalized patients with known coronary artery disease (CAD) or DM, aged >27 years of old, were enrolled. The success rates for apo B and LDL-C goal attainments were evaluated and compared by categorization and by sex. Results When the success rates for apo B were compared with the ones for LDL-C, the former was higher than the latter across all categorizations, with the statistically significant differences seen in all patients, CAD alone and DM alone (P<0.0001), but not in coexistence of CAD and DM (P=0.190). The trend toward to higher success rates for LDL-C and apo B goal attainments in men than in women were noteworthy across all categorizations although only in all patients and in DM alone patients were the statistically significant differences found (P<0.01). Conclusions The LDL-C lags behind the apo B in goal attainments in Chinese patients. Whether these discrepancies are associated with the occurrence differences for CAD and for stroke between the East Asia and the Western countries warrants further study. PMID:25984449

  12. Intensive Lowering of Low-Density Lipoprotein Cholesterol Levels for Primary Prevention of Coronary Artery Disease

    PubMed Central

    Karalis, Dean G.

    2009-01-01

    Coronary artery disease (CAD) is the leading cause of morbidity and mortality in the United States, and a high concentration of low-density lipoprotein cholesterol (LDL-C) is a major risk factor for CAD. Current guidelines recommend the use of statins to lower LDL-C levels for the primary prevention of CAD based on an individual's risk factor profile and baseline LDL-C level. For moderaterisk individuals, those with 2 or more major risk factors for CAD and a Framingham risk score of 10% to 20%, the recommendation is to use a statin to lower LDL-C levels to less than 130 mg/dL. However, up to 40% of individuals who develop CAD have LDL-C levels lower than this cutoff. In 2004, the National Cholesterol Education Program Adult Treatment Panel III guidelines were updated to include an LDL-C goal of less than 100 mg/dL for individuals at moderately high risk of developing CAD. The guidelines identified several risk factors that when present would favor the use of pharmacological therapy to achieve this more aggressive LDL-C goal. This review evaluates the evidence supporting an LDL-C target of less than 100 mg/dL for moderately high-risk individuals and reviews those risk factors that when present help identify patients who would benefit from achieving this lower LDL-C goal. English-language publications in MEDLINE and references from relevant articles published between January 1, 1980, and November 30, 2008, were reviewed. Main keywords searched were coronary artery disease, hyperlipidemia, statins, cardiac risk factors, inflammatory markers, metabolic syndrome, and coronary artery calcium. PMID:19339653

  13. Processing false solutions in additions: differences between high- and lower-skilled arithmetic problem-solvers.

    PubMed

    Núñez-Peña, Maria Isabel; Suárez-Pellicioni, Macarena

    2012-05-01

    This paper focuses on the capacity to solve numerical incongruities in high- and lower-skilled arithmetic problem-solvers by investigating event-related brain potentials elicited by incorrect solutions to additions. Fifteen high-skill and fifteen low-skill individuals were presented with simple addition problems in a verification task. The proposed solution was manipulated by presenting correct solutions and incorrect solutions very close to the correct ones. Incorrect solutions elicited a negative component followed by a late positive component (LPC/P3b), whose amplitude was smaller for the low-skill group than for the high-skill group. Because the LPC/P3b amplitude has been taken as an indicator of the plausibility of the stimulus, this result suggests that incorrect solutions close to the correct ones appear more plausible to low-skilled individuals than to their high-skilled counterparts. This result is interpreted in terms of differences in the strength of association between problems and potential solutions depending on arithmetical skill.

  14. The Food Matrix and Sterol Characteristics Affect the Plasma Cholesterol Lowering of Phytosterol/Phytostanol1

    PubMed Central

    Cusack, Laura Kells; Fernandez, Maria Luz; Volek, Jeff S.

    2013-01-01

    Foods with added phytosterols/phytostanols (PS) are recommended to lower LDL cholesterol (LDL-c) concentrations. Manufacturers have incorporated PS into a variety of common foods. Understanding the cholesterol-lowering impact of the food matrix and the PS characteristics would maximize their success and increase the benefit to consumers. This review systematically examines whether the PS characteristics and the fatty acid composition of foods with added PS affects serum LDL-c. A total of 33 studies published between the years 1998 and 2011 inclusive of 66 individual primary variables (strata) were evaluated. The functional food matrices included margarine, mayonnaise, yogurt, milk, cheese, meat, grain, juice, and chocolate. Consistently, ≥10% reductions in LDL-c were reported when the characteristics of the food matrix included poly- and monounsaturated fatty acids known to lower LDL-c. Also, >10% mean reductions in LDL-c were reported when β-sitostanol and campestanol as well as stanol esters were used. These characteristics allow both low-fat and high-fat foods to successfully incorporate PS and significantly lower LDL-c. PMID:24228192

  15. The food matrix and sterol characteristics affect the plasma cholesterol lowering of phytosterol/phytostanol.

    PubMed

    Cusack, Laura Kells; Fernandez, Maria Luz; Volek, Jeff S

    2013-11-01

    Foods with added phytosterols/phytostanols (PS) are recommended to lower LDL cholesterol (LDL-c) concentrations. Manufacturers have incorporated PS into a variety of common foods. Understanding the cholesterol-lowering impact of the food matrix and the PS characteristics would maximize their success and increase the benefit to consumers. This review systematically examines whether the PS characteristics and the fatty acid composition of foods with added PS affects serum LDL-c. A total of 33 studies published between the years 1998 and 2011 inclusive of 66 individual primary variables (strata) were evaluated. The functional food matrices included margarine, mayonnaise, yogurt, milk, cheese, meat, grain, juice, and chocolate. Consistently, ≥10% reductions in LDL-c were reported when the characteristics of the food matrix included poly- and monounsaturated fatty acids known to lower LDL-c. Also, >10% mean reductions in LDL-c were reported when β-sitostanol and campestanol as well as stanol esters were used. These characteristics allow both low-fat and high-fat foods to successfully incorporate PS and significantly lower LDL-c.

  16. Additives

    NASA Technical Reports Server (NTRS)

    Smalheer, C. V.

    1973-01-01

    The chemistry of lubricant additives is discussed to show what the additives are chemically and what functions they perform in the lubrication of various kinds of equipment. Current theories regarding the mode of action of lubricant additives are presented. The additive groups discussed include the following: (1) detergents and dispersants, (2) corrosion inhibitors, (3) antioxidants, (4) viscosity index improvers, (5) pour point depressants, and (6) antifouling agents.

  17. Process for lowering the dielectric constant of polyimides using diamic acid additives

    NASA Technical Reports Server (NTRS)

    Stoakley, Diane M. (Inventor); St.clair, Anne K. (Inventor)

    1990-01-01

    Linear aromatic polyimides with low dielectric constants are produced by adding a diamic acid additive to the polyamic acid resin formed by the condensation of an aromatic dianhydride with an aromatic diamine. The resulting modified polyimide is a better electrical insulator than state-of-the-art commercially available polyimides.

  18. Markedly lowering the viscosity of aqueous solutions of DNA by additives.

    PubMed

    Elkin, Igor; Weight, Alisha K; Klibanov, Alexander M

    2015-10-15

    Aqueous solutions of DNAs, while relevant in drug delivery and as a target of therapies, are often very viscous making them difficult to use. Since less viscous solutions could enable targeted drug delivery and/or therapies, the purpose of the present work was to explore compounds capable of "thinning" such DNA solutions under pharmaceutically relevant conditions. To this end, viscosities of aqueous solutions of DNAs and model polyanions were examined at 25 °C in the absence and presence of a number of bulky organic salts (and related compounds) previously found to substantially lower the viscosities of concentrated protein solutions. Out of two dozen compounds tested, only three were found to be effective; the FDA-approved local anesthetics lidocaine, mepivacaine, and prilocaine at near-isotonic concentrations and pH 6.4 lowered solution viscosity of three different DNAs up to about 20 fold. The observed multi-fold viscosity reductions appear to be due to these bulky organic salts' structure-specific non-covalent binding to nucleotide bases resulting in denaturation (unwinding) to, and stabilization of, single-stranded DNA.

  19. [Is the Finnish "healthy margarine" food or medicine? Addition of plant sterols can lower cholesterol levels].

    PubMed

    Wikström, A C

    1998-11-11

    Sine the autumn of 1995, Benecol, a proprietary brand of cholesterol-lowering margarine, has been available in ordinary grocery shops in Finland. The active ingredient is a sitostanol ester. Several studies in humans have shown use of the margarine to result in an approximately 10 per cent reduction in total serum cholesterol, and a 13-15 per cent reduction of LDL-cholesterol. However, further studies are required of its phyto-oestrogenic and endocrine effects, and its effects on growing children, particularly regarding subsequent fertility in boys. Although the margarine is classed as a 'functional food' in Finland, the question arises where the line is to be drawn between medicines and food-stuffs.

  20. Effects of Lipid-Lowering Drugs on High-Density Lipoprotein Subclasses in Healthy Men—A Randomized Trial

    PubMed Central

    Spenrath, Nadine; Montalto, Giuseppe; Krone, Wilhelm; Gouni-Berthold, Ioanna

    2014-01-01

    Context and Objective Investigating the effects of lipid-lowering drugs on HDL subclasses has shown ambiguous results. This study assessed the effects of ezetimibe, simvastatin, and their combination on HDL subclass distribution. Design and Participants A single-center randomized parallel 3-group open-label study was performed in 72 healthy men free of cardiovascular disease with a baseline LDL-cholesterol of 111±30 mg/dl (2.9±0.8 mmol/l) and a baseline HDL-cholesterol of 64±15 mg/dl (1.7±0.4 mmol/l). They were treated with ezetimibe (10 mg/day, n = 24), simvastatin (40 mg/day, n = 24) or their combination (n = 24) for 14 days. Blood was drawn before and after the treatment period. HDL subclasses were determined using polyacrylamide gel-tube electrophoresis. Multivariate regression models were used to determine the influence of treatment and covariates on changes in HDL subclass composition. Results Baseline HDL subclasses consisted of 33±10% large, 48±6% intermediate and 19±8% small HDL. After adjusting for baseline HDL subclass distribution, body mass index, LDL-C and the ratio triglycerides/HDL-C, there was a significant increase in large HDL by about 3.9 percentage points (P<0.05) and a decrease in intermediate HDL by about 3.5 percentage points (P<0.01) in both simvastatin-containing treatment arms in comparison to ezetimibe. The parameters obtained after additional adjustment for the decrease in LDL-C indicated that about one third to one half of these effects could be explained by the extent of LDL-C-lowering. Conclusions In healthy men, treatment with simvastatin leads to favorable effects on HDL subclass composition, which was not be observed with ezetimibe. Part of these differential effects may be due to the stronger LDL-C-lowering effects of simvastatin. Trial Registration ClinicalTrials.gov NCT00317993 PMID:24662777

  1. Diesel engine experiments with oxygen enrichment, water addition and lower-grade fuel

    SciTech Connect

    Sekar, R.R.; Marr, W.W.; Cole, R.L.; Marciniak, T.J. ); Schaus, J.E. )

    1990-01-01

    The concept of oxygen enriched air applied to reciprocating engines is getting renewed attention in the context of the progress made in the enrichment methods and the tougher emissions regulations imposed on diesel and gasoline engines. An experimental project was completed in which a direct injection diesel engine was tested with intake oxygen levels of 21% -- 35%. Since an earlier study indicated that it is necessary to use a cheaper fuel to make the concept economically attractive, a less refined fuel was included in the test series. Since a major objection to the use of oxygen enriched combustion air had been the increase in NO{sub x} emissions, a method must be found to reduce NO{sub x}. Introduction of water into the engine combustion process was included in the tests for this purpose. Fuel emulsification with water was the means used here even though other methods could also be used. The teat data indicated a large increase in engine power density, slight improvement in thermal efficiency, significant reductions in smoke and particulate emissions and NO{sub x} emissions controllable with the addition of water. 15 refs., 10 figs., 2 tabs.

  2. Targeting PCSK9 as a promising new mechanism for lowering low-density lipoprotein cholesterol.

    PubMed

    Della Badia, Laura A; Elshourbagy, Nabil A; Mousa, Shaker A

    2016-08-01

    Statins and other lipid-lowering drugs have dominated the market for many years for achievement of recommended levels of low-density lipoprotein cholesterol (LDL-C). However, a substantial number of high-risk patients are unable to achieve the LDL-C goal. Proprotein convertase subtilisin/kexin 9 (PCSK9) has recently emerged as a new, promising key therapeutic target for hypercholesterolemia. PCSK9 is a protease involved in chaperoning the low-density lipoprotein receptor to the process of degradation. PCSK9 inhibitors and statins effectively lower LDL-C. The PCSK9 inhibitors decrease the degradation of the LDL receptors, whereas statins mainly interfere with the synthetic machinery of cholesterol by inhibiting the key rate limiting enzyme, the HMG CoA reductase. PCSK9 inhibitors are currently being developed as monoclonal antibodies for their primary use in lowering LDL-C. They may be especially useful for patients with homozygous familial hypercholesterolemia, who at present receive minimal benefit from traditional statin therapy. The monoclonal antibody PCSK9 inhibitors, recently granted FDA approval, show the most promising safety and efficacy profile compared to other, newer LDL-C lowering therapies. This review will primarily focus on the safety and efficacy of monoclonal antibody PCSK9 inhibitors in comparison to statins. The review will also address new, alternative PCSK9 targeting drug classes such as small molecules, gene silencing agents, apolipoprotein B antisense oligonucleotides, and microsomal triglyceride transfer protein inhibitors.

  3. Targeting PCSK9 as a promising new mechanism for lowering low-density lipoprotein cholesterol.

    PubMed

    Della Badia, Laura A; Elshourbagy, Nabil A; Mousa, Shaker A

    2016-08-01

    Statins and other lipid-lowering drugs have dominated the market for many years for achievement of recommended levels of low-density lipoprotein cholesterol (LDL-C). However, a substantial number of high-risk patients are unable to achieve the LDL-C goal. Proprotein convertase subtilisin/kexin 9 (PCSK9) has recently emerged as a new, promising key therapeutic target for hypercholesterolemia. PCSK9 is a protease involved in chaperoning the low-density lipoprotein receptor to the process of degradation. PCSK9 inhibitors and statins effectively lower LDL-C. The PCSK9 inhibitors decrease the degradation of the LDL receptors, whereas statins mainly interfere with the synthetic machinery of cholesterol by inhibiting the key rate limiting enzyme, the HMG CoA reductase. PCSK9 inhibitors are currently being developed as monoclonal antibodies for their primary use in lowering LDL-C. They may be especially useful for patients with homozygous familial hypercholesterolemia, who at present receive minimal benefit from traditional statin therapy. The monoclonal antibody PCSK9 inhibitors, recently granted FDA approval, show the most promising safety and efficacy profile compared to other, newer LDL-C lowering therapies. This review will primarily focus on the safety and efficacy of monoclonal antibody PCSK9 inhibitors in comparison to statins. The review will also address new, alternative PCSK9 targeting drug classes such as small molecules, gene silencing agents, apolipoprotein B antisense oligonucleotides, and microsomal triglyceride transfer protein inhibitors. PMID:27133571

  4. COST-EFFECTIVENESS OF LOWER TARGETS FOR BLOOD PRESSURE AND LDL CHOLESTEROL IN DIABETES: THE STOP ATHEROSCLEROSIS IN NATIVE DIABETICS STUDY (SANDS)

    PubMed Central

    Wilson, Charlton; Huang, Chun-Chih; Shara, Nawar; Howard, Barbara V.; Fleg, Jerome L.; Henderson, Jeffrey A.; Howard, Wm. James; Huentelman, Heather; Lee, Elisa T.; Mete, Mihriye; Russell, Marie; Galloway, James M.; Silverman, Angela; Stylianou, Mario; Umans, Jason; Weir, Matthew R.; Yeh, Fawn; Ratner, Robert E.

    2010-01-01

    Background The Stop Atherosclerosis in Native Diabetics Study (SANDS) reported cardiovascular benefit of aggressive versus standard treatment targets for both low-density lipoprotein cholesterol (LDL-C) and blood pressure (BP) in diabetic individuals. Objective In this analysis, we examined within trial cost-effectiveness of aggressive targets of LDL-C ≤70 mg/dL and systolic blood pressure (SBP) ≤115 mmHg vs. standard targets of LDL-C ≤100 mg/dL and SBP ≤130 mmHg. Design Randomized, open label blinded-to-endpoint 3-year trial. Data Sources SANDS clinical trial database, Quality of Wellbeing (QWB) survey, Centers for Medicare and Medicaid Services, Wholesale Drug Prices. Target Population American Indians ≥ age 40 years with type 2 diabetes and no prior cardiovascular events. Time Horizon April 2003-July 2007. Perspective Health payer. Interventions Participants were randomized to aggressive vs. standard groups with treatment algorithms defined for both. Outcome Measures Incremental cost-effectiveness. Results of Base-Case Analysis Compared with the standard group, the aggressive group had slightly lower costs of medical services ($-116), but a 54% higher cost for BP medication ($1,242) and a 116% higher cost for lipid-lowering medication ($2,863), resulting in an increased cost of $3,988 over 3 years. Those in the aggressively treated group gained 0.0480 quality-adjusted life-years (QALY) over the standard group. Using a 3% discount rate for costs and outcomes, the resulting cost per QALY was $82,589. Results of Sensitivity Analysis Using a 25%, 50%, and 75% reduction in drug costs resulted in a cost per QALY of $61,329, $40,070, and $18,810, respectively. Limitations This study was limited by use of a single ethnic group and by its 3-year duration. Conclusions Within this 3-year study, treatment to lower BP and LDL-C below standard targets was not cost-effective due to the cost of the additional medications required to meet the lower targets. With the

  5. Lipid-lowering agents.

    PubMed

    Ewang-Emukowhate, Mfon; Wierzbicki, Anthony S

    2013-09-01

    The role of lipid lowering in reducing the risk of mortality and morbidity from cardiovascular disease (CVD) is well established. Treatment particularly aimed at decreasing low-density lipoprotein cholesterol (LDL-C) is effective in reducing the risk of death from coronary heart disease and stroke. Statins form the cornerstone of treatment. However, in some individuals with a high risk of CVD who are unable to achieve their target LDL-C due to either intolerance or lack of efficacy, there is the need for alternative therapies. This review provides an overview of the different classes of currently available lipid-lowering medications including statins, fibrates, bile acid sequestrants (resins), and omega-3 fatty acids. Data are presented on their indications, pharmacology, and the relevant end point clinical trial data with these drugs. It also discusses the human trial data on some novel therapeutic agents that are being developed including those for homozygous familial hypercholesterolemia--the antisense oligonucleotide mipomersen and the microsomal transfer protein inhibitor lomitapide. Data are presented on phase II and III trials on agents with potentially wider applications, cholesterol ester transfer protein inhibitors and proprotein convertase subtilisin kexin 9 inhibitors. The data on a licensed gene therapy for lipoprotein lipase deficiency are also presented. PMID:23811423

  6. Lipid-lowering agents.

    PubMed

    Ewang-Emukowhate, Mfon; Wierzbicki, Anthony S

    2013-09-01

    The role of lipid lowering in reducing the risk of mortality and morbidity from cardiovascular disease (CVD) is well established. Treatment particularly aimed at decreasing low-density lipoprotein cholesterol (LDL-C) is effective in reducing the risk of death from coronary heart disease and stroke. Statins form the cornerstone of treatment. However, in some individuals with a high risk of CVD who are unable to achieve their target LDL-C due to either intolerance or lack of efficacy, there is the need for alternative therapies. This review provides an overview of the different classes of currently available lipid-lowering medications including statins, fibrates, bile acid sequestrants (resins), and omega-3 fatty acids. Data are presented on their indications, pharmacology, and the relevant end point clinical trial data with these drugs. It also discusses the human trial data on some novel therapeutic agents that are being developed including those for homozygous familial hypercholesterolemia--the antisense oligonucleotide mipomersen and the microsomal transfer protein inhibitor lomitapide. Data are presented on phase II and III trials on agents with potentially wider applications, cholesterol ester transfer protein inhibitors and proprotein convertase subtilisin kexin 9 inhibitors. The data on a licensed gene therapy for lipoprotein lipase deficiency are also presented.

  7. Effect of Low-Density Lipoprotein Cholesterol Lowering by Ezetimibe/Simvastatin on Outcome Incidence: Overview, Meta-Analyses, and Meta-Regression Analyses of Randomized Trials.

    PubMed

    Thomopoulos, Costas; Skalis, George; Michalopoulou, Helena; Tsioufis, Costas; Makris, Thomas

    2015-12-01

    This analysis investigated the extent of different outcome reductions from low-density lipoprotein cholesterol (LDL-C) lowering following ezetimibe/simvastatin treatment and the proportionality of outcome to LDL-C reductions. The authors searched PubMed between 1997 and mid-June 2015 (any language) and the Cochrane Library to identify all randomized controlled trials comparing ezetimibe/simvastatin with placebo or less intensive LDL-C lowering. Risk ratios (RR) and 95% confidence intervals (CIs), standardized to 20 mg/dL LDL-C reduction, were calculated for 5 primary outcomes (fatal and nonfatal) and 4 secondary outcomes (non-cardiovascular [CV] death, cancer, myopathy, and hepatopathy). Five ezetimibe/simvastatin RCTs (30 051 individuals) were eligible, 2 comparing ezetimibe/simvastatin vs placebo and 3 vs less intensive treatment. Outcomes reduced almost to the same extent were stroke (RR: -13%, 95% CI: -21% to -3%), coronary heart disease (CHD; RR: -12%, 95% CI: -19% to -5%), and composite of stroke and CHD (RR: -14%, 95% CI: -20% to -8%). Absolute risk reductions: 5 strokes, 10 CHD events, and 16 stroke and CHD events prevented for every 1000 patients treated for 5 years. Residual risk was almost 7× higher than absolute risk reduction for all the above outcomes. All death outcomes were not reduced, and secondary outcomes did not differ between groups. Logarithmic risk ratios were not associated with LDL-C lowering. Our meta-analysis provides evidence that, in patients with different CV disease burden, major CV events are safely reduced by LDL-C lowering with ezetimibe/simvastatin, while raising the hypothesis that the extent of LDL-C lowering might not be accompanied by incremental clinical-event reduction.

  8. Association between cholesterol synthesis/absorption markers and effects of cholesterol lowering by atorvastatin among patients with high risk of coronary heart disease.

    PubMed

    Qi, Yue; Liu, Jing; Ma, Changsheng; Wang, Wei; Liu, Xiaohui; Wang, Miao; Lv, Qiang; Sun, Jiayi; Liu, Jun; Li, Yan; Zhao, Dong

    2013-11-01

    No indices are currently available to facilitate clinicians to identify patients who need either statin monotherapy or statin-ezetimibe combined treatment. We aimed to investigate whether cholesterol synthesis and absorption markers can predict the cholesterol-lowering response to statin. Total 306 statin-naïve patients with high risk of coronary heart disease (CHD) were treated with atorvastatin 20 mg/day for 1 month. Cholesterol synthesis and absorption markers and LDL cholesterol (LDL-C) levels were measured before and after treatment. Atorvastatin decreased LDL-C by 36.8% (range: decrease of 74.5% to increase of 31.9%). Baseline cholesterol synthesis marker lathosterol and cholesterol absorption marker campesterol codetermined the effect of atorvastatin treatment. The effect of cholesterol lowering by atorvastatin was significantly associated with baseline lathosterol levels but modified bidirectionally by baseline campesterol levels. In patients with the highest baseline campesterol levels, atorvastatin treatment decreased cholesterol absorption by 46.1%, which enhanced the effect of LDL-C lowering. Atorvastatin treatment increased cholesterol absorption by 52.3% in those with the lowest baseline campesterol levels, which attenuated the effect of LDL-C reduction. Especially those with the highest lathosterol but the lowest campesterol levels at baseline had significantly less LDL-C reduction than those with the same baseline lathosterol levels but the highest campesterol levels (27.3% versus 42.4%, P = 0.002). These results suggest that combined patterns of cholesterol synthesis/absorption markers, rather than each single marker, are potential predictors of the LDL-C-lowering effects of atorvastatin in high-risk CHD patients.

  9. Systematic study of the effects of lowering low-density lipoprotein-cholesterol on regression of coronary atherosclerotic plaques using intravascular ultrasound

    PubMed Central

    2014-01-01

    Background Conflicting results currently exist on the effects of LDL-C levels and statins therapy on coronary atherosclerotic plaque, and the target level of LDL-C resulting in the regression of the coronary atherosclerotic plaques has not been settled. Methods PubMed, EMBASE, and Cochrane databases were searched from Jan. 2000 to Jan. 2014 for randomized controlled or blinded end-points trials assessing the effects of LDL-C lowering therapy on regression of coronary atherosclerotic plaque (CAP) in patients with coronary heart disease by intravascular ultrasound. Data concerning the study design, patient characteristics, and outcomes were extracted. The significance of plaques regression was assessed by computing standardized mean difference (SMD) of the volume of CAP between the baseline and follow-up. SMD were calculated using fixed or random effects models. Results Twenty trials including 5910 patients with coronary heart disease were identified. Mean lowering LDL-C by 45.4% and to level 66.8 mg/dL in the group of patients with baseline mean LDL-C 123.7 mg/dL, mean lowering LDL-C by 48.8% and to level 60.6 mg/dL in the group of patients with baseline mean LDL-C 120 mg/dL, and mean lowering LDL-C by 40.4% and to level 77.8 mg/dL in the group of patients with baseline mean LDL-C 132.4 mg/dL could significantly reduce the volume of CAP at follow up (SMD −0.108 mm3, 95% CI −0.176 ~ −0.040, p = 0.002; SMD −0.156 mm3, 95% CI −0.235 ~ −0.078, p = 0.000; SMD −0.123 mm3, 95% CI −0.199 ~ −0.048, p = 0.001; respectively). LDL-C lowering by rosuvastatin (mean 33 mg daily) and atorvastatin (mean 60 mg daily) could significantly decrease the volumes of CAP at follow up (SMD −0.162 mm3, 95% CI: −0.234 ~ −0.081, p = 0.000; SMD −0.101, 95% CI: −0.184 ~ −0.019, p = 0.016; respectively). The mean duration of follow up was from 17 ~ 21 months. Conclusions Intensive lowering LDL-C (rosuvastatin

  10. Cholesterol-lowering effects and mechanisms in view of bile acid pathway of resveratrol and resveratrol-glucuronides

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Resveratrol (Res) was previously reported to be capable of lowering plasma TC and LDL-C. The mechanism behind Res is not clearly understood, although it is presumed to have an effect on bile acid metabolism in the liver: a significant way in eliminating cholesterol from the body. As one of the major...

  11. [Comparison of calculated LDL cholesterol (LDL-C) versus measured LDL cholesterol (LDL-M) and potential impact in terms of therapeutic management].

    PubMed

    Reignier, Arnaud; Sacchetto, Emilie; Hardouin, Jean-Benoît; Orsonneau, Jean-Luc; Le Carrer, Didier; Delaroche, Odile; Bigot-Corbel, Edith

    2014-01-01

    LDL-cholesterol value is one of the criteria used by the Haute autorité de santé (HAS) in the management of patients in primary and secondary prevention with the aim to reduce cardiovascular mortality. In this respect, the recommendations have been established based on target to achieve LDL-cholesterol. Currently in France, the determination of LDL-cholesterol is mainly carried out by the Friedewald formula whose limits are well known. However, reliable methods for the determination of LDL-cholesterol exist. We compared the results of calculated and measured LDL-cholesterol obtained from 444 patients presenting normal triglyceridemia values in terms of ranking relative to the thresholds of the HAS. The correlation between the two methods is quite good, but a significant difference (p <0.0001) was observed between the calculated and measured values of LDL-cholesterol. On the other hand in 17% of cases the classification of subjects will be different, with a majority so overestimation of calculated LDL-cholesterol with respect to measured LDL-cholesterol. This overestimation is not proportional, in fact most values measured LDL-cholesterol, the higher the calculate-measured difference is important. The rating difference is particularly important when subjects have between 1 and 3 factors of cardiovascular risk where the target LDL-cholesterol to achieve is between 1.3 and 1.9 g/L. The management of patients with lipid lowering may potentially be dependent on the method used for the determination of LDL-cholesterol.

  12. Higher Physical Activity Is Associated With Lower Aortic Stiffness but Not With Central Blood Pressure: The ADDITION-Pro Study

    PubMed Central

    Laursen, Anne Sofie Dam; Hansen, Anne-Louise Smidt; Wiinberg, Niels; Brage, Søren; Sandbæk, Annelli; Lauritzen, Torsten; Witte, Daniel R.; Jørgensen, Marit Eika; Johansen, Nanna Borup

    2015-01-01

    Abstract Physical activity is associated with reduced cardiovascular disease risk. However, improvements in conventional risk factors due to physical activity do not explain its full benefit. Therefore, we examined associations of objectively measured physical activity energy expenditure and intensity with central hemodynamics to provide new insight into the link between physical activity and cardiovascular disease. We analyzed data from 1816 Danes (median age: 66 years) without cardiovascular disease. Physical activity was estimated using combined accelerometry and heart rate monitoring. Aortic stiffness was assessed by applanation tonometry, as aortic pulse wave velocity, and central blood pressure was estimated from radial waveforms. Associations between physical activity energy expenditure and central hemodynamics were examined by linear regression. Furthermore, the consequence of substituting 1 hour sedentary behavior with 1 hour light or moderate-to-vigorous physical activity on central hemodynamics was examined. Median physical activity energy expenditure was 28.0 kJ/kg/d (IQR: 19.8; 38.7). A 10 kJ/kg/d higher energy expenditure was associated with 0.75% lower aortic pulse wave velocity (CI: −1.47; −0.03). Associations with central systolic blood pressure and central pulse pressure were not statistically significant. We observed no difference in central hemodynamics when substituting 1 hour sedentary behavior with 1 hour light or moderate-to-vigorous physical activity. In this relatively inactive population, higher physical activity energy expenditure was associated with lower aortic stiffness, while there was no statistically significant association between substitution of activity intensity and central hemodynamics. This suggests that lower aortic stiffness is one of a number of health benefits attributed to higher habitual physical activity. PMID:25654392

  13. Cholesterol-lowering benefits of oat-containing cereal in Hispanic americans.

    PubMed

    Karmally, Wahida; Montez, Maria G; Palmas, Walter; Martinez, Wendy; Branstetter, Anita; Ramakrishnan, Rajasekhar; Holleran, Steve F; Haffner, Steven M; Ginsberg, Henry N

    2005-06-01

    This randomized, controlled trial of cholesterol lowering by an oat bran cereal containing beta glucan vs a corn cereal without soluble fiber in Hispanic Americans was conducted for 11 weeks. One-hundred fifty-two men and women, ages 30 to 70 years, with baseline low-density lipoprotein cholesterol (LDL-C) levels between 120 and 190 mg/dL and triglycerides <400 mg/dL were included. After eating a National Cholesterol Education Program Step 1 diet for 5 weeks, subjects were randomly assigned to the corn or the oat cereal for the next 6 weeks. The daily dose of beta glucan was 3 g. Consumption of oat cereal was associated with a reduction in plasma levels of both total cholesterol (-10.9+/-21.6 mg/dL; -4.5%) and LDL-C (-9.4+/-20.3 mg/dL; -5.3%). Consumption of corn cereal did not affect either total cholesterol (+1.2+/-18.3 mg/dL; 1.1%) or LDL-C (+1.2+/-17.5 mg/dL; 2.2%). Differences between the effects of the two cereals on total cholesterol and LDL-C were significant, P =.0003 and P =.0007, respectively. PMID:15942550

  14. Addition of an anabolic steroid to strength training promotes muscle strength in the nonparetic lower limb of poststroke hemiplegia patients.

    PubMed

    Shimodozono, Megumi; Kawahira, Kazumi; Ogata, Atsuko; Etoh, Seiji; Tanaka, Nobuyuki

    2010-09-01

    In this prospective observer-blinded open-label nonrandomized controlled trial, 25 inpatients with hemiplegia 1-8 months after stroke were assigned to an anabolic androgenic steroid (AAS; n = 14) or a control (n = 11) group: the former received 100 mg metenolone enanthate by intramuscular injection once a week for 6 weeks along with rehabilitation therapy including muscle strength training of the nonparetic lower limb, which consisted of 100 repetitions of isokinetic reciprocal knee extension/flexion (60 degrees /s) on a dynamometer once a day for 5 days a week over 6 weeks, and the latter received rehabilitation therapy alone. The maximal peak torque of the nonparetic lower limb, including the isokinetic (60 degrees /s, 120 degrees /s, and 180 degrees /s), isotonic, and isometric muscle strength of knee extension/flexion, measured every 2 weeks, was compared with the baseline values. Significant increases in peak torque were seen at 2 weeks in 9 of the 10 conditions and at 6 weeks in 8 of the 10 conditions tested for the AAS group but in only 1 and 5 conditions for the control group, respectively. While no contraindications for AAS were encountered, the combination of AAS and muscle strength training tended to have a positive effect on muscle strength after stroke.

  15. Lower Low-Density Lipoprotein Cholesterol Levels Are Associated with Severe Dengue Outcome.

    PubMed

    Biswas, Hope H; Gordon, Aubree; Nuñez, Andrea; Perez, Maria Angeles; Balmaseda, Angel; Harris, Eva

    2015-01-01

    Dengue virus (DENV) is a flavivirus of worldwide importance, with approximately 4 billion people across 128 countries at risk of infection, and up to 390 million infections and 96 million clinically apparent cases estimated annually. Previous in vitro studies have shown that lipids and lipoproteins play a role in modifying virus infectivity. However, the relationship between development of severe dengue and total cholesterol, high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C), respectively, is unclear. We analyzed data from 789 laboratory-confirmed dengue cases and 447 other febrile illnesses (OFI) in a prospective pediatric hospital-based study in Managua, Nicaragua between August 2005 and January 2013, using three different classifications of dengue severity: World Health Organization (WHO) 1997, WHO 2009, and standardized intervention categories. Total serum cholesterol and LDL-C levels decreased over the course of illness and were generally lower with increasing dengue severity, regardless of classification scheme. Greater decreases in LDL-C than HDL-C were observed among dengue-positive patients compared to patients with OFI and among severe dengue compared to mild dengue cases. Furthermore, daily cholesterol levels declined with daily albumin blood levels. To examine the effect of cholesterol at presentation on subsequent risk of development of severe dengue, relative risks and 95% confidence intervals were calculated using multivariable modified Poisson models. We found that lower total serum cholesterol and LDL-C levels at presentation were associated with subsequent risk of developing dengue hemorrhagic fever/dengue shock syndrome using the WHO 1997 dengue severity classification, and thus that the reduction in LDL-C is likely driving the decreases observed in total serum cholesterol levels among dengue-positive patients. Our results suggest that cholesterol blood levels are important correlates of dengue

  16. Cholesterol-lowering Action of BNA-based Antisense Oligonucleotides Targeting PCSK9 in Atherogenic Diet-induced Hypercholesterolemic Mice

    PubMed Central

    Yamamoto, Tsuyoshi; Harada-Shiba, Mariko; Nakatani, Moeka; Wada, Shunsuke; Yasuhara, Hidenori; Narukawa, Keisuke; Sasaki, Kiyomi; Shibata, Masa-Aki; Torigoe, Hidetaka; Yamaoka, Tetsuji; Imanishi, Takeshi; Obika, Satoshi

    2012-01-01

    Recent findings in molecular biology implicate the involvement of proprotein convertase subtilisin/kexin type 9 (PCSK9) in low-density lipoprotein receptor (LDLR) protein regulation. The cholesterol-lowering potential of anti-PCSK9 antisense oligonucleotides (AONs) modified with bridged nucleic acids (BNA-AONs) including 2′,4′-BNA (also called as locked nucleic acid (LNA)) and 2′,4′-BNANC chemistries were demonstrated both in vitro and in vivo. An in vitro transfection study revealed that all of the BNA-AONs induce dose-dependent reductions in PCSK9 messenger RNA (mRNA) levels concomitantly with increases in LDLR protein levels. BNA-AONs were administered to atherogenic diet-fed C57BL/6J mice twice weekly for 6 weeks; 2′,4′-BNA-AON that targeted murine PCSK9 induced a dose-dependent reduction in hepatic PCSK9 mRNA and LDL cholesterol (LDL-C); the 43% reduction of serum LDL-C was achieved at a dose of 20 mg/kg/injection with only moderate increases in toxicological indicators. In addition, the serum high-density lipoprotein cholesterol (HDL-C) levels increased. These results support antisense inhibition of PCSK9 as a potential therapeutic approach. When compared with 2′,4′-BNA-AON, 2′,4′-BNANC-AON showed an earlier LDL-C–lowering effect and was more tolerable in mice. Our results validate the optimization of 2′,4′-BNANC-based anti-PCSK9 antisense molecules to produce a promising therapeutic agent for the treatment of hypercholesterolemia. PMID:23344002

  17. Efficacy of lipophilic vs lipophobic opioids in addition to hyperbaric bupivacaine for patients undergoing lower segment caeserean section

    PubMed Central

    Agrawal, Amit; Asthana, Veena; Sharma, J. P.; Gupta, Vineeta

    2016-01-01

    Background: Subarachnoid block is the preferred technique for providing anesthesia for patients undergoing cesarean section. Various pharmacological agents in added to local anesthetics (LA) modify their original effects in terms of block characteristics and quality of analgesia. However, there is ongoing debate about this practice of using adjuncts with LA. We tested whether addition of lipophilic versus lipophobic opioids to LA gives any clinical benefits to maternal and fetal outcome when used in these patients requiring spinal anesthesia. Subjects and Methods: Sixty American Society of Anesthesiologists I and II parturients, undergoing elective cesarean section requiring subarachnoid block, were included in our study. The parturients were allocated randomly to three groups of 20 each to receive bupivacaine 12.5 mg (Group I), bupivacaine 12.5 mg + morphine 0.2 mg (Group II), bupivacaine 12.5 mg + fentanyl 25 μg (Group III), preservative free physiological saline 0.9% was added to all the solutions to achieve a total volume of 4 ml. The parameters studied were the time of onset, sensory level of the block achieved, total duration of analgesia, any need of rescue analgesics, maternal side effects, and fetal outcome. Results: Onset of block was early 4.30 ± 0.12 min in Group III as compared to Group I 4.64 ± 0.28 min and Group II 4.505 ± 0.22 min. Mean duration of analgesia (hours) was higher in Group II 15.91 ± 0.96 h as compared to Group I 1.95 ± 0.55 h and Group III 4.39 ± 0.2 h. Incidence of nausea, vomiting, and shivering was more in the control group as compared to study groups, whereas sedation and pruritus were seen more in the study groups. No adverse effects on fetus were seen with use of opioids and comparable Apgar scores were noted. Conclusion: Addition of intrthecal fentanyl causes rapid onset of block whereas intrathecal morphine provides prolonged analgesia with comparable neonatal wellbeing. PMID:27746526

  18. Dose-dependent LDL-cholesterol lowering effect by plant stanol ester consumption: clinical evidence.

    PubMed

    Laitinen, Kirsi; Gylling, Helena

    2012-10-22

    Elevated serum lipids are linked to cardiovascular diseases calling for effective therapeutic means to reduce particularly LDL-cholesterol (LDL-C) levels. Plant stanols reduce levels of LDL-C by partly blocking cholesterol absorption. Accordingly the consumption of foods with added plant stanols, typically esterified with vegetable oil fatty acids in commercial food products, are recommended for lowering serum cholesterol levels. A daily intake of 1.5 to 2.4 g of plant stanols has been scientifically evaluated to lower LDL-C by 7 to 10% in different populations, ages and with different diseases. Based on earlier studies, a general understanding is that no further reduction may be achieved in intakes in excess of approximately 2.5 g/day. Recent studies however suggest that plant stanols show a continuous dose-response effect in serum LDL-C lowering. This review discusses the evidence for a dose-effect relationship between plant stanol ester consumption and reduction of LDL-C concentrations with daily intakes of plant stanols of 4 g/day or more. We identified five such studies and the overall data demonstrate a linear dose-effect relationship with the most pertinent LDL-Cholesterol lowering outcome, 18%, achieved by a daily intake of 9 to 10 g of plant stanols. Along with reduction in LDL-C, the studies demonstrated a decrease in cholesterol absorption markers, the serum plant sterol to cholesterol ratios, by increasing the dose of plant stanol intake. None of the studies with daily intakes up to 10 g of plant stanols reported adverse clinical or biochemical effects from plant stanols. In a like manner, the magnitude of decrease in serum antioxidant vitamins was not related to the dose of plant stanols consumed and the differences between plant stanol ester consumers and controls were minor and insignificant or nonexisting. Consumption of plant stanols in high doses is feasible as a range of food products are commercially available for consumption including spreads

  19. Clinical and biochemical outcomes for additive mesenteric and lower body perfusion during hypothermic circulatory arrest for complex total aortic arch replacement surgery.

    PubMed

    Fernandes, P; Cleland, A; Adams, C; Chu, M W A

    2012-11-01

    Surgical repair of transverse aortic arch aneurysms frequently employ hypothermia and antegrade cerebral perfusion as protective strategies during circulatory arrest. However, prolonged mesenteric and lower limb ischemia can lead to significant lactic acidosis and end organ dysfunction, which remains a significant cause of post-operative morbidity and mortality. We report our experience with additive warm mesenteric and lower body perfusion (1-3 L/min, 30°C) in addition to continuous cerebral and myocardial perfusion in 5 patients who underwent total aortic arch replacement with trifurcated head vessel re-implantation and distal elephant trunk reconstruction. Concomitant surgical procedures included re-operations (2), aortic root operations (2), coronary artery bypass (2) and descending thoracic aortic replacement (1). Serum lactate levels demonstrated a rapid decline from a peak 9.9 ± 2.6 post circulatory arrest to 3.4 ± 2.0 in the intensive care unit (ICU). The lowest serum bicarbonate levels were 19.3 ± 3.5 mmol/L, intra-operatively, which normalized to 28.4 ± 2.4 mmol/L on return to the ICU. The lowest pH levels were 7.25 ± 0.10, corrected to 7.43 ± 0.04 on return to the ICU. Mean cardiopulmonary bypass and aortic cross-clamp times were 361 ± 104 and 253 ± 85 minutes, respectively. Mean cerebral and lower body circulatory arrest times were 0 (0) and 50 ± 35 minutes, respectively. The mean time required for systemic rewarming was 95 ± 66 minutes. There were no in-hospital mortalities and no patient experienced any neurological, mesenteric, renal or lower limb ischemic complications. Two patients required mechanical ventilation >24 hours, and one patient returned for reoperation for bleeding. Median intensive care unit and total hospital lengths of stay were 5 and 16 days, respectively. Our results suggest early serum lactate clearance, normalization of acidosis, and metabolic recovery when utilizing a simultaneous cerebral perfusion and warm body

  20. Variability in Ozone in the Tropical Upper Troposphere-Lower Stratosphere from the 1998-2000 SHADOZ (Southern Hemisphere Additional Ozonesondes) Data

    NASA Technical Reports Server (NTRS)

    Thompson, A. M.; Witte, J. C.; McPeters, R. D.; Schmidlin, F. J.; Oltmans, S. J.; Kirchhoff, V. W. J. H.; Coetzee, G. J. R.; Posny, F.; Kawakami, S.; Ogawa, T.; Bhartia, P. K. (Technical Monitor)

    2002-01-01

    The first view of lower stratospheric and upper tropospheric structure from sondes is provided by a 3-year, 10-site record from the Southern Hemisphere ADditional OZonesondes (SHADOZ) network: . Observations covering 1998-2000 were made over Ascension Island; Nairobi, Kenya; Irene, South Africa; Reunion Island; Watukosek, Java; Fiji; Tahiti; American Samoa; San Cristobal, Galapagos; Natal, Brazil. Taking the UT/LS (upper troposphere- lower stratosphere) as the region between 12 and 17 km, we examine ozone variability in this region on a week-to-week and seasonal basis. The tropopause is lower in September-October-November than in March-April-May, when ozone is a minimum at most SHADOZ stations. A zonal wave-one pattern (referring to ozone mixing ratios greater over the Atlantic and adjacent continents than over the Pacific and eastern Indian Ocean), persists all year. The wave, predominantly in the troposphere and with variable magnitude, appears to be due to general circulation - with subsidence over the Atlantic and frequent deep convection over the Pacific and Indian Ocean. The variability of deep convection most prominent at Java, Fiji, Samoa and Natal - is explored in time-vs-altitude ozone curtains. Stratospheric incursions into the troposphere are most prominent in soundings at Irene and Reunion Island.

  1. Variability in Ozone in the Tropical Upper Troposphere-Lower Stratosphere from the 1998 - 200 SHADOZ (Southern Hemisphere ADditional Ozonesondes) Data

    NASA Astrophysics Data System (ADS)

    Thompson, A.; Witte, J.; Oltmans, S.; Coetzee, G.; Kawakami, S.; Ogawa, T.

    The first view of lower stratospheric and upper tropospheric structure from sondes is provided by a 3 year, 10-site record from the Southern Hemisphere ADditional- OZonesondes (SHADOZ) network: . Observations covering 1998-2000 were made over Ascension Island; Nairobi, Kenya; Irene, South Africa; Reunion Island; Watukosek, Java; Fiji; Tahiti; American Samoa; San Crist"bal, Galapagos; Natal, Brazil. Taking the UT/LS (upper troposphere-lower stratosphere) as the region between 12 and 17 km, we examine ozone variability in this region on a week- to- week and seasonal basis. The tropopause is lower in September-October-November than in March-April- May, when ozone is a minimum at most SHADOZ stations. A zonal wave-one pattern (referring to ozone mixing ratios greater over the Atlantic and adjacent continents than over the Pacific and eastern Indian Ocean), persists all year. The wave, predominantly in the troposphere and with variable magnitude, appears to be due to general circulation - with subsidence over the Atlantic and frequent deep convection over the Pacific and Indian Ocean. The variability of deep convection - most prominent at Java, Fiji, Samoa and Natal - is explored in time-vs-altitude ozone curtains. Stratospheric incursions into the troposphere are most prominent in soundings at Irene and Reunion Island.

  2. The Role of Patients’ Age on Their Preferences for Choosing Additional Blood Pressure-Lowering Drugs: A Discrete Choice Experiment in Patients with Diabetes

    PubMed Central

    de Vries, Sieta T.; de Vries, Folgerdiena M.; Dekker, Thijs; Haaijer-Ruskamp, Flora M.; de Zeeuw, Dick; Ranchor, Adelita V.; Denig, Petra

    2015-01-01

    Objectives To assess whether patients’ willingness to add a blood pressure-lowering drug and the importance they attach to specific treatment characteristics differ among age groups in patients with type 2 diabetes. Materials and Methods Patients being prescribed at least an oral glucose-lowering and a blood pressure-lowering drug completed a questionnaire including a discrete choice experiment. This experiment contained choice sets with hypothetical blood pressure-lowering drugs and a no additional drug alternative, which differed in their characteristics (i.e. effects and intake moments). Differences in willingness to add a drug were compared between patients <75 years (non-aged) and ≥75 years (aged) using Pearson χ2-tests. Multinomial logit models were used to assess and compare the importance attached to the characteristics. Results Of the 161 patients who completed the questionnaire, 151 (72%) could be included in the analyses (mean age 68 years; 42% female). Aged patients were less willing to add a drug than non-aged patients (67% versus 84% respectively; P = 0.017). In both age groups, the effect on blood pressure was most important for choosing a drug, followed by the risk of adverse drug events and the risk of death. The effect on limitations due to stroke was only significant in the non-aged group. The effect on blood pressure was slightly more important in the non-aged than the aged group (P = 0.043). Conclusions Aged patients appear less willing to add a preventive drug than non-aged patients. The importance attached to various treatment characteristics does not seem to differ much among age groups. PMID:26445349

  3. A family-specific linkage analysis of blood lipid response to fenofibrate in the Genetics of Lipid Lowering Drug and Diet Network (GOLDN)

    PubMed Central

    Hidalgo, Bertha; Aslibekyan, Stella; Wiener, Howard W.; Irvin, Marguerite R.; Straka, Robert J.; Borecki, Ingrid B.; Tiwari, Hemant K.; Tsai, Michael Y.; Hopkins, Paul N.; Ordovas, Jose M.; Arnett, Donna K.

    2015-01-01

    Cost-effective identification of novel pharmacogenetic variants remains a pressing need in the field. Using data from the Genetics of Lipid Lowering Drugs and Diet Network, we identified genomic regions of relevance to fenofibrate response in a sample of 173 families. Our approach included a multipoint linkage scan, followed by selection of the families showing evidence of linkage. We identified a strong signal for changes in LDL-C on chromosome 7 (peak LOD score=4.76) in the full sample (n=821). The signal for LDL-C response remained even after adjusting for baseline LDL-C. Restricting analyses only to the families contributing to the linkage signal for LDL-C (N=19), we observed a peak LOD score of 5.17 for chromosome 7. Two genes under this peak (ABCB4 and CD36) were of biological interest. These results suggest that linked family analyses might be a useful approach to gene discovery in the presence of a complex (e.g. multigenic) phenotype. PMID:26203732

  4. Addition of hydrochlorothiazide to angiotensin receptor blocker therapy can achieve a lower sodium balance with no acceleration of intrarenal renin angiotensin system in patients with chronic kidney disease

    PubMed Central

    Fuwa, Daisuke; Fukuda, Michio; Ogiyama, Yoshiaki; Sato, Ryo; Mizuno, Masashi; Miura, Toshiyuki; Abe-Dohmae, Sumiko; Michikawa, Makoto; Kobori, Hiroyuki; Ohte, Nobuyuki

    2016-01-01

    Objective Angiotensin receptor blockers (ARBs) produce a lower sodium (Na) balance, and the natriuretic effect is enhanced under Na deprivation, despite falls in blood pressure (BP) and glomerular filtration rate (GFR). Methods The effect of additional hydrochlorothiazide (HCTZ; 12.5 mg/day) to ARB treatment (valsartan; 80 mg/day) on glomerulotubular Na balance was evaluated in 23 patients with chronic kidney disease. Results Add-on HCTZ decreased GFR, tubular Na load, and tubular Na reabsorption (tNa), although 24-hour urinary Na excretion (UNaV) remained constant. Daily urinary angiotensinogen excretion (UAGTV, 152±10→82±17 μg/g Cre) reduced (p=0.02). Changes in tubular Na load (r2=0.26) and tNa (r2=0.25) correlated with baseline 24-hour UAGTV. Changes in filtered Na load correlated with changes in nighttime systolic BP (r2=0.17), but not with changes in daytime systolic BP. The change in the tNa to filtered Na load ratio was influenced by the change in daytime UNaV (β=−0.67, F=16.8), rather than the change in nighttime UNaV. Conclusions Lower Na balance was produced by add-on HCTZ to ARB treatment without an increase of intra-renal renin-angiotensin system activity, leading to restoration of nocturnal hypertension. A further study is needed to demonstrate that the reduction of UAGTV by additional diuretics to ARBs prevents the progression of nephropathy or cardiovascular events. PMID:27283968

  5. EFFECT OF LOWER TARGETS FOR BLOOD PRESSURE AND LDL CHOLESTEROL ON ATHEROSCLEROSIS IN DIABETES

    PubMed Central

    Howard, Barbara V.; Roman, Mary J.; Fleg, Jerome L.; Galloway, James M.; Henderson, Jeffrey A.; Howard, Wm. James; Lee, Elisa T.; Mete, Mihriye; Poolaw, Bryce; Devereux, Richard B.; Russell, Marie; Silverman, Angela; Stylianou, Mario; Umans, Jason; Wang, Wenyu; Weissman, Neil; Weir, Matthew R.; Wilson, Charlton; Yeh, Fawn; Zhu, Jianhui; Ratner, Robert E.

    2008-01-01

    Context Individuals with diabetes are at greatly increased risk for developing cardiovascular disease (CVD), but more aggressive targets for risk factor control have not been tested. Objective To compare the progression of subclinical atherosclerotic disease in diabetic adults treated to aggressive targets of low-density lipoprotein cholesterol (LDL-C) ≤ 70 mg/dL and blood pressure (BP) ≤ 115/75 mm Hg (aggressive) versus treatment to standard targets of LDL-C ≤ 100 mg/dL and BP ≤ 130/85 mm Hg (standard). Design Randomized, open label, blinded-to-endpoint 3-year trial in individuals with diabetes conducted April 2003-July 2004. Setting Four clinical centers in southwestern Oklahoma; Phoenix, AZ; northeastern Arizona; and South Dakota. Participants 499 American Indian men and women ≥ age 40 with type 2 diabetes and no prior CVD events. Interventions Participants were randomized to aggressive vs. standard treatment. The same treatment algorithms were followed for both groups. Main Outcome Measures Primary endpoint was a composite of progression of atherosclerosis as measured by common carotid artery intimal medial thickness (IMT) and clinical events. Secondary endpoints included other carotid and cardiac ultrasonographic measures. Results LDL-C and systolic BP (SBP) goals for both groups were reached within 12 months and maintained to 36 months. LDL-C and SBP in the last 12 months averaged 72 and 104 mg/dL and 116 and 129 mm Hg in the aggressive and standard groups, respectively. Regression of IMT (-0.017 vs. 0.041 mm, p < .0001) and arterial mass (-0.14 vs. 1.14 mm2, p < .0001) and greater decrease in left ventricular mass (-2.4 vs. -1.3 g/m2.7, p = .05) were observed in the aggressive group. Clinical CVD events were lower than expected and did not differ between groups Conclusions Reducing LDL-C and SBP to lower targets resulted in regression of carotid IMT and greater decrease in left ventricular mass in individuals with type 2 diabetes. Clinical events

  6. Gravity and Rossby wave signatures in the tropical troposphere and lower stratosphere based on Southern Hemisphere Additional Ozonesondes (SHADOZ), 1998-2007

    NASA Astrophysics Data System (ADS)

    Thompson, Anne M.; Allen, Amber L.; Lee, Sukyoung; Miller, Sonya K.; Witte, Jacquelyn C.

    2011-03-01

    Prior investigations attempted to determine the relative influence of advection and convective processes on ozone and water vapor distributions in the tropical tropopause layer (TTL) through analyses of tracers, related physical parameters (e.g., outgoing long-wave radiation, precipitable water, and temperature), or with models. In this study, stable laminae in Southern Hemisphere Additional Ozonesonde Network (SHADOZ) ozone profiles from 1998 to 2007 are interpreted in terms of gravity waves (GW) or Rossby waves (RW) that are identified with vertical and quasi-horizontal displacements, respectively. Using the method of Pierce and Grant (1998) as applied by Thompson et al. (2007a, 2007b, 2010, 2011), amplitudes and frequencies in ozone laminae are compared among representative SHADOZ sites over Africa and the Pacific, Indian, and Atlantic oceans. GW signals maximize in the TTL and lower stratosphere. Depending on site and season, GW are identified in up to 90% of the soundings. GW are most prevalent over the Pacific and eastern Indian oceans, a distribution consistent with vertically propagating equatorial Kelvin waves. Ozone laminae from RW occur more often below the tropical tropopause and with lower frequency (<20%). Gravity wave and Rossby wave indices (GWI, RWI) are formulated to facilitate analysis of interannual variability of wave signatures among sites. GWI is positively correlated with a standard ENSO (El Niño-Southern Oscillation) index over American Samoa (14°S, 171°W) and negatively correlated at Watukosek, Java (7.5°S, 114°E), Kuala Lumpur (3°N, 102°E), and Ascension Island (8°S, 15°W). Generally, the responses of GW and RW to ENSO are consistent with prior studies.

  7. Gravity and Rossby Wave Signatures in the Tropical Troposphere and Lower Stratosphere Based on Southern Hemisphere Additional Ozonesondes (SHADOZ), 1998-2007

    NASA Technical Reports Server (NTRS)

    Thompson, Anne M.; Allen, Amber L.; Lee, Sukyoung; Miller, Sonya K.; Witte, Jacquelyn C.

    2011-01-01

    Prior investigations attempted to determine the relative influence of advection and convective processes on ozone and water vapor distributions in the tropical tropopause layer (TTL) through analyses of tracers, related physical parameters (e.g., outgoing long-wave radiation, precipitable water, and temperature), or with models. In this study, stable laminae in Southern Hemisphere Additional Ozonesonde Network (SHADOZ) ozone profIles from 1998 to 2007 are interpreted in terms of gravity waves (GW) or Rossby waves (RW) that are identified with vertical and quasi-horizontal displacements, respectively. Using the method of Pierce and Grant (1998) as applied by Thompson et al. (2007a, 2007b, 2010, 2011), amplitudes and frequencies in ozone laminae are compared among representative SHADOZ sites over Africa and the Pacific, Indian, and Atlantic oceans. GW signals maximize in the TTL and lower stratosphere. Depending on site and season, GW are identified in up to 90% of the soundings. GW are most prevalent over the Pacific and eastern Indian oceans, a distribution consistent with vertically propagating equatorial Kelvin waves. Ozone laminae from RW occur more often below the tropical tropopause and with lower frequency 20%). Gravity wave and Rossby wave indices (GWI, RWI) are formulated to facilitate analysis of interannual variability of wave signatures among sites. GWI is positively correlated with a standard ENSO (El Nino-Southern Oscillation) index over American Samoa (14degS, 171degW) and negatively correlated at Watukosek, Java (7.5degS, 114degE), Kuala Lumpur (3degN, 102degE), and Ascension Island (80degS, 15degW). Generally, the responses of GW and RW to ENSO are consistent with prior studies.

  8. The lipid-lowering effects of lomitapide are unaffected by adjunctive apheresis in patients with homozygous familial hypercholesterolaemia – a post-hoc analysis of a Phase 3, single-arm, open-label trial

    PubMed Central

    Stefanutti, C; Blom, DJ; Averna, MR; Meagher, EA; Theron, HdT; Marais, AD; Hegele, RA; Sirtori, CR; Shah, PK; Gaudet, D; Vigna, GB; Sachais, BS; Di Giacomo, S; du Plessis, AME; Bloedon, LT; Balser, J; Rader, DJ; Cuchel, M

    2015-01-01

    Objective Lomitapide (a microsomal triglyceride transfer protein inhibitor) is an adjunctive treatment for homozygous familial hypercholesterolaemia (HoFH), a rare genetic condition characterised by elevated low-density lipoprotein-cholesterol (LDL-C), and premature, severe, accelerated atherosclerosis. Standard of care for HoFH includes lipid-lowering drugs and lipoprotein apheresis. We conducted a post-hoc analysis using data from a Phase 3 study to assess whether concomitant apheresis affected the lipid-lowering efficacy of lomitapide. Methods Existing lipid-lowering therapy, including apheresis, was to remain stable from Week −6 to Week 26. Lomitapide dose was escalated on the basis of individual safety/tolerability from 5 mg to 60 mg a day (maximum). The primary endpoint was mean percent change in LDL-C from baseline to Week 26 (efficacy phase), after which patients remained on lomitapide through Week 78 for safety assessment and further evaluation of efficacy. During this latter period, apheresis could be adjusted. We analysed the impact of apheresis on LDL-C reductions in patients receiving lomitapide. Results Of the 29 patients that entered the efficacy phase, 18 (62%) were receiving apheresis at baseline. Twenty-three patients (13 receiving apheresis) completed the Week 26 evaluation. Of the six patients who discontinued in the first 26 weeks, five were receiving apheresis. There were no significant differences in percent change from baseline of LDL-C at Week 26 in patients treated (−48%) and not treated (−55%) with apheresis (p=0.545). Changes in Lp(a) levels were modest and not different between groups (p=0.436). Conclusion The LDL-C lowering efficacy of lomitapide is unaffected by lipoprotein apheresis. PMID:25897792

  9. Lack of Effect of Lowering LDL Cholesterol on Cancer: Meta-Analysis of Individual Data from 175,000 People in 27 Randomised Trials of Statin Therapy

    PubMed Central

    2012-01-01

    Background Statin therapy reduces the risk of occlusive vascular events, but uncertainty remains about potential effects on cancer. We sought to provide a detailed assessment of any effects on cancer of lowering LDL cholesterol (LDL-C) with a statin using individual patient records from 175,000 patients in 27 large-scale statin trials. Methods and Findings Individual records of 134,537 participants in 22 randomised trials of statin versus control (median duration 4.8 years) and 39,612 participants in 5 trials of more intensive versus less intensive statin therapy (median duration 5.1 years) were obtained. Reducing LDL-C with a statin for about 5 years had no effect on newly diagnosed cancer or on death from such cancers in either the trials of statin versus control (cancer incidence: 3755 [1.4% per year [py

  10. Projections of costs, financing, and additional resource requirements for low- and lower middle-income country immunization programs over the decade, 2011-2020.

    PubMed

    Gandhi, Gian; Lydon, Patrick; Cornejo, Santiago; Brenzel, Logan; Wrobel, Sandra; Chang, Hugh

    2013-04-18

    The Decade of Vaccines Global Vaccine Action Plan has outlined a set of ambitious goals to broaden the impact and reach of immunization across the globe. A projections exercise has been undertaken to assess the costs, financing availability, and additional resource requirements to achieve these goals through the delivery of vaccines against 19 diseases across 94 low- and middle-income countries for the period 2011-2020. The exercise draws upon data from existing published and unpublished global forecasts, country immunization plans, and costing studies. A combination of an ingredients-based approach and use of approximations based on past spending has been used to generate vaccine and non-vaccine delivery costs for routine programs, as well as supplementary immunization activities (SIAs). Financing projections focused primarily on support from governments and the GAVI Alliance. Cost and financing projections are presented in constant 2010 US dollars (US$). Cumulative total costs for the decade are projected to be US$57.5 billion, with 85% for routine programs and the remaining 15% for SIAs. Delivery costs account for 54% of total cumulative costs, and vaccine costs make up the remainder. A conservative estimate of total financing for immunization programs is projected to be $34.3 billion over the decade, with country governments financing 65%. These projections imply a cumulative funding gap of $23.2 billion. About 57% of the total resources required to close the funding gap are needed just to maintain existing programs and scale up other currently available vaccines (i.e., before adding in the additional costs of vaccines still in development). Efforts to mobilize additional resources, manage program costs, and establish mutual accountability between countries and development partners will all be necessary to ensure the goals of the Decade of Vaccines are achieved. Establishing or building on existing mechanisms to more comprehensively track resources and

  11. Ezetimibe reduces plaque inflammation in a rabbit model of atherosclerosis and inhibits monocyte migration in addition to its lipid-lowering effect

    PubMed Central

    Gómez-Garre, D; Muñoz-Pacheco, P; González-Rubio, ML; Aragoncillo, P; Granados, R; Fernández-Cruz, A

    2009-01-01

    Background and purpose: Ezetimibe, a selective inhibitor of intestinal cholesterol absorption, might also suppress inflammatory components of atherogenesis. We have studied the effects of ezetimibe on two characteristics of atherosclerotic plaques (infiltrate and fibrosis) and on expression of inflammatory genes in a rabbit model of accelerated atherosclerosis. Experimental approach: Femoral atherosclerosis was induced by a combination of endothelial desiccation and atherogenic diet. Animals were randomized to ezetimibe (0.6 mg·kg−1·day−1), simvastatin (5 mg·kg−1·day−1), ezetimibe plus simvastatin or no treatment, still on atherogenic diet. A control group of rabbits received normolipidemic diet. Key results: Rabbits fed the normolipidemic diet showed normal plasma lipid levels. Either the normolipidemic diet or drug treatment reduced the intima/media ratio (normolipidemic diet: 22%, ezetimibe: 13%, simvastatin: 27%, ezetimibe + simvastatin: 28%), compared with rabbits with atherosclerosis. Ezetimibe also decreased macrophage content and monocyte chemoattractant protein-1 expression in atherosclerotic lesions. Furthermore, ezetimibe reduced the increased activity of nuclear factor κB in peripheral blood leucocytes and plasma C-reactive protein levels in rabbits with atherosclerosis. In THP-1 cells, ezetimibe decreased monocyte chemoattractant protein-1-induced monocyte migration. Importantly, the combination of ezetimibe with simvastatin was associated with a more significant reduction in plaque monocyte/macrophage content and some proinflammatory markers than observed with each drug alone. Conclusions and implications: Ezetimibe had beneficial effects both on atherosclerosis progression and plaque stabilization and showed additional anti-atherogenic benefits when combined with simvastatin. Its effect on monocyte migration provides a potentially beneficial action, in addition to its effects on lipids. PMID:19222481

  12. Male mice housed in groups engage in frequent fighting and show a lower response to additional bone loading than females or individually housed males that do not fight.

    PubMed

    Meakin, Lee B; Sugiyama, Toshihiro; Galea, Gabriel L; Browne, William J; Lanyon, Lance E; Price, Joanna S

    2013-05-01

    Experiments to investigate bone's physiological adaptation to mechanical loading frequently employ models that apply dynamic loads to bones in vivo and assess the changes in mass and architecture that result. It is axiomatic that bones will only show an adaptive response if the applied artificial loading environment differs in a significant way from that to which the bones have been habituated by normal functional loading. It is generally assumed that this normal loading is similar between experimental groups. In the study reported here we found that this was not always the case. Male and female 17-week-old C57BL/6 mice were housed in groups of six, and a single episode (40 cycles) of non-invasive axial loading, engendering 2,200 με on the medial surface of the proximal tibiae in sample mice, was applied to right tibiae on alternate days for two weeks. This engendered an adaptive increase in bone mass in females, but not males. Observation revealed the main difference in behaviour between males and females was that males were involved in fights 1.3 times per hour, whereas the females never fought. We therefore housed all mice individually. In females, there was a similar significant osteogenic response to loading in cortical and trabecular bone of both grouped and individual mice. In contrast, in males, adaptive increases in the loaded compared with non-loaded control bones was only apparent in animals housed individually. Our interpretation of these findings is that the frequent vigorous fighting that occurs between young adult males housed in groups could be sufficient to engender peak strains and strain rates that equal or exceed the stimulus derived from artificial loading. This indicates the importance of ensuring that physical activity is consistent between groups. Reducing the background level of the naturally engendered strain environment allows adaptive responses to artificial loading to be demonstrated at lower loads.

  13. Aluminum bioavailability from the approved food additive leavening agent acidic sodium aluminum phosphate, incorporated into a baked good, is lower than from water.

    PubMed

    Yokel, Robert A; Florence, Rebecca L

    2006-10-01

    There are estimates of oral aluminum (Al) bioavailability from drinking water, but little information on Al bioavailability from foods. Foods contribute approximately 95% and drinking water 1-2% of the typical human's daily Al intake. The objectives were to estimate oral Al bioavailability from a representative food containing the food additive acidic sodium aluminum phosphate (acidic SALP), a leavening agent in baked goods. Rats were acclimated to a special diet that resulted in no stomach contents 14 h after its withdrawal. They were trained to rapidly consume a biscuit containing 1.5% acidic SALP. Oral Al bioavailability was then determined from a biscuit containing 1% or 2% acidic SALP, synthesized to contain (26)Al. The rats received concurrent (27)Al infusion. Blood was repeatedly withdrawn and serum analyzed for (26)Al by accelerator mass spectrometry. Total Al was determined by atomic absorption spectrometry. Oral (26)Al bioavailability was determined from the area under the (26)Al, compared to (27)Al, serum concentrationxtime curves. Oral Al bioavailability (F) from biscuit containing 1% or 2% acidic (26)Al-SALP averaged approximately 0.11% and 0.13%; significantly less than from water, which was previously shown to be approximately 0.3%. The time to maximum serum (26)Al concentration was 4.2 and 6h after consumption of biscuit containing 1% or 2% (26)Al-acidic SALP, respectively, compared to 1-2h following (26)Al in water. These results of oral Al bioavailability from acidic (26)Al-SALP in a biscuit (F approximately 0.1%) and results from (26)Al in water (F approximately 0.3%) x the contributions of food and drinking water to the typical human's daily Al intake ( approximately 5-10mg from food and 0.1mg from water, respectively) suggest food provides approximately 25-fold more Al to systemic circulation, and potential Al body burden, than does drinking water.

  14. Comparison of Low-Dose Rosuvastatin with Atorvastatin in Lipid-Lowering Efficacy and Safety in a High-Risk Pakistani Cohort: An Open-Label Randomized Trial

    PubMed Central

    Arshad, Abdul Rehman

    2014-01-01

    Background. Treatment of hyperlipidemia is helpful in both primary and secondary prevention of coronary heart disease and stroke. Aim. To compare lipid-lowering efficacy of rosuvastatin with atorvastatin. Methodology. This open-label randomized controlled trial was carried out at 1 Mountain Medical Battalion from September 2012 to August 2013 on patients with type 2 diabetes, hypertension, myocardial infarction, or stroke, meriting treatment with a statin. Those with secondary causes of dyslipidemia were excluded. Blood samples for estimation of serum total cholesterol, triglycerides, HDL-C, and LDL-C were collected after a 12-hour fast. Patients were randomly allocated to receive either atorvastatin 10 mg HS or rosuvastatin 5 mg HS daily. Lipid levels were rechecked after six weeks. Results. Atorvastatin was used in 63 patients and rosuvastatin in 66. There was a greater absolute and percent reduction in serum LDL-C levels with rosuvastatin as compared to atorvastatin (0.96 versus 0.54 mg/dL; P = 0.011 and 24.34 versus 13.66%; P = 0.045), whereas reduction in all other fractions was equal. Myalgias were seen in 5 (7.94%) patients treated with atorvastatin and 8 (12.12%) patients treated with rosuvastatin (P: 0.432). Conclusion. Rosuvastatin produces a greater reduction in serum LDL-C levels and should therefore be preferred over atorvastatin. PMID:24800084

  15. Variation in prescribing of lipid-lowering medication in primary care is associated with incidence of cardiovascular disease and all-cause mortality in people with screen-detected diabetes: findings from the ADDITION-Denmark trial

    PubMed Central

    Simmons, R K; Carlsen, A H; Griffin, S J; Charles, M; Christiansen, J S; Borch-Johnsen, K; Sandbæk, A; Lauritzen, T

    2014-01-01

    Aims To examine variation between general practices in the prescription of lipid-lowering treatment to people with screen-detected Type 2 diabetes, and associations with practice and participant characteristics and risk of cardiovascular events and all-cause mortality. Methods Observational cohort analysis of data from 1533 people with screen-detected Type 2 diabetes aged 40–69 years from the ADDITION-Denmark study. One hundred and seventy-four general practices were cluster randomized to receive: (1) routine diabetes care according to national guidelines (623 individuals), or (2) intensive multifactorial target-driven management (910 individuals). Multivariable logistic regression was used to quantify the association between the proportion of individuals in each practice who redeemed prescriptions for lipid-lowering medication in the two years following diabetes diagnosis and a composite cardiovascular disease (CVD) outcome, adjusting for age, sex, prevalent chronic disease, baseline CVD risk factors, smoking and lipid-lowering medication, and follow-up time. Results The proportion of individuals treated with lipid-lowering medication varied widely between practices (0–100%). There were 118 CVD events over 9431 person-years of follow-up. For the whole trial cohort, the risk of CVD was significantly higher in practices in the lowest compared with the highest quartile for prescribing lipid-lowering medication [adjusted odds ratio (OR) 3.4, 95% confidence interval (CI) 1.6–7.3]. Similar trends were found for all-cause mortality. Conclusions More frequent prescription of lipid-lowering treatment was associated with a lower incidence of CVD and all-cause mortality. Improved understanding of factors underlying practice variation in prescribing may enable more frequent use of lipid-lowering treatment. The results highlight the benefits of intensive treatment of people with screen-detected diabetes (Clinical Trials Registry No; NCT 00237549). What's new Despite

  16. Use of localized human growth hormone and testosterone injections in addition to manual therapy and exercise for lower back pain: a case series with 12-month follow-up

    PubMed Central

    Dubick, Marc N; Ravin, Thomas H; Michel, Yvonne; Morrisette, David C

    2015-01-01

    Objective The objective of this case series was to investigate the feasibility and safety of a novel method for the management of chronic lower back pain. Injections of recombinant human growth hormone and testosterone to the painful and dysfunctional areas in individuals with chronic lower back pain were used. In addition, the participants received manual therapies and exercise addressing physical impairments such as motor control, strength, endurance, pain, and loss of movement. Pain ratings and self-rated functional outcomes were assessed. Study design This is a case series involving consecutive patients with chronic lower back pain who received the intervention of injections of recombinant human growth hormone and testosterone, and attended chiropractic and/or physical therapy. Outcomes were measured at 12 months from the time of injection. Setting A community based hospital affiliated office, and a private practice block suite. Participants A total of 60 consecutive patients attending a pain management practice for chronic lower back pain were recruited for the experimental treatment. Most participants were private pay. Interventions Participants who provided informed consent and were determined not to have radicular pain received diagnostic blocks. Those who responded favorably to the diagnostic blocks received injections of recombinant human growth hormone and testosterone in the areas treated with the blocks. Participants also received manipulation- and impairment-based exercises. Outcome measures Outcomes were assessed at 12 months through pain ratings with the Mankowski Pain Scale and the Oswestry Disability Index. Results Of the 60 patients recruited, 49 provided informed consent, and 39 completed all aspects of the study. Those patients receiving the intervention reported a significant decrease in pain ratings (P<0.01) and a significant improvement in self-rated Oswestry Disability Index scores (P<0.01). In addition, in the Oswestry Disability Index

  17. Viscosity rather than quantity of dietary fibre predicts cholesterol-lowering effect in healthy individuals.

    PubMed

    Vuksan, Vladimir; Jenkins, Alexandra L; Rogovik, Alexander L; Fairgrieve, Christopher D; Jovanovski, Elena; Leiter, Lawrence A

    2011-11-01

    The well-documented lipid-lowering effects of fibre may be related to its viscosity, a phenomenon that has been understudied, especially when fibre is given against the background of a typical North American (NA) diet. In this three-arm experiment, we compared the lipid-lowering effect of low-viscosity wheat bran (WB), medium-viscosity psyllium (PSY) and a high-viscosity viscous fibre blend (VFB), as part of a fibre intervention aimed at increasing fibre intake to recommended levels within the context of a NA diet in apparently healthy individuals. Using a randomised cross-over design, twenty-three participants (twelve males and eleven females; age 35 (SD 12) years; LDL-cholesterol (C) 2.9 (SEM 0.6) mmol/l) consuming a typical NA diet received a standard, fibre-enriched cereal, where approximately one-third of the fibre was either a low-viscosity (570 centipoise (cP)) WB, medium-viscosity (14,300 cP) PSY or a high-viscosity (136,300 cP) novel VFB, for 3 weeks separated by washout periods of ≥ 2 weeks. There were no differences among the treatments in the amount of food consumed, total dietary fibre intake, reported physical activity and body weight. Final intake of the WB, PSY and VFB was 10.8, 9.0 and 5.1 g, respectively. Reduction in LDL-C was greater with the VFB compared with the medium-viscosity PSY (-12.6 (SEM 3.5) %, P = 0.002) and low-viscosity WB (-14.6 (SEM 4.2) %, P = 0.003). The magnitude of LDL-C reduction showed a positive association with fibre apparent viscosity (r - 0.41, P = 0.001). Despite the smaller quantity consumed, the high-viscosity fibre lowered LDL-C to a greater extent than lower-viscosity fibres. These data support the inclusion of high-viscosity fibre in the diet to reduce plasma lipids among apparently healthy individuals consuming a typical NA diet.

  18. African Nutmeg (Monodora Myristica) Lowers Cholesterol and Modulates Lipid Peroxidation in Experimentally Induced Hypercholesterolemic Male Wistar Rats

    PubMed Central

    Onyenibe, Nwozo Sarah; Fowokemi, Kasumu Titilayo; Emmanuel, Oyinloye Babatunji

    2015-01-01

    To evaluate the cholesterol lowering potential and protective ability of aqueous extract of Monodora myristica experimental hypercholesterolemic rats, a short-term study was conducted. Hypercholesterolemia was induced by administering cholesterol orally at a dose of 40 mg/kg/0.3 ml. Plant extracts 100 or 200 mg/kg body weight and Questran 0.26 g/kg were administered five times a week for eight weeks for amelioration. Hypolipidemic effects were evaluated by measuring total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and triglycerides (TG) in the serum, while the protective ability was measured by the extent of lipid peroxidation (LPO) as well as enzymatic and non-enzymatic antioxidants levels in post mitochondrial fractions (PMF) of the hepatic and cardiac homogenates. Serum aminotransferases activities were also monitored. Results obtained shows that treatment with M. myristica elicited a significant reduction in serum TC, TG and LDL-C levels while there was concomitant increase in HDL-C of hypercholesterolemic rats. Elevations in serum aminotransferases activities and LPO level were reversed and a significant amelioration was noticed in enzymatic and non-enzymatic antioxidants status in the liver and heart of hypercholesterolemic rats. This study suggests that M. myristica possess cholesterol lowering potentials and protective ability in experimental hypercholesterolemia rat model. PMID:26199582

  19. African Nutmeg (Monodora Myristica) Lowers Cholesterol and Modulates Lipid Peroxidation in Experimentally Induced Hypercholesterolemic Male Wistar Rats.

    PubMed

    Onyenibe, Nwozo Sarah; Fowokemi, Kasumu Titilayo; Emmanuel, Oyinloye Babatunji

    2015-06-01

    To evaluate the cholesterol lowering potential and protective ability of aqueous extract of Monodora myristica experimental hypercholesterolemic rats, a short-term study was conducted. Hypercholesterolemia was induced by administering cholesterol orally at a dose of 40 mg/kg/0.3 ml. Plant extracts 100 or 200 mg/kg body weight and Questran 0.26 g/kg were administered five times a week for eight weeks for amelioration. Hypolipidemic effects were evaluated by measuring total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and triglycerides (TG) in the serum, while the protective ability was measured by the extent of lipid peroxidation (LPO) as well as enzymatic and non-enzymatic antioxidants levels in post mitochondrial fractions (PMF) of the hepatic and cardiac homogenates. Serum aminotransferases activities were also monitored. Results obtained shows that treatment with M. myristica elicited a significant reduction in serum TC, TG and LDL-C levels while there was concomitant increase in HDL-C of hypercholesterolemic rats. Elevations in serum aminotransferases activities and LPO level were reversed and a significant amelioration was noticed in enzymatic and non-enzymatic antioxidants status in the liver and heart of hypercholesterolemic rats. This study suggests that M. myristica possess cholesterol lowering potentials and protective ability in experimental hypercholesterolemia rat model. PMID:26199582

  20. Efficacy and tolerability of a combined lipid-lowering nutraceutical on cholesterolemia, hs-CRP level and endothelial function in moderately hypercholesterolemic subjects.

    PubMed

    Cicero, A F; Colletti, A; Rosticci, M; Grandi, E; Borghi, C

    2016-01-01

    Our aim was to test, by a double-blind, placebo-controlled randomized clinical trial, whether a short-term treatment with a combined lipid-lowering nutraceutical could improve endothelial function in a cohort of moderately hypercholesterolemic subjects. Thus, 80 healthy, moderately hypercholesterolemic subjects were consecutively enrolled and, after 4 weeks of stabilization diet, they were randomized to either the tested lipid-lowering nutraceutical or placebo for 8 weeks. At the beginning and end of treatment a complete lipid pattern, safety parameters, hs-CRP and endothelial function were measured. When compared to placebo, during nutraceutical treatment patients experienced a more favorable percentage change in total cholesterol (TC vs baseline: -17.9%; TC vs placebo: -5.6%), LDL-cholesterol (LDL-C vs baseline: -23.3%; LDL-C vs placebo: -2.8%), hs-CRP (hs-CRP vs baseline: -2.4%; hs-CRP vs placebo: -1.5%), and endothelial function (pulse volume displacement vs baseline: +17%; pulse volume displacement vs placebo treatment: -3.3%). No significant difference was observed in respect to effects on triglycerides, HDL-cholesterol and safety parameters. On the basis of our data, the tested lipid-lowering nutraceutical seems to significantly improve endothelial function in moderately hypercholesterolemic subjects. These results have to be confirmed on larger patient samples and over longer periods. PMID:27358154

  1. High-fat diet from perilla oil induces insulin resistance despite lower serum lipids and increases hepatic fatty acid oxidation in rats

    PubMed Central

    2014-01-01

    Background The purpose of this study is to investigate the effects of a high-fat diet from perilla oil on serum lipids, hepatic lipid metabolism and insulin sensitivity. Methods Male Sprague–Dawley (SD) rats were fed either a control (CT) diet or a diet high in perilla oil (HP). After 16 weeks of feeding, the serum lipids were measured, and the gene expressions involved in hepatic fatty acid oxidation and synthesis were determined. In addition, hepatic fat deposition was detected, and insulin sensitivity was evaluated by means of euglycemic-hyperinsulinemic clamp. Results Compared with the rats in the CT group, the HP-feeding significantly decreased the levels of triglyceride (TG), total cholesterol (TCH) and HDL-cholesterol (HDL-c). HP-feeding did not change the levels of LDL-cholesterol (LDL-c), free fatty acid (FFA), intrahepatic lipids or body weight. Moreover, the HP-feeding dramatically increased the mRNA expressions of fatty acid oxidation markers (PPAR-alpha, CPT1A) and fatty acid synthesis markers (SREBP-1, FASN and ACC) in the liver. The HP-feeding induced increased protein levels of CPT1A, while reducing the protein levels of FASN and ACC in the liver. However, the glucose infusion rate significantly increased in the HP group compared with the CT group. Conclusions Our data show that, in rats, excessive perilla oil intake may significantly lower serum lipids, strengthen hepatic fatty acid oxidation, and inhibit hepatic fatty acid synthesis, but at the same time may also lead to insulin resistance. PMID:24422660

  2. Familial hypercholesterolemia and estimation of US patients eligible for low-density lipoprotein apheresis after maximally tolerated lipid-lowering therapy.

    PubMed

    Vishwanath, Raghu; Hemphill, Linda C

    2014-01-01

    Familial hypercholesterolemia (FH), an autosomal-dominant inherited disorder, can occur in either the heterozygous (HeFH) or homozygous (HoFH) state, and is characterized by high levels of serum low-density lipoprotein cholesterol (LDL-C). Although potent statins and maximally tolerated lipid-lowering therapy (LLT) have greatly reduced the risk of premature coronary heart disease (CHD) and death, all patients with HoFH and many with severe HeFH remain far from treatment goals and are thus at risk of cardiovascular disease. LDL apheresis is the treatment of choice for these patients but remains underutilized. No formal studies or epidemiologic data have estimated the prevalence of HoFH. An HeFH prevalence of 1:500 and a simplified Hardy-Weinberg equilibrium model was used to determine the probability of finding HoFH as 1:1 million in the general population. A US population of approximately 314.8 million was used to determine the number of cases of HoFH and HeFH. The following key parameters were used to estimate the prevalence of severe HeFH: baseline pretreatment LDL-C level and distribution of patients with FH, posttreatment LDL-C level and distribution after maximally tolerated LLT, and baseline percentage of patients with HeFH who have CHD. We assumed an HeFH prevalence of 1:500 and used statistics for a Gaussian distribution after the posttreatment means and standard deviations of LDL-C levels in patients with HeFH receiving maximally tolerated LLT, as has been documented by data from clinical trials and cross-sectional studies. These estimates do not include the statin-intolerant population. The objective of this analysis was to determine the prevalence of the US population with severe HeFH with or without CHD who still will be eligible for LDL apheresis despite maximally tolerated LLT. We estimated that there are 315 US patients with HoFH and 650,000 with HeFH. The estimated prevalence of the severe HeFH population eligible for apheresis is approximately 1

  3. Novel LDL-oriented pharmacotherapeutical strategies.

    PubMed

    Huang, Lin-Zhang; Zhu, Hai-Bo

    2012-04-01

    Elevated levels of low-density cholesterol (LDL-C) are highly correlated with increased risk of cardiovascular diseases (CVD). Thus, current guidelines have recommended progressively lower LDL-C for cholesterol treatment and CVD prevention as the primary goal of therapy. Even so, some patients in the high risk category fail to achieve recommended LDL-C targets with currently available medications. Thereby, additional pharmaceutical strategies are urgently required. In the review, we aim to provide an overview of both current and emerging LDL-C lowering drugs. As for current available LDL-C lowering agents, attentions are mainly focused on statins, niacin, bile acid sequestrants, ezetimibe, fibrates and omega-3 fatty acids. On the other hand, the emerging drugs differ from mechanisms are including: intervention of cholesterol biosynthesis downstream enzyme (squalene synthase inhibitors), inhibition of lipoprotein assembly (antisense mRNA inhibitors of apolipoprotein B and microsomal transfer protein inhibitors), enhanced lipoprotein clearance (proprotein convertase subtilisin kexin type 9, thyroid hormone analogues), inhibition of intestinal cholesterol absorption (Niemann-Pick C1-like 1 protein and acyl coenzyme A:cholesterol acyltransferase inhibitors) and interrupting enterohepatic circulation (apical sodium-dependent bile acid transporter inhibitors). Several ongoing agents are in their different stages of clinical trials, in expectation of promising antihyperlipidemic drugs. Therefore, alternative drugs monotherapy or in combination with statins will be sufficient to reduce LDL-C concentrations to optimal levels, and a new era for better LDL-C managements is plausible. PMID:22306845

  4. Drug treatment of hyperlipidaemia: a guide to the rational use of lipid-lowering drugs.

    PubMed

    Toth, Peter P

    2010-07-30

    Mammalian sterol and lipid metabolism depends on a large number of highly evolved biochemical and histological processes responsible for the absorption, distribution and steady-state anabolic/catabolic handling of these substances. Lipoproteins are complex polymolecular assemblies comprising phospholipids, cholesterol and cholesterol esters, triglycerides and a variety of apolipoproteins. The primary function of lipoproteins is to facilitate the systemic distribution of sterols and lipids. Abnormalities in lipoprotein metabolism are quite common and are attributable to a large number of genetic mutations, metabolic derangements such as insulin resistance or thyroid dysfunction, and excess availability of cholesterol and fat from dietary sources. Dyslipidaemic states facilitate endothelial dysfunction and atherogenesis. Dyslipidaemia is recognized as a risk factor for cardiovascular disease in both men and women, and people of all racial and ethnic groups throughout the world. Dyslipidaemia is modifiable with dietary change and the use of medications that impact on lipid metabolism through a variety of mechanisms. Reducing atherogenic lipoprotein burden in serum is associated with significant and meaningful reductions in risk for a variety of cardiovascular endpoints, including myocardial infarction, ischaemic stroke, development of peripheral arterial disease and mortality. This review provides an overview on how to best position lipid-lowering drugs when attempting to normalize serum lipid profiles and reduce risk for cardiovascular disease. HMG-CoA reductase inhibitors (statins) are widely accepted to be the agents of choice for reducing serum levels of low-density lipoprotein cholesterol (LDL-C) in both the primary and secondary prevention settings. Ezetimibe and bile acid sequestrants are both effective agents for reducing LDL-C, either used alone or in combination with statins. The statins, fibric acid derivatives (fibrates) and niacin raise high

  5. Food additives

    PubMed Central

    Spencer, Michael

    1974-01-01

    Food additives are discussed from the food technology point of view. The reasons for their use are summarized: (1) to protect food from chemical and microbiological attack; (2) to even out seasonal supplies; (3) to improve their eating quality; (4) to improve their nutritional value. The various types of food additives are considered, e.g. colours, flavours, emulsifiers, bread and flour additives, preservatives, and nutritional additives. The paper concludes with consideration of those circumstances in which the use of additives is (a) justified and (b) unjustified. PMID:4467857

  6. Phosphazene additives

    DOEpatents

    Harrup, Mason K; Rollins, Harry W

    2013-11-26

    An additive comprising a phosphazene compound that has at least two reactive functional groups and at least one capping functional group bonded to phosphorus atoms of the phosphazene compound. One of the at least two reactive functional groups is configured to react with cellulose and the other of the at least two reactive functional groups is configured to react with a resin, such as an amine resin of a polycarboxylic acid resin. The at least one capping functional group is selected from the group consisting of a short chain ether group, an alkoxy group, or an aryloxy group. Also disclosed are an additive-resin admixture, a method of treating a wood product, and a wood product.

  7. Potlining Additives

    SciTech Connect

    Rudolf Keller

    2004-08-10

    In this project, a concept to improve the performance of aluminum production cells by introducing potlining additives was examined and tested. Boron oxide was added to cathode blocks, and titanium was dissolved in the metal pool; this resulted in the formation of titanium diboride and caused the molten aluminum to wet the carbonaceous cathode surface. Such wetting reportedly leads to operational improvements and extended cell life. In addition, boron oxide suppresses cyanide formation. This final report presents and discusses the results of this project. Substantial economic benefits for the practical implementation of the technology are projected, especially for modern cells with graphitized blocks. For example, with an energy savings of about 5% and an increase in pot life from 1500 to 2500 days, a cost savings of $ 0.023 per pound of aluminum produced is projected for a 200 kA pot.

  8. Overcoming toxicity and side-effects of lipid-lowering therapies.

    PubMed

    Wilkinson, Michael J; Laffin, Luke J; Davidson, Michael H

    2014-06-01

    Lowering serum lipid levels is part of the foundation of treating and preventing clinically significant cardiovascular disease. Recently, the American Heart Association/American College of Cardiology released cholesterol guidelines which advocate for high efficacy statins rather than LDL-c goals for five patient subgroups at high risk for cardiovascular disease. Therefore, it is critical that clinicians have an approach for managing side-effects of statin therapy. Statins are associated with myopathy, transaminase elevations, and an increased risk of incident diabetes mellitus among some patients; connections between statins and other processes, such as renal and neurologic function, have also been studied with mixed results. Statin-related adverse effects might be minimized by careful assessment of patient risk factors. Strategies to continue statin therapy despite adverse effects include switching to another statin at a lower dose and titrating up, giving intermittent doses of statins, and adding non-statin agents. Non-statin lipid-lowering drugs have their own unique limitations. Management strategies and algorithms for statin-associated toxicities are available to help guide clinicians. Clinical practice should emphasize tailoring therapy to address each individual's cholesterol goals and risk of developing adverse effects on lipid-lowering drugs.

  9. Alirocumab: First Global Approval.

    PubMed

    Markham, Anthony

    2015-09-01

    Alirocumab (Praluent®) is a fully human monoclonal antibody developed by Regeneron Pharmaceuticals and Sanofi that has been approved in the US as an adjunct to diet and maximally tolerated statin therapy for the treatment of adults with heterozygous familial hypercholesterolaemia (HeFH) or clinical atherosclerotic cardiovascular disease, who require additional lowering of LDL-C. It specifically binds proprotein convertase subtilisin/kexin type 9 (PCSK9)-a down regulator of liver low-density lipoprotein (LDL)-receptors-thereby increasing the ability of the liver to bind LDL-cholesterol (LDL-C) and reducing levels of LDL-C in blood. It has been shown to reduce LDL-C levels in patients with hypercholesterolaemia, including HeFH, both as monotherapy and in conjunction with statin therapy. This article summarizes the milestones in the development of alirocumab leading to this first approval. PMID:26370210

  10. Harmonic Frequency Lowering

    PubMed Central

    Kirchberger, Martin

    2016-01-01

    A novel algorithm for frequency lowering in music was developed and experimentally tested in hearing-impaired listeners. Harmonic frequency lowering (HFL) combines frequency transposition and frequency compression to preserve the harmonic content of music stimuli. Listeners were asked to make judgments regarding detail and sound quality in music stimuli. Stimuli were presented under different signal processing conditions: original, low-pass filtered, HFL, and nonlinear frequency compressed. Results showed that participants reported perceiving the most detail in the HFL condition. In addition, there was no difference in sound quality across conditions. PMID:26834122

  11. Current Treatment of Dyslipidemia: A New Paradigm for Statin Drug Use and the Need for Additional Therapies.

    PubMed

    Kones, Richard; Rumana, Umme

    2015-07-01

    Coronary heart disease (CHD) is the leading cause of death in most countries, with the high prevalence currently driven by dual epidemics of obesity and diabetes. Statin drugs, the most effective, evidence-based agents to prevent and treat this disease, have a central role in management and are advised in all published guidelines. The 2013 American College of Cardiology/American Heart Association (ACC/AHA) cholesterol and assessment guidelines ('new ACC/AHA guidelines') emphasized global cardiovascular (CV) risk reduction as opposed to targeting low-density lipoprotein-cholesterol (LDL-C) levels, stressed the use of statins in two dose intensities, utilized a new risk calculator using pooled cohort equations, and lowered the risk cutoff for initiation of statin therapy. Although there were major strengths of the new ACC/AHA guidelines, substantial controversy followed their release, particulars of which are discussed in this review. They were generally regarded as improvements in an ongoing transition using evidenced-based data for maximum patient benefit. Several guidelines, other than the ACC/AHA guidelines, currently provide practitioners with choices, some depending on practice locations. Cholesterol control with statin drugs is used in all paradigms. However, some patients respond inadequately, approximately 15% are intolerant, and other factors prevent attaining cholesterol goals in as many as 40% of patients. Even after treatment, substantial residual risk for ongoing major events remains. Another readily available modality that can rival statin drugs in effectiveness is vast improvement in diet and lifestyle within the general population; however, despite great effort, existing programs to implement such changes have failed. Hence, despite unrivaled success, there is great need for additional drugs to prevent and treat CHD, whether as monotherapy or in combination with statin drugs. New American guidelines do not discuss or recommend any nonstatin drugs for

  12. Relationship between the cholesterol ester transfer protein TaqIB polymorphism and the lipid-lowering effect of atorvastatin in patients with coronary atherosclerotic heart disease.

    PubMed

    Li, J; Zhang, L; Xie, N Z; Deng, B; Lv, L X; Zheng, L Q

    2014-03-24

    This study aimed to investigate the relationship between the cholesterol ester transfer protein (CETP) gene TaqIB polymorphism and the lipid-lowering effect of atorvastatin in patients with coronary atherosclerotic heart disease. Two hundred eighty-eight patients were divided into a control group, an acute coronary syndrome (ACS) group, and a stable coronary heart disease (CHD) group. Blood biochemical indices were determined using the enzyme method, and polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) analysis was performed to study the TaqIB polymorphism of the CETP gene. The ACS and stable CHD groups were treated with atorvastatin, and blood lipid levels were reexamined after three months. Plasma levels of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and lipoprotein(a) were all significantly higher in the ACS and stable CHD groups compared to the control group (P < 0.05 or P < 0.01). After three months of treatment with atorvastatin, plasma levels of TC, LDL-C, triglycerides (TG) (only in patients with genotype B2B2), and lipoprotein(a) (only in patients with genotype B1B2) were all significantly decreased (P < 0.05 or P < 0.01). After treatment, the plasma level of TG was lower in patients with genotype B2B2 compared to patients with genotypes B1B1 or B1B2 (B1 carriers) (P < 0.01). Therefore, the CETP TaqIB polymorphism is associated with the lipid-lowering effect of atorvastatin in patients with CHD.

  13. Polyimide processing additives

    NASA Technical Reports Server (NTRS)

    Fletcher, James C. (Inventor); Pratt, J. Richard (Inventor); St.clair, Terry L. (Inventor); Stoakley, Diane M. (Inventor); Burks, Harold D. (Inventor)

    1992-01-01

    A process for preparing polyimides having enhanced melt flow properties is described. The process consists of heating a mixture of a high molecular weight poly-(amic acid) or polyimide with a low molecular weight amic acid or imide additive in the range of 0.05 to 15 percent by weight of additive. The polyimide powders so obtained show improved processability, as evidenced by lower melt viscosity by capillary rheometry. Likewise, films prepared from mixtures of polymers with additives show improved processability with earlier onset of stretching by TMA.

  14. Polyimide processing additives

    NASA Technical Reports Server (NTRS)

    Pratt, J. Richard (Inventor); St.clair, Terry L. (Inventor); Stoakley, Diane M. (Inventor); Burks, Harold D. (Inventor)

    1993-01-01

    A process for preparing polyimides having enhanced melt flow properties is described. The process consists of heating a mixture of a high molecular weight poly-(amic acid) or polyimide with a low molecular weight amic acid or imide additive in the range of 0.05 to 15 percent by weight of the additive. The polyimide powders so obtained show improved processability, as evidenced by lower melt viscosity by capillary rheometry. Likewise, films prepared from mixtures of polymers with additives show improved processability with earlier onset of stretching by TMA.

  15. Viruses of lower vertebrates.

    PubMed

    Essbauer, S; Ahne, W

    2001-08-01

    Viruses of lower vertebrates recently became a field of interest to the public due to increasing epizootics and economic losses of poikilothermic animals. These were reported worldwide from both wildlife and collections of aquatic poikilothermic animals. Several RNA and DNA viruses infecting fish, amphibians and reptiles have been studied intensively during the last 20 years. Many of these viruses induce diseases resulting in important economic losses of lower vertebrates, especially in fish aquaculture. In addition, some of the DNA viruses seem to be emerging pathogens involved in the worldwide decline in wildlife. Irido-, herpes- and polyomavirus infections may be involved in the reduction in the numbers of endangered amphibian and reptile species. In this context the knowledge of several important RNA viruses such as orthomyxo-, paramyxo-, rhabdo-, retro-, corona-, calici-, toga-, picorna-, noda-, reo- and birnaviruses, and DNA viruses such as parvo-, irido-, herpes-, adeno-, polyoma- and poxviruses, is described in this review. PMID:11550762

  16. Glucose and low-density lipoprotein cholesterol lowering in elderly patients with type 2 diabetes: focus on combination therapy with colesevelam HCl.

    PubMed

    Marrs, Joel C

    2012-05-01

    The prevalence of type 2 diabetes mellitus is high among the elderly population. Treatment of elderly patients with type 2 diabetes presents challenges because of co-morbidities and the potential increase in the risk of adverse effects. Hyperlipidaemia is also common in the elderly population. Glucose- and lipid-lowering treatment in elderly patients should be individualized on the basis of the patient's life expectancy, health status and cardiovascular risk factors, and evidence-based guideline recommendations. Because elderly patients often have impaired renal and hepatic function, careful considerations must be made when selecting appropriate glucose- and lipid-lowering therapy. There are a number of potential safety issues associated with various glucose- and lipid-lowering therapies that are relevant to elderly patients, including increased risk of heart failure exacerbations, weight loss, increased risk of hypoglycaemia, increased risk of myopathy, and contraindications of some agents in patients with hepatic or renal impairment. The bile acid sequestrant colesevelam HCl is unique compared with other glucose- and lipid-lowering therapies because it is the only product approved by the US Food and Drug Administration, as an adjunct to diet and exercise, to lower both glucose and low-density lipoprotein cholesterol (LDL-C) in adults with type 2 diabetes and primary hyperlipidaemia, respectively. Furthermore, colesevelam has been shown to have similar glucose- and lipid-lowering efficacy in patients aged <65 years and those aged ≥65 years. Colesevelam was not associated with weight gain, was associated with a low incidence of hypoglycaemia, and can be safely combined with a broad range of glucose-lowering agents (metformin, sulfonylureas and insulin) and lipid-lowering statins. Currently, colesevelam is available in tablet form and as a powder for oral suspension formulation; the latter may be of benefit to elderly patients with swallowing difficulties. As

  17. The PCSK9 Inhibitors: A Novel Therapeutic Target Enters Clinical Practice

    PubMed Central

    Lepor, Norman E.; Kereiakes, Dean J.

    2015-01-01

    There is a critical need for alternative, potent agents that can reduce low-density lipoprotein cholesterol (LDL-C) levels in patients with heterozygous familial hyperlipidemia and statin intolerance and those not reaching lipid-lowering treatment goals who are at high risk for cardiovascular (CV) events. The first proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor was approved in July 2015 by the US Food and Drug Administration as an adjunct to diet and maximally tolerated statin therapy for treatment of adults with heterozygous familial hyperlipidemia or clinical atherosclerotic CV disease, who require additional lowering of LDL-C levels. In clinical trials, PCSK9 inhibitors have been shown to reduce LDL-C levels by as much as 60% to 70% when administered as monotherapy or as an add-on treatment to statins and other lipid-lowering therapies. In studies of PCSK9 genetic mutations, loss of function in the PCSK9 allele was associated with a relative decrease of 88% in the risk for atherosclerotic CV events during 15 years of patient follow-up. The use of PCSK9 inhibitors may eventually support the LDL-C hypothesis that the lower the LDL-C level, the lower the CV risk. Although some recent clinical practice guidelines have deemphasized the importance of numeric LDL-C targets, many clinicians are reluctant to discard them, and this position is supported by recent clinical evidence. We eagerly await the results of the ODYSSEY, FOURIER, and SPIRE clinical outcome trials, which we anticipate will provide further validation that “lower is better” with respect to reducing LDL-C levels and improving clinical outcomes. PMID:26834934

  18. The PCSK9 Inhibitors: A Novel Therapeutic Target Enters Clinical Practice.

    PubMed

    Lepor, Norman E; Kereiakes, Dean J

    2015-12-01

    There is a critical need for alternative, potent agents that can reduce low-density lipoprotein cholesterol (LDL-C) levels in patients with heterozygous familial hyperlipidemia and statin intolerance and those not reaching lipid-lowering treatment goals who are at high risk for cardiovascular (CV) events. The first proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor was approved in July 2015 by the US Food and Drug Administration as an adjunct to diet and maximally tolerated statin therapy for treatment of adults with heterozygous familial hyperlipidemia or clinical atherosclerotic CV disease, who require additional lowering of LDL-C levels. In clinical trials, PCSK9 inhibitors have been shown to reduce LDL-C levels by as much as 60% to 70% when administered as monotherapy or as an add-on treatment to statins and other lipid-lowering therapies. In studies of PCSK9 genetic mutations, loss of function in the PCSK9 allele was associated with a relative decrease of 88% in the risk for atherosclerotic CV events during 15 years of patient follow-up. The use of PCSK9 inhibitors may eventually support the LDL-C hypothesis that the lower the LDL-C level, the lower the CV risk. Although some recent clinical practice guidelines have deemphasized the importance of numeric LDL-C targets, many clinicians are reluctant to discard them, and this position is supported by recent clinical evidence. We eagerly await the results of the ODYSSEY, FOURIER, and SPIRE clinical outcome trials, which we anticipate will provide further validation that "lower is better" with respect to reducing LDL-C levels and improving clinical outcomes. PMID:26834934

  19. Additive effect of mutations in LDLR and PCSK9 genes on the phenotype of familial hypercholesterolemia.

    PubMed

    Pisciotta, Livia; Priore Oliva, Claudio; Cefalù, Angelo Baldassare; Noto, Davide; Bellocchio, Antonella; Fresa, Raffaele; Cantafora, Alfredo; Patel, Dilip; Averna, Maurizio; Tarugi, Patrizia; Calandra, Sebastiano; Bertolini, Stefano

    2006-06-01

    Patients homozygous or compound heterozygous for LDLR mutations or double heterozygous for LDLR and apo B R3500Q mutation have higher LDL-C levels, more extensive xanthomatosis and more severe premature coronary disease (pCAD) than simple heterozygotes for mutations in either these genes or for missense mutations in PCSK9 gene. It is not known whether combined mutations in LDLR and PKCS9 are associated with such a severe phenotype. We sequenced Apo B and PCSK9 genes in two patients with the clinical diagnosis of homozygous FH who were heterozygous for LDLR gene mutations. Proband Z.P. (LDL-C 13.39 mmol/L and pCAD) was heterozygous for an LDLR mutation (p.E228K) inherited from her father (LDL-C 8.07 mmol/L) and a PCSK9 mutation (p.R496W) from her mother (LDL-C 5.58 mmol/L). Proband L.R. and her sister (LDL-C 11.51 and 10.47 mmol/L, xanthomatosis and carotid atherosclerosis) were heterozygous for an LDLR mutation (p.Y419X) inherited from their mother (LDL-C 6.54 mmol/L) and a PCSK9 mutation (p.N425S) probably from their deceased father. The LDL-C levels in double heterozygotes of these two families were 56 and 44% higher than those found in simple heterozygotes for the two LDLR mutations, respectively. The two PCSK9 mutations are novel and were not found in 110 controls and 80 patients with co-dominant hypercholesterolemia. These observations indicate that rare missense mutations of PCSK9 may worsen the clinical phenotype of patients carrying LDLR mutations. PMID:16183066

  20. Effects of intensive atorvastatin and rosuvastatin treatment on apolipoprotein B-48 and remnant lipoprotein cholesterol levels

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Atorvastatin and rosuvastatin at maximal doses are both highly effective in lowering low-density lipoprotein cholesterol (LDL-C) and triglyceride (TG) levels. Rosuvastatin has been shown to be more effective than atorvastatin in lowering LDL-C, small dense LDL-C and in raising high-density lipoprote...

  1. The Effect of Almonds on Biomarkers of Lipid Peroxidation in Older Hyperlipidemic Subjects

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Nut consumption has been associated with reduced coronary heart disease (CHD) risk. In addition to cholesterol-lowering properties, almonds have been shown to lower oxidized low density lipoprotein cholesterol (LDL-C) concentrations. However, little is known regarding their effects on other marker...

  2. Efficacy and safety of alirocumab as add-on therapy in high-cardiovascular-risk patients with hypercholesterolemia not adequately controlled with atorvastatin (20 or 40 mg) or rosuvastatin (10 or 20 mg): design and rationale of the ODYSSEY OPTIONS Studies.

    PubMed

    Robinson, Jennifer G; Colhoun, Helen M; Bays, Harold E; Jones, Peter H; Du, Yunling; Hanotin, Corinne; Donahue, Stephen

    2014-10-01

    The phase 3 ODYSSEY OPTIONS studies (OPTIONS I, NCT01730040; OPTIONS II, NCT01730053) are multicenter, multinational, randomized, double-blind, active-comparator, 24-week studies evaluating the efficacy and safety of alirocumab, a fully human monoclonal antibody targeting proprotein convertase subtilisin/kexin type 9, as add-on therapy in ∼ 650 high-cardiovascular (CV)-risk patients whose low-density lipoprotein cholesterol (LDL-C) levels are ≥100 mg/dL or ≥70 mg/dL according to the CV-risk category, high and very high CV risk, respectively, with atorvastatin (20-40 mg/d) or rosuvastatin (10-20 mg/d). Patients are randomized to receive alirocumab 75 mg via a single, subcutaneous, 1-mL injection by prefilled pen every 2 weeks (Q2W) as add-on therapy to atorvastatin (20-40 mg) or rosuvastatin (10-20 mg); or to receive ezetimibe 10 mg/d as add-on therapy to statin; or to receive statin up-titration; or to switch from atorvastatin to rosuvastatin (OPTIONS I only). At week 12, based on week 8 LDL-C levels, the alirocumab dose may be increased from 75 mg to 150 mg Q2W if LDL-C levels remain ≥100 mg/dL or ≥70 mg/dL in patients with high or very high CV risk, respectively. The primary efficacy endpoint in both studies is difference in percent change in calculated LDL-C from baseline to week 24 in the alirocumab vs control arms. The studies may provide guidance to inform clinical decision-making when patients with CV risk require additional lipid-lowering therapy to further reduce LDL-C levels. The flexibility of the alirocumab dosing regimen allows for individualized therapy based on the degree of LDL-C reduction required to achieve the desired LDL-C level. PMID:25269777

  3. Efficacy and Safety of Alirocumab as Add-on Therapy in High–Cardiovascular-Risk Patients With Hypercholesterolemia Not Adequately Controlled With Atorvastatin (20 or 40 mg) or Rosuvastatin (10 or 20 mg): Design and Rationale of the ODYSSEY OPTIONS Studies

    PubMed Central

    Robinson, Jennifer G; Colhoun, Helen M; Bays, Harold E; Jones, Peter H; Du, Yunling; Hanotin, Corinne; Donahue, Stephen

    2014-01-01

    The phase 3 ODYSSEY OPTIONS studies (OPTIONS I, NCT01730040; OPTIONS II, NCT01730053) are multicenter, multinational, randomized, double-blind, active-comparator, 24-week studies evaluating the efficacy and safety of alirocumab, a fully human monoclonal antibody targeting proprotein convertase subtilisin/kexin type 9, as add-on therapy in ∼ 650 high-cardiovascular (CV)-risk patients whose low-density lipoprotein cholesterol (LDL-C) levels are ≥100 mg/dL or ≥70 mg/dL according to the CV-risk category, high and very high CV risk, respectively, with atorvastatin (20–40 mg/d) or rosuvastatin (10–20 mg/d). Patients are randomized to receive alirocumab 75 mg via a single, subcutaneous, 1-mL injection by prefilled pen every 2 weeks (Q2W) as add-on therapy to atorvastatin (20–40 mg) or rosuvastatin (10–20 mg); or to receive ezetimibe 10 mg/d as add-on therapy to statin; or to receive statin up-titration; or to switch from atorvastatin to rosuvastatin (OPTIONS I only). At week 12, based on week 8 LDL-C levels, the alirocumab dose may be increased from 75 mg to 150 mg Q2W if LDL-C levels remain ≥100 mg/dL or ≥70 mg/dL in patients with high or very high CV risk, respectively. The primary efficacy endpoint in both studies is difference in percent change in calculated LDL-C from baseline to week 24 in the alirocumab vs control arms. The studies may provide guidance to inform clinical decision-making when patients with CV risk require additional lipid-lowering therapy to further reduce LDL-C levels. The flexibility of the alirocumab dosing regimen allows for individualized therapy based on the degree of LDL-C reduction required to achieve the desired LDL-C level. PMID:25269777

  4. Efficacy and safety of alirocumab as add-on therapy in high-cardiovascular-risk patients with hypercholesterolemia not adequately controlled with atorvastatin (20 or 40 mg) or rosuvastatin (10 or 20 mg): design and rationale of the ODYSSEY OPTIONS Studies.

    PubMed

    Robinson, Jennifer G; Colhoun, Helen M; Bays, Harold E; Jones, Peter H; Du, Yunling; Hanotin, Corinne; Donahue, Stephen

    2014-10-01

    The phase 3 ODYSSEY OPTIONS studies (OPTIONS I, NCT01730040; OPTIONS II, NCT01730053) are multicenter, multinational, randomized, double-blind, active-comparator, 24-week studies evaluating the efficacy and safety of alirocumab, a fully human monoclonal antibody targeting proprotein convertase subtilisin/kexin type 9, as add-on therapy in ∼ 650 high-cardiovascular (CV)-risk patients whose low-density lipoprotein cholesterol (LDL-C) levels are ≥100 mg/dL or ≥70 mg/dL according to the CV-risk category, high and very high CV risk, respectively, with atorvastatin (20-40 mg/d) or rosuvastatin (10-20 mg/d). Patients are randomized to receive alirocumab 75 mg via a single, subcutaneous, 1-mL injection by prefilled pen every 2 weeks (Q2W) as add-on therapy to atorvastatin (20-40 mg) or rosuvastatin (10-20 mg); or to receive ezetimibe 10 mg/d as add-on therapy to statin; or to receive statin up-titration; or to switch from atorvastatin to rosuvastatin (OPTIONS I only). At week 12, based on week 8 LDL-C levels, the alirocumab dose may be increased from 75 mg to 150 mg Q2W if LDL-C levels remain ≥100 mg/dL or ≥70 mg/dL in patients with high or very high CV risk, respectively. The primary efficacy endpoint in both studies is difference in percent change in calculated LDL-C from baseline to week 24 in the alirocumab vs control arms. The studies may provide guidance to inform clinical decision-making when patients with CV risk require additional lipid-lowering therapy to further reduce LDL-C levels. The flexibility of the alirocumab dosing regimen allows for individualized therapy based on the degree of LDL-C reduction required to achieve the desired LDL-C level.

  5. A matrix lower bound

    SciTech Connect

    Grcar, Joseph F.

    2002-02-04

    A matrix lower bound is defined that generalizes ideas apparently due to S. Banach and J. von Neumann. The matrix lower bound has a natural interpretation in functional analysis, and it satisfies many of the properties that von Neumann stated for it in a restricted case. Applications for the matrix lower bound are demonstrated in several areas. In linear algebra, the matrix lower bound of a full rank matrix equals the distance to the set of rank-deficient matrices. In numerical analysis, the ratio of the matrix norm to the matrix lower bound is a condition number for all consistent systems of linear equations. In optimization theory, the matrix lower bound suggests an identity for a class of min-max problems. In real analysis, a recursive construction that depends on the matrix lower bound shows that the level sets of continuously differential functions lie asymptotically near those of their tangents.

  6. Clinical efficacy and safety of evolocumab for low-density lipoprotein cholesterol reduction.

    PubMed

    Henry, Courtney A; Lyon, Ronald A; Ling, Hua

    2016-01-01

    Multiple categories of medications have been developed to manage lipid profiles and reduce the risk of cardiovascular events in patients with heart disease. However, currently marketed medications have not solved the problems associated with preventing and treating cardiovascular diseases completely. A substantial population of patients cannot take advantage of statin therapy due to statin intolerance, heart failure, or kidney hemodialysis, suggesting a need for additional effective agents to reduce low-density lipoprotein cholesterol (LDL-C) levels. Proprotein convertase subtilisin/kexin type 9 (PCSK9) was discovered in 2003 and subsequently emerged as a novel target for LDL-C-lowering therapy. Evolocumab is a fully human monoclonal immunoglobulin G2 (IgG2) directed against human PCSK9. By inactivating PCSK9, evolocumab upregulates LDL receptors causing increased catabolism of LDL-C and the consequent reduction of LDL-C levels in blood. Overall, evolocumab has had notable efficacy, with LDL-C reduction ranging from 53% to 75% in monotherapy and combination therapies, and is associated with minor adverse effects. However, studies regarding the ability of evolocumab to reduce mortality as well as long-term safety concerns are limited. The fact that the drug was introduced at a cost much higher than the existing medications and shows a low incremental mortality benefit suggests that many payers will consider evolocumab to have an unfavorable cost-benefit ratio.

  7. Clinical efficacy and safety of evolocumab for low-density lipoprotein cholesterol reduction

    PubMed Central

    Henry, Courtney A; Lyon, Ronald A; Ling, Hua

    2016-01-01

    Multiple categories of medications have been developed to manage lipid profiles and reduce the risk of cardiovascular events in patients with heart disease. However, currently marketed medications have not solved the problems associated with preventing and treating cardiovascular diseases completely. A substantial population of patients cannot take advantage of statin therapy due to statin intolerance, heart failure, or kidney hemodialysis, suggesting a need for additional effective agents to reduce low-density lipoprotein cholesterol (LDL-C) levels. Proprotein convertase subtilisin/kexin type 9 (PCSK9) was discovered in 2003 and subsequently emerged as a novel target for LDL-C-lowering therapy. Evolocumab is a fully human monoclonal immunoglobulin G2 (IgG2) directed against human PCSK9. By inactivating PCSK9, evolocumab upregulates LDL receptors causing increased catabolism of LDL-C and the consequent reduction of LDL-C levels in blood. Overall, evolocumab has had notable efficacy, with LDL-C reduction ranging from 53% to 75% in monotherapy and combination therapies, and is associated with minor adverse effects. However, studies regarding the ability of evolocumab to reduce mortality as well as long-term safety concerns are limited. The fact that the drug was introduced at a cost much higher than the existing medications and shows a low incremental mortality benefit suggests that many payers will consider evolocumab to have an unfavorable cost–benefit ratio. PMID:27143910

  8. Clinical efficacy and safety of evolocumab for low-density lipoprotein cholesterol reduction.

    PubMed

    Henry, Courtney A; Lyon, Ronald A; Ling, Hua

    2016-01-01

    Multiple categories of medications have been developed to manage lipid profiles and reduce the risk of cardiovascular events in patients with heart disease. However, currently marketed medications have not solved the problems associated with preventing and treating cardiovascular diseases completely. A substantial population of patients cannot take advantage of statin therapy due to statin intolerance, heart failure, or kidney hemodialysis, suggesting a need for additional effective agents to reduce low-density lipoprotein cholesterol (LDL-C) levels. Proprotein convertase subtilisin/kexin type 9 (PCSK9) was discovered in 2003 and subsequently emerged as a novel target for LDL-C-lowering therapy. Evolocumab is a fully human monoclonal immunoglobulin G2 (IgG2) directed against human PCSK9. By inactivating PCSK9, evolocumab upregulates LDL receptors causing increased catabolism of LDL-C and the consequent reduction of LDL-C levels in blood. Overall, evolocumab has had notable efficacy, with LDL-C reduction ranging from 53% to 75% in monotherapy and combination therapies, and is associated with minor adverse effects. However, studies regarding the ability of evolocumab to reduce mortality as well as long-term safety concerns are limited. The fact that the drug was introduced at a cost much higher than the existing medications and shows a low incremental mortality benefit suggests that many payers will consider evolocumab to have an unfavorable cost-benefit ratio. PMID:27143910

  9. High dose simvastatin exhibits enhanced lipid lowering effects relative to simvastatin/ezetimibe combination therapy

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Technical Abstract: Background: Statins are the frontline in cholesterol reduction therapies; however use in combination with agents that possess complimentary mechanisms of action may achieve further reduce in LDL-C. Methods and Results: Thirty-nine patients were treated with either 80mg simvasta...

  10. Transconjunctival Lower Blepharoplasty.

    PubMed

    Pack, Sean; Quereshy, Faisal A; Altay, Mehmet Ali; Baur, Dale A

    2016-09-01

    There is no secret to achieving successful results with lower belpharoplasties; as is the case with any surgical procedure, proper patient evaluation and development of a comprehensive, anatomic-based treatment plan are prerequisites for success. For situations in which a patient has little lid laxity and pseudoherniated periorbital fat, transconjunctival lower blepharoplasty is the treatment of choice. Transconjunctival lower blepharoplasty enables the surgeon to reposition fat, effectively blending the lid-cheek junction and filling the tear trough deformity. In order to better enable clinicians to achieve optimal outcomes, the authors advocate an anatomic-based approach for patient evaluation and treatment planning.

  11. Lower Extremity Radiography

    MedlinePlus

    ... images of the toes, feet, ankles, lower leg, knee, upper leg or hip. These types of examinations are performed to detect conditions such as fractures, soft tissue damage and arthritis. A physician will ...

  12. New Frontiers in the Treatment of Diabetic Dyslipidemia

    PubMed Central

    Wang, Shu-Yi; Hsieh, Ming-Chia; Tu, Shih-Te; Chuang, Chieh-Sen

    2013-01-01

    Dyslipidemia is a major risk factor for cardiovascular complications in people with diabetes. Lowering low-density lipoprotein cholesterol (LDL-C) levels is effective in the primary and secondary prevention of diabetic vascular complications. However, LDL-C levels do not reflect all aspects of diabetic dyslipidemia, which is characterized by hypertriglyceridemia and low high-density lipoprotein cholesterol (HDL-C). Statins, nicotinic acid, and fibrates play a role in treating diabetic dyslipidemia. Atherosclerosis is a major disorder of the blood vessel wall in patients with diabetes. A number of antihyperlipidemic agents may be beneficial and exhibit effects at the actual site of vascular disease and not only on plasma lipoprotein concentrations. Several novel therapeutic compounds are currently being developed. These include additional therapeutics for LDL-C, triglycerides, HDL-C, and modulators of inflammation that can be used as possible synergic agents for the treatment of atherosclerosis and irregularities in plasma lipoprotein concentrations. PMID:24380093

  13. Lower Hybrid Solitary Structures

    NASA Technical Reports Server (NTRS)

    Schuck, Peter W.

    2011-01-01

    Lower hybrid solitary structures (LHSS) have been observed by sounding rockets in the auroral ionosphere for over a decade and a half. LHSS are spatial structures embedded in space plasmas containing ambient whistler mode hiss. They are characterized by a density depletion of a few percent to several tens of percent in which electric fields near, both above and below, the lower hybrid resonance are more intense than the background fields by a factor of three to five. LHSS have dimensions across the magnetic field of a few to many thermal ion gyroradii, usually 10-100 meters and a density profile that is Gaussian and consistent with cylindrical symmetry. Along the magnetic field the dimensions are estimated to be several kilometers to several hundred kilometers. Electric field interferometry reveals that the phase fronts of LHSS electric fields rotate azimuthally within the density depletions; right-hand above the lower hybrid resonance and left-hand below the lower hybrid resonance [Pincon et al., 1997; Schuck et al., 1998; Bonnell et al., 1998; Tjulin et al., 2003; Schuck et al., 2003]. The description of this phenomena was driven by the observations the Cornell University sounding rocket program headed by the late Paul Kintner.

  14. Lower extremity orthoses.

    PubMed

    Bogucki, Artur

    2002-01-31

    This article presents the medical indications and contemporary technical capabilities in orthotic management of lower extremity. The classification included typical orthoses as well as devices that today constitute an integral part of modern therapeutic procedures are presented. Therapeutic success is conditioned by professional team-work of the physician, the therapist, the orthotic technician and the patient. PMID:17679908

  15. Lower extremity prostheses.

    PubMed

    Bogucki, A

    2001-01-01

    This article discusses the technical and medical difficulties involved in the proper fitting of prostheses on the lower extremity. The factors determining the success of a prosthesis include the quality of the stump, the skill of prosthesis socket fabrication, and the proper ordering of components, as well as rehabilitation supervised by experts and professional care for the amputee. PMID:17984917

  16. Characteristics of the Russian Lower Class

    ERIC Educational Resources Information Center

    Tikhonova, N. E.

    2011-01-01

    Lower socioeconomic strata in Russia have their origins in both the former Soviet lower strata and economic decline of the 1990s. Part of the reason for their persistence is the geographic mismatch between jobs and the labor supply, in addition to lack of education, skills, and social support. The situation cannot be solved by just providing…

  17. Lower cranial nerves.

    PubMed

    Soldatos, Theodoros; Batra, Kiran; Blitz, Ari M; Chhabra, Avneesh

    2014-02-01

    Imaging evaluation of cranial neuropathies requires thorough knowledge of the anatomic, physiologic, and pathologic features of the cranial nerves, as well as detailed clinical information, which is necessary for tailoring the examinations, locating the abnormalities, and interpreting the imaging findings. This article provides clinical, anatomic, and radiological information on lower (7th to 12th) cranial nerves, along with high-resolution magnetic resonance images as a guide for optimal imaging technique, so as to improve the diagnosis of cranial neuropathy.

  18. [Food additives and healthiness].

    PubMed

    Heinonen, Marina

    2014-01-01

    Additives are used for improving food structure or preventing its spoilage, for example. Many substances used as additives are also naturally present in food. The safety of additives is evaluated according to commonly agreed principles. If high concentrations of an additive cause adverse health effects for humans, a limit of acceptable daily intake (ADI) is set for it. An additive is a risk only when ADI is exceeded. The healthiness of food is measured on the basis of nutrient density and scientifically proven effects.

  19. Tevatron lower temperature operation

    SciTech Connect

    Theilacker, J.C.

    1994-07-01

    This year saw the completion of three accelerator improvement projects (AIP) and two capital equipment projects pertaining to the Tevatron cryogenic system. The projects result in the ability to operate the Tevatron at lower temperature, and thus higher energy. Each project improves a subsystem by expanding capabilities (refrigerator controls), ensuring reliability (valve box, subatmospheric hardware, and compressor D), or enhancing performance (cold compressors and coldbox II). In January of 1994, the Tevatron operated at an energy of 975 GeV for the first time. This was the culmination, of many years of R&D, power testing in a sector (one sixth) of the Tevatron, and final system installation during the summer of 1993. Although this is a modest increase in energy, the discovery potential for the Top quark is considerably improved.

  20. Lower respiratory tract infections.

    PubMed

    Chang, Anne B; Chang, Christina C; O'Grady, K; Torzillo, P J

    2009-12-01

    Acute lower respiratory infections (ALRI) are the major cause of morbidity and mortality in young children worldwide. ALRIs are important indicators of the health disparities that persist between Indigenous and non-Indigenous children in developed countries. Bronchiolitis and pneumonia account for the majority of the ALRI burden. The epidemiology, diagnosis, and management of these diseases in Indigenous children are discussed. In comparison with non-Indigenous children in developing countries they have higher rates of disease, more complications, and their management is influenced by several unique factors including the epidemiology of disease and, in some remote regions, constraints on hospital referral and access to highly trained staff. The prevention of repeat infections and the early detection and management of chronic lung disease is critical to the long-term respiratory and overall health of these children.

  1. Crane Lowers Aeroshell

    NASA Technical Reports Server (NTRS)

    2003-01-01

    January 31, 2003

    In the Payload Hazardous Servicing Facility, an overhead crane lowers the Mars Exploration Rover (MER) aeroshell toward a rotation stand. Set to launch in 2003, the MER Mission will consist of two identical rovers designed to cover roughly 110 yards (100 meters) each Martian day. Each rover will carry five scientific instruments that will allow it to search for evidence of liquid water that may have been present in the planet's past. The rovers will be identical to each other, but will land at different regions of Mars. The first rover has a launch window opening May 30, and the second rover a window opening June 25, 2003.

  2. EFFECT OF STATINS ALONE VERSUS STATINS PLUS EZETIMIBE ON CAROTID ATHEROSCLEROSIS IN TYPE 2 DIABETES: THE SANDS TRIAL

    PubMed Central

    Fleg, Jerome L.; Mete, Mihriye; Howard, Barbara V.; Umans, Jason G.; Roman, Mary J.; E, Robert; Ratner, MD; Silverman, Angela; Galloway, James M.; Henderson, Jeffrey A.; Weir, Matthew R.; Wilson, Charlton; Stylianou, Mario; Howard, Wm. James

    2009-01-01

    Objective This secondary analysis from the Stop Atherosclerosis in Native Diabetics Study examines the effects of lowering low-density lipoprotein cholesterol (LDL-C) with statins alone versus statins plus ezetimibe (E) on common carotid artery intimal medial thickness (CIMT) in patients with type 2 diabetes and no prior cardiovascular event. Background It is unknown whether the addition of E to statin therapy affects subclinical atherosclerosis. Methods Within an aggressive group (target LDL-C ≤70mg/dL; non-high-density lipoprotein [non-HDL]-C ≤<100 mg/dL; systolic blood pressure [SBP] ≤115mmHg), change in CIMT over 36mos was compared in diabetic individuals >40 yrs receiving statins plus E versus statins alone. CIMT changes in both aggressive subgroups were compared with changes in the standard subgroups (target LDL-C ≤<100mg/dL; non-HDL-C ≤ 130 mg/dL; SBP ≤130mmHg). Results Mean (95%CI) LDL-C was reduced by 31 (23, 37)mg/dL and 32 (27, 38)mg/dL in the aggressive group receiving statins plus E and statins alone, respectively, compared with changes of 1 (−3, 6) mg/dL in the standard group (p<0.0001 vs both aggressive subgroups. Within the aggressive group, mean IMT at 36mos regressed from baseline similarly in the E (−.025 [−05,.003] mm) and non-E subgroups (−.012 [−.03,.008] mm) but progressed in the standard treatment arm (0.039 [0.02, 0.06] mm), intergroup p<0.0001. Conclusions Reducing LDL-C to aggressive targets resulted in similar regression of CIMT in patients who attained equivalent LDL-C reductions from a statin alone or statin plus E. CIMT increased in those achieving standard targets. PMID:19095139

  3. Additional Types of Neuropathy

    MedlinePlus

    ... A A Listen En Español Additional Types of Neuropathy Charcot's Joint Charcot's Joint, also called neuropathic arthropathy, ... can stop bone destruction and aid healing. Cranial Neuropathy Cranial neuropathy affects the 12 pairs of nerves ...

  4. Food Additives and Hyperkinesis

    ERIC Educational Resources Information Center

    Wender, Ester H.

    1977-01-01

    The hypothesis that food additives are causally associated with hyperkinesis and learning disabilities in children is reviewed, and available data are summarized. Available from: American Medical Association 535 North Dearborn Street Chicago, Illinois 60610. (JG)

  5. Smog control fuel additives

    SciTech Connect

    Lundby, W.

    1993-06-29

    A method is described of controlling, reducing or eliminating, ozone and related smog resulting from photochemical reactions between ozone and automotive or industrial gases comprising the addition of iodine or compounds of iodine to hydrocarbon-base fuels prior to or during combustion in an amount of about 1 part iodine per 240 to 10,000,000 parts fuel, by weight, to be accomplished by: (a) the addition of these inhibitors during or after the refining or manufacturing process of liquid fuels; (b) the production of these inhibitors for addition into fuel tanks, such as automotive or industrial tanks; or (c) the addition of these inhibitors into combustion chambers of equipment utilizing solid fuels for the purpose of reducing ozone.

  6. Implications of Total to High-Density Lipoprotein Cholesterol Ratio Discordance With Alternative Lipid Parameters for Coronary Atheroma Progression and Cardiovascular Events.

    PubMed

    Elshazly, Mohamed B; Nicholls, Stephen J; Nissen, Steven E; St John, Julie; Martin, Seth S; Jones, Steven R; Quispe, Renato; Stegman, Brian; Kapadia, Samir R; Tuzcu, E Murat; Puri, Rishi

    2016-09-01

    The total cholesterol to high-density lipoprotein cholesterol (TC/HDL-C) ratio may quantify atherogenic lipoproteins beyond low-density lipoprotein cholesterol (LDL-C), non-HDL-C and apolipoprotein B (apoB). We analyzed pooled data from 9 trials involving 4,957 patients with coronary artery disease undergoing serial intravascular ultrasonography to assess changes in percent atheroma volume (ΔPAV) and 2-year major adverse cardiovascular event (MACE) rates when TC/HDL-C levels were discordant with LDL-C, non-HDL-C, and apoB. Discordance was investigated when lipid levels were stratified by LDL-C 80, non-HDL-C 107, and apoB 76 mg/dl) or LDL-C 70, non-HDL-C 89, and apoB 59 mg/dl). When stratified by median levels, TC/HDL-C was commonly observed to be discordant with LDL-C (26%), non-HDL-C (20%), and apoB (27%). In patients with LDL-C, non-HDL-C, or apoB LDL-C, non-HDL-C, or apoB ≥median, those with a discordant TC/HDL-C lower MACE (15.0%, 17.3%, 19.9%, respectively) compared with TC/HDL-C ≥median (24.7%, 24.2%, 26.4%; p <0.001, 0.003, 0.03, respectively). In conclusion, the TC/HDL-C ratio reclassifies atheroma progression and MACE rates when discordant with LDL-C, non-HDL-C, and apoB within subjects. Thus, using the ratio, in addition to individual lipid parameters, may identify patients who may benefit from more intensive lipid modification. PMID:27392507

  7. Additive Manufacturing Infrared Inspection

    NASA Technical Reports Server (NTRS)

    Gaddy, Darrell

    2014-01-01

    Additive manufacturing is a rapid prototyping technology that allows parts to be built in a series of thin layers from plastic, ceramics, and metallics. Metallic additive manufacturing is an emerging form of rapid prototyping that allows complex structures to be built using various metallic powders. Significant time and cost savings have also been observed using the metallic additive manufacturing compared with traditional techniques. Development of the metallic additive manufacturing technology has advanced significantly over the last decade, although many of the techniques to inspect parts made from these processes have not advanced significantly or have limitations. Several external geometry inspection techniques exist such as Coordinate Measurement Machines (CMM), Laser Scanners, Structured Light Scanning Systems, or even traditional calipers and gages. All of the aforementioned techniques are limited to external geometry and contours or must use a contact probe to inspect limited internal dimensions. This presentation will document the development of a process for real-time dimensional inspection technique and digital quality record of the additive manufacturing process using Infrared camera imaging and processing techniques.

  8. Phenylethynyl Containing Reactive Additives

    NASA Technical Reports Server (NTRS)

    Connell, John W. (Inventor); Smith, Joseph G., Jr. (Inventor); Hergenrother, Paul M. (Inventor)

    2002-01-01

    Phenylethynyl containing reactive additives were prepared from aromatic diamine, containing phenylethvnvl groups and various ratios of phthalic anhydride and 4-phenylethynviphthalic anhydride in glacial acetic acid to form the imide in one step or in N-methyl-2-pvrrolidinone to form the amide acid intermediate. The reactive additives were mixed in various amounts (10% to 90%) with oligomers containing either terminal or pendent phenylethynyl groups (or both) to reduce the melt viscosity and thereby enhance processability. Upon thermal cure, the additives react and become chemically incorporated into the matrix and effect an increase in crosslink density relative to that of the host resin. This resultant increase in crosslink density has advantageous consequences on the cured resin properties such as higher glass transition temperature and higher modulus as compared to that of the host resin.

  9. Defining the Role of PCSK9 Inhibitors in the Treatment of Hyperlipidemia.

    PubMed

    Whayne, Thomas F

    2016-04-01

    Statins remain the mainstay of medical cardiovascular risk reduction because of their effectiveness in decreasing low-density lipoprotein cholesterol (LDL-C) as well as some other potentially beneficial effects. The latest US 2013 lipid guidelines essentially recommend only the prescription of a high-dose statin for the high-risk patient. However, both quite old and quite new outcomes evidence, such as reported for ezetimibe, emphasize that LDL-C lowering is, in and of itself, quite important for cardiovascular risk reduction. It appears that the proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors represent a major new contribution to this effort, especially for patients with severe familial hypercholesterolemia, proven clinical cardiovascular disease, statin intolerance, or failure to attain an acceptably low LDL-C goal despite maximum available medical management. Very recent clinical trials have proven overwhelmingly the effectiveness and safety of PCSK9 inhibitors for lowering LDL-C. Both alirocumab and evolocumab have now been approved by the US FDA and there are some initial favorable outcomes data. This review is intended to summarize available evidence and emphasize the possible clinical role of these inhibitors following the approval of alirocumab and evolocumab. Understanding the negative receptor feedback of PCSK9 and the mechanism and beneficial effect of PCSK9 inhibitors for cardiovascular risk reduction is essential for the up-to-date practitioner of cardiovascular medicine. There is every reasonable hope for significant cardiovascular benefit from these new additions to our medical cardiovascular armamentarium.

  10. Defining the Role of PCSK9 Inhibitors in the Treatment of Hyperlipidemia.

    PubMed

    Whayne, Thomas F

    2016-04-01

    Statins remain the mainstay of medical cardiovascular risk reduction because of their effectiveness in decreasing low-density lipoprotein cholesterol (LDL-C) as well as some other potentially beneficial effects. The latest US 2013 lipid guidelines essentially recommend only the prescription of a high-dose statin for the high-risk patient. However, both quite old and quite new outcomes evidence, such as reported for ezetimibe, emphasize that LDL-C lowering is, in and of itself, quite important for cardiovascular risk reduction. It appears that the proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors represent a major new contribution to this effort, especially for patients with severe familial hypercholesterolemia, proven clinical cardiovascular disease, statin intolerance, or failure to attain an acceptably low LDL-C goal despite maximum available medical management. Very recent clinical trials have proven overwhelmingly the effectiveness and safety of PCSK9 inhibitors for lowering LDL-C. Both alirocumab and evolocumab have now been approved by the US FDA and there are some initial favorable outcomes data. This review is intended to summarize available evidence and emphasize the possible clinical role of these inhibitors following the approval of alirocumab and evolocumab. Understanding the negative receptor feedback of PCSK9 and the mechanism and beneficial effect of PCSK9 inhibitors for cardiovascular risk reduction is essential for the up-to-date practitioner of cardiovascular medicine. There is every reasonable hope for significant cardiovascular benefit from these new additions to our medical cardiovascular armamentarium. PMID:26596726

  11. PCSK9 inhibitors and cardiovascular disease: heralding a new therapeutic era

    PubMed Central

    Chapman, M. John; Stock, Jane K.; Ginsberg, Henry N.

    2015-01-01

    Purpose of review The first monoclonal antibodies targeting proprotein convertase subtilisin/kexin type 9 (PCSK9) have been approved for clinical use. This timely review highlights recent developments. Recent findings Low-density lipoprotein cholesterol (LDL-C) is the primary driver of atherosclerosis and the key target for intervention. Yet despite best treatment including statins, attaining sufficient LDL-C lowering can be problematic for high cardiovascular risk patients. The development of PCSK9 inhibitors, driven by novel genetic and mechanistic insights, offers an answer. Removal of circulating PCSK9 increases LDL receptor availability, and thus markedly decreases plasma LDL-C levels (by ∼50–60%), and is additive to the lipid lowering effects of statins and ezetimibe. PCSK9 inhibition also reduces (by 25–30%) plasma levels of lipoprotein(a), a causal factor in atherosclerotic vascular disease, suggestive of partial catabolism of lipoprotein(a) by LDL receptors. The ODYSSEY and PROFICIO (Programme to Reduce LDL-C and Cardiovascular Outcomes Following Inhibition of PCSK9 In Different Populations) clinical trial programmes involving a wide range of high-risk patients, including statin intolerant patients, have confirmed the consistency of the LDL response, even with concomitant high-intensity statin or nonstatin therapy. Extensive evidence to date attests to a favourable safety and tolerability profile for these innovative agents. Summary The new pharmacotherapeutic era of PCSK9 inhibition is upon us, promising major reduction in cardiovascular events across a wide spectrum of high-risk patients. PMID:26780005

  12. 19. Lower Mezzanine betting area. Camera pointed WNW from stairsteps ...

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

    19. Lower Mezzanine betting area. Camera pointed WNW from stairsteps leading up to original Clubhouse. (July 1993) - Longacres, Clubhouse & Additions, 1621 Southwest Sixteenth Street, Renton, King County, WA

  13. Multifunctional fuel additives

    SciTech Connect

    Baillargeon, D.J.; Cardis, A.B.; Heck, D.B.

    1991-03-26

    This paper discusses a composition comprising a major amount of a liquid hydrocarbyl fuel and a minor low-temperature flow properties improving amount of an additive product of the reaction of a suitable diol and product of a benzophenone tetracarboxylic dianhydride and a long-chain hydrocarbyl aminoalcohol.

  14. Biobased lubricant additives

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Fully biobased lubricants are those formulated using all biobased ingredients, i.e. biobased base oils and biobased additives. Such formulations provide the maximum environmental, safety, and economic benefits expected from a biobased product. Currently, there are a number of biobased base oils that...

  15. 5. Underside of deck showing lower chords, lower chord connections, ...

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

    5. Underside of deck showing lower chords, lower chord connections, stringers, and beams, looking east - Main Street Bridge, Spanning Sugar River at Main Street (State Routes 12 & 103), Claremont, Sullivan County, NH

  16. Continuum lowering - A new perspective

    NASA Astrophysics Data System (ADS)

    Crowley, B. J. B.

    2014-12-01

    What is meant by continuum lowering and ionization potential depression (IPD) in a Coulomb system depends very much upon precisely what question is being asked. It is shown that equilibrium (equation of state) phenomena and non-equilibrium dynamical processes like photoionization are characterized by different values of the IPD. In the former, the ionization potential of an atom embedded in matter is the difference in the free energy of the many-body system between states of thermodynamic equilibrium differing by the ionization state of just one atom. Typically, this energy is less than that required to ionize the same atom in vacuo. Probably, the best known example of this is the IPD given by Stewart and Pyatt (SP). However, it is a common misconception that this formula should apply directly to the energy of a photon causing photoionization, since this is a local adiabatic process that occurs in the absence of a response from the surrounding plasma. To achieve the prescribed final equilibrium state, in general, additional energy, in the form of heat and work, is transferred between the atom and its surroundings. This additional relaxation energy is sufficient to explain the discrepancy between recent spectroscopic measurements of IPD in dense plasmas and the predictions of the SP formula. This paper provides a detailed account of an analytical approach, based on SP, to calculating thermodynamic and spectroscopic (adiabatic) IPDs in multicomponent Coulomb systems of arbitrary coupling strength with Te ≠ Ti. The ramifications for equilibrium Coulomb systems are examined in order to elucidate the roles of the various forms of the IPD and any possible connection with the plasma microfield. The formulation embodies an analytical equation of state (EoS) that is thermodynamically self-consistent, provided that the bound and free electrons are dynamically separable, meaning that the system is not undergoing pressure ionization. Apart from this restriction, the model is

  17. [Up to date lipid lowering treatment].

    PubMed

    Paragh, György; Karádi, István

    2016-07-01

    Considerable evidence suggests that "the lower the better" is a reasonable approach for reducing cardiovascular risk by lowering LDL cholesterol levels. Despite the reduction in cardiovascular events and mortality achieved by statin therapy, significant residual risk remains, especially in severe hereditary hypercholesterolemia, such as familial hypercholesterolemia. Some new strategies to achieve even lower LDL levels are now available, including the addition of cholesterol absorption inhibitor ezetimibe, and the recently available Proprotein convertase subtilisin/kexin type 9 monoclonal antibodies. In addition, new LDL drugs may be effectively administrated in those individuals who are unable to tolerate statins. The authors summarize the efficacy and clinical indications of these new agents and review the currently available guidelines. Orv. Hetil., 2016, 157(31), 1219-1223.

  18. Vinyl capped addition polyimides

    NASA Technical Reports Server (NTRS)

    Vannucci, Raymond D. (Inventor); Malarik, Diane C. (Inventor); Delvigs, Peter (Inventor)

    1991-01-01

    Polyimide resins (PMR) are generally useful where high strength and temperature capabilities are required (at temperatures up to about 700 F). Polyimide resins are particularly useful in applications such as jet engine compressor components, for example, blades, vanes, air seals, air splitters, and engine casing parts. Aromatic vinyl capped addition polyimides are obtained by reacting a diamine, an ester of tetracarboxylic acid, and an aromatic vinyl compound. Low void materials with improved oxidative stability when exposed to 700 F air may be fabricated as fiber reinforced high molecular weight capped polyimide composites. The aromatic vinyl capped polyimides are provided with a more aromatic nature and are more thermally stable than highly aliphatic, norbornenyl-type end-capped polyimides employed in PMR resins. The substitution of aromatic vinyl end-caps for norbornenyl end-caps in addition polyimides results in polymers with improved oxidative stability.

  19. Tackifier for addition polyimides

    NASA Technical Reports Server (NTRS)

    Butler, J. M.; St.clair, T. L.

    1980-01-01

    A modification to the addition polyimide, LaRC-160, was prepared to improve tack and drape and increase prepeg out-time. The essentially solventless, high viscosity laminating resin is synthesized from low cost liquid monomers. The modified version takes advantage of a reactive, liquid plasticizer which is used in place of solvent and helps solve a major problem of maintaining good prepeg tack and drape, or the ability of the prepeg to adhere to adjacent plies and conform to a desired shape during the lay up process. This alternate solventless approach allows both longer life of the polymer prepeg and the processing of low void laminates. This approach appears to be applicable to all addition polyimide systems.

  20. Electrophilic addition of astatine

    SciTech Connect

    Norseev, Yu.V.; Vasaros, L.; Nhan, D.D.; Huan, N.K.

    1988-03-01

    It has been shown for the first time that astatine is capable of undergoing addition reactions to unsaturated hydrocarbons. A new compound of astatine, viz., ethylene astatohydrin, has been obtained, and its retention numbers of squalane, Apiezon, and tricresyl phosphate have been found. The influence of various factors on the formation of ethylene astatohydrin has been studied. It has been concluded on the basis of the results obtained that the univalent cations of astatine in an acidic medium is protonated hypoastatous acid.

  1. Functional Generalized Additive Models.

    PubMed

    McLean, Mathew W; Hooker, Giles; Staicu, Ana-Maria; Scheipl, Fabian; Ruppert, David

    2014-01-01

    We introduce the functional generalized additive model (FGAM), a novel regression model for association studies between a scalar response and a functional predictor. We model the link-transformed mean response as the integral with respect to t of F{X(t), t} where F(·,·) is an unknown regression function and X(t) is a functional covariate. Rather than having an additive model in a finite number of principal components as in Müller and Yao (2008), our model incorporates the functional predictor directly and thus our model can be viewed as the natural functional extension of generalized additive models. We estimate F(·,·) using tensor-product B-splines with roughness penalties. A pointwise quantile transformation of the functional predictor is also considered to ensure each tensor-product B-spline has observed data on its support. The methods are evaluated using simulated data and their predictive performance is compared with other competing scalar-on-function regression alternatives. We illustrate the usefulness of our approach through an application to brain tractography, where X(t) is a signal from diffusion tensor imaging at position, t, along a tract in the brain. In one example, the response is disease-status (case or control) and in a second example, it is the score on a cognitive test. R code for performing the simulations and fitting the FGAM can be found in supplemental materials available online.

  2. 10. WEST ELEVATION OF SHOWROOM ADDITION WITH ACCESS DOORS TO ...

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

    10. WEST ELEVATION OF SHOWROOM ADDITION WITH ACCESS DOORS TO SHOP ON LOWER LEVEL. NOTE BOW SECTION OF OLD DORY BOAT USED AS STEP INTO LOWER LEVEL. - Lowell's Boat Shop, 459 Main Street, Amesbury, Essex County, MA

  3. Retargeting the management of hypercholesterolemia - focus on evolocumab.

    PubMed

    Colletti, Alessandro; Derosa, Giuseppe; Cicero, Arrigo Fg

    2016-01-01

    Hypercholesterolemia is one of the main risk factors for atherosclerosis and cardiovascular diseases. The treatment is based on the modification of the diet and lifestyle and if necessary on a pharmacological therapy. The most widely used drugs are the inhibitors of 3-hydroxy-3-methyl-glutaryl coenzyme A reductase (statins); nevertheless, many patients do not reach optimal levels of low-density lipoprotein-cholesterol (LDL-C) even with maximal dosage of statins (eventually associated to ezetimibe) or present side effects, which do not allow them to continue the treatment. Inhibitors of PCSK9 represent a new therapeutic approach for lowering LDL-C. Evolocumab and alirocumab are human monoclonal antibodies, which bind to extracellular PCSK9 and thus interfere with the degradation of low-density lipoprotein receptor. Evolocumab use is approved for the treatment of patients with heterozygous familial hypercholesterolemia (FH) and homozygous FH as an adjunct to diet and maximally tolerated statin therapy or for subjects with clinical atherosclerotic cardiovascular disease who require additional lowering of LDL-C. Phase III clinical trials have demonstrated the effectiveness of evolocumab (140 mg/every 2 weeks or 420 mg/month, via subcutaneous injection) in monotherapy and in combination with statins, in the treatment of patients intolerant to statins or with FH. In monotherapy, it reduces LDL-C by 55%, and its association with statins leads to a reduction of LDL-C by up to 63%-75%. Evolocumab has been demonstrated to be safe and well tolerated. Ongoing clinical trials are assessing the long-term effects of evolocumab on the incidence of cardiovascular risk, safety, and tolerability. This review resumes the available clinical evidence on the efficacy and safety of evolocumab, for which a relatively large amount of clinical data are currently available, and discusses the retargeting of cholesterol-lowering therapy in clinical practice.

  4. Retargeting the management of hypercholesterolemia – focus on evolocumab

    PubMed Central

    Colletti, Alessandro; Derosa, Giuseppe; Cicero, Arrigo FG

    2016-01-01

    Hypercholesterolemia is one of the main risk factors for atherosclerosis and cardiovascular diseases. The treatment is based on the modification of the diet and lifestyle and if necessary on a pharmacological therapy. The most widely used drugs are the inhibitors of 3-hydroxy-3-methyl-glutaryl coenzyme A reductase (statins); nevertheless, many patients do not reach optimal levels of low-density lipoprotein-cholesterol (LDL-C) even with maximal dosage of statins (eventually associated to ezetimibe) or present side effects, which do not allow them to continue the treatment. Inhibitors of PCSK9 represent a new therapeutic approach for lowering LDL-C. Evolocumab and alirocumab are human monoclonal antibodies, which bind to extracellular PCSK9 and thus interfere with the degradation of low-density lipoprotein receptor. Evolocumab use is approved for the treatment of patients with heterozygous familial hypercholesterolemia (FH) and homozygous FH as an adjunct to diet and maximally tolerated statin therapy or for subjects with clinical atherosclerotic cardiovascular disease who require additional lowering of LDL-C. Phase III clinical trials have demonstrated the effectiveness of evolocumab (140 mg/every 2 weeks or 420 mg/month, via subcutaneous injection) in monotherapy and in combination with statins, in the treatment of patients intolerant to statins or with FH. In monotherapy, it reduces LDL-C by 55%, and its association with statins leads to a reduction of LDL-C by up to 63%–75%. Evolocumab has been demonstrated to be safe and well tolerated. Ongoing clinical trials are assessing the long-term effects of evolocumab on the incidence of cardiovascular risk, safety, and tolerability. This review resumes the available clinical evidence on the efficacy and safety of evolocumab, for which a relatively large amount of clinical data are currently available, and discusses the retargeting of cholesterol-lowering therapy in clinical practice.

  5. Retargeting the management of hypercholesterolemia – focus on evolocumab

    PubMed Central

    Colletti, Alessandro; Derosa, Giuseppe; Cicero, Arrigo FG

    2016-01-01

    Hypercholesterolemia is one of the main risk factors for atherosclerosis and cardiovascular diseases. The treatment is based on the modification of the diet and lifestyle and if necessary on a pharmacological therapy. The most widely used drugs are the inhibitors of 3-hydroxy-3-methyl-glutaryl coenzyme A reductase (statins); nevertheless, many patients do not reach optimal levels of low-density lipoprotein-cholesterol (LDL-C) even with maximal dosage of statins (eventually associated to ezetimibe) or present side effects, which do not allow them to continue the treatment. Inhibitors of PCSK9 represent a new therapeutic approach for lowering LDL-C. Evolocumab and alirocumab are human monoclonal antibodies, which bind to extracellular PCSK9 and thus interfere with the degradation of low-density lipoprotein receptor. Evolocumab use is approved for the treatment of patients with heterozygous familial hypercholesterolemia (FH) and homozygous FH as an adjunct to diet and maximally tolerated statin therapy or for subjects with clinical atherosclerotic cardiovascular disease who require additional lowering of LDL-C. Phase III clinical trials have demonstrated the effectiveness of evolocumab (140 mg/every 2 weeks or 420 mg/month, via subcutaneous injection) in monotherapy and in combination with statins, in the treatment of patients intolerant to statins or with FH. In monotherapy, it reduces LDL-C by 55%, and its association with statins leads to a reduction of LDL-C by up to 63%–75%. Evolocumab has been demonstrated to be safe and well tolerated. Ongoing clinical trials are assessing the long-term effects of evolocumab on the incidence of cardiovascular risk, safety, and tolerability. This review resumes the available clinical evidence on the efficacy and safety of evolocumab, for which a relatively large amount of clinical data are currently available, and discusses the retargeting of cholesterol-lowering therapy in clinical practice. PMID:27660454

  6. Retargeting the management of hypercholesterolemia - focus on evolocumab.

    PubMed

    Colletti, Alessandro; Derosa, Giuseppe; Cicero, Arrigo Fg

    2016-01-01

    Hypercholesterolemia is one of the main risk factors for atherosclerosis and cardiovascular diseases. The treatment is based on the modification of the diet and lifestyle and if necessary on a pharmacological therapy. The most widely used drugs are the inhibitors of 3-hydroxy-3-methyl-glutaryl coenzyme A reductase (statins); nevertheless, many patients do not reach optimal levels of low-density lipoprotein-cholesterol (LDL-C) even with maximal dosage of statins (eventually associated to ezetimibe) or present side effects, which do not allow them to continue the treatment. Inhibitors of PCSK9 represent a new therapeutic approach for lowering LDL-C. Evolocumab and alirocumab are human monoclonal antibodies, which bind to extracellular PCSK9 and thus interfere with the degradation of low-density lipoprotein receptor. Evolocumab use is approved for the treatment of patients with heterozygous familial hypercholesterolemia (FH) and homozygous FH as an adjunct to diet and maximally tolerated statin therapy or for subjects with clinical atherosclerotic cardiovascular disease who require additional lowering of LDL-C. Phase III clinical trials have demonstrated the effectiveness of evolocumab (140 mg/every 2 weeks or 420 mg/month, via subcutaneous injection) in monotherapy and in combination with statins, in the treatment of patients intolerant to statins or with FH. In monotherapy, it reduces LDL-C by 55%, and its association with statins leads to a reduction of LDL-C by up to 63%-75%. Evolocumab has been demonstrated to be safe and well tolerated. Ongoing clinical trials are assessing the long-term effects of evolocumab on the incidence of cardiovascular risk, safety, and tolerability. This review resumes the available clinical evidence on the efficacy and safety of evolocumab, for which a relatively large amount of clinical data are currently available, and discusses the retargeting of cholesterol-lowering therapy in clinical practice. PMID:27660454

  7. Performance Boosting Additive

    NASA Technical Reports Server (NTRS)

    1999-01-01

    Mainstream Engineering Corporation was awarded Phase I and Phase II contracts from Goddard Space Flight Center's Small Business Innovation Research (SBIR) program in early 1990. With support from the SBIR program, Mainstream Engineering Corporation has developed a unique low cost additive, QwikBoost (TM), that increases the performance of air conditioners, heat pumps, refrigerators, and freezers. Because of the energy and environmental benefits of QwikBoost, Mainstream received the Tibbetts Award at a White House Ceremony on October 16, 1997. QwikBoost was introduced at the 1998 International Air Conditioning, Heating, and Refrigeration Exposition. QwikBoost is packaged in a handy 3-ounce can (pressurized with R-134a) and will be available for automotive air conditioning systems in summer 1998.

  8. Sewage sludge additive

    NASA Technical Reports Server (NTRS)

    Kalvinskas, J. J.; Mueller, W. A.; Ingham, J. D. (Inventor)

    1980-01-01

    The additive is for a raw sewage treatment process of the type where settling tanks are used for the purpose of permitting the suspended matter in the raw sewage to be settled as well as to permit adsorption of the dissolved contaminants in the water of the sewage. The sludge, which settles down to the bottom of the settling tank is extracted, pyrolyzed and activated to form activated carbon and ash which is mixed with the sewage prior to its introduction into the settling tank. The sludge does not provide all of the activated carbon and ash required for adequate treatment of the raw sewage. It is necessary to add carbon to the process and instead of expensive commercial carbon, coal is used to provide the carbon supplement.

  9. Perspectives on Additive Manufacturing

    NASA Astrophysics Data System (ADS)

    Bourell, David L.

    2016-07-01

    Additive manufacturing (AM) has skyrocketed in visibility commercially and in the public sector. This article describes the development of this field from early layered manufacturing approaches of photosculpture, topography, and material deposition. Certain precursors to modern AM processes are also briefly described. The growth of the field over the last 30 years is presented. Included is the standard delineation of AM technologies into seven broad categories. The economics of AM part generation is considered, and the impacts of the economics on application sectors are described. On the basis of current trends, the future outlook will include a convergence of AM fabricators, mass-produced AM fabricators, enabling of topology optimization designs, and specialization in the AM legal arena. Long-term developments with huge impact are organ printing and volume-based printing.

  10. Sarks as additional fermions

    NASA Astrophysics Data System (ADS)

    Agrawal, Jyoti; Frampton, Paul H.; Jack Ng, Y.; Nishino, Hitoshi; Yasuda, Osamu

    1991-03-01

    An extension of the standard model is proposed. The gauge group is SU(2) X ⊗ SU(3) C ⊗ SU(2) S ⊗ U(1) Q, where all gauge symmetries are unbroken. The colour and electric charge are combined with SU(2) S which becomes strongly coupled at approximately 500 GeV and binds preons to form fermionic and vector bound states. The usual quarks and leptons are singlets under SU(2) X but additional fermions, called sarks. transform under it and the electroweak group. The present model explains why no more than three light quark-lepton families can exist. Neutral sark baryons, called narks, are candidates for the cosmological dark matter having the characteristics designed for WIMPS. Further phenomenological implications of sarks are analyzed i including electron-positron annihilation. Z 0 decay, flavor-changing neutral currents. baryon-number non-conservation, sarkonium and the neutron electric dipole moment.

  11. Management of dyslipidemias with fibrates, alone and in combination with statins: role of delayed-release fenofibric acid

    PubMed Central

    Moutzouri, Elisavet; Kei, Anastazia; Elisaf, Moses S; Milionis, Haralampos J

    2010-01-01

    Cardiovascular disease (CVD) represents the leading cause of mortality worldwide. Lifestyle modifications, along with low-density lipoprotein cholesterol (LDL-C) reduction, remain the highest priorities in CVD risk management. Among lipid-lowering agents, statins are most effective in LDL-C reduction and have demonstrated incremental benefits in CVD risk reduction. However, in light of the residual CVD risk, even after LDL-C targets are achieved, there is an unmet clinical need for additional measures. Fibrates are well known for their beneficial effects in triglycerides, high-density lipoprotein cholesterol (HDL-C), and LDL-C subspecies modulation. Fenofibrate is the most commonly used fibric acid derivative, exerts beneficial effects in several lipid and nonlipid parameters, and is considered the most suitable fibrate to combine with a statin. However, in clinical practice this combination raises concerns about safety. ABT-335 (fenofibric acid, Trilipix®) is the newest formulation designed to overcome the drawbacks of older fibrates, particularly in terms of pharmacokinetic properties. It has been extensively evaluated both as monotherapy and in combination with atorvastatin, rosuvastatin, and simvastatin in a large number of patients with mixed dyslipidemia for up to 2 years and appears to be a safe and effective option in the management of dyslipidemia. PMID:20730069

  12. PCSK9 inhibition in patients with hypercholesterolemia.

    PubMed

    Desai, Nihar R; Sabatine, Marc S

    2015-10-01

    Proprotein convertase subtilisin/kexin type 9 (PCSK9) is a serine protease that plays an important role in modulating low-density lipoprotein cholesterol (LDL-C) levels by targeting LDL-C receptors for lysosomal degradation. Genetic association studies have demonstrated that loss-of-function mutations in PCSK9 are associated with low plasma LDL-C levels and a reduction in the incidence of adverse cardiovascular events. Monoclonal antibodies directed against PCSK9 have been developed and have been shown in phase 1, 2, and 3 trials to dramatically reduce LDL-C regardless of background lipid-lowering therapy, including in clinically challenging populations such as patients intolerant to statin therapy and those with familial hypercholesterolemia. To date, the clinical trials have not raised any significant safety concerns, with no appreciable excess of myalgias, elevation in aminotransferases, or other adverse events. Large, cardiovascular outcomes trials are underway to assess definitively the efficacy and safety of 3 monoclonal antibodies (evolocumab, alirocumab, and bococizumab), while additional non-monoclonal antibody approaches to inhibit PCSK9 continue in the early-phase development. PMID:25771732

  13. Management of dyslipidemias with fibrates, alone and in combination with statins: role of delayed-release fenofibric acid.

    PubMed

    Moutzouri, Elisavet; Kei, Anastazia; Elisaf, Moses S; Milionis, Haralampos J

    2010-08-09

    Cardiovascular disease (CVD) represents the leading cause of mortality worldwide. Lifestyle modifications, along with low-density lipoprotein cholesterol (LDL-C) reduction, remain the highest priorities in CVD risk management. Among lipid-lowering agents, statins are most effective in LDL-C reduction and have demonstrated incremental benefits in CVD risk reduction. However, in light of the residual CVD risk, even after LDL-C targets are achieved, there is an unmet clinical need for additional measures. Fibrates are well known for their beneficial effects in triglycerides, high-density lipoprotein cholesterol (HDL-C), and LDL-C subspecies modulation. Fenofibrate is the most commonly used fibric acid derivative, exerts beneficial effects in several lipid and nonlipid parameters, and is considered the most suitable fibrate to combine with a statin. However, in clinical practice this combination raises concerns about safety. ABT-335 (fenofibric acid, Trilipix) is the newest formulation designed to overcome the drawbacks of older fibrates, particularly in terms of pharmacokinetic properties. It has been extensively evaluated both as monotherapy and in combination with atorvastatin, rosuvastatin, and simvastatin in a large number of patients with mixed dyslipidemia for up to 2 years and appears to be a safe and effective option in the management of dyslipidemia.

  14. Additive lattice kirigami

    PubMed Central

    Castle, Toen; Sussman, Daniel M.; Tanis, Michael; Kamien, Randall D.

    2016-01-01

    Kirigami uses bending, folding, cutting, and pasting to create complex three-dimensional (3D) structures from a flat sheet. In the case of lattice kirigami, this cutting and rejoining introduces defects into an underlying 2D lattice in the form of points of nonzero Gaussian curvature. A set of simple rules was previously used to generate a wide variety of stepped structures; we now pare back these rules to their minimum. This allows us to describe a set of techniques that unify a wide variety of cut-and-paste actions under the rubric of lattice kirigami, including adding new material and rejoining material across arbitrary cuts in the sheet. We also explore the use of more complex lattices and the different structures that consequently arise. Regardless of the choice of lattice, creating complex structures may require multiple overlapping kirigami cuts, where subsequent cuts are not performed on a locally flat lattice. Our additive kirigami method describes such cuts, providing a simple methodology and a set of techniques to build a huge variety of complex 3D shapes. PMID:27679822

  15. Additive lattice kirigami

    PubMed Central

    Castle, Toen; Sussman, Daniel M.; Tanis, Michael; Kamien, Randall D.

    2016-01-01

    Kirigami uses bending, folding, cutting, and pasting to create complex three-dimensional (3D) structures from a flat sheet. In the case of lattice kirigami, this cutting and rejoining introduces defects into an underlying 2D lattice in the form of points of nonzero Gaussian curvature. A set of simple rules was previously used to generate a wide variety of stepped structures; we now pare back these rules to their minimum. This allows us to describe a set of techniques that unify a wide variety of cut-and-paste actions under the rubric of lattice kirigami, including adding new material and rejoining material across arbitrary cuts in the sheet. We also explore the use of more complex lattices and the different structures that consequently arise. Regardless of the choice of lattice, creating complex structures may require multiple overlapping kirigami cuts, where subsequent cuts are not performed on a locally flat lattice. Our additive kirigami method describes such cuts, providing a simple methodology and a set of techniques to build a huge variety of complex 3D shapes.

  16. Management of Hypercholesterolemia, Appropriateness of Therapeutic Approaches and New Drugs in Patients with High Cardiovascular Risk.

    PubMed

    Agabiti Rosei, Enrico; Salvetti, Massimo

    2016-09-01

    Control of lipid levels is one of the most effective strategies for cardiovascular (CV) event prevention. In fact, many clinical trials have clearly demonstrated that low-density lipoprotein cholesterol (LDL-C) lowering, primarily with statins, reduces major CV events and mortality. The evidence from these trials has been useful in designing the cholesterol treatment guidelines, which are mainly aimed at preventing and managing cardiovascular disease (CVD). However, available data indicate that a large proportion of patients fail to achieve lipid goals, and this is particularly frequent in patients at high or very high CV risk. Furthermore, owing to side effects, a significant percentage of patients cannot tolerate statin treatment. Hence, researchers have focused their attention on novel LDL-C-lowering agents that act via mechanisms distinct from that of statins. Among the new compounds under investigation, the monoclonal antibodies to proprotein convertase subtilisin/kexin type 9 (PCSK9) seem particularly promising, having recently been shown to be well tolerated and highly effective at lowering LDL-C, with a possible effect on the occurrence of CV events. Currently, alirocumab is approved by the US Food and Drug Administration (FDA) as an adjunct to diet and maximally tolerated statin therapy for use in adults with heterozygous familial hypercholesterolemia (FH) or those with atherosclerotic CV disease who require additional LDL-C lowering; it has also been recently approved by the European Medicines Agency (EMA) for use in patients with heterozygous FH, non-familial hypercholesterolemia or mixed dyslipidemia in whom statins are ineffective or not tolerated. Evolocumab is approved by the FDA as an adjunct to diet and maximally tolerated statins for adults with hetero- and homozygous FH and those with atherosclerotic CV disease who require additional lowering of LDL-C, and by the EMA in adults with primary hypercholesterolemia or mixed dyslipidemia, as an adjunct

  17. Management of Hypercholesterolemia, Appropriateness of Therapeutic Approaches and New Drugs in Patients with High Cardiovascular Risk.

    PubMed

    Agabiti Rosei, Enrico; Salvetti, Massimo

    2016-09-01

    Control of lipid levels is one of the most effective strategies for cardiovascular (CV) event prevention. In fact, many clinical trials have clearly demonstrated that low-density lipoprotein cholesterol (LDL-C) lowering, primarily with statins, reduces major CV events and mortality. The evidence from these trials has been useful in designing the cholesterol treatment guidelines, which are mainly aimed at preventing and managing cardiovascular disease (CVD). However, available data indicate that a large proportion of patients fail to achieve lipid goals, and this is particularly frequent in patients at high or very high CV risk. Furthermore, owing to side effects, a significant percentage of patients cannot tolerate statin treatment. Hence, researchers have focused their attention on novel LDL-C-lowering agents that act via mechanisms distinct from that of statins. Among the new compounds under investigation, the monoclonal antibodies to proprotein convertase subtilisin/kexin type 9 (PCSK9) seem particularly promising, having recently been shown to be well tolerated and highly effective at lowering LDL-C, with a possible effect on the occurrence of CV events. Currently, alirocumab is approved by the US Food and Drug Administration (FDA) as an adjunct to diet and maximally tolerated statin therapy for use in adults with heterozygous familial hypercholesterolemia (FH) or those with atherosclerotic CV disease who require additional LDL-C lowering; it has also been recently approved by the European Medicines Agency (EMA) for use in patients with heterozygous FH, non-familial hypercholesterolemia or mixed dyslipidemia in whom statins are ineffective or not tolerated. Evolocumab is approved by the FDA as an adjunct to diet and maximally tolerated statins for adults with hetero- and homozygous FH and those with atherosclerotic CV disease who require additional lowering of LDL-C, and by the EMA in adults with primary hypercholesterolemia or mixed dyslipidemia, as an adjunct

  18. PCSK9 inhibition in the management of hyperlipidemia: focus on evolocumab.

    PubMed

    Blom, Dirk J; Dent, Ricardo; Castro, Rita C; Toth, Peter P

    2016-01-01

    Proprotein convertase subtilisin/kexin type 9 (PCSK9) increases low-density lipoprotein cholesterol (LDL-C) concentrations through interference with normal physiologic hepatic LDL receptor (LDLR) recycling. Inhibiting PCSK9 results in improved LDLR recycling, increased LDLR availability on hepatocyte cell surfaces, and reduced blood LDL-C levels, making PCSK9 inhibition a novel therapeutic strategy for managing hypercholesterolemia. Monoclonal antibodies directed against PCSK9 have been developed for this purpose. A large number of clinical trials have demonstrated that monoclonal antibodies against PCSK9 yield substantial reductions in LDL-C when administered as monotherapy or in combination with statins to patients with nonfamilial and familial forms of hypercholesterolemia. Data from long-term trials demonstrate that the LDL-C-lowering effect of PCSK9 inhibitors is durable. These agents are generally well tolerated, and few patients discontinue treatment due to adverse events. Moreover, PCSK9 inhibitors do not appear to elicit the hepatic and muscle-related side effects associated with statin use. The ultimate value of PCSK9 inhibitors will be measured by their effect on clinical outcomes. Early evidence of a reduction in cardiovascular events after 1 year of treatment was shown in a prospective exploratory analysis of two ongoing long-term open-label extension evolocumab trials. Similarly, cardiovascular events were reduced in another exploratory analysis after >1 year of therapy with alirocumab. For the primary care physician, PCSK9 inhibitors represent a welcome additional option for lowering LDL-C in patients with familial forms of hypercholesterolemia and those with clinical atherosclerotic cardiovascular disease who are on maximally tolerated statin therapy.

  19. PCSK9 inhibition in the management of hyperlipidemia: focus on evolocumab.

    PubMed

    Blom, Dirk J; Dent, Ricardo; Castro, Rita C; Toth, Peter P

    2016-01-01

    Proprotein convertase subtilisin/kexin type 9 (PCSK9) increases low-density lipoprotein cholesterol (LDL-C) concentrations through interference with normal physiologic hepatic LDL receptor (LDLR) recycling. Inhibiting PCSK9 results in improved LDLR recycling, increased LDLR availability on hepatocyte cell surfaces, and reduced blood LDL-C levels, making PCSK9 inhibition a novel therapeutic strategy for managing hypercholesterolemia. Monoclonal antibodies directed against PCSK9 have been developed for this purpose. A large number of clinical trials have demonstrated that monoclonal antibodies against PCSK9 yield substantial reductions in LDL-C when administered as monotherapy or in combination with statins to patients with nonfamilial and familial forms of hypercholesterolemia. Data from long-term trials demonstrate that the LDL-C-lowering effect of PCSK9 inhibitors is durable. These agents are generally well tolerated, and few patients discontinue treatment due to adverse events. Moreover, PCSK9 inhibitors do not appear to elicit the hepatic and muscle-related side effects associated with statin use. The ultimate value of PCSK9 inhibitors will be measured by their effect on clinical outcomes. Early evidence of a reduction in cardiovascular events after 1 year of treatment was shown in a prospective exploratory analysis of two ongoing long-term open-label extension evolocumab trials. Similarly, cardiovascular events were reduced in another exploratory analysis after >1 year of therapy with alirocumab. For the primary care physician, PCSK9 inhibitors represent a welcome additional option for lowering LDL-C in patients with familial forms of hypercholesterolemia and those with clinical atherosclerotic cardiovascular disease who are on maximally tolerated statin therapy. PMID:27274264

  20. PCSK9 inhibition in the management of hyperlipidemia: focus on evolocumab

    PubMed Central

    Blom, Dirk J; Dent, Ricardo; Castro, Rita C; Toth, Peter P

    2016-01-01

    Proprotein convertase subtilisin/kexin type 9 (PCSK9) increases low-density lipoprotein cholesterol (LDL-C) concentrations through interference with normal physiologic hepatic LDL receptor (LDLR) recycling. Inhibiting PCSK9 results in improved LDLR recycling, increased LDLR availability on hepatocyte cell surfaces, and reduced blood LDL-C levels, making PCSK9 inhibition a novel therapeutic strategy for managing hypercholesterolemia. Monoclonal antibodies directed against PCSK9 have been developed for this purpose. A large number of clinical trials have demonstrated that monoclonal antibodies against PCSK9 yield substantial reductions in LDL-C when administered as monotherapy or in combination with statins to patients with nonfamilial and familial forms of hypercholesterolemia. Data from long-term trials demonstrate that the LDL-C-lowering effect of PCSK9 inhibitors is durable. These agents are generally well tolerated, and few patients discontinue treatment due to adverse events. Moreover, PCSK9 inhibitors do not appear to elicit the hepatic and muscle-related side effects associated with statin use. The ultimate value of PCSK9 inhibitors will be measured by their effect on clinical outcomes. Early evidence of a reduction in cardiovascular events after 1 year of treatment was shown in a prospective exploratory analysis of two ongoing long-term open-label extension evolocumab trials. Similarly, cardiovascular events were reduced in another exploratory analysis after >1 year of therapy with alirocumab. For the primary care physician, PCSK9 inhibitors represent a welcome additional option for lowering LDL-C in patients with familial forms of hypercholesterolemia and those with clinical atherosclerotic cardiovascular disease who are on maximally tolerated statin therapy. PMID:27274264

  1. Measured versus calculated LDL-cholesterol in subjects with type 2 diabetes

    PubMed Central

    Fawwad, Asher; Sabir, Rubina; Riaz, Musarrat; Moin, Hassan; Basit, Abdul

    2016-01-01

    Objective: There is a strong positive association between increased low-density lipoprotein cholesterol (LDL-C) and coronary heart disease (CHD). The accuracy of LDL-C estimation is essential and critically important. The aim of present study was to compare calculated LDL-C with direct homogeneous assay in patients with type 2 diabetes. Methods: This observational study was carried out at Baqai Institute of Diabetology and Endocrinology (BIDE) from January 2011 to December 2013. A total of 9620 patients with type 2 diabetes were included in the study. Fasting blood glucose, total Cholesterol, triglyceride, HDL cholesterol and LDL cholesterol were obtained using standard methods. Calculated LDL-C was obtained by Friedewald formula. Results: Mean difference of measured and calculated LDL-C was found to be -0.25, 6.63 and 46.55 mg/dl at triglyceride levels < 150 mg/dl, 150 - 400 mg/dl and ≥ 400 mg/dl, respectively. The result shows that the difference between measured and calculated LDL-C increases as the triglyceride level increases. Conclusions: The findings of our study suggested that calculated LDL-C was lower, as compared to measured LDL-C, which may cause misclassifications that may have an impact on therapeutic decisions in patients with diabetes. Calculated LDL-C may depend on triglyceride levels so LDL-C should be measured by direct assay in routine clinical laboratories. PMID:27648047

  2. Lower-Conductivity Thermal-Barrier Coatings

    NASA Technical Reports Server (NTRS)

    Miller, Robert A.; Zhu, Dongming

    2003-01-01

    Thermal-barrier coatings (TBCs) that have both initial and post-exposure thermal conductivities lower than those of yttria-stabilized zirconia TBCs have been developed. TBCs are thin ceramic layers, generally applied by plasma spraying or physical vapor deposition, that are used to insulate air-cooled metallic components from hot gases in gas turbine and other heat engines. Heretofore, yttria-stabilized zirconia (nominally comprising 95.4 atomic percent ZrO2 + 4.6 atomic percent Y2O3) has been the TBC material of choice. The lower-thermal-conductivity TBCs are modified versions of yttria-stabilized zirconia, the modifications consisting primarily in the addition of other oxides that impart microstructural and defect properties that favor lower thermal conductivity.

  3. Exploration methods - lower Tuscaloosa trend, southwest Mississippi

    SciTech Connect

    Hersch, J.B.

    1987-09-01

    The unexpanded lower Tuscaloosa Formation is a major oil producer in southwest Mississippi. Exploration of the trend began in the mid-1940s with major fields being found on large uplifts and low-relief structural noses. Today the trend is considered mature; however, the discoveries since 1980 of several significant stratigraphically controlled fields, such as Liberty, Millbrook, Olive, and Newtonia, have renewed exploratory interest. Seismic stratigraphy is critical in exploration for stratigraphic reservoirs of this type. Sands can be predicted chiefly because of the low velocity of reservoir sands relative to the enclosing higher velocity shales. The environment of deposition of the lower Tuscaloosa reservoir sands may be fluvial, transitional marine, or transgressive marine. The geologic arguments for the various environments of deposition become moot, for the erratic geometry of sand distribution is common to all these environments. Without modern seismic data, the projection of sand distribution away from well control is very risky. Standard geologic exploration techniques, such as sand isopachs and paleostructure maps, are of limited value in exploring for new fields in areas where well control is sparse or absent. A structure map of the top of the lower Tuscaloosa and a petrophysical (sonic log) understanding of the objective section (top of lower Tuscaloosa marker to top of Lower Cretaceous unconformity) may lead to the discovery of additional small to medium-sized stratigraphically trapped oil fields (1-7 million bbl of oil equivalent).

  4. Running With an Elastic Lower Limb Exoskeleton.

    PubMed

    Cherry, Michael S; Kota, Sridhar; Young, Aaron; Ferris, Daniel P

    2016-06-01

    Although there have been many lower limb robotic exoskeletons that have been tested for human walking, few devices have been tested for assisting running. It is possible that a pseudo-passive elastic exoskeleton could benefit human running without the addition of electrical motors due to the spring-like behavior of the human leg. We developed an elastic lower limb exoskeleton that added stiffness in parallel with the entire lower limb. Six healthy, young subjects ran on a treadmill at 2.3 m/s with and without the exoskeleton. Although the exoskeleton was designed to provide ~50% of normal leg stiffness during running, it only provided 24% of leg stiffness during testing. The difference in added leg stiffness was primarily due to soft tissue compression and harness compliance decreasing exoskeleton displacement during stance. As a result, the exoskeleton only supported about 7% of the peak vertical ground reaction force. There was a significant increase in metabolic cost when running with the exoskeleton compared with running without the exoskeleton (ANOVA, P < .01). We conclude that 2 major roadblocks to designing successful lower limb robotic exoskeletons for human running are human-machine interface compliance and the extra lower limb inertia from the exoskeleton.

  5. Muscles of the Lower Extremity

    MedlinePlus

    ... Home » Cancer Registration & Surveillance Modules » Anatomy & Physiology » Muscular System » Muscle Groups » Lower Extremity Cancer Registration & Surveillance Modules Anatomy & Physiology Intro to the Human Body Body Functions & Life Process Anatomical Terminology Review Quiz ...

  6. Feline Lower Urinary Tract Disease

    MedlinePlus

    ... gland) can cause lower urinary tract disease in cats. Although they are much less common causes, FLUTD ... your veterinarian about the best diet for your cat. Many commercial diets are acceptable, but some urinary ...

  7. Does cholesterol lowering prevent stroke?

    PubMed

    Henry, R Y; Kendall, M J

    1998-10-01

    The importance of lowering plasma cholesterol to reduce the incidence of coronary events is well established. However, in the prevention of stroke disease, control of hypertension has been the main aim of treatment and lipid lowering therapy has not hitherto been considered to be desirable or necessary. In this review, the evidence from large multicentre trials, imaging studies and meta-analyses is presented. It shows convincingly that HMG-CoA reductase inhibitors (Statins) reduce stroke risk. PMID:9875681

  8. Krill oil supplementation lowers serum triglycerides without increasing low-density lipoprotein cholesterol in adults with borderline high or high triglyceride levels.

    PubMed

    Berge, Kjetil; Musa-Veloso, Kathy; Harwood, Melody; Hoem, Nils; Burri, Lena

    2014-02-01

    The aim of the study was to explore the effects of 12 weeks daily krill oil supplementation on fasting serum triglyceride (TG) and lipoprotein particle levels in subjects whose habitual fish intake is low and who have borderline high or high fasting serum TG levels (150-499 mg/dL). We hypothesized that Krill oil lowers serum TG levels in subjects with borderline high or high fasting TG levels. To test our hypothesis 300 male and female subjects were included in a double-blind, randomized, multi-center, placebo-controlled study with five treatment groups: placebo (olive oil) or 0.5, 1, 2, or 4 g/day of krill oil. Serum lipids were measured after an overnight fast at baseline, 6 and 12 weeks. Due to a high intra-individual variability in TG levels, data from all subjects in the four krill oil groups were pooled to increase statistical power, and a general time- and dose-independent one-way analysis of variance was performed to assess efficacy. Relative to subjects in the placebo group, those administered krill oil had a statistically significant calculated reduction in serum TG levels of 10.2%. Moreover, LDL-C levels were not increased in the krill oil groups relative to the placebo group. The outcome of the pooled analysis suggests that krill oil is effective in reducing a cardiovascular risk factor. However, owing to the individual fluctuations of TG concentrations measured, a study with more individual measurements per treatment group is needed to increase the confidence of these findings. PMID:24461313

  9. A VOYAGER Meta-Analysis of the Impact of Statin Therapy on Low-Density Lipoprotein Cholesterol and Triglyceride Levels in Patients With Hypertriglyceridemia.

    PubMed

    Karlson, Björn W; Palmer, Michael K; Nicholls, Stephen J; Lundman, Pia; Barter, Philip J

    2016-05-01

    Elevated triglyceride (TG) levels are associated with increased cardiovascular disease risk. In patients with mild-to-moderate hypertriglyceridemia, defined by the European Atherosclerosis Society Consensus Panel as a TG level of 177 to 885 mg/dl (2.0 to 10.0 mmol/L), low-density lipoprotein cholesterol (LDL-C) reduction remains the primary treatment goal. Using data from the indiVidual patient meta-analysis Of statin therapY in At risk Groups: Effects of Rosuvastatin, atorvastatin and simvastatin (VOYAGER) meta-analysis, we analyzed LDL-C and TG reductions in patients with baseline TG ≥177 mg/dl (≥2.0 mmol/L). Least squares mean percentage change from baseline in LDL-C and TG was compared using 15,800 patient exposures to rosuvastatin 5 to 40 mg, atorvastatin 10 to 80 mg, and simvastatin 10 to 80 mg in patients with baseline TG ≥177 mg/dl (≥2.0 mmol/L). Comparisons were made using mixed-effects models with data only from studies directly comparing treatments by randomized design. Mean LDL-C reductions ranged from -26.9% to -55.5%. Rosuvastatin 10 to 40 mg resulted in significantly greater LDL-C reductions than equal or double doses of atorvastatin and simvastatin (p <0.05). Mean TG reductions ranged from -15.1% to -31.3%. Rosuvastatin 10 mg resulted in significantly greater TG reductions than atorvastatin 10 mg (p <0.05). Rosuvastatin 20 and 40 mg resulted in TG reductions similar to those with equal doses of atorvastatin. Rosuvastatin 10 to 40 mg resulted in significantly greater TG reductions than equal or double doses of simvastatin (p <0.05). In conclusion, in patients with hypertriglyceridemia, LDL-C reduction was substantial and dependent on the choice and dose of statin. TG reduction was numerically less than for LDL-C, and additional TG-lowering therapy may be considered to further reduce residual cardiovascular risk.

  10. Effects of a carbohydrate-restricted diet with and without supplemental soluble fiber on plasma low-density lipoprotein cholesterol and other clinical markers of cardiovascular risk.

    PubMed

    Wood, Richard J; Fernandez, Maria Luz; Sharman, Matthew J; Silvestre, Ricardo; Greene, Christine M; Zern, Tosca L; Shrestha, Sudeep; Judelson, Daniel A; Gomez, Ana L; Kraemer, William J; Volek, Jeff S

    2007-01-01

    Carbohydrate-restricted diets (CRDs) promote weight loss, reductions in plasma triacylglycerol (TAG) levels, and increases in high-density lipoprotein cholesterol (HDL-C) levels but may cause undesirable low-density lipoprotein cholesterol (LDL-C) responses in some people. The objective of the present study was to determine the effect of adding soluble fiber to a CRD on plasma LDL-C and other traditionally measured markers of cardiovascular disease. Using a parallel-arm, double-blind, placebo-controlled design, 30 overweight and obese men (body mass index, 25-35 kg/m(2)) were randomly assigned to supplement a CRD with soluble fiber (Konjac-mannan, 3g/d) (n = 15) or placebo (n = 15). Plasma lipids, anthropometrics, body composition, blood pressure, and nutrient intake were evaluated at baseline and at 6 and 12 weeks. Compliance was excellent as assessed by 7-day weighed dietary records and ketonuria. Both groups experienced decreases in (P < .01) body weight, percent body fat, systolic blood pressure, waist circumference, and plasma glucose levels. After 12 weeks, HDL-C and TAG improved significantly in the fiber (10% and -34%) and placebo (14%, -43%) groups. LDL-C decreased by 17.6% (P < .01) at week 6 and 14.1% (P < .01) at week 12 in the fiber group. Conversely, LDL-C reductions were significant in the placebo group only after 12 weeks (-6.0%, P < .05). We conclude that although clearly effective at lowering LDL-C, adding soluble fiber to a CRD during active and significant weight loss provides no additional benefits to the diet alone. Furthermore, a CRD led to clinically important positive alterations in cardiovascular disease risk factors.

  11. Lower paleozoic of Baltic Area

    SciTech Connect

    Haselton, T.M.; Surlyk, F.

    1988-01-01

    The Baltic Sea offers a new and exciting petroleum play in northwestern Europe. The Kaliningrad province in the Soviet Union, which borders the Baltic Sea to the east, contains an estimated 3.5 billion bbl of recoverable oil from lower Paleozoic sandstones. To the south, in Poland, oil and gas fields are present along a trend that projects offshore into the Baltic. Two recent Petrobaltic wells in the southern Baltic have tested hydrocarbons from lower Paleozoic sandstone. Minor production comes from Ordovician reefs on the Swedish island of Gotland in the western Baltic. The Baltic synclise, which began subsiding in the late Precambrian, is a depression in the East European platform. Strate dip gently to the south where the Baltic Synclise terminates against a structurally complex border zone. Depth to the metamorphosed Precambrian basement is up to 4,000 m. Overlying basement is 200-300 m of upper Precambrian arkosic sandstone. The Lower Cambrian consists of shallow marine quartzites. During Middle and Late Camnbrian, restricted circulation resulted in anoxic conditions and the deposition of Alum shale. The Lower Ordovician consists of quartzites and shale. The Upper Ordovician includes sandstones and algal reefs. The Silurian contains marginal carbonates and shales. For the last 25 years, exploration in northwest Europe has concentrated on well-known Permian sandstone, Jurassic sandstone, and Cretaceous chalk plays. Extrapolation of trends known and exploited in eastern Europe could open an entirely new oil province in the lower Paleozoic in the Baltic.

  12. Automatic toilet seat lowering apparatus

    SciTech Connect

    Guerty, Harold G.

    1994-09-06

    A toilet seat lowering apparatus includes a housing defining an internal cavity for receiving water from the water supply line to the toilet holding tank. A descent delay assembly of the apparatus can include a stationary dam member and a rotating dam member for dividing the internal cavity into an inlet chamber and an outlet chamber and controlling the intake and evacuation of water in a delayed fashion. A descent initiator is activated when the internal cavity is filled with pressurized water and automatically begins the lowering of the toilet seat from its upright position, which lowering is also controlled by the descent delay assembly. In an alternative embodiment, the descent initiator and the descent delay assembly can be combined in a piston linked to the rotating dam member and provided with a water channel for creating a resisting pressure to the advancing piston and thereby slowing the associated descent of the toilet seat. A toilet seat lowering apparatus includes a housing defining an internal cavity for receiving water from the water supply line to the toilet holding tank. A descent delay assembly of the apparatus can include a stationary dam member and a rotating dam member for dividing the internal cavity into an inlet chamber and an outlet chamber and controlling the intake and evacuation of water in a delayed fashion. A descent initiator is activated when the internal cavity is filled with pressurized water and automatically begins the lowering of the toilet seat from its upright position, which lowering is also controlled by the descent delay assembly. In an alternative embodiment, the descent initiator and the descent delay assembly can be combined in a piston linked to the rotating dam member and provided with a water channel for creating a resisting pressure to the advancing piston and thereby slowing the associated descent of the toilet seat.

  13. On lower bounds for polarisability

    NASA Astrophysics Data System (ADS)

    Montgomery, H. E.; Pupyshev, V. I.

    2013-09-01

    The response of molecular systems to external fields was one of the first areas studied after development of the new quantum mechanics. Early work by Kirkwood and Buckingham developed polarisability lower bounds that are still used today. This work uses an inequality proposed by Linderberg to develop a treatment of polarisability lower bounds that unifies the work of Kirkwood and Buckingham with Hylleraas' variational perturbation theory. In particular, the prehistory of the works of Kirkwood and Buckingham is described. Numerical examples are presented to demonstrate the convergence of approximate wavefunctions in the confined atom problem. The applicability of dimensional scaling and its utility in the analysis of confined systems are also discussed.

  14. 5. EAST ELEVATION WITH DECK AND ACCESS DOORS TO LOWER ...

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

    5. EAST ELEVATION WITH DECK AND ACCESS DOORS TO LOWER LEVEL (PAINT SHOP), OFFICE ADDITION AT RIGHT. LOWELL'S RESIDENCE CAN BE SEEN IN BACKGROUND AT FAR RIGHT. - Lowell's Boat Shop, 459 Main Street, Amesbury, Essex County, MA

  15. Genetic APOC3 mutation, serum triglyceride concentrations, and coronary heart disease

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Recent decades have witnessed an increased awareness of the importance of lowering triglyceride concentrations in conjunction with lowering LDL cholesterol (LDL-C) to achieve optimal reduction of the risk for coronary heart disease (CHD). Historically, LDL-C was the only target of pharmacologic ther...

  16. Slavery in the Lower South.

    ERIC Educational Resources Information Center

    Landers, Jane

    2003-01-01

    Provides a detailed account of slave history within the Lower South region of the colonial United States. Focuses on the experiences of Africans in the colonies. Explores the role of the English, Spanish, and French in establishing slavery within the future United States. Addresses the systems of slavery used and treatment of the Africans. (CMK)

  17. Concomitant Ordering and Symmetry Lowering

    ERIC Educational Resources Information Center

    Boo, William O. J.; Mattern, Daniell L.

    2008-01-01

    Examples of concomitant ordering include magnetic ordering, Jahn-Teller cooperative ordering, electronic ordering, ionic ordering, and ordering of partially-filled sites. Concomitant ordering sets in when a crystal is cooled and always lowers the degree of symmetry of the crystal. Concomitant ordering concepts can also be productively applied to…

  18. Materials as additives for advanced lubrication

    DOEpatents

    Pol, Vilas G.; Thackeray, Michael M.; Mistry, Kuldeep; Erdemir, Ali

    2016-09-13

    This invention relates to carbon-based materials as anti-friction and anti-wear additives for advanced lubrication purposes. The materials comprise carbon nanotubes suspended in a liquid hydrocarbon carrier. Optionally, the compositions further comprise a surfactant (e.g., to aid in dispersion of the carbon particles). Specifically, the novel lubricants have the ability to significantly lower friction and wear, which translates into improved fuel economies and longer durability of mechanical devices and engines.

  19. Reactor vessel lower head integrity

    SciTech Connect

    Rubin, A.M.

    1997-02-01

    On March 28, 1979, the Three Mile Island Unit 2 (TMI-2) nuclear power plant underwent a prolonged small break loss-of-coolant accident that resulted in severe damage to the reactor core. Post-accident examinations of the TMI-2 reactor core and lower plenum found that approximately 19,000 kg (19 metric tons) of molten material had relocated onto the lower head of the reactor vessel. Results of the OECD TMI-2 Vessel Investigation Project concluded that a localized hot spot of approximately 1 meter diameter had existed on the lower head. The maximum temperature on the inner surface of the reactor pressure vessel (RPV) in this region reached 1100{degrees}C and remained at that temperature for approximately 30 minutes before cooling occurred. Even under the combined loads of high temperature and high primary system pressure, the TMI-2 RPV did not fail. (i.e. The pressure varied from about 8.5 to 15 MPa during the four-hour period following the relocation of melt to the lower plenum.) Analyses of RPV failure under these conditions, using state-of-the-art computer codes, predicted that the RPV should have failed via local or global creep rupture. However, the vessel did not fail; and it has been hypothesized that rapid cooling of the debris and the vessel wall by water that was present in the lower plenum played an important role in maintaining RPV integrity during the accident. Although the exact mechanism(s) of how such cooling occurs is not known, it has been speculated that cooling in a small gap between the RPV wall and the crust, and/or in cracks within the debris itself, could result in sufficient cooling to maintain RPV integrity. Experimental data are needed to provide the basis to better understand these phenomena and improve models of RPV failure in severe accident codes.

  20. Prevention of Decline in Cognition after Stroke Trial (PODCAST): a study protocol for a factorial randomised controlled trial of intensive versus guideline lowering of blood pressure and lipids

    PubMed Central

    2013-01-01

    Background Stroke is a common cause of cognitive impairment and dementia. However, effective strategies for reducing the risk of post-stroke dementia remain undefined. Potential strategies include intensive lowering of blood pressure and/or lipids. Methods/Design Design: multi-centre prospective randomised open-label blinded-endpoint controlled partial-factorial phase IV trial in secondary and primary care. Participants: 100 participants from 30 UK Stroke Research Network sites who are post- ischemic stroke or intracerebral haemorrhage by three to seven months. Interventions - all patients (1:1): intensive versus guideline blood pressure lowering (target systolic < 125 mmHg versus < 140 mmHg). Interventions - ischemic stroke (1:1): intensive versus guideline lipid lowering (target low density lipoprotein-cholesterol (LDL-c) < 1.4 mmol/l versus < 3 mmol/l). Hypotheses: does ‘intensive’ blood pressure lowering therapy and/or ‘intensive’ lipid control reduce cognitive decline and dementia in people with ischemic stroke; and does ‘intensive’ blood pressure lowering therapy reduce cognitive decline and dementia in patients with hemorrhagic stroke. Primary outcome: Addenbrooke’s Cognitive Examination-Revised. Secondary outcomes: feasibility of recruitment and retention of participants, tolerability and safety of the interventions, achieving and maintaining the blood pressure and lipid targets, maintaining differences in systolic blood pressure (> 10 mmHg) and low density lipoprotein-cholesterol (> 1 mmol/l) between the treatment groups, and performing clinic and telephone follow-up of cognition measures. Randomisation: using stratification, minimization and simple randomization. Blinding: participants receive open-label management. Cognition is assessed both unblinded (in clinic) and blinded (by telephone) to treatment. Adjudication of events (dementia, vascular, serious adverse events) is blinded to management. Discussion The PODCAST

  1. Accelerated hypergolic ignition with lowering of temperature

    SciTech Connect

    Panda, S.P.; Kulkarni, S.G.; Prabhakaran, C. . Faculty of Explosives and Applied Chemistry)

    1994-06-01

    Hypergolic liquid fuels known to undergo cationic polymerization at the preignition stage with red fuming nitric acid (RFNA) as oxidizer have been found to exhibit synergistic hypergolic ignition at zero and subzero temperatures. This accelerated ignition with lowering of temperature has been ascribed to negative activation energy usually associated with most cationic polymerization systems. The best ignition was obtained with blends of fuels consisting of norbornadiene and furfuryl alcohol which underwent strong cationic polymerization with protonic acids and possibly Diels-Alder addition to each other.

  2. Cholesterol-lowering effect of plant sterols.

    PubMed

    AbuMweis, Suhad S; Jones, Peter J H

    2008-12-01

    Plant sterols are plant components that have a chemical structure similar to cholesterol except for the addition of an extra methyl or ethyl group; however, plant sterol absorption in humans is considerably less than that of cholesterol. In fact, plant sterols reduce cholesterol absorption and thus reduce circulating levels of cholesterol. Earlier studies that have tested the efficacy of plant sterols as cholesterol-lowering agents incorporated plant sterols into fat spreads. Later on, plant sterols were added to other food matrices, including juices, nonfat beverages, milk and yogurt, cheese, meat, croissants and muffins, and cereal and chocolate bars. The beneficial physiologic effects of plant sterols could be further enhanced by combining them with other beneficial substances, such as olive and fish oils, fibers, and soy proteins, or with exercise. The addition of plant sterols to the diet is suggested by health experts as a safe and effective way to reduce the risk of coronary heart disease. PMID:18937893

  3. Catalyst for producing lower alcohols

    DOEpatents

    Rathke, Jerome W.; Klingler, Robert J.; Heiberger, John J.

    1987-01-01

    A process and system for the production of the lower alcohols such as methanol, ethanol and propanol involves the reaction of carbon monoxide and water in the presence of a lead salt and an alkali metal formate catalyst combination. The lead salt is present as solid particles such as lead titanate, lead molybdate, lead vanadate, lead zirconate, lead tantalate and lead silicates coated or in slurry within molten alkali metal formate. The reactants, carbon monoxide and steam are provided in gas form at relatively low pressures below 100 atmospheres and at temperatures of 200-400.degree. C. The resulted lower alcohols can be separated into boiling point fractions and recovered from the excess reactants by distillation.

  4. Lower Mortality in Magnet Hospitals

    PubMed Central

    McHugh, Matthew D.; Kelly, Lesly A.; Smith, Herbert L.; Wu, Evan S.; Vanak, Jill M.; Aiken, Linda H.

    2014-01-01

    Background Although there is evidence that hospitals recognized for nursing excellence—Magnet hospitals—are successful in attracting and retaining nurses, it is uncertain whether Magnet recognition is associated with better patient outcomes than non-Magnets, and if so why. Objectives To determine whether Magnet hospitals have lower risk-adjusted mortality and failure-to-rescue compared with non-Magnet hospitals, and to determine the most likely explanations. Method and Study Design Analysis of linked patient, nurse, and hospital data on 56 Magnet and 508 non-Magnet hospitals. Logistic regression models were used to estimate differences in the odds of mortality and failure-to-rescue for surgical patients treated in Magnet versus non-Magnet hospitals, and to determine the extent to which differences in outcomes can be explained by nursing after accounting for patient and hospital differences. Results Magnet hospitals had significantly better work environments and higher proportions of nurses with bachelor's degrees and specialty certification. These nursing factors explained much of the Magnet hospital effect on patient outcomes. However, patients treated in Magnet hospitals had 14% lower odds of mortality (odds ratio 0.86; 95% confidence interval, 0.76–0.98; P = 0.02) and 12% lower odds of failure-to-rescue (odds ratio 0.88; 95% confidence interval, 0.77–1.01; P = 0.07) while controlling for nursing factors as well as hospital and patient differences. Conclusions The lower mortality we find in Magnet hospitals is largely attributable to measured nursing characteristics but there is a mortality advantage above and beyond what we could measure. Magnet recognition identifies existing quality and stimulates further positive organizational behavior that improves patient outcomes. PMID:24022082

  5. Lower Mortality in Magnet Hospitals

    PubMed Central

    McHugh, Matthew D.; Kelly, Lesly A.; Smith, Herbert L.; Wu, Evan S.; Vanak, Jill M.; Aiken, Linda H.

    2012-01-01

    Background Although there is evidence that hospitals recognized for nursing excellence— Magnet hospitals—are successful in attracting and retaining nurses, it is uncertain whether Magnet recognition is associated with better patient outcomes than non-Magnets, and if so why. Objectives To determine whether Magnet hospitals have lower risk-adjusted mortality and failure-to-rescue compared to non-Magnet hospitals, and to determine the most likely explanations. Method and Study Design Analysis of linked patient, nurse, and hospital data on 56 Magnet and 508 non-Magnet hospitals. Logistic regression models were used to estimate differences in the odds of mortality and failure-to-rescue for surgical patients treated in Magnet vs. non-Magnet hospitals, and to determine the extent to which differences in outcomes can be explained by nursing after accounting for patient and hospital differences. Results Magnet hospitals had significantly better work environments and higher proportions of nurses with bachelor’s degrees and specialty certification. These nursing factors explained much of the Magnet hospital effect on patient outcomes. However, patients treated in Magnet hospitals had 14% lower odds of mortality (OR 0.86, 95% CI 0.76-0.98, p=0.02) and 12% lower odds of failure-to-rescue (OR 0.88, 95% CI 0.77-1.01, p=0.07) while controlling for nursing factors as well as hospital and patient differences. Conclusions Magnet hospitals have lower mortality than is fully accounted for by measured characteristics of nursing. Magnet recognition likely both identifies existing quality and stimulates further positive organizational behavior that improves patient outcomes. PMID:23047129

  6. Approach to lower back pain.

    PubMed

    Moosajee, F; Kalla, A A

    2015-12-01

    Lower back pain is one of the most common symptoms–and the most common musculoskeletal problem–seen by general practitioners. Iti s also a common cause of disability and an expensive condition in terms of economic impact because of absenteeism. This article discusses an approach to this common symptom and how to distinguish the benign, mechanical type of back pain from the more sinister, but less frequently encountered, inflammatory back pain. PMID:26933725

  7. Drugs targeting high-density lipoprotein cholesterol for coronary artery disease management.

    PubMed

    Katz, Pamela M; Leiter, Lawrence A

    2012-01-01

    Many patients remain at high risk for future cardiovascular events despite levels of low-density lipoprotein cholesterol (LDL-C) at, or below, target while taking statin therapy. Much effort is therefore being focused on strategies to reduce this residual risk. High-density lipoprotein cholesterol (HDL-C) is a strong, independent, inverse predictor of coronary heart disease risk and is therefore an attractive therapeutic target. Currently available agents that raise HDL-C have only modest effects and there is limited evidence of additional cardiovascular risk reduction on top of background statin therapy associated with their use. It was hoped that the use of cholesteryl ester transfer protein (CETP) inhibitors would provide additional benefit, but the results of clinical outcome studies to date have been disappointing. The results of ongoing trials with other CETP inhibitors that raise HDL-C to a greater degree and also lower LDL-C, as well as with other emerging therapies are awaited.

  8. Incorporation of additives into polymers

    DOEpatents

    McCleskey, T. Mark; Yates, Matthew Z.

    2003-07-29

    There has been invented a method for incorporating additives into polymers comprising: (a) forming an aqueous or alcohol-based colloidal system of the polymer; (b) emulsifying the colloidal system with a compressed fluid; and (c) contacting the colloidal polymer with the additive in the presence of the compressed fluid. The colloidal polymer can be contacted with the additive by having the additive in the compressed fluid used for emulsification or by adding the additive to the colloidal system before or after emulsification with the compressed fluid. The invention process can be carried out either as a batch process or as a continuous on-line process.

  9. [Patch-testing methods: additional specialised or additional series].

    PubMed

    Cleenewerck, M-B

    2009-01-01

    The tests in the European standard battery must occasionally be supplemented by specialised or additional batteries, particularly where the contact allergy is thought to be of occupational origin. These additional batteries cover all allergens associated with various professional activities (hairdressing, baking, dentistry, printing, etc.) and with different classes of materials and chemical products (glue, plastic, rubber...). These additional tests may also include personal items used by patients on a daily basis such as cosmetics, shoes, plants, textiles and so on.

  10. Additive manufacturing of optical components

    NASA Astrophysics Data System (ADS)

    Heinrich, Andreas; Rank, Manuel; Maillard, Philippe; Suckow, Anne; Bauckhage, Yannick; Rößler, Patrick; Lang, Johannes; Shariff, Fatin; Pekrul, Sven

    2016-08-01

    The development of additive manufacturing methods has enlarged rapidly in recent years. Thereby, the work mainly focuses on the realization of mechanical components, but the additive manufacturing technology offers a high potential in the field of optics as well. Owing to new design possibilities, completely new solutions are possible. This article briefly reviews and compares the most important additive manufacturing methods for polymer optics. Additionally, it points out the characteristics of additive manufactured polymer optics. Thereby, surface quality is of crucial importance. In order to improve it, appropriate post-processing steps are necessary (e.g. robot polishing or coating), which will be discussed. An essential part of this paper deals with various additive manufactured optical components and their use, especially in optical systems for shape metrology (e.g. borehole sensor, tilt sensor, freeform surface sensor, fisheye lens). The examples should demonstrate the potentials and limitations of optical components produced by additive manufacturing.

  11. Adenomatoid hyperplasia of lower lip.

    PubMed

    Sharma, Gaganjot Kaur; Sharma, Manish; Vanaki, Srinivas S

    2011-10-01

    Adenomatoid hyperplasia (AH) is an uncommon, non-neoplastic swelling on the palate caused due to hyperplasia of the mucinous acini. The lesion clinically presents as a sessile tumor-like nodule resembling pleomorphic adenoma. Histopathologic findings include lobules of enlarged mucinous acini which are filled with secretory granules. The nuclei are squeezed to the basal portions, associated with focal inflammation and ductal dilatation, and a history of trauma is often elicited. Here, we report a rare case of AH of the lower lip in a 20-year-old male patient, which mimics a mucous retention cyst or mucocele. PMID:22135695

  12. Lower Sioux Wind Feasibility & Development

    SciTech Connect

    Minkel, Darin

    2012-04-01

    This report describes the process and findings of a Wind Energy Feasibility Study (Study) conducted by the Lower Sioux Indian Community (Community). The Community is evaluating the development of a wind energy project located on tribal land. The project scope was to analyze the critical issues in determining advantages and disadvantages of wind development within the Community. This analysis addresses both of the Community's wind energy development objectives: the single turbine project and the Commerical-scale multiple turbine project. The main tasks of the feasibility study are: land use and contraint analysis; wind resource evaluation; utility interconnection analysis; and project structure and economics.

  13. Anthrax of the lower lip.

    PubMed

    Veraldi, Stefano; Nazzaro, Gianluca; Çuka, Ermira; Drago, Lorenzo

    2013-12-01

    Anthrax of the oral cavity and oropharynx is well known, whereas anthrax of the lips is very rare. We present a case of anthrax of the lower lip in a 57-year-old man. The infection was characterized by a wide, black eschar, surrounded by vesicles, crusts, and erythematous-edematous halo, with submandibular and laterocervical lymphadenopathy. The oral cavity, oropharynx, and tonsils were normal. Laboratory examinations revealed leukocytosis and increased inflammatory markers. Otolaryngologic, gastrointestinal, lung, and neurologic examinations were negative. The patient was successfully treated with oral ciprofloxacin. Although rare, anthrax should be considered in the differential clinical diagnosis in patients returning from areas where this disease is endemic. PMID:24120906

  14. [Lower is better: ENHANCE affair].

    PubMed

    Scardi, Sabino; Umari, Paolo; D'Agata, Bianca Maria

    2008-06-01

    Ezetimibe lowers the intestinal absorption of cholesterol, being complementary to the effects of statin. To check its efficacy in lowering the carotid intima-media thickness, in 2002 a multicenter international trial called ENHANCE was started, in order to assess by ultrasound the regression of atherosclerotic plaques. The protocol tested the use of simvastatin 80 mg + placebo versus simvastatin 80 mg + ezetimibe 10 mg in 720 randomized patients. Both drugs were well tolerated. Combination therapy was associated with a larger reduction in LDL cholesterol, but there were no differences in the intima-media thickness measured at three sites in the carotid arteries, nor differences in cardiovascular events between the two groups in the trial. These results provoked disappointment of sponsors (Merck, Schering Plough) who, although the results of the trial were available since march 2007, delayed official communication of about 18 months. This led to speculations and rumors among media, American Government, cardiologic scientific associations, and consequences in the Ezetimibe market and at Wall Street. In particular, the American College of Cardiology didn't accept the communication of ENHANCE results to the Late Breaking Trial Session of the Chicago congress, diverting it to another secondary forum. In conclusion, the experience of the ENHANCE trial suggests to pharmaceutical companies, researchers, clinicians, scientific companies and media a deep meditation in order to avoid in the future similar problems in the management of results of medical research.

  15. Enantioselective Michael Addition of Water

    PubMed Central

    Chen, Bi-Shuang; Resch, Verena; Otten, Linda G; Hanefeld, Ulf

    2015-01-01

    The enantioselective Michael addition using water as both nucleophile and solvent has to date proved beyond the ability of synthetic chemists. Herein, the direct, enantioselective Michael addition of water in water to prepare important β-hydroxy carbonyl compounds using whole cells of Rhodococcus strains is described. Good yields and excellent enantioselectivities were achieved with this method. Deuterium labeling studies demonstrate that a Michael hydratase catalyzes the water addition exclusively with anti-stereochemistry. PMID:25529526

  16. Enantioselective Michael addition of water.

    PubMed

    Chen, Bi-Shuang; Resch, Verena; Otten, Linda G; Hanefeld, Ulf

    2015-02-01

    The enantioselective Michael addition using water as both nucleophile and solvent has to date proved beyond the ability of synthetic chemists. Herein, the direct, enantioselective Michael addition of water in water to prepare important β-hydroxy carbonyl compounds using whole cells of Rhodococcus strains is described. Good yields and excellent enantioselectivities were achieved with this method. Deuterium labeling studies demonstrate that a Michael hydratase catalyzes the water addition exclusively with anti-stereochemistry.

  17. Gasoline additives, emissions, and performance

    SciTech Connect

    1995-12-31

    The papers included in this publication deal with the influence of fuel, additive, and hardware changes on a variety of vehicle performance characteristics. Advanced techniques for measuring these performance parameters are also described. Contents include: Fleet test evaluation of gasoline additives for intake valve and combustion chamber deposit clean up; A technique for evaluating octane requirement additives in modern engines on dynamometer test stands; A fleet test of two additive technologies comparing their effects on tailpipe emissions; Investigation into the vehicle exhaust emissions of high percentage ethanol blends; Variability in hydrocarbon speciation measurements at low emission (ULEV) levels; and more.

  18. Geomorphology of the lower Copper River, Alaska

    USGS Publications Warehouse

    Brabets, T.P.

    1996-01-01

    The Copper River, located in southcentral Alaska, drains an area of more than 24,000 square miles. About 30 miles above its mouth, this large river enters Miles Lake, a proglacial lake formed by the retreat of Miles Glacier. Downstream from the outlet of Miles Lake, the Copper River flows past the face of Childs Glacier before it enters a large, broad, alluvial flood plain. The Copper River Highway traverses this flood plain and in 1996, 11 bridges were located along this section of the highway. These bridges cross parts or all of the Copper River and in recent years, some of these bridges have sustained serious damage due to the changing course of the Copper River. Although the annual mean discharge of the lower Copper River is 57,400 cubic feet per second, most of the flow occurs during the summer months from snowmelt, rainfall, and glacial melt. Approximately every six years, an outburst flood from Van Cleve Lake, a glacier-dammed lake formed by Miles Glacier, releases approximately 1 million acre-feet of water into the Copper River. At the peak outflow rate from Van Cleve Lake, the flow of the Copper River will increase an additional 140,000 and 190,000 cubic feet per second. Bedload sampling and continuous seismic reflection were used to show that Miles Lake traps virtually all the bedload being transported by the Copper River as it enters the lake from the north. The reservoir-like effect of Miles Lake results in the armoring of the channel of the Copper River downstream from Miles Lakes, past Childs Glacier, until it reaches the alluvial flood plain. At this point, bedload transport begins again. The lower Copper River transports 69 million tons per year of suspended sediment, approximately the same quantity as the Yukon River, which drains an area of more than 300,000 square miles. By correlating concurrent flows from a long-term streamflow- gaging station on the Copper River with a short-term streamflow-gaging station at the outlet of Miles Lake, long

  19. Lower and lower Middle Pennsylvanian coal palynofloras, southwestern Virginia

    USGS Publications Warehouse

    Eble, C.F.

    1996-01-01

    Lower and lower Middle Pennsylvanian coals, recovered from an exploratory drilling program in southwestern Virginia, were analyzed for their palynomorph content. Results show them to be dominated by spores produced by arboreous lycopsids. Lycospora pellucida and Lycospora pusilla generally are the most common species, with others, namely Lycospora granulata, L. micropapillata and Lycospora orbicula being locally abundant. Densosporites, Cristatisporites, Radiizonates and Cingulizonates, representing small lycopsids, and Granulatisporites, produced by small ferns, and perhaps some pteridosperms typically are sub-dominant taxa. The recovered palynofloras are similar in overall composition making individual coal bed identification and correlation very difficult, if not impossible. However, the introduction and extinction of a few forms do assist the correlation of packages of strata, on both an intra- and interbasinal scale. Dictyotriletes bireticulatus is first observed in basal Lee Formation strata, at about the level of the Cove Creek coal bed. Radiizonates aligerans and R. striatus also appear more abundantly at this level, although some forms have been observed in older, Pocahontas Formation coals. This level essentially coincides with the Namurian C/Westphalian A boundary, based on plant megafossil evidence. Laevigatosporites minor, L. vulgaris, Endosporites globiformis, E. zonalis and Granasporites medius are first seen consistently just above the Sewell coal bed. Radiizonates aligerans, R. striatus and Densosporites irregularis are last seen in the early Middle Pennsylvanian, at about the level of the Splash Dam coal bed. Schulzospora rara occurs throughout Early and early Middle Pennsylvanian strata, and is last seen in the Manchester coal. The Manchester is directly overlain by the Betsie Shale, a widespread marine unit; the base of the Betsie marks the Westphalian A/B contact. When compared with palynomorph assemblage zonations published for the Western

  20. Cholesterol-lowering probiotics: in vitro selection and in vivo testing of bifidobacteria.

    PubMed

    Bordoni, Alessandra; Amaretti, Alberto; Leonardi, Alan; Boschetti, Elisa; Danesi, Francesca; Matteuzzi, Diego; Roncaglia, Lucia; Raimondi, Stefano; Rossi, Maddalena

    2013-09-01

    Thirty-four strains of bifidobacteria belonging to Bifidobacterium adolescentis, Bifidobacterium animalis, Bifidobacterium bifidum, Bifidobacterium breve, Bifidobacterium longum, and Bifidobacterium pseu-docatenulatum were assayed in vitro for the ability to assimilate cholesterol and for bile salt hydrolase (BSH) against glycocholic and taurodeoxycholic acids (GCA and TDCA). Cholesterol assimilation was peculiar characteristic of two strains belonging to the species B. bifidum (B. bifidum MB 107 and B. bifidum MB 109), which removed 81 and 50 mg of cholesterol per gram of biomass, being the median of specific cholesterol absorption by bifidobacteria 19 mg/g. Significant differences in BSH activities were not established among bifidobacterial species. However, the screening resulted in the selection of promising strains able to efficiently deconjugate GCA and TDCA. No relationship was recognized between BSH phenotype and the extent of cholesterol assimilation. On the basis of cholesterol assimilation or BSHGCA and BSHTDCA activities, B. bifidum MB 109 (DSMZ 23731), B. breve MB 113 (DSMZ 23732), and B. animalis subsp. lactis MB 2409 (DSMZ 23733) were combined in a probiotic mixture to be fed to hypercholesterolemic rats. The administration of this probiotic formulation resulted in a significant reduction of total cholesterol and low-density cholesterol (LDL-C), whereas it did not affect high-density cholesterol (HDL-C) and HDL-C/LDL-C ratio.

  1. Automated lower limb prosthesis design

    NASA Astrophysics Data System (ADS)

    Bhatia, Gulab H.; Commean, Paul K.; Smith, Kirk E.; Vannier, Michael W.

    1994-09-01

    The design of lower limb prostheses requires definitive geometric data to customize socket shape. Optical surface imaging and spiral x-ray computed tomography were applied to geometric analysis of limb residua in below knee (BK) amputees. Residua (limb remnants after amputation) of BK amputees were digitized and measured. Surface (optical) and volumetric (CT) data of the residuum were used to generate solid models and specify socket shape in (SDRC I-DEAS) CAD software. Volume measurements on the solid models were found to correspond within 2% of surface models and direct determinations made using Archimedean weighing. Anatomic 3D reconstruction of the residuum by optical surface and spiral x-ray computed tomography imaging are feasible modalities for prosthesis design.

  2. Color Addition and Subtraction Apps

    ERIC Educational Resources Information Center

    Ruiz, Frances; Ruiz, Michael J.

    2015-01-01

    Color addition and subtraction apps in HTML5 have been developed for students as an online hands-on experience so that they can more easily master principles introduced through traditional classroom demonstrations. The evolution of the additive RGB color model is traced through the early IBM color adapters so that students can proceed step by step…

  3. PCSK9 inhibitors--past, present and future.

    PubMed

    Reiner, Željko

    2015-01-01

    Lowering low-density lipoprotein cholesterol (LDL-C) reduces cardiovascular disease (CVD) morbidity and mortality. Statins are the treatment of choice for lowering LDL-C but a considerable number of patients treated with statins are unable to achieve LDL-C target values and many are statin-intolerant. New LDL-C-lowering drugs--antibodies to PCSK9 (alirocumab, evolocumab and bococizumab)--have been developed and are being tested in large clinical trials. They further reduce LDL-C above maximally tolerated statin therapy by up to > 70%; they also reduce Lp(a), non-HDL-C, apolipoprotein-B, and modestly increase HDL-C. These drugs are well tolerated and even patients who achieved very low LDL-C ≤ 0.65 mmol/l (∼ 25 mg/dl) did not have any significant adverse effects. Treatment with PCSK9 inhibitors resulted in LDL-C target values in 70-90% of patients according to the guidelines. However, although PCSK9 inhibitors seem to be the most promising emerging therapeutic option for LDL-C lowering today, outcome data with endpoints on their effects are still lacking. Another important open question is their long-term safety. Their use in statin-intolerant patients also raises questions, as the criteria for statin-intolerance are neither clear nor generally accepted. The presumed high cost of PCSK9 inhibitors might be an obstacle for their broader use.

  4. PCSK9 inhibitors--past, present and future.

    PubMed

    Reiner, Željko

    2015-01-01

    Lowering low-density lipoprotein cholesterol (LDL-C) reduces cardiovascular disease (CVD) morbidity and mortality. Statins are the treatment of choice for lowering LDL-C but a considerable number of patients treated with statins are unable to achieve LDL-C target values and many are statin-intolerant. New LDL-C-lowering drugs--antibodies to PCSK9 (alirocumab, evolocumab and bococizumab)--have been developed and are being tested in large clinical trials. They further reduce LDL-C above maximally tolerated statin therapy by up to > 70%; they also reduce Lp(a), non-HDL-C, apolipoprotein-B, and modestly increase HDL-C. These drugs are well tolerated and even patients who achieved very low LDL-C ≤ 0.65 mmol/l (∼ 25 mg/dl) did not have any significant adverse effects. Treatment with PCSK9 inhibitors resulted in LDL-C target values in 70-90% of patients according to the guidelines. However, although PCSK9 inhibitors seem to be the most promising emerging therapeutic option for LDL-C lowering today, outcome data with endpoints on their effects are still lacking. Another important open question is their long-term safety. Their use in statin-intolerant patients also raises questions, as the criteria for statin-intolerance are neither clear nor generally accepted. The presumed high cost of PCSK9 inhibitors might be an obstacle for their broader use. PMID:26329686

  5. Food combinations for cholesterol lowering.

    PubMed

    Harland, Janice I

    2012-12-01

    Reducing elevated LDL-cholesterol is a key public health challenge. There is substantial evidence from randomised controlled trials (RCT) that a number of foods and food components can significantly reduce LDL-cholesterol. Data from RCT have been reviewed to determine whether effects are additive when two or more of these components are consumed together. Typically components, such as plant stanols and sterols, soya protein, β-glucans and tree nuts, when consumed individually at their target rate, reduce LDL-cholesterol by 3-9 %. Improved dietary fat quality, achieved by replacing SFA with unsaturated fat, reduces LDL-cholesterol and can increase HDL-cholesterol, further improving blood lipid profile. It appears that the effect of combining these interventions is largely additive; however, compliance with multiple changes may reduce over time. Food combinations used in ten 'portfolio diet' studies have been reviewed. In clinical efficacy studies of about 1 month where all foods were provided, LDL-cholesterol is reduced by 22-30 %, whereas in community-based studies of >6 months' duration, where dietary advice is the basis of the intervention, reduction in LDL-cholesterol is about 15 %. Inclusion of MUFA into 'portfolio diets' increases HDL-cholesterol, in addition to LDL-cholesterol effects. Compliance with some of these dietary changes can be achieved more easily compared with others. By careful food component selection, appropriate to the individual, the effect of including only two components in the diet with good compliance could be a sustainable 10 % reduction in LDL-cholesterol; this is sufficient to make a substantial impact on cholesterol management and reduce the need for pharmaceutical intervention.

  6. Is the lower mantle stagnant?

    NASA Astrophysics Data System (ADS)

    Hofmeister, A. M.

    2008-12-01

    I calculate geotherms for the lower mantle (LM) from the solution to Fourier's equation for spherical shells with heating internally and below, by utilizing new models and measurements of thermal diffusivity (D) at temperature (T) and pressure (P), available constraints from mineral physics, various distributions of radiogenic elements, and integrating outward from the core-mantle boundary (CMB). A perovskite-rich LM can conductively carry heat from below any given radius under a wide range of conditions, mainly due to high thermal conductivity associated with lattice compression. The base model uses recent experimental measurements of eutectic melting in the Fe-S system (Chudinovskikh and Boehler, 2007, EPSL, p. 97) which indicate CMB temperatures of 3000 K, and assumes that 2 TW emanates from the core, consistent with power attributed to the geodynamo. For the continental crust, a low estimate of 8 TW is used, for a total Q=30 TW, indicated by spherical harmonic analysis of heat flux data (Hamza et al. 2008, IJES). I use recent experimental measurements of D of perovskite-family minerals at high temperature using laser flash analysis (Hofmeister, in press, PEPI). For D(T) of MgO, dD/dP and estimation of the effects of Fe content and the transition to post-perovskite, we use the damped harmonic oscillator model (Hofmeister et al, 2007, Treatise in Geophysics). High temperature values for heat capacity are used and density from PREM. A small radiative contribution for 1 mm grains (Hofmeister (2005, J. Geodynamics) is assumed. Base model calculations provide T =1700 K at 670 km, which is consistent with phase equilibria. Effects on the geotherm are: negligible for ppv being present, minor for the amount of radiative transfer or of internal heating in the LM, moderate for proportion of perovskite or changes in core heat or CMB temperatures. For example, a pure perovskite LM without radiative transfer is conductive having T from 2000 to 4000 K from 670 km to the CMB

  7. [LDL cholesterol control in patients with very high cardiovascular risk. A simplified algorithm for achieving LDL cholesterol goals "in two steps"].

    PubMed

    Guijarro-Herraiz, Carlos; Masana-Marin, Luis; Galve, Enrique; Cordero-Fort, Alberto

    2014-01-01

    Reducing low density lipoprotein-cholesterol (LDL-c) is the main lipid goal of treatment for patients with very high cardiovascular risk. In these patients the therapeutic goal is to achieve a LDL-c lower than 70 mg/dL, as recommended by the guidelines for cardiovascular prevention commonly used in Spain and Europe. However, the degree of achieving these objectives in this group of patients is very low. This article describes the prevalence of the problem and the causes that motivate it. Recommendations and tools that can facilitate the design of an optimal treatment strategy for achieving the goals are also given. In addition, a new tool with a simple algorithm that can allow these very high risk patients to achieve the goals "in two-steps", i.e., with only two doctor check-ups, is presented. PMID:25048471

  8. [PCSK9 inhibitors : Recommendations for patient selection].

    PubMed

    Laufs, U; Custodis, F; Werner, C

    2016-06-01

    The 2 or 4‑week subcutaneous therapy with the recently approved antibodies alirocumab and evolocumab for inhibition of proprotein convertase subtilisin-kexin type 9 (PCSK9) reduces low-density lipoprotein cholesterol (LDL-C) in addition to statins and ezetimibe by 50-60 %. The therapy is well-tolerated. The safety profile in the published studies is comparable to placebo. Outcome data and information on long-term safety and the influence on cardiovascular events are not yet available but the results of several large trials are expected in 2016-2018. At present (spring 2016) PCSK9 inhibitors represent an option for selected patients with a high cardiovascular risk and high LDL-C despite treatment with the maximum tolerated oral lipid-lowering therapy. This group includes selected patients with familial hypercholesterolemia and high-risk individuals with statin-associated muscle symptoms (SAMS). PMID:27207595

  9. [LDL cholesterol control in patients with very high cardiovascular risk. A simplified algorithm for achieving LDL cholesterol goals "in two steps"].

    PubMed

    Guijarro-Herraiz, Carlos; Masana-Marin, Luis; Galve, Enrique; Cordero-Fort, Alberto

    2014-01-01

    Reducing low density lipoprotein-cholesterol (LDL-c) is the main lipid goal of treatment for patients with very high cardiovascular risk. In these patients the therapeutic goal is to achieve a LDL-c lower than 70 mg/dL, as recommended by the guidelines for cardiovascular prevention commonly used in Spain and Europe. However, the degree of achieving these objectives in this group of patients is very low. This article describes the prevalence of the problem and the causes that motivate it. Recommendations and tools that can facilitate the design of an optimal treatment strategy for achieving the goals are also given. In addition, a new tool with a simple algorithm that can allow these very high risk patients to achieve the goals "in two-steps", i.e., with only two doctor check-ups, is presented.

  10. Color Addition and Subtraction Apps

    NASA Astrophysics Data System (ADS)

    Ruiz, Frances; Ruiz, Michael J.

    2015-10-01

    Color addition and subtraction apps in HTML5 have been developed for students as an online hands-on experience so that they can more easily master principles introduced through traditional classroom demonstrations. The evolution of the additive RGB color model is traced through the early IBM color adapters so that students can proceed step by step in understanding mathematical representations of RGB color. Finally, color addition and subtraction are presented for the X11 colors from web design to illustrate yet another real-life application of color mixing.

  11. Lower hybrid wavepacket stochasticity revisited

    SciTech Connect

    Fuchs, V.; Krlín, L.; Pánek, R.; Preinhaelter, J.; Seidl, J.; Urban, J.

    2014-02-12

    Analysis is presented in support of the explanation in Ref. [1] for the observation of relativistic electrons during Lower Hybrid (LH) operation in EC pre-heated plasma at the WEGA stellarator [1,2]. LH power from the WEGA TE11 circular waveguide, 9 cm diameter, un-phased, 2.45 GHz antenna, is radiated into a B≅0.5 T, Ðœ„n{sub e}≅5×10{sup 17} 1/m{sup 3} plasma at T{sub e}≅10 eV bulk temperature with an EC generated 50 keV component [1]. The fast electrons cycle around flux or drift surfaces with few collisions, sufficient for randomizing phases but insufficient for slowing fast electrons down, and thus repeatedly interact with the rf field close to the antenna mouth, gaining energy in the process. Our antenna calculations reveal a standing electric field pattern at the antenna mouth, with which we formulate the electron dynamics via a relativistic Hamiltonian. A simple approximation of the equations of motion leads to a relativistic generalization of the area-preserving Fermi-Ulam (F-U) map [3], allowing phase-space global stochasticity analysis. At typical WEGA plasma and antenna conditions, the F-U map predicts an LH driven current of about 230 A, at about 225 W of dissipated power, in good agreement with the measurements and analysis reported in [1].

  12. Russian Docking Module is lowered

    NASA Technical Reports Server (NTRS)

    1995-01-01

    The Russian-built Docking Module (DM) is lowered for installation into the payload bay of the Space Shuttle Orbiter Atlantis while the spaceplane is in Orbiter Processing Facility bay 2. The module will fly as a primary payload on the second Space Shuttle/Mir space station docking mission, STS-74, which is now scheduled for liftoff in the fall of 1995. During the mission, the module will first be attached with the orbiter's robot arm to the Orbiter Docking System (ODS) in the payload bay of the orbiter Atlantis and then be docked with the Mir. When Atlantis undocks from the Mir, it will leave the new docking module permanently attached to the space station for use during future Shuttle Mir docking missions. The new module will simplify future Shuttle linkups with Mir by improving orbiter clearances when it serves as a bridge between the two space vehicles. The white structures attached to the module's sides are solar panels that will be attached to the Mir after the conclusion of the STS-74 mission.

  13. A lamin in lower eukaryotes?

    PubMed Central

    Batsios, Petros; Peter, Tatjana; Baumann, Otto; Stick, Reimer; Meyer, Irene; Gräf, Ralph

    2012-01-01

    Lamins are the major components of the nuclear lamina and serve not only as a mechanical support, but are also involved in chromatin organization, epigenetic regulation, transcription and mitotic events. Despite these universal tasks, lamins have so far been found only in metazoans. Yet, recently we have identified Dictyostelium NE81 as the first lamin-like protein in a lower eukaryote. Based on the current knowledge, we draw a model for nuclear envelope organization in Dictyostelium in this Extra View and we review the experimental data that justified this classification. Furthermore we provide unpublished data underscoring the requirement of posttranslational CaaX-box processing for proper protein localization at the nuclear envelope. Sequence comparison of NE81 sequences from four Dictyostelia with bona fide lamins illustrates the evolutional relationship between these proteins. Under certain conditions these usually unicellular social amoebae congregate to form a multicellular body. We propose that the evolution of the lamin-like NE81 went along with the invention of multicellularity. PMID:22572958

  14. Extrachromosomal elements in lower eukaryotes:

    SciTech Connect

    Wickner, R.B.; Hinnebusch, A.; Lambowitz, A.M.; Gunsalus, I.C.; Hollaender, A.

    1986-01-01

    While most genes are chromosomal, the nonchromosomal genes have played a disproportionate role in molecular biology, in part because of their easy accessibility and in part because they represent the most mobile portion of a cell's genome. Fungi, yeasts, protozoa, slime molds, algae, and other single-celled nucleated species, have recently gained dramatic popularity with the development of transformation methods for Saccharomyces, Neurospora, Schizosaccharomyces, Dictyostelium, and others of this group. The realization that Saccharomyces has oncogenes, RNA tumor viruses, intervening sequences, and all the mitotic, mitochondrial, and other structures typical of so-called ''higher'' eukaryotic organisms has confirmed the use of such organisms as model systems. Their use in biotechnology also shows great promise. The study in lower eukaryotes of mitochondria and chloroplasts has yielded many insights into similar structures in higher organisms as well as many unexpected finds, such as mechanisms of intron excision and the biology of introns, RNA catalysis, variation of the genetic code, and mechanisms of protein import across membranes.

  15. Lipid-lowering therapy in older persons

    PubMed Central

    2015-01-01

    Numerous randomized, double-blind, placebo-controlled studies and observational studies have shown that statins reduce mortality and major cardiovascular events in older high-risk persons with hypercholesterolemia. The Heart Protection Study showed that statins reduced mortality and major cardiovascular events in high-risk persons regardless of the initial level of serum lipids, age, or gender. The updated National Cholesterol Education Program III guidelines state that in very high-risk persons, a serum low-density lipoprotein (LDL) cholesterol level of < 70 mg/dl (1.8 mmol/l) is a reasonable clinical strategy for moderately high-risk persons (2 or more risk factors and a 10-year risk for coronary artery disease of 10% to 20%), and the serum LDL cholesterol should be reduced to < 100 mg/dl (2.6 mmol/l). When LDL cholesterol-lowering drug therapy is used to treat high-risk persons or moderately high-risk persons, the serum LDL cholesterol should be reduced by at least 30% to 40%. The serum LDL cholesterol should be decreased to less than 160 mg/dl in persons at low risk for cardiovascular disease. Addition of other lipid-lowering drugs to statin therapy has not been demonstrated to further reduce cardiovascular events and mortality. PMID:25861289

  16. Diagnosis of Lower Hybrid on MST

    SciTech Connect

    Burke, D. R.; Goetz, J. A.; Kaufman, M. C.; Almagri, A. F.; Anderson, J. K.; Forest, C. B.; Prager, S. C.

    2007-09-28

    RF driven current has never been demonstrated in a Reversed Field Pinch. Recently the lower hybrid system on the Madison Symmetric Torus reached a new operating regime. This upgrade allows RF powers of up to 5% of the Ohmic input power to be injected. It is therefore anticipated that the lower hybrid system is on the threshold of producing meaningful changes to the RFP equilibrium. A diagnostic set is under development to facilitate the study of such changes and lay the foundation for near megawatt operations. Many measurements are being studied for viability. These include electron cyclotron emission, examinations of bulk ion and electron heating, surface perturbation pickup coils, magnetic probe measurements, and Langmuir probe measurements. In addition, several x-ray diagnostics are in operation: pulse height analysis is performed on detector arrays to determine the 5-200 keV spectrum. An insertable target probe is available to create x-rays from fast electrons. Tomographic inversion of 2-D Soft x-ray detectors yields equilibrium information through island structure. Results from experiments with source power up to 225 kW will be presented. Preliminary results from CQL3D Fokker-Planck simulations will also be presented.

  17. Teebi hypertelorism syndrome: additional cases.

    PubMed

    Machado-Paula, Ligiane Alves; Guion-Almeida, Maria Leine

    2003-03-01

    We report on two unrelated Brazilian boys who have craniofacial and digital anomalies resembling those reported with Teebi hypertelorism syndrome. Additional features such as cleft lip and palate, large uvula, atypical chin and abnormal scapulae were observed.

  18. Polyolefins as additives in plastics

    SciTech Connect

    Deanin, R.D.

    1993-12-31

    Polyolefins are not only major commodity plastics - they are also very useful as additives, both in other polyolefins and also in other types of plastics. This review covers ethylene, propylene, butylene and isobutylene polymers, in blends with each other, and as additives to natural rubber, styrene/butadiene rubber, polystyrene, polyvinyl chloride, polymethyl methacrylate, polyphenylene oxide, polycarbonate, thermoplastic polyesters, polyurethanes, polyamides, and mixed automotive plastics recycling.

  19. Food additives and preschool children.

    PubMed

    Martyn, Danika M; McNulty, Breige A; Nugent, Anne P; Gibney, Michael J

    2013-02-01

    Food additives have been used throughout history to perform specific functions in foods. A comprehensive framework of legislation is in place within Europe to control the use of additives in the food supply and ensure they pose no risk to human health. Further to this, exposure assessments are regularly carried out to monitor population intakes and verify that intakes are not above acceptable levels (acceptable daily intakes). Young children may have a higher dietary exposure to chemicals than adults due to a combination of rapid growth rates and distinct food intake patterns. For this reason, exposure assessments are particularly important in this age group. The paper will review the use of additives and exposure assessment methods and examine factors that affect dietary exposure by young children. One of the most widely investigated unfavourable health effects associated with food additive intake in preschool-aged children are suggested adverse behavioural effects. Research that has examined this relationship has reported a variety of responses, with many noting an increase in hyperactivity as reported by parents but not when assessed using objective examiners. This review has examined the experimental approaches used in such studies and suggests that efforts are needed to standardise objective methods of measuring behaviour in preschool children. Further to this, a more holistic approach to examining food additive intakes by preschool children is advisable, where overall exposure is considered rather than focusing solely on behavioural effects and possibly examining intakes of food additives other than food colours.

  20. Chemical defense lowers plant competitiveness.

    PubMed

    Ballhorn, Daniel J; Godschalx, Adrienne L; Smart, Savannah M; Kautz, Stefanie; Schädler, Martin

    2014-11-01

    Both plant competition and plant defense affect biodiversity and food web dynamics and are central themes in ecology research. The evolutionary pressures determining plant allocation toward defense or competition are not well understood. According to the growth-differentiation balance hypothesis (GDB), the relative importance of herbivory and competition have led to the evolution of plant allocation patterns, with herbivore pressure leading to increased differentiated tissues (defensive traits), and competition pressure leading to resource investment towards cellular division and elongation (growth-related traits). Here, we tested the GDB hypothesis by assessing the competitive response of lima bean (Phaseolus lunatus) plants with quantitatively different levels of cyanogenesis-a constitutive direct, nitrogen-based defense against herbivores. We used high (HC) and low cyanogenic (LC) genotypes in different competition treatments (intra-genotypic, inter-genotypic, interspecific), and in the presence or absence of insect herbivores (Mexican bean beetle, Epilachna varivestis) to quantify vegetative and generative plant parameters (above and belowground biomass as well as seed production). Highly defended HC-plants had significantly lower aboveground biomass and seed production than LC-plants when grown in the absence of herbivores implying significant intrinsic costs of plant cyanogenesis. However, the reduced performance of HC- compared to LC-plants was mitigated in the presence of herbivores. The two plant genotypes exhibited fundamentally different responses to various stresses (competition, herbivory). Our study supports the GDB hypothesis by demonstrating that competition and herbivory affect different plant genotypes differentially and contributes to understanding the causes of variation in defense within a single plant species.

  1. Lower Cost CPV 3-Sun Mirror Modules

    SciTech Connect

    Fraas, Dr. Lewis; Avery, James E.; Minkin, Leonid M; Huang, H,; Gehl, Anthony C; Maxey, L Curt

    2007-01-01

    In a series of patent applications filed between 2002 and 2005, JX Crystals Inc described a evolutionary lower-cost low-concentration planar solar photovoltaic module that uses multiple linear rows of silicon cells and standard one-sun circuit laminations incorporating glass and EVA weather proofing encapsulations. The three novel features that we described are interdependent and integrated together to yield lower cost PV modules. These 3 novel features are: (1) The use of rows of linear mirrors or linear Fresnel lenses aligned with the cell rows and concentrating the sunlight onto the cell rows. (2) The addition of a thin aluminum sheet heat spreader on the back of the circuit lamination to spread the heat away from the cell rows so that the cell operating temperature remains acceptably low. (3) The incorporation of slots in the back of the aluminum sheet heat spreader to accommodate the differences in thermal expansion between the silicon cells, the glass, and the aluminum so that the circuit interconnectivity is maintained over time. Various embodiments of this planar linear concentrator panel are shown in figures 1 to 5. Figures 1 and 2 show the original planar linear concentrator module concept from July of 2002 with either mirrors (figure 1) or linear Fresnel lenses (figure 2). The idea was expanded in 2003 with the idea of an aluminum sheet heat spreader added to the back of a standard PV circuit lamination as shown in figure 3. In 2003, we also transitioned from half cells to third cells using SunPower cells as shown in figure 4. JX Crystals Inc then received funding for the 3-sun PV mirror module concept from the Shanghai Science and Technology Commission in 2003 and from the Shanghai Flower Port and the Shanghai Import and Export Trading Company in 2005. This funding led to a 800 panel pilot production run of our JX Crystals designed 3-sun module in 2006. 672 of these panels were installed in a 100 kW demonstration and an additional 24 panels were

  2. Extension of the standard addition method by blank addition.

    PubMed

    Steliopoulos, Panagiotis

    2015-01-01

    Standard addition involves adding varying amounts of the analyte to sample portions of fixed mass or fixed volume and submitting those portions to the sample preparation procedure. After measuring the final extract solutions, the observed signals are linearly regressed on the spiked amounts. The original unknown amount is estimated by the opposite of the abscissa intercept of the fitted straight line [1]. A limitation of this method is that only data points with abscissa values equal to and greater than zero are available so that there is no information on whether linearity holds below the spiking level zero. An approach to overcome this limitation is introduced.•Standard addition is combined with blank addition.•Blank addition means that defined mixtures of blank matrix and sample material are subjected to sample preparation to give final extract solutions.•Equations are presented to estimate the original unknown amount and to calculate the 1-2α confidence interval about this estimate using the combined data set.

  3. ADDITIVITY ASSESSMENT OF TRIHALOMETHANE MIXTURES BY PROPORTIONAL RESPONSE ADDITION

    EPA Science Inventory

    If additivity is known or assumed, the toxicity of a chemical mixture may be predicted from the dose response curves of the individual chemicals comprising the mixture. As single chemical data are abundant and mixture data sparse, mixture risk methods that utilize single chemical...

  4. Extension of the standard addition method by blank addition

    PubMed Central

    Steliopoulos, Panagiotis

    2015-01-01

    Standard addition involves adding varying amounts of the analyte to sample portions of fixed mass or fixed volume and submitting those portions to the sample preparation procedure. After measuring the final extract solutions, the observed signals are linearly regressed on the spiked amounts. The original unknown amount is estimated by the opposite of the abscissa intercept of the fitted straight line [1]. A limitation of this method is that only data points with abscissa values equal to and greater than zero are available so that there is no information on whether linearity holds below the spiking level zero. An approach to overcome this limitation is introduced.•Standard addition is combined with blank addition.•Blank addition means that defined mixtures of blank matrix and sample material are subjected to sample preparation to give final extract solutions.•Equations are presented to estimate the original unknown amount and to calculate the 1-2α confidence interval about this estimate using the combined data set. PMID:26844210

  5. [INVITED] Lasers in additive manufacturing

    NASA Astrophysics Data System (ADS)

    Pinkerton, Andrew J.

    2016-04-01

    Additive manufacturing is a topic of considerable ongoing interest, with forecasts predicting it to have major impact on industry in the future. This paper focusses on the current status and potential future development of the technology, with particular reference to the role of lasers within it. It begins by making clear the types and roles of lasers in the different categories of additive manufacturing. This is followed by concise reviews of the economic benefits and disadvantages of the technology, current state of the market and use of additive manufacturing in different industries. Details of these fields are referenced rather than expanded in detail. The paper continues, focusing on current indicators to the future of additive manufacturing. Barriers to its development, trends and opportunities in major industrial sectors, and wider opportunities for its development are covered. Evidence indicates that additive manufacturing may not become the dominant manufacturing technology in all industries, but represents an excellent opportunity for lasers to increase their influence in manufacturing as a whole.

  6. Evaluation of certain food additives.

    PubMed

    2015-01-01

    This report represents the conclusions of a Joint FAO/WHO Expert Committee convened to evaluate the safety of various food additives, including flavouring agents, and to prepare specifications for identity and purity. The first part of the report contains a general discussion of the principles governing the toxicological evaluation of and assessment of dietary exposure to food additives, including flavouring agents. A summary follows of the Committee's evaluations of technical, toxicological and dietary exposure data for eight food additives (Benzoe tonkinensis; carrageenan; citric and fatty acid esters of glycerol; gardenia yellow; lutein esters from Tagetes erecta; octenyl succinic acid-modified gum arabic; octenyl succinic acid-modified starch; paprika extract; and pectin) and eight groups of flavouring agents (aliphatic and alicyclic hydrocarbons; aliphatic and aromatic ethers; ionones and structurally related substances; miscellaneous nitrogen-containing substances; monocyclic and bicyclic secondary alcohols, ketones and related esters; phenol and phenol derivatives; phenyl-substituted aliphatic alcohols and related aldehydes and esters; and sulfur-containing heterocyclic compounds). Specifications for the following food additives were revised: citric acid; gellan gum; polyoxyethylene (20) sorbitan monostearate; potassium aluminium silicate; and Quillaia extract (Type 2). Annexed to the report are tables summarizing the Committee's recommendations for dietary exposures to and toxicological evaluations of all of the food additives and flavouring agents considered at this meeting.

  7. Clinical effects of sulphite additives.

    PubMed

    Vally, H; Misso, N L A; Madan, V

    2009-11-01

    Sulphites are widely used as preservative and antioxidant additives in the food and pharmaceutical industries. Topical, oral or parenteral exposure to sulphites has been reported to induce a range of adverse clinical effects in sensitive individuals, ranging from dermatitis, urticaria, flushing, hypotension, abdominal pain and diarrhoea to life-threatening anaphylactic and asthmatic reactions. Exposure to the sulphites arises mainly from the consumption of foods and drinks that contain these additives; however, exposure may also occur through the use of pharmaceutical products, as well as in occupational settings. While contact sensitivity to sulphite additives in topical medications is increasingly being recognized, skin reactions also occur after ingestion of or parenteral exposure to sulphites. Most studies report a 3-10% prevalence of sulphite sensitivity among asthmatic subjects following ingestion of these additives. However, the severity of these reactions varies, and steroid-dependent asthmatics, those with marked airway hyperresponsiveness, and children with chronic asthma, appear to be at greater risk. In addition to episodic and acute symptoms, sulphites may also contribute to chronic skin and respiratory symptoms. To date, the mechanisms underlying sulphite sensitivity remain unclear, although a number of potential mechanisms have been proposed. Physicians should be aware of the range of clinical manifestations of sulphite sensitivity, as well as the potential sources of exposure. Minor modifications to diet or behaviour lead to excellent clinical outcomes for sulphite-sensitive individuals.

  8. Additive Manufacturing of Hybrid Circuits

    NASA Astrophysics Data System (ADS)

    Sarobol, Pylin; Cook, Adam; Clem, Paul G.; Keicher, David; Hirschfeld, Deidre; Hall, Aaron C.; Bell, Nelson S.

    2016-07-01

    There is a rising interest in developing functional electronics using additively manufactured components. Considerations in materials selection and pathways to forming hybrid circuits and devices must demonstrate useful electronic function; must enable integration; and must complement the complex shape, low cost, high volume, and high functionality of structural but generally electronically passive additively manufactured components. This article reviews several emerging technologies being used in industry and research/development to provide integration advantages of fabricating multilayer hybrid circuits or devices. First, we review a maskless, noncontact, direct write (DW) technology that excels in the deposition of metallic colloid inks for electrical interconnects. Second, we review a complementary technology, aerosol deposition (AD), which excels in the deposition of metallic and ceramic powder as consolidated, thick conformal coatings and is additionally patternable through masking. Finally, we show examples of hybrid circuits/devices integrated beyond 2-D planes, using combinations of DW or AD processes and conventional, established processes.

  9. Postmarketing surveillance of food additives.

    PubMed

    Butchko, H H; Tschanz, C; Kotsonis, F N

    1994-08-01

    Postmarketing surveillance of consumption and of anecdotal reports of adverse health effects has been recognized by a number of regulatory authorities as a potentially useful method to provide further assurance of the safety of new food additives. Surveillance of consumption is used to estimate more reliably actual consumption levels relative to the acceptable daily intake of a food additive. Surveillance of anecdotal reports of adverse health effects is used to determine the presence of infrequent idiosyncratic responses that may not be predictable from premarket evaluations. The high-intensity sweetner, aspartame, is a food additive that has been the subject of extensive evaluation during the postmarketing period and is thus used as an example to discuss postmarketing surveillance.

  10. Tougher Addition Polyimides Containing Siloxane

    NASA Technical Reports Server (NTRS)

    St. Clair, T. L.; Maudgal, S.

    1986-01-01

    Laminates show increased impact resistances and other desirable mechanical properties. Bismaleamic acid extended by reaction of diaminosiloxane with maleic anhydride in 1:1 molar ratio, followed by reaction with half this molar ratio of aromatic dianhydride. Bismaleamic acid also extended by reaction of diaminosiloxane with maleic anhydride in 1:2 molar ratio, followed by reaction with half this molar ratio of aromatic diamine (Michael-addition reaction). Impact resistances improved over those of unmodified bismaleimide, showing significant increase in toughness. Aromatic addition polyimides developed as both matrix and adhesive resins for applications on future aircraft and spacecraft.

  11. PCSK9: From discovery to therapeutic applications.

    PubMed

    Farnier, Michel

    2014-01-01

    The proprotein convertase subtilisin/kexin type 9 (PCSK9) regulates cholesterol metabolism mainly by targeting the low-density lipoprotein receptor (LDLR) for degradation in the liver. Gain-of-function mutations in PCSK9 are one of the genetic causes of autosomal dominant hypercholesterolaemia. Conversely, loss-of-function mutations are associated with lower concentrations of LDL cholesterol (LDL-C) and reduced coronary heart disease. As these loss-of-function mutations are not associated with apparent deleterious effects, PCSK9 inhibition is an attractive new strategy for lowering LDL-C concentration. Among the various approaches to PCSK9 inhibition, human data are only available for inhibition of PCSK9 binding to LDLR by monoclonal antibodies. In phase II studies, the two most advanced monoclonal antibodies in development (alirocumab and evolocumab) decreased atherogenic lipoproteins very effectively and were well tolerated. A dramatic decrease in LDL-C up to 70% can be obtained with the most efficacious doses. Efficacy has been evaluated so far in addition to statins in hypercholesterolaemic patients with or without familial hypercholesterolaemia, in patients with intolerance to statin therapy and in monotherapy. Large phase III programmes are ongoing to evaluate the long-term efficacy and safety of these very promising new agents.

  12. PCSK9: From discovery to therapeutic applications.

    PubMed

    Farnier, Michel

    2014-01-01

    The proprotein convertase subtilisin/kexin type 9 (PCSK9) regulates cholesterol metabolism mainly by targeting the low-density lipoprotein receptor (LDLR) for degradation in the liver. Gain-of-function mutations in PCSK9 are one of the genetic causes of autosomal dominant hypercholesterolaemia. Conversely, loss-of-function mutations are associated with lower concentrations of LDL cholesterol (LDL-C) and reduced coronary heart disease. As these loss-of-function mutations are not associated with apparent deleterious effects, PCSK9 inhibition is an attractive new strategy for lowering LDL-C concentration. Among the various approaches to PCSK9 inhibition, human data are only available for inhibition of PCSK9 binding to LDLR by monoclonal antibodies. In phase II studies, the two most advanced monoclonal antibodies in development (alirocumab and evolocumab) decreased atherogenic lipoproteins very effectively and were well tolerated. A dramatic decrease in LDL-C up to 70% can be obtained with the most efficacious doses. Efficacy has been evaluated so far in addition to statins in hypercholesterolaemic patients with or without familial hypercholesterolaemia, in patients with intolerance to statin therapy and in monotherapy. Large phase III programmes are ongoing to evaluate the long-term efficacy and safety of these very promising new agents. PMID:24373748

  13. Lubricating additive for drilling muds

    SciTech Connect

    Gutierrez, A.; Brois, S. J.; Brownawell, D. W.; Walker, T. O.

    1985-01-01

    Aqueous drilling fluids containing a minor amount of an additive composition featuring oxazolines of C/sub 1/-C/sub 30/ alkylthioglycolic acid. Such fluids are especially useful where reduced torque drilling fluids are needed. Another embodiment of this invention relates to a method of drilling utilizing the above-described fluids.

  14. Tetrasulfide extreme pressure lubricant additives

    SciTech Connect

    Gast, L.E.; Kenney, H.E.; Schwab, A.W.

    1980-08-19

    A novel class of compounds has been prepared comprising the tetrasulfides of /sup 18/C hydrocarbons, /sup 18/C fatty acids, and /sup 18/C fatty and alkyl and triglyceride esters. These tetrasulfides are useful as extreme pressure lubricant additives and show potential as replacements for sulfurized sperm whale oil.

  15. Promoting Additive Acculturation in Schools.

    ERIC Educational Resources Information Center

    Gibson, Margaret A.

    1995-01-01

    A study focusing on 113 ninth graders of Mexican descent indicates that most students and their parents adhere to a strategy of additive acculturation (incorporating skills of the new culture and language), but that the school curriculum and general school climate devalue Mexican culture. (SLD)

  16. Individualized Additional Instruction for Calculus

    ERIC Educational Resources Information Center

    Takata, Ken

    2010-01-01

    College students enrolling in the calculus sequence have a wide variance in their preparation and abilities, yet they are usually taught from the same lecture. We describe another pedagogical model of Individualized Additional Instruction (IAI) that assesses each student frequently and prescribes further instruction and homework based on the…

  17. Out of bounds additive manufacturing

    DOE PAGES

    Holshouser, Chris; Newell, Clint; Palas, Sid; Love, Lonnie J.; Kunc, Vlastimil; Lind, Randall F.; Lloyd, Peter D.; Rowe, John C.; Blue, Craig A.; Duty, Chad E.; et al

    2013-03-01

    Lockheed Martin and Oak Ridge National Laboratory are working on an additive manufacturing system capable of manufacturing components measured not in terms of inches or feet, but multiple yards in all dimensions with the potential to manufacture parts that are completely unbounded in size.

  18. Tinkertoy Color-Addition Device.

    ERIC Educational Resources Information Center

    Ferguson, Joe L.

    1995-01-01

    Describes construction and use of a simple home-built device, using an overhead projector, for use in demonstrations of the addition of various combinations of red, green, and blue light. Useful in connection with discussions of color, color vision, or color television. (JRH)

  19. Additional Financial Resources for Education.

    ERIC Educational Resources Information Center

    Hubbard, Ben C.

    This paper discusses the continuing need for additional educational funds and suggests that the only way to gain these funds is through concerted and persistent political efforts by supporters of education at both the federal and state levels. The author first points out that for many reasons declining enrollment may not decrease operating costs…

  20. Evaluation of certain food additives.

    PubMed

    2012-01-01

    This report represents the conclusions of a Joint FAO/WHO Expert Committee convened to evaluate the safety of various food additives, including flavouring agents, with a view to concluding as to safety concerns and to preparing specifications for identity and purity. The first part of the report contains a general discussion of the principles governing the toxicological evaluation of and assessment of dietary exposure to food additives, including flavouring agents. A summary follows of the Committee's evaluations of technical, toxicological and dietary exposure data for five food additives (magnesium dihydrogen diphosphate; mineral oil (medium and low viscosity) classes II and III; 3-phytase from Aspergillus niger expressed in Aspergillus niger; serine protease (chymotrypsin) from Nocardiopsis prasina expressed in Bacillus licheniformis; and serine protease (trypsin) from Fusarium oxysporum expressed in Fusarium venenatum) and 16 groups of flavouring agents (aliphatic and aromatic amines and amides; aliphatic and aromatic ethers; aliphatic hydrocarbons, alcohols, aldehydes, ketones, carboxylic acids and related esters, sulfides, disulfides and ethers containing furan substitution; aliphatic linear alpha,beta-unsaturated aldehydes, acids and related alcohols, acetals and esters; amino acids and related substances; epoxides; furfuryl alcohol and related substances; linear and branched-chain aliphatic, unsaturated, unconjugated alcohols, aldehydes, acids and related esters; miscellaneous nitrogen-containing substances; phenol and phenol derivatives; pyrazine derivatives; pyridine, pyrrole and quinoline derivatives; saturated aliphatic acyclic branched-chain primary alcohols, aldehydes and acids; simple aliphatic and aromatic sulfides and thiols; sulfur-containing heterocyclic compounds; and sulfur-substituted furan derivatives). Specifications for the following food additives were revised: ethyl cellulose, mineral oil (medium viscosity), modified starches and titanium

  1. Evaluation of certain food additives.

    PubMed

    2012-01-01

    This report represents the conclusions of a Joint FAO/WHO Expert Committee convened to evaluate the safety of various food additives, including flavouring agents, with a view to concluding as to safety concerns and to preparing specifications for identity and purity. The first part of the report contains a general discussion of the principles governing the toxicological evaluation of and assessment of dietary exposure to food additives, including flavouring agents. A summary follows of the Committee's evaluations of technical, toxicological and dietary exposure data for five food additives (magnesium dihydrogen diphosphate; mineral oil (medium and low viscosity) classes II and III; 3-phytase from Aspergillus niger expressed in Aspergillus niger; serine protease (chymotrypsin) from Nocardiopsis prasina expressed in Bacillus licheniformis; and serine protease (trypsin) from Fusarium oxysporum expressed in Fusarium venenatum) and 16 groups of flavouring agents (aliphatic and aromatic amines and amides; aliphatic and aromatic ethers; aliphatic hydrocarbons, alcohols, aldehydes, ketones, carboxylic acids and related esters, sulfides, disulfides and ethers containing furan substitution; aliphatic linear alpha,beta-unsaturated aldehydes, acids and related alcohols, acetals and esters; amino acids and related substances; epoxides; furfuryl alcohol and related substances; linear and branched-chain aliphatic, unsaturated, unconjugated alcohols, aldehydes, acids and related esters; miscellaneous nitrogen-containing substances; phenol and phenol derivatives; pyrazine derivatives; pyridine, pyrrole and quinoline derivatives; saturated aliphatic acyclic branched-chain primary alcohols, aldehydes and acids; simple aliphatic and aromatic sulfides and thiols; sulfur-containing heterocyclic compounds; and sulfur-substituted furan derivatives). Specifications for the following food additives were revised: ethyl cellulose, mineral oil (medium viscosity), modified starches and titanium

  2. Additive monitoring and interactions during copper electroprocessing

    NASA Astrophysics Data System (ADS)

    Collins, Dale Wade

    The electrochemical deposition of copper has been a major focus of research for decades. Renewed interest in copper electroplating is not limited to the copper producers but is also a major concern of semiconductor manufacturers. The focus on copper electrochemistry by the semiconductor manufacturers has increased since IBM's announcement in 1997 that copper will be used for metallization in high speed/power semiconductors [1--3]. The desire to use copper instead of aluminum is simply a reflection on copper's superior conductivity (lower RC time constants) and resistance to electromigration (generally proportional to the melting point). This dissertation is the compilation of the research into analytical techniques for monitoring surface-active additives in common sulfuric acid/copper sulfate plating baths. Chronopotentiometric, DC and AC voltammetry were the major analytical techniques used in this research. Several interactions between the additives will also be presented along with their apparent decline in activity. The decline in activity is well known in the industry and is also detected by these methods as presented in chapters 4 and 5. Finally, a systemic approach for monitoring the additive Galactosal, which is commonly used in electrowinning, will be outlined. The monitoring system proposed herein would have to be adjusted for each electrowinning facility because each has a unique chemistry and cell configuration.

  3. Bond additivity corrections for quantum chemistry methods

    SciTech Connect

    C. F. Melius; M. D. Allendorf

    1999-04-01

    In the 1980's, the authors developed a bond-additivity correction procedure for quantum chemical calculations called BAC-MP4, which has proven reliable in calculating the thermochemical properties of molecular species, including radicals as well as stable closed-shell species. New Bond Additivity Correction (BAC) methods have been developed for the G2 method, BAC-G2, as well as for a hybrid DFT/MP2 method, BAC-Hybrid. These BAC methods use a new form of BAC corrections, involving atomic, molecular, and bond-wise additive terms. These terms enable one to treat positive and negative ions as well as neutrals. The BAC-G2 method reduces errors in the G2 method due to nearest-neighbor bonds. The parameters within the BAC-G2 method only depend on atom types. Thus the BAC-G2 method can be used to determine the parameters needed by BAC methods involving lower levels of theory, such as BAC-Hybrid and BAC-MP4. The BAC-Hybrid method should scale well for large molecules. The BAC-Hybrid method uses the differences between the DFT and MP2 as an indicator of the method's accuracy, while the BAC-G2 method uses its internal methods (G1 and G2MP2) to provide an indicator of its accuracy. Indications of the average error as well as worst cases are provided for each of the BAC methods.

  4. Decontamination formulation with sorbent additive

    DOEpatents

    Tucker; Mark D. , Comstock; Robert H.

    2007-10-16

    A decontamination formulation and method of making that neutralizes the adverse health effects of both chemical and biological compounds, especially chemical warfare (CW) and biological warfare (BW) agents, and toxic industrial chemicals. The formulation provides solubilizing compounds that serve to effectively render the chemical and biological compounds, particularly CW and BW compounds, susceptible to attack, and at least one reactive compound that serves to attack (and detoxify or kill) the compound. The formulation includes at least one solubilizing agent, a reactive compound, a bleaching activator, a sorbent additive, and water. The highly adsorbent, water-soluble sorbent additive (e.g., sorbitol or mannitol) is used to "dry out" one or more liquid ingredients, such as the liquid bleaching activator (e.g., propylene glycol diacetate or glycerol diacetate) and convert the activator into a dry, free-flowing powder that has an extended shelf life, and is more convenient to handle and mix in the field.

  5. Additive-free digital microfluidics.

    PubMed

    Freire, Sergio L S; Tanner, Brendan

    2013-07-16

    Digital microfluidics, a technique for manipulation of droplets, is becoming increasingly important for the development of miniaturized platforms for laboratory processes. Despite the enthusiasm, droplet motion is frequently hindered by the desorption of proteins or other analytes to surfaces. Current approaches to minimize this unwanted surface fouling involve the addition of extra species to the droplet or its surroundings, which might be problematic depending on the droplet content. Here, a new strategy is introduced to move droplets containing cells and other analytes on solid substrates, without extra moieties; in particular, droplets with bovine serum albumin could be moved at a concentration 2000 times higher than previously reported (without additives). This capability is achieved by using a soot-based superamphiphobic surface combined with a new device geometry, which favors droplet rolling. Contrasting with electrowetting, wetting forces are not required for droplet motion.

  6. Additive concentrates for distillate fuels

    SciTech Connect

    Rossi, A.; Lewtas, K.

    1985-08-27

    An additive concentrate for incorporation into wax containing petroleum fuel oil compositions to improve low temperature flow properties comprising an oil solution containing: 3% to 90 wt. % of a C30-C300 oil-soluble nitrogen compound wax crystal growth inhibitor having at least one straight C8-C40 alkyl chain and partial esters, and at least one mole per mole of an organic acid capable of hydrogen bonding to improve the solubility in the oil.

  7. Additive manufacturing of hybrid circuits

    DOE PAGES

    Bell, Nelson S.; Sarobol, Pylin; Cook, Adam; Clem, Paul G.; Keicher, David M.; Hirschfeld, Deidre; Hall, Aaron Christopher

    2016-03-26

    There is a rising interest in developing functional electronics using additively manufactured components. Considerations in materials selection and pathways to forming hybrid circuits and devices must demonstrate useful electronic function; must enable integration; and must complement the complex shape, low cost, high volume, and high functionality of structural but generally electronically passive additively manufactured components. This article reviews several emerging technologies being used in industry and research/development to provide integration advantages of fabricating multilayer hybrid circuits or devices. First, we review a maskless, noncontact, direct write (DW) technology that excels in the deposition of metallic colloid inks for electrical interconnects.more » Second, we review a complementary technology, aerosol deposition (AD), which excels in the deposition of metallic and ceramic powder as consolidated, thick conformal coatings and is additionally patternable through masking. As a result, we show examples of hybrid circuits/devices integrated beyond 2-D planes, using combinations of DW or AD processes and conventional, established processes.« less

  8. Evaluation of certain food additives.

    PubMed

    2009-01-01

    This report represents the conclusions of a Joint FAO/WHO Expert Committee convened to evaluate the safety of various food additives, including flavouring agents, with a view to recommending acceptable daily intakes (ADIs) and to preparing specifications for identity and purity. The first part of the report contains a general discussion of the principles governing the toxicological evaluation and assessment of intake of food additives (in particular, flavouring agents). A summary follows of the Committee's evaluations of technical, toxicological and intake data for certain food additives (asparaginase from Aspergillus niger expressed in A. niger, calcium lignosulfonate (40-65), ethyl lauroyl arginate, paprika extract, phospholipase C expressed in Pichia pastoris, phytosterols, phytostanols and their esters, polydimethylsiloxane, steviol glycosides and sulfites [assessment of dietary exposure]) and 10 groups of related flavouring agents (aliphatic branched-chain saturated and unsaturated alcohols, aldehydes, acids and related esters; aliphatic linear alpha,beta-unsaturated aldehydes, acids and related alcohols, acetals and esters; aliphatic secondary alcohols, ketones and related esters; alkoxy-substituted allylbenzenes present in foods and essential oils and used as flavouring agents; esters of aliphatic acyclic primary alcohols with aliphatic linear saturated carboxylic acids; furan-substituted aliphatic hydrocarbons, alcohols, aldehydes, ketones, carboxylic acids and related esters, sulfides, disulfides and ethers; miscellaneous nitrogen-containing substances; monocyclic and bicyclic secondary alcohols, ketones and related esters; hydroxy- and alkoxy-substituted benzyl derivatives; and substances structurally related to menthol). Specifications for the following food additives were revised: canthaxanthin; carob bean gum and carob bean gum (clarified); chlorophyllin copper complexes, sodium and potassium salts; Fast Green FCF; guar gum and guar gum (clarified

  9. Fire-Retardant Polymeric Additives

    NASA Technical Reports Server (NTRS)

    Williams, Martha K.; Smith, Trent M.

    2011-01-01

    Polyhydroxyamide (PHA) and polymethoxyamide (PMeOA) are fire-retardant (FR) thermoplastic polymers and have been found to be useful as an additive for imparting fire retardant properties to other compatible, thermoplastic polymers (including some elastomers). Examples of compatible flammable polymers include nylons, polyesters, and acrylics. Unlike most prior additives, PHA and PMeOA do not appreciably degrade the mechanical properties of the matrix polymer; indeed, in some cases, mechanical properties are enhanced. Also, unlike some prior additives, PHA and PMeOA do not decompose into large amounts of corrosive or toxic compounds during combustion and can be processed at elevated temperatures. PMeOA derivative formulations were synthesized and used as an FR additive in the fabrication of polyamide (PA) and polystyrene (PS) composites with notable reduction (>30 percent for PS) in peak heat release rates compared to the neat polymer as measured by a Cone Calorimeter (ASTM E1354). Synergistic effects were noted with nanosilica composites. These nanosilica composites had more than 50-percent reduction in peak heat release rates. In a typical application, a flammable thermoplastic, thermoplastic blend, or elastomer that one seeks to render flame-retardant is first dry-mixed with PHA or PMeOA or derivative thereof. The proportion of PHA or PMeOA or derivative in the mixture is typically chosen to lie between 1 and 20 weight percent. The dry blend can then be melt-extruded. The extruded polymer blend can further be extruded and/or molded into fibers, pipes, or any other of a variety of objects that may be required to be fire-retardant. The physical and chemical mechanisms which impart flame retardancy of the additive include inhibiting free-radical oxidation in the vapor phase, preventing vaporization of fuel (the polymer), and cooling through the formation of chemical bonds in either the vapor or the condensed phase. Under thermal stress, the cyclic hydroxyl/ methoxy

  10. Smolt Monitoring at the Head of Lower Granite Reservoir and Lower Granite Dam, 1994 Annual Report.

    SciTech Connect

    Buettner, Edwin W.; Brimmer, Arnold F.

    1994-10-01

    This project monitored the daily passage of chinook salmon Oncorhynchus tshawytscha and steelhead trout O. mykiss smolts during the 1994 spring outmigration at migrant traps on the Snake River, Clearwater River, and Salmon River. The 1994 snowpack was among the lowest since the beginning of the present drought, and the subsequent runoff was very poor. All hatchery chinook salmon released above Lower Granite Dam were marked with a fin clip in 1994. Total annual (hatchery + wild) chinook salmon catch at the Snake River trap was 1.5 times greater than in 1993. Hatchery and wild steelhead trout catches were similar to 1993. The Snake River trap collected 30 age 0 chinook salmon. Hatchery chinook salmon catch at the Clearwater River trap was 3.5 times higher than in 1993, and wild chinook salmon catch was 4.2 times higher. Hatchery steelhead trout trap catch was less than half of 1993 numbers because the trap was fishing near the north shore during the majority of the hatchery steelhead movement due to flow augmentations from Dworshak. Wild steelhead trout trap catch was 2 times higher than in 1993. The Salmon River trap was operated for about a month longer in 1994 than in 1993 due to extremely low flows. Hatchery chinook salmon catch was 1.4 times greater in 1994 than the previous year. Wild chinook salmon catch was slightly less in 1994. The 1994 hatchery steelhead trout collection did not change significantly from 1993 numbers. Wild steelhead trout collection in 1994 was 59% of the 1993 catch. Fish tagged with Passive Integrated Transponder (PIT) tags at the Snake River trap were interrogated at four dams with PIT tag detection systems (Lower Granite, Little Goose, Lower Monumental, and McNary dams). Because of the addition of the fourth interrogation site (Lower Monumental) in 1993, cumulative interrogation data is not comparable with the prior five years (1988-1992).

  11. Additive manufacturing of biologically-inspired materials.

    PubMed

    Studart, André R

    2016-01-21

    Additive manufacturing (AM) technologies offer an attractive pathway towards the fabrication of functional materials featuring complex heterogeneous architectures inspired by biological systems. In this paper, recent research on the use of AM approaches to program the local chemical composition, structure and properties of biologically-inspired materials is reviewed. A variety of structural motifs found in biological composites have been successfully emulated in synthetic systems using inkjet-based, direct-writing, stereolithography and slip casting technologies. The replication in synthetic systems of design principles underlying such structural motifs has enabled the fabrication of lightweight cellular materials, strong and tough composites, soft robots and autonomously shaping structures with unprecedented properties and functionalities. Pushing the current limits of AM technologies in future research should bring us closer to the manufacturing capabilities of living organisms, opening the way for the digital fabrication of advanced materials with superior performance, lower environmental impact and new functionalities.

  12. Denitrification with carbon addition--kinetic considerations.

    PubMed

    Dold, P; Takács, I; Mokhayeri, Y; Nichols, A; Hinojosa, J; Riffat, R; Bott, C; Bailey, W; Murthy, S

    2008-05-01

    The Blue Plains Advanced Wastewater Treatment Plant (Washington, D.C.) uses methanol as an external carbon source in a postdenitrification process, to achieve low effluent total nitrogen concentrations. This becomes more difficult in winter, at lower mixed liquor temperatures and higher flows, as a consequence of the kinetic behavior of the methanol-utilizing heterotrophs. The paper reports on an experimental batch test study conducted on Blue Plains postdenitrification sludge to investigate (1) the maximum specific growth rate of methanol-utilizing heterotrophs (Mu(METH)); (2) the temperature dependency of the growth rate; and (3) the efficacy of alternate substrates (ethanol, acetate, and sugar). A limited number of tests were conducted on sludge from two other treatment plants with methanol addition. PMID:18605381

  13. Acute toxicity of gasoline and some additives.

    PubMed Central

    Reese, E; Kimbrough, R D

    1993-01-01

    The acute toxicity of gasoline; its components benzene, toluene, and xylene; and the additives ethanol, methanol, and methyl tertiary butyl ether are reviewed. All of these chemicals are only moderately to mildly toxic at acute doses. Because of their volatility, these compounds are not extensively absorbed dermally unless the exposed skin is occluded. Absorption through the lungs and the gastrointestinal tract is quite efficient. After ingestion, the principal danger for a number of these chemicals, particularly gasoline, is aspiration pneumonia, which occurs mainly in children. It is currently not clear whether aspiration pneumonia would still be a problem if gasoline were diluted with ethanol or methanol. During the normal use of gasoline or mixtures of gasoline and the other solvents as a fuel, exposures would be much lower than the doses that have resulted in poisoning. No acute toxic health effects would occur during the normal course of using automotive fuels. PMID:8020435

  14. Dielectric breakdown of additively manufactured polymeric materials

    DOE PAGES

    Monzel, W. Jacob; Hoff, Brad W.; Maestas, Sabrina S.; French, David M.; Hayden, Steven C.

    2016-01-11

    Dielectric strength testing of selected Polyjet-printed polymer plastics was performed in accordance with ASTM D149. This dielectric strength data is compared to manufacturer-provided dielectric strength data for selected plastics printed using the stereolithography (SLA), fused deposition modeling (FDM), and selective laser sintering (SLS) methods. Tested Polyjet samples demonstrated dielectric strengths as high as 47.5 kV/mm for a 0.5 mm thick sample and 32.1 kV/mm for a 1.0 mm sample. As a result, the dielectric strength of the additively manufactured plastics evaluated as part of this study was lower than the majority of non-printed plastics by at least 15% (with themore » exception of polycarbonate).« less

  15. Acute toxicity of gasoline and some additives

    SciTech Connect

    Reese, E.; Kimbrough, R.D.

    1993-12-01

    The acute toxicity of gasoline; its components benzene, toluene, and xylene; and the additives ethanol, methanol, and methyl tertiary butyl ether are reviewed. All of these chemicals are only moderately to mildly toxic at acute doses. Because of their volatility, these compounds are not extensively absorbed dermally unless the exposed skin is occluded. Absorption through the lungs and the gastrointestinal tract is quite efficient. After ingestion, the principal danger for a number of these chemicals, particularly gasoline, is aspiration pneumonia, which occurs mainly in children. It is currently not clear whether aspiration pneumonia would still be a problem if gasoline were diluted with ethanol or methanol. During the normal use of gasoline or mixtures of gasoline and the other solvents as a fuel, exposures would be much lower than the doses that have resulted in poisoning. No acute toxic health effects would occur during the normal course of using automotive fuels. 128 refs., 7 tabs.

  16. Design and rationale of the LAPLACE-TIMI 57 trial: a phase II, double-blind, placebo-controlled study of the efficacy and tolerability of a monoclonal antibody inhibitor of PCSK9 in subjects with hypercholesterolemia on background statin therapy.

    PubMed

    Kohli, Payal; Desai, Nihar R; Giugliano, Robert P; Kim, Jae B; Somaratne, Ransi; Huang, Fannie; Knusel, Beat; McDonald, Shannon; Abrahamsen, Timothy; Wasserman, Scott M; Scott, Robert; Sabatine, Marc S

    2012-01-01

    Lowering low-density lipoprotein cholesterol (LDL-C) is a cornerstone for the prevention of atherosclerotic heart disease, improving clinical outcomes and reducing vascular mortality in patients with hypercholesterolemia. The clinical benefits of LDL-C reduction appear to extend even to patients starting with LDL-C as low as 60-80 mg/dL prior to initiating therapy. Statins are the first-line agents for treating hypercholesterolemia and are effective in reducing LDL-C, but many patients are unable to achieve their optimal lipid targets despite intensive statin therapy. Therefore, there has been a strong impetus for the development of novel pharmacologic agents designed to lower LDL-C further in patients already on statin therapy. Genetic mutations resulting in altered cholesterol homeostasis provide valuable information regarding novel approaches for treating hypercholesterolemia. To that end, mutations in proprotein convertase subtilisin/kexin type 9 (PCSK9) were linked to altered levels of LDL-C, illustrating this protein's role in lipid metabolism. PCSK9 promotes degradation of the LDL receptor, preventing its transport back to the cell surface and thereby increasing circulating LDL-C. Conversely, inhibition of PCSK9 can profoundly decrease circulating LDL-C, and thus is an attractive new target for LDL-C-lowering therapy. AMG 145 is a fully human monoclonal immunoglobulin G2 antibody that binds specifically to human PCSK9 and inhibits its interaction with the low-density lipoprotein receptor. In this manuscript, we describe the rationale and design of LDL-C Assessment with PCSK9 Monoclonal Antibody Inhibition Combined With Statin Therapy-Thrombolysis In Myocardial Infarction 57 (LAPLACE-TIMI 57; NCT01380730), a 12-week, randomized, double-blind, dose-ranging, placebo-controlled study designed to assess the safety and efficacy of AMG 145 when added to statin therapy in patients with hypercholesterolemia.

  17. Metal Additive Manufacturing: A Review

    NASA Astrophysics Data System (ADS)

    Frazier, William E.

    2014-06-01

    This paper reviews the state-of-the-art of an important, rapidly emerging, manufacturing technology that is alternatively called additive manufacturing (AM), direct digital manufacturing, free form fabrication, or 3D printing, etc. A broad contextual overview of metallic AM is provided. AM has the potential to revolutionize the global parts manufacturing and logistics landscape. It enables distributed manufacturing and the productions of parts-on-demand while offering the potential to reduce cost, energy consumption, and carbon footprint. This paper explores the material science, processes, and business consideration associated with achieving these performance gains. It is concluded that a paradigm shift is required in order to fully exploit AM potential.

  18. Individualized additional instruction for calculus

    NASA Astrophysics Data System (ADS)

    Takata, Ken

    2010-10-01

    College students enrolling in the calculus sequence have a wide variance in their preparation and abilities, yet they are usually taught from the same lecture. We describe another pedagogical model of Individualized Additional Instruction (IAI) that assesses each student frequently and prescribes further instruction and homework based on the student's performance. Our study compares two calculus classes, one taught with mandatory remedial IAI and the other without. The class with mandatory remedial IAI did significantly better on comprehensive multiple-choice exams, participated more frequently in classroom discussion and showed greater interest in theorem-proving and other advanced topics.

  19. The Mozart Effect: Additional Data.

    PubMed

    Hughes, John R.

    2002-04-01

    After the review of the Mozart effect was published in this journal (Hughes JR. Epilepsy Behav 2001;2:369-417), additional data from the music of Haydn and Liszt have been analyzed that may account for the decrease in seizure activity originally reported during Mozart music. Even with these added data Mozart music continued to score significantly higher than the selections from the other six composers in one of the important characteristics of this music, namely, the repetition of the melody. However Haydn's values were second highest among Mozart, J. S. Bach, Wagner, Beethoven, Chopin, and Liszt.

  20. 43. INTERIOR VIEW, CRUSHING ADDITION. THE SYMONS VIBRATING SCREEN SITS ...

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

    43. INTERIOR VIEW, CRUSHING ADDITION. THE SYMONS VIBRATING SCREEN SITS ON TOP OF THE PLATFORM. OVERSIZE ORE IS FED BY CHUTE TO THE GYRATORY SECONDARY CRUSHER (MISSING) SITTING ON CONCRETE FOUNDATIONS TO LOWER RIGHT. UNDERSIZE ORE WAS FED BY THE LOWER CHUTE (CENTER LEFT) TO THE 24 INCH BELT CONVEYOR UNDER THE SECONDARY CRUSHER. THE DRYER ROOM IS BEYOND. - Bald Mountain Gold Mill, Nevada Gulch at head of False Bottom Creek, Lead, Lawrence County, SD

  1. Can Stress Lower a Woman's Fertility?

    MedlinePlus

    ... https://medlineplus.gov/news/fullstory_161057.html Can Stress Lower a Woman's Fertility? Greatest impact is around ... HealthDay News) -- New research seems to confirm that stress lowers a woman's chances of becoming pregnant, particularly ...

  2. Augmented amputations of the lower extremity.

    PubMed

    Mohler, D G; Kessler, J I; Earp, B E

    2000-02-01

    Ten patients who had amputations of a lower extremity for high-grade sarcomas underwent bone augmentation with either allograft or autograft between 1988 and 1996. There were eight transfemoral amputations and two transtibial amputations. The transferred segments consisted of one proximal tibia and six distal tibia autografts, two allografts, one autograft talar dome and first metatarsal, and one with a patellar cap of a supracondylar amputation. The average length of followup was 54 months. There were no nonunions of any of the grafts. There were three wound problems requiring additional operations. One autograft resorbed, and one autograft had a late infection. There was one local recurrence. Augmentation to provide length resulted in a 42% increase in bone length in those performed purely for length. All patients were able to use standard prostheses. Functional outcome was appropriate to the amputation level. Half of the patients avoided more proximal levels of amputation because of the ability to augment the osteotomy. The use of nonvascularized structural autografts or allografts is a simple procedure that can produce a superior residual limb in patients undergoing amputation. Its use should be considered in patients for whom traditional amputation techniques will result in poor function, difficulty in fitting a prosthesis, or greater than necessary anatomic loss. PMID:10693566

  3. [Roman medical instruments from Lower Moesia].

    PubMed

    Aparaschivei, D; Matei, I

    2010-01-01

    To elucidate the evolution of society over time, ancient medicine is a very interesting and important researching field. Archaeological discoveries, such as the objects described by this article, but other ancient sources, also, are able to provide a complex framework of medical practice in Roman times. The geographic area that we have like target in this material is the province of Lower Moesia, which includes the territory between Danube and Black Sea (Romanian Dobrodja) and northern Bulgaria. In the present study we present nine ancient medical instruments, from a private collection: two tweezers, two ear probes, a probe-spatula, a probe-spoon, a spoon for pharmacy and two fragments of some kind of hooks used in surgical operations. Most likely, we have a mixed medical kit with tools used in general medicine, surgery, in preparation of the pharmaceutical treatments, but very possible, also, in cosmetic practices. Publication of these archaeological materials is, in addition to an extra page in the history of ancient medicine, a pretext for stepping up in a research field that, in other regions of the former Roman Empire, it is a great interest for researchers.

  4. Additive manufacturing of RF absorbers

    NASA Astrophysics Data System (ADS)

    Mills, Matthew S.

    The ability of additive manufacturing techniques to fabricate integrated electromagnetic absorbers tuned for specific radio frequency bands within structural composites allows for unique combinations of mechanical and electromagnetic properties. These composites and films can be used for RF shielding of sensitive electromagnetic components through in-plane and out-of-plane RF absorption. Structural composites are a common building block of many commercial platforms. These platforms may be placed in situations in which there is a need for embedded RF absorbing properties along with structural properties. Instead of adding radar absorbing treatments to the external surface of existing structures, which adds increased size, weight and cost; it could prove to be advantageous to integrate the microwave absorbing properties directly into the composite during the fabrication process. In this thesis, a method based on additive manufacturing techniques of composites structures with prescribed electromagnetic loss, within the frequency range 1 to 26GHz, is presented. This method utilizes screen printing and nScrypt micro dispensing to pattern a carbon based ink onto low loss substrates. The materials chosen for this study will be presented, and the fabrication technique that these materials went through to create RF absorbing structures will be described. The calibration methods used, the modeling of the RF structures, and the applications in which this technology can be utilized will also be presented.

  5. Fuel Additives: Canada bans MMT

    SciTech Connect

    Sissell, K.

    1997-04-16

    The Canadian Senate voted late last week to ban use of the manganese-based fuel additive MMT, produced only in the US by Ethyl. MMT, which has been sold in Canada for the past 20 years and accounts for about half of Ethyl`s Canadian sales, has been criticized by environmentalists, who have raised public health concerns, and automakers, who say it harms emission control systems. {open_quotes}Canada`s vote is a great victory for public health and the environment,{close_quotes} says Environmental Defense Fund executive director Fred Krupp. {open_quotes}The US should move swiftly to follow suit and suspend sales of MMT until adequate toxicity testing on the additive is completed.{close_quotes} EPA had refused to approve MMT for sale because of health concerns but was compelled to do so by a December 1995 court ruling. Ethyl asserts the ban violates Canada`s obligations under Nafta and says it will file a damage claim with the Nafta arbitration panel.

  6. Structure design of lower limb exoskeletons for gait training

    NASA Astrophysics Data System (ADS)

    Li, Jianfeng; Zhang, Ziqiang; Tao, Chunjing; Ji, Run

    2015-09-01

    Due to the close physical interaction between human and machine in process of gait training, lower limb exoskeletons should be safe, comfortable and able to smoothly transfer desired driving force/moments to the patients. Correlatively, in kinematics the exoskeletons are required to be compatible with human lower limbs and thereby to avoid the uncontrollable interactional loads at the human-machine interfaces. Such requirement makes the structure design of exoskeletons very difficult because the human-machine closed chains are complicated. In addition, both the axis misalignments and the kinematic character difference between the exoskeleton and human joints should be taken into account. By analyzing the DOF(degree of freedom) of the whole human-machine closed chain, the human-machine kinematic incompatibility of lower limb exoskeletons is studied. An effective method for the structure design of lower limb exoskeletons, which are kinematically compatible with human lower limb, is proposed. Applying this method, the structure synthesis of the lower limb exoskeletons containing only one-DOF revolute and prismatic joints is investigated; the feasible basic structures of exoskeletons are developed and classified into three different categories. With the consideration of quasi-anthropopathic feature, structural simplicity and wearable comfort of lower limb exoskeletons, a joint replacement and structure comparison based approach to select the ideal structures of lower limb exoskeletons is proposed, by which three optimal exoskeleton structures are obtained. This paper indicates that the human-machine closed chain formed by the exoskeleton and human lower limb should be an even-constrained kinematic system in order to avoid the uncontrollable human-machine interactional loads. The presented method for the structure design of lower limb exoskeletons is universal and simple, and hence can be applied to other kinds of wearable exoskeletons.

  7. Neutron Characterization for Additive Manufacturing

    NASA Technical Reports Server (NTRS)

    Watkins, Thomas; Bilheux, Hassina; An, Ke; Payzant, Andrew; DeHoff, Ryan; Duty, Chad; Peter, William; Blue, Craig; Brice, Craig A.

    2013-01-01

    Oak Ridge National Laboratory (ORNL) is leveraging decades of experience in neutron characterization of advanced materials together with resources such as the Spallation Neutron Source (SNS) and the High Flux Isotope Reactor (HFIR) shown in Fig. 1 to solve challenging problems in additive manufacturing (AM). Additive manufacturing, or three-dimensional (3-D) printing, is a rapidly maturing technology wherein components are built by selectively adding feedstock material at locations specified by a computer model. The majority of these technologies use thermally driven phase change mechanisms to convert the feedstock into functioning material. As the molten material cools and solidifies, the component is subjected to significant thermal gradients, generating significant internal stresses throughout the part (Fig. 2). As layers are added, inherent residual stresses cause warping and distortions that lead to geometrical differences between the final part and the original computer generated design. This effect also limits geometries that can be fabricated using AM, such as thin-walled, high-aspect- ratio, and overhanging structures. Distortion may be minimized by intelligent toolpath planning or strategic placement of support structures, but these approaches are not well understood and often "Edisonian" in nature. Residual stresses can also impact component performance during operation. For example, in a thermally cycled environment such as a high-pressure turbine engine, residual stresses can cause components to distort unpredictably. Different thermal treatments on as-fabricated AM components have been used to minimize residual stress, but components still retain a nonhomogeneous stress state and/or demonstrate a relaxation-derived geometric distortion. Industry, federal laboratory, and university collaboration is needed to address these challenges and enable the U.S. to compete in the global market. Work is currently being conducted on AM technologies at the ORNL

  8. Additives in fibers and fabrics.

    PubMed

    Barker, R H

    1975-06-01

    The additives and contaminants which occur in textile fibers vary widely, depending on the type of fiber and the pretreatment which it has received. Synthetic fibers such as nylon and polyester contain trace amounts of contaminants such as catalysts and catalyst deactivators which remain after the synthesis of the basic polymers. In addition, there are frequently a number of materials which are added to perform specific functions in almost all man-made fibers. Examples of these would include traces of metals or metal salts used as tracers for identification of specific lots of fiber, TiO2 or similar materials added as delustrants, and a host of organic species added for such special purposes as antistatic agents or flame retardants. There may also be considerable quantities of residual monomer or small oligomers dissolved in the polymer matrix. The situation becomes even more complex after the fibers are converted into fabric form. Numerous materials are applied at various stages of fabric preparation to act as lubricants, sizing agents, antistats, bleaches, and wetting agents to facilitate the processing, but these are normally removed before the fabric reaches the cutters of the ultimate consumers and therefore usually do not constitute potential hazards. However, there are many other chemical agents which are frequently added during the later stages of fabric preparation and which are not designed to be removed. Aside from dyes and printing pigments, the most common additive for apparel fabrics is a durable press treatment. This generally involves the use of materials capable of crosslinking cellulosics by reacting through such functions as N-methylolated amides or related compounds such as ureas and carbamates. These materials pose some potential hazards due to both the nitrogenous bases and the formaldehyde which they usually release. There is usually also some residual catalyst in fabrics which have received such treatments. Other types of chemical treatments

  9. Additives in fibers and fabrics.

    PubMed Central

    Barker, R H

    1975-01-01

    The additives and contaminants which occur in textile fibers vary widely, depending on the type of fiber and the pretreatment which it has received. Synthetic fibers such as nylon and polyester contain trace amounts of contaminants such as catalysts and catalyst deactivators which remain after the synthesis of the basic polymers. In addition, there are frequently a number of materials which are added to perform specific functions in almost all man-made fibers. Examples of these would include traces of metals or metal salts used as tracers for identification of specific lots of fiber, TiO2 or similar materials added as delustrants, and a host of organic species added for such special purposes as antistatic agents or flame retardants. There may also be considerable quantities of residual monomer or small oligomers dissolved in the polymer matrix. The situation becomes even more complex after the fibers are converted into fabric form. Numerous materials are applied at various stages of fabric preparation to act as lubricants, sizing agents, antistats, bleaches, and wetting agents to facilitate the processing, but these are normally removed before the fabric reaches the cutters of the ultimate consumers and therefore usually do not constitute potential hazards. However, there are many other chemical agents which are frequently added during the later stages of fabric preparation and which are not designed to be removed. Aside from dyes and printing pigments, the most common additive for apparel fabrics is a durable press treatment. This generally involves the use of materials capable of crosslinking cellulosics by reacting through such functions as N-methylolated amides or related compounds such as ureas and carbamates. These materials pose some potential hazards due to both the nitrogenous bases and the formaldehyde which they usually release. There is usually also some residual catalyst in fabrics which have received such treatments. Other types of chemical treatments

  10. An Additive Manufacturing Test Artifact.

    PubMed

    Moylan, Shawn; Slotwinski, John; Cooke, April; Jurrens, Kevin; Donmez, M Alkan

    2014-01-01

    A test artifact, intended for standardization, is proposed for the purpose of evaluating the performance of additive manufacturing (AM) systems. A thorough analysis of previously proposed AM test artifacts as well as experience with machining test artifacts have inspired the design of the proposed test artifact. This new artifact is designed to provide a characterization of the capabilities and limitations of an AM system, as well as to allow system improvement by linking specific errors measured in the test artifact to specific sources in the AM system. The proposed test artifact has been built in multiple materials using multiple AM technologies. The results of several of the builds are discussed, demonstrating how the measurement results can be used to characterize and improve a specific AM system. PMID:26601039

  11. An Additive Manufacturing Test Artifact

    PubMed Central

    Moylan, Shawn; Slotwinski, John; Cooke, April; Jurrens, Kevin; Donmez, M Alkan

    2014-01-01

    A test artifact, intended for standardization, is proposed for the purpose of evaluating the performance of additive manufacturing (AM) systems. A thorough analysis of previously proposed AM test artifacts as well as experience with machining test artifacts have inspired the design of the proposed test artifact. This new artifact is designed to provide a characterization of the capabilities and limitations of an AM system, as well as to allow system improvement by linking specific errors measured in the test artifact to specific sources in the AM system. The proposed test artifact has been built in multiple materials using multiple AM technologies. The results of several of the builds are discussed, demonstrating how the measurement results can be used to characterize and improve a specific AM system. PMID:26601039

  12. SIPSEY WILDERNESS AND ADDITIONS, ALABAMA.

    USGS Publications Warehouse

    Schweinfurth, Stanley P.; Mory, Peter C.

    1984-01-01

    On the basis of geologic, geochemical, and mineral surveys the Sipsey Wilderness and additions are deemed to have little promise for the occurrence of metallic mineral resources. Although limestone, shale, and sandstone resources that occur in the area are physically suitable for a variety of uses, similar materials are available outside the area closer to transportation routes and potential markets. A small amount of coal has been identified in the area, occurring as nonpersistent beds less than 28 in. thick. Oil and (or) natural gas resources may be present if suitable structural traps exist in the subsurface. Therefore, the area has a probable oil and gas potential. Small amounts of asphaltic sandstone and limestone, commonly referred to as tar sands, may also occur in the subsurface. 5 refs.

  13. An Additive Manufacturing Test Artifact.

    PubMed

    Moylan, Shawn; Slotwinski, John; Cooke, April; Jurrens, Kevin; Donmez, M Alkan

    2014-01-01

    A test artifact, intended for standardization, is proposed for the purpose of evaluating the performance of additive manufacturing (AM) systems. A thorough analysis of previously proposed AM test artifacts as well as experience with machining test artifacts have inspired the design of the proposed test artifact. This new artifact is designed to provide a characterization of the capabilities and limitations of an AM system, as well as to allow system improvement by linking specific errors measured in the test artifact to specific sources in the AM system. The proposed test artifact has been built in multiple materials using multiple AM technologies. The results of several of the builds are discussed, demonstrating how the measurement results can be used to characterize and improve a specific AM system.

  14. A novel addition polyimide adhesive

    NASA Technical Reports Server (NTRS)

    St.clair, T. L.; Progar, D. J.

    1981-01-01

    An addition polyimide adhesive, LARC 13, was developed which shows promise for bonding both titanium and composites for applications which require service temperatures in excess of 533 K. The LARC 13 is based on an oligomeric bis nadimide containing a meta linked aromatic diamine. The adhesive melts prior to polymerization due to its oligomeric nature, thereby allowing it to be processed at 344 kPa or less. Therefore, LARC 13 is ideal for the bonding of honeycomb sandwich structures. After melting, the resin thermosets during the cure of the nadic endcaps to a highly crosslinked system. Few volatiles are evolved, thus allowing large enclosed structures to be bonded. Preparation of the adhesive as well as bonding, aging, and testing of lap shear and honeycomb samples are discussed.

  15. Adverse reactions to food additives.

    PubMed

    Simon, R A

    1986-01-01

    There are thousands of agents that are intentionally added to the food that we consume. These include preservatives, stabilizers, conditioners, thickeners, colorings, flavorings, sweeteners, antioxidants, etc. etc. Yet only a surprisingly small number have been associated with hypersensitivity reactions. Amongst all the additives, FD&C dyes have been most frequently associated with adverse reactions. Tartrazine is the most notorious of them all; however, critical review of the medical literature and current Scripps Clinic studies would indicate that tartrazine has been confirmed to be at best only occasionally associated with flares of urticaria or asthma. There is no convincing evidence in the literature of reactivity to the other azo or nonazo dyes. This can also be said of BHA/BHT, nitrites/nitrates and sorbates. Parabens have been shown to elicit IgE mediated hypersensitivity reactions when used as pharmaceutical preservatives; however, as with the other additives noted above, ingested parabens have only occasionally been associated with adverse reactions. MSG, the cause of the 'Chinese restaurant syndrome' has only been linked to asthma in one report. Sulfiting agents used primarily as food fresheners and to control microbial growth in fermented beverages have been established as the cause of any where from mild to severe and even fatal reactions in at least 5% of the asthmatic population. Other reactions reported to follow sulfite ingestion include anaphylaxis, gastro intestinal complaints and dermatological eruptions. The prevalence of these non asthmatic reactions is unknown. The mechanism of sulfite sensitive asthma is also unknown but most likely involves hyperreactivity to inhale SO2 in the great majority of cases; however, there are reports of IgE mediated reactions and other sulfite sensitive asthmatics have been found with low levels of sulfite oxidase; necessary to oxidize endogenous sulfite to sulfate.

  16. Additive manufacturing of glass for optical applications

    NASA Astrophysics Data System (ADS)

    Luo, Junjie; Gilbert, Luke J.; Bristow, Douglas A.; Landers, Robert G.; Goldstein, Jonathan T.; Urbas, Augustine M.; Kinzel, Edward C.

    2016-04-01

    Glasses including fused quartz have significant scientific and engineering applications including optics, communications, electronics, and hermetic seals. This paper investigates a filament fed process for Additive Manufacturing (AM) of fused quartz. Additive manufacturing has several potential benefits including increased design freedom, faster prototyping, and lower processing costs for small production volumes. However, current research in AM of glasses is limited and has focused on non-optical applications. Fused quartz is studied here because of its desirability for high-quality optics due to its high transmissivity and thermal stability. Fused quartz also has a higher working temperature than soda lime glass which poses a challenge for AM. In this work, fused quartz filaments are fed into a CO2 laser generated melt pool, smoothly depositing material onto the work piece. Single tracks are printed to explore the effects that different process parameters have on the morphology of printed fused quartz. A spectrometer is used to measure the thermal radiation incandescently emitted from the melt pool. Thin-walls are printed to study the effects of layer-to-layer height. Finally, a 3D fused quartz cube is printed using the newly acquired layer height and polished on each surface. The transmittance and index homogeneity of the polished cube are both measured. These results show that the filament fed process has the potential to print fused quartz with optical transparency and of index of refraction uniformity approaching bulk processed glass.

  17. Therapeutic Management of Familial Hypercholesterolemia: Current and Emerging Drug Therapies.

    PubMed

    Patel, Roshni S; Scopelliti, Emily M; Savelloni, Julie

    2015-12-01

    Familial hypercholesterolemia (FH) is a genetic disorder characterized by significantly elevated low-density lipoprotein cholesterol (LDL-C) concentrations that result from mutations of the LDL receptor, apolipoprotein B (apo B-100), and proprotein convertase subtilisin/kexin type 9 (PCSK9). Early and aggressive treatment can prevent premature atherosclerotic cardiovascular disease in these high-risk patients. Given that the cardiovascular consequences of FH are similar to typical hypercholesterolemia, traditional therapies are utilized to decrease LDL-C levels. Patients with FH should receive statins as first-line treatment; high-potency statins at high doses are often required. Despite the use of statins, additional treatments are often necessary to achieve appropriate LDL-C lowering in this patient population. Novel drug therapies that target the pathophysiologic defects of the condition are continuously emerging. Contemporary therapies including mipomersen (Kynamro, Genzyme), an oligonucleotide inhibitor of apo B-100 synthesis; lomitapide (Juxtapid, Aegerion), a microsomal triglyceride transfer protein inhibitor; and alirocumab (Praluent, Sanofi-Aventis/Regeneron) and evolocumab (Repatha, Amgen), PCSK9 inhibitors, are currently approved by the U.S. Food and Drug Administration for use in FH. This review highlights traditional as well as emerging contemporary therapies with supporting clinical data to evaluate current recommendations and discuss the future direction of FH management.

  18. OSLER and ODYSSEY LONG TERM: PCSK9 inhibitors on the right track of reducing cardiovascular events.

    PubMed

    Hassan, Mohamed

    2015-01-01

    Proprotein convertase subtilisin kexin 9 (PCSK9) inhibitors have emerged as a novel treatment option in patients with hypercholesterolemia. Evolocumab and alirocumab have achieved consistent and significant (around 60%) reduction in low-density lipoprotein cholesterol (LDL-C) levels when added to statin therapy in short term studies. The Open-Label Study of Long-term Evaluation Against LDL-C (OSLER), and The Long-term Safety and Tolerability of Alirocumab in High Cardiovascular Risk Patients with Hypercholesterolemia Not Adequately Controlled with Their Lipid Modifying Therapy (ODYSSEY LONG TERM) studies are two phase 3, multicentre, randomized, placebo controlled studies that were conducted to evaluate the long term efficacy and safety of evolocumab and alirocumab respectively in reducing lipids and cardiovascular (CV) events. Both studies demonstrated additional 48-53% reduction of CV events when added to statin therapy. Most adverse events occurred with similar frequency in the two groups; however the rate of neurocognitive adverse events was higher with evolocumab and alirocumab than with placebo. These data provide strong support for the notion that lower LDL-C goal is better, and may confirm the role of PCSK9 inhibitors as a new frontier in lipid management. The results of larger long-term outcome studies are still awaited.

  19. Therapeutic Management of Familial Hypercholesterolemia: Current and Emerging Drug Therapies.

    PubMed

    Patel, Roshni S; Scopelliti, Emily M; Savelloni, Julie

    2015-12-01

    Familial hypercholesterolemia (FH) is a genetic disorder characterized by significantly elevated low-density lipoprotein cholesterol (LDL-C) concentrations that result from mutations of the LDL receptor, apolipoprotein B (apo B-100), and proprotein convertase subtilisin/kexin type 9 (PCSK9). Early and aggressive treatment can prevent premature atherosclerotic cardiovascular disease in these high-risk patients. Given that the cardiovascular consequences of FH are similar to typical hypercholesterolemia, traditional therapies are utilized to decrease LDL-C levels. Patients with FH should receive statins as first-line treatment; high-potency statins at high doses are often required. Despite the use of statins, additional treatments are often necessary to achieve appropriate LDL-C lowering in this patient population. Novel drug therapies that target the pathophysiologic defects of the condition are continuously emerging. Contemporary therapies including mipomersen (Kynamro, Genzyme), an oligonucleotide inhibitor of apo B-100 synthesis; lomitapide (Juxtapid, Aegerion), a microsomal triglyceride transfer protein inhibitor; and alirocumab (Praluent, Sanofi-Aventis/Regeneron) and evolocumab (Repatha, Amgen), PCSK9 inhibitors, are currently approved by the U.S. Food and Drug Administration for use in FH. This review highlights traditional as well as emerging contemporary therapies with supporting clinical data to evaluate current recommendations and discuss the future direction of FH management. PMID:26684558

  20. OSLER and ODYSSEY LONG TERM: PCSK9 inhibitors on the right track of reducing cardiovascular events

    PubMed Central

    Hassan, Mohamed

    2015-01-01

    Proprotein convertase subtilisin kexin 9 (PCSK9) inhibitors have emerged as a novel treatment option in patients with hypercholesterolemia. Evolocumab and alirocumab have achieved consistent and significant (around 60%) reduction in low-density lipoprotein cholesterol (LDL-C) levels when added to statin therapy in short term studies. The Open-Label Study of Long-term Evaluation Against LDL-C (OSLER), and The Long-term Safety and Tolerability of Alirocumab in High Cardiovascular Risk Patients with Hypercholesterolemia Not Adequately Controlled with Their Lipid Modifying Therapy (ODYSSEY LONG TERM) studies are two phase 3, multicentre, randomized, placebo controlled studies that were conducted to evaluate the long term efficacy and safety of evolocumab and alirocumab respectively in reducing lipids and cardiovascular (CV) events. Both studies demonstrated additional 48–53% reduction of CV events when added to statin therapy. Most adverse events occurred with similar frequency in the two groups; however the rate of neurocognitive adverse events was higher with evolocumab and alirocumab than with placebo. These data provide strong support for the notion that lower LDL-C goal is better, and may confirm the role of PCSK9 inhibitors as a new frontier in lipid management. The results of larger long-term outcome studies are still awaited. PMID:26566525

  1. OSLER and ODYSSEY LONG TERM: PCSK9 inhibitors on the right track of reducing cardiovascular events.

    PubMed

    Hassan, Mohamed

    2015-01-01

    Proprotein convertase subtilisin kexin 9 (PCSK9) inhibitors have emerged as a novel treatment option in patients with hypercholesterolemia. Evolocumab and alirocumab have achieved consistent and significant (around 60%) reduction in low-density lipoprotein cholesterol (LDL-C) levels when added to statin therapy in short term studies. The Open-Label Study of Long-term Evaluation Against LDL-C (OSLER), and The Long-term Safety and Tolerability of Alirocumab in High Cardiovascular Risk Patients with Hypercholesterolemia Not Adequately Controlled with Their Lipid Modifying Therapy (ODYSSEY LONG TERM) studies are two phase 3, multicentre, randomized, placebo controlled studies that were conducted to evaluate the long term efficacy and safety of evolocumab and alirocumab respectively in reducing lipids and cardiovascular (CV) events. Both studies demonstrated additional 48-53% reduction of CV events when added to statin therapy. Most adverse events occurred with similar frequency in the two groups; however the rate of neurocognitive adverse events was higher with evolocumab and alirocumab than with placebo. These data provide strong support for the notion that lower LDL-C goal is better, and may confirm the role of PCSK9 inhibitors as a new frontier in lipid management. The results of larger long-term outcome studies are still awaited. PMID:26566525

  2. Cholesterol: the good, the bad, and the ugly - therapeutic targets for the treatment of dyslipidemia.

    PubMed

    Elshourbagy, Nabil A; Meyers, Harold V; Abdel-Meguid, Sherin S

    2014-01-01

    Maintaining cholesterol and triglyceride (TG) levels within healthy limits is critical for decreasing the risk of heart disease. Dyslipidemia refers to the abnormal levels of lipids in the blood, including low high-density lipoprotein cholesterol (HDL-C), also known as good cholesterol, high low-density lipoprotein cholesterol (LDL-C), also known as bad cholesterol, and/or high TG levels that contribute to the development and progression of atherosclerosis. In this article we reviewed some of the current therapeutic targets for the treatment of dyslipidemia, with a primary focus on endothelial lipase and lecithin cholesterol acyl transferase for raising HDL-C, and the proprotein convertase subtilisin-like kexin type 9 (PCSK9), microsomal triglyceride transfer protein, and the messenger RNA of apolipoprotein B for lowering LDL-C. In addition, we reviewed the role of apolipoprotein AI (apoAI) in raising HDL-C, where we discuss three apoAI-based drugs under development. These are its mutated dimer (apoAI-Milano), a complex with phospholipids, and a mimetic peptide. Atherosclerosis, mainly because of dyslipidemia, is a leading cause of cardiovascular disease. Regarding the title of this article, the 'good' refers to HDL-C, the 'bad' refers to LDL-C, and the 'ugly' refers to atherosclerosis. PMID:24334831

  3. Effects of psyllium on LDL-cholesterol concentrations in Brazilian children and adolescents: a randomised, placebo-controlled, parallel clinical trial.

    PubMed

    Ribas, Simone Augusta; Cunha, Diana Barbosa; Sichieri, Rosely; Santana da Silva, Luiz Carlos

    2015-01-14

    The present study investigated the LDL-cholesterol (LDL-C)-lowering effects of psyllium in Brazilian dyslipidaemic children and adolescents. A total of fifty-one individuals (6-19 years) with mild-to-moderate hypercholesterolaemia were evaluated by conducting a randomised, double-blind, placebo-controlled, parallel clinical trial. Over an 8-week trial period, the participants were randomly allocated to one of two groups (control: n 25 and psyllium: n 26) using a computer-generated random number sequence. Fasting blood samples, dietary records and anthropometric data were collected. Both groups were treated with the National Cholesterol Education Program Step 2 diet for 6 weeks before randomisation. After this run-in period, a daily supplement of 7·0 g psyllium was given to the intervention group, while an equivalent amount of cellulose was given to the control group. Statistically significant changes between the control and intervention groups over time were observed for total cholesterol (7·7%; - 0·39 mmol/l; P= 0·003) and LDL-C (10·7%; - 0·36 mmol/l; P= 0·01). None of the participants reported any aversion to the smell, taste, appearance or texture of psyllium. No serious adverse effects were reported during the study. In addition to causing a significant reduction in LDL-C concentrations, psyllium therapy was found to be both safe and acceptable for the treatment of hypercholesterolaemic children and adolescents.

  4. Mechanical properties of additively manufactured octagonal honeycombs.

    PubMed

    Hedayati, R; Sadighi, M; Mohammadi-Aghdam, M; Zadpoor, A A

    2016-12-01

    Honeycomb structures have found numerous applications as structural and biomedical materials due to their favourable properties such as low weight, high stiffness, and porosity. Application of additive manufacturing and 3D printing techniques allows for manufacturing of honeycombs with arbitrary shape and wall thickness, opening the way for optimizing the mechanical and physical properties for specific applications. In this study, the mechanical properties of honeycomb structures with a new geometry, called octagonal honeycomb, were investigated using analytical, numerical, and experimental approaches. An additive manufacturing technique, namely fused deposition modelling, was used to fabricate the honeycomb from polylactic acid (PLA). The honeycombs structures were then mechanically tested under compression and the mechanical properties of the structures were determined. In addition, the Euler-Bernoulli and Timoshenko beam theories were used for deriving analytical relationships for elastic modulus, yield stress, Poisson's ratio, and buckling stress of this new design of honeycomb structures. Finite element models were also created to analyse the mechanical behaviour of the honeycombs computationally. The analytical solutions obtained using Timoshenko beam theory were close to computational results in terms of elastic modulus, Poisson's ratio and yield stress, especially for relative densities smaller than 25%. The analytical solutions based on the Timoshenko analytical solution and the computational results were in good agreement with experimental observations. Finally, the elastic properties of the proposed honeycomb structure were compared to those of other honeycomb structures such as square, triangular, hexagonal, mixed, diamond, and Kagome. The octagonal honeycomb showed yield stress and elastic modulus values very close to those of regular hexagonal honeycombs and lower than the other considered honeycombs. PMID:27612831

  5. Mechanical properties of additively manufactured octagonal honeycombs.

    PubMed

    Hedayati, R; Sadighi, M; Mohammadi-Aghdam, M; Zadpoor, A A

    2016-12-01

    Honeycomb structures have found numerous applications as structural and biomedical materials due to their favourable properties such as low weight, high stiffness, and porosity. Application of additive manufacturing and 3D printing techniques allows for manufacturing of honeycombs with arbitrary shape and wall thickness, opening the way for optimizing the mechanical and physical properties for specific applications. In this study, the mechanical properties of honeycomb structures with a new geometry, called octagonal honeycomb, were investigated using analytical, numerical, and experimental approaches. An additive manufacturing technique, namely fused deposition modelling, was used to fabricate the honeycomb from polylactic acid (PLA). The honeycombs structures were then mechanically tested under compression and the mechanical properties of the structures were determined. In addition, the Euler-Bernoulli and Timoshenko beam theories were used for deriving analytical relationships for elastic modulus, yield stress, Poisson's ratio, and buckling stress of this new design of honeycomb structures. Finite element models were also created to analyse the mechanical behaviour of the honeycombs computationally. The analytical solutions obtained using Timoshenko beam theory were close to computational results in terms of elastic modulus, Poisson's ratio and yield stress, especially for relative densities smaller than 25%. The analytical solutions based on the Timoshenko analytical solution and the computational results were in good agreement with experimental observations. Finally, the elastic properties of the proposed honeycomb structure were compared to those of other honeycomb structures such as square, triangular, hexagonal, mixed, diamond, and Kagome. The octagonal honeycomb showed yield stress and elastic modulus values very close to those of regular hexagonal honeycombs and lower than the other considered honeycombs.

  6. [Impact of lipid metabolism parameters on the development and progression of coronary artery disease : An update].

    PubMed

    Sinning, D; Leistner, D M; Landmesser, U

    2016-06-01

    Disorders of lipid metabolism play a major role in the development and progression of coronary artery disease. Dyslipidemia therefore plays a central role in therapeutic approaches for prevention and treatment of cardiovascular events associated with coronary artery disease. Epidemiological studies have shown an association between various lipid metabolism parameters, the risk of developing coronary artery disease and progression of a pre-existing disease. In particular, increased levels of low-density lipoprotein cholesterol (LDL-C), reduced levels of HDL cholesterol (HDL-C), as well as high levels of triglycerides and increased lipoprotein(a) [Lp(a)] levels can be taken into account when assessing the risk stratification of patients for primary prevention of coronary artery disease. Lifestyle and dietary changes, intensified statin therapy and possibly the addition of ezetimibe remain the major interventions in both primary and secondary prevention of coronary artery disease, as they improve the prognosis particularly by lowering levels of LDL-C. Recently, genetic studies have contributed to extending our understanding of the relationship between lipid metabolism and coronary artery disease. A causal role for progression of coronary artery disease could be demonstrated for LDL-C, Lpa and triglyceride-rich lipoproteins (TRL), which could not be demonstrated for HDL-C in various studies. Furthermore, the effect of reduction of LDL-C by proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibition and by the cholesteryl ester transfer protein (CETP) inhibitor anacetrapib on cardiovascular events is currently being investigated in large clinical outcome study programs.

  7. Evaluation of Sexual Dimorphism in the Efficacy and Safety of Simvastatin/Atorvastatin Therapy in a Southern Brazilian Cohort

    PubMed Central

    Smiderle, Lisiane; Lima, Luciana O.; Hutz, Mara Helena; der Sand, Cézar Roberto Van; der Sand, Luiz Carlos Van; Ferreira, Maria Elvira Wagner; Pires, Renan Canibal; Almeida, Silvana; Fiegenbaum, Marilu

    2014-01-01

    Background Dyslipidemia is the primary risk factor for cardiovascular disease, and statins have been effective in controlling lipid levels. Sex differences in the pharmacokinetics and pharmacodynamics of statins contribute to interindividual variations in drug efficacy and toxicity. Objective To evaluate the presence of sexual dimorphism in the efficacy and safety of simvastatin/atorvastatin treatment. Methods Lipid levels of 495 patients (331 women and 164 men) were measured at baseline and after 6 ± 3 months of simvastatin/atorvastatin treatment to assess the efficacy and safety profiles of both drugs. Results Women had higher baseline levels of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) compared with men (p < 0.0001). After treatment, women exhibited a greater decrease in plasma TC and LDL-C levels compared with men. After adjustment for covariates, baseline levels of TC and LDL-C influenced more than 30% of the efficacy of lipid-lowering therapy (p < 0.001), regardless of sex. Myalgia [with or without changes in creatine phosphokinase (CPK) levels] occurred more frequently in women (25.9%; p = 0.002), whereas an increase in CPK and/or abnormal liver function was more frequent in in men (17.9%; p = 0.017). Conclusions Our results show that baseline TC and LDL-C levels are the main predictors of simvastatin/atorvastatin therapy efficacy, regardless of sex. In addition, they suggest the presence of sexual dimorphism in the safety of simvastatin/atorvastatin. The effect of sex differences on receptors, transporter proteins, and gene expression pathways needs to be better evaluated and characterized to confirm these observations. PMID:25120083

  8. 6th Hellenic Congress in Athens, of the Hellenic Atherosclerosis Society, on the 04-06 December 2014 Novel Pharmacologic Treatments of Familial Hypercholesterolaemia

    PubMed Central

    Athyros, VG

    2015-01-01

    Familial hypercholesterolaemia (FH) is the most common inherited monogenic lipid disorder. It is caused by mutations of genes related to low density lipoprotein (LDL) receptors, apolipoprotein B or proprotein convertase subtilisin/kexin type 9 (PCSK9). Homozygous FH (HoFH; 1/400,000 births) is treated by LDL apheresis. Recently lomitapide has been used for the treatment of HoFH as a monotherapy or in addition to LDL apheresis. Heterozygous FH (HeFH), 1/250-1/200 births, is associated with an increased cardiovascular disease (CVD) risk. The main treatment for HeFH has been high doses of high intensity statins plus ezetimibe. However, this is not usually enough to attain LDL-C targets, especially in those with overt CVD or equivalents (LDL-C goal of<70 mg/dl). Data from the Atherosclerosis Risk in Communities study showed that loss of function mutations of PCSK9 were associated with a 28% lower LDL-C level and an 88% reduction in the risk of CVD in blacks, while in whites these numbers were 15% and 47%, respectively. This led to the development of technology to block PCSK9 with monoclonal human antibodies (e.g. evolocumab and alirocumab). These antibodies have been shown in phase II and III trials to be safe and to produce reductions in LDL-C levels by around 60% either as monotherapy or on top of optimal therapy with statins and ezetimibe. These antibodies are administered subcutaneously every 2 weeks with an automatic device. Anti-PCSK9 antibodies are expected to be licensed soon (? in 2015) and are considered by many as “the statins of the 21st century”. PMID:26664657

  9. 6th Hellenic Congress in Athens, of the Hellenic Atherosclerosis Society, on the 04-06 December 2014 Novel Pharmacologic Treatments of Familial Hypercholesterolaemia.

    PubMed

    Athyros, V G

    2015-01-01

    Familial hypercholesterolaemia (FH) is the most common inherited monogenic lipid disorder. It is caused by mutations of genes related to low density lipoprotein (LDL) receptors, apolipoprotein B or proprotein convertase subtilisin/kexin type 9 (PCSK9). Homozygous FH (HoFH; 1/400,000 births) is treated by LDL apheresis. Recently lomitapide has been used for the treatment of HoFH as a monotherapy or in addition to LDL apheresis. Heterozygous FH (HeFH), 1/250-1/200 births, is associated with an increased cardiovascular disease (CVD) risk. The main treatment for HeFH has been high doses of high intensity statins plus ezetimibe. However, this is not usually enough to attain LDL-C targets, especially in those with overt CVD or equivalents (LDL-C goal of<70 mg/dl). Data from the Atherosclerosis Risk in Communities study showed that loss of function mutations of PCSK9 were associated with a 28% lower LDL-C level and an 88% reduction in the risk of CVD in blacks, while in whites these numbers were 15% and 47%, respectively. This led to the development of technology to block PCSK9 with monoclonal human antibodies (e.g. evolocumab and alirocumab). These antibodies have been shown in phase II and III trials to be safe and to produce reductions in LDL-C levels by around 60% either as monotherapy or on top of optimal therapy with statins and ezetimibe. These antibodies are administered subcutaneously every 2 weeks with an automatic device. Anti-PCSK9 antibodies are expected to be licensed soon (? in 2015) and are considered by many as "the statins of the 21(st) century". PMID:26664657

  10. Additive for otto cycle engines and fuel mixture so obtained

    SciTech Connect

    Scifoni, M.

    1985-02-12

    The additive for Otto cycle engines according to the present invention consists of a mixture of water, ethanol, methanol and butanol to which is added a determined quantity of a liquid obtained by pressing prickly pear leaves. Added in a small percentage to the fuel, gasoline, LP or methane, this additive prevents the oxidation associated with the use of water and/or alcohols in Otto cycle engines, lowers fuel consumption and allows the use of low octane fuel.

  11. Additive attacks on speaker recognition

    NASA Astrophysics Data System (ADS)

    Farrokh Baroughi, Alireza; Craver, Scott

    2014-02-01

    Speaker recognition is used to identify a speaker's voice from among a group of known speakers. A common method of speaker recognition is a classification based on cepstral coefficients of the speaker's voice, using a Gaussian mixture model (GMM) to model each speaker. In this paper we try to fool a speaker recognition system using additive noise such that an intruder is recognized as a target user. Our attack uses a mixture selected from a target user's GMM model, inverting the cepstral transformation to produce noise samples. In our 5 speaker data base, we achieve an attack success rate of 50% with a noise signal at 10dB SNR, and 95% by increasing noise power to 0dB SNR. The importance of this attack is its simplicity and flexibility: it can be employed in real time with no processing of an attacker's voice, and little computation is needed at the moment of detection, allowing the attack to be performed by a small portable device. For any target user, knowing that user's model or voice sample is sufficient to compute the attack signal, and it is enough that the intruder plays it while he/she is uttering to be classiffed as the victim.

  12. Additive Transforms Paint into Insulation

    NASA Technical Reports Server (NTRS)

    2007-01-01

    Tech Traders Inc. sought assistance developing low-cost, highly effective coatings and paints that created useful thermal reflectance and were safe and non-toxic. In cooperation with a group of engineers at Kennedy Space Center., Tech Traders created Insuladd, a powder additive made up of microscopic, inert gas-filled, ceramic microspheres that can be mixed into ordinary interior or exterior paint, allowing the paint to act like a layer of insulation. When the paint dries, this forms a radiant heat barrier, turning the ordinary house paint into heat-reflecting thermal paint. According to Tech Traders, the product works with all types of paints and coatings and will not change the coverage rate, application, or adhesion of the paint. Other useful applications include feed storage silos to help prevent feed spoilage, poultry hatcheries to reduce the summer heat and winter cold effects, and on military vehicles and ships. Tech Traders has continued its connection to the aerospace community by recently providing Lockheed Martin Corporation with one of its thermal products for use on the F-22 Raptor.

  13. Sustainability Characterization for Additive Manufacturing

    PubMed Central

    Mani, Mahesh; Lyons, Kevin W; Gupta, SK

    2014-01-01

    Additive manufacturing (AM) has the potential to create geometrically complex parts that require a high degree of customization, using less material and producing less waste. Recent studies have shown that AM can be an economically viable option for use by the industry, yet there are some inherent challenges associated with AM for wider acceptance. The lack of standards in AM impedes its use for parts production since industries primarily depend on established standards in processes and material selection to ensure the consistency and quality. Inability to compare AM performance against traditional manufacturing methods can be a barrier for implementing AM processes. AM process sustainability has become a driver due to growing environmental concerns for manufacturing. This has reinforced the importance to understand and characterize AM processes for sustainability. Process characterization for sustainability will help close the gaps for comparing AM performance to traditional manufacturing methods. Based on a literature review, this paper first examines the potential environmental impacts of AM. A methodology for sustainability characterization of AM is then proposed to serve as a resource for the community to benchmark AM processes for sustainability. Next, research perspectives are discussed along with relevant standardization efforts. PMID:26601038

  14. Additively manufactured porous tantalum implants.

    PubMed

    Wauthle, Ruben; van der Stok, Johan; Amin Yavari, Saber; Van Humbeeck, Jan; Kruth, Jean-Pierre; Zadpoor, Amir Abbas; Weinans, Harrie; Mulier, Michiel; Schrooten, Jan

    2015-03-01

    The medical device industry's interest in open porous, metallic biomaterials has increased in response to additive manufacturing techniques enabling the production of complex shapes that cannot be produced with conventional techniques. Tantalum is an important metal for medical devices because of its good biocompatibility. In this study selective laser melting technology was used for the first time to manufacture highly porous pure tantalum implants with fully interconnected open pores. The architecture of the porous structure in combination with the material properties of tantalum result in mechanical properties close to those of human bone and allow for bone ingrowth. The bone regeneration performance of the porous tantalum was evaluated in vivo using an orthotopic load-bearing bone defect model in the rat femur. After 12 weeks, substantial bone ingrowth, good quality of the regenerated bone and a strong, functional implant-bone interface connection were observed. Compared to identical porous Ti-6Al-4V structures, laser-melted tantalum shows excellent osteoconductive properties, has a higher normalized fatigue strength and allows for more plastic deformation due to its high ductility. It is therefore concluded that this is a first step towards a new generation of open porous tantalum implants manufactured using selective laser melting.

  15. Additively manufactured porous tantalum implants.

    PubMed

    Wauthle, Ruben; van der Stok, Johan; Amin Yavari, Saber; Van Humbeeck, Jan; Kruth, Jean-Pierre; Zadpoor, Amir Abbas; Weinans, Harrie; Mulier, Michiel; Schrooten, Jan

    2015-03-01

    The medical device industry's interest in open porous, metallic biomaterials has increased in response to additive manufacturing techniques enabling the production of complex shapes that cannot be produced with conventional techniques. Tantalum is an important metal for medical devices because of its good biocompatibility. In this study selective laser melting technology was used for the first time to manufacture highly porous pure tantalum implants with fully interconnected open pores. The architecture of the porous structure in combination with the material properties of tantalum result in mechanical properties close to those of human bone and allow for bone ingrowth. The bone regeneration performance of the porous tantalum was evaluated in vivo using an orthotopic load-bearing bone defect model in the rat femur. After 12 weeks, substantial bone ingrowth, good quality of the regenerated bone and a strong, functional implant-bone interface connection were observed. Compared to identical porous Ti-6Al-4V structures, laser-melted tantalum shows excellent osteoconductive properties, has a higher normalized fatigue strength and allows for more plastic deformation due to its high ductility. It is therefore concluded that this is a first step towards a new generation of open porous tantalum implants manufactured using selective laser melting. PMID:25500631

  16. Sustainability Characterization for Additive Manufacturing.

    PubMed

    Mani, Mahesh; Lyons, Kevin W; Gupta, S K

    2014-01-01

    Additive manufacturing (AM) has the potential to create geometrically complex parts that require a high degree of customization, using less material and producing less waste. Recent studies have shown that AM can be an economically viable option for use by the industry, yet there are some inherent challenges associated with AM for wider acceptance. The lack of standards in AM impedes its use for parts production since industries primarily depend on established standards in processes and material selection to ensure the consistency and quality. Inability to compare AM performance against traditional manufacturing methods can be a barrier for implementing AM processes. AM process sustainability has become a driver due to growing environmental concerns for manufacturing. This has reinforced the importance to understand and characterize AM processes for sustainability. Process characterization for sustainability will help close the gaps for comparing AM performance to traditional manufacturing methods. Based on a literature review, this paper first examines the potential environmental impacts of AM. A methodology for sustainability characterization of AM is then proposed to serve as a resource for the community to benchmark AM processes for sustainability. Next, research perspectives are discussed along with relevant standardization efforts.

  17. Lower Face: Clinical Anatomy and Regional Approaches with Injectable Fillers.

    PubMed

    Braz, André; Humphrey, Shannon; Weinkle, Susan; Yee, G Jackie; Remington, B Kent; Lorenc, Z Paul; Yoelin, Steve; Waldorf, Heidi A; Azizzadeh, Babak; Butterwick, Kimberly J; de Maio, Mauricio; Sadick, Neil; Trevidic, Patrick; Criollo-Lamilla, Gisella; Garcia, Philippe

    2015-11-01

    The use of injectable fillers enables facial sculpting through treatment of volume depletion and modeling of facial contours. Injectable fillers are among the most frequently performed minimally invasive cosmetic procedures.However, treatment of the lower third of the face can be challenging and requires expertise in facial anatomy. In this article, the authors provide a comprehensive review of the anatomy of the lower third of the face, highlighting danger zones. In addition, the authors describe their preferred approach and detailed technique used in the treatment of each specific area, namely the jawline, prejowl sulcus, melomental folds, and lips.

  18. [Spontaneous loss of sensibility of the lower lip].

    PubMed

    Berghuis-Bergsma, N; Phan, T T H; Witjes, M J H

    2006-10-01

    A young African male was referred after the spontaneous loss of sensibility to the left of the lower lip. Anaesthesia of the left lower alveolar nerve could be confirmed. X-rays did not reveal any signs of pathology in the left mandible while clinically the gingival was tender on palpation. He was known to have sickle cell anemia. Differential diagnosis included a sickle cell mediated osteomyelitis due to infarction of the microvasculature. The diagnostic work up included additional PET scans to confirm the clinical diagnosis. The pathogenesis of sickle cell anemia and its importance to the dentist is discussed. PMID:17058763

  19. Groundwater from Lower Cretaceous rocks in Kansas

    USGS Publications Warehouse

    Keene, Katherine M.; Bayne, Charles Knight

    1976-01-01

    Sandstones in Lower Cretaceous rocks contain supplies, of water that may be adequate to meet increasing present and future demands for supplemental municipal and domestic use in central and western Kansas. An estimated 70 to 80 million acre-feet (86,000 to 99,000 cubic hectometers) of water containing less than 1,000 milligrams per liter dissolved solids may be acceptable for use at the present (1976). An additional 10 to 15 million acre-feet (12,000 to 18,000 cubic hectometers) containing 1,000 to 3,000 milligrams per liter dissolved solids is estimated to be available for use in the future with appropriate desalinization. Lower Cretaceous rocks crop out from Washington County on the north to Comanche County on-the south. The rocks dip from a structural high in the southwest part of the State to structural lows in the northwest and north-central part. Depth below land surface increases generally northwestward to about 2,600 feet (790 meters); thickness of the rocks increases westward, nearly zero to about 850 feet (260 meters). The rocks consist chiefly of marine to nonmarine shale and silt- stone interbedded with coastal to deltaic sandstone. The interbedded sandstone, which composes about one-third of the rocks, consists of one or more lenses that thicken westward to about 400 feet (120 meters) in the central part of western Kansas. The yield of water to individual wells is related to areal extent, thickness, and interconnection of the sand lenses and to grain size and cementation of the sand. Large amounts of water may be pumped by wells where loosely cemented sand lenses are interconnected. Wells commonly yield adequate supplies for domestic and stock use; reported yields from municipal and irrigation wells range from about 100 to 2,000 gallons per minute (6 to 125 liters per second). Recharge to the Lower Cretaceous-rocks occurs in the area of outcrop and from hydraulically connected saturated Cenozoic rocks, especially in the southern part of the State

  20. Military boot attenuates axial loading to the lower leg.

    PubMed

    Yoganandan, Narayan; Schlick, Michael; Arun, Mike W J; Pintar, Frank A

    2014-01-01

    Biomechanical tests to understand injury mechanisms and derive injury tolerance information using Post-Mortem Human Subjects (PMHS) have not used foot protection and they have primarily focused on civilian environments such as automotive and athletic- and sports-related events. As military personnel use boots, tests with the boot are required to understand their effect on attenuating lower leg loads. The purpose of this study was therefore, to determine the modulation of human lower leg kinematics with boot compressions and share of the force absorbed by the boot from underbody blast loading. Axial impacts were delivered to the Hybrid III dummy lower leg in the neutral position. The dummy leg was instrumented with its internal upper and lower tibia load cells, and in addition, a knee load cell was attached to the proximal end. Tests were conducted at 4.4 to 8.9 m/s, with and without boots, and repeat tests were done. Morphologies of the force-time responses were similar at the three load cell locations and for all input combinations and booted and unbooted conditions. However, booted tests resulted in considerably lower maximum forces (approximately two-third reduction) than unbooted tests. These results clearly show that boots can absorb a considerable share of the impact energy and decrease impact loads transmitted to the lower leg under vertical loading, thus necessitating the generation of tolerance data using PMHS for this environment.

  1. 33. VIEW OF WEST WALL OF CRUSHING ADDITION FROM SOUTHWEST. ...

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

    33. VIEW OF WEST WALL OF CRUSHING ADDITION FROM SOUTHWEST. STEPHENS-ADAMSON 25 TON/HR BUCKET ELEVATOR IN CENTER. TEAM SUPERVISOR ROBERT W. GRZYWACZ ON LOWER LEVEL (LOCATION OF STEARNS-ROGER DRYER). - Bald Mountain Gold Mill, Nevada Gulch at head of False Bottom Creek, Lead, Lawrence County, SD

  2. Simvastatin and dipentyl phthalate lower testosterone production and exhibit dose additive effects on the fetal testis via distinct mechanistic pathways

    EPA Science Inventory

    Sex differentiation of the mammalian reproductive tract is a highly regulated process that is driven, in part, by fetal testosterone (T) production. In utero exposure to phthalate esters (PE) during sex differentiation can result in reproductive tract malformations in rats. PE al...

  3. Doppler ultrasonography in lower extremity peripheral arterial disease.

    PubMed

    Verim, Samet; Taşçı, Ilker

    2013-04-01

    Systemic atherosclerosis is a condition which progresses with age, decreases quality of life, and life expectancy. Lower extremity peripheral arterial disease (PAD) is a common manifestation of systemic atherosclerosis in the elderly. These individuals have a 2 to 4 fold higher risk of coronary heart disease and stroke. In addition, systemic atherosclerosis causes overall functional disability including restricted lower extremity movements. When used alone for diagnostic purposes, claudication is an unreliable sign of PAD in all age groups especially the elderly. Moreover, claudication is difficult to define due to the advancing age and degenerative changes in lumbar and peripheral joints. Doppler ultrasonography (US) is an easily available and noninvasive means of arterial visualization in the lower extremities. In this review, supporting evidence for the use of Doppler US in the diagnosis of PAD will be discussed. Past and present recommendations regarding Doppler US in the current PAD guidelines will be overviewed.

  4. Paraxial WKB Method Applied to the Lower Hybrid Wave Propagation

    SciTech Connect

    Bertelli, N; Poli, E; Harvey, R; Wright, J C; Bonoli, P T; Phillips, C K; Simov, A P; Valeo, E

    2012-07-12

    The paraxial WKB (pWKB) approximation, also called beam tracing method, has been employed in order to study the propagation of lower hybrid (LH) waves in a tokamak plasma. Analogous to the well-know ray tracing method, this approach reduces Maxwell's equations to a set of ordinary differential equations, while, in addition, retains the effects of the finite beam cross-section, and, thus, the effects of diffraction. A new code, LHBEAM (Lower Hybrid BEAM tracing), is presented, which solves the pWKB equations in tokamak geometry for arbitrary launching conditions and for analytic and experimental plasma equilibria. In addition, LHBEAM includes linear electron Landau damping for the evaluation of the absorbed power density and the reconstruction of the wave electric field in both the physical and Fourier space. Illustrative LHBEAM calculations are presented along with a comparison with the ray tracing code GENRAY and the full wave solver TORIC-LH.

  5. Reliability of Calculated Low-Density Lipoprotein Cholesterol.

    PubMed

    Meeusen, Jeffrey W; Snozek, Christine L; Baumann, Nikola A; Jaffe, Allan S; Saenger, Amy K

    2015-08-15

    Aggressive low-density lipoprotein cholesterol (LDL-C)-lowering strategies are recommended for prevention of cardiovascular events in high-risk populations. Guidelines recommend a 30% to 50% reduction in at-risk patients even when LDL-C concentrations are between 70 and 130 mg/dl (1.8 to 3.4 mmol/L). However, calculation of LDL-C by the Friedewald equation is the primary laboratory method for routine LDL-C measurement. We compared the accuracy and reproducibility of calculated LDL-C <130 mg/dl (3.4 mmol/L) to LDL-C measured by β quantification (considered the gold standard method) in 15,917 patients with fasting triglyceride concentrations <400 mg/dl (4.5 mmol/L). Both variation and bias of calculated LDL-C increased at lower values of measured LDL-C. The 95% confidence intervals for a calculated LDL-C of 70 mg/dl (1.8 mmol/L) and 30 mg/dl (0.8 mmol/L) were 60 to 86 mg/dl (1.6 to 2.2 mmol/L) and 24 to 60 mg/dl (0.6 to 1.6 mmol/L), respectively. Previous recommendations have emphasized the requirement for a fasting sample with triglycerides <400 mg/dl (4.5 mmol/L) to calculate LDL-C by the Friedewald equation. However, no recommendations have addressed the appropriate lower reportable limit for calculated LDL-C. In conclusion, calculated LDL-C <30 mg/dl (0.8 mmol/L) should not be reported because of significant deviation from the gold standard measured LDL-C results, and caution is advised when using calculated LDL-CF values <70 mg/dl (1.8 mmol/L) to make treatment decisions.

  6. Management of familial hypercholesterolemia: a review of the recommendations from the National Lipid Association Expert Panel on Familial Hypercholesterolemia.

    PubMed

    Robinson, Jennifer G

    2013-03-01

    Familial hypercholesterolemia (FH) is a genetic disorder of lipid metabolism that is characterized by a significant elevation in levels of low-density lipoprotein cholesterol (LDL-C), and patients are at very high risk for premature coronary heart disease (CHD). The etiology of FH includes known mutations in the gene of the LDL receptor, LDLR; the gene of apolipoprotein B, apo B; and the proprotein convertase subtilisin/kexin type 9 gene, PCSK9. The National Lipid Association Expert Panel on Familial Hypercholesterolemia has provided recommendations for the screening and treatment of patients with FH. Early identification and aggressive treatment of FH in individual patients, as well as screening of all first-degree relatives, are recommended to minimize the risk for premature CHD. Similar to patients with conventional hypercholesterolemia, patients with FH should receive statins as initial treatment, but patients with FH may require higher doses of statins, more potent statins, statin-based combination therapy, or adjunctive therapies. Patients with FH who have additional risk factors for, or existing, cardiovascular disease or those with an inadequate response to initial statin therapy should have access to higher doses of the most efficacious statins; statins used in combination with other LDL-C-lowering agents should also be supported by formularies; additional treatments, such as LDL-C apheresis or novel therapies, may also be required to achieve acceptable LDL-C levels. New treatment approaches include mipomersen, which was approved by the FDA in January 2013. Mipomersen is an oligonucleotide inhibitor of apolipoprotein B-100 synthesis (called an antisense inhibitor) indicated as an adjunct to lipid-lowering medications and diet to reduce LDL-C, apolipoprotein B, total cholesterol, and non-high density lipoprotein-cholesterol (non-HDL-C) levels in patients with homozygous FH (HoFH). The microsomal transfer protein lomitapide has also received FDA approval for

  7. A review of low-density lipoprotein cholesterol, treatment strategies, and its impact on cardiovascular disease morbidity and mortality.

    PubMed

    Wadhera, Rishi K; Steen, Dylan L; Khan, Irfan; Giugliano, Robert P; Foody, JoAnne M

    2016-01-01

    Cardiovascular (CV) disease is a leading cause of death worldwide, accounting for approximately 31.4% of deaths globally in 2012. It is estimated that, from 1980 to 2000, reduction in total cholesterol accounted for a 33% decrease in coronary heart disease (CHD) deaths in the United States. In other developed countries, similar decreases in CHD deaths (ranging from 19%-46%) have been attributed to reduction in total cholesterol. Low-density lipoprotein cholesterol (LDL-C) has now largely replaced total cholesterol as a risk marker and the primary treatment target for hyperlipidemia. Reduction in LDL-C levels by statin-based therapies has been demonstrated to result in a reduction in the risk of nonfatal CV events and mortality in a continuous and graded manner over a wide range of baseline risk and LDL-C levels. This article provides a review of (1) the relationship between LDL-C and CV risk from a biologic, epidemiologic, and genetic standpoint; (2) evidence-based strategies for LDL-C lowering; (3) lipid-management guidelines; (4) new strategies to further reduce CV risk through LDL-C lowering; and (5) population-level and health-system initiatives aimed at identifying, treating, and lowering lifetime LDL-C exposure. PMID:27206934

  8. Spin transition zone in Earth's lower mantle

    SciTech Connect

    Lin, J.-F.; Vanko, G.; Jacobsen, S.D.; Iota, V.; Struzhkin, V.V.; Prakapenka, V.B.; Kuznetsov, A.; Yoo, C.-S.

    2008-06-16

    Mineral properties in Earth's lower mantle are affected by iron electronic states, but representative pressures and temperatures have not yet been probed. Spin states of iron in lower-mantle ferropericlase have been measured up to 95 gigapascals and 2000 kelvin with x-ray emission in a laser-heated diamond cell. A gradual spin transition of iron occurs over a pressure-temperature range extending from about 1000 kilometers in depth and 1900 kelvin to 2200 kilometers and 2300 kelvin in the lower mantle. Because low-spin ferropericlase exhibits higher density and faster sound velocities relative to the high-spin ferropericlase, the observed increase in low-spin (Mg,Fe)O at mid-lower mantle conditions would manifest seismically as a lower-mantle spin transition zone characterized by a steeper-than-normal density gradient.

  9. Low coefficient of thermal expansion polyimides containing metal ion additives

    NASA Technical Reports Server (NTRS)

    Stoakley, D. M.; St. Clair, A. K.

    1992-01-01

    Polyimides have become widely used as high performance polymers as a result of their excellent thermal stability and toughness. However, lowering their coefficient of thermal expansion (CTE) would increase their usefulness for aerospace and electronic applications where dimensional stability is a requirement. The incorporation of metal ion-containing additives into polyimides, resulting in significantly lowered CTE's, has been studied. Various metal ion additives have been added to both polyamic acid resins and soluble polyimide solutions in the concentration range of 4-23 weight percent. The incorporation of these metal ions has resulted in reductions in the CTE's of the control polyimides of 12 percent to over 100 percent depending on the choice of additive and its concentration.

  10. Smolt Monitoring at the Head of Lower Granite Reservoir and Lower Granite Dam, 2002 Annual Report.

    SciTech Connect

    Buettner, Edwin W.; Putnam, Scott A.

    2009-02-18

    in hatchery Chinook catch in 2002 was due to a 3.1 fold increase in hatchery production and differences in flow between years. Changes in hatchery and wild steelhead catch are probably due to differences in flow between years. Travel time (d) and migration rate (km/d) through Lower Granite Reservoir for PIT-tagged Chinook salmon and steelhead trout marked at the Snake River trap were affected by discharge. Statistical analysis of 2002 data detected a relation between migration rate and discharge for hatchery and wild Chinook salmon. For hatchery and wild Chinook salmon there was a 4.7-fold and a 3.7-fold increase in migration rate, respectively, between 50 and 100 kcfs. For steelhead trout tagged at the Snake River trap, statistical analysis detected a significant relation between migration rate and Lower Granite Reservoir inflow discharge. For hatchery and wild steelhead trout, there was a 1.8-fold and a 1.7-fold increase in migration rate, respectively, between 50 and 100 kcfs. Travel time and migration rate to Lower Granite Dam for fish marked at the Salmon River trap were calculated. Statistical analysis of the 2002 data detected a significant relation between migration rate and Lower Granite Reservoir inflow discharge for wild Chinook salmon and hatchery steelhead trout. The analysis was unable to detect a relation between migration rate and discharge for hatchery Chinook salmon. The lack of a detectable relation was probably a result of the migration rate data being spread over a very narrow range of discharge. Not enough data were available to perform the analysis for wild steelhead trout. Migration rate increased 4.3-fold for wild Chinook salmon and 2.2-fold for hatchery steelhead between 50 kcfs and 100 kcfs. Fish tagged with passive integrated transponder (PIT) tags at the Snake River trap were interrogated at four dams with PIT tag detection systems (Lower Granite, Little Goose, Lower Monumental, and McNary dams). Because of the addition of the fourth

  11. A review of selected chemical additives in cosmetic products.

    PubMed

    Juhász, Margit Lai Wun; Marmur, Ellen S

    2014-01-01

    The addition of chemical additives to consumer cosmetic products is a common practice to increase cosmetic effectiveness, maintain cosmetic efficacy, and produce a longer-lasting, more viable product. Recently, manufacturers have come under attack for the addition of chemicals including dioxane, formaldehyde, lead/lead acetate, parabens, and phthalate, as these additives may prove harmful to consumer health. Although reports show that these products may indeed adversely affect human health, these studies are conducted using levels of the aforementioned chemicals at much higher levels of exposure than those found in cosmetic products. When cosmeceuticals are used as per manufacturer's instructions, it is estimated that the levels of harmful additives found in these products are considerably lower than reported toxic concentrations.

  12. Upper and lower neural tube defects: an alternate hypothesis.

    PubMed Central

    Garabedian, B H; Fraser, F C

    1993-01-01

    It has been suggested that neural tube defects (NTDs) of the upper type (anencephaly, encephalocele, and thoracic spina bifida) may have a pathogenesis different from those of the lower type (lumbosacral spina bifida), since recurrent cases within a sibship were said always to be concordant with respect to NTD type. Also, spontaneous abortion, additional malformation, and recurrence rate were observed to be higher in the upper group, and there was an excess of females in upper NTD probands. To test this hypothesis, we measured the above variables in upper and lower NTDs in a sample from Quebec. We found less than full concordance (50%) of NTD type in 18 sib pairs. Recurrence rate was not significantly lower in the lower NTD group (5.6 v 5.8%). The other variables were in general agreement with previous studies, inconsistent findings possibly attributable to different NTD population incidences. These findings can be accounted for if upper and lower NTDs share a similar pathogenesis and the embryo is more susceptible during early than late neural tube formation. PMID:8230161

  13. Clinical presentation and manual therapy for lower quadrant musculoskeletal conditions

    PubMed Central

    Courtney, Carol A; Clark, Jeffrey D; Duncombe, Alison M; O’Hearn, Michael A

    2011-01-01

    Chronic lower quadrant injuries constitute a significant percentage of the musculoskeletal cases seen by clinicians. While impairments may vary, pain is often the factor that compels the patient to seek medical attention. Traumatic injury from sport is one cause of progressive chronic joint pain, particularly in the lower quarter. Recent studies have demonstrated the presence of peripheral and central sensitization mechanisms in different lower quadrant pain syndromes, such as lumbar spine related leg pain, osteoarthritis of the knee, and following acute injuries such as lateral ankle sprain and anterior cruciate ligament rupture. Proper management of lower quarter conditions should include assessment of balance and gait as increasing pain and chronicity may lead to altered gait patterns and falls. In addition, quantitative sensory testing may provide insight into pain mechanisms which affect management and prognosis of musculoskeletal conditions. Studies have demonstrated analgesic effects and modulation of spinal excitability with use of manual therapy techniques, with clinical outcomes of improved gait and functional ability. This paper will discuss the evidence which supports the use of manual therapy for lower quarter musculoskeletal dysfunction. PMID:23115474

  14. Smolt Monitoring at the Head of Lower Granite Reservoir and Lower Granite Dam, 2005 Annual Report.

    SciTech Connect

    Buettner, Edwin W.; Putnam, Scott A.

    2009-02-18

    began on March 6 and were terminated on May 17 due to high flows. There were two days when the trap was taken out of service because of mechanical failure. Travel time (d) and migration rate (km/d) through Lower Granite Reservoir for passive integrated transponder (PIT) tagged Chinook salmon and steelhead trout marked at the Snake River trap were affected by discharge. Statistical analysis of 2005 data detected a relation between migration rate and discharge for hatchery Chinook but was unable to detect a relation for wild Chinook. The inability to detect a migration rate discharge relation for wild Chinook salmon was caused by a lack of data. For hatchery Chinook salmon there was a 1.8-fold increase in migration rate between 50 and 100 kcfs. For steelhead trout tagged at the Snake River trap, statistical analysis detected a significant relation between migration rate and lower Granite Reservoir inflow discharge. For hatchery and wild steelhead trout, there was a 2.2-fold and a 2.2-fold increase in migration rate, respectively, between 50 and 100 kcfs. Travel time and migration rate to Lower Granite Dam for fish marked at the Salmon River trap were calculated. Statistical analysis of the 2005 data detected a significant relation between migration rate and Lower Granite Reservoir inflow discharge for hatchery Chinook salmon, wild Chinook salmon, hatchery steelhead trout, and wild steelhead trout. Migration rate increased 4.2-fold for hatchery Chinook salmon, 2.9-fold for wild Chinook salmon and 2.5-fold for hatchery steelhead, and 1.7-fold for wild steelhead as discharge increased between 50 kcfs and 100 kcfs. Fish tagged with PIT tags at the Snake River and Salmon River traps were interrogated at four dams with PIT tag detection systems (Lower Granite, Little Goose, Lower Monumental and McNary dams). Because of the addition of the fourth interrogation site (Lower Monumental) in 1993 and the installation of the Removable Spillway Weir at Lower Granite Dam in 2001

  15. Smolt Monitoring at the Head of Lower Granite Reservoir and Lower Granite Dam, 2003 Annual Report.

    SciTech Connect

    Buettner, Edwin W.; Putnam, Scott A.

    2009-02-18

    Chinook salmon and 2.4-fold for hatchery steelhead as discharge increased between 50 kcfs and 100 kcfs. Fish tagged with passive integrated transponder (PIT) tags at the Snake River and Salmon River traps were interrogated at four dams with PIT tag detection systems (Lower Granite, Little Goose, Lower Monumental, and McNary dams). Because of the addition of the fourth interrogation site (Lower Monumental) in 1993 and the installation of the Removable Spillway Weir at Lower Granite Dam in 2001, caution must be used in comparing cumulative interrogation data. Cumulative interrogations at the four dams for fish marked at the Snake River trap were 65% for hatchery Chinook, 72% for wild Chinook, 66% for hatchery steelhead, and 67% for wild steelhead. Cumulative interrogations at the four dams for fish marked at the Salmon River trap were 48% for hatchery Chinook, 61% for wild Chinook salmon, 57% for hatchery steelhead trout, and 56% for wild steelhead trout.

  16. Smolt Monitoring at the Head of Lower Granite Reservoir and Lower Granite Dam, 2004 Annual Report.

    SciTech Connect

    Buettner, Edwin W.; Putnam, Scott A.

    2009-02-18

    Monumental, and McNary dams). Because of the addition of the fourth interrogation site (Lower Monumental) in 1993 and the installation of the Removable Spillway Weir at Lower Granite Dam in 2001, caution must be used in comparing cumulative interrogation data. Cumulative interrogations at the four dams for fish marked at the Snake River trap were 82% for hatchery Chinook, 77% for wild Chinook, 90% for hatchery steelhead, and 90% for wild steelhead. Cumulative interrogations at the four dams for fish marked at the Salmon River trap were 68% for hatchery Chinook, 70% for wild Chinook salmon, 80% for hatchery steelhead trout, and 79% for wild steelhead trout.

  17. Management of lower-pole caliceal stones.

    PubMed

    Gerber, Glenn S

    2003-09-01

    A series of 205 urologists answered questions about their choice of treatment for lower-caliceal stones. The preferred approaches were extracorporeal shockwave lithotripsy (SWL) for stones <1 cm and percutaneous nephrolithotomy (PCNL) for those >2 cm. For stones of 1 to 2 cm, 65% preferred SWL and 30% would advise PCNL. Thus, SWL is recommended for lower-caliceal stones more frequently than is justified by published success rates. Continued efforts need to be made to inform practicing urologists regarding the most appropriate therapy for patients with lower-pole stones >1 cm.

  18. Laser action by optically depumping lower states

    DOEpatents

    Krupke, William F.

    1977-01-01

    A method and apparatus for obtaining laser action between an upper energy level and a lower energy level of a gaseous medium, which comprises populating the upper energy level to some degree (short of achieving a conventional inverted population) by any suitable pumping means, and thereafter establishing an inverted population by transiently and selectively depumping the lower energy level such as by exposing the medium to an intense source of radiation which selectively causes the transformation of the lower energy level species to some other energy level. Thus, a thermally pumped/optically depumped gas laser system is produced.

  19. Laser action by optically depumping lower states

    DOEpatents

    Krupke, W.F.

    1975-11-26

    A method and apparatus are described for obtaining laser action between an upper energy level and a lower energy level of a gaseous medium. The upper energy level is populated to some degree (short of achieving a conventional inverted population) by any suitable pumping means, and an inverted population is established by transiently and selectively depumping the lower energy level. The depumping may be done by exposing the medium to an intense source of radiation which selectively causes the transformation of the lower energy level species to some other energy level. Thus, a thermally pumped/optically depumped gas laser system is produced.

  20. [Psychological adjustment following lower limb amputation].

    PubMed

    Panyi, Lilla Krisztina; Lábadi, Beatrix

    2015-09-27

    Rehabilitation of lower limb amputees and the fitting of their prosthesis depend highly on the psychological adjustment process and motivational state of the patient. The loss of a limb is extremely challenging and can cause various physical and psychological problems. Depression, anxiety, decreased well-being and quality of life, body image dissatisfaction and changes in self-concept and identity are frequent after lower limb amputation. In the interest of adjustment patients have to cope with the emerging changes and difficulties in their lifes as well as the problems in psychological functioning. It is important for them to accept the alterations in their body and identity, and integrate them in a new self-concept in which process motivation is a fundamental issue. The aim of this article is to review the literature on psychological consequences of lower limb amputation, and to propose an integrative way of rehabilitation for lower limb amputees. PMID:26550913

  1. Herniated Disk in the Lower Back

    MedlinePlus

    ... lives. A high percentage of people will have low back and leg pain caused by a herniated disk. Although a herniated ... pressure against the outer ring may cause lower back pain. If the disk is very worn or injured, ...

  2. Two simple treatments for lower lip mucocoeles.

    PubMed

    Gill, D

    1996-11-01

    Mucocoeles commonly affect the lower lip of the elderly. These can be treated successfully and simply with repeated freeze-thaw cryotherapy cycles, or by punch biopsy which gives histology. PMID:8961595

  3. Lower Saccharide Nanometric Materials and Methods

    SciTech Connect

    Schilling, Christopher H.; Tomasik, Piotr; Sikora, Marek

    2004-07-13

    A ceramic composition having at least one nanometric ceramic powder, at least one lower saccharide, and water. The composition is useful in many industrial applications, including preparation of stronger and substantially defect free green and sintered ceramic bodies.

  4. Surface Material Lowers School Maintenance Cost

    ERIC Educational Resources Information Center

    Modern Schools, 1976

    1976-01-01

    An experimental new surface material for schools, called "vitreous tile," is proving successful in lowering school maintenance costs by preventing destruction caused by vandalism, stains, and color fading. (Author)

  5. Lower crustal mush generation and evolution

    NASA Astrophysics Data System (ADS)

    Karakas, Ozge; Bachmann, Olivier; Dufek, Josef; Wright, Heather; Mangan, Margaret

    2016-04-01

    Recent seismic, field, and petrologic studies on several active and fossil volcanic settings provide important constraints on the time, volume, and melt fraction of their lower crustal magma bodies. However, these studies provide an incomplete picture of the time and length scales involved during their thermal and compositional evolution. What has been lacking is a thermal model that explains the temporal evolution and state of the lower crustal magma bodies during their growth. Here we use a two-dimensional thermal model and quantify the time and length scales involved in the long-term thermal and compositional evolution of the lower crustal mush regions underlying the Salton Sea Geothermal Field (USA), Mt St Helens (USA), and the Ivrea-Verbano Zone (North Italy). Although a number of seismic, tectonic, petrologic, and field studies explained the tectonic and magmatic evolution of these regions, controversy remains on their lower crustal heat sources, melt fraction, and origin of erupted magmas. Our thermal modeling results suggest that given a geologically reasonable range of basalt fluxes (~10^-3 to 10^-4 km3/yr), a long-lived (>105 yr) crystalline mush is formed in the lower crust. The state of the lower crustal mush is strongly influenced by the magma flux, crustal thickness, and water content of intruded basalt, giving an average melt fraction of <0.2 in thin crust with dry injections (Salton Sea Geothermal Field) and up to 0.4-0.5 in thicker crust with wet injections (Mt St Helens and Ivrea Zone). The melt in the lower crustal mush is mainly evolving through fractional crystallization of basalt with minor crustal assimilation in all regions, in agreement with isotopic studies. Quantification of the lower crustal mush regions is key to understanding the mass and heat balance in the crust, evolution of magma plumbing systems, and geothermal energy exploration.

  6. Cranberries and lower urinary tract infection prevention.

    PubMed

    Hisano, Marcelo; Bruschini, Homero; Nicodemo, Antonio Carlos; Srougi, Miguel

    2012-01-01

    Lower urinary tract infections are very common diseases. Recurrent urinary tract infections remain challenging to treat because the main treatment option is long-term antibiotic prophylaxis; however, this poses a risk for the emergence of bacterial resistance. Some options to avoid this risk are available, including the use of cranberry products. This article reviews the key methods in using cranberries as a preventive measure for lower urinary tract infections, including in vitro studies and clinical trials.

  7. Prevention of Lower Extremity Injuries in Basketball

    PubMed Central

    Taylor, Jeffrey B.; Ford, Kevin R.; Nguyen, Anh-Dung; Terry, Lauren N.; Hegedus, Eric J.

    2015-01-01

    Context: Lower extremity injuries are common in basketball, yet it is unclear how prophylactic interventions affect lower extremity injury incidence rates. Objective: To analyze the effectiveness of current lower extremity injury prevention programs in basketball athletes, focusing on injury rates of (1) general lower extremity injuries, (2) ankle sprains, and (3) anterior cruciate ligament (ACL) tears. Data Sources: PubMed, MEDLINE, CINAHL, SPORTDiscus, and the Cochrane Register of Controlled Trials were searched in January 2015. Study Selection: Studies were included if they were randomized controlled or prospective cohort trials, contained a population of competitive basketball athletes, and reported lower extremity injury incidence rates specific to basketball players. In total, 426 individual studies were identified. Of these, 9 met the inclusion criteria. One other study was found during a hand search of the literature, resulting in 10 total studies included in this meta-analysis. Study Design: Systematic review and meta-analysis. Level of Evidence: Level 2. Data Extraction: Details of the intervention (eg, neuromuscular vs external support), size of control and intervention groups, and number of injuries in each group were extracted from each study. Injury data were classified into 3 groups based on the anatomic diagnosis reported (general lower extremity injury, ankle sprain, ACL rupture). Results: Meta-analyses were performed independently for each injury classification. Results indicate that prophylactic programs significantly reduced the incidence of general lower extremity injuries (odds ratio [OR], 0.69; 95% CI, 0.57-0.85; P < 0.001) and ankle sprains (OR, 0.45; 95% CI, 0.29-0.69; P < 0.001), yet not ACL ruptures (OR, 1.09; 95% CI, 0.36-3.29; P = 0.87) in basketball athletes. Conclusion: In basketball players, prophylactic programs may be effective in reducing the risk of general lower extremity injuries and ankle sprains, yet not ACL injuries. PMID

  8. The lower ionosphere at high latitudes

    NASA Astrophysics Data System (ADS)

    Schunk, R. W.; Sojka, J. J.

    The lower ionosphere is a particularly difficult region to both observe and model. Although radars and rockets have probed this region for more than two decades, our overall understanding of the interplay between radiative, chemical, dynamical, and electrodynamical processes in the lower ionosphere is relatively poor in comparison to the other regions of the solar-terrestrial system. Part of the problem is that the various radar and rocket campaigns have focused on different scientific issues, have been of limited duration, or have been restricted to specific geographical locations. However, the lower ionosphere is a complex region, being acted upon by magnetospheric processes from above and stratospheric processes from below. Within the lower ionosphere are chemical reactions involving negative, positive, and cluster ions; transport processes that sometimes involve ordinary diffusion, turbulence, and wave-particle interactions due to plasma instabilities; radiative processes that could involve multiple scattering effects; and energetics that could result in non-Maxwellian ion velocity distribution functions. A further complication arises in that the processes acting on and within the lower ionosphere do so on widely different spatial and temporal scales, and these scales are directly reproduced in the medium. An overview of our current knowledge of the lower ionosphere is presented in this brief review, with the emphasis on the high latitude region.

  9. An anti-PCSK9 antibody reduces LDL-cholesterol on top of a statin and suppresses hepatocyte SREBP-regulated genes.

    PubMed

    Zhang, Liwen; McCabe, Timothy; Condra, Jon H; Ni, Yan G; Peterson, Laurence B; Wang, Weirong; Strack, Alison M; Wang, Fubao; Pandit, Shilpa; Hammond, Holly; Wood, Dana; Lewis, Dale; Rosa, Ray; Mendoza, Vivienne; Cumiskey, Anne Marie; Johns, Douglas G; Hansen, Barbara C; Shen, Xun; Geoghagen, Neil; Jensen, Kristian; Zhu, Lei; Wietecha, Karol; Wisniewski, Douglas; Huang, Lingyi; Zhao, Jing Zhang; Ernst, Robin; Hampton, Richard; Haytko, Peter; Ansbro, Frances; Chilewski, Shannon; Chin, Jayne; Mitnaul, Lyndon J; Pellacani, Andrea; Sparrow, Carl P; An, Zhiqiang; Strohl, William; Hubbard, Brian; Plump, Andrew S; Blom, Daniel; Sitlani, Ayesha

    2012-01-01

    Proprotein convertase subtilisin/kexin type 9 (PCSK9) is a promising therapeutic target for treating coronary heart disease. We report a novel antibody 1B20 that binds to PCSK9 with sub-nanomolar affinity and antagonizes PCSK9 function in-vitro. In CETP/LDLR-hemi mice two successive doses of 1B20, administered 14 days apart at 3 or 10 mpk, induced dose dependent reductions in LDL-cholesterol (≥ 25% for 7-14 days) that correlated well with the extent of PCSK9 occupancy by the antibody. In addition, 1B20 induces increases in total plasma antibody-bound PCSK9 levels and decreases in liver mRNA levels of SREBP-regulated genes PCSK9 and LDLR, with a time course that parallels decreases in plasma LDL-cholesterol (LDL-C). Consistent with this observation in mice, in statin-responsive human primary hepatocytes, 1B20 lowers PCSK9 and LDLR mRNA levels and raises serum steady-state levels of antibody-bound PCSK9. In addition, mRNA levels of several SREBP regulated genes involved in cholesterol and fatty-acid synthesis including ACSS2, FDPS, IDI1, MVD, HMGCR, and CYP51A1 were decreased significantly with antibody treatment of primary human hepatocytes. In rhesus monkeys, subcutaneous (SC) dosing of 1B20 dose-dependently induces robust LDL-C lowering (maximal ~70%), which is correlated with increases in target engagement and total antibody-bound PCSK9 levels. Importantly, a combination of 1B20 and Simvastatin in dyslipidemic rhesus monkeys reduced LDL-C more than either agent alone, consistent with a mechanism of action that predicts additive effects of anti-PCSK9 agents with statins. Our results suggest that antibodies targeting PCSK9 could provide patients powerful LDL lowering efficacy on top of statins, and lower cardiovascular risk.

  10. 16 CFR 1102.16 - Additional information.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... PUBLICLY AVAILABLE CONSUMER PRODUCT SAFETY INFORMATION DATABASE Content Requirements § 1102.16 Additional... in the Database any additional information it determines to be in the public interest,...

  11. 16 CFR 1102.16 - Additional information.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... PUBLICLY AVAILABLE CONSUMER PRODUCT SAFETY INFORMATION DATABASE Content Requirements § 1102.16 Additional... in the Database any additional information it determines to be in the public interest,...

  12. 16 CFR 1102.16 - Additional information.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... PUBLICLY AVAILABLE CONSUMER PRODUCT SAFETY INFORMATION DATABASE Content Requirements § 1102.16 Additional... in the Database any additional information it determines to be in the public interest,...

  13. The therapeutic role of niacin in dyslipidemia management.

    PubMed

    Boden, William E; Sidhu, Mandeep S; Toth, Peter P

    2014-03-01

    There is abundant epidemiologic evidence to support the independent, inverse relationship between low levels of high-density lipoprotein cholesterol (HDL-C) and incident cardiovascular (CV) risk, the clinical importance of which is underscored by the high prevalence of low HDL-C in populations with coronary heart disease (CHD), with or without elevated levels of low-density lipoprotein cholesterol (LDL-C). The National Cholesterol Education Program recommended that optimal treatment for high-risk patients includes both lowering LDL-C and non-HDL-C to risk stratified levels and raising HDL-C when it is <40 mg/dL, although no target level for the latter lipoprotein was suggested. Niacin is the most powerful agent currently available for raising low levels of HDL-C. It also induces significant reductions in triglycerides, lipoprotein(a), and LDL-C levels while also favorably altering LDL particle size and number. In the Coronary Drug Project, niacin treatment was associated with significant reductions in CV events and long-term mortality, similar to the reductions seen in the statin monotherapy trials. In combination trials, niacin plus a statin or bile acid sequestrant produces additive reductions in CHD morbidity and mortality and promotes regression of coronary atherosclerosis. Recently, 2 clinical outcome trials (Atherothrombosis Intervention in Metabolic Syndrome With Low HDL/High Triglycerides and Impact on Global Health Outcomes [AIM-HIGH] and Second Heart Protection Study [HPS-2 THRIVE]) failed to show a reduction in CV events in patients treated to optimally low levels of LDL-C. Despite favorable effects on HDL-C and triglycerides, these studies did not demonstrate incremental clinical benefit with niacin when added to simvastatin, although notable limitations were identified in each of these trials. Thus, there is insufficient evidence from clinical trials to recommend HDL-targeted therapy for additional event reduction at the present time. However, niacin

  14. Additive Construction using Basalt Regolith Fines

    NASA Technical Reports Server (NTRS)

    Mueller, Robert P.; Sibille, Laurent; Hintze, Paul E.; Lippitt, Thomas C.; Mantovani, James G.; Nugent, Matthew W.; Townsend, Ivan I.

    2014-01-01

    Planetary surfaces are often covered in regolith (crushed rock), whose geologic origin is largely basalt. The lunar surface is made of small-particulate regolith and areas of boulders located in the vicinity of craters. Regolith composition also varies with location, reflecting the local bedrock geology and the nature and efficiency of the micrometeorite-impact processes. In the lowland mare areas (suitable for habitation), the regolith is composed of small granules (20 - 100 microns average size) of mare basalt and volcanic glass. Impacting micrometeorites may cause local melting, and the formation of larger glassy particles, and this regolith may contain 10-80% glass. Studies of lunar regolith are traditionally conducted with lunar regolith simulant (reconstructed soil with compositions patterned after the lunar samples returned by Apollo). The NASA Kennedy Space Center (KSC) Granular Mechanics & Regolith Operations (GMRO) lab has identified a low fidelity but economical geo-technical simulant designated as Black Point-1 (BP-1). It was found at the site of the Arizona Desert Research and Technology Studies (RATS) analog field test site at the Black Point lava flow in adjacent basalt quarry spoil mounds. This paper summarizes activities at KSC regarding the utilization of BP-1 basalt regolith and comparative work with lunar basalt simulant JSC-1A as a building material for robotic additive construction of large structures. In an effort to reduce the import or in-situ fabrication of binder additives, we focused this work on in-situ processing of regolith for construction in a single-step process after its excavation. High-temperature melting of regolith involves techniques used in glassmaking and casting (with melts of lower density and higher viscosity than those of metals), producing basaltic glass with high durability and low abrasive wear. Most Lunar simulants melt at temperatures above 1100 C, although melt processing of terrestrial regolith at 1500 C is not

  15. Lower extremity muscle activation during baseball pitching.

    PubMed

    Campbell, Brian M; Stodden, David F; Nixon, Megan K

    2010-04-01

    The purpose of this study was to investigate muscle activation levels of select lower extremity muscles during the pitching motion. Bilateral surface electromyography data on 5 lower extremity muscles (biceps femoris, rectus femoris, gluteus maximus, vastus medialis, and gastrocnemius) were collected on 11 highly skilled baseball pitchers and compared with individual maximal voluntary isometric contraction (MVIC) data. The pitching motion was divided into 4 distinct phases: phase 1, initiation of pitching motion to maximum stride leg knee height; phase 2, maximum stride leg knee height to stride foot contact (SFC); phase 3, SFC to ball release; and phase 4, ball release to 0.5 seconds after ball release (follow-through). Results indicated that trail leg musculature elicited moderate to high activity levels during phases 2 and 3 (38-172% of MVIC). Muscle activity levels of the stride leg were moderate to high during phases 2-4 (23-170% of MVIC). These data indicate a high demand for lower extremity strength and endurance. Specifically, coaches should incorporate unilateral and bilateral lower extremity exercises for strength improvement or maintenance and to facilitate dynamic stabilization of the lower extremities during the pitching motion.

  16. Ionic Liquids as Novel Lubricants and /or Lubricant Additives

    SciTech Connect

    Qu, J.; Viola, M. B.

    2013-10-31

    This ORNL-GM CRADA developed ionic liquids (ILs) as novel lubricants or oil additives for engine lubrication. A new group of oil-miscible ILs have been designed and synthesized with high thermal stability, non-corrosiveness, excellent wettability, and most importantly effective anti-scuffing/anti-wear and friction reduction characteristics. Mechanistic analysis attributes the superior lubricating performance of IL additives to their physical and chemical interactions with metallic surfaces. Working with a leading lubricant formulation company, the team has successfully developed a prototype low-viscosity engine oil using a phosphonium-phosphate IL as an anti-wear additive. Tribological bench tests of the IL-additized formulated oil showed 20-33% lower friction in mixed and elastohydrodynamic lubrication and 38-92% lower wear in boundary lubrication when compared with commercial Mobil 1 and Mobil Clean 5W-30 engine oils. High-temperature, high load (HTHL) full-size engine tests confirmed the excellent anti-wear performance for the IL-additized engine oil. Sequence VID engine dynamometer tests demonstrated an improved fuel economy by >2% for this IL-additized engine oil benchmarked against the Mobil 1 5W-30 oil. In addition, accelerated catalyst aging tests suggest that the IL additive may potentially have less adverse impact on three-way catalysts compared to the conventional ZDDP. Follow-on research is needed for further development and optimization of IL chemistry and oil formulation to fully meet ILSAC GF-5 specifications and further enhance the automotive engine efficiency and durability.

  17. Health studies indicate MTBE is safe gasoline additive

    SciTech Connect

    Anderson, E.V.

    1993-09-01

    Implementation of the oxygenated fuels program by EPA in 39 metropolitan areas, including Fairbanks and Anchorage, Alaska, in the winter of 1992, encountered some unexpected difficulties. Complaints of headaches, dizziness, nausea, and irritated eyes started in Fairbanks, jumped to Anchorage, and popped up in various locations in the lower 48 states. The suspected culprit behind these complaints was the main additive for oxygenation of gasoline is methyl tert-butyl ether (MTBE). A test program, hastily organized in response to these complaints, has indicated that MTBE is a safe gasoline additive. However, official certification of the safety of MTBE is still awaited.

  18. Upper entropy axioms and lower entropy axioms

    NASA Astrophysics Data System (ADS)

    Guo, Jin-Li; Suo, Qi

    2015-04-01

    The paper suggests the concepts of an upper entropy and a lower entropy. We propose a new axiomatic definition, namely, upper entropy axioms, inspired by axioms of metric spaces, and also formulate lower entropy axioms. We also develop weak upper entropy axioms and weak lower entropy axioms. Their conditions are weaker than those of Shannon-Khinchin axioms and Tsallis axioms, while these conditions are stronger than those of the axiomatics based on the first three Shannon-Khinchin axioms. The subadditivity and strong subadditivity of entropy are obtained in the new axiomatics. Tsallis statistics is a special case of satisfying our axioms. Moreover, different forms of information measures, such as Shannon entropy, Daroczy entropy, Tsallis entropy and other entropies, can be unified under the same axiomatics.

  19. Upper entropy axioms and lower entropy axioms

    SciTech Connect

    Guo, Jin-Li Suo, Qi

    2015-04-15

    The paper suggests the concepts of an upper entropy and a lower entropy. We propose a new axiomatic definition, namely, upper entropy axioms, inspired by axioms of metric spaces, and also formulate lower entropy axioms. We also develop weak upper entropy axioms and weak lower entropy axioms. Their conditions are weaker than those of Shannon–Khinchin axioms and Tsallis axioms, while these conditions are stronger than those of the axiomatics based on the first three Shannon–Khinchin axioms. The subadditivity and strong subadditivity of entropy are obtained in the new axiomatics. Tsallis statistics is a special case of satisfying our axioms. Moreover, different forms of information measures, such as Shannon entropy, Daroczy entropy, Tsallis entropy and other entropies, can be unified under the same axiomatics.

  20. Lower-Limb Rehabilitation Robot Design

    NASA Astrophysics Data System (ADS)

    Bouhabba, E. M.; Shafie, A. A.; Khan, M. R.; Ariffin, K.

    2013-12-01

    It is a general assumption that robotics will play an important role in therapy activities within rehabilitation treatment. In the last decade, the interest in the field has grown exponentially mainly due to the initial success of the early systems and the growing demand caused by increasing numbers of stroke patients and their associate rehabilitation costs. As a result, robot therapy systems have been developed worldwide for training of both the upper and lower extremities. This paper investigates and proposes a lower-limb rehabilitation robot that is used to help patients with lower-limb paralysis to improve and resume physical functions. The proposed rehabilitation robot features three rotary joints forced by electric motors providing linear motions. The paper covers mechanism design and optimization, kinematics analysis, trajectory planning, wearable sensors, and the control system design. The design and control system demonstrate that the proposed rehabilitation robot is safe and reliable with the effective design and better kinematic performance.

  1. Progressive Thinning of Visual Motion Area in Lower Limb Amputees

    PubMed Central

    Jiang, Guangyao; Li, Chuanming; Wu, Jixiang; Jiang, Tianzi; Zhang, Yi; Zhao, Lu; Evans, Alan C.; Li, Lei; Ran, Shuhua; Yin, Xuntao; Wang, Jian

    2016-01-01

    Accumulating evidence has indicated that amputation or deafferentation of a limb induces functional or structural reorganization in the visual areas. However, the extent of the visual areas involved after lower limb amputation remains uncertain. In this investigation, we studied 48 adult patients with unilateral lower limb amputation and 48 matched healthy controls using T1-weighted magnetic resonance imaging. Template-based regions of interest analysis was implemented to detect the changes of cortical thickness in the specific visual areas. Compared with normal controls, amputees exhibited significantly lower thickness in the V5/middle temporal (V5/MT+) visual area, as well as a trend of cortical thinning in the V3d. There was no significant difference in the other visual areas between the two groups. In addition, no significant difference of cortical thickness was found between patients with amputation at different levels. Across all amputees, correlation analyses revealed that the cortical thickness of the V5/MT+ was negatively correlated to the time since amputation. In conclusion, our findings indicate that the amputation of unilateral lower limb could induce changes in the motor-related visual cortex and provide an update on the plasticity of the human brain after limb injury. PMID:26973497

  2. Sound velocities of ferropericlase in the Earth's lower mantle.

    SciTech Connect

    Lin, J. F.; Jacobsen, S. D.; Sturhahn, W.; Jackson, J. M.; Zhao, J.; Yoo, C. S.; X-Ray Science Division

    2006-11-18

    Sound velocity measurements on candidate mantle minerals at relevant mantle conditions are needed to interpret Earth's seismic structure in terms of model abundances, variable composition, and other potentially influential parameters such as electronic spin-pairing transitions. Here the sound velocities of the lower-mantle ferropericlase have been measured by nuclear resonant inelastic X-ray scattering to 110 GPa. Compressional and shear wave velocities and their pressure derivatives rise dramatically across the spin-pairing transition of iron in (Mg0.75Fe0.25)O above 50 GPa. Effects of the transition on the sound velocities of (Mg, Fe)O at lower-mantle pressures yield values that are much greater than what is predicted by studying pure MgO and high-spin ferropericlase. Our results indicate that sound velocities of the low-spin ferropericlase need to be considered in future geophysical and geochemical models, which could offset the effect of the addition of iron in the lower-mantle minerals and affect the evaluation of the lower-mantle heterogeneities.

  3. Lower Hybrid to Whistler Wave Conversion

    SciTech Connect

    Winske, Dan

    2012-07-16

    In this presentation we discuss recent work concerning the conversion of whistler waves to lower hybrid waves (as well as the inverse process). These efforts have been motivated by the issue of attenuation of upward propagating whistler waves in the ionosphere generated by VLF transmitters on the ground, i.e., the 'Starks 20 db' problem, which affects the lifetimes of energetic electrons trapped in the geomagnetic field at low magnetic altitude (L). We discuss recent fluid and kinetic plasma simulations as well as ongoing experiments at UCLA to quantify linear and nonlinear mode conversion of lower hybrid to whistler waves.

  4. Uniquely designed nuclear structures of lower eukaryotes.

    PubMed

    Iwamoto, Masaaki; Hiraoka, Yasushi; Haraguchi, Tokuko

    2016-06-01

    The nuclear structures of lower eukaryotes, specifically protists, often vary from those of yeasts and metazoans. Several studies have demonstrated the unique and fascinating features of these nuclear structures, such as a histone-independent condensed chromatin in dinoflagellates and two structurally distinct nuclear pore complexes in ciliates. Despite their unique molecular/structural features, functions required for formation of their cognate molecules/structures are highly conserved. This provides important information about the structure-function relationship of the nuclear structures. In this review, we highlight characteristic nuclear structures found in lower eukaryotes, and discuss their attractiveness as potential biological systems for studying nuclear structures.

  5. Lower Rio Parana Panaramic, Argentina, South America

    NASA Technical Reports Server (NTRS)

    1992-01-01

    This southeast looking view shows the lower Parana River (32.0S, 59.5W) of central Argentina with floodwaters obscuring most of the valley bottom detail. The rain swollen lower 300 km of the river, that displaced some 200,000 people, even appears as an arm of the ocean. Uruguay is visible at top left and cities appear as small white patches. Buenos Aires, South America's largest city, can be seen on the south shore of Rio de la Plata.

  6. Overuse lower extremity injuries in sports.

    PubMed

    Fullem, Brian W

    2015-04-01

    When athletes train harder the risk of injury increases, and there are several common overuse injuries to the lower extremity. Three of the most common lower extremity overuse injuries in sports are discussed including the diagnosis and treatments: medial tibal stress syndrome, iliotibial band syndrome, and stress fractures. The charge of sports medicine professionals is to identify and treat the cause of the injuries and not just treat the symptoms. Symptomatology is an excellent guide to healing and often the patient leads the physician to the proper diagnosis through an investigation of the athlete's training program, past injury history, dietary habits, choice of footwear, and training surface. PMID:25804713

  7. Lower body negative pressure, experiment M092

    NASA Technical Reports Server (NTRS)

    Johnson, R. L.; Nicogossian, A. E.; Jackson, M. M.; Hoffler, G. W.; Wolthuis, R. A.

    1973-01-01

    Evaluation of orthostatic intolerance has been achieved by the use of lower body negative pressure (LBNP). The LBNP technique, though independent of gravity, simulates its effect by exposing the legs and the lower abdomen to reduced ambient pressures. This LBNP experiment, conducted during the 56-day simulation of the Skylab environment, was designed to supply baseline information on cardiovascular responses to periodic orthostatic stress. Impaired orthostatic tolerance, manifested by the increased heart rate, diminished systolic and pulse pressure, and increased tendency to syncope in the upright position, or during LBNP, was not observed in this experiment.

  8. Botulinum toxin for the lower urinary tract.

    PubMed

    Chuang, Yao-Chi; Kuo, Hann-Chorng; Chancellor, Michael B

    2010-04-01

    Botulinum toxins (BoNTs) are known for their ability to potently and selectively modulate neurotransmission for successful long-term treatment of muscle hypercontractility. Recent studies suggest that BoNT has effects on modulation of sensory processing, inflammation and glandular function. Urologists and urogynaecologists have become interested in the potential application of BoNTs in patients with lower urinary tract symptoms, including detrusor and sphincter overactivity, bladder hypersensitivity, interstitial cystitis/painful bladder symptoms and benign prostatic hyperplasia. We review the biological action of BoNT in bladder and prostate, and present the techniques and results of the clinical studies with BoNT in the lower urinary tract.

  9. Studies in upper and lower atmosphere coupling

    NASA Technical Reports Server (NTRS)

    Chiu, Y. T.; Rice, C. J.; Sharp, L. R.

    1979-01-01

    The theoretical and data-analytic work on upper and lower atmosphere coupling performed under a NASA Headquarters contract during the period April 1978 to March 1979 are summarized. As such, this report is primarily devoted to an overview of various studies published and to be published under this contract. Individual study reports are collected as exhibits. Work performed under the subject contract are in the following four areas of upper-lower atmosphere coupling: (1) Magnetosphere-ionosphere electrodynamic coupling in the aurora; (2) Troposphere-thermosphere coupling; (3) Ionosphere-neutral-atmosphere coupling; and (4) Planetary wave dynamics in the middle atmosphere.

  10. Exertional compartment syndromes of the lower extremity.

    PubMed

    Schepsis, A A; Lynch, G

    1996-03-01

    Compartment syndromes may be acute or chronic secondary to exertion or exercise. The chronic or exertional type most commonly involves the lower extremity, particularly the anterior compartment of the lower leg, and is the subject of this review. Rarely, an exertional compartment syndrome may become acute. The diagnosis is based on history, physical examination, and compartment pressure measurements. The differential diagnosis of exertional leg pain includes stress fractures, stress reaction, periostitis, claudication, popliteal artery entrapment, and peripheral nerve entrapment. Unusual causes, such as a ganglion of the proximal tibiofibular joint causing an anterior compartment syndrome, have recently been reported.

  11. 45. VIEW OF UPPER LEVEL CRUSHER ADDITION FROM CRUSHED OXIDIZED ...

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

    45. VIEW OF UPPER LEVEL CRUSHER ADDITION FROM CRUSHED OXIDIZED ORE BIN. 18 INCH BELT CONVEYOR BIN FEED, LOWER CENTER, WITH STEPHENS-ADAMSON 25 TON/HR ELEVATOR SPLIT DISCHARGE (OXIDIZED/UNOXIDIZED) IN CENTER. CRUDE ORE BINS AND MACHINE SHOP BEYOND. NOTE TOP OF CRUSHED OXIDIZED ORE BIN IS BELOW TOP OF CRUDE ORE BINS. - Bald Mountain Gold Mill, Nevada Gulch at head of False Bottom Creek, Lead, Lawrence County, SD

  12. Decision-Making, Science and Gasoline Additives

    NASA Astrophysics Data System (ADS)

    Weaver, J. W.; Small, M. C.

    2001-12-01

    Methyl-tert butyl ether (MTBE) has been used as a gasoline additive to serve two major purposes. The first use was as an octane-enhancer to replace organic lead, beginning in 1979. The second use, which began about 1992, was as a oxygenated additive to meet requirements of the Clean Air Act Amendments (CAAA) of 1990. Generally, the amount of MTBE used for octane enhancement was lower than that required to meet CAAA requirements. An unintended consequence of MTBE use has been widespread groundwater contamination. The decision to use certain amounts of MTBE or other chemcials as gasoline additives is the outcome of economic, regulatory, policy, political, and scientific considerations. Decision makers ask questions such as "How do ground water impacts change with changing MTBE content? How many wells would be impacted? and What are the associated costs?" These are best answered through scientific inquiry, but many different approaches could be developed. Decision criteria include time, money, comprehensiveness, and complexity of the approach. Because results must be communicated to a non-technical audience, there is a trade off between the complexity of the approach and the ability to convince economists, lawyers and policy makers that results make sense. The question on MTBE content posed above was investigated using transport models, a release scenario and gasoline composition. Because of the inability of transport models to predict future concentrations, an approach was chosen to base comparative assessment on a calibrated model. By taking this approach, "generic" modeling with arbitrarily selected parameters was avoided and the validity of the simulation results rests upon relatively small extrapolations from the original calibrated models. A set of simulations was performed that assumed 3% (octane enhancement) and 11% (CAAA) MTBE in gasoline. The results were that ground water concentrations would be reduced in proportion to the reduction of MTBE in the fuel

  13. Lower Granite Dam Smolt Monitoring Program, 1999 Annual Report.

    SciTech Connect

    Verhey, Peter; Morrill, Charles; Mensik, Fred

    1999-01-01

    The 1999 fish collection season at Lower Granite was characterized by high spring flows and spill, low levels of debris, cool water temperatures, increased hatchery chinook numbers, and an overall decrease in numbers of smolts collected and transported. A total of 5,882,872 juvenile salmonids were collected at Lower Granite. Of these, 5,466,057 were transported to release sites below Bonneville Dam, 5,232,105 by barge and 233,952 by truck. An additional 339,398 fish were bypassed back to the river. A total of 117,609 salmonids were examined in daily samples. Nine research projects conducted by four agencies impacted a total of 440,810 smolts (7.5% of the total collected) of which 247,268 were PIT tagged and 572 were recorded as incidental mortalities.

  14. Diagnostic Work-Up of Lower Urinary Tract Symptoms.

    PubMed

    Hecht, Sarah L; Hedges, Jason C

    2016-08-01

    The goal of work-up of lower urinary tract symptoms is to establish the severity and cause of lower urinary tract symptoms and to predict with certainty which patients will respond to which treatments. Clinical guidelines exist to guide urologists in decision-making. All patients need a medical history with a validated symptom score, a physical examination, and a urinalysis. Prostate-specific antigen, postvoid urine residual, and peak urine flow rate provide additional information at little cost. For more invasive testing high-level data are lacking and guidelines defer to the urologist. Even the most extensive work-up is imperfect, and thus the attempt to balance costs with benefits of invasive testing. PMID:27476123

  15. Septic tank additive impacts on microbial populations.

    PubMed

    Pradhan, S; Hoover, M T; Clark, G H; Gumpertz, M; Wollum, A G; Cobb, C; Strock, J

    2008-01-01

    Environmental health specialists, other onsite wastewater professionals, scientists, and homeowners have questioned the effectiveness of septic tank additives. This paper describes an independent, third-party, field scale, research study of the effects of three liquid bacterial septic tank additives and a control (no additive) on septic tank microbial populations. Microbial populations were measured quarterly in a field study for 12 months in 48 full-size, functioning septic tanks. Bacterial populations in the 48 septic tanks were statistically analyzed with a mixed linear model. Additive effects were assessed for three septic tank maintenance levels (low, intermediate, and high). Dunnett's t-test for tank bacteria (alpha = .05) indicated that none of the treatments were significantly different, overall, from the control at the statistical level tested. In addition, the additives had no significant effects on septic tank bacterial populations at any of the septic tank maintenance levels. Additional controlled, field-based research iswarranted, however, to address additional additives and experimental conditions.

  16. Chronic Lower Leg Pain in Athletes

    PubMed Central

    Brewer, Rachel Biber; Gregory, Andrew J. M.

    2012-01-01

    Context: Chronic lower leg pain in athletes can be a frustrating problem for patients and a difficult diagnosis for clinicians. Myriad approaches have been suggested to evaluate these conditions. With the continued evolution of diagnostic studies, evidence-based guidance for a standard approach is unfortunately sparse. Evidence Acquisition: PubMed was searched from January 1980 to May 2011 to identify publications regarding chronic lower leg pain in athletes (excluding conditions related to the foot), including differential diagnosis, clinical presentation, physical examination, history, diagnostic workup, and treatment. Results: Leg pain in athletes can be caused by many conditions, with the most frequent being medial tibial stress syndrome; chronic exertional compartment syndrome, stress fracture, nerve entrapment, and popliteal artery entrapment syndrome are also considerations. Conservative management is the mainstay of care for the majority of causes of chronic lower leg pain; however, surgical intervention may be necessary. Conclusion: Chronic lower extremity pain in athletes includes a wide differential and can pose diagnostic dilemmas for clinicians. PMID:23016078

  17. NCES Finds States Lowered "Proficiency" Bar

    ERIC Educational Resources Information Center

    Viadero, Debra

    2009-01-01

    With 2014 approaching as the deadline by which states must get all their students up to "proficient" levels on state tests, a study released last week by the U.S. Department of Education's top statistics agency suggests that some states may have lowered student-proficiency standards on such tests in recent years. For the 47-state study,…

  18. Concordances for Lower-Level Classes.

    ERIC Educational Resources Information Center

    Cain, Gordon

    2002-01-01

    Relates how one teacher used a C-ROM encyclopedia, a concordancer, and a word processor to make concordances suitable for lower-level language learners. These concordances helped overcome the unfamiliarity of 80-character KWIC lines and the difficulties of obscure vocabulary, and were useful in the teaching of grammar and lexis. (Author/VWL)

  19. Cartilaginous choristoma of the lower lip.

    PubMed

    Shibasaki, Maiko; Iwai, Toshinori; Chikumaru, Hiroshi; Inayama, Yoshiaki; Tohnai, Iwai

    2013-03-01

    Choristoma is a tumor-like mass consisting of normal cells in an abnormal location. Cartilaginous choristoma, which is composed of ectopic cartilaginous tissue, very rarely presents in the oral cavity and most commonly in the tongue. Here we report an extremely rare case of cartilaginous choristoma of the lower lip.

  20. Density profile of pyrolitic lower mantle

    NASA Astrophysics Data System (ADS)

    Sinmyo, R.; Hirose, K.; Ohishi, Y.

    2010-12-01

    Density profile of pyrolite at lower mantle high-pressure (P) and -temperature (T) conditions was investigated by using laser-heated diamond-anvil cell up to 117 GPa and 2800 K. The density was determined from chemical composition and unit-cell volume of each constituent mineral (MgSiO3-rich perovskite, ferropericlase and CaSiO3-rich perovskite). The chemical compositions of coexisting phases were analyzed by transmission electron microscope, and their volumes were obtained by in-situ X-ray diffraction measurements. To avoid extensive chemical segregation during laser-heating, sample was coated by gold that worked as a laser absorber (Sinmyo and Hirose 2010 PEPI). Results of chemical analyses show that Mg-Fe (total Fe) partitioning coefficient between MgSiO3-rich perovskite and ferropericlase [K* = (Fe*/Mg)Pv/(Fe*/Mg)Fp] is about 0.6, slightly higher than the value previously reported in the pyrolitic bulk composition (Murakami et al. 2005 GRL). The lower K* value in the previous study may be attributed to the chemical heterogeneity in the sample induced by strong temperature gradient during laser heating. The calculated density profile of pyrolite is indeed in good agreement with the PREM model within experimental errors, in contrast with the mismatch reported by the previous study (Ricolleau et al. 2009 GRL). Our results support the lower mantle has pyrolitic bulk composition, and thus it is not necessary to suppose the chemically stratification in the lower mantle.

  1. Elasticity of ferropericlase at lower mantle conditions

    NASA Astrophysics Data System (ADS)

    Wu, Z.; Justo, J. F.; Wentzcovitch, R. M.

    2014-12-01

    Clarification of the effect of the iron spin change on properties of Fp is important to address the relative abundance of Fp in the lower mantle. However, recent reports to this question show completely different conclusions. The calculated density of a pyrolite aggregate with spin crossover-related change in iron partitioning up to 45 GPa compared well with the density in PREM [1]. On the other hand, Murakami et al's analysis of VS in aggregates with variable amounts of Fp concluded the opposite - the lower mantle is more perovskitic than pyrolitic [2]. We investigated thermoelasticity of Fp with first principles DFT+U calculations. The calculated thermoelasticity are in good consitence with the available experimental data on samples with various iron concentrations. The results can well explain discrepancy on softening of the shear modulus of Fp among different experiments[3,4]. We predict velocities of Fp at lower mantle conditions and suggest that pyrolite is a reasonable compositional model for the lower mantle. Our results show the importance of constraining the elastic properties of minerals without extrapolations for analyses of the thermochemical state of this region[5]. [1] Irifune et al., Science 327, 193 (2010). [2] Murakami et al., Nature 485, 90 (2012). [3] Crowhurst et al., Science 319, 451 (2008). [4] Marquardt et al., Science 324, 224 (2009). [5]Wu et al., Phys. Rev. Lett. 110. 228501 (2013)

  2. Explaining Lower Educated Workers' Training Intentions

    ERIC Educational Resources Information Center

    Sanders, Jos; Oomens, Shirley; Blonk, Roland W. B.; Hazelzet, Astrid

    2011-01-01

    Purpose: The purpose of this study is to contribute to the discussion on how to increase lower educated workers' participation in training programs inside and outside the workplace through stimulating intentions with respect to training. Design/methodology/approach: This article is based on data from the Study on Life Long Learning and Employment…

  3. Use and Usefulness of Lower Limb Prostheses.

    ERIC Educational Resources Information Center

    Buijk, Catharina A.

    1988-01-01

    Adults (n=181) in the Netherlands were surveyed concerning their use of lower limb prostheses. Results are analyzed in terms of age and sex of users, reason for amputation, level of amputation, description of prosthesis, amount of time able to walk or stand, satisfaction with the prosthesis, and user recommendations. (JDD)

  4. Opinion formation with upper and lower bounds

    NASA Astrophysics Data System (ADS)

    Yano, Ryosuke; Martin, Arnaud

    2015-12-01

    We investigate the opinion formation with upper and lower bounds. We formulate the binary exchange of opinions between two peoples under the second (or political) party using the relativistic inelastic-Boltzmann-Vlasov equation with randomly perturbed motion. In this paper, we discuss the relativistic effects on the opinion formation of peoples from the standpoint of the relativistic kinetic theory.

  5. Lowering the Permanent Rate of Unemployment.

    ERIC Educational Resources Information Center

    Feldstein, Martin S.

    The first section of the study on lowering the permanent rate of unemployment discusses the effects and limitations of increasing aggregate demand through fiscal and monetary policy and indicates the inability to achieve the desired level of unemployment simply by stimulating demand. Section 2 analyzes the characteristics and structure of our…

  6. Salivary Cortisol Lower in Posttraumatic Stress Disorder

    PubMed Central

    Wahbeh, Helané; Oken, Barry S.

    2013-01-01

    Altered cortisol has been demonstrated to be lower in posttraumatic stress disorder (PTSD) in most studies. This cross-sectional study evaluated salivary cortisol at waking, 30 minutes after, and bedtime in 51 combat veterans with PTSD compared to 20 veterans without PTSD. It also examined the relationship of cortisol to PTSD symptoms using two classifications: DSM-IV and the more recent four-factor classification proposed for DSM-V. The PTSD group had lower cortisol values than the control group (F(6, 69) = 3.35, p = .006). This significance did not change when adding age, body mass index, smoking, medications affecting cortisol, awakening time, sleep duration, season, depression, perceived stress, service era, combat exposure, and lifetime trauma as covariates. Post-hoc analyses revealed that the PTSD group had lower area under the curve ground and waking, 30min, and bedtime values while the cortisol awakening response and area under the curve increase were not different between groups. The four-factor avoidance PTSD symptom cluster was associated with cortisol but not the other symptom clusters. This study supports the finding that cortisol is lower in people with PTSD. PMID:23529862

  7. Caring for patients with lower limb amputation.

    PubMed

    Ruff, Deborah

    In 2014 a National Confidential Enquiry into Patient Outcome and Death report examined the care of people requiring lower limb amputation as a consequence of complications associated with vascular disease or diabetes. It suggests that less than half of patients who undergo surgery receive good care. This article summarises the key findings of the report and the implications for nursing practice.

  8. Dynamic modeling of lower hybrid current drive

    SciTech Connect

    Ignat, D.W.; Valeo, E.J.; Jardin, S.C.

    1993-10-01

    A computational model of lower hybrid current drive in the presence of an electric field is described and some results are given. Details of geometry, plasma profiles and circuit equations are treated carefully. Two-dimensional velocity space effects are approximated in a one-dimensional Fokker-Planck treatment.

  9. THE LOWER STATUS PUERTO RICAN FAMILY. REVISED.

    ERIC Educational Resources Information Center

    BRAM, JOSEPH

    THIS SOCIOLOGICAL ANALYSIS DESCRIBES THE LOWER-STATUS URBAN AND RURAL FAMILIES IN PUERTO RICO. THE "JIBAROS," THE RURAL POOR OF THE HIGHLANDS, ARE LANDLESS AGRICULTURAL WORKERS WHO ARE MORE ISOLATED, LESS LITERATE, AND LESS ACCULTURATED TO URBAN LIFE THAN OTHER PUERTO RICANS. THEY TEND TO BE IDEALIZED AS THE PROTOTYPES OF THE ISLAND FOLK CULTURE.…

  10. Exploring the Limits of Frequency Lowering

    ERIC Educational Resources Information Center

    Souza, Pamela E.; Arehart, Kathryn H.; Kates, James M.; Croghan, Naomi B. H.; Gehani, Namita

    2013-01-01

    Purpose: This study examined how frequency lowering affected sentence intelligibility and quality for adults with postlingually acquired, mild-to-moderate hearing loss. Method: Listeners included adults aged 60-92 years with sloping sensorineural hearing loss and a control group of similarly aged adults with normal hearing. Sentences were…

  11. Lower Cretaceous lacustrine deposits and paleosol development

    SciTech Connect

    Mantzios, C.; Vondra, C.F.

    1987-05-01

    The Little Sheep Mudstone Member of the Lower Cretaceous Cloverly Formation in the Big Horn basin, Wyoming, is predominantly a montmorillonite-rich lacustrine deposit. It is informally subdivided into lower and upper units. The lower unit is a playa-lake deposit rich in bentonite derived from the alteration of volcanic ash which had its origin to the west. Horizons of silcretes and septarian nodules are common. The latter show irregular lenticular cracks and are filled with coarse calcite and barite crystals. They formed by desiccation of a clay-gel during dry periods. Silcretes are diagenetic products that formed due to the lowering of silica solubility along with decreasing of the pH value. Desiccation cracks on the playa surface were filled with chalcedony which later underwent replacement by calcite. The upper unit is a perennial saline lake deposit similar to that accumulating in Lake Magadi of the Eastern Rift Valley, Kenya, Chert nodules covered with calcium carbonate form stratigraphically persistent horizons. This chert is the product of the magadiite-kenyaite-chert transformation of Hay. Lenticular devitrified tuffs occurring at various stratigraphic positions up to 3 m thick were deposited in depressions or swales. Locally the tuffs show evidence of mass movement. Pedogenic features in both units indicate paleosol development. Tree trunks, plant roots, burrows, clay-rich zones, and organic-rich A and more iron-rich B master horizons are recognized. These paleosols resemble modern-day Vertisols. The lower unit is not as extensive areally as the upper unit which is present throughout the Big Horn basin, indicating that extensive lakes occurred during the Early Cretaceous in the Sevier foreland basin.

  12. Electron beam driven lower hybrid waves in a dusty plasma

    SciTech Connect

    Prakash, Ved; Vijayshri; Sharma, Suresh C.; Gupta, Ruby

    2013-05-15

    An electron beam propagating through a magnetized dusty plasma drives electrostatic lower hybrid waves to instability via Cerenkov interaction. A dispersion relation and the growth rate of the instability for this process have been derived taking into account the dust charge fluctuations. The frequency and the growth rate of the unstable wave increase with the relative density of negatively charged dust grains. Moreover, the growth rate of the instability increases with beam density and scales as the one-third power of the beam density. In addition, the dependence of the growth rate on the beam velocity is also discussed.

  13. Additive Manufacturing of Aerospace Propulsion Components

    NASA Technical Reports Server (NTRS)

    Misra, Ajay K.; Grady, Joseph E.; Carter, Robert

    2015-01-01

    The presentation will provide an overview of ongoing activities on additive manufacturing of aerospace propulsion components, which included rocket propulsion and gas turbine engines. Future opportunities on additive manufacturing of hybrid electric propulsion components will be discussed.

  14. 46 CFR 355.5 - Additional material.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... STATES CITIZENSHIP § 355.5 Additional material. If additional material is determined to be essential to clarify or support the evidence of U.S. citizenship, such material shall be furnished by...

  15. 46 CFR 355.5 - Additional material.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... STATES CITIZENSHIP § 355.5 Additional material. If additional material is determined to be essential to clarify or support the evidence of U.S. citizenship, such material shall be furnished by...

  16. 46 CFR 355.5 - Additional material.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... STATES CITIZENSHIP § 355.5 Additional material. If additional material is determined to be essential to clarify or support the evidence of U.S. citizenship, such material shall be furnished by...

  17. 46 CFR 355.5 - Additional material.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... STATES CITIZENSHIP § 355.5 Additional material. If additional material is determined to be essential to clarify or support the evidence of U.S. citizenship, such material shall be furnished by...

  18. 46 CFR 355.5 - Additional material.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... STATES CITIZENSHIP § 355.5 Additional material. If additional material is determined to be essential to clarify or support the evidence of U.S. citizenship, such material shall be furnished by...

  19. [Safety of food additives in Japan].

    PubMed

    Ito, Sumio

    2011-01-01

    Recently, many accidents relating to food happened in Japan. The consumer's distrust for food, food companies, and the administration is increasing. The consumer especially has an extreme refusal feeling for chemicals such as food additives and agricultural chemicals, and begins to request agricultural chemical-free vegetables and food additive-free food. Food companies also state no agricultural chemicals and no food additives to correspond with consumers' request and aim at differentiating. The food additive is that the Ministry of Health, Labour and Welfare specifies the one that person's health might not be ruined by providing for Food Sanitation Law Article 10 in our country. The standard for food additives and standard for use of food additives are provided according to regulations of Food Sanitation Law Article 11. Therefore, it is thought that the food additive used is safe now. Then, it reports on the procedure and the safety examination, etc. in our country for designation for food additive this time.

  20. 42 CFR 412.115 - Additional payments.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Payment Systems § 412.115 Additional payments. (a) Bad debts. An additional payment is made to each hospital in accordance with § 413.89 of this chapter for bad debts attributable to deductible...

  1. 42 CFR 412.115 - Additional payments.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Payment Systems § 412.115 Additional payments. (a) Bad debts. An additional payment is made to each hospital in accordance with § 413.89 of this chapter for bad debts attributable to deductible...

  2. 42 CFR 412.115 - Additional payments.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Payment Systems § 412.115 Additional payments. (a) Bad debts. An additional payment is made to each hospital in accordance with § 413.89 of this chapter for bad debts attributable to deductible...

  3. Geomorphology of the lower Copper River, Alaska

    USGS Publications Warehouse

    Brabets, Timothy P.

    1997-01-01

    The Copper River, located in southcentral Alaska, drains an area of more than 24,000 square miles. About 30 miles above its mouth, this large river enters Miles Lake, a proglacial lake formed by the retreat of Miles Glacier. Downstream from the outlet of Miles Lake, the Copper River flows past the face of Childs Glacier before it enters a large, broad, alluvial flood plain. The Copper River Highway traverses this flood plain and in 1995, 11 bridges were located along this section of the highway. These bridges cross parts of the Copper River and in recent years, some of these bridges have sustained serious damage due to the changing course of the Copper River. Although the annual mean discharge of the lower Copper River is 57,400 cubic feet per second, most of the flow occurs during the summer months from snowmelt, rainfall, and glacial melt. Approximately every six years, an outburst flood from Van Cleve Lake, a glacier-dammed lake formed by Miles Glacier, releases approximately 1 million acre-feet of water into the Copper River. When the outflow rate from Van Cleve Lake reaches it peak, the flow of the Copper River will increase between 150,000 to 190,000 cubic feet per second. Data collected by bedload sampling and continuous seismic reflection indicated that Miles Lake traps virtually all the bedload being transported by the Copper River as it enters the lake from the north. The reservoir-like effect of Miles Lake results in the armoring of the channel of the Copper River downstream from Miles Lake, past Childs Glacier, until it reaches the alluvial flood plain. At this point, bedload transport begins again. The lower Copper River transports 69 million tons per year of suspended sediment, approximately the same quantity as the Yukon River, which drains an area of more than 300,000 square miles. By correlating concurrent flows from a long-term streamflow-gaging station on the Copper River with a short-term streamflow-gaging station at the outlet of Miles Lake

  4. Lower extremity finite element model for crash simulation

    SciTech Connect

    Schauer, D.A.; Perfect, S.A.

    1996-03-01

    A lower extremity model has been developed to study occupant injury mechanisms of the major bones and ligamentous soft tissues resulting from vehicle collisions. The model is based on anatomically correct digitized bone surfaces of the pelvis, femur, patella and the tibia. Many muscles, tendons and ligaments were incrementally added to the basic bone model. We have simulated two types of occupant loading that occur in a crash environment using a non-linear large deformation finite element code. The modeling approach assumed that the leg was passive during its response to the excitation, that is, no active muscular contraction and therefore no active change in limb stiffness. The approach recognized that the most important contributions of the muscles to the lower extremity response are their ability to define and modify the impedance of the limb. When nonlinear material behavior in a component of the leg model was deemed important to response, a nonlinear constitutive model was incorporated. The accuracy of these assumptions can be verified only through a review of analysis results and careful comparison with test data. As currently defined, the model meets the objective for which it was created. Much work remains to be done, both from modeling and analysis perspectives, before the model can be considered complete. The model implements a modeling philosophy that can accurately capture both kinematic and kinetic response of the lower limb. We have demonstrated that the lower extremity model is a valuable tool for understanding the injury processes and mechanisms. We are now in a position to extend the computer simulation to investigate the clinical fracture patterns observed in actual crashes. Additional experience with this model will enable us to make a statement on what measures are needed to significantly reduce lower extremity injuries in vehicle crashes. 6 refs.

  5. Results from a new auroral lower ionosphere model

    NASA Astrophysics Data System (ADS)

    McKinnell, L. A.; Friedrich, M.

    This paper presents first results from the development of a new auroral latitude lower ionospheric model. The major difference between this new model and other models for the same region is that the technique of neural networks (NNs) was employed in the development. Data from the European Incoherent Scatter facility combined with rocket measurements were used to provide a database of reliable lower ionosphere data from approximately 70° geomagnetic. NN modelling requires a substantial database of reliable data with which the NN is trained to learn the relationship between the input space and the output parameter. Combinations of various input parameters known to produce a response in the lower ionosphere were investigated as potential contributors to the input space. The final input space consisted of local magnetic time, riometer absorption, a local magnetic K index, the inverse Chapman function corresponding to the solar zenith angle, the F10.7 cm solar radio flux, and the pressure surface. The pressure surface is a representation of the seasonal variation and the altitude. The output was the electron density for the given set of input parameters at a particular pressure surface. Therefore, an average electron density profile describing the behaviour of the auroral lower ionosphere can be determined for a particular instance of the input space. A process of minimisation of mean squared errors was used to optimise the NNs. It is shown that this model is capable of predicting realistic average electron density profiles for the high latitude lower ionosphere. In addition, the ability of this model to simulate the total absorption to within the resolution of a riometer will be demonstrated. It is the intention of the authors to provide this model in a suitable form for incorporation into the International Reference Ionosphere model and, therefore, these results may be of interest to the ionospheric community.

  6. 17 CFR 230.408 - Additional information.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 17 Commodity and Securities Exchanges 2 2010-04-01 2010-04-01 false Additional information. 230... RULES AND REGULATIONS, SECURITIES ACT OF 1933 General Requirements § 230.408 Additional information. (a) In addition to the information expressly required to be included in a registration statement,...

  7. 17 CFR 230.408 - Additional information.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 17 Commodity and Securities Exchanges 2 2013-04-01 2013-04-01 false Additional information. 230... RULES AND REGULATIONS, SECURITIES ACT OF 1933 General Requirements § 230.408 Additional information. (a) In addition to the information expressly required to be included in a registration statement,...

  8. 47 CFR 25.111 - Additional information.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 47 Telecommunication 2 2013-10-01 2013-10-01 false Additional information. 25.111 Section 25.111... Applications and Licenses General Application Filing Requirements § 25.111 Additional information. (a) The Commission may request from any party at any time additional information concerning any application, or...

  9. 10 CFR 810.14 - Additional information.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 4 2013-01-01 2013-01-01 false Additional information. 810.14 Section 810.14 Energy DEPARTMENT OF ENERGY ASSISTANCE TO FOREIGN ATOMIC ENERGY ACTIVITIES § 810.14 Additional information. The... activity to submit additional information....

  10. 47 CFR 25.111 - Additional information.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 47 Telecommunication 2 2012-10-01 2012-10-01 false Additional information. 25.111 Section 25.111... Applications and Licenses General Application Filing Requirements § 25.111 Additional information. (a) The Commission may request from any party at any time additional information concerning any application, or...

  11. 10 CFR 725.13 - Additional information.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 4 2013-01-01 2013-01-01 false Additional information. 725.13 Section 725.13 Energy DEPARTMENT OF ENERGY PERMITS FOR ACCESS TO RESTRICTED DATA Applications § 725.13 Additional information. The... and before the termination of the permit, require additional information in order to enable the...

  12. 47 CFR 25.111 - Additional information.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 47 Telecommunication 2 2011-10-01 2011-10-01 false Additional information. 25.111 Section 25.111... Applications and Licenses General Application Filing Requirements § 25.111 Additional information. (a) The Commission may request from any party at any time additional information concerning any application, or...

  13. 20 CFR 802.215 - Additional briefs.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Additional briefs. 802.215 Section 802.215 Employees' Benefits BENEFITS REVIEW BOARD, DEPARTMENT OF LABOR RULES OF PRACTICE AND PROCEDURE Prereview Procedures Initial Processing § 802.215 Additional briefs. Additional briefs may be filed or ordered in...

  14. 10 CFR 55.7 - Additional requirements.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 2 2014-01-01 2014-01-01 false Additional requirements. 55.7 Section 55.7 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) OPERATORS' LICENSES General Provisions § 55.7 Additional requirements. The Commission may, by rule, regulation, or order, impose upon any licensee such requirements, in addition...

  15. 10 CFR 55.7 - Additional requirements.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 2 2010-01-01 2010-01-01 false Additional requirements. 55.7 Section 55.7 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) OPERATORS' LICENSES General Provisions § 55.7 Additional requirements. The Commission may, by rule, regulation, or order, impose upon any licensee such requirements, in addition...

  16. 77 FR 53180 - Procurement List; Additions

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-31

    ... INFORMATION: Additions On 6/15/2012 (77 FR 35942-35944) and 6/29/2012 (77 FR 38775-38776), the Committee for... PEOPLE WHO ARE BLIND OR SEVERELY DISABLED Procurement List; Additions AGENCY: Committee for Purchase from People who are Blind or Severely Disabled. ACTION: Additions to the Procurement List. SUMMARY:...

  17. 76 FR 35415 - Procurement List; Addition

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-17

    ... INFORMATION: Additions On 4/29/2011 (76 FR 23998), the Committee for Purchase From People Who Are Blind or... PEOPLE WHO ARE BLIND OR SEVERELY DISABLED Procurement List; Addition AGENCY: Committee for Purchase From People Who Are Blind or Severely Disabled. ACTION: Addition to the Procurement List. SUMMARY: This...

  18. 78 FR 9386 - Procurement List; Addition

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-08

    ... INFORMATION: Addition On 11/30/2012 (77 FR 71400-71401), the Committee for Purchase From People Who Are Blind... PEOPLE WHO ARE BLIND OR SEVERELY DISABLED Procurement List; Addition AGENCY: Committee for Purchase From People Who Are Blind or Severely Disabled. ACTION: Addition to the Procurement List. SUMMARY: This...

  19. 77 FR 31335 - Procurement List; Additions

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-25

    ... . SUPPLEMENTARY INFORMATION: Additions On March 16, 2012 (77 FR 15736) and March 23, 2012 (77 FR 17035), the... PEOPLE WHO ARE BLIND OR SEVERELY DISABLED Procurement List; Additions AGENCY: Committee for Purchase From People Who Are Blind or Severely Disabled. ACTION: Additions to the Procurement List. SUMMARY:...

  20. 76 FR 19751 - Procurement List; Addition

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-08

    ... INFORMATION: Addition On 1/28/2011 (76 FR 5142-5143), the Committee for Purchase From People Who Are Blind or... PEOPLE WHO ARE BLIND OR SEVERELY DISABLED Procurement List; Addition AGENCY: Committee for Purchase From People Who Are Blind or Severely Disabled. ACTION: Addition to the Procurement List. SUMMARY: This...

  1. 75 FR 4784 - Procurement List; Addition

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-29

    ... INFORMATION: Addition On 11/16/2009 (74 FR 58949-58950), the Committee for Purchase From People Who Are Blind... PEOPLE WHO ARE BLIND OR SEVERELY DISABLED Procurement List; Addition AGENCY: Committee for Purchase From People Who Are Blind or Severely Disabled. ACTION: Addition to the Procurement List. SUMMARY: This...

  2. 76 FR 23997 - Procurement List; Addition

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-29

    ... INFORMATION: Addition On 2/25/2011 (76 FR 10571), the Committee for Purchase From People Who Are Blind or... PEOPLE WHO ARE BLIND OR SEVERELY DISABLED Procurement List; Addition AGENCY: Committee for Purchase From People Who Are Blind or Severely Disabled. ACTION: Addition to the Procurement List. SUMMARY: This...

  3. 75 FR 22745 - Procurement List Additions

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-30

    ... INFORMATION: Additions On 10/23/2009 (74 FR 54783-54784) and 3/5/2010 (75 FR 10223-10224), the Committee for... PEOPLE WHO ARE BLIND OR SEVERELY DISABLED Procurement List Additions AGENCY: Committee for Purchase From People Who Are Blind or Severely Disabled. ACTION: Additions to the Procurement List. SUMMARY:...

  4. 77 FR 71400 - Procurement List, Additions

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-30

    ... . SUPPLEMENTARY INFORMATION: Additions On 8/24/2012 (77 FR 51522-51523) and 10/5/2012 (77 FR 60969), the Committee... PEOPLE WHO ARE BLIND OR SEVERELY DISABLED Procurement List, Additions AGENCY: Committee for Purchase From People Who Are Blind or Severely Disabled. ACTION: Additions to the Procurement List. SUMMARY:...

  5. 75 FR 72815 - Procurement List Additions

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-26

    ... INFORMATION: Additions On 6/4/2010 (75 FR 31768-31769) and 10/1/2010 (75 FR 60739-60740), the Committee for... PEOPLE WHO ARE BLIND OR SEVERELY DISABLED Procurement List Additions AGENCY: Committee for Purchase From People Who Are Blind or Severely Disabled. ACTION: Additions to the Procurement List. SUMMARY:...

  6. 77 FR 59595 - Procurement List; Additions

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-28

    ... . SUPPLEMENTARY INFORMATION: Additions On 7/9/2012 (77 FR 40344-40345) and 7/20/2012 (77 FR 42701-42702), the... PEOPLE WHO ARE BLIND OR SEVERELY DISABLED Procurement List; Additions AGENCY: Committee for Purchase From People Who Are Blind or Severely Disabled. ACTION: Additions to the Procurement List. SUMMARY:...

  7. 77 FR 34025 - Procurement List; Addition

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-08

    ... INFORMATION: ] Addition On 4/132012 (77 FR 22289-22290), the Committee for Purchase From People Who Are Blind... PEOPLE WHO ARE BLIND OR SEVERELY DISABLED Procurement List; Addition AGENCY: Committee for Purchase From People Who Are Blind or Severely Disabled. ACTION: Addition to the Procurement List. SUMMARY: This...

  8. 78 FR 2378 - Procurement List, Addition

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-11

    ... INFORMATION: Addition On 11/9/2012 (77 FR 67343-67344), the Committee for Purchase From People Who Are Blind... PEOPLE WHO ARE BLIND OR SEVERELY DISABLED Procurement List, Addition AGENCY: Committee for Purchase From People Who Are Blind or Severely Disabled. ACTION: Addition to the Procurement List. SUMMARY: This...

  9. 76 FR 54741 - Procurement List; Additions

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-02

    ... INFORMATION: Additions On 7/8/2011 (76 FR 40342-40343), the Committee for Purchase From People Who Are Blind... PEOPLE WHO ARE BLIND OR SEVERELY DISABLED Procurement List; Additions AGENCY: Committee for Purchase From People Who Are Blind or Severely Disabled. ACTION: Additions to the Procurement List. SUMMARY:...

  10. Polymeric Additives For Graphite/Epoxy Composites

    NASA Technical Reports Server (NTRS)

    Kourtides, D. A.; Nir, Z.

    1990-01-01

    Report describes experimental studies of properties of several graphite/epoxy composites containing polymeric additives as flexibilizing or toughening agents. Emphasizes effects of brominated polymeric additives (BPA's) with or without carboxy-terminated butadiene acrylonitrile rubber. Reviews effects of individual and combined additives on fracture toughnesses, environmental stabilities, hot/wet strengths, thermomechanical behaviors, and other mechanical properties of composites.

  11. 14 CFR 29.927 - Additional tests.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 1 2013-01-01 2013-01-01 false Additional tests. 29.927 Section 29.927... STANDARDS: TRANSPORT CATEGORY ROTORCRAFT Powerplant Rotor Drive System § 29.927 Additional tests. (a) Any additional dynamic, endurance, and operational tests, and vibratory investigations necessary to...

  12. 14 CFR 27.927 - Additional tests.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 1 2014-01-01 2014-01-01 false Additional tests. 27.927 Section 27.927... STANDARDS: NORMAL CATEGORY ROTORCRAFT Powerplant Rotor Drive System § 27.927 Additional tests. (a) Any additional dynamic, endurance, and operational tests, and vibratory investigations necessary to...

  13. 14 CFR 29.927 - Additional tests.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Additional tests. 29.927 Section 29.927... STANDARDS: TRANSPORT CATEGORY ROTORCRAFT Powerplant Rotor Drive System § 29.927 Additional tests. (a) Any additional dynamic, endurance, and operational tests, and vibratory investigations necessary to...

  14. 14 CFR 27.927 - Additional tests.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 1 2013-01-01 2013-01-01 false Additional tests. 27.927 Section 27.927... STANDARDS: NORMAL CATEGORY ROTORCRAFT Powerplant Rotor Drive System § 27.927 Additional tests. (a) Any additional dynamic, endurance, and operational tests, and vibratory investigations necessary to...

  15. 14 CFR 29.927 - Additional tests.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 1 2014-01-01 2014-01-01 false Additional tests. 29.927 Section 29.927... STANDARDS: TRANSPORT CATEGORY ROTORCRAFT Powerplant Rotor Drive System § 29.927 Additional tests. (a) Any additional dynamic, endurance, and operational tests, and vibratory investigations necessary to...

  16. 14 CFR 27.927 - Additional tests.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Additional tests. 27.927 Section 27.927... STANDARDS: NORMAL CATEGORY ROTORCRAFT Powerplant Rotor Drive System § 27.927 Additional tests. (a) Any additional dynamic, endurance, and operational tests, and vibratory investigations necessary to...

  17. 7 CFR 1944.686 - Additional grants.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 13 2011-01-01 2009-01-01 true Additional grants. 1944.686 Section 1944.686...) PROGRAM REGULATIONS (CONTINUED) HOUSING Housing Preservation Grants § 1944.686 Additional grants. An additional HPG grant may be made when the grantee has achieved or nearly achieved the goals established...

  18. 7 CFR 1944.545 - Additional grants.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 13 2013-01-01 2013-01-01 false Additional grants. 1944.545 Section 1944.545...) PROGRAM REGULATIONS (CONTINUED) HOUSING Technical and Supervisory Assistance Grants § 1944.545 Additional grants. An additional grant may be made to an applicant that has previously received a TSA grant and...

  19. 7 CFR 1944.545 - Additional grants.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 13 2011-01-01 2009-01-01 true Additional grants. 1944.545 Section 1944.545...) PROGRAM REGULATIONS (CONTINUED) HOUSING Technical and Supervisory Assistance Grants § 1944.545 Additional grants. An additional grant may be made to an applicant that has previously received a TSA grant and...

  20. 7 CFR 1944.686 - Additional grants.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 13 2013-01-01 2013-01-01 false Additional grants. 1944.686 Section 1944.686...) PROGRAM REGULATIONS (CONTINUED) HOUSING Housing Preservation Grants § 1944.686 Additional grants. An additional HPG grant may be made when the grantee has achieved or nearly achieved the goals established...

  1. 24 CFR 964.410 - Additional definitions.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 24 Housing and Urban Development 4 2012-04-01 2012-04-01 false Additional definitions. 964.410... Additional definitions. The following additional definitions apply to this subpart only: Directly assisted... assisted by a public housing agency; (2) Whose name appears on the lease; and (3) Is eighteen years of...

  2. 24 CFR 964.410 - Additional definitions.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 24 Housing and Urban Development 4 2011-04-01 2011-04-01 false Additional definitions. 964.410... Additional definitions. The following additional definitions apply to this subpart only: Directly assisted... assisted by a public housing agency; (2) Whose name appears on the lease; and (3) Is eighteen years of...

  3. 24 CFR 964.410 - Additional definitions.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 24 Housing and Urban Development 4 2013-04-01 2013-04-01 false Additional definitions. 964.410... Additional definitions. The following additional definitions apply to this subpart only: Directly assisted... assisted by a public housing agency; (2) Whose name appears on the lease; and (3) Is eighteen years of...

  4. 10 CFR 55.7 - Additional requirements.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 2 2012-01-01 2012-01-01 false Additional requirements. 55.7 Section 55.7 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) OPERATORS' LICENSES General Provisions § 55.7 Additional requirements. The Commission may, by rule, regulation, or order, impose upon any licensee such requirements, in addition to those established in...

  5. 44 CFR 6.81 - Additional copies.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Additional copies. 6.81... HOMELAND SECURITY GENERAL IMPLEMENTATION OF THE PRIVACY ACT OF 1974 Fees § 6.81 Additional copies. A reasonable number of additional copies shall be provided for the applicable fee to a requestor who...

  6. Lower Stratospheric Measurement Issues Workshop Report

    NASA Technical Reports Server (NTRS)

    Schmeltekopf, Arthur L.

    1992-01-01

    The Lower Stratospheric Measurement Issues workshop was held on 17-19 Oct. 1990. The 3-day workshop was sponsored by the Atmospheric Effects of Stratospheric Aircraft (AESA) component of the High Speed Research Program (HSRP). Its purpose was to provide a scientific forum for addressing specific issues regarding chemistry and transport in the lower stratosphere, for which measurements are essential to an assessment of the environmental impact of a projected fleet of high speed civil transports (HSCTs). The objective of the workshop was to obtain vigorous and critical review of the following topics: (1) atmospheric measurements needed for the assessment; (2) present capability for making those measurements; and (3) areas in instrumentation or platform development essential to making the measurements.

  7. Lower respiratory tract infections: prevention using vaccines.

    PubMed

    Whitney, Cynthia G; Harper, Scott A

    2004-12-01

    In summary, vaccines are available to prevent two of the most common and most deadly causes of lower respiratory tract infections: pneumococcal disease and influenza. Pneumococcal polysaccharide vaccine prevents pneumococcal bacteremia; influenza vaccines prevent influenza as well as several complications of influenza. Despite all that is known about how well these vaccines work, influenza and pneumococcal vaccines are underused markedly, especially among some minority groups that are affected dis-proportionately by disease. Coverage also remains low among health care workers, although providing influenza vaccine to health care workers saves lives among patients. Tools such as standing orders can help clinicians increase vaccine coverage in their patient populations. While research for new and improved vaccines to prevent lower respiratory tract infections continues,focusing on simple measures for increasing vaccine use can help prevent morbidity and mortality now.

  8. Nonlinear lower hybrid modeling in tokamak plasmas

    SciTech Connect

    Napoli, F.; Schettini, G.; Castaldo, C.; Cesario, R.

    2014-02-12

    We present here new results concerning the nonlinear mechanism underlying the observed spectral broadening produced by parametric instabilities occurring at the edge of tokamak plasmas in present day LHCD (lower hybrid current drive) experiments. Low frequency (LF) ion-sound evanescent modes (quasi-modes) are the main parametric decay channel which drives a nonlinear mode coupling of lower hybrid (LH) waves. The spectrum of the LF fluctuations is calculated here considering the beating of the launched LH wave at the radiofrequency (RF) operating line frequency (pump wave) with the noisy background of the RF power generator. This spectrum is calculated in the frame of the kinetic theory, following a perturbative approach. Numerical solutions of the nonlinear LH wave equation show the evolution of the nonlinear mode coupling in condition of a finite depletion of the pump power. The role of the presence of heavy ions in a Deuterium plasma in mitigating the nonlinear effects is analyzed.

  9. Lower third molar eruption following orthodontic treatment.

    PubMed

    Salehi, P; Danaie, S Momene

    2008-01-01

    This study assessed the effect of extraction and preservation of the 1st premolar on lower 3rd molar eruption. Orthodontic clinic records from 1993 to 1995 were evaluated before and after treatment and 8-9 years after treatment for 3 groups of patients: 32 with extraction of 1st premolars in both jaws, 32 with no extraction but orthodontic treatment and 48 controls with no extraction but orthodontic treatment in the upper jaws only. Successful eruption of 3rd molars was evaluated. There was a significant difference in the rates of successful eruptions in the extraction (42%), non-extraction (12%) and control (20%) groups. The findings indicate that 1st premolar extraction may increase the chance of 3rd molar eruption, leading to a lower incidence of health and economic complications.

  10. Continental crustal composition and lower crustal models

    NASA Technical Reports Server (NTRS)

    Taylor, S. R.

    1983-01-01

    The composition of the upper crust is well established as being close to that of granodiorite. The upper crustal composition is reflected in the uniform REE abundances in shales which represent an homogenization of the various REE patterns. This composition can only persist to depths of 10-15 km, for heat flow and geochemical balance reasons. The composition of the total crust is model dependent. One constraint is that it should be capable of generating the upper granodioritic (S.L.) crust by partial melting within the crust. This composition is based on the andesite model, which assumes that the total crust has grown by accretion of island arc material. A representation of the growth rate of the continental crust is shown. The composition of the lower crust, which comprises 60-80% of the continental crust, remains a major unknown factor for models of terrestrial crustal evolution. Two approaches are used to model the lower crust.

  11. Lower third molar eruption following orthodontic treatment.

    PubMed

    Salehi, P; Danaie, S Momene

    2008-01-01

    This study assessed the effect of extraction and preservation of the 1st premolar on lower 3rd molar eruption. Orthodontic clinic records from 1993 to 1995 were evaluated before and after treatment and 8-9 years after treatment for 3 groups of patients: 32 with extraction of 1st premolars in both jaws, 32 with no extraction but orthodontic treatment and 48 controls with no extraction but orthodontic treatment in the upper jaws only. Successful eruption of 3rd molars was evaluated. There was a significant difference in the rates of successful eruptions in the extraction (42%), non-extraction (12%) and control (20%) groups. The findings indicate that 1st premolar extraction may increase the chance of 3rd molar eruption, leading to a lower incidence of health and economic complications. PMID:19161121

  12. Statin therapy in patients with acute coronary syndrome: low-density lipoprotein cholesterol goal attainment and effect of statin potency

    PubMed Central

    Chinwong, Dujrudee; Patumanond, Jayanton; Chinwong, Surarong; Siriwattana, Khanchai; Gunaparn, Siriluck; Hall, John Joseph; Phrommintikul, Arintaya

    2015-01-01

    Background Elevated low-density lipoprotein cholesterol (LDL-C) is associated with an increased risk of coronary artery disease. Current guidelines recommend an LDL-C target of <70 mg/dL (<1.8 mmol/L) for acute coronary syndrome (ACS) patients, and the first-line treatment to lower lipids is statin therapy. Despite current guidelines and the efficacious lipid-lowering agents available, about half of patients at very high risk, including ACS patients, fail to achieve their LDL-C goal. This study assessed LDL-C goal attainment according to use of high and low potency statins in routine practice in Thailand. Methods A retrospective cohort study was performed by retrieving data from medical records and the electronic hospital database for a tertiary care hospital in Thailand between 2009 and 2011. Included were ACS patients treated with statins at baseline and with follow-up of LDL-C levels. Patients were divided into high or low potency statin users, and the proportion reaching the LDL-C goal of <70 mg/dL was determined. A Cox proportional hazard model was applied to determine the relationship between statin potency and LDL-C goal attainment. Propensity score adjustment was used to control for confounding by indication. Results Of 396 ACS patients (60% males, mean age 64.3±11.6 years), 229 (58%) were treated with high potency statins and 167 (42%) with low potency statins. A quarter reached their target LDL-C goal (25% for patients on high potency statins and 23% on low potency statins). High potency statins were not associated with increased LDL-C goal attainment (adjusted hazards ratio 1.22, 95% confidence interval 0.79–1.88; P=0.363). Conclusion There was no significant effect of high potency statins on LDL-C goal attainment. Moreover, this study showed low LDL-C goal attainment for patients on either low or high potency statins. The reasons for the low LDL-C goal attainment rate warrants further investigation. PMID:25670902

  13. Ultrasound of lower limb sports injuries

    PubMed Central

    Purohit, Neeraj B

    2015-01-01

    Musculoskeletal ultrasound utilises high-frequency linear transducers to produce high-resolution images of soft tissue structures. It is an increasingly useful tool in the assessment of both acute and chronic musculoskeletal injuries; it is relatively cheap, portable and can be used to facilitate targeted injections. In this review paper, we aim to provide a summary on the normal and abnormal appearances of skeletal tissue in the setting of acute and chronic lower limb sporting injuries. PMID:27433251

  14. Lower body graduated negative pressure system

    NASA Technical Reports Server (NTRS)

    1983-01-01

    The first task concerning the Lower Body Negative Pressure Suit was to determine the best type construction for a leg section with these goals in mind: good mobility, minimum amount of bulk, ease of storage, lightweight, rigid enough to withstand atmospheric pressure, and minimum amount of preparation before donning and donning time. After a study of three systems, wire hoops (rings) separated on inch apart in an airtight material furnished by NASA were chosen.

  15. Panafrican distribution of Lower Miocene Hominoidea

    NASA Astrophysics Data System (ADS)

    Senut, Brigitte; Pickford, Martin; Wessels, Dudley

    1997-11-01

    Palaeontological survey of the Neogene littoral deposits of the Namaqualand coastal strip, Northern Cape Province, South Africa, has resulted in the collection of the first Lower Miocene faunas from South Africa. Among the mammals from Ryskop and Hondeklip Bay is a gorilla-sized hominoid. This discovery greatly increases the geographic range of early Miocene hominoids and suggests that even at this remote epoch, the superfamily had a Panafrican distribution.

  16. Detecting Lower Bounds to Quantum Channel Capacities.

    PubMed

    Macchiavello, Chiara; Sacchi, Massimiliano F

    2016-04-01

    We propose a method to detect lower bounds to quantum capacities of a noisy quantum communication channel by means of a few measurements. The method is easily implementable and does not require any knowledge about the channel. We test its efficiency by studying its performance for most well-known single-qubit noisy channels and for the generalized Pauli channel in an arbitrary finite dimension.

  17. Transcutaneous lower blepharoplasty, painless suture removal.

    PubMed

    De Vita, Roy; Buccheri, Ernesto Maria

    2013-01-01

    Despite being referred to as one of the more challenging procedures in plastic surgery, lower blepharoplasty is one of the most commonly requested and performed aesthetic procedures.Our experience, from February 2007 to March 2012, is based on 214 transcutaneous lower blepharoplasty procedures in which the skin flap was sutured by means of the epidermal-dermal U stitch, a new, simple, and reliable method. Patients were followed up for a mean period ranging from 7 to 70 months. To our knowledge, the literature proposes a single-stitch closure or continuous suture in transcutaneous lower blepharoplasty using nylon or silk 4-5-0 to close the skin incision (1-3-5). According to our experience before 2007 based on patients' reports, single-stitch subciliary suture removal is a source of stress for the patient that causes anxiety, discomfort, and pain.Thus, in February 2007, following transepithelial lower blepharoplasty, we started using a new, simple way to suture the subciliary skin flap adopting the epidermal-dermal U nylon 5-0 stitch to avoid any discomfort and drastically reduce the level of anxiety and pain at the time of suture removal. According to our experience, the healing of the wound does not require any subsequent scar revision resulting from healing defects or pathological scar tissue; the complication rate in our series is in keeping with that reported by other authors in the literature.In conclusion, our experience indicates that the suture technique we describe is an easily reproducible, rapid, discomfort-free, and painless means of removing stitches. PMID:24036781

  18. Accelerating procelain formation by incorporating a complex additive

    SciTech Connect

    Maslennikova, G.N.; Dubovitskii, S.A.; Moroz, I.K.

    1986-05-01

    The authors studied the influence of a complex additive consisting of oxides of calcium, zinc, and magnesium on the formaton of porcelain. In order to achieve a more uniform distribution of the complex additive in the porcelain body it was incorporated in the form of water soluble salts-nitrates, which ensured comparability of results and excluded the effect of the different types of anions. The study of the main parameters of sintering (porosity, shrinkage, and mechanical strength) for the test bodies showed that they sinter at lower temperatures and attain zero porosity, maximum shrinkage, and mechanical strength. The most typical bodies indentified in this way were investigated by methods of complex differential thermal analysis and x-ray diffraction. Thus, the introduction of complex additives consisting of calcium, zinc, and magnesium oxides contributes to the earlier formation of porcelain. With the reduction of firing temperatures by 100/sup 0/C the authors observe an improvement in the basic properties of porcelain.

  19. Polymeric additives for antistatic treatment of sheet molding composites (SMC)

    NASA Astrophysics Data System (ADS)

    Gedan-Smolka, Michaela; Schubert, Katrin; Taeger, Antje; Marks, Hagen

    2016-03-01

    Novel oligomeric/polymeric additives with ionic units were synthesized in a one pot procedure in order to enhance the specific surface resistivity of SMC-materials. In contrast to industrially used inorganic salts or carbon materials, such as carbon black or CNT's, these substances are nearly colorless and matrix compatible and, resulting from that, easy to homogenize with the SMC-matrix. Furthermore, it was found, that additives which can be covalently bonded to the matrix during the molding procedure are preferred compared to physically mixed substances. The effectiveness of chemically bonded substances regarding with the lowering of the specific surface resistivity is higher and selected additives do not change the reactivity and resulting mechanical properties of the molded material.

  20. Development of new addition-type composite resins

    NASA Technical Reports Server (NTRS)

    Kray, R. J.

    1981-01-01

    The most promising of a number of new addition type polyimides and polyaromatic melamine (NCNS) resins for use in high performance composite materials. Three different cure temperature ranges were of interest: 530-560 K (500-550 F), 475-530 K (400-500 F), and 450 K (350 F). Examined were a wide variety of polyimide precursors terminated with 5 norbornene groups and addition polymerized at 560 K similar to PMR-15 and LARC-160 polyimides. In addition, a number of lower curing cinnamal end capped polyimides and a bismaleimide were investigated but were not found promising. A group of NCNS resins were investigated and some were found to be superior to current epoxy resins in moisture resistance, oxidative aging and flame and smoke properties.

  1. Ab Initio Treatment of Lower Mantle Mineral Solvi.

    NASA Astrophysics Data System (ADS)

    Jung, D. Y.; Oganov, A. R.; Schmidt, M. W.

    2006-12-01

    The lower mantle of the Earth extends from about 670 to 2980 km depth and consists mainly of MgSiO3- perovskite (~ 70 vol%), (Mg,Fe)O magnesiowüstite (~ 20 vol%) and CaSiO3-perovskite (~ 10 vol%). To obtain a realistic picture of the lower mantle, it is necessary to consider the perovskite minerals as coexisting solid solutions with a large miscibility gap, as this is the case in nature. In this work we investigate the solvi of the three binaries in the Ca-perovskite - Mg-perovskite - corundum ternary, i.e. the solid solutions relevant for the Earth's lower mantle minerals in a simplified CMAS system. It is possible to calculate thermodynamic properties, structures and energetics of the individual minerals at extreme conditions of the mantle using ab initio methods, such as the density functional theory (DFT). We use the DFT together with the generalized gradient approximation (GGA) and the projector augmented wave (PAW) method, as implemented in the VASP code. The binary solvi are modelled through a subregular solid solution model together with point defect calculations at different pressures in the lower mantle regime. Point defects in the (Ca,Mg)-perovskite system are simple substitutions, but in MgSiO3-Al2O3 there is a coupled charge substitution of 2Al3+ with Mg2+Si^{4+}. Additionally, different symmetries of the perovskite (and akimotoite/ilmenite for MgSiO3) structures have been taken into account, thus allowing for phase transitions in solid solutions. At pressures and temperatures of the lower mantle, the solvus in the (Ca,Mg)SiO3 system remains wide open and solubilities of Ca in Mg-perovskite and Mg in Ca-perovskite decrease with pressure (at constant temperature and along any adiabatic geotherm). Calculations on the MgSiO3-Al2O3 (akimotoite-corundum) solvus show higher solubilities. Still, we find it unlikely that Ca-perovskite would disappear (i.e. fully dissolve in Mg-perovskite) at conditions of the lower mantle, at last not in the simplified CMAS

  2. Lower urinary tract development and disease

    PubMed Central

    Rasouly, Hila Milo; Lu, Weining

    2013-01-01

    Congenital Anomalies of the Lower Urinary Tract (CALUT) are a family of birth defects of the ureter, the bladder and the urethra. CALUT includes ureteral anomalies such as congenital abnormalities of the ureteropelvic junction (UPJ) and ureterovesical junction (UVJ), and birth defects of the bladder and the urethra such as bladder-exstrophy-epispadias complex (BEEC), prune belly syndrome (PBS), and posterior urethral valves (PUV). CALUT is one of the most common birth defects and is often associated with antenatal hydronephrosis, vesicoureteral reflux (VUR), urinary tract obstruction, urinary tract infections (UTI), chronic kidney disease and renal failure in children. Here, we discuss the current genetic and molecular knowledge about lower urinary tract development and genetic basis of CALUT in both human and mouse models. We provide an overview of the developmental processes leading to the formation of the ureter, bladder, and urethra, and different genes and signaling pathways controlling these developmental processes. Human genetic disorders that affect the ureter, bladder and urethra and associated gene mutations are also presented. As we are entering the post-genomic era of personalized medicine, information in this article may provide useful interpretation for the genetic and genomic test results collected from patients with lower urinary tract birth defects. With evidence-based interpretations, clinicians may provide more effective personalized therapies to patients and genetic counseling for their families. PMID:23408557

  3. Acidification of the lower Mississippi River

    SciTech Connect

    Bryan, C.F.; Rutherford, D.A.; Walker-Bryan, B.

    1992-05-01

    Nonpoint-source pollutants are implicated in the global acidification of fresh waters. Our ability to differentiate the effects of point-source and nonpoint-source pollution on the acidification of large rivers is limited. Most studies of point-source discharges have been concerned with municipal programs for reducing biochemical oxygen demand, bacterial counts, and total phosphorus; few have addressed acidification of rivers. Because of the meager information on the role of nonpoint-source and industrial pollution in the acidification of large rivers, we examined long-term trends (and cyclic seasonal events) in pH, alkalinity, and selected ions in the lower Mississippi River basin from 1958 to 1986. Time-series analyses disclosed significant declines in pH and alkalinity and increases in strong acid anions in the lower 300 km (industrial corridor) of the lower Mississippi River. However, upstream from most industry on the Mississippi River and throughout the Atchafalaya River, where agricultural development has predominated, long-term trends in those characteristics were variable or nonsignificant. 34 refs., 4 figs., 1 tab.

  4. Growth of the lower continental crust

    NASA Technical Reports Server (NTRS)

    Rudnick, Roberta L.

    1988-01-01

    One of the largest uncertainties in crustal composition and growth models is the nature of the lower continental crust. Specifically, by what processes is it formed and modified, and when is it formed, particularly in reference to the upper crust? The main reason for this lack of information is the scarcity of lower crustal rock samples. These are restricted to two types: rocks which outcrop in granulite facies terrains and granulite facies xenoliths which are transported to the earth's surface by young volcanics. The important conclusions arising from the xenolith studies are: the majority of mafic lower crustal xenoliths formed through cumulate process, resitic xenoliths are rare; and formation and metamorphism of the deep crust is intimately linked to igneous activity and/or orogeny which are manifest in one form or another at the earth's surface. Therefore, estimates of crustal growth based on surface exposures is representative, although the proportion of remobilized pre-existing crust may be significantly greater at the surface than in the deep crust.

  5. Lower limb loading in step aerobic dance.

    PubMed

    Wu, H-W; Hsieh, H-M; Chang, Y-W; Wang, L-H

    2012-11-01

    Participation in aerobic dance is associated with a number of lower extremity injuries, and abnormal joint loading seems to be a factor in these. However, information on joint loading is limited. The purpose of this study was to investigate the kinetics of the lower extremity in step aerobic dance and to compare the differences of high-impact and low-impact step aerobic dance in 4 aerobic movements (mambo, kick, L step and leg curl). 18 subjects were recruited for this study. High-impact aerobic dance requires a significantly greater range of motion, joint force and joint moment than low-impact step aerobic dance. The peak joint forces and moments in high-impact step aerobic dance were found to be 1.4 times higher than in low-impact step aerobic dance. Understanding the nature of joint loading may help choreographers develop dance combinations that are less injury-prone. Furthermore, increased knowledge about joint loading may be helpful in lowering the risk of injuries in aerobic dance instructors and students.

  6. Titan's zonal winds in its lower stratosphere

    NASA Astrophysics Data System (ADS)

    Flasar, F. Michael; Schinder, Paul J.

    2016-10-01

    Titan's atmosphere near 80 km (20 mbar) marks the transition between lower altitudes, where radiative damping times are large and seasonal variations are muted, and higher higher altitudes, where the damping times are much smaller and temperatures and winds vary significantly over the year. Cassini radio occultation soundings at high northern latitudes in winter have indicated a sharp transition from a highly stable temperature profile in the lower stratosphere to a layer between 80 and 100 km where temperatures decrease with altitude. The cause of this destabilization may be associated with the enhanced infrared opacity of a cloud of organic ices. It is curious that 20 mbar is also the level where the Doppler Wind Experiment on the Huygens Probe at 10° S observed a deep minimum in the zonal wind profile. Application of the gradient wind relation to the altitude-pressure profiles obtained from the Cassini radio occultation soundings have shown that this minimum is global. More recent soundings, obtained as Titan's southern hemisphere moves toward winter, indicate that this structure persists. The cause of this peculiar behavior is not really understood, but the the deceleration of the zonal winds observed in the lower stratosphere may be caused by radiative damping of vertically propagating atmospheric waves in a region where the damping time decreases rapidly with altitude.

  7. Neural Control of the Lower Urinary Tract

    PubMed Central

    de Groat, William C.; Griffiths, Derek; Yoshimura, Naoki

    2015-01-01

    This article summarizes anatomical, neurophysiological, pharmacological, and brain imaging studies in humans and animals that have provided insights into the neural circuitry and neurotransmitter mechanisms controlling the lower urinary tract. The functions of the lower urinary tract to store and periodically eliminate urine are regulated by a complex neural control system in the brain, spinal cord, and peripheral autonomic ganglia that coordinates the activity of smooth and striated muscles of the bladder and urethral outlet. The neural control of micturition is organized as a hierarchical system in which spinal storage mechanisms are in turn regulated by circuitry in the rostral brain stem that initiates reflex voiding. Input from the forebrain triggers voluntary voiding by modulating the brain stem circuitry. Many neural circuits controlling the lower urinary tract exhibit switch-like patterns of activity that turn on and off in an all-or-none manner. The major component of the micturition switching circuit is a spinobulbospinal parasympathetic reflex pathway that has essential connections in the periaqueductal gray and pontine micturition center. A computer model of this circuit that mimics the switching functions of the bladder and urethra at the onset of micturition is described. Micturition occurs involuntarily in infants and young children until the age of 3 to 5 years, after which it is regulated voluntarily. Diseases or injuries of the nervous system in adults can cause the re-emergence of involuntary micturition, leading to urinary incontinence. Neuroplasticity underlying these developmental and pathological changes in voiding function is discussed. PMID:25589273

  8. Ferrous iron partitioning in the lower mantle

    NASA Astrophysics Data System (ADS)

    Muir, Joshua M. R.; Brodholt, John P.

    2016-08-01

    We used density functional theory (DFT) to examine the partitioning of ferrous iron between periclase and bridgmanite under lower mantle conditions. To study the effects of the three major variables - pressure, temperature and concentration - these have been varied from 0 to 150 GPa, from 1000 to 4000 K and from 0 to 100% total iron content. We find that increasing temperature increases KD, increasing iron concentration decreases KD, while pressure can both increase and decrease KD. We find that KD decreases slowly from about 0.32 to 0.06 with depth under lower mantle conditions. We also find that KD increases sharply to 0.15 in the very lowermost mantle due to the strong temperature increases near the CMB. Spin transitions have a large effect on the activity of ferropericlase which causes KD to vary with pressure in a peak-like fashion. Despite the apparently large changes in KD through the mantle, this actually results in relatively small changes in total iron content in the two phases, with XFefp ranging from about 0.20 to 0.35, before decreasing again to about 0.28 at the CMB, and XFebd has a pretty constant value of about 0.04-0.07 throughout the lower mantle. For the very high Fe concentrations suggested for ULVZs, Fe partitions very strongly into ferropericlase.

  9. Surface Ocean—Lower Atmosphere Processes

    NASA Astrophysics Data System (ADS)

    Le Quéré, Corinne; Saltzman, Eric S.

    The focus of Surface Ocean-Lower Atmosphere Processes is biogeochemical interactions between the surface ocean and the lower atmosphere. This volume is an outgrowth of the Surface Ocean-Lower Atmosphere Study (SOLAS) Summer School. The volume is designed to provide graduate students, postdoctoral fellows, and researchers from a wide range of academic backgrounds with a basis for understanding the nature of ocean-atmosphere interactions and the current research issues in this area. The volume highlights include the following: • Background material on ocean and atmosphere structure, circulation, and chemistry and on marine ecosystems • Integrative chapters on the global carbon cycle and ocean biogeochemistry • Issue-oriented chapters on the iron cycle and dimethylsulfide • Tool-oriented chapters on biogeochemical modeling and remote sensing • A framework of underlying physical/chemical/biological principles, as well as perspectives on current research issues in the field. The readership for this book will include graduate students and/or advanced undergraduate students, postdoctoral researchers, and researchers in the fields of oceanography and atmospheric science. It will also be useful for experienced researchers in specific other disciplines who wish to broaden their perspectives on the complex biogeochemical coupling between ocean and atmosphere and the importance of this coupling to understanding global change.

  10. Pharmacology of the lower urinary tract

    PubMed Central

    Hennenberg, Martin; Stief, Christian G.; Gratzke, Christian

    2014-01-01

    Pharmacology of the lower urinary tract provides the basis for medical treatment of lower urinary tract symptoms (LUTS). Therapy of LUTS addresses obstructive symptoms (frequently explained by increased prostate smooth muscle tone and prostate enlargement) in patients with benign prostate hyperplasia (BPH) and storage symptoms in patients with overactive bladder (OAB). Targets for medical treatment include G protein-coupled receptors (α1-adrenoceptors, muscarinic acetylcholine receptors, β3-adrenoceptors) or intracellular enzymes (5α-reductase; phosphodiesterase-5, PDE5). Established therapies of obstructive symptoms aim to induce prostate smooth muscle relaxation by α1-blockers or PDE5 inhibitors, or to reduce prostate growth and volume with 5α-reductase inhibitors. Available options for treatment of OAB comprise anitmuscarinics, β3-adrenoceptor agonists, and botulinum toxin A, which improve storage symptoms by inhibition of bladder smooth muscle contraction. With the recent approval of β3-antagonists, PDE inhibitors, and silodosin for therapy of LUTS, progress from basic research of lower urinary tract pharmacology was translated into new clinical applications. Further targets are in preclinical stages of examination, including modulators of the endocannabinoid system and transient receptor potential (TRP) channels. PMID:24744518

  11. Expanded polytetrafluoroethylene augmentation of the lower face.

    PubMed

    Sherris, D A; Larrabee, W F

    1996-05-01

    Most options for rejuvenation of the lower face use soft-tissue fillers that augment the appropriate sites. Each of these options has associated risks and benefits. The U.S. Food and Drug Administration recently approved the use of expanded polytetrafluoroethylene (E-PTFE) as a soft-tissue filler in the face. From January 1991 through December 1993, the authors used E-PTFE soft-tissue patches for lower facial augmentation in 41 patients at 115 implant sites. Postsurgical follow-up has ranged from 2.5 to 4.5 years; during this time, complications have occurred in 4 patients. One implant had to be removed because of a seroma (1 patient), 4 implants required further secondary augmentation (2 patients), and 1 implant required revision because of malposition (1 patient). There have been no cases of implant infection, extrusion, long-term inflammation, or capsule formation. In this article, the authors review the technical aspects of E-PTFE use and discuss issues relating to the long-term efficacy of this new option for soft-tissue augmentation. The technique is also compared with other options for rejuvenation of the lower face. PMID:8628100

  12. Vertical profile measurements of lower troposphere ionisation

    NASA Astrophysics Data System (ADS)

    Harrison, R. G.; Nicoll, K. A.; Aplin, K. L.

    2014-11-01

    Vertical soundings of the atmospheric ion production rate have been obtained from Geiger counters integrated with conventional meteorological radiosondes. In launches made from Reading (UK) during 2013-2014, the Regener-Pfotzer ionisation maximum was at an altitude equivalent to a pressure of (63.1±2.4) hPa, or, expressed in terms of the local air density, (0.101±0.005) kg m-3. The measured ionisation profiles have been evaluated against the Usoskin-Kovaltsov model and, separately, surface neutron monitor data from Oulu. Model ionisation rates agree well with the observed cosmic ray ionisation below 20 km altitude. Above 10 km, the measured ionisation rates also correlate well with simultaneous neutron monitor data, although, consistently with previous work, measured variability at the ionisation maximum is greater than that found by the neutron monitor. However, in the lower atmosphere (below 5 km altitude), agreement between the measurements and simultaneous neutron monitor data is poor. For studies of transient lower atmosphere phenomena associated with cosmic ray ionisation, this indicates the need for in situ ionisation measurements and improved lower atmosphere parameterisations.

  13. NO removal by reducing agents and additives in the selective non-catalytic reduction (SNCR) process.

    PubMed

    Bae, Sang Wook; Roh, Seon Ah; Kim, Sang Done

    2006-09-01

    The effect of the additives on the selective non-catalytic reduction (SNCR) reaction has been determined in a three-stage laboratory scale reactor. The optimum reaction temperature is lowered and the reaction temperature window is widened with increasing concentrations of the gas additives (CO, CH4). The optimum reaction temperature is lowered and the maximum NO removal efficiency decreases with increasing the concentration of alcohol additives (CH3OH, C2H5OH). The addition of phenol lowers the optimum reaction temperature about 100-150 degrees C similar to that of the toluene addition. The volatile organic compounds (VOCs: C6H5OH, C7H8) can be utilized in the SNCR process to enhance NO reduction and removed at the same time. A previously proposed simple kinetic model can successfully apply the NO reduction by NH3 and the present additives.

  14. Diet Quality and Change in Blood Lipids during 16 Years of Follow-up and Their Interaction with Genetic Risk for Dyslipidemia.

    PubMed

    Sonestedt, Emily; Hellstrand, Sophie; Drake, Isabel; Schulz, Christina-Alexandra; Ericson, Ulrika; Hlebowicz, Joanna; Persson, Margaretha M; Gullberg, Bo; Hedblad, Bo; Engström, Gunnar; Orho-Melander, Marju

    2016-01-01

    A high diet quality according to the Swedish nutrition recommendations is associated with a reduced risk of cardiovascular disease in the population-based Malmö Diet and Cancer cohort. To further clarify this protective association, we examined the association between high diet quality and change in triglycerides, high density lipoprotein-cholesterol (HDL-C), and low density lipoprotein-cholesterol (LDL-C) after 16 years of follow-up in 3152 individuals (61% women; 46-68 years at baseline). In addition, we examined if genetic risk scores composed of 80 lipid-associated genetic variants modify these associations. A diet quality index based on intakes of saturated fat, polyunsaturated fat, sucrose, fiber, fruit and vegetables, and fish was constructed. A high diet quality was associated with lower risk of developing high triglycerides (p = 0.02) and high LDL-C (p = 0.03) during follow-up compared with a low diet quality. We found an association between diet quality and long-term change in HDL-C only among those with lower genetic risk for low HDL-C as opposed to those with higher genetic risk (p-interaction = 0.04). Among those with lower genetic risk for low HDL-C, low diet quality was associated with decreased HDL-C during follow-up (p = 0.05). In conclusion, individuals with high adherence to the Swedish nutrition recommendation had lower risk of developing high triglycerides and LDL-C during 16 years of follow-up. PMID:27171109

  15. Diet Quality and Change in Blood Lipids during 16 Years of Follow-up and Their Interaction with Genetic Risk for Dyslipidemia

    PubMed Central

    Sonestedt, Emily; Hellstrand, Sophie; Drake, Isabel; Schulz, Christina-Alexandra; Ericson, Ulrika; Hlebowicz, Joanna; Persson, Margaretha M.; Gullberg, Bo; Hedblad, Bo; Engström, Gunnar; Orho-Melander, Marju

    2016-01-01

    A high diet quality according to the Swedish nutrition recommendations is associated with a reduced risk of cardiovascular disease in the population-based Malmö Diet and Cancer cohort. To further clarify this protective association, we examined the association between high diet quality and change in triglycerides, high density lipoprotein-cholesterol (HDL-C), and low density lipoprotein-cholesterol (LDL-C) after 16 years of follow-up in 3152 individuals (61% women; 46–68 years at baseline). In addition, we examined if genetic risk scores composed of 80 lipid-associated genetic variants modify these associations. A diet quality index based on intakes of saturated fat, polyunsaturated fat, sucrose, fiber, fruit and vegetables, and fish was constructed. A high diet quality was associated with lower risk of developing high triglycerides (p = 0.02) and high LDL-C (p = 0.03) during follow-up compared with a low diet quality. We found an association between diet quality and long-term change in HDL-C only among those with lower genetic risk for low HDL-C as opposed to those with higher genetic risk (p-interaction = 0.04). Among those with lower genetic risk for low HDL-C, low diet quality was associated with decreased HDL-C during follow-up (p = 0.05). In conclusion, individuals with high adherence to the Swedish nutrition recommendation had lower risk of developing high triglycerides and LDL-C during 16 years of follow-up. PMID:27171109

  16. Interactive effects of nutrient additions and predation on infaunal communities

    USGS Publications Warehouse

    Posey, M.H.; Alphin, T.D.; Cahoon, L.; Lindquist, D.; Becker, M.E.

    1999-01-01

    Nutrient additions represent an important anthropogenic stress on coastal ecosystems. At moderate levels, increased nutrients may lead to increased primary production and, possibly, to increased biomass of consumers although complex trophic interactions may modify or mask these effects. We examined the influence of nutrient additions and interactive effects of trophic interactions (predation) on benthic infaunal composition and abundances through small-scale field experiments in 2 estuaries that differed in ambient nutrient conditions. A blocked experimental design was used that allowed an assessment of direct nutrient effects in the presence and absence of predation by epibenthic predators as well as an assessment of the independent effects of predation. Benthic microalgal production increased with experimental nutrient additions and was greater when infaunal abundances were lower, but there were no significant interactions between these factors. Increased abundances of one infaunal taxa, Laeonereis culveri, as well as the grazer feeding guild were observed with nutrient additions and a number of taxa exhibited higher abundances with predator exclusion. In contrast to results from freshwater systems there were no significant interactive effects between nutrient additions and predator exclusion as was predicted. The infaunal responses observed here emphasize the importance of both bottom-up (nutrient addition and primary producer driven) and top-down (predation) controls in structuring benthic communities. These processes may work at different spatial and temporal scales, and affect different taxa, making observation of potential interactive effects difficult.

  17. The effects of atmosphere and additives of coal slag viscosity

    SciTech Connect

    Hurley, J.P.; Watne, T.M.; Nowok, J.W.

    1996-12-31

    The viscosities of a Powder River Basin slag were measured in air, air + 10% water vapor, and a reducing atmosphere. The temperature of critical viscosity (T), below which the viscosity increases dramatically, was approximately 1250{degrees}C in air and air + water vapor, but dropped to 1180{degrees}C when measured in the reducing atmosphere. Since the corrosivity of the slag is much higher when its viscosity is low, the slag will be highly corrosive at the substantially lower temperature in reducing gas. The addition of alumina increased viscosity and T{sub c} making the slag less corrosive, while magnesia additions dropped viscosity but increased T{sub c}. These changes imply that magnesia additions will make the slag slightly more corrosive in its liquid range, but that the slag will harden and become less corrosive at a higher temperature than without the magnesia addition. The changes in T{sub c} were more substantial when measured in the presence of water vapor in the case of alumina additions, but less substantial in the case of magnesia additions.

  18. Symbiotic fungal associations in 'lower' land plants.

    PubMed Central

    Read, D J; Ducket, J G; Francis, R; Ligron, R; Russell, A

    2000-01-01

    An analysis of the current state of knowledge of symbiotic fungal associations in 'lower' plants is provided. Three fungal phyla, the Zygomycota, Ascomycota and Basidiomycota, are involved in forming these associations, each producing a distinctive suite of structural features in well-defined groups of 'lower' plants. Among the 'lower' plants only mosses and Equisetum appear to lack one or other of these types of association. The salient features of the symbioses produced by each fungal group are described and the relationships between these associations and those formed by the same or related fungi in 'higher' plants are discussed. Particular consideration is given to the question of the extent to which root fungus associations in 'lower' plants are analogous to 'mycorrhizas' of 'higher' plants and the need for analysis of the functional attributes of these symbioses is stressed. Zygomycetous fungi colonize a wide range of extant lower land plants (hornworts, many hepatics, lycopods, Ophioglossales, Psilotales and Gleicheniaceae), where they often produce structures analogous to those seen in the vesicular-arbuscular (VA) mycorrhizas of higher plants, which are formed by members of the order Glomales. A preponderance of associations of this kind is in accordance with palaeohbotanical and molecular evidence indicating that glomalean fungi produced the archetypal symbioses with the first plants to emerge on to land. It is shown, probably for the first time, that glomalean fungi forming typical VA mycorrhiza with a higher plant (Plantago lanceolata) can colonize a thalloid liverwort (Pellia epiphylla), producing arbuscules and vesicles in the hepatic. The extent to which these associations, which are structurally analogous to mycorrhizas, have similar functions remains to be evaluated. Ascomycetous associations are found in a relatively small number of families of leafy liverworts. The structural features of the fungal colonization of rhizoids and underground axes of

  19. Lower Gastrointestinal (GI) Tract X-Ray (Radiography)

    MedlinePlus

    ... Resources Professions Site Index A-Z X-ray (Radiography) - Lower GI Tract Lower gastrointestinal tract radiography or ... Radiography? What is Lower GI Tract X-ray Radiography (Barium Enema)? Lower gastrointestinal (GI) tract radiography, also ...

  20. Role of phytosterols in lipid-lowering: current perspectives.

    PubMed

    Gupta, A K; Savopoulos, C G; Ahuja, J; Hatzitolios, A I

    2011-04-01

    The cholesterol-lowering effect of plant sterols was first discovered in the early 1950s. However, it is only recently that plant sterols have become clinically important, when advances in food-technology have made it possible to combine sterols with a variety of food products including margarines, yogurts, fruit juices and cereal bars. We review the clinical trial evidence of lipid-lowering efficacy of plant sterols and discuss their implications in routine clinical practice. To generate the evidence we searched the Pubmed database for English language literature, using relevant keywords and medical subject heading (MeSH) terms, and extracted the findings from recently published studies and meta-analyses on this topic. Our findings suggest that the short-term use of food supplements rich in plant sterols is a safe and effective strategy; to maximize the benefits of dietary and lifestyle therapy, either with or without statin therapy, among majority of dyslipidemic patients with need for additional lipid-lowering. PMID:21325285

  1. Lower Columbia River Terminal Fisheries Research Project : Final Environmental Assessment.

    SciTech Connect

    United States. Bonneville Power Administration.

    1995-04-01

    This notice announces BPA`S`s decision to fund the Oregon Department of Fish and Wildlife (ODFW), the Washington Department of Fish and Wildlife (WDFW), and the Clatsop Economic Development Committee for the Lower Columbia River Terminal Fisheries Research Project (Project). The Project will continue the testing of various species/stocks, rearing regimes, and harvest options for terminal fisheries, as a means to increase lower river sport and commercial harvest of hatchery fish, while providing both greater protection of weaker wild stocks and increasing the return of upriver salmon runs to potential Zone 6 Treaty fisheries. The Project involves relocating hatchery smolts to new, additional pen locations in three bays/sloughs in the lower Columbia River along both the Oregon and Washington sides. The sites are Blind Slough and Tongue Point in Clatsop County, Oregon, and Grays Bay/Deep River, Wahkiakum County, Washington. The smolts will be acclimated for various lengths of time in the net pens and released from these sites. The Project will expand upon an existing terminal fisheries project in Youngs Bay, Oregon. The Project may be expanded to other sites in the future, depending on the results of this initial expansion. BPA`S has determined the project is not a major Federal action significantly affecting the quality of the human environment, within the meaning of the National Environmental Policy Act (NEPA) of 1969. Therefore, the preparation of an environmental impact statement is not required, and BPA`S is issuing this FONSI.

  2. [Blood pressure limits--the lower, the better?].

    PubMed

    Leibundgut, Gregor

    2015-06-01

    Arterial hypertension is a widespread risk factor for cardiovascular disease. The benefit of a consistent drug therapy is proportionally associated with the degree of blood pressure reduction. By extrapolating the data, the assumption arose “the lower the better” and was widely accepted. However, several studies found an increase in morbidity and mortality with an excessive reduction of blood pressure (J-curve). This seems to affect mainly cardiac risk, and only at lower blood pressures<60 mmHg also the cerebral risk. An important factor here is the diastolic blood pressure. Others found a linear correlation. Overall, a j-shaped connection remains controversial and is not considered equally for all organ systems. At the same time cardiovascular risk seems not to increase with additional reduction in blood pressure of <140 mm Hg to <120 mmHg. This has led to the latest guidelines of all societies recommending higher target values. Reasons for higher targets in drug therapy of arterial hypertension, are increased adverse drug reactions or increased healthcare costs with few additional benefit. The current recommendations of the ESH/ESC, AHA/ACC/ASH and the JNC 8 set a higher target value for some subgroups, but remain inconsistent among themselves. PMID:26098188

  3. A rare case of sialolithiasis of the lower lip simulating a mucocele and review of the literature.

    PubMed

    Okada, Hiroyuki; Yokokawa, Machiyo; Komiya, Masamichi; Akimoto, Yoshiaki; Kaneda, Takashi; Yamamoto, Hirotsugu

    2011-01-01

    Sialolithiasis of the minor salivary glands, especially in the lower lip, is rare. We report a case of sialolithiasis of the lower lip simulating a mucocele as well as review four additional cases affecting the lower lip and 39 cases affecting the upper lip, together with details of the clinical and histopathologic findings. PMID:21716987

  4. Effects of lipid-lowering agents on inflammation, haemostasis and blood pressure.

    PubMed

    Tziomalos, Konstantinos; Karagiannis, Asterios; Athyros, Vasilios G

    2014-01-01

    In addition to the modification of the lipid profile, most lipid-lowering agents appear to modulate other atherogenic pathways. We summarize the effects of lipid-lowering agents on inflammation, hemostasis and blood pressure. We also discuss the potential contribution of these actions on cardiovascular disease prevention. Most lipid-lowering agents appear to exert anti-inflammatory, antithrombotic and antihypertensive effects. These pleiotropic actions appear to contribute to the reduction in cardiovascular events and deep venous thrombosis during statin treatment. Regarding other lipid-lowering agents, it is unclear whether their effects on inflammation, thrombosis or blood pressure play a role in their antiatherogenic potential.

  5. Spectral energetics of the lower thermosphere

    SciTech Connect

    Raskin, R.G.

    1992-01-01

    A spectral energetics analysis of the lower thermosphere is carried out using simulated data from the NCAR Thermosphere-Ionosphere General Circulation Model (TIGCM). The results clarify the physical processes through which upwardly propagating semidiurnal tides dissipate and release their energy into the lower thermosphere. Energy residing within the study region is partitioned into reservoirs of available potential energy, irrotational kinetic energy, and nondivergent kinetic energy at four vertical levels. A definition of available potential energy is used that is appropriate for regions of variable mean molecular weight. The reservoirs are further subdivided by vector spherical harmonic wave numbers, and an energy budget is computed for each mode. The source, sink, and transformation terms are obtained using a post-processor that reproduces the contribution of each term in the momentum and thermodynamic equations. The loss terms for the zonal wave number two modes represent the dissipating forces for the semidiurnal tides. Viscosity, heat conduction, and ion drag represent the primary dissipative forces. Numerical smoothing within the TIGCM, representing the subgrid-scale diffusion, is found to have a non-negligible contribution to the tidal dissipation. A small terdiurnal tide that is excited by ion drag is also observed in the model. A sensitivity analysis is carried out to ascertain the effects of the seasonal cycle, solar cycle, UT, and geomagnetic activity. At solar maximum, solar heating at the trough of the tide is an important dissipative force; the altitude of tidal dissipation is correspondingly lower. At high values of geomagnetic forcing, the propagating semidiurnal tide is completely dissipated within the study region.

  6. Folic acid supplementation lowers blood arsenic2

    PubMed Central

    Gamble, Mary V; Liu, Xinhua; Slavkovich, Vesna; Pilsner, J Richard; Ilievski, Vesna; Factor-Litvak, Pam; Levy, Diane; Alam, Shafiul; Islam, Mominul; Parvez, Faruque; Ahsan, Habibul; Graziano, Joseph H

    2007-01-01

    Background Chronic arsenic exposure currently affects >100 million persons worldwide. Methylation of ingested inorganic arsenic (InAs) to monomethylarsonic (MMAs) and dimethylarsinic (DMAs) acids relies on folate-dependent one-carbon metabolism and facilitates urinary arsenic elimination. Objective We hypothesized that folic acid supplementation to arsenic-exposed Bangladeshi adults would increase arsenic methylation and thereby lower total blood arsenic. Design In this randomized, double-blind, placebo-controlled trial, we evaluated blood concentrations of total arsenic, InAs, MMAs, and DMAs in 130 participants with low plasma folate (<9 nmol/L) before and after 12 wk of supplementation with folic acid (400 μg/d) or placebo. Results MMAs in blood was reduced by a mean ± SE of 22.24 ± 2.86% in the folic acid supplementation group and by 1.24 ± 3.59% in the placebe group (P < 0.0001). There was no change in DMAs in blood; DMAs is rapidly excreted in urine as evidenced by an increase in urinary DMAs (P = 0.0099). Total blood arsenic was reduced by 13.62% in the folic acid supplementation group and by 2.49% in the placebo group (P = 0.0199). Conclusions Folic acid supplementation to participants with low plasma concentrations of folate lowered blood arsenic concentrations, primarily by decreasing blood MMAs and increasing urinary DMAs. Therapeutic strategies to facilitate arsenic methylation, particularly in populations with folate deficiency or hyperhomocysteinemia or both, may lower blood arsenic concentrations and thereby contribute to the prevention of arsenic-induced illnesses. PMID:17921403

  7. Lateral variations in lower mantle seismic velocity

    NASA Technical Reports Server (NTRS)

    Duffy, Thomas S.; Ahrens, Thomas J.

    1992-01-01

    To obtain a theoretical model which provides a rationale for the observed high values of velocity variations, the effect of a 0.1 to 0.2 percent partially molten volatile-rich material in various geometries which are heterogeneously dispersed in the lower mantle is examined. Data obtained indicate that, depending on aspect ratio and geometry, 0.1-0.2 percent partial melting in conjunction with about 100 K thermal anomalies can explain the seismic variations provided the compressibility of the melt differs by less than about 20 percent from the surrounding solid.

  8. Whistle lower-better late than never

    PubMed Central

    Srinivasan, Arjun; Sivaramakrishnan, Mahadevan; Vallandramam, Pattabhi Raman R; Yadav, Pavan

    2016-01-01

    16 years old boy with childhood history of chronic respiratory symptoms requiring several admissions presented with recent worsening of symptoms. Chest x-ray showed left lower lobe collapse and flexible bronchoscopy revealed stenosis of left main bronchus. Foreign body was seen beyond the stenosis, which was removed after dilatation of narrowed bronchus under general anesthesia using rigid bronchoscopy. Patient's father gave a history of aspiration of whistle 14 years ago, which had then been removed. Patient is now free of symptoms after removal of foreign body. PMID:27185996

  9. Powered lower limb orthoses for gait rehabilitation

    PubMed Central

    Ferris, Daniel P.; Sawicki, Gregory S.; Domingo, Antoinette

    2006-01-01

    Bodyweight supported treadmill training has become a prominent gait rehabilitation method in leading rehabilitation centers. This type of locomotor training has many functional benefits but the labor costs are considerable. To reduce therapist effort, several groups have developed large robotic devices for assisting treadmill stepping. A complementary approach that has not been adequately explored is to use powered lower limb orthoses for locomotor training. Recent advances in robotic technology have made lightweight powered orthoses feasible and practical. An advantage to using powered orthoses as rehabilitation aids is they allow practice starting, turning, stopping, and avoiding obstacles during overground walking. PMID:16568153

  10. Fluvial terraces of the lower Susquehanna River

    NASA Astrophysics Data System (ADS)

    Pazzaglia, Frank J.; Gardner, Thomas W.

    1993-11-01

    Fluvial terraces of the lower Susquehanna River offer a unique opportunity to investigate the late stage geologic and geomorphic evolution of the U.S. Atlantic passive margin. Petrography and elevation distinguish and provide a basis for correlation of two groups of terraces, the upland terraces and lower terraces, through the Piedmont, Newark Basin, and Great Valley. Downstream correlation to dated upper Coastal Plain and Fall Zone fluvial deposits, relative weathering, and soil profile development characteristics establish terrace age. Upland terraces (Tg1, Tg2, and Tg3), middle to late Miocene strath terraces 80 to 140 m above the present channel, occur only along the Piedmont reach. They are underlain by unstratified, texturally-mature, quartz-dominated roundstone diamictons. Lower terraces (QTg, Qt1-Qt6), Pliocene and Pleistocene strath and thin aggradational terraces within 45 m of the present channel, are underlain by stratified and unstratified, texturally and compositionally immature sand, gravel, and pebbly silt. Terrace age and longitudinal profiles suggest complex interactions among relative base level, long-term flexural isostatic processes, climate, and river grade. Our model for terrace genesis requires the Susquehanna River to attain and maintain a characteristics graded longitudinal profile over graded time. For the U.S. Atlantic margin, we propose that straths are continually cut along this graded profile during periods of relative base level stability, achieved by slow, steady, isostatic continental uplift acting in concert with eustatic rise. Change in an external modulating factor, such as eustatic fall or climate change, results in fluvial incision and subsequent genesis of strath terraces. Longitudinal profiles of lower Susquehanna River terraces, which converge at the river mouth, diverge through the Piedmont, and reconverge north of the Piedmont, contrast with their hypothesized, original concave-up profiles. Progressive and cumulative

  11. Whistle lower-better late than never.

    PubMed

    Srinivasan, Arjun; Sivaramakrishnan, Mahadevan; Vallandramam, Pattabhi Raman R; Yadav, Pavan

    2016-01-01

    16 years old boy with childhood history of chronic respiratory symptoms requiring several admissions presented with recent worsening of symptoms. Chest x-ray showed left lower lobe collapse and flexible bronchoscopy revealed stenosis of left main bronchus. Foreign body was seen beyond the stenosis, which was removed after dilatation of narrowed bronchus under general anesthesia using rigid bronchoscopy. Patient's father gave a history of aspiration of whistle 14 years ago, which had then been removed. Patient is now free of symptoms after removal of foreign body.

  12. Gemfibrozil, stretching arms beyond lipid lowering

    PubMed Central

    Roy, Avik; Pahan, Kalipada

    2009-01-01

    Gemfibrozil is long known for its ability to reduce the level of triglycerides in the blood circulation and to decrease the risk of hyperlipidemia. However, a number of recent studies reveal that apart from its lipid-lowering effects, gemfibrozil can also regulate many other signaling pathways responsible for inflammation, switching of T-helper cells, cell-to-cell contact, migration, and oxidative stress. In this review, we have made an honest attempt to analyze various biological activities of gemfibrozil and associated mechanisms that may help to consider this drug for different human disorders as primary or adjunct therapy. PMID:19694602

  13. Viscosity profile of the lower mantle

    NASA Technical Reports Server (NTRS)

    Ellsworth, K.; Schubert, G.; Sammis, C. G.

    1985-01-01

    The viscosity of the earth's mantle is an important factor in studies of mantle convection and other problems in geodynamics. The present investigation is concerned with a determination of the variation of effective viscosity across the lower mantle from models of the Gibb's free energy of activation G(asterisk) and the adiabatic temperature profile. The variation of G(asterisk) with depth is calculated using both an elastic strain energy model, in which G(asterisk) is related to the seismic velocities, and a model which assumes G(asterisk) is proportional to the melting temperature.

  14. Geophysical - new technology, lower cost gearing search

    SciTech Connect

    Heitman, L.B.

    1985-12-01

    Seismic companies will remain competitive only if they reduce costs and at the same time increase the technological capabilities of their products. Overcapacity and lower prices plague geophysical films. Several key improvements in offshore seismic data collection were made during 1985, e.g., wide-tow seismic source arrays that improve the signal-to-noise ratio of the data by reducing various unwanted noise compounds have become standard and seismic source levels have also been increased by a wider variety of air and water gun offering. These improvement in data collection are discussed.

  15. The climate of Lower Franconia since 1500

    NASA Astrophysics Data System (ADS)

    Glaser, R.; Hagedorn, H.

    1991-09-01

    The present article summarizes the essential methods and results of an investigation which was carried out by the paleoclimatological working group of the Geographical Institute of the University of Würzburg from 1983 1989. The aim of this investigation was a seasonal scale reconstruction of the historical climate of Lower Franconia (southern Germany) using instrumental data, narrative sources and harvest records for wine, grain and hay as well as dendrological data (proxy data). Both method and data discussed and regional climate patterns within Franconia are presented.

  16. Cincinnati Big Area Additive Manufacturing (BAAM)

    SciTech Connect

    Duty, Chad E.; Love, Lonnie J.

    2015-03-04

    Oak Ridge National Laboratory (ORNL) worked with Cincinnati Incorporated (CI) to demonstrate Big Area Additive Manufacturing which increases the speed of the additive manufacturing (AM) process by over 1000X, increases the size of parts by over 10X and shows a cost reduction of over 100X. ORNL worked with CI to transition the Big Area Additive Manufacturing (BAAM) technology from a proof-of-principle (TRL 2-3) demonstration to a prototype product stage (TRL 7-8).

  17. 42 CFR 57.217 - Additional conditions.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... TEACHING FACILITIES, EDUCATIONAL IMPROVEMENTS, SCHOLARSHIPS AND STUDENT LOANS Health Professions Student Loans § 57.217 Additional conditions. The Secretary may with respect to any agreement entered into...

  18. 42 CFR 57.217 - Additional conditions.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... TEACHING FACILITIES, EDUCATIONAL IMPROVEMENTS, SCHOLARSHIPS AND STUDENT LOANS Health Professions Student Loans § 57.217 Additional conditions. The Secretary may with respect to any agreement entered into...

  19. 42 CFR 57.217 - Additional conditions.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... TEACHING FACILITIES, EDUCATIONAL IMPROVEMENTS, SCHOLARSHIPS AND STUDENT LOANS Health Professions Student Loans § 57.217 Additional conditions. The Secretary may with respect to any agreement entered into...

  20. 42 CFR 57.217 - Additional conditions.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... TEACHING FACILITIES, EDUCATIONAL IMPROVEMENTS, SCHOLARSHIPS AND STUDENT LOANS Health Professions Student Loans § 57.217 Additional conditions. The Secretary may with respect to any agreement entered into...

  1. 42 CFR 57.217 - Additional conditions.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... TEACHING FACILITIES, EDUCATIONAL IMPROVEMENTS, SCHOLARSHIPS AND STUDENT LOANS Health Professions Student Loans § 57.217 Additional conditions. The Secretary may with respect to any agreement entered into...

  2. Allergic and immunologic reactions to food additives.

    PubMed

    Gultekin, Fatih; Doguc, Duygu Kumbul

    2013-08-01

    For centuries, food additives have been used for flavouring, colouring and extension of the useful shelf life of food, as well as the promotion of food safety. During the last 20 years, the studies implicating the additives contained in foods and medicine as a causative factor of allergic reactions have been proliferated considerably. In this review, we aimed to overview all of the food additives which were approved to consume in EU and find out how common and serious allergic reactions come into existence following the consuming of food additives.

  3. Classification of additives for organic photovoltaic devices.

    PubMed

    Machui, Florian; Maisch, Philipp; Burgués-Ceballos, Ignasi; Langner, Stefan; Krantz, Johannes; Ameri, Tayebeh; Brabec, Christoph J

    2015-04-27

    The use of additives to improve the performance of organic photovoltaic cells has been intensely researched in recent years. However, so far, no system has been reported for the classification of additives and their functions. In this report, a system for classifying additives according to the fundamental mechanism by which they influence microstructure formation for P3HT:PCBM is suggested. The major parameters used for their classification are solubility and drying kinetics. Both are discussed in detail and their consequences on processing are analyzed. Furthermore, a general mechanism to classify the impact of additives on structure formation is suggested and discussed for different materials relevant to organic photovoltaic devices.

  4. 15 CFR 292.6 - Additional requirements.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... OF STANDARDS AND TECHNOLOGY, DEPARTMENT OF COMMERCE NIST EXTRAMURAL PROGRAMS MANUFACTURING EXTENSION PARTNERSHIP; INFRASTRUCTURE DEVELOPMENT PROJECTS § 292.6 Additional requirements. Federal policies...

  5. Sources of suspended sediment in the Lower Roanoke River, NC

    NASA Astrophysics Data System (ADS)

    Jalowska, A. M.; McKee, B. A.; Rodriguez, A. B.; Laceby, J. P.

    2015-12-01

    The Lower Roanoke River, NC, extends 220 km from the fall line to the bayhead delta front in the Albemarle Sound. The Lower Roanoke is almost completely disconnected from the upper reaches by a series of dams, with the furthest downstream dam located at the fall line. The dams effectively restrict the suspended sediment delivery from headwaters, making soils and sediments from the Lower Roanoke River basin, the sole source of suspended sediment. In flow-regulated rivers, bank erosion, especially mass wasting, is the major contributor to the suspended matter. Additional sources of the suspended sediment considered in this study are river channel, surface soils, floodplain surface sediments, and erosion of the delta front and prodelta. Here, we examine spatial and temporal variations in those sources. This study combined the use of flow and grain size data with a sediment fingerprinting method, to examine the contribution of surface and subsurface sediments to the observed suspended sediment load along the Lower Roanoke River. The fingerprinting method utilized radionuclide tracers 210Pb (natural atmospheric fallout), and 137Cs (produced by thermonuclear bomb testing). The contributions of surface and subsurface sources to the suspended sediment were calculated with 95% confidence intervals using a Monte-Carlo numerical mixing model. Our results show that with decreasing river slope and changing hydrography along the river, the contribution of surface sediments increases and becomes a main source of sediments in the Roanoke bayhead delta. At the river mouth, the surface sediment contribution decreases and is replaced by sediments eroded from the delta front and prodelta. The area of high surface sediment contribution is within the middle and upper parts of the delta, which are considered net depositional. Our study demonstrates that floodplains, often regarded to be a sediment sink, are also a sediment source, and they should be factored into sediment, carbon and

  6. [Blood pressure: the lower the better? Maybe yes].

    PubMed

    Verdecchia, Paolo; Angeli, Fabio; Aita, Adolfo; Bartolini, Claudia; Garofoli, Marta; Reboldi, Gianpaolo

    2016-05-01

    The SPRINT study tested the hypothesis that hypertensive patients randomized to a more intensive treatment, aimed at lowering systolic blood pressure (BP) below 120 mmHg have a lower incidence of major cardiovascular events when compared to patients randomized to a less intensive treatment (systolic BP reduction below 140 mmHg). Overall, 9361 patients were randomized to the more intensive (n=4678) or less intensive (n=4683) antihypertensive treatment. The study was prematurely interrupted because of an excess benefit in the more intensive arm. Indeed, the group randomized to the more intensive arm showed, when compared to the group randomized to the less intensive arm, a 25% reduction in the primary endpoint (1.65 vs 2.19% per year; p<0.001), a 43% reduction in cardiovascular death (0.25 vs 0.43%; p=0.005), a 27% reduction in all-cause death (1.03% vs 1.40%; p=0.003) and a 38% reduction in hospitalizations for heart failure (0.41 vs 0.67%; p<0.002). Unexpectedly, there was no significant reduction in the risk of stroke (not significant 11% reduction). The SPRINT study unequivocally shows that, in hypertensive patients with systolic BP ≥130 mmHg and no history of diabetes, previous stroke and polycystic renal disease, we should try to lower systolic BP to levels below 120 mmHg with the objective to lower the incidence of heart failure in addition to all-cause and cardiovascular death. Future guidelines on the management of patients with hypertension should implement the results of the SPRINT study. PMID:27310905

  7. Distributive justice and cognitive enhancement in lower, normal intelligence.

    PubMed

    Dunlop, Mikael; Savulescu, Julian

    2014-01-01

    There exists a significant disparity within society between individuals in terms of intelligence. While intelligence varies naturally throughout society, the extent to which this impacts on the life opportunities it affords to each individual is greatly undervalued. Intelligence appears to have a prominent effect over a broad range of social and economic life outcomes. Many key determinants of well-being correlate highly with the results of IQ tests, and other measures of intelligence, and an IQ of 75 is generally accepted as the most important threshold in modern life. The ability to enhance our cognitive capacities offers an exciting opportunity to correct disabling natural variation and inequality in intelligence. Pharmaceutical cognitive enhancers, such as modafinil and methylphenidate, have been shown to have the capacity to enhance cognition in normal, healthy individuals. Perhaps of most relevance is the presence of an 'inverted U effect' for most pharmaceutical cognitive enhancers, whereby the degree of enhancement increases as intelligence levels deviate further below the mean. Although enhancement, including cognitive enhancement, has been much debated recently, we argue that there are egalitarian reasons to enhance individuals with low but normal intelligence. Under egalitarianism, cognitive enhancement has the potential to reduce opportunity inequality and contribute to relative income and welfare equality in the lower, normal intelligence subgroup. Cognitive enhancement use is justifiable under prioritarianism through various means of distribution; selective access to the lower, normal intelligence subgroup, universal access, or paradoxically through access primarily to the average and above average intelligence subgroups. Similarly, an aggregate increase in social well-being is achieved through similar means of distribution under utilitarianism. In addition, the use of cognitive enhancement within the lower, normal intelligence subgroup negates, or at

  8. Magnetic sorbents added to soil slurries lower Cr aqueous concentration

    NASA Astrophysics Data System (ADS)

    Aravantinos, Konstantinos; Isari, Ekavi; Karapanagioti, Hrissi K.; Manariotis, Ioannis D.; Werner, David

    2016-04-01

    g/L, respectively). One month after the addition of amendments AC, AC/Fe, and BC/Fe, Cr concentration in the slurry was lower than the detection limit which was 0.5 μg/L (except of one of the soils with the AC that was 2.1 μg/L). The slurries with BC demonstrated Cr concentrations equal to 4.2 and 7.1 μg/L, respectively. All these properties point to promising materials that can effectively be used for in-situ environmental remediation and also be recovered.

  9. Synthesis of acid addition salt of delta-aminolevulinic acid from 5-bromo levulinic acid esters

    DOEpatents

    Moens, Luc

    2003-06-24

    A process of preparing an acid addition salt of delta-aminolevulinc acid comprising: a) dissolving a lower alkyl 5-bromolevulinate and hexamethylenetetramine in a solvent selected from the group consisting of water, ethyl acetate, chloroform, acetone, ethanol, tetrahydrofuran and acetonitrile, to form a quaternary ammonium salt of the lower alkyl 5-bromolevulinate; and b) hydrolyzing the quaternary ammonium salt with an inorganic acid to form an acid addition salt of delta-aminolevulinic acid.

  10. Silurian and Lower Devonian of southwestern Virginia

    SciTech Connect

    Dennison, J.M.

    1984-12-01

    Thermal maturity of the Silurian and Lower Devonian rocks in Virginia west of New River decreases southwestward. Oil and gas shows are reported. The total thickness of Lower Devonian plus Silurian strata ranges from 52 to 1000 ft (16 to 305 m), with a maximum in Buchanan County. Sandstones were derived from sources southeast of the central Appalachian basin, some from lands southeast of the outcrop belt, and some formed by reworking of sandstones within the outcrop areas. Sandstones change northwestward to shales in the Clinch and Rose Hill Formations. In the Middle Silurian and Helderberg Group, sandstones grade northwestward to limestones. Limestones in the Hancock Formation change westward to dolomite. The Onesquethaw Stage is represented by sandstone, chert, and limestone assigned to the Wildcat Valley and Huntersville Formations. In the Middle Silurian (Keefer or Big Six sandstone) and Early Devonian (Wildcat Valley Sandstone), longshore currents carried sand across the southwest end of the basin toward Kentucky. Several regional unconformities are present. These unconformities are mostly related to sea level changes, but some are probably tectonic in origin. Five unconformities are significant: 1) at base of Silurian, 2) at base of upper Helderberg over much of the area, 3) at base of Oriskany Sandstone, 4) at base of Huntersville Formation, and 5) at base of Upper Devonian black shales in extreme western Virginia, where Chattanooga Shale overlies middle Devonian to Middle Silurian strata.

  11. Flexible remediation design lowers total cost

    SciTech Connect

    Struttman, T.; Towarnicky, J.

    1995-08-01

    Most groundwater remediation systems are built to operate for many years. Predicting time to cleanup is difficult due to unforeseeable problems and changes in underground conditions. As a result, many treatment systems tend to be over-designed, with multiple built-in safety factors and excessive capital costs. Total time in operation also is unnecessarily long because upfront assumptions often fail to match future realities. A Superfund site remediation in Arizona illustrates how a flexible, ongoing design approach can significantly reduce life cycle costs. The site is a municipal airport where degreasing activities from the 1940s through the 1970s left trichloroethylene (TCE) in the soil and in two aquifers beneath the site. The soil is being remediated in five areas, representing approximately 10 acres. The upper aquifer plume covers approximately 400 acres, and the two lower aquifer plumes cover 10 and 30 acres. The cleanup involves extraction of groundwater in a pump-and-treat system of 16 extraction wells, followed by treatment with an air stripper for the upper aquifer and liquid-phase high-pressure carbon on the lower aquifer. The treated/clean water is reinjected to augment hydraulic control.

  12. New perspectives on nursing lower limb amputees.

    PubMed

    Crowther, H

    1982-09-01

    New perspectives on nursing lower limb amputees arise from the author's researches into amputee rehabilitation and a summary of other recent research findings. These are dealt with in the context of basic amputee treatment and the nursing process. There is new material on the psychological and neurological sequelae of amputation, the practical problems of loss of a limb and the prosthetic dimension of treatment. The patients' reactions to lower limb amputation were found to vary from intense grief to intense relief, many noting it to be of minor or moderate consequence. The model of sudden and shocking loss is largely incorrect. Attention is drawn to an unrecognized ordinariness which should become part of amputee nursing. Patients have many practical problems. These are social and economic, personal and domestic. The ward environment is unsuited to these needs but, working closely with therapists, nurses can do much to facilitate amputee rehabilitation. The modern purpose of amputation surgery is prosthetic replacement. Nurses should be working with some urgency towards uniting patient and prosthesis. Pain and discomfort are underestimated and research shows them to be a major characteristic of amputation continually and for many years after surgery. A variety of pain syndromes are involved. PMID:6924673

  13. A Third Generation Lower Hybrid Coupler

    SciTech Connect

    S. Bernabei; J. Hosea; C. Kung; D. Loesser; J. Rushinski; J.R. Wilson; R. Parker

    2001-12-05

    The Princeton Plasma Physics Laboratory (PPPL) and the Massachusetts Institute of Technology (MIT) are preparing an experiment of current profile control using lower-hybrid waves in order to produce and sustain advanced tokamak regimes in steady-state conditions in Alcator C-Mod. Unlike JET's, ToreSupra's and JT60's couplers, the C-Mod lower-hybrid coupler does not employ the now conventional multijunction design, but will have similar characteristics, compactness, and internal power division while retaining full control of the antenna element phasing. This is achieved by using 3 dB vertical power splitters and a stack of laminated plates with the waveguides milled in them. Construction is simplified and allows easy control and maintenance of all parts. Many precautions are taken to avoid arcing. Special care is also taken to avoid the recycling of reflected power which could affect the coupling and the launched n(subscript ||) spectrum. The results from C-Mod should allow further simplification in the designs of the coupler planned for KSTAR (Korea Superconducting Tokamak Advanced Research) and ITER (International Thermonuclear Experimental Reactor).

  14. Estrogens and Male Lower Urinary Tract Dysfunction

    PubMed Central

    Wynder, Jalissa L.; Nicholson, Tristan M.; DeFranco, Donald B.

    2016-01-01

    Benign prostatic hyperplasia (BPH) and associated lower urinary tract symptoms (LUTS) are common clinical problems in urology and affect the majority of men at some time during their lives. The development of BPH/LUTS is associated with an increased ratio of estrogen to androgen levels, and this ratio, when mimicked in a variety of animals, induces BPH and lower urinary tract dysfunction (LUTD). While the precise molecular etiology remains unclear, estrogens have been implicated in the development and maintenance of BPH. Numerous endogenous and exogenous estrogens exist in humans. These estrogens act via multiple estrogen receptors to promote or inhibit prostatic hyperplasia and other BPH-associated processes. The prostate is an estrogen target tissue, and estrogens directly and indirectly affect growth and differentiation of prostate. The precise role of estrogen action directly affecting prostate growth and differentiation in the context of BPH is an understudied area and remains to be elucidated. Estrogens and selective estrogen receptor modulators (SERMs) have been shown to promote or inhibit prostate proliferation illustrating their potential roles in the development of BPH as therapy. More work will be required to identify estrogen signaling pathways associated with LUTD in order to develop more efficacious drugs for BPH treatment and prevention. PMID:26156791

  15. Alignment of lower-limb prostheses.

    PubMed

    Zahedi, M S; Spence, W D; Solomonidis, S E; Paul, J P

    1986-04-01

    Alignment of a prosthesis is defined as the position of the socket relative to the other prosthetic components of the limb. During dynamic alignment the prosthetist, using subjective judgment and feedback from the patient, aims to achieve the most suitable limb geometry for best function and comfort. Until recently it was generally believed that a patient could only be satisfied with a unique "optimum alignment." The purpose of this systematic study of lower-limb alignment parameters was to gain an understanding of the factors that make a limb configuration or optimum alignment, acceptable to the patient, and to obtain a measure of the variation of this alignment that would be acceptable to the amputee. In this paper, the acceptable range of alignments for 10 below- and 10 above-knee amputees are established. Three prosthetists were involved in the majority of the 183 below-knee and 100 above-knee fittings, although several other prosthetists were also involved. The effects of each different prosthetist on the established range of alignment for each patient are reported to be significant. It is now established that an amputee can tolerate several alignments ranging in some parameters by as much as 148 mm in shifts and 17 degrees in tilts. This paper describes the method of defining and measuring the alignment of lower-limb prostheses. It presents quantitatively established values for bench alignment position and the range of adjustment required for incorporation into the design of new alignment units.

  16. Lower urinary tract symptoms in men

    PubMed Central

    Hollingsworth, John M

    2014-01-01

    Benign prostatic hyperplasia (BPH) is a highly prevalent and costly condition that affects older men worldwide. Many affected men develop lower urinary tract symptoms, which can have a negative impact on their quality of life. In the past, transurethral resection of the prostate (TURP) was the mainstay of treatment. However, several efficacious drug treatments have been developed, which have transformed BPH from an acute surgical entity to a chronic medical condition. Specifically, multiple clinical trials have shown that α adrenoceptor antagonists can significantly ameliorate lower urinary tract symptoms. Moreover, 5α reductase inhibitors, alone or combined with an α adrenoceptor antagonist, can reverse the natural course of BPH, reducing the risk of urinary retention and the need for surgical intervention. Newer medical regimens including the use of antimuscarinic agents or phosphodiesterase type 5 inhibitors, have shown promise in men with predominantly storage symptoms and concomitant erectile dysfunction, respectively. For men who do not adequately respond to conservative measures or pharmacotherapy, minimally invasive surgical techniques (such as transurethral needle ablation, microwave thermotherapy, and prostatic urethral lift) may be of benefit, although they lack the durability of TURP. A variety of laser procedures have also been introduced, whose improved hemostatic properties abrogate many of the complications associated with traditional surgery. PMID:25125424

  17. A kind of optimizing design method of progressive addition lenses

    NASA Astrophysics Data System (ADS)

    Tang, Yunhai; Qian, Lin; Wu, Quanying; Yu, Jingchi; Chen, Hao; Wang, Yuanyuan

    2010-10-01

    Progressive addition lenses are a kind of ophthalmic lenses with freeform surface. The surface curvature of the progressive addition lenses varies gradually from a minimum value in the upper, distance-viewing area, to a maximum value in the lower, near-viewing area. A kind of optimizing design method of progressive addition lenses is proposed to improve the optical quality by modifying the vector heights of the surface of designed progressive addition lenses initially. The relationship among mean power, cylinder power and the vector heights of the surface is deduced, and the optimizing factor is also gained. The vector heights of the surface of designed progressive addition lenses initially are used to calculate the plots of mean power and cylinder power based on the principle of differential geometry. The mean power plot is changed by adjusting the optimizing factor. Otherwise, the novel plot of the mean power can also be derived by shifting the mean power of one selected region to another and then by interpolating and smoothing. A partial differential equation of the elliptic type is founded based on the changed mean power. The solution of the equation is achieved by iterative method. The optimized vector heights of the surface are solved out. Compared with the original lens, the region in which the astigmatism near the nasal side on distance-vision portion is less than 0.5 D has become broader, and the clear regions on distance-vision and near-vision portion are wider.

  18. Hypolipidimic and antioxidant activities of oleuropein and its hydrolysis derivative-rich extracts from Chemlali olive leaves.

    PubMed

    Jemai, Hedya; Bouaziz, Mohamed; Fki, Ines; El Feki, Abdelfattah; Sayadi, Sami

    2008-11-25

    Oleuropein-rich extracts from olive leaves and their enzymatic and acid hydrolysates, respectively rich in oleuropein aglycone and hydroxytyrosol, were prepared under optimal conditions. The antioxidant activities of these extracts were examined by a series of models in vitro. In this study the lipid-lowering and the antioxidative activities of oleuropein, oleuropein aglycone and hydroxytyrosol-rich extracts in rats fed a cholesterol-rich diet were tested. Wistar rats fed a standard laboratory diet or cholesterol-rich diets for 16 weeks were used. The serum lipid levels, the thiobarbituric acid reactive substances (TBARS) level, as indicator of lipid peroxidation, and the activities of liver antioxidant enzymes (superoxide dismutase (SOD) and catalase (CAT)) were examined. The cholesterol-rich diet induced hyperlipidemia resulting in the elevation of total cholesterol (TC), triglycerides (TG) and low-density lipoprotein cholesterol (LDL-C). Administration of polyphenol-rich olive leaf extracts significantly lowered the serum levels of TC, TG and LDL-C and increased the serum level of high-density lipoprotein cholesterol (HDL-C). Furthermore, the content of TBARS in liver, heart, kidneys and aorta decreased significantly after oral administration of polyphenol-rich olive leaf extracts compared with those of rats fed a cholesterol-rich diet. In addition, these extracts increased the serum antioxidant potential and the hepatic CAT and SOD activities. These results suggested that the hypocholesterolemic effect of oleuropein, oleuropein aglycone and hydroxytyrosol-rich extracts might be due to their abilities to lower serum TC, TG and LDL-C levels as well as slowing the lipid peroxidation process and enhancing antioxidant enzyme activity.

  19. Overview of Omega-3 Fatty Acid Therapies

    PubMed Central

    Bradberry, J. Chris; Hilleman, Daniel E.

    2013-01-01

    The triglyceride (TG)-lowering benefits of the very-long-chain omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are well documented. Available as prescription formulations and dietary supplements, EPA and DHA are recommended by the American Heart Association for patients with coronary heart disease and hypertriglyceridemia. Dietary supplements are not subject to the same government regulatory standards for safety, efficacy, and purity as prescription drugs are; moreover, supplements may contain variable concentrations of EPA and DHA and possibly other contaminants. Reducing low-density lipoprotein-cholesterol (LDL-C) levels remains the primary treatment goal in the management of dyslipidemia. Dietary supplements and prescription formulations that contain both EPA and DHA may lower TG levels, but they may also increase LDL-C levels. Two prescription formulations of long-chain omega-3 fatty acids are available in the U.S. Although prescription omega-3 acid ethyl esters (OM-3-A EEs, Lovaza) contain high-purity EPA and DHA, prescription icosapent ethyl (IPE, Vascepa) is a high-purity EPA agent. In clinical trials of statin-treated and non–statin-treated patients with hypertriglyceridemia, both OM-3-A EE and IPE lowered TG levels and other atherogenic markers; however, IPE did not increase LDL-C levels. Results of recent outcomes trials of long-chain omega-3 fatty acids, fibrates, and niacin have been disappointing, failing to show additional reductions in adverse cardiovascular events when combined with statins. Therefore, the REDUCE–IT study is being conducted to evaluate the effect of the combination of IPE and statins on cardiovascular outcomes in high-risk patients. The results of this trial are eagerly anticipated. PMID:24391388

  20. 10 CFR 810.14 - Additional information.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 4 2012-01-01 2012-01-01 false Additional information. 810.14 Section 810.14 Energy DEPARTMENT OF ENERGY ASSISTANCE TO FOREIGN ATOMIC ENERGY ACTIVITIES § 810.14 Additional information. The Department of Energy may at any time require a person engaging in any generally or specifically...