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Sample records for adult circulatory system

  1. Mathematical circulatory system model

    NASA Technical Reports Server (NTRS)

    Lakin, William D. (Inventor); Stevens, Scott A. (Inventor)

    2010-01-01

    A system and method of modeling a circulatory system including a regulatory mechanism parameter. In one embodiment, a regulatory mechanism parameter in a lumped parameter model is represented as a logistic function. In another embodiment, the circulatory system model includes a compliant vessel, the model having a parameter representing a change in pressure due to contraction of smooth muscles of a wall of the vessel.

  2. Representations of the Human Circulatory System

    ERIC Educational Resources Information Center

    Lopez-Manjon, Asuncion; Angon, Yolanda Postigo

    2009-01-01

    There is no agreement about the robustness of intuitive representations of the circulatory system and their susceptibility to change by instruction. In this paper, we analyse to what extent students with varying degrees of biology instruction and different ages (High School Health Science and Social Science students and first and final year…

  3. Physics of the Circulatory System.

    ERIC Educational Resources Information Center

    Van Heuvelen, Alan

    1989-01-01

    Discusses some calculations and demonstrations illustrating the role of physics in cardiovascular system. Describes a model for the system, work done by the heart, pressure in blood vessel, and gravitational effects. (YP)

  4. The Circulatory System in Liver Disease.

    PubMed

    Hollenberg, Steven M; Waldman, Brett

    2016-07-01

    In the cirrhotic liver, distortion of the normal liver architecture is caused by structural and vascular changes. Portal hypertension is often associated with a hyperdynamic circulatory syndrome in which cardiac output and heart rate are increased and systemic vascular resistance is decreased. The release of several vasoactive substances is the primary factor involved in the reduction of mesenteric arterial resistance, resulting in sodium and water retention with eventual formation of ascites. Management of these patients with acute cardiac dysfunction often requires invasive hemodynamic monitoring in an intensive care unit setting to tailor decisions regarding use of fluids and vasopressors. PMID:27339674

  5. An Integrated Simulation Tool for Modeling the Human Circulatory System

    NASA Astrophysics Data System (ADS)

    Asami, Ken'ichi; Kitamura, Tadashi

    This paper presents an integrated simulation of the circulatory system in physiological movement. The large circulatory system model includes principal organs and functional units in modules in which comprehensive physiological changes such as nerve reflexes, temperature regulation, acid/base balance, O2/CO2 balance, and exercise are simulated. A beat-by-beat heart model, in which the corresponding electrical circuit problems are solved by a numerical analytic method, enables calculation of pulsatile blood flow to the major organs. The integration of different perspectives on physiological changes makes this simulation model applicable for the microscopic evaluation of blood flow under various conditions in the human body.

  6. NUCLEAR-FUELED CIRCULATORY SUPPORT SYSTEMS IV: RADIOLOGIC PERSPECTIVES

    PubMed Central

    Huffman, F. N.; Norman, J. C.

    1974-01-01

    If an implantable artificial heart can be developed, it should prove beneficial to a significant group of patients. A variety of energy sources, such as biologic, electromagnetic, and nuclear, are under evaluation. Currently, biologic fuel cell technology is not sufficiently advanced to permit its extrapolation to the power levels required for implantable circulatory support systems. Electromagnetic systems have the disadvantage of heavy batteries of considerable bulk requiring frequent recharging. Radioisotope-fueled thermal engine systems have the potential of providing degrees of freedom not possible with rechargeable units. However, radiosotope circulatory support systems subject their recipients to prolonged intracorporeal radiation, add to environmental background radiation, and constitute an exceedingly small, but finite, hazard due to possible violation of fuel containment. PMID:15215965

  7. Functional stability of cerebral circulatory system

    NASA Technical Reports Server (NTRS)

    Moskalenko, Y. Y.

    1980-01-01

    The functional stability of the cerebral circulation system seems to be based on the active mechanisms and on those stemming from specific of the biophysical structure of the system under study. This latter parameter has some relevant criteria for its quantitative estimation. The data obtained suggest that the essential part of the mechanism for active responses of cerebral vessels which maintains the functional stability of this portion of the vascular system, consists of a neurogenic component involving central nervous structures localized, for instance, in the medulla oblongata.

  8. [Heart and vascular surgery interventions with hypothermic circulatory arrest in adults].

    PubMed

    Kipfer, B; Leupi, F; Althaus, U

    1990-10-01

    In the period between 1981 and 1988, 51 patients were operated on the thoracic aorta using the hypothermic circulatory arrest technique. 31 patients had a dissection of the thoracic aorta, in 16 cases, an aneurysm was the reason for the intervention. In addition, we used the hypothermic circulatory arrest for a thrombectomy in the aortic arch and two mitral-valve replacements. The following operations were performed: 14 x composite graft, 19 x supracoronar prosthesis (6 x with aortic valve replacement, 3 x with partial replacement of aortic arch), 17 operations were performed either for aortic arch or aorta descendens replacement. In our retrospective study, 7 courses were fata (14%), 3 patients had complications with residuals. Compared with a group of 105 patients operated on the thoracic aorta in the same period without circulatory arrest, we found no difference with regard to the lethality and morbidity. We conclude that the hypothermic circulatory arrest is a safe technique for selected problems in cardiovascular surgery in adults. PMID:2074178

  9. Computational Hemodynamic Simulation of Human Circulatory System under Altered Gravity

    NASA Technical Reports Server (NTRS)

    Kim. Chang Sung; Kiris, Cetin; Kwak, Dochan

    2003-01-01

    A computational hemodynamics approach is presented to simulate the blood flow through the human circulatory system under altered gravity conditions. Numerical techniques relevant to hemodynamics issues are introduced to non-Newtonian modeling for flow characteristics governed by red blood cells, distensible wall motion due to the heart pulse, and capillary bed modeling for outflow boundary conditions. Gravitational body force terms are added to the Navier-Stokes equations to study the effects of gravity on internal flows. Six-type gravity benchmark problems are originally presented to provide the fundamental understanding of gravitational effects on the human circulatory system. For code validation, computed results are compared with steady and unsteady experimental data for non-Newtonian flows in a carotid bifurcation model and a curved circular tube, respectively. This computational approach is then applied to the blood circulation in the human brain as a target problem. A three-dimensional, idealized Circle of Willis configuration is developed with minor arteries truncated based on anatomical data. Demonstrated is not only the mechanism of the collateral circulation but also the effects of gravity on the distensible wall motion and resultant flow patterns.

  10. 78 FR 11208 - Circulatory System Devices Panel of the Medical Devices Advisory Committee; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-15

    ... HUMAN SERVICES Food and Drug Administration Circulatory System Devices Panel of the Medical Devices... (FDA). The meeting will be open to the public. Name of Committee: Circulatory System Devices Panel of... approval application for the MitraClip Delivery System sponsored by Abbott Vascular. The system consists...

  11. The Circulatory System. Instructional Materials in Anatomy and Physiology for Pennsylvania Health Occupations Programs.

    ERIC Educational Resources Information Center

    National Evaluation Systems, Inc., Amherst, MA.

    This instructional modular unit with instructor's guide provides materials on aspects of one of the major systems of the human body--the circulatory system. Its purpose is to introduce the student to the structures and functions of the human circulatory system--and the interrelationships of the two--and to familiarize the student with some of the…

  12. 76 FR 58019 - Circulatory System Devices Panel of the Medical Devices Advisory Committee; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-19

    ... HUMAN SERVICES Food and Drug Administration Circulatory System Devices Panel of the Medical Devices... (FDA). The meeting will be open to the public. Name of Committee: Circulatory System Devices Panel of... sponsored by AtriCure, Inc., for the AtriCure Synergy Ablation System to be used for the treatment of...

  13. ICD-11 and SNOMED CT Common Ontology: circulatory system.

    PubMed

    Rodrigues, Jean-Marie; Schulz, Stefan; Rector, Alan; Spackman, Kent; Millar, Jane; Campbell, James; Ustün, Bedirhan; Chute, Christopher G; Solbrig, Harold; Della Mea, Vincenzo; Persson, Kristina Brand

    2014-01-01

    The improvement of semantic interoperability between data in electronic health records and aggregated data for health statistics requires efforts to carefully align the two domain terminologies ICD and SNOMED CT. Both represent a new generation of ontology-based terminologies and classifications. The proposed alignment of these two systems and, in consequence, the validity of their cross-utilisation, requires a specific resource, named Common Ontology. We present the ICD-11 SNOMED CT Common Ontology building process including: a) the principles proposed for aligning the two systems with the help of a common model of meaning, b) the design of this common ontology, and c) preliminary results of the application to the diseases of the circulatory system. PMID:25160347

  14. 77 FR 18829 - Circulatory System Devices Panel of the Medical Devices Advisory Committee; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-28

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration Circulatory System Devices Panel of the Medical Devices... (FDA). The meeting will be open to the public. Name of Committee: Circulatory System Devices Panel...

  15. Adhesion Molecules: Master Controllers of the Circulatory System.

    PubMed

    Schmidt, Eric P; Kuebler, Wolfgang M; Lee, Warren L; Downey, Gregory P

    2016-01-01

    This manuscript will review our current understanding of cellular adhesion molecules (CAMs) relevant to the circulatory system, their physiological role in control of vascular homeostasis, innate and adaptive immune responses, and their importance in pathophysiological (disease) processes such as acute lung injury, atherosclerosis, and pulmonary hypertension. This is a complex and rapidly changing area of research that is incompletely understood. By design, we will begin with a brief overview of the structure and classification of the major groups of adhesion molecules and their physiological functions including cellular adhesion and signaling. The role of specific CAMs in the process of platelet aggregation and hemostasis and leukocyte adhesion and transendothelial migration will be reviewed as examples of the complex and cooperative interplay between CAMs during physiological and pathophysiological processes. The role of the endothelial glycocalyx and the glycobiology of this complex system related to inflammatory states such as sepsis will be reviewed. We will then focus on the role of adhesion molecules in the pathogenesis of specific disease processes involving the lungs and cardiovascular system. The potential of targeting adhesion molecules in the treatment of immune and inflammatory diseases will be highlighted in the relevant sections throughout the manuscript. © 2016 American Physiological Society. Compr Physiol 6:945-973, 2016. PMID:27065171

  16. Endoglin regulates mural cell adhesion in the circulatory system.

    PubMed

    Rossi, Elisa; Smadja, David M; Boscolo, Elisa; Langa, Carmen; Arevalo, Miguel A; Pericacho, Miguel; Gamella-Pozuelo, Luis; Kauskot, Alexandre; Botella, Luisa M; Gaussem, Pascale; Bischoff, Joyce; Lopez-Novoa, José M; Bernabeu, Carmelo

    2016-04-01

    The circulatory system is walled off by different cell types, including vascular mural cells and podocytes. The interaction and interplay between endothelial cells (ECs) and mural cells, such as vascular smooth muscle cells or pericytes, play a pivotal role in vascular biology. Endoglin is an RGD-containing counter-receptor for β1 integrins and is highly expressed by ECs during angiogenesis. We find that the adhesion between vascular ECs and mural cells is enhanced by integrin activators and inhibited upon suppression of membrane endoglin or β1-integrin, as well as by addition of soluble endoglin (SolEng), anti-integrin α5β1 antibody or an RGD peptide. Analysis of different endoglin mutants, allowed the mapping of the endoglin RGD motif as involved in the adhesion process. In Eng (+/-) mice, a model for hereditary hemorrhagic telangectasia type 1, endoglin haploinsufficiency induces a pericyte-dependent increase in vascular permeability. Also, transgenic mice overexpressing SolEng, an animal model for preeclampsia, show podocyturia, suggesting that SolEng is responsible for podocytes detachment from glomerular capillaries. These results suggest a critical role for endoglin in integrin-mediated adhesion of mural cells and provide a better understanding on the mechanisms of vessel maturation in normal physiology as well as in pathologies such as preeclampsia or hereditary hemorrhagic telangiectasia. PMID:26646071

  17. Evaluation of exercise-respiratory system modifications and preliminary respiratory-circulatory system integration scheme

    NASA Technical Reports Server (NTRS)

    Gallagher, R. R.

    1974-01-01

    The respiratory control system, functioning as an independent system, is presented with modifications of the exercise subroutine. These modifications illustrate an improved control of ventilation rates and arterial and compartmental gas tensions. A very elementary approach to describing the interactions of the respiratory and circulatory system is presented.

  18. Mortality from Circulatory System Diseases and Malformations in Children in the State of Rio de Janeiro

    PubMed Central

    Salim, Thais Rocha; Soares, Gabriel Porto; Klein, Carlos Henrique; de Oliveira, Glaucia Maria Moraes

    2016-01-01

    Background The epidemiological profile of mortality in a population is important for the institution of measures to improve health care and reduce mortality Objective To estimate mortality rates and the proportional mortality from cardiovascular diseases and malformations of the circulatory system in children and adolescents. Methods This is a descriptive study of mortality from cardiovascular diseases, malformations of the circulatory system, from all causes, ill-defined causes and external causes in children and adolescents in the state of Rio de Janeiro from 1996 to 2012. Populations were obtained from the Brazilian Institute of Geography and Statistics (Instituto Brasileiro de Geografia e Estatística - IBGE) and deaths obtained from the Department of Informatics of the Unified Health System (DATASUS)/Ministry of Health. Results There were 115,728 deaths from all causes, 69,757 in males. The annual mortality from cardiovascular diseases was 2.7/100,000 in men and 2.6/100,000 in women. The annual mortality from malformations of the circulatory system was 7.5/100,000 in men and 6.6/100,000 in women. Among the specific causes of circulatory diseases, cardiomyopathies had the highest rates of annual proportional mortality, and from malformations of the circulatory system, it occurred due to unspecified malformations of the circulatory system, at all ages and in both genders. Conclusion Mortality from malformations of the circulatory system was most striking in the first years of life, while cardiovascular diseases were more relevant in adolescents. Low access to prenatal diagnosis or at birth probably prevented the proper treatment of malformations of the circulatory system. PMID:27192384

  19. The Circulatory System [and] Instructor's Guide: The Circulatory System. Health Occupations Education Module: Instructional Materials in Anatomy and Physiology for Pennsylvania Health Occupations Programs.

    ERIC Educational Resources Information Center

    National Evaluation Systems, Inc., Amherst, MA.

    This module on the circulatory system is one of 17 modules designed for individualized instruction in health occupations education programs at both the secondary and postsecondary levels. It is part of an eight-unit subset on anatomy and physiology within the set of 17 modules. Following a preface which explains to the student how to use the…

  20. From Head to Toe: Respiratory, Circulatory, and Skeletal Systems. Book 3.

    ERIC Educational Resources Information Center

    Wiebe, Arthur, Ed.; And Others

    Designed to supplement curricular programs dealing with the human body, this booklet offers an activity-based, student-oriented approach for middle school teachers and students. Twelve activities focus on principles and skills related to the respiratory, circulatory, and skeletal systems. Each activity consists of student sheets and a teacher's…

  1. The Decapod Crustacean Circulatory System: A Case That Is neither Open nor Closed

    NASA Astrophysics Data System (ADS)

    McGaw, Iain J.

    2005-02-01

    Historically, the decapod crustacean circulatory system has been classed as open. However, recent work on the blue crab, Callinectes sapidus, suggests the circulatory system may be more complex than previously described. Corrosion casting techniques were refined and used to map the circulatory system of a variety of crab species (order: Decapoda; family: Cancridae) to determine if the complexity observed in the blue crab was present in other species. Seven arteries arose from the single chambered heart. The anterior aorta, the paired anterolateral arteries, and the paired hepatic arteries exited from the anterior aspect of the heart. The small-diameter posterior aorta exited posteriorly from the heart. Exiting from the ventral surface of the heart, the sternal artery branched to supply the legs and mouthparts of the crab. These arteries were more complex than previously described, with arterioles perfusing all areas of the body. The arterioles split into fine capillary-like vessels. Most of these capillaries were blind ending. However, in several areas (antennal gland, supraesophageal ganglion) complete capillary beds were present. After passing through the capillary-like vessels, blood drained into a series of sinuses. However, rather than being arbitrary spaces as previously described, scanning electron micrographs showed the sinuses to be distinct units. Most of the sinuses formed a series of flattened membrane-bound lacunae. This complexity may qualify the decapod crustacean circulatory system as one that is "partially closed" rather than open.

  2. Bilingual Skills Training Program. Barbering/Cosmetology. Module 10.0: Circulatory System.

    ERIC Educational Resources Information Center

    Northern New Mexico Community Coll., El Rito.

    This module on the circulatory or vascular system is the tenth of ten (CE 028 308-318) in the barbering/cosmetology course of a bilingual skills training program. (A Vocabulary Development Workbook for modules 6-10 is available as CE 028 313.) The course is designed to furnish theoretical and laboratory experience. Module objectives are for…

  3. 77 FR 25183 - Circulatory System Devices Panel of the Medical Devices Advisory Committee; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-27

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration Circulatory System Devices Panel of the Medical Devices Advisory Committee; Notice of Meeting AGENCY: Food and Drug Administration, HHS. ACTION: Notice. This notice announces a forthcoming meeting of a...

  4. Facilitating Conceptual Change in Ninth Grade Students' Understanding of Human Circulatory System Concepts

    ERIC Educational Resources Information Center

    Alkhawaldeh, Salem A.

    2007-01-01

    The purpose of this study was to investigate the effectiveness of the conceptual change text oriented instruction over traditionally designed instruction on ninth grade students' understanding of the human circulatory system concepts, and their retention of this understanding. The subjects of this study consist of 73 ninth grade female students…

  5. The Persistence of Misconceptions about the Human Blood Circulatory System among Students in Different Grade Levels

    ERIC Educational Resources Information Center

    Ozgur, Sami

    2013-01-01

    In this paper, it is aimed to investigate the persistence of misconceptions in the topic of the human blood circulatory system among students in different grade levels. For this reason, after discussions with biology educators, two tests consisting of open-ended questions were developed by the researcher and administered to students in four…

  6. 76 FR 36548 - Circulatory System Devices Panel of the Medical Devices Advisory Committee; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-22

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration Circulatory System Devices Panel of the Medical Devices Advisory Committee; Notice of Meeting AGENCY: Food and Drug Administration, HHS. ACTION: Notice. This notice announces a forthcoming meeting of a...

  7. Students' Achievement in Human Circulatory System Unit: The Effect of Reasoning Ability and Gender.

    ERIC Educational Resources Information Center

    Sungur, Semra; Tekkaya, Ceren

    2003-01-01

    Investigates the effect of gender and reasoning ability on the human circulatory system concepts achievement and attitude toward biology. Reports a statistically significant mean difference between concrete and formal students with regard to achievement and attitude toward biology. (Contains 24 references.) (Author/YDS)

  8. 78 FR 67365 - Circulatory System Devices Panel of the Medical Devices Advisory Committee; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-12

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration Circulatory System Devices Panel of the Medical Devices Advisory Committee; Notice of Meeting AGENCY: Food and Drug Administration, HHS. ACTION: Notice. This notice announces a forthcoming meeting of a...

  9. Learning in a Non-Physical Science Domain: The Human Circulatory System.

    ERIC Educational Resources Information Center

    Chi, Michelene T. H.; And Others

    This research explores the moment-by-moment understanding students exhibit in the learning of a non-physical science domain--the human circulatory system. The goal was to understand how students learn by capturing the nature of their initial mental models (naive conceptions), and by seeing how new information gets assimilated into their mental…

  10. Students' Alternative Conceptions of the Human Circulatory System: A Cross-Age Study.

    ERIC Educational Resources Information Center

    Arnaudin, Mary W.; Mintzes, Joel J.

    1985-01-01

    Concept maps and structured/clinical interviews were completed by 25 fourth graders and 25 college freshmen to determine knowledge of the human circulatory system. Students (N=945) at various levels were then measured for misconception frequencies. Student preconceptions appear to be tenacious, but confrontation strategies may assist fundamental…

  11. Developing seventh grade students' systems thinking skills in the context of the human circulatory system.

    PubMed

    Raved, Lena; Yarden, Anat

    2014-01-01

    Developing systems thinking skills in school can provide useful tools to deal with a vast amount of medical and health information that may help learners in decision making in their future lives as citizen. Thus, there is a need to develop effective tools that will allow learners to analyze biological systems and organize their knowledge. Here, we examine junior high school students' systems thinking skills in the context of the human circulatory system. A model was formulated for developing teaching and learning materials and for characterizing students' systems thinking skills. Specifically, we asked whether seventh grade students, who studied about the human circulatory system, acquired systems thinking skills, and what are the characteristics of those skills? Concept maps were used to characterize students' systems thinking components and examine possible changes in the students' knowledge structure. These maps were composed by the students before and following the learning process. The study findings indicate a significant improvement in the students' ability to recognize the system components and the processes that occur within the system, as well as the relationships between different levels of organization of the system, following the learning process. Thus, following learning students were able to organize the systems' components and its processes within a framework of relationships, namely the students' systems thinking skills were improved in the course of learning using the teaching and learning materials. PMID:25520948

  12. Effects of a new nitro compound on the systemic circulatory system in dogs.

    PubMed

    Taki, K; Hashiba, Y; Sumita, T; Shoji, T; Ishikawa, N

    1991-09-01

    The present study was undertaken to evaluate the effects of a newly synthesized nitro compound (E-4701) on the systemic circulatory system with special reference to venous return and vascular compliance. Dogs were anesthetized with sodium pentobarbital. After opening the chest, cannulae were inserted into the superior and inferior vena cavae and into the right atrial appendage. The venous flow from the caval veins was redirected to a blood reservoir with an outlet at a constant height. The blood was pumped into the right atrium at a constant flow rate. E-4701 had a hypotensive effect, and also caused a decrease in reservoir blood volume; i.e., a decrease in venous return. Venous return via the superior vena cava was increased, whereas return via the inferior vena cava was decreased. Similar effects on the systemic circulatory system were observed with nitroprusside. The lowest dose of nitroprusside that caused a significant reduction in blood pressure was the same dose as that which caused a decrease in reservoir blood volume. However, a low dose of E-4701 caused a significant reduction in reservoir blood volume without affecting the systemic blood pressure. Arterial and venous compliances were increased by both E-4701 and nitroprusside. Nitroglycerin and isosorbide dinitrate increased venous compliance, but did not affect arterial compliance. The results suggest that E-4701 caused an almost equipotent reduction in blood pressure and venous return by dilating the arterial and venous vascular beds. The capacitance vessels may be more sensitive to E-4701 than the resistance vessels. PMID:1720838

  13. OUTCOMES OF THE FIFTH INTERNATIONAL CONFERENCE ON PEDIATRIC MECHANICAL CIRCULATORY SUPPORT SYSTEMS AND PEDIATRIC CARDIOPULMONARY PERFUSION

    PubMed Central

    Ündar, Akif

    2009-01-01

    The overall objective of the Conference was to bring together internationally know clinicians, bioengineers, and basic scientists involved in research on pediatric mechanical cardiac support systems and pediatric cardiopulmonary bypass procedures. The primary focus was to explicitly describe the problems with current pediatric mechanical circulatory support systems, methods, and techniques during acute and chronic support. The organizers were able to bring together respected international scholars from over 25 different countries at past conferences that has already made a significant impact on the treatment of pediatric cardiac patients during the past three years. Over 1,300 participants (250–300 participants each year) from many countries, including Argentina, Australia, Austria, Belgium, Brazil, Canada, China, Finland, France, Germany, Greece, Ireland, Italy, Japan, Kuwait, Netherlands, New Zealand, Poland, South Korea, Saudi Arabia, Scotland, Spain, Switzerland, Taiwan, Turkey, the United Kingdom, and the United States, have participated in the 2005, 2006, 2007, 2008, and 2009 events. To date, The Fifth International Conference on Pediatric Mechanical Circulatory Support Systems and Pediatric Cardiopulmonary Perfusion is the only conference solely dedicated to pediatric cardiac devices used during acute and chronic mechanical circulatory support. There is no other national or international conference to precisely define the problems with pediatric cardiac patients, and to suggest solutions with new methodologies and devices for pediatric patients, but specifically for neonates and infants. PMID:20021466

  14. Design of a hydraulic analog of the circulatory system for evaluating artificial hearts.

    PubMed

    Donovan, F M

    1975-01-01

    A major problem in improving artificial heart designs is the absence of methods for accurate in vitro testing of artificial heart systems. A mock circulatory system has been constructed which hydraulically simulates the systemic and pulmonary circulations of the normal human. The device is constructed of 1/2 in. acrylic sheet and has overall dimensions of 24 in. wide, 16 in. tall, and 8 in. deep. The artificial heart to be tested is attached to the front of the device, and pumps fluid from the systemic venous chamber into the pulmonary arterial chamber and from the pulmonary venous chamber into the systemic arterial chamber. Each of the four chambers is hermetically sealed. The compliance of each chamber is determined by the volume of air trapped above the fluid in that chamber. The pulmonary and systemic resistances are set automatically by bellows-operated valves to simulate the barroreceptor response in the systemic arteries and the passive pulmonary resistance response in the pulmonary arteries. Cardiac output is measured by a turbine flowmeter in the systemic circulation. Results using the Kwan-Gett artificial heart show a good comparison between the mock circulatory system response and the calf response. PMID:1225373

  15. An "ancient" complexity? Evolutionary morphology of the circulatory system in Xiphosura.

    PubMed

    Göpel, Torben; Wirkner, Christian S

    2015-08-01

    Horseshoe crabs (Xiphosura) have been an object of zoological research for almost 200 years. Although some morphological work on the circulatory system has been done, the three-dimensional structure of this complex organ system has never been shown satisfactorily and some crucial questions remain unanswered. Here, the circulatory systems of juveniles of the horseshoe crab taxa Limulus polyphemus and Carcinoscorpius rotundicauda were investigated using a combination of an injection method and micro-computed tomography. Data were processed and 3D-visualized using reconstruction software. Furthermore, the heart was examined using scanning electron microscopy. Additionally, the histology of some structures was investigated via light microscopy and transmission electron microscopy. The results show the high degree of complexity of the arterial and lacunar systems of Xiphosura and provide insights into their three-dimensional structure and relationship to other organ systems such as the central nervous system. We show that the major lacunae, previously described as vessel-like - though indeed highly ramified - can clearly be distinguished from arteries in histological sections because they have no distinct walls. Similarities and differences between the xiphosuran species and arachnids are highlighted and possible phylogenetic implications and evolutionary scenarios discussed. PMID:25964110

  16. Burden of Circulatory System Diseases and Ignored Barriers of Knowledge Translation

    PubMed Central

    Ghafouri, Hamed-Basir; Saravani, Shahzad; Shokraneh, Farhad

    2012-01-01

    Circulatory system disease raise third highest disability-adjusted life years among Iranians and ischemic cardiac diseases are main causes for such burden. Despite available evidences on risk factors of the disease, no effective intervention was implemented to control and prevent the disease. This paper non-systematically reviews available literature on the problem, solutions, and barriers of implementation of knowledge translation in Iran. It seems that there are ignored factors such as cultural and motivational issues in knowledge translation interventions but there are hopes for implementation of started projects and preparation of students as next generation of knowledge transferors. PMID:24250994

  17. Perturbation analysis of internal balancing for lightly damped mechanical systems with gyroscopic and circulatory forces

    NASA Technical Reports Server (NTRS)

    Blelloch, P. A.; Mingori, D. L.; Wei, J. D.

    1987-01-01

    Approximate expressions are developed for internally balanced singular values corresponding to the modes of mechanical systems with gyroscopic forces, light damping, and small circulatory forces. A brief overview is first given of the balanced realization model reduction method, including a discussion of recent work. The models considered are defined, and a perturbation analysis is used to show that the modal representation becomes asymptotically balanced as damping reduces to zero. The approximate balanced singular values are calculated, and a simple example of a flexible, dual-spin spacecraft is given as an illustration of the results.

  18. Noninvasive optoacoustic system for rapid diagnosis and management of circulatory shock

    NASA Astrophysics Data System (ADS)

    Petrov, Irene Y.; Kinsky, Michael; Petrov, Yuriy; Petrov, Andrey; Henkel, S. N.; Seeton, Roger; Esenaliev, Rinat O.; Prough, Donald S.

    2013-03-01

    Circulatory shock can lead to death or severe complications, if not promptly diagnosed and effectively treated. Typically, diagnosis and management of circulatory shock are guided by blood pressure and heart rate. However, these variables have poor specificity, sensitivity, and predictive value. Early goal-directed therapy in septic shock patients, using central venous catheterization (CVC), reduced mortality from 46.5% to 30%. However, CVC is invasive and complication-prone. We proposed to use an optoacoustic technique for noninvasive, rapid assessment of peripheral and central venous oxygenation. In this work we used a medical grade optoacoustic system for noninvasive, ultrasound image-guided measurement of central and peripheral venous oxygenation. Venous oxygenation during shock declines more rapidly in the periphery than centrally. Ultrasound imaging of the axillary [peripheral] and internal jugular vein [central] was performed using the Vivid e (GE Healthcare). We built an optoacoustic interface incorporating an optoacoustic transducer and a standard ultrasound imaging probe. Central and peripheral venous oxygenations were measured continuously in healthy volunteers. To simulate shock-induced changes in central and peripheral oxygenation, we induced peripheral vasoconstriction in the upper extremity by using a cooling blanket. Central and peripheral venous oxygenations were measured before (baseline) and after cooling and after rewarming. During the entire experiment, central venous oxygenation was relatively stable, while peripheral venous oxygenation decreased by 5-10% due to cooling and recovered after rewarming. The obtained data indicate that noninvasive, optoacoustic measurements of central and peripheral venous oxygenation may be used for diagnosis and management of circulatory shock with high sensitivity and specificity.

  19. Mock circulatory system for the evaluation of left ventricular assist devices, endoluminal prostheses, and vascular diseases.

    PubMed

    Legendre, Daniel; Fonseca, Jeison; Andrade, Aron; Biscegli, José Francisco; Manrique, Ricardo; Guerrino, Domingos; Prakasan, Akash Kuzhiparambil; Ortiz, Jaime Pinto; Lucchi, Julio Cesar

    2008-06-01

    A new digital computer mock circulatory system has been developed in order to replicate the physiologic and pathophysiologic characteristics of the human cardiovascular system. The computer performs the acquisition of pressure, flow, and temperature in an open loop system. A computer program has been developed in Labview programming environment to evaluate all these physical parameters. The acquisition system was composed of pressure, flow, and temperature sensors and also signal conditioning modules. In this study, some results of flow, cardiac frequencies, pressures, and temperature were evaluated according to physiologic ventricular states. The results were compared with literature data. In further works, performance investigations will be conducted on a ventricular assist device and endoprosthesis. Also, this device should allow for evaluation of several kinds of vascular diseases. PMID:18422796

  20. Noninvasive optoacoustic system for rapid diagnostics and management of circulatory shock

    NASA Astrophysics Data System (ADS)

    Esenaliev, Rinat O.; Petrov, Irene Y.; Petrov, Yuriy; Kinsky, Michael; Prough, Donald S.

    2012-02-01

    Circulatory shock is lethal, if not promptly diagnosed and effectively treated. Typically, circulatory shock resuscitation is guided by blood pressure, heart rate, and mental status, which have poor predictive value. In patients, in whom early goaldirected therapy was applied using central venous oxygenation measurement, a substantial reduction of mortality was reported (from 46.5% to 30%). However, central venous catheterization is invasive, time-consuming and often results in complications. We proposed to use the optoacoustic technique for noninvasive, rapid assessment of central venous oxygenation. In our previous works we demonstrated that the optoacoustic technique can provide measurement of blood oxygenation in veins and arteries due to high contrast and high resolution. In this work we developed a novel optoacoustic system for noninvasive, automatic, real-time, and continuous measurement of central venous oxygenation. We performed pilot clinical tests of the system in human subjects with different oxygenation in the internal jugular vein and subclavian vein. A novel optoacoustic interface incorporating highly-sensitive optoacoustic probes and standard ultrasound imaging probes were developed and built for the study. Ultrasound imaging systems Vivid i and hand-held Vscan (GE Healthcare) as well as Site-Rite 5 (C.R. Bard) were used in the study. We developed a special algorithm for oxygenation monitoring with minimal influence of overlying tissue. The data demonstrate that the system provides precise measurement of venous oxygenation continuously and in real time. Both current value of the venous oxygenation and trend (in absolute values and for specified time intervals) are displayed in the system. The data indicate that: 1) the optoacoustic system developed by our group is capable of noninvasive measurement of blood oxygenation in specific veins; 2) clinical ultrasound imaging systems can facilitate optoacoustic probing of specific blood vessels; 3) the

  1. Non-Intrusive Device for Real-Time Circulatory System Assessment with Advanced Signal Processing Capabilities

    NASA Astrophysics Data System (ADS)

    Pinheiro, E.; Postolache, O.; Girão, P.

    2010-01-01

    This paper presents a device that uses three cardiography signals to characterize several important parameters of a subject's circulatory system. Using electrocardiogram, finger photoplethysmogram, and ballistocardiogram, three heart rate estimates are acquired from beat-to-beat time interval extraction. Furthermore, pre-ejection period, pulse transit time (PTT), and pulse arrival time (PAT) are computed, and their long-term evolution is analyzed. The system estimates heart rate variability (HRV) and blood pressure variability (BPV) from the heart rate and PAT time series, to infer the activity of the cardiac autonomic system. The software component of the device evaluates the frequency content of HRV and BPV, and also their fractal dimension and entropy, thus providing a detailed analysis of the time series' regularity and complexity evolution, to allow personalized subject evaluation.

  2. Assessment of left heart and pulmonary circulation flow dynamics by a new pulsed mock circulatory system

    NASA Astrophysics Data System (ADS)

    Tanné, David; Bertrand, Eric; Kadem, Lyes; Pibarot, Philippe; Rieu, Régis

    2010-05-01

    We developed a new mock circulatory system that is able to accurately simulate the human blood circulation from the pulmonary valve to the peripheral systemic capillaries. Two independent hydraulic activations are used to activate an anatomical-shaped left atrial and a left ventricular silicon molds. Using a lumped model, we deduced the optimal voltage signals to control the pumps. We used harmonic analysis to validate the experimental pulmonary and systemic circulation models. Because realistic volumes are generated for the cavities and the resulting pressures were also coherent, the left atrium and left ventricle pressure-volume loops were concordant with those obtained in vivo. Finally we explored left atrium flow pattern using 2C-3D+T PIV measurements. This gave a first overview of the complex 3D flow dynamics inside realistic left atrium geometry.

  3. Stability of circulatory elastic systems in the presence of magnetic damping.

    NASA Technical Reports Server (NTRS)

    Smith, T. E.; Herrmann, G.

    1971-01-01

    The effect of a type of magnetic damping on the stability of equilibrium of some circulatory elastic systems is examined. A simple system with two degrees of freedom is considered first, and a destabilization is found to be caused by the magnetic field. The nature of the destabilization, however, is not identical to that caused by internal viscous damping. The differences and similarities between the two effects are discussed, and the results are also compared with those of linear external viscous damping. A continuous cantilever bar subjected to a follower force at its free end is then examined. It is found that the critical load is independent of the strength of the magnetic field, and is considerably lower than the corresponding critical load in the absence of a magnetic field. Finally, the continuous cantilever is treated approximately by Galerkin's procedure and also by using a two-degree-of-freedom model of the cantilever; the results obtained are qualitatively the same.

  4. Development and Validation of a Two-Tier Instrument to Examine Understanding of Internal Transport in Plants and the Human Circulatory System

    ERIC Educational Resources Information Center

    Wang, Jing-Ru

    2004-01-01

    This study is intended to develop an assessment instrument to investigate students' understandings about internal transport in plants and human circulatory system. A refined process of a two-tier diagnostic test was used to develop the instrument. Finally, three versions of the Internal Transport in Plants and the Human Circulatory System test…

  5. A fast building and effective hydraulic pediatric mock circulatory system for the evaluation of a left ventricular assist device.

    PubMed

    Huang, Feng; Ruan, Xiaodong; Zou, Jun; Qian, Wenwei; Fu, Xin

    2013-01-01

    A mock circulatory system (MCS) has been proven a useful tool in the development of a ventricular assist device. Nowadays a MCS aimed at the evaluation of pediatric blood pumps, which require many different considerations compared with that of adults, has become an urgent need. This article presents the details on how the dynamic process of the left ventricle, which is described in terms of the pressure-volume loop (P-V loop), and the properties of the circulation such as compliance and resistance are simulated by hydraulic elements. A simple control method is introduced to reproduce the physiological afterload and preload sensitivities of the mock ventricle for the first time. Hemodynamic performance of the system is obtained by medical sensors to validate the similarity of the device to the native cardiovascular system. The actual sensitivities of the mock ventricle are obtained intuitively from the changes of the P-V loops. The aortic input impedance of the MCS is also obtained and compared with the data from previous medical reports. At last a pediatric left ventricular assist device (LVAD) prototype is introduced for testing to further verify the effectiveness of the MCS. The experimental results indicate that this pediatric MCS is capable of reproducing basic hemodynamic characteristics of a child in both normal and pathological conditions and it is sufficient for testing a pediatric LVAD. Besides, most components constituting the main hydraulic part of this MCS are inexpensive off-the-shelf products, making the MCS easy and fast to build. PMID:24088901

  6. [Forming a community at risk for circulatory system diseases among workers engaged into underground mining].

    PubMed

    Shliapnikov, D M; Shur, P Z; Kostarev, V G; Alexeyev, V B; Vlasova, E M; Uhabov, V M

    2015-01-01

    Forming a community at risk for circulatory system diseases will increase efficiency of medical and prophylactic measures on managing risk of arterial hypertension. Epidemiologic analysis helped to reveal reliable connection between arterial hypertension predictors and work conditions of mining machine operators and supported actualization of high occupational risk suggested in a priori evaluation. Mathematic modelling helped to forecast increase in the disease probability: with noise level of 94 dB after 10 years of work, 17.9% of workers are expected to have arterial hypertension preventing from further occupational activity. Forecasting results of arterial hypertension probability help to form risk groups for medical and preventive technologies managing occupational risk, and predictors enable to specify necessity of individual medical preventive measures. PMID:27024920

  7. Numerical Models of Human Circulatory System under Altered Gravity: Brain Circulation

    NASA Technical Reports Server (NTRS)

    Kim, Chang Sung; Kiris, Cetin; Kwak, Dochan; David, Tim

    2003-01-01

    A computational fluid dynamics (CFD) approach is presented to model the blood flow through the human circulatory system under altered gravity conditions. Models required for CFD simulation relevant to major hemodynamic issues are introduced such as non-Newtonian flow models governed by red blood cells, a model for arterial wall motion due to fluid-wall interactions, a vascular bed model for outflow boundary conditions, and a model for auto-regulation mechanism. The three-dimensional unsteady incompressible Navier-Stokes equations coupled with these models are solved iteratively using the pseudocompressibility method and dual time stepping. Moving wall boundary conditions from the first-order fluid-wall interaction model are used to study the influence of arterial wall distensibility on flow patterns and wall shear stresses during the heart pulse. A vascular bed modeling utilizing the analogy with electric circuits is coupled with an auto-regulation algorithm for multiple outflow boundaries. For the treatment of complex geometry, a chimera overset grid technique is adopted to obtain connectivity between arterial branches. For code validation, computed results are compared with experimental data for steady and unsteady non-Newtonian flows. Good agreement is obtained for both cases. In sin-type Gravity Benchmark Problems, gravity source terms are added to the Navier-Stokes equations to study the effect of gravitational variation on the human circulatory system. This computational approach is then applied to localized blood flows through a realistic carotid bifurcation and two Circle of Willis models, one using an idealized geometry and the other model using an anatomical data set. A three- dimensional anatomical Circle of Willis configuration is reconstructed from human-specific magnetic resonance images using an image segmentation method. The blood flow through these Circle of Willis models is simulated to provide means for studying gravitational effects on the brain

  8. [The gender aspects of diet factors effect on development of diseases of circulatory system among rural population].

    PubMed

    Kamalova, F M; Valeeva, E R

    2014-01-01

    The unhealthy diet is one of important controllable risk factors of development of noninfectious diseases. The gender differences in attitude to one's own health confirm significance of their effect on health condition. The study was carried out to establish the effect of diet factors on the rate of diseases of circulatory system in rural population with consideration of gender distribution. The analysis of results of sampling examination of rural population established that 51% of disease rate in males and 22% of disease rate in females are related to diseases of circulatory system. In males and females rate of diseases of circulatory system is determined by diet factors. The direction of relationship is direct and inverse, differs in males and females and depends on diet factors. The gender differences were manifested not only in conditionality of rate of diseases of circulatory system by diet factors but also by their mutual interaction. The health management of rural population is based on examination and analysis of relationship between health of rural population and factors of their diet. PMID:25799749

  9. The Contribution of Conceptual Change Texts Accompanied by Concept Mapping to Students' Understanding of the Human Circulatory System.

    ERIC Educational Resources Information Center

    Sungur, Semra; Tekkaya, Ceren; Geban, Omer

    2001-01-01

    Investigates the contribution of conceptual change texts accompanied by concept mapping instruction to 10th-grade students' understanding of the human circulatory system. Indicates that the conceptual change texts accompanied by concept mapping instruction produced a positive effect on students' understanding of concepts. Concludes that students…

  10. Relations of Cognitive and Motivational Variables with Students' Human Circulatory System Achievement in Traditional and Learning Cycle Classrooms

    ERIC Educational Resources Information Center

    Sadi, Özlem; Çakiroglu, Jale

    2014-01-01

    This study is aimed at investigating the relationships among students' relevant prior knowledge, meaningful learning orientation, reasoning ability, self-efficacy, locus of control, attitudes toward biology and achievement with the human circulatory system (HCS) using the learning cycle (LC) and the traditional classroom setting. The study…

  11. Students' Visualization of Diagrams Representing the Human Circulatory System: The Use of Spatial Isomorphism and Representational Conventions

    ERIC Educational Resources Information Center

    Cheng, Maurice M. W.; Gilbert, John K.

    2015-01-01

    This study investigated students' interpretation of diagrams representing the human circulatory system. We conducted an interview study with three students aged 14-15 (Year 10) who were studying biology in a Hong Kong school. During the interviews, students were asked to interpret diagrams and relationships between diagrams that represented…

  12. Effect of 5E Instructional Model in Student Success in Primary School 6th Year Circulatory System Topic

    ERIC Educational Resources Information Center

    Cardak, Osman; Dikmenli, Musa; Saritas, Ozge

    2008-01-01

    The aim of this study is to research the effect of the 5E instructional model on primary (sixth grade) student success during the circulatory system unit. This study was conducted with 38 students in two different classes by the same researcher in 2006-2007. One of the classes was assigned as the control group and the other as the experimental…

  13. Continuous flow total artificial heart: modeling and feedback control in a mock circulatory system.

    PubMed

    Khalil, Hassan A; Kerr, Daniel T; Franchek, Matthew A; Metcalfe, Ralph W; Benkowski, Robert J; Cohn, William E; Tuzun, Egemen; Radovancevic, Branislav; Frazier, O H; Kadipasaoglu, Kamuran A

    2008-01-01

    We developed a mock circulatory loop and used mathematical modeling to test the in vitro performance of a physiologic flow control system for a total artificial heart (TAH). The TAH was constructed from two continuous flow pumps. The objective of the control system was to maintain loop flow constant in response to changes in outflow resistance of either pump. Baseline outflow resistances of the right (pulmonary vascular resistance) and the left (systemic vascular resistance) pumps were set at 2 and 18 Wood units, respectively. The corresponding circuit flow was 4 L/min. The control system consisted of two digital integral controllers, each regulating the voltage, hence, the rotational speed of one of the pumps. The in vitro performance of the flow control system was validated by increasing systemic and pulmonary vascular resistances in the mock loop by 4 and 8 Wood units (simulating systemic and pulmonary hypertension conditions), respectively. For these simulated hypertensive states, the flow controllers regulated circuit flow back to 4 L/min within seconds by automatically adjusting the rotational speed of either or both pumps. We conclude that this multivariable feedback mechanism may constitute an adequate supplement to the inherent pressure sensitivity of rotary blood pumps for the automatic flow control and left-right flow balance of a dual continuous flow pump TAH system. PMID:18496274

  14. Programmed death 1 protects from fatal circulatory failure during systemic virus infection of mice.

    PubMed

    Frebel, Helge; Nindl, Veronika; Schuepbach, Reto A; Braunschweiler, Thomas; Richter, Kirsten; Vogel, Johannes; Wagner, Carsten A; Loffing-Cueni, Dominique; Kurrer, Michael; Ludewig, Burkhard; Oxenius, Annette

    2012-12-17

    The inhibitory programmed death 1 (PD-1)-programmed death ligand 1 (PD-L1) pathway contributes to the functional down-regulation of T cell responses during persistent systemic and local virus infections. The blockade of PD-1-PD-L1-mediated inhibition is considered as a therapeutic approach to reinvigorate antiviral T cell responses. Yet previous studies reported that PD-L1-deficient mice develop fatal pathology during early systemic lymphocytic choriomeningitis virus (LCMV) infection, suggesting a host protective role of T cell down-regulation. As the exact mechanisms of pathology development remained unclear, we set out to delineate in detail the underlying pathogenesis. Mice deficient in PD-1-PD-L1 signaling or lacking PD-1 signaling in CD8 T cells succumbed to fatal CD8 T cell-mediated immunopathology early after systemic LCMV infection. In the absence of regulation via PD-1, CD8 T cells killed infected vascular endothelial cells via perforin-mediated cytolysis, thereby severely compromising vascular integrity. This resulted in systemic vascular leakage and a consequential collapse of the circulatory system. Our results indicate that the PD-1-PD-L1 pathway protects the vascular system from severe CD8 T cell-mediated damage during early systemic LCMV infection, highlighting a pivotal physiological role of T cell down-regulation and suggesting the potential development of immunopathological side effects when interfering with the PD-1-PD-L1 pathway during systemic virus infections. PMID:23230000

  15. Pumping Rate Study of a Left Ventricular Assist Device in a Mock Circulatory System.

    PubMed

    Zhuang, Xiaoqi; Yang, Ming; Xu, Liang; Ou, Wenchu; Xu, Zihao; Meng, Fan; Huang, Huan

    2016-01-01

    The aim of this work was to investigate the hemodynamic influence of the change of pump rate on the cardiovascular system with consideration of heart rate and the resonant characteristics of the arterial system when a reliable synchronous triggering source is unavailable. Hemodynamic waveforms are recorded at baseline conditions and with the pump rate of left ventricular assist device (LVAD) at 55, 60, 66, and 70 beats per minute for four test conditions in a mock circulatory system. The total input work (TIW) and energy equivalent pressure (EEP) are calculated as metrics for evaluating the hemodynamic performance within different test conditions. Experimental results show that TIW and EEP achieve their maximum values, where the pump rate is equal to the heart rate. In addition, it demonstrates that TIW and EEP are significantly affected by changing pump rate of LVAD, especially when the pump rate is closing to the natural frequency of the arterial system. When a reliable synchronous triggering source is not available for LVAD, it is suggested that selecting a pump rate equal to the resonant frequency of the arterial system could achieve better supporting effects. PMID:26955001

  16. 38 CFR 4.62 - Circulatory disturbances.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... FOR RATING DISABILITIES Disability Ratings The Musculoskeletal System § 4.62 Circulatory disturbances. The circulatory disturbances, especially of the lower extremity following injury in the popliteal... 38 Pensions, Bonuses, and Veterans' Relief 1 2014-07-01 2014-07-01 false Circulatory...

  17. 38 CFR 4.62 - Circulatory disturbances.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... FOR RATING DISABILITIES Disability Ratings The Musculoskeletal System § 4.62 Circulatory disturbances. The circulatory disturbances, especially of the lower extremity following injury in the popliteal... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Circulatory...

  18. 38 CFR 4.62 - Circulatory disturbances.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... FOR RATING DISABILITIES Disability Ratings The Musculoskeletal System § 4.62 Circulatory disturbances. The circulatory disturbances, especially of the lower extremity following injury in the popliteal... 38 Pensions, Bonuses, and Veterans' Relief 1 2011-07-01 2011-07-01 false Circulatory...

  19. 38 CFR 4.62 - Circulatory disturbances.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... FOR RATING DISABILITIES Disability Ratings The Musculoskeletal System § 4.62 Circulatory disturbances. The circulatory disturbances, especially of the lower extremity following injury in the popliteal... 38 Pensions, Bonuses, and Veterans' Relief 1 2012-07-01 2012-07-01 false Circulatory...

  20. 38 CFR 4.62 - Circulatory disturbances.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... FOR RATING DISABILITIES Disability Ratings The Musculoskeletal System § 4.62 Circulatory disturbances. The circulatory disturbances, especially of the lower extremity following injury in the popliteal... 38 Pensions, Bonuses, and Veterans' Relief 1 2013-07-01 2013-07-01 false Circulatory...

  1. Development of an in-vitro circulatory system with known resistance and capacitance

    NASA Technical Reports Server (NTRS)

    Offerdahl, C. D.; Schaub, J. D.; Koenig, S. C.; Swope, R. D.; Ewert, D. L.; Convertino, V. A. (Principal Investigator)

    1996-01-01

    An in-vitro (hydrodynamic) model of the circulatory system was developed. The model consisted of a pump, compliant tubing, and valves for resistance. The model is used to simulate aortic pressure and flow. These parameters were measured using a Konigsburg Pressure transducer and a Triton ART2 flow probe. In addition, venous pressure and flow were measured on the downstream side of the resistance. The system has a known compliance and resistance. Steady and pulsatile flow tests were conducted to determine the resistance of the model. A static compliance test was used to determine the compliance of the system. The aortic pressure and flow obtained from the hydrodynamic model will be used to test the accuracy of parameter estimation models such as the 2-element and 4-element Windkessel models and the 3-element Westkessel model. Verifying analytical models used in determining total peripheral resistance (TPR) and systemic arterial compliance (SAC) is important because it provides insight into hemodynamic parameters that indicate baroreceptor responsiveness to situations such as changes in gravitational acceleration.

  2. Programmed death 1 protects from fatal circulatory failure during systemic virus infection of mice

    PubMed Central

    Frebel, Helge; Nindl, Veronika; Schuepbach, Reto A.; Braunschweiler, Thomas; Richter, Kirsten; Vogel, Johannes; Wagner, Carsten A.; Loffing-Cueni, Dominique; Kurrer, Michael; Ludewig, Burkhard

    2012-01-01

    The inhibitory programmed death 1 (PD-1)–programmed death ligand 1 (PD-L1) pathway contributes to the functional down-regulation of T cell responses during persistent systemic and local virus infections. The blockade of PD-1–PD-L1–mediated inhibition is considered as a therapeutic approach to reinvigorate antiviral T cell responses. Yet previous studies reported that PD-L1–deficient mice develop fatal pathology during early systemic lymphocytic choriomeningitis virus (LCMV) infection, suggesting a host protective role of T cell down-regulation. As the exact mechanisms of pathology development remained unclear, we set out to delineate in detail the underlying pathogenesis. Mice deficient in PD-1–PD-L1 signaling or lacking PD-1 signaling in CD8 T cells succumbed to fatal CD8 T cell–mediated immunopathology early after systemic LCMV infection. In the absence of regulation via PD-1, CD8 T cells killed infected vascular endothelial cells via perforin-mediated cytolysis, thereby severely compromising vascular integrity. This resulted in systemic vascular leakage and a consequential collapse of the circulatory system. Our results indicate that the PD-1–PD-L1 pathway protects the vascular system from severe CD8 T cell–mediated damage during early systemic LCMV infection, highlighting a pivotal physiological role of T cell down-regulation and suggesting the potential development of immunopathological side effects when interfering with the PD-1–PD-L1 pathway during systemic virus infections. PMID:23230000

  3. Students' Visualization of Diagrams Representing the Human Circulatory System: The use of spatial isomorphism and representational conventions

    NASA Astrophysics Data System (ADS)

    Cheng, Maurice M. W.; Gilbert, John K.

    2015-01-01

    This study investigated students' interpretation of diagrams representing the human circulatory system. We conducted an interview study with three students aged 14-15 (Year 10) who were studying biology in a Hong Kong school. During the interviews, students were asked to interpret diagrams and relationships between diagrams that represented aspects of the circulatory system. All diagrams used in the interviews had been used by their teacher when teaching the topic. Students' interpretations were expressed by their verbal response and their drawing. Dual coding theory was used to interpret students' responses. There was evidence that one student relied on verbal recall as a strategy in interpreting diagrams. It was found that students might have relied unduly on similarities in spatial features, rather than on deeper meanings represented by conventions, of diagrams when they associated diagrams that represented different aspects of the circulatory system. A pattern of students' understanding of structure-behaviour-function relationship of the biological system was observed. This study suggests the importance of a consistent diagrammatic and verbal representation in communicating scientific ideas. Implications for teaching practice that facilitates learning with diagrams and address students' undue focus on spatial features of diagrams are discussed.

  4. Global solution to a hyperbolic problem arising in the modeling of blood flow in circulatory systems

    NASA Astrophysics Data System (ADS)

    Ruan, Weihua; Clark, M. E.; Zhao, Meide; Curcio, Anthony

    2007-07-01

    This paper considers a system of first-order, hyperbolic, partial differential equations in the domain of a one-dimensional network. The system models the blood flow in human circulatory systems as an initial-boundary-value problem with boundary conditions of either algebraic or differential type. The differential equations are nonhomogeneous with frictional damping terms and the state variables are coupled at internal junctions. The existence and uniqueness of the local classical solution have been established in our earlier work [W. Ruan, M.E. Clark, M. Zhao, A. Curcio, A hyperbolic system of equations of blood flow in an arterial network, J. Appl. Math. 64 (2) (2003) 637-667; W. Ruan, M.E. Clark, M. Zhao, A. Curcio, Blood flow in a network, Nonlinear Anal. Real World Appl. 5 (2004) 463-485; W. Ruan, M.E. Clark, M. Zhao, A. Curcio, A quasilinear hyperbolic system that models blood flow in a network, in: Charles V. Benton (Ed.), Focus on Mathematical Physics Research, Nova Science Publishers, Inc., New York, 2004, pp. 203-230]. This paper continues the analysis and gives sufficient conditions for the global existence of the classical solution. We prove that the solution exists globally if the boundary data satisfy the dissipative condition (2.3) or (3.2), and the norms of the initial and forcing functions in a certain Sobolev space are sufficiently small. This is only the first step toward establishing the global existence of the solution to physiologically realistic models, because, in general, the chosen dissipative conditions (2.3) and (3.2) do not appear to hold for the originally proposed boundary conditions (1.3)-(1.12).

  5. Interdisciplinary studies on the development of nuclear-fueled circulatory support systems: Collaboration of industry and academe

    NASA Technical Reports Server (NTRS)

    Norman, J. C.

    1974-01-01

    The purpose of this report is to acquaint the Houston community with specific areas of available technology, both public and private, to demonstrate to industry how this technology may be acquired and put to use to provide new and useful services for man. Much of the technology utilized in the development of nuclear-fueled circulatory support systems in our laboratories has evolved from industry, NASA, and AEC; our projects involve radiation biology, thermodynamics, energy transfers, hemodynamics, hematology, pathology, and surgery.

  6. Single and combined effects of air pollutants on circulatory and respiratory system-related mortality in Belgrade, Serbia.

    PubMed

    Stojić, Svetlana Stanišić; Stanišić, Nemanja; Stojić, Andreja; Šoštarić, Andrej

    2016-01-01

    The aim of this study was to investigate the association between short- and long-term exposure to particulate matter (PM10), nitrogen dioxide (NO2), sulfur dioxide (SO2), and soot and mortality attributed to circulatory and respiratory diseases in Belgrade area (Serbia). The analyzed data set comprised results of regular pollutant monitoring and corresponding administrative records on frequency of daily mortality in the period 2009-2014. Nonlinear exposure-response dependencies and delayed effects of temperature were examined by means of distributed lag nonlinear models. The air pollutant loadings and circulatory system-related death rates in Belgrade area are among the highest in Europe. Data demonstrated that excess risk of death with short-term exposure to elevated concentrations of PM10, SO2, and soot was not significant, whereas marked effect size estimates for exposure over 90 d preceding mortality were found. The influence of chronic exposure was shown to be greater for respiratory than circulatory system-related mortality. When stratified by age and gender, higher risk was noted for male individuals below the age of 65 years. PMID:26699658

  7. Results following implantation of mechanical circulatory support systems: The Montreal Heart Institute experience

    PubMed Central

    El-Hamamsy, Ismaïl; Jacques, Frédéric; Perrault, Louis P; Bouchard, Denis; Demers, Philippe; White, Michel; Pelletier, Guy B; Racine, Normand; Pellerin, Michel; Carrier, Michel

    2009-01-01

    BACKGROUND: Mechanical circulatory support systems (MCSS) have been available in Canada since 1986. Accepted indications include bridging to transplantation or recovery. The present study reviewed the results following MCSS implantation at the Montreal Heart Institute (Montreal, Quebec). METHODS: From September 1987 to September 2006, 43 MCSS were implanted (32 Thoratec [Thoratec Corporation, USA], nine Cardio West TAH [SynCardia Systems Inc, USA], two Novacor [World Heart Corporation, Canada]) in 43 patients (mean [± SD] age 44±13 years; range 19 to 64 years). Indications for implantation included cardiogenic shock due to ischemic (n=19), viral (n=10) or other types of cardiomyopathies (n=14). RESULTS: The mean ejection fraction before implantation was 17.6±6.5% (range 10% to 45%). Before MCSS implantation, most patients showed signs of end-organ failure, including mechanical ventilation (77%), central venous pressure higher than 16 mmHg (44%), oliguria (35%) and hepatic dysfunction (19%). The mean duration of MCSS support was 22.8±32.8 days (range one to 158 days). Survival to transplantation or recovery was 74%. Only one patient was successfully bridged to recovery. Complications were common during MCSS support. They included re-exploration for bleeding (47%), respiratory failure (44%), renal failure requiring temporary dialysis (40%), infection (33%) and neurological events (16%). Only one patient had device failure. In patients successfully bridged to transplantation, early actuarial survival (one month) following transplantation averaged 71±8% and was 57±9% at one year. CONCLUSION: MCSS support with a left ventricular assist device or a total artificial heart provides an effective means of bridging terminally ill patients to transplantation or recovery. Early survival after transplantation shows satisfactory results. However, these results come at the expense of frequent device-related complications, and device failure remains a constant threat. PMID

  8. [THE CHARACTERISTIC OF SOMATOTYPE AND FUNCTIONAL STATE OF CIRCULATORY SYSTEM OF STUDENT YOUTH OF THE NORTHEAST OF RUSSIA].

    PubMed

    Timofeieva, A V; Klimova, T M; Mikhailova, A E; Zakharova, R N; Vinokurova, S P; Timofeiev, L F

    2015-01-01

    The article considers results of single-step study in random sampling of female students of the M.K. Ammosov north-east federal university (n=456). The study was carried out to investigate somatotype and functional state of circulatory system. The standard technique was applied to measure height, body mass, chest circumference, level of arterial pressure and rate of heart beats. The type of somatotype was established using Pignet index. The tone of vegetative system was determined using Kérdö index. The adaptation potential of circulatory system was determined using functional changes index. The results of study established that in 61% of examined female students the type of constitution corresponds to normosthenic one. The percentage of persons with asthenic and hypersthenic type of constitution amounted to 27% and 12% correspondingly. The signs of increasing oftone ofsympathetic nervous system are observed in 89% of girls. The functional condition of circulatory system is evaluated as "tension of adaptation mechanisms" that is apparently related to period of adaptation to new conditions. The prolonged preservation of such states results in exhaustion offunctional resources of organism and can promote development of diseases. In conditions of impacting of unfavorable ecological factors the deconditionning disorders can significantly contribute to health disturbances and decreasing of life quality. To preserve youth's health during period of education the comprehensive strategy is to be implemented such components as dynamic monitoring of health, organization of adequate diet, explanation of necessity of observance of sleep and rest pattern, development of conditions for active aerobic physical exertion and activities on correction of risk factors of development of diseases are to be included. PMID:26987173

  9. Development and initial in vivo testing of a new hydraulic drive system (Paedipump) for circulatory support in infants.

    PubMed

    Reiss, N; Morshuis, M; Landich, R; Frerichs, I; Frerichs, A; Hellige, G; Illian, M; Dramburg, W; Scheid, P; Minami, K; Körfer, R

    1998-07-01

    The main limitation in the use of circulatory support in children is the lack of an adequate system with regard to size and pumping capacity. Recently, two pneumatically driven ventricular support systems with low volume chambers for use in a pediatric population became available. We have developed a hydraulic drive system with an advantageous exact control of the stroke volume. The system enables two different modes of operation: the full-empty and the filled-empty modes. In both cases the ventricle is empty at the end of systole. This new system was tested in experimental animals (6 pigs, body weight 9.5-14.0 kg) with normal and reduced left ventricular function (MAP<45 mmHg). A 25 ml ventricle (HIA-Medos) was implanted. The full-empty and the filled-empty mode used led to a significant load reduction, both in animals with normal and impaired cardiac function. Plasma lactate levels, pH-values and total body O2-consumption were in the normal range during circulatory support indicating adequate organ perfusion. Results showed that sufficient ventricular support was achieved during all pumping modes due to the possibility of controlling and modifying the stroke volume of the hydraulically driven support system employed according to necessity. This is a promising feature for its future application in infants with congenital or acquired heart diseases. PMID:9745998

  10. Atmospheric pressure fluctuations in the far infrasound range and emergency transport events coded as circulatory system diseases

    NASA Astrophysics Data System (ADS)

    Didyk, L. A.; Gorgo, Yu. P.; Dirckx, J. J. J.; Bogdanov, V. B.; Buytaert, J. A. N.; Lysenko, V. A.; Didyk, N. P.; Vershygora, A. V.; Erygina, V. T.

    2008-09-01

    This study examines whether a relation exists between rapid atmospheric pressure fluctuations, attributed to the far infrasound frequency range (APF), and a number of emergency transport events coded as circulatory system diseases (EEC). Over an entire year, the average integral amplitudes of APF in the range of periods from 3 s to 120 s over each hour (HA) were measured. Daily dynamics of HA averaged over the year revealed a wave shape with smooth increase from night to day followed by decrease from day to night. The total daily number of EEC within the city of Kiev, Ukraine, was related to the daily mean of HA (DHA) and to the ratio of HA averaged over the day time to HA averaged over the night time (Rdn), and was checked for confounding effects of classical meteorological variables through non-parametric regression algorithms. The number of EEC were significantly higher on days with high DHA (3.72 11.07 Pa, n = 87) compared to the low DHA (0.7 3.62 Pa, n = 260, p = 0.01), as well at days with low Rdn (0.21 1.64, n = 229) compared to the high Rdn (1.65 7.2, n = 118, p = 0.03). A difference between DHA and Rdn effects on the emergency events related to different categories of circulatory diseases points to a higher sensitivity of rheumatic and cerebro-vascular diseases to DHA, and ischaemic and hypertensive diseases to Rdn. Results suggest that APF could be considered as a meteorotropic factor capable of influencing circulatory system diseases.

  11. The human heart and the circulatory system as an interesting interdisciplinary topic in lessons of physics and biology

    NASA Astrophysics Data System (ADS)

    Volná, M.; Látal, F.; Kubínek, R.; Richterek, L.

    2014-01-01

    Many topics which are closely related can be found in the national curriculum of the Czech Republic for physics and biology. One of them is the heart and the circulatory system in the human body. This topic was examined cross curriculum, a teaching module was created and the topic was chosen for our research. The task was to determine if the students of bachelor study are aware of connections between physics and biology within this topic and whether we can help them effectively to describe the corresponding physics phenomena in the human body connected, for example, with a heart attack or with the measurement of blood pressure. In this paper, the heart and the circulatory system are presented as suitable topics for an interdisciplinary teaching module which includes both theoretical and experimental parts. The module was evaluated by a group of first-year undergraduate students of physics at the Faculty of Science, Palacký University. The acquired knowledge was compared with another control group through a test. The highest efficiency of the module was evaluated on the basis of questions that covered the calculation problems.

  12. NASA Models of Space Radiation Induced Cancer, Circulatory Disease, and Central Nervous System Effects

    NASA Technical Reports Server (NTRS)

    Cucinotta, Francis A.; Chappell, Lori J.; Kim, Myung-Hee Y.

    2013-01-01

    The risks of late effects from galactic cosmic rays (GCR) and solar particle events (SPE) are potentially a limitation to long-term space travel. The late effects of highest concern have significant lethality including cancer, effects to the central nervous system (CNS), and circulatory diseases (CD). For cancer and CD the use of age and gender specific models with uncertainty assessments based on human epidemiology data for low LET radiation combined with relative biological effectiveness factors (RBEs) and dose- and dose-rate reduction effectiveness factors (DDREF) to extrapolate these results to space radiation exposures is considered the current "state-of-the-art". The revised NASA Space Risk Model (NSRM-2014) is based on recent radio-epidemiology data for cancer and CD, however a key feature of the NSRM-2014 is the formulation of particle fluence and track structure based radiation quality factors for solid cancer and leukemia risk estimates, which are distinct from the ICRP quality factors, and shown to lead to smaller uncertainties in risk estimates. Many persons exposed to radiation on earth as well as astronauts are life-time never-smokers, which is estimated to significantly modify radiation cancer and CD risk estimates. A key feature of the NASA radiation protection model is the classification of radiation workers by smoking history in setting dose limits. Possible qualitative differences between GCR and low LET radiation increase uncertainties and are not included in previous risk estimates. Two important qualitative differences are emerging from research studies. The first is the increased lethality of tumors observed in animal models compared to low LET radiation or background tumors. The second are Non- Targeted Effects (NTE), which include bystander effects and genomic instability, which has been observed in cell and animal models of cancer risks. NTE's could lead to significant changes in RBE and DDREF estimates for GCR particles, and the potential

  13. Mortality from Circulatory System Diseases among French Uranium Miners: A Nested Case-Control Study.

    PubMed

    Drubay, Damien; Caër-Lorho, Sylvaine; Laroche, Pierre; Laurier, Dominique; Rage, Estelle

    2015-05-01

    A significant association has been observed between radon exposure and cerebrovascular disease (CeVD) mortality among French uranium miners, but risk factors for circulatory system diseases (CSD) have not been previously considered. We conducted new analyses in the recently updated (through 2007) French cohort of uranium miners (n = 5,086), which included 442 deaths from CSD, 167 of them from ischemic heart disease (IHD) and 105 from CeVD. A nested case-control study was then set up to collect and investigate the influence of these risk factors on the relationships between mortality from CSD and occupational external gamma ray and internal ionizing radiation exposure (radon and long-lived radionuclides) in this updated cohort. The nested case-control study included miners first employed after 1955, still employed in 1976 and followed up through 2007. Individual information about CSD risk factors was collected from medical files for the 76 deaths from CSD (including 26 from IHD and 16 from CeVD) and 237 miners who had not died of CSD by the end of follow-up. The exposure-risk relationships were assessed with a Cox proportional hazard model weighted by the inverse sampling probability. A significant increase in all CSD and CeVD mortality risks associated with radon exposure was observed in the total cohort [hazard ratios: HRCSD/100 working level months (WLM) = 1.11, 95% confidence interval (1.01; 1.22) and HRCeVD/100 WLM = 1.25 (1.09; 1.43), respectively]. A nonsignificant exposure-risk relationship was observed for every type of cumulative ionizing radiation exposure and every end point [e.g., HRCSD/100WLM = 1.43 (0.71; 2.87)]. The adjustment for each CSD risk factor did not substantially change the exposure-risk relationships. When the model was adjusted for overweight, hypertension, diabetes, hypercholesterolemia and smoking status, the HR/100WLM for CSD, for example, was equal to 1.21 (0.54; 2.75); and when it was adjusted for risk factors selected with the

  14. Long-term allergen exposure induces adipose tissue inflammation and circulatory system injury.

    PubMed

    Jung, Chien-Cheng; Su, Huey-Jen

    2016-05-01

    The purpose of this study was to study whether allergen exposure can induce inflammation and lower the anti-inflammation levels in serum and in adipose tissues, and further develop cardiovascular injury. Our data showed that heart rate was significantly higher in the OVA-challenged mice compared to control mice. Moreover, there were higher expressions of pro-inflammation genes in the OVA-challenged mice in adipose tissues, and the expressions of anti-inflammation genes were lower. The levels of inflammation mediators were associated in serum and adipose tissues. The level of circulatory injury lactate dehydrogenase was significantly associated with the levels of E-selectin, resistin and adiponectin in the serum. The hematoxylin and eosin and immunohistochemistry stains indicated the OVA-challenged mice had higher levels of inflammation. In summary, the current study demonstrated allergen exposure can cause cardiovascular injury, and inflammatory mediators in adipose tissues play an important role in the pathogenesis of cardiovascular injury. PMID:27004794

  15. [Preoperative preparation of pregnant with hypertension according to state of the autonomic nervous system and circulatory system].

    PubMed

    Gur'ianov, V A; Tolmachev, G N; Volodin, A V; Marichik, N V; Nemirovskiĭ, V B; Pivovarova, G M; Shepetovskaia, N L

    2010-01-01

    Pregnancy in patients with hypertension is considered in the spotlight of creation of general adaptation syndrome. According to evidence, when a stable hypertension in pregnant patients with hyper- and eukinetic types of haemodynamics is observed, the response of circulatory system and body fluid compartments has a moderate difference with normal. In pregnant patients with hypertension and a hypokinetic type of haemodynamics and pregnant patients with gestosis developed against the background of eukinetic type of hypertension, a physiological decrease of total peripheral resistance (TPR) is absent, which contributes into interstitial hyperhydration. In pregnant patients with gestosis developed against the background of hypokinetic type of haemodynamics, a pathological rise of TPR occurs, which is followed with a more significant interstitial hyperhydration. A differentiated preoperative preparation of pregnant with hypertension with the calcium antagonists and hydroxyethyl starch solution (130/0,4) favours the conversion of hyper- and hypokinetic types of haemodynamics to eukinetic, forms a physiological type of sympathicotonia and improves the water-salt metabolism. PMID:21400790

  16. Effect of Nano-sized Carbon Black Particles on Lung and Circulatory System by Inhalation Exposure in Rats

    PubMed Central

    Kang, Min-Gu; Cho, Hae-Won; Han, Jeong-Hee; Chung, Yong-Hyun; Rim, Kyung-Taek; Yang, Jeong-Sun; Kim, Hwa; Lee, Moo-Yeol

    2011-01-01

    Objectives We sought to establish a novel method to generate nano-sized carbon black particles (nano-CBPs) with an average size smaller than 100 nm for examining the inhalation exposure risks of experimental rats. We also tested the effect of nano-CBPs on the pulmonary and circulatory systems. Methods We used chemical vapor deposition (CVD) without the addition of any additives to generate nano-CBPs with a particle size (electrical mobility diameter) of less than 100nm to examine the effects of inhalation exposure. Nano-CBPs were applied to a nose-only inhalation chamber system for studying the inhalation toxicity in rats. The effect on the lungs and circulatory system was determined according to the degree of inflammation as quantified by bronchoalveolar lavage fluid (BALF). The functional alteration of the hemostatic and vasomotor activities was measured by plasma coagulation, platelet activity, contraction and relaxation of blood vessels. Results Nano-CBPs were generated in the range of 83.3-87.9 nm. Rats were exposed for 4 hour/day, 5 days/week for 4 weeks to 4.2 × 106, 6.2 × 105, and 1.3 × 105 particles/cm3. Exposure of nano-CBPs by inhalation resulted in minimal pulmonary inflammation and did not appear to damage the lung tissue. In addition, there was no significant effect on blood functions, such as plasma coagulation and platelet aggregation, or on vasomotor function. Conclusion We successfully generated nano-CBPs in the range of 83.3-87.9 nm at a maximum concentration of 4.2 × 106 particles/cm3 in a nose-only inhalation chamber system. This reliable method can be useful to investigate the biological and toxicological effects of inhalation exposure to nano-CBPs on experimental rats. PMID:22953212

  17. Teaching Bio-inspired design using heart and circulatory system as a model

    NASA Astrophysics Data System (ADS)

    Gharib, Morteza

    2007-11-01

    Cardiovasculr system is an open book of design for an engineer searching for innovation in the particular area of efficient fluid transport. But the routs of technology transfer from nature's technology to engineering science are not always so obvious. The main challenge is how to train our future students to find these hidden innovations and apply them based on sound engineering and scientific principles. As part of a 3 quarter course at Caltech that is called ``Physiology for Bioengineers,'' we try to discuss examples of such cases by introducing students to the critical thinking that is required for model development. In this talk, I will give two examples from the third quarter of this course where students are asked to develop a physics-based model to describe the efficient pumping of blood in embryonic and adult hearts.

  18. Numerical modeling of the fetal blood flow in the placental circulatory system

    NASA Astrophysics Data System (ADS)

    Shannon, Alexander; Gallucci, Sergio; Mirbod, Parisa

    2015-11-01

    The placenta is a unique organ of exchange between the growing fetus and the mother. It incorporates almost all functions of the adult body, acting as the fetal lung, digestive and immune systems, to mention a few. The exchange of oxygen and nutrients takes place at the surface of the villous tree. Using an idealized geometry of the fetal villous trees in the mouse placenta, in this study we performed 3D computational analysis of the unsteady fetal blood flow, gas, and nutrient transport over the chorionic plate. The fetal blood was treated as an incompressible Newtonian fluid, and the oxygen and nutrient were treated as a passive scalar dissolved in blood plasma. The flow was laminar, and a commercial CFD code (COMSOL Multiphysics) has been used for the simulation. COMSOL has been selected because it is multi-physics FEM software that allows for the seamless coupling of different physics represented by partial differential equations. The results clearly illustrate that the specific branching pattern and the in-plane curvature of the fetal villous trees affect the delivery of blood, gas and nutrient transport to the whole placenta.

  19. Pediatric Mechanical Circulatory Support

    PubMed Central

    Lorts, Angela; Morales, David

    2013-01-01

    Mechanical circulatory support (MCS) in the pediatric heart failure population has a limited history especially for infants, and neonates. It has been increasingly recognized that there is a rapidly expanding population of children diagnosed and living with heart failure. This expanding population has resulted in increasing numbers of children with medically resistant end-stage heart failure. The traditional therapy for these children has been heart transplantation. However, children with heart failure unlike adults do not have symptoms until they present with end-stage heart failure and therefore, cannot safely wait for transplantation. Many of these children were bridged to heart transplantation utilizing extracorporeal membranous oxygenation as a bridge to transplant which has yielded poor results. As such, industry, clinicians, and the government have refocused interest in developing increasing numbers of MCS options for children living with heart failure as a bridge to transplantation and as a chronic therapy. In this review, we discuss MCS options for short and long-term support that are currently available for infants and children with end-stage heart failure. PMID:24368965

  20. Hemodynamic evaluation of a chronically implanted, electrically powered left ventricular assist system: responses to acute circulatory stress.

    PubMed

    McKay, R G; Penny, W F; Wyman, R M; Clay, W; Carr, J G; Bernhard, W F; Grossman, W

    1991-12-01

    Hemodynamic stress testing was performed in four calves with a chronically implanted left ventricular assist device consisting of a double-valved pump interposed between the left ventricular apex and the descending thoracic aorta. The device was powered either pneumatically (n = 1) or with a transcutaneous energy transmission system (n = 3). Hemodynamic evaluation (cardiac output and right and left ventricular and pulmonary and carotid artery pressures) was carried out at baseline and during all hemodynamically stressed states. Atrial pacing and ventricular pacing to a heart rate of 140 beats/min resulted in no significant change in right or left heart filling pressures or cardiac output. Preload reduction with nitroprusside or transient inferior vena cava balloon occlusion resulted in a marked decrease in left ventricular pressure with preservation of mean arterial pressure. Phenylephrine administration resulted in a marked rise in mean arterial pressure with no change in cardiac output or filling pressure. Induction of ventricular fibrillation resulted in a decrease of mean left ventricular pressure to 11 +/- 8 mm Hg, but mean arterial pressure was maintained at greater than or equal to 50 mm Hg. It is concluded that a multicomponent, implantable, electrically powered assist system is capable of maintaining a normal cardiac output under a wide range of loading conditions and chronotropic states. Although this device is clearly preload dependent, it is capable of maintaining normal systemic pressures during conditions of severe left ventricular dysfunction and circulatory collapse. PMID:1960330

  1. Application of a PExSim for modeling a POLVAD artificial heart and the human circulatory system with left ventricle assistance

    NASA Astrophysics Data System (ADS)

    Siewnicka, Alicja; Fajdek, Bartlomiej; Janiszowski, Krzysztof

    2010-01-01

    This paper presents a model of the human circulatory system with the possible addition of a parallel assist device, which was developed for the purpose of artificial heart monitoring. Information about an identification experiment of an extracorporeal ventricle assist device POLVAD is included. The modelling methods applied and the corresponding functional blocks in a PExSim package are presented. The results of the simulation for physiological conditions, left ventricle failure and pathological conditions with parallel assistance are included.

  2. [Hemodynamic correlation between the reaction of circulatory system on physical activity and exogenic adrenaline in liquidators of Chernobyl accident with neurocirculatory dystonia syndrome].

    PubMed

    Kovalenko, A N; Vereskun, S B

    2007-01-01

    The article presents a correlation analysis between hemodynamic changes occurred after performing submaximum physical activity using bicycle ergometer (physical stress) and intravenous injection of adrenalin (pharmacological stress) in 30 liquidators of Chernobyl accident and who have a neurocirculatory dystonia syndrome. It enables to establish interrelations for a number of maximal values of parameters of hemodynamics which is determined by the same shifts in circulatory system with sympathoadrenal direction during these two kinds of stress influence. PMID:18416159

  3. A biplane roentgen videometry system for dynamic /60 per second/ studies of the shape and size of circulatory structures, particularly the left ventricle.

    NASA Technical Reports Server (NTRS)

    Ritman, E. L.; Sturm, E.; Wood, E. H.; Heintzen, P. H.

    1971-01-01

    A roentgen-television digital-computer technique and a display system developed for dynamic circulatory structure studies are described. Details are given for a videoroentgenographic setup which is used for obtaining biplane roentgen silhouettes of a left ventricle. A 60 per sec measurement of the shape and volume of angiographically outlined cardiac chambers can be made by this technique along with simultaneous ECG, pressure, and flow measurements accessible for real-time digital computer processing and analysis.

  4. In vitro performance analysis of a novel pulsatile diagonal pump in a simulated pediatric mechanical circulatory support system.

    PubMed

    Wang, Shigang; Kunselman, Allen R; Ündar, Akif

    2014-01-01

    The objective of this study was to evaluate the pump performance of the third-generation Medos diagonal pump, the Deltastream DP3, on hemodynamic profile and pulsatility in a simulated pediatric mechanical circulatory support (MCS) system. The experimental circuit consisted of a Medos Deltastream DP3 pump head and console (MEDOS Medizintechnik AG, Stolberg, Germany), a 14-Fr Terumo TenderFlow Pediatric arterial cannula and a 20-Fr Terumo TenderFlow Pediatric venous return cannula (Terumo Corporation, Tokyo, Japan), and 3 ft of tubing with an internal diameter of in. for both arterial and venous lines. Trials were conducted at flow rates ranging from 250 mL/min to 1000 mL/min (250-mL/min increments) and rotational speeds ranging from 1000 to 4000 rpm (1000-rpm increments) using human blood (hematocrit 40%). The postcannula pressure was maintained at 60 mm Hg by a Hoffman clamp. Real-time pressure and flow data were recorded using a Labview-based acquisition system. The pump provided adequate nonpulsatile and pulsatile flow, created more hemodynamic energy under pulsatile mode, and generated higher positive and negative pressures when the inlet and outlet of the pump head, respectively, were clamped. After the conversion from nonpulsatile to pulsatile mode, the flow rates and the rotational speeds increased. In conclusion, the novel Medos Deltastream DP3 diagonal pump is able to supply the required flow rate for pediatric MCS, generate adequate quality of pulsatility, and provide surplus hemodynamic energy output in a simulated pediatric MCS system. PMID:24237183

  5. Relationships between Digestive, Circulatory, and Urinary Systems in Portuguese Primary Textbooks

    ERIC Educational Resources Information Center

    Carvalho, Graça S.; Clèment, Pierre

    2007-01-01

    In this study, 63 Portuguese primary schoolbooks (1920-2005) were analyzed. The analysis focused on text information (reference to blood absorption and association of the digestive system to other human systems) and on information from images (presence or absence of image "confusion" (when the sequence of the digestive tract is not…

  6. 78 FR 55081 - Circulatory System Devices Panel of the Medical Devices Advisory Committee; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-09

    ... Delivery System allows the placement of the Pressure Sensor within the distal pulmonary artery. There are... Sensor is properly positioned within the distal pulmonary artery. Once the Sensor is in position,...

  7. 75 FR 7282 - Circulatory System Devices Panel of the Medical Devices Advisory Committee; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-02-18

    ... approval application (PMA) for the Cardiac Resynchronization Therapy Defibrillators (CRT-Ds) sponsored by... recommendations and vote on a PMA for the REVO MRI Pacemaker System sponsored by Medtronic. The REVO MRI...

  8. 77 FR 16038 - Circulatory System Devices Panel of the Medical Devices Advisory Committee; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-19

    ... the premarket approval application (PMA) for the HeartWare Ventricular Assist System (HVAS) sponsored..., the committee will discuss, make recommendations and vote on information related to the PMA for...

  9. 75 FR 81282 - Circulatory System Devices Panel of the Medical Devices Advisory Committee; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-27

    ... premarket approval application (PMA)) or reclassify to class II (subject to premarket notification (510(k... PMA supplement for the RX Acculink Carotid Stent System, sponsored by Abbott Vascular. The RX...

  10. On the destabilizing effect of damping on discrete and continuous circulatory systems

    NASA Astrophysics Data System (ADS)

    Luongo, Angelo; D`Annibale, Francesco

    2014-12-01

    The 'Ziegler paradox', concerning the destabilizing effect of damping on elastic systems loaded by nonconservative positional forces, is addressed. The paper aims to look at the phenomenon in a new perspective, according to which no surprising discontinuities in the critical load exist between undamped and damped systems. To show that the actual critical load is found as an (infinitesimal) perturbation of one of the infinitely many sub-critically loaded undamped systems. A series expansion of the damped eigenvalues around the distinct purely imaginary undamped eigenvalues is performed, with the load kept as a fixed, although unknown, parameter. The first sensitivity of the eigenvalues, which is found to be real, is zeroed, so that an implicit expression for the critical load multiplier is found, which only depends on the 'shape' of damping, being independent of its magnitude. An interpretation is given of the destabilization paradox, by referring to the concept of 'modal damping', according to which the sign of the projection of the damping force on the eigenvector of the dual basis, and not on the eigenvector itself, is the true responsible for stability. The whole procedure is explained in detail for discrete systems, and successively extended to continuous systems. Two sample structures are studied for illustrative purposes: the classical reverse double-pendulum under a follower force and a linear visco-elastic beam under a follower force and a dead load.

  11. 76 FR 56200 - Circulatory System Devices Panel of the Medical Devices Advisory Committee; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-12

    ... and are pre-loaded onto 6 or 7 Fr \\1\\ (diameter of 2 or 2.3 mm) delivery systems. Upon deployment, the... femoropopliteal arteries having reference vessel diameter from 4 mm to 9 mm and total lesion lengths per patient of 280 mm. \\1\\ ``Fr'' stands for French. It is a term that defines the diameter of a catheter....

  12. Assessment of a continuous blood gas monitoring system in animals during circulatory stress

    PubMed Central

    2011-01-01

    Background The study was aimed to determine the measurement accuracy of The CDI™ blood parameter monitoring system 500 (Terumo Cardiovascular Systems Corporation, Ann Arbor MI) in the real-time continuous measurement of arterial blood gases under different cardiocirculatory stress conditions Methods Inotropic stimulation (Dobutamine 2.5 and 5 μg/kg/min), vasoconstriction (Arginine-vasopressin 4, 8 and 16 IU/h), hemorrhage (-10%, -20%, -35%, and -50% of the theoretical volemia), and volume resuscitation were induced in ten swine (57.4 ± 10.7 Kg).Intermittent blood gas assessments were carried out using a routine gas analyzer at any experimental phase and compared with values obtained at the same time settings during continuous monitoring with CDI™ 500 system. The Bland-Altman analysis was employed. Results Bias and precision for pO2 were - 0.06 kPa and 0.22 kPa, respectively (r2 = 0.96); pCO2 - 0.02 kPa and 0.15 kPa, respectively; pH -0.001 and 0.01 units, respectively ( r2 = 0.96). The analysis showed very good agreement for SO2 (bias 0.04,precision 0.33, r2 = 0.95), Base excess (bias 0.04,precision 0.28, r2 = 0.98), HCO3 (bias 0.05,precision 0.62, r2 = 0.92),hemoglobin (bias 0.02,precision 0.23, r2 = 0.96) and K+ (bias 0.02, precision 0.27, r2 = 0.93). The sensor was reliable throughout the experiment during hemodynamic variations. Conclusions Continuous blood gas analysis with the CDI™ 500 system was reliable and it might represent a new useful tool to accurately and timely monitor gas exchange in critically ill patients. Nonetheless, our findings need to be confirmed by larger studies to prove its reliability in the clinical setting. PMID:21223536

  13. Sodium tanshinone IIA sulfonate increased intestinal hemodynamics without systemic circulatory changes in healthy newborn piglets.

    PubMed

    Liu, Jiangqin; Morton, Jude; Miedzyblocki, Margaret; Lee, Tze Fun; Bigam, David L; Fok, Tai Fai; Chen, Chao; Lee, Shoo K; Davidge, Sandra T; Cheung, Po-Yin

    2009-10-01

    In traditional Chinese medicine, tanshinone IIA is a lipid-soluble component of Danshen that has been widely used for various cardiovascular and cerebrovascular disorders, including neonatal asphyxia. Despite promising effects, little is known regarding the hemodynamic effects of tanshinone IIA in newborn subjects. To examine the dose-response effects of sodium tanshinone IIA sulfonate (STS) on systemic and regional hemodynamics and oxygen transport, 12 newborn piglets were anesthetized and acutely instrumented for the placement of femoral arterial and venous, pulmonary arterial catheters to measure mean arterial, central venous, and pulmonary arterial pressures, respectively. The blood flow at the common carotid, renal, pulmonary, and superior mesenteric (SMA) arteries were continuously monitored after treating the piglets with either STS (0.1-30 mg/kg iv) or saline treatment (n = 6/group). To further delineate the underlying mechanisms for vasorelaxant effects of STS, in vitro vascular myography was carried out to compare its effect on rat mesenteric and carotid arteries (n = 4-5/group). STS dose-dependently increased the SMA blood flow and the corresponding oxygen delivery with no significant effect on systemic and pulmonary, carotid and renal hemodynamic parameters. In vitro studies also demonstrated that STS selectively dilated rat mesenteric but not carotid arteries. Vasodilation in mesenteric arteries was inhibited by apamin and TRAM-34 (calcium-activated potassium channel inhibitors) but not by meclofenamate (cyclooxygenase inhibitor) or N-nitro-l-arginine methyl ester hydrochloride (nitric oxide synthase inhibitor). In summary, without significant hemodynamic effects on newborn piglets, intravenous infusion of STS selectively increased mesenteric perfusion in a dose-dependent manner, possibly via an endothelium-derived hyperpolarizing factor vasodilating pathway. PMID:19617411

  14. Neural crest cell contribution to the developing circulatory system: implications for vascular morphology?

    PubMed

    Bergwerff, M; Verberne, M E; DeRuiter, M C; Poelmann, R E; Gittenberger-de Groot, A C

    1998-02-01

    In this study, the distribution patterns of neural crest (NC) cells (NCCs) in the developing vascular system of the chick were thoroughly studied and examined for a correlation with smooth muscle cell differentiation and vascular morphogenesis. For this purpose, we performed long-term lineage tracing using quail-chick chimera techniques and premigratory NCC infection with a replication-incompetent retrovirus containing the LacZ reporter gene in combination with immunohistochemistry. Results indicate that NCC deposition around endothelial tubes is influenced by anteroposterior positional information from the pharyngeal arterial system. NCCs were shown to be among the first cells to differentiate into primary smooth muscle cells of the arch arteries. At later stages, NCCs eventually differentiated into adventitial fibroblasts and smooth muscle cells and nonmuscular cells of the media and intima. NCCs were distributed in the aortic arch and pulmonary arch arteries and in the brachiocephalic and carotid arteries. The coronary and pulmonary arteries and the descending aorta, however, remained devoid of NCCs. A new finding was that the media of part of the anterior cardinal veins was also determined to be NC-derived. NC-derived elastic arteries differed from non-NC elastic vessels in their cellular constitution and elastic fiber organization, and the NC appeared not to be involved in designating a muscular or elastic artery. Boundaries between NC-infested areas and mesodermal vessel structures were mostly very sharp and tended to coincide with marked changes in vascular morphology, with the exception of an intriguing area in the aortic and pulmonary trunks. PMID:9468193

  15. Influence of apnoeic oxygenation in respiratory and circulatory system under general anaesthesia.

    PubMed

    Kolettas, Alexander; Grosomanidis, Vasilis; Kolettas, Vasilis; Zarogoulidis, Paul; Tsakiridis, Kosmas; Katsikogiannis, Nikolaos; Tsiouda, Theodora; Kiougioumtzi, Ioanna; Machairiotis, Nikolaos; Drylis, Georgios; Kesisis, Georgios; Beleveslis, Thomas; Zarogoulidis, Konstantinos

    2014-03-01

    Apnoeic oxygenation is an alternative technique of oxygenation which is recommended in the consecutive oxygen administration with varying flows (2-10 lt/min) through a catheter which is positioned over the keel of the trachea. Apnoeic oxygenation maintains for a significant period of time the oxygenation of blood in breathless conditions. This technique was first applied in 1947 by Draper, Whitehead, and Spencer and it was studied sporadically by other inventors too. However, the international literature shows few studies that have examined closely apnoeic oxygenation and its effects on Hemodynamic image and the respiratory system of the human body. Recently they have begun to arise some studies which deal with the application of this technique in several conditions such as difficult tracheal intubation, ventilation of guinea pigs in campaign conditions where the oxygen supply is limited and calculable, the application of this technique in combination with the use of extracorporeal removal of carbon dioxide (CO2). All the above indicate, the clinical use of this technique. PMID:24672687

  16. Influence of apnoeic oxygenation in respiratory and circulatory system under general anaesthesia

    PubMed Central

    Kolettas, Alexander; Grosomanidis, Vasilis; Kolettas, Vasilis; Tsakiridis, Kosmas; Katsikogiannis, Nikolaos; Tsiouda, Theodora; Kiougioumtzi, Ioanna; Machairiotis, Nikolaos; Drylis, Georgios; Kesisis, Georgios; Beleveslis, Thomas; Zarogoulidis, Konstantinos

    2014-01-01

    Apnoeic oxygenation is an alternative technique of oxygenation which is recommended in the consecutive oxygen administration with varying flows (2-10 lt/min) through a catheter which is positioned over the keel of the trachea. Apnoeic oxygenation maintains for a significant period of time the oxygenation of blood in breathless conditions. This technique was first applied in 1947 by Draper, Whitehead, and Spencer and it was studied sporadically by other inventors too. However, the international literature shows few studies that have examined closely apnoeic oxygenation and its effects on Hemodynamic image and the respiratory system of the human body. Recently they have begun to arise some studies which deal with the application of this technique in several conditions such as difficult tracheal intubation, ventilation of guinea pigs in campaign conditions where the oxygen supply is limited and calculable, the application of this technique in combination with the use of extracorporeal removal of carbon dioxide (CO2). All the above indicate, the clinical use of this technique. PMID:24672687

  17. Abdominal Circulatory Interactions.

    PubMed

    Dagar, Gaurav; Taneja, Amit; Nanchal, Rahul S

    2016-04-01

    The abdominal compartment is separated from the thoracic compartment by the diaphragm. Under normal circumstances, a large portion of the venous return crosses the splanchnic and nonsplanchnic abdominal regions before entering the thorax and the right side of the heart. Mechanical ventilation may affect abdominal venous return independent of its interactions at the thoracic level. Changes in pressure in the intra-abdominal compartment may have important implications for organ function within the thorax, particularly if there is a sustained rise in intra-abdominal pressure. It is important to understand the consequences of abdominal pressure changes on respiratory and circulatory physiology. This article elucidates important abdominal-respiratory-circulatory interactions and their clinical effects. PMID:27016167

  18. Transfusion associated circulatory overload.

    PubMed

    Agnihotri, Naveen; Agnihotri, Ajju

    2014-06-01

    Transfusion associated circulatory overload (TACO) is an established, but grossly under diagnosed and underreported complication of blood transfusion. We present the case of a 46-year-old diabetic and hypertensive patient admitted to our hospital for recurrent episodes of urinary retention. Over initial 3 days of the admission, the patient received multiple units of packed red blood cells (RBC) and fresh frozen plasma, uneventfully. However, the patient developed signs and symptoms suggestive of TACO with only small amount of the 4(th) unit of RBC. The patient had to be shifted to the Intensive Care Unit for further management of this complication. Etiology of TACO is more complex than a mere circulatory overload and is still not completely understood. TACO leads to a prolonged hospital stay and morbidity in the patients developing this complication. TACO thus needs to be suspected in patients at risk for this complication. PMID:24987240

  19. Development of a Deprivation Index and its relation to premature mortality due to diseases of the circulatory system in Hungary, 1998-2004.

    PubMed

    Juhász, Attila; Nagy, Csilla; Páldy, Anna; Beale, Linda

    2010-05-01

    An association between health and socio-economic status is well known. Based on international and national studies, the aims of this study were to develop a multi-dimensional index at the municipality level, to provide information about socio-economic deprivation in Hungary and to investigate the association between socio-economic status and the spatial distribution of premature mortality due to diseases of the circulatory system. Seven municipality level socio-economic indicators were used from the National Information System of Spatial Development (income, low qualification, unemployment, one-parent families, large families, density of housing and car ownership). After normalisation and standardisation, indicator weights were evaluated using factor analysis. A risk analysis study was conducted using the Rapid Inquiry Facility software to evaluate the association between deprivation and the spatial distribution of premature mortality due to diseases of the circulatory system for the years 1998-2004. Areas of significantly high deprivation were identified in the northeastern, eastern and southwestern parts of Hungary. A statistically significant association was found between premature cardiovascular mortality and deprivation status in both genders. The Deprivation Index is the first composite index at the municipality level in Hungary and includes key factors that affect socio-economic status. The identified association highlighted the fact that inequalities in socio-economic status may reflect the spatial distribution of health status in a population. The results can be used to inform prevention strategies and help plan local health promotion programs aimed at reducing health inequalities. PMID:20199838

  20. Vascular Endothelial Growth Factor Receptor Family in Ascidians, Halocynthia roretzi (Sea Squirt). Its High Expression in Circulatory System-Containing Tissues.

    PubMed

    Samarghandian, Saeed; Shibuya, Masabumi

    2013-01-01

    The vascular endothelial growth factor (VEGF)-VEGF Receptor (VEGFR) system is an important pathway for regulation of angiogenesis. However, its evolutionary development, particularly the step from invertebrates to vertebrates, is still largely unknown. Here, we molecularly cloned the VEGFR-like gene from Halocynthia roretzi, a species belonging to the Tunicata, the chordate subphylum recently considered the sister group of vertebrates. The cDNA encoded a homolog of human VEGFR, including the transmembrane domain, and the tyrosine kinase domain with a kinase-insert region, which was designated S. sq VEGFR (GenBank AB374180). Similar to Tunicates including ascidians in the phylogenetic tree, the Amphioxus, another chordate, is located close to vertebrates. However, S. sq VEGFR has a higher homology than the Amphioxus VEGFR-like molecule (GenBank AB025557) to human VEGFR in the kinase domain-2 region. The S. sq VEGFR mRNA was expressed at highest levels in circulatory system-containing tissues, suggesting that S. sq VEGFR plays an important role in the formation or maintenance of circulatory system in Tunicates, Halocynthia roretzi. PMID:23455462

  1. Pulsatile-flow mechanical circulatory support (MCS) as a bridge to transplantation or recovery. Single-centre experience with the POLCAS system in 2014

    PubMed Central

    Kuśmierczyk, Mariusz; Szymański, Jarosław; Juraszek, Andrzej; Kołsut, Piotr; Kuśmierski, Krzysztof; Zieliński, Tomasz; Sobieszczańska-Małek, Małgorzata; Sitkowska-Rysiak, Ewa

    2015-01-01

    Introduction Mechanical circulatory support (MCS) is a recognised method of treatment for patients with end-stage chronic or acute heart failure. The POLCAS pulsatile-flow system has been used in our institution for 15 years. Currently, it is being widely replaced by continuous-flow mechanical circulatory support equipment of the second and third generations (HeartMateII, HeartWare). The MCS presented in this study is associated with a significant risk of complications and its use is increasingly considered controversial. The aim of the study was an evaluation of the results of treatment utilising the POLCAS MCS system at our institution in 2014. Material and methods The POLCAS system was implanted in 12 patients aged 16-63 years (42 ± 17 years) during a period of 12 months (from January to December, 2014). Full-blown cardiogenic shock was observed in all patients before MCS implantation. Four of the analysed patients (33%) required prior circulatory support with other devices: IABP (n = 2) or ECMO (n = 2). Episodes of cardiac arrest were reported in three patients; three other patients experienced serious arrhythmias, which accelerated the decision to implant MCS. The presented data was retrospectively obtained from the CliniNET system of the Institute of Cardiology. OpenOffice Calc spreadsheet was used for data analysis. Results Average MCS time was 41 days ± 25 (from 15 to 91 days). Survival until transplantation or explantation was 91.67%. The most frequent complications following the therapy were: cardiac tamponade or bleeding requiring an intervention – 25% (n = 3), renal failure requiring dialysis – 25% (n = 3), ischaemic stroke associated with the MCS – 16.6% (n = 2), bacteraemia – 16.6% (n = 2), and wound infection – 8% (n = 1). No malfunctions of the MCS system were reported. Early survival in patients who completed the MCS therapy, defined as discharge, amounted to 63.6% (n = 7). Conclusions The POLCAS heart assist system is an effective

  2. Children's Beliefs about the Human Circulatory System: An Aid for Teachers Regarding the Role Intuitive Beliefs Play in the Development of Formal Concepts in 7-14-Year Olds. Report No. 82:16.

    ERIC Educational Resources Information Center

    Catherall, Robin W.

    This exploratory study was aimed at uncovering children's beliefs and ideas about the human circulatory system. Thirty-two subjects, aged 7 to 14 years, were interviewed using a modification of Piaget's clinical method. The data were analyzed by developing a conceptual inventory of beliefs for each of five research questions. It was found that the…

  3. Influences of Changes in the Level of Support and Walking Speed on the H Reflex of the Soleus Muscle and Circulatory Dynamics on Body Weight-supported Treadmill Training: Investigation in Healthy Adults

    PubMed Central

    Watanabe, Shinichi; Oya, Yosuke; Iwata, Jun; Someya, Fujiko

    2014-01-01

    [Purpose] To investigate the therapeutic usefulness of treadmill walking using a body weight support device (BWS), changes in circulatory dynamics and muscle activities with various levels of support were investigated. [Subjects and Methods] The subjects were divided into 3 groups: 20% BWS, 40% BWS, and full body weight (FBW). The subjects walked at maximum and normal speeds. Under each condition, H and M waves and skin temperature before and after walking and changes in the heart rate during walking were measured. [Results] The heart rate continued to increase after 3 minutes of FBW at the maximum walking speed, but a steady state was reached after 3 minutes under the other walking conditions. Regarding skin temperature, no significant difference from that at rest was noted 30 minutes after walking at the normal speed, but it was significantly higher than that at rest at 30 minutes after walking at the maximum speed. The H/M ratio was significantly higher after walking at the maximum walking speed in the FBW and 20% BWS groups compared with the 40% BWS groups. [Conclusion] Treatment with 40% BWS at the maximum walking speed was safe for the circulatory system and may be effective in elevating the skin temperature for a prolonged period compared with the effects of the other walking conditions at normal speed. PMID:25276013

  4. Circulatory responses to hypoxia in experimental myocardial infarction.

    NASA Technical Reports Server (NTRS)

    Schroll, M.; Robison, S. C.; Harrison, D. C.

    1971-01-01

    Three levels of decreased arterial oxygen saturation elicited a graded circulatory response in dogs, manifested by stepwise increases in cardiac output, left ventricular dp/dt, and stroke volume, and decreases in systemic vascular resistance. Responses to similar hypoxia challenges after experimental myocardial infarction were qualitatively similar but quantitatively less. Although the circulatory compensation for hypoxia was less effective after myocardial infarction, no further deterioration of the haemodynamics was noted.

  5. Activation of the PGI(2)/IP system contributes to the development of circulatory failure in a rat model of endotoxic shock.

    PubMed

    Höcherl, Klaus; Schmidt, Christoph; Kurt, Birgül; Bucher, Michael

    2008-08-01

    Prostacyclin levels are increased in septic patients and several animal models of septic shock, and selective inhibition of cyclooxygenase-2 improved cardiovascular dysfunction in rats treated with lipopolysaccharide (LPS). Here, we examine the specific role of prostacyclin and of the receptor for prostacyclin (IP) in the development of LPS-induced circulatory failure. Intravenous injection of LPS (10 mg/kg) into male Sprague-Dawley rats caused a strong increase in plasma prostacyclin levels, which was paralleled by a decrease in blood pressure and an increase in heart rate. Moreover, LPS injection increased the mRNA expression of the IP receptor in the heart, aorta, lung, liver, adrenal glands, and kidneys. Cotreatment with the IP antagonist CAY-10441 (1, 10, 30, and 100 mg/kg) dose-dependently moderated the LPS-induced changes in mean arterial blood pressure, heart rate, cardiac output, and systemic vascular resistance. The development of cardiovascular failure was ameliorated by CAY-10441 in spite of the typical LPS-induced increases in plasma levels of cytokines and NO. In vitro, cytokines dose- and time-dependently induced IP expression in rat vascular smooth muscle cells. Incubation of cells with the stable IP agonist iloprost in the presence of the phosphodiesterase inhibitor 3-isobutyl-1-mehylxanthine resulted in higher cAMP levels in cytokine-treated cells compared with untreated cells. Taken together, our data demonstrate a prominent role of the prostacyclin/IP system in the development of LPS-induced cardiovascular failure. PMID:18606903

  6. A Mock Circulatory System to Assess the Performance of Continuous-Flow Left Ventricular Assist Devices (LVADs): Does Axial Flow Unload Better Than Centrifugal LVAD?

    PubMed Central

    2014-01-01

    Hemodynamic performances comparisons between different types of left ventricular assist devices (LVADs) remain difficult in a clinical context. The aim of this study was to create an experimental model to assess and compare two types of LVAD under hemodynamic conditions that simulated physical effort and pulmonary hypertension. An experimental mock circulatory system was created to simulate the systemic and pulmonary circulations and consisted of pulsatile left and right cardiac simulators (cardiowest pump), air/water tanks to model compliances, and tubes to model the venous and arterial resistances. Two types of continuous-flow ventricular assist devices were connected to this pulsated model: an axial flow pump, Heartmate II (HTM II), and a centrifugal pump, VentrAssist (VTA). The hemodynamic conditions at rest and during exercise were replicated. Mean aortic pressures were not significantly different at rest and during effort but mean flow under maximum pump speed was higher with HTM II (13 L vs. 10 L, p = 0.02). Left atrial pressure was lower at rest and during effort for the HTM II (11 mm Hg vs. 3 mm Hg, p = 0.02 and 9 mm Hg vs. 2 mm Hg, p = 0.008) than with the VTA, but with greater risk of left-ventricle suck-down for the axial flow. Power consumption for a similar flow was lower with the VTA during rest (4.7 W vs. 6.9 W, p = 0.002) and during effort (4.3 W vs. 6.6 W, p = 0.008). In case of high pulmonary vascular resistance with preserved right ventricular function, lower right ventricular pressure was obtained with HTM II (21 mm Hg vs. 28 mm Hg, p = 0.03). Observed results are in favor of a better discharge of the left and right cavities with the HTM II compared to the VTA yet with a higher risk of left cavity collapse occurrence. PMID:24577368

  7. A mock circulatory system to assess the performance of continuous-flow left ventricular assist devices (LVADs): does axial flow unload better than centrifugal LVAD?

    PubMed

    Sénage, Thomas; Février, Dorothée; Michel, Magali; Pichot, Emmanuel; Duveau, Daniel; Tsui, Steven; Trochu, Jean Noel; Roussel, Jean Christian

    2014-01-01

    Hemodynamic performances comparisons between different types of left ventricular assist devices (LVADs) remain difficult in a clinical context. The aim of this study was to create an experimental model to assess and compare two types of LVAD under hemodynamic conditions that simulated physical effort and pulmonary hypertension. An experimental mock circulatory system was created to simulate the systemic and pulmonary circulations and consisted of pulsatile left and right cardiac simulators (cardiowest pump), air/water tanks to model compliances, and tubes to model the venous and arterial resistances. Two types of continuous-flow ventricular assist devices were connected to this pulsated model: an axial flow pump, Heartmate II (HTM II), and a centrifugal pump, VentrAssist (VTA). The hemodynamic conditions at rest and during exercise were replicated. Mean aortic pressures were not significantly different at rest and during effort but mean flow under maximum pump speed was higher with HTM II (13 L vs. 10 L, p = 0.02). Left atrial pressure was lower at rest and during effort for the HTM II (11 mm Hg vs. 3 mm Hg, p = 0.02 and 9 mm Hg vs. 2 mm Hg, p = 0.008) than with the VTA, but with greater risk of left-ventricle suck-down for the axial flow. Power consumption for a similar flow was lower with the VTA during rest (4.7 W vs. 6.9 W, p = 0.002) and during effort (4.3 W vs. 6.6 W, p = 0.008). In case of high pulmonary vascular resistance with preserved right ventricular function, lower right ventricular pressure was obtained with HTM II (21 mm Hg vs. 28 mm Hg, p = 0.03). Observed results are in favor of a better discharge of the left and right cavities with the HTM II compared to the VTA yet with a higher risk of left cavity collapse occurrence. PMID:24577368

  8. [Transfusion-associated circulatory overload].

    PubMed

    Ozier, Y; Mouquet, F; Rieux, C; Mertes, P-M; Muller, J-Y; Caldani, C; Boudjedir, K; Carlier, M

    2012-11-01

    A working group of the French National Hemovigilance Committee has been in charge of heightening awareness of Transfusion-Associated Circulatory Overload (TACO) among physicians and nurses. This multidisciplinary group has produced the present document that focuses on epidemiological data provided by the French haemovigilance network, physiopathology, diagnosis, treatment and specific actions that could prevent or minimize the risk of TACO. PMID:23039960

  9. The influence of the winter North Atlantic Oscillation index on hospital admissions through diseases of the circulatory system in Lisbon, Portugal

    NASA Astrophysics Data System (ADS)

    Almendra, Ricardo; Santana, Paula; Vasconcelos, João; Silva, Giovani; Gonçalves, Fábio; Ambrizzi, Tércio

    2016-07-01

    The aim of this paper is to analyze the relationship between North Atlantic Oscillation (NAO), meteorological variables, air pollutants, and hospital admissions due to diseases of circulatory systems in Lisbon (Portugal) during winter months (2003-2012). This paper is one of the few studies analyzing the impact of NAO on health through its influence on thermal stress and air pollution and is the first to be conducted in Lisbon. This study uses meteorological data (synthetized into a thermal comfort index), air pollutant metrics, and the NAO index (all clustered in 10-day cycles to overcome daily variability of the NAO index). The relationship between morbidity, thermal comfort index, NAO index, and air pollutants was explored through several linear models adjusted to seasonality through a periodic function. The possible indirect effect between the NAO index and hospital admissions was tested, assuming that NAO (independent variable) is affecting hospital admissions (outcome variable) through thermal discomfort and/or pollution levels (tested as individual mediators). This test was conducted through causal mediation analysis and adjusted for seasonal variation. The results from this study suggest a possible indirect relationship between NAO index and hospital admissions. Although NAO is not significantly associated with hospital admissions, it is significantly associated with CO, PM2.5, NO, and SO2 levels, which in turn increase the probability of hospitalization. The discomfort index (built with temperature and relative humidity) is significantly associated with hospital admissions, but its variability is not explained by the NAO index. This study highlights the impacts of the atmospheric circulation patterns on health. Furthermore, understanding the influence of the atmospheric circulation patterns can support the improvement of the existing contingency plans.

  10. Bi-ventricular circulatory support with the Abiomed AB5000 system in a patient with idiopathic refractory ventricular fibrillation.

    PubMed

    Zhang, Li; Kapetanakis, Emmanouil I; Cooke, Richard H; Sweet, Leslie C; Boyce, Steven W

    2007-01-01

    A 45-year-old man had life-threatening recurrent idiopathic ventricular fibrillation and persistent cardiogenic shock develop. The episodes of ventricular fibrillation were refractory to aggressive medical management; therefore an Abiomed AB5000 bi-ventricular support system was implanted for arrhythmia control. The device was able to maintain hemodynamic stability during the following 2 weeks. The patient was discharged from the hospital with fully recovered cardiac function. PMID:17184687

  11. [Circulatory survival of irreversible comas].

    PubMed

    Cartier, F; Chevet, D; Garré, M; Launois, B; Thomas, R; Le Pollès, R

    1975-01-18

    On the basis of a series of 53 cases of irreversible coma maintained in circulatory survival with the aim of removing the kidneys, the authors discuss the mode of treatment, with particular reference to the intravenous fluids used and the use of medications influencing the circulation. Fluid and electrolytes given must be adjusted hourly to ensure the exact replacement of urinary losses. Isoprotenerol is the only medication usually necessary. In the event of circulatory insufficiency, which is difficult to foresee and hence prevent, immediate volume expansion in a short a time as possible and isoprotenerol most frequently correct the situation (14 out of 17 cases). Thus effective circulation may be maintained until the kidneys are removed (48 out of 53 cases). 92 p.cent of the grafted kidneys functioned from the first day onwards. PMID:1093120

  12. Addressing Consent Issues in Donation After Circulatory Determination of Death.

    PubMed

    Overby, Kim J; Weinstein, Michael S; Fiester, Autumn

    2015-01-01

    Given the widening gap between the number of individuals on transplant waiting lists and the availability of donated organs, as well as the recent plateau in donations based on neurological criteria (i.e., brain death), there has been a growing interest in expanding donation after circulatory determination of death. While the prevalence of this form of organ donation continues to increase, many thorny ethical issues remain, often creating moral distress in both clinicians and families. In this article, we address one of these issues, namely, the challenges surrounding patient and surrogate informed consent for donation after circulatory determination of death. First we discuss several general concerns regarding consent related to this form of organ donation, and then we address additional issues that are unique to three different patient categories: adult patients with medical decision-making capacity or potential capacity, adult patients who lack capacity, and pediatric patients. PMID:26225503

  13. Weakened Immune System and Adult Vaccination

    MedlinePlus

    ... for Healthcare Professionals Weakened Immune System and Adult Vaccination Recommend on Facebook Tweet Share Compartir Vaccines are ... up to age 26 years Learn about adult vaccination and other health conditions Asplenia Diabetes Type 1 ...

  14. State of the art of mechanical circulatory support.

    PubMed

    Mallidi, Hari R; Anand, Jatin; Cohn, William E

    2014-04-01

    Mechanical circulatory support of the failing heart has become an important means of treating end-stage heart disease. This rapidly growing therapeutic field has produced impressive clinical outcomes and has great potential to help thousands of otherwise terminal patients worldwide. In this review, we examine the state of the art of mechanical circulatory support: current practice, totally implantable systems of the future, evolving biventricular support mechanisms, the potential for myocardial recovery and adjunctive treatment methods, and miniaturized devices with expanded indications for therapy. PMID:24808767

  15. State of the Art of Mechanical Circulatory Support

    PubMed Central

    Mallidi, Hari R.; Anand, Jatin; Cohn, William E.

    2014-01-01

    Mechanical circulatory support of the failing heart has become an important means of treating end-stage heart disease. This rapidly growing therapeutic field has produced impressive clinical outcomes and has great potential to help thousands of otherwise terminal patients worldwide. In this review, we examine the state of the art of mechanical circulatory support: current practice, totally implantable systems of the future, evolving biventricular support mechanisms, the potential for myocardial recovery and adjunctive treatment methods, and miniaturized devices with expanded indications for therapy. PMID:24808767

  16. User's instructions for the Guyton circulatory dynamics model using the Univac 1110 batch and demand processing (with graphic capabilities)

    NASA Technical Reports Server (NTRS)

    Archer, G. T.

    1974-01-01

    The model presents a systems analysis of a human circulatory regulation based almost entirely on experimental data and cumulative present knowledge of the many facets of the circulatory system. The model itself consists of eighteen different major systems that enter into circulatory control. These systems are grouped into sixteen distinct subprograms that are melded together to form the total model. The model develops circulatory and fluid regulation in a simultaneous manner. Thus, the effects of hormonal and autonomic control, electrolyte regulation, and excretory dynamics are all important and are all included in the model.

  17. [Circulatory assist devices in cardiology].

    PubMed

    Ferrari, M; Figulla, H R

    2005-03-24

    One out of 13 patients with an acute myocardial infarction is endangered of cardiogenic shock. In addition, acute valvular leakage, shunt vitiae, and acute myocarditis can lead to acute myocardial failure. As a therapeutic option, mechanical assist devices offer cardiac support and hemodynamic stabilization under these circumstances. The following minimal-invasive devices are used in cardiology and intensive care medicine: intra-aortic balloon pulsation (IABP), intra-vascular axial screw pumps, extra-corporal centrifugal pumps with and without additional membrane oxygenator. The IABP improves left ventricular function by a systolic reduction of the after-load, and an increase of diastolic blood pressure dependent on myocardial function. In contrast, axial screw pumps and centrifugal pumps can provide circulatory support independently of myocardial function. Mechanical assist devices can prevent irreversible damage not only by offering a reduction of myocardial work load, but also by improving organ perfusion in cardiogenic shock situations. Another indication for mechanical circulatory support depicts high-risk coronary angioplasty if the left ventricular ejection fraction is severely reduced or the target vessel supplies more than 50 % of vital myocardium. In case of irreversible heart failure, turbine pumps or centrifugal pumps offer a stabilization for the patient's transfer to a cardiac surgery center. They can also be used for bridging to heart transplantation in acute situations. Technical improvements will enhance the use of mechanical assist devices in the near future. Especially the development of portable emergency devices will enrich therapeutic possibilities in cardiology and intensive care medicine. PMID:15776348

  18. Information Systems: An Introduction for Adult Educators.

    ERIC Educational Resources Information Center

    Caldwell, Phyllis A.

    In this paper, the author's primary focus is on a marketing information system and its potential importance for adult educators. The content is in seven sections. The first two sections briefly introduce information systems in general and their relevance for adult educators. The third section briefly describes general management information…

  19. [Importance of mechanical assist devices in acute circulatory arrest].

    PubMed

    Ferrari, Markus Wolfgang

    2016-03-01

    Mechanical assist devices are indicated for hemodynamic stabilization in acute circulatory arrest if conventional means of cardiopulmonary resuscitation are unable to re-establish adequate organ perfusion. Their temporary use facilitates further diagnostic and therapeutic options in selected patients, e.g. coronary angiography followed by revascularization.External thorax compression devices allow sufficient cardiac massage in case of preclinical or in-hospital circulatory arrest, especially under complex transfer conditions. These devices perform standardized thorax compressions at a rate of 80-100 per minute. Invasive mechanical support devices are used in the catheter laboratory or in the intensive care unit. Axial turbine pumps, e.g. the Impella, continuously pump blood from the left ventricle into the aortic root. The Impella can also provide right ventricle support by pumping blood from the vena cava into the pulmonary artery. So-called emergency systems or ECMO devices consist of a centrifugal pump and a membrane oxygenator allowing complete takeover of cardiac and pulmonary functions. Withdrawing blood from the right atrium and vena cava, oxygenated blood is returned to the abdominal aorta. Isolated centrifugal pumps provide left heart support without an oxygenator after transseptal insertion of a venous cannula into the left atrium.Mechanical assist devices are indicated for acute organ protection and hemodynamic stabilization for diagnostic and therapeutic measures as well as bridge to myocardial recovery. Future technical developments and better insights into the pathophysiology of mechanical circulatory support will broaden the spectrum of indications of such devices in acute circulatory arrest. PMID:26860409

  20. Hemodynamics of Mechanical Circulatory Support.

    PubMed

    Burkhoff, Daniel; Sayer, Gabriel; Doshi, Darshan; Uriel, Nir

    2015-12-15

    An increasing number of devices can provide mechanical circulatory support (MCS) to patients with acute hemodynamic compromise and chronic end-stage heart failure. These devices work by different pumping mechanisms, have various flow capacities, are inserted by different techniques, and have different sites from which blood is withdrawn and returned to the body. These factors result in different primary hemodynamic effects and secondary responses of the body. However, these are not generally taken into account when choosing a device for a particular patient or while managing a patient undergoing MCS. In this review, we discuss fundamental principles of cardiac, vascular, and pump mechanics and illustrate how they provide a broad foundation for understanding the complex interactions between the heart, vasculature, and device, and how they may help guide future research to improve patient outcomes. PMID:26670067

  1. Cell-Mediated Delivery of Nanoparticles: Taking Advantage of Circulatory Cells to Target Nanoparticles

    PubMed Central

    Anselmo, Aaron C.; Mitragotri, Samir

    2014-01-01

    Cellular hitchhiking leverages the use of circulatory cells to enhance the biological outcome of nanoparticle drug delivery systems, which often suffer from poor circulation time and limited targeting. Cellular hitchhiking utilizes the natural abilities of circulatory cells to: (i) navigate the vasculature while avoiding immune system clearance, (ii) remain relatively inert until needed and (iii) perform specific functions, including nutrient delivery to tissues, clearance of pathogens, and immune system surveillance. A variety of synthetic nanoparticles attempt to mimic these functional attributes of circulatory cells for drug delivery purposes. By combining the advantages of circulatory cells and synthetic nanoparticles, many advanced drug delivery systems have been developed that adopt the concept of cellular hitchhiking. Here, we review the development and specific applications of cellular hitchhiking-based drug delivery systems. PMID:24747161

  2. Recent advances in computational methodology for simulation of mechanical circulatory assist devices

    PubMed Central

    Marsden, Alison L.; Bazilevs, Yuri; Long, Christopher C.; Behr, Marek

    2014-01-01

    Ventricular assist devices (VADs) provide mechanical circulatory support to offload the work of one or both ventricles during heart failure. They are used in the clinical setting as destination therapy, as bridge to transplant, or more recently as bridge to recovery to allow for myocardial remodeling. Recent developments in computational simulation allow for detailed assessment of VAD hemodynamics for device design and optimization for both children and adults. Here, we provide a focused review of the recent literature on finite element methods and optimization for VAD simulations. As VAD designs typically fall into two categories, pulsatile and continuous flow devices, we separately address computational challenges of both types of designs, and the interaction with the circulatory system with three representative case studies. In particular, we focus on recent advancements in finite element methodology that has increased the fidelity of VAD simulations. We outline key challenges, which extend to the incorporation of biological response such as thrombosis and hemolysis, as well as shape optimization methods and challenges in computational methodology. PMID:24449607

  3. [Organ donation after circulatory death].

    PubMed

    de Jonge, J; Kalisvaart, M; van der Hoeven, M; Epker, J; de Haan, J; IJzermans, J N M; Grüne, F

    2016-02-01

    Approximately 17 million inhabitants live in the Netherlands. The number of potential organ donors in 1999 was the lowest in Europe with only 10 donors per million inhabitants. Medical associations, public health services, health insurance companies and the government had to find common solutions in order to improve organ allocation, logistics of donations and to increase the number of transplantations. After a prolonged debate on medical ethical issues of organ transplantation, all participants were able to agree on socio-medico-legal regulations for organ donation and transplantation. In addition to improving the procedure for organ donation after brain death (DBD) the most important step was the introduction of organ donation after circulatory death (DCD). Measures such as the introduction of a national organ donor database, improved information to the public, further education on intensive care units (ICU), guidelines for end of life care on the ICU, establishment of transplantation coordinators on site, introduction of autonomous explantation teams and strict procedures on the course of organ donations, answered many practical issues about logistics and responsibilities for DBD and DCD. In 2014 the number of postmortem organ donations rose to 16.4 per million inhabitants. Meanwhile, up to 60 % of organ donations in the Netherlands originate from a DCD procedure compared to approximately 10 % in the USA. This overview article discusses the developments and processes of deceased donation in the Netherlands after 15 years of experience with DCD. PMID:26810404

  4. Circulatory Syndrome: An Evolution of the Metabolic Syndrome Concept!

    PubMed Central

    Khoshdel, Ali Reza; Carney, Shane L; Gillies, Alastair

    2012-01-01

    The metabolic syndrome has been a useful, though controversial construct in clinical practice as well as a valuable model in order to understand the interactions of diverse cardiovascular risk factors. However the increasing importance of the circulatory system in particular the endothelium, in both connecting and controlling organ function has underlined the limitations of the metabolic syndrome definition. The proposed “Circulatory Syndrome” is an attempt to refine the metabolic syndrome concept by the addition of recently documented markers of cardiovascular disease including renal impairment, microalbuminuria, arterial stiffness, ventricular dysfunction and anaemia to more classic factors including hypertension, dyslipidemia and abnormal glucose metabolism; all of which easily measured in clinical practice. These markers interact with each other as well as with other factors such as aging, obesity, physical inactivity, diet and smoking. The final common pathways of inflammation, oxidative stress and hypercoagulability thereby lead to endothelial damage and eventually cardiovascular disease. Nevertheless, the Circulatory (MARC) Syndrome, like its predecessor the metabolic syndrome, is only a small step toward an understanding of these complex and as yet poorly understood markers of disease. PMID:22845817

  5. AC Electrothermal Circulatory Pumping Chip for Cell Culture.

    PubMed

    Lang, Qi; Wu, Yanshuang; Ren, Yukun; Tao, Ye; Lei, Lei; Jiang, Hongyuan

    2015-12-01

    Herein we describe a novel AC electrothermal (ACET) fluidic circulatory pumping chip to overcome the challenge of fluid-to-tissue ratio for "human-on-a-chip" cell culture systems. To avoid the deleterious effects of Joule heating and electric current on sample cells, a rectangular microchannel was designed with distantly separated regions for pumping and cell culture. Temperature variations were examined using a commercial thermocouple sensor to detect temperature values in both pumping and culture regions. To generate a sufficient ACET circulatory pumping rate, 30 pairs of asymmetrical electrodes were employed in the pumping region; generated ACET velocity was measured by fluorescent microparticle image velocimetry. The benefits of our pumping chip were demonstrated by culturing human embryonic kidney cells (HEK293T) and human colon carcinoma cells (SW620) for 72 h with an energized voltage of 3 V and 10 MHz. Cells grew and proliferated well, implying our ACET circulatory pumping chip has great potential for cell culture and tissue engineering applications. PMID:26558750

  6. Acoustic analysis of a mechanical circulatory support.

    PubMed

    Hubbert, Laila; Sundbom, Per; Loebe, Matthias; Peterzén, Bengt; Granfeldt, Hans; Ahn, Henrik

    2014-07-01

    Mechanical circulatory support technology is continually improving. However, adverse complications do occur with devastating consequences, for example, pump thrombosis that may develop in several parts of the pump system. The aim of this study was to design an experimental clot/thrombosis model to register and analyze acoustic signals from the left ventricular assist device (LVAD) HeartMate II (HMII) (Thoratec Corporation, Inc., Pleasanton, CA, USA) and detect changes in sound signals correlating to clots in the inflow, outflow, and pump housing. Using modern telecom techniques, it was possible to register and analyze the HMII pump-specific acoustic fingerprint in an experimental model of LVAD support using a mock loop. Increase in pump speed significantly (P<0.005) changed the acoustic fingerprint at certain frequency (0-23,000 Hz) intervals (regions: R1-3 and peaks: P1,3-4). When the ball valves connected to the tubing were narrowed sequentially by ∼50% of the inner diameter (to mimic clot in the out- and inflow tubing), the frequency spectrum changed significantly (P<0.005) in P1 and P2 and R1 when the outflow tubing was narrowed. This change was not seen to the same extent when the lumen of the ball valve connected to the inflow tube was narrowed by ∼50%. More significant (P<0.005) acoustic changes were detected in P1 and P2 and R1 and R3, with the largest dB figs. in the lower frequency ranges in R1 and P2, when artificial clots and blood clots passed through the pump system. At higher frequencies, a significant change in dB figs. in R3 and P4 was detected when clots passed through the pump system. Acoustic monitoring of pump sounds may become a valuable tool in LVAD surveillance. PMID:24372095

  7. Circulatory changes associated with the closure of the ductus arteriosus in hatching emu (Dromaius novaehollandiae).

    PubMed

    Shell, Lauren; Burggren, Warren; Muirhead, David; Nelson, Thomas C; Dzialowski, Edward M

    2016-01-01

    In developing avian embryos, the right and left ductus arteriosi (DA) allow for a shunt of systemic venous return away from the lungs to the body and chorioallantoic membrane (CAM). Unlike in mammals where the transition from placental respiration to lung respiration is instantaneous, in birds the transition from embryonic CAM respiration to lung respiration can take over 24h. To understand the physiological consequences of this long transition we examined circulatory changes and DA morphological changes during hatching in the emu (Dromaius novaehollandiae), a primitive ratite bird. By tracking microspheres injected into a CAM vein, we observed no change in DA blood flow between the pre-pipped to internally pipped stages. Two hours after external pipping, however, a significant decrease in DA blood flow occurred, evident from a decreased systemic blood flow and subsequent increased lung blood flow. Upon hatching, the right-to-left shunt disappeared. These physiological changes in DA blood flow correspond with a large decrease in DA lumen diameter from the pre-pipped stages to Day 1 hatchlings. Upon hatching, the right-to-left shunt disappeared and at the same time apoptosis of smooth muscle cells began remodeling the DA for permanent closure. After the initial smooth muscle contraction, the lumen disappeared as intimal cushioning formed, the internal elastic lamina degenerated, and numerous cells underwent regulated apoptosis. The DA closed rapidly between the initiation of external pipping and hatching, resulting in circulatory patterns similar to the adult. This response is most likely produced by increased DA constriction in response to increased arterial oxygen levels and the initiation of vessel remodeling. PMID:26549875

  8. EXTRACORPOREAL MEMBRANE OXYGENATION vs. COUNTERPULSATILE, PULSATILE, AND CONTINUOUS LEFT VENTRICULAR UNLOADING FOR PEDIATRIC MECHANICAL CIRCULATORY SUPPORT

    PubMed Central

    Bartoli, Carlo R.; Koenig, Steven C.; Ionan, Constantine; Gillars, Kevin J.; Mitchell, Mike E.; Austin, Erle H.; Gray, Laman A.; Pantalos, George M.

    2014-01-01

    OBJECTIVE Despite progress with adult ventricular assist devices (VADs), limited options exist to support pediatric patients with life-threatening heart disease. Extracorporeal membrane oxygenation (ECMO) remains the clinical standard. To characterize (patho)physiologic responses to different modes of mechanical unloading of the failing pediatric heart, ECMO was compared to either intraaortic balloon pump (IABP), pulsatile-flow (PF)VAD, or continuous-flow (CF)VAD support in a pediatric heart failure model. DESIGN Experimental. SETTING Large animal laboratory operating room. SUBJECTS Yorkshire piglets (n=47, 11.7±2.6 kg). INTERVENTIONS In piglets with coronary ligation-induced cardiac dysfunction, mechanical circulatory support devices were implanted and studied during maximum support. MEASUREMENTS and MAIN RESULTS Left ventricular, right ventricular, coronary, carotid, systemic arterial, and pulmonary arterial hemodynamics were measured with pressure and flow transducers. Myocardial oxygen consumption and total-body oxygen consumption (VO2) were calculated from arterial, venous, and coronary sinus blood sampling. Blood flow was measured in 17 organs with microspheres. Paired student t-tests compared baseline and heart failure conditions. One-way repeated-measures ANOVA compared heart failure, device support mode(s), and ECMO. Statistically significant (p<0.05) findings included: 1) improved left ventricular blood supply/demand ratio during PFVAD, CFVAD, and ECMO but not IABP support, 2) improved global myocardial blood supply/demand ratio during PFVAD, and CFVAD but not IABP or ECMO support, and 3) diminished pulsatility during ECMO and CFVAD but not IABP and PFVAD support. A profile of systems-based responses was established for each type of support. CONCLUSIONS Each type of pediatric VAD provided hemodynamic support by unloading the heart with a different mechanism that created a unique profile of physiological changes. These data contribute novel, clinically

  9. Bleeding following deep hypothermia and circulatory arrest in children.

    PubMed

    Mossad, Emad B; Machado, Sandra; Apostolakis, John

    2007-03-01

    Deep hypothermic circulatory arrest (DHCA) is a technique of extracorporeal circulation commonly used in children with complex congenital heart defects undergoing surgical repairs. The use of profound cooling (20 degrees C) and complete cessation of circulation allow adequate exposure and correction of these complex lesions, with enhanced cerebral protection. However, the profound physiologic state of DHCA results in significant derangement of the coagulation system and a high incidence of postoperative bleeding. This review examines the impact of DHCA on bleeding and transfusion requirements in children and the pathophysiology of DHCA-induced platelet dysfunction. It also focuses on possible pharmacologic interventions to decrease bleeding following DHCA in children. PMID:17484172

  10. Postcardiotomy mechanical circulatory support in two infants with williams' syndrome.

    PubMed

    Contrafouris, Constantinos A; Chatzis, Andrew C; Kanakis, Meletios A; Azariadis, Prodromos A; Mitropoulos, Fotios A

    2014-01-01

    Supravalvar aortic stenosis (SVAS) in patients with Williams' syndrome is often accompanied by coronary, pulmonary, and even myocardial lesions and therefore associated with increased perioperative morbidity and mortality. Extracorporeal membrane oxygenation (ECMO) provides reliable short-term mechanical circulatory support to patients, especially young, in acute postoperative cardiac failure when conventional means are ineffective. The incorporation of centrifugal pumps in these systems has made their use more efficient and less traumatic. We describe our experience of using the Levitronix CentriMag pump in two patients with Williams' syndrome who underwent surgical correction of supravalvular aortic stenosis. PMID:24741444

  11. [The prevention of transfusion-associated circulatory overload].

    PubMed

    Ozier, Y

    2014-11-01

    Hydrostatic pulmonary edema is a frequent and severe complication of blood transfusion. Recent epidemiological studies open the way for a better prevention of Transfusion-Associated Circulatory Overload. Preventive measures rely solely on the medical and nursing staff. Mitigation strategies include a careful identification of patients and conditions at-risk, a single-unit transfusion policy in patients with chronic anemia, the use of slow infusion rates, the careful monitoring of patient vital signs (particularly systemic arterial blood pressure). Peritransfusion IV diuretics use is likely to be helpful, although optimal prescribing patterns have not been defined. PMID:25277421

  12. Biplane roentgen videometric system for dynamic, 60/sec, studies of the shape and size of circulatory structures, particularly the left ventricle.

    NASA Technical Reports Server (NTRS)

    Ritman, E. L.; Sturm, R. E.; Wood, E. H.

    1973-01-01

    An operator interactive video system for the measurement of roentgen angiographically outlined structures is described. Left ventricular volume and three-dimensional shapes are calculated from up to 200 pairs of diameters measured from ventriculograms at the rate of 60 pairs of biplane images per second. The accuracy and reproducibility of volumes calculated by the system were established by analysis of roentgenograms of inanimate objects of known volume and by comparison of left ventricular stroke volumes calculated by the system with the stroke volumes calculated by an indicator-dilution technique and an aortic root electromagnetic flowmeter. Computer-generated display of the large amounts of data obtained by the videometry system is described.

  13. [Medicinal plants useful in the cure of circulatory problems in legs].

    PubMed

    Alonso, Maria José

    2005-03-01

    Once the fundamentals of phyto-therapy in its western use are understood, this article presents concrete a application of medicinal plants: circulatory problems in legs, a problem which affects a growing sector of the population. According to epidemiological studies, close to 80% of adults suffer problems such as tired legs, swellings, edemas, cramps, or varicose veins during their lifetimes; these appear due to an insufficiency when veins can not conveniently transport blood to the heart. PMID:15871340

  14. The System of Adult Education in Yugoslavia. Notes and Essays on Education for Adults, 59.

    ERIC Educational Resources Information Center

    Savicevic, Dusan M.

    Now an integral part of the Yugoslav national educational system, adult education in Yugoslavia is based on the principles of permanence, democracy, decentralization, functional unity, diversity and dynamism, and voluntarism. Adult basic, vocational, general, and other forms of adult education are offered in varying degrees and forms by primary…

  15. The Role of Diverse Institutions in Framing Adult Learning Systems

    ERIC Educational Resources Information Center

    Saar, Ellu; Ure, Odd Bjorn; Desjardins, Richard

    2013-01-01

    This article considers the role of diverse institutions in framing adult learning systems. The focus is on institutional characteristics and configurations in different countries and their potential impact on the extent of adult learning, as well as on inequalities in access to adult learning. Typologies of education and training systems as well…

  16. Quantitative three-dimensional dynamic imaging of structure and function of the cardiopulmonary and circulatory systems in all regions of the body

    NASA Technical Reports Server (NTRS)

    Sturm, R. E.; Ritman, E. L.; Wood, E. H.

    1975-01-01

    The background for, and design of a third generation, general purpose, all electronic spatial scanning system, the DSR is described. Its specified performance capabilities provide dynamic and stop action three dimensional spatial reconstructions of any portion of the body based on a minimum exposure time of 0.01 second for each 28 multiplanar 180 deg scanning set, a maximum scan repetition rate of sixty 28 multiplane scan sets per second, each scan set consisting of a maximum of 240 parallel cross sections of a minimum thickness of 0.9 mm, and encompassing a maximum cylindrical volume about 23 cm in length and up to 38 cm in diameter.

  17. Adult Neurogenesis and the Olfactory System

    PubMed Central

    Whitman, Mary C.; Greer, Charles A.

    2009-01-01

    Though initially described in the early 1960s, it is only within the past decade that the concept of continuing adult neurogenesis has gained widespread acceptance. Neuroblasts from the subventricular zone (SVZ) migrate along the rostral migratory stream (RMS) into the olfactory bulb, where they differentiate into interneurons. Neuroblasts from the subgranular zone (SGZ) of the hippocampal formation show relatively little migratory behavior, and differentiate into dentate gyrus granule cells. In sharp contrast to embryonic and perinatal development, these newly differentiated neurons must integrate into a fully functional circuit, without disrupting ongoing performance. Here, after a brief historical overview and introduction to olfactory circuitry, we review recent advances in the biology of neural stem cells, mechanisms of migration in the RMS and olfactory bulb, differentiation and survival of new neurons, and finally mechanisms of synaptic integration. Our primary focus is on the olfactory system, but we also contrast the events occurring there with those in the hippocampal formation. Although both SVZ and SGZ neurogenesis are involved in some types of learning, their full functional significance remains unclear. Since both systems offer models of integration of new neuroblasts, there is immense interest in using neural stem cells to replace neurons lost in injury or disease. Though many questions remain unanswered, new insights appear daily about adult neurogenesis, regulatory mechanisms, and the fates of the progeny. We discuss here some of the central features of these advances, as well as speculate on future research directions. PMID:19615423

  18. Model-referenced cardiovascular circulatory simulator: construction and control.

    PubMed

    Gwak, Kwan-Woong

    2015-04-01

    Physiological feasibility is the most important requirement for cardiovascular circulatory simulators (CCSs). However, previous simulators have been validated by a comparison with specific human data sets, which are valid only for very limited conditions, and so it is difficult to validate the fidelity of a CCS for various body conditions. To overcome this critical limitation, we propose a model-referenced CCS that reproduces the behavior of an electrical-analog model of the cardiovascular circulatory system, for which physiological fidelity is well established over a wide range. In this study, the electrical-analog reference model was realized in the hardware simulator using fluidic element modeling and by the feedback control of a mock ventricle. The proposed simulator showed a good match with the reference model behavior, and its physiological validity was thereby verified. The proposed simulator is able to show responsiveness to various body conditions as well. To the best of the author's knowledge, this is the first report of an in vitro CCS verified to be consistent with reference model behavior. PMID:25345617

  19. Circulatory function during exercise: integration of convection and diffusion.

    PubMed

    Jones, J H

    1994-01-01

    The cardiovascular system has frequently been hypothesized to be the limiting step for O2 transport that determines VO2 max in many species of mammals. Careful analysis of the factors that determine how O2 is transported by the circulation demonstrate that such a single-step limitation cannot exist. Evaluation of the results of experiments in which circulatory O2 transport capacity was experimentally altered demonstrates no direct or absolute relationship between changes in O2 transport capacity and changes in VO2 max. Furthermore, experimental evidence collected during maximal exercise in hypoxia and hyperoxia supports the concept that multiple components of the O2 transport system contribute to limiting O2 flux at VO2 max. Consideration of the basic equations that describe O2 transport through the respiratory system shows that changes in PO2 at each step of the system required to increase O2 flux through that step conflict with the changes in PO2 required to increase flux through adjacent steps. Changes in convection, capacitance, or conductance at one step affect gas transport through the adjacent steps. Hence, no single-step limitation to O2 transport is possible, because the convective and diffusive gas exchangers are interdependent. Increasing QT at VO2 max always increases O2 flux (although not necessarily in proportion to the increase in QT), unless VO2 max is limited by mitochondrial oxidative capacity, as in goats. Cardiovascular structure and function in mammals reflects allometric, adaptive and induced variation. Maximal heart rate is determined strictly by body size, thus maximal QT/Mb is inevitably lower in larger mammals. Adaptive and induced variation elicit hypertrophy of muscle, capillaries, and mitochondria, increasing circulatory capacity and VO2 max. When selection for maximal respiratory function is weak, as in most species of mammals, any component(s) of the respiratory system may be underdeveloped, relative to other structures in the system

  20. Circulatory mitochondrial DNA is a pro-inflammatory agent in maintenance hemodialysis patients.

    PubMed

    Cao, Hongdi; Ye, Hong; Sun, Zhiping; Shen, Xia; Song, Zongwei; Wu, Xiaochun; He, Weichun; Dai, Chunsun; Yang, Junwei

    2014-01-01

    Chronic inflammation is highly prevalent in maintenance hemodialysis (MHD) patients, and it has been shown to be a strong predictor of morbidity and mortality. Mitochondrial DNA (mtDNA) released into circulation after cell damage can promote inflammation in patients and animal models. However, the role and mechanisms of circulatory mtDNA in chronic inflammation in MHD patients remain unknown. Sixty MHD patients and 20 health controls were enrolled in this study. The circulatory mtDNA was detected by quantitative real-time PCR assay. Plasma interleukin 6 (IL-6) and tumor necrosis factor α (TNF-α) were quantitated by ELISA assay. Dialysis systems in MHD patients and in vitro were used to evaluate the effect of different dialysis patterns on circulatory mtDNA. Circulatory mtDNA was elevated in MHD patients comparing to that of health control. Regression analysis demonstrated that plasma mtDNA was positively associated with TNF-α and the product of serum calcium and phosphorus, while negatively associated with hemoglobin and serum albumin in MHD patients. MtDNA induced the secretion of IL-6 and TNF-α in the THP-1 cells. Single high-flux hemodialysis (HF-HD) and on line hemodiafiltration (OL-HDF) but not low-flux hemodialysis (LF-HD) could partially reduce plasma mtDNA in MHD patients. In vitro, both HD and hemofiltration (HF) could fractional remove mtDNA. Collectively, circulatory mtDNA is elevated and its level is closely correlated with chronic inflammation in MHD patients. HF-HD and HDF can partially reduce circulatory mtDNA in MHD patients. PMID:25485699

  1. Transfusion associated circulatory overload: a critical incident.

    PubMed

    Goodall, E

    2014-01-01

    Transfusion associated circulatory overload (TACO) is a serious but under-recognised complication of blood transfusion. While the exact incidence rate is unknown the associated morbidity and mortality make this a transfusion reaction worthy of attention. This article provides details of a critical incident involving TACO followed by a literature review and discussion written from the perspective of a student ODP. The goal of this article is to raise awareness of TACO amongst hospital staff to facilitate faster recognition and earlier intervention in future events. PMID:24516967

  2. The Arlington Adult Learning System (AALS) Curriculum: A Transitional ESL Curriculum for Adults.

    ERIC Educational Resources Information Center

    Arlington County Public Schools, VA. REEP, Arlington Education and Employment Program.

    The English-as-a-Second-Language (ESL) curriculum of the Arlington (Virginia) Adult Learning System (AALS) is presented. AALS is a consortium in which an adult education provider (the public school system) coordinates efforts of its own organization with a community-based organization, a vocational institute, and a university to transition…

  3. Postoperative mechanical circulatory support with Biomedicus centrifugal pump.

    PubMed

    Mert, Murat; Akcevin, Atif; Yildiz, Cenk E; Suzer, Kaya

    2005-03-01

    Despite advances in surgical techniques, myocardial protection, and management protocols, approximately 1% of patients undergoing open heart operations still need mechanical circulatory support for severe cardiac dysfunction. The Biomedicus centrifugal pump, available in most cardiovascular centers, is a highly effective and relatively inexpensive system compared to other more sophisticated devices for the same purpose. Of 10 patients aged 5 to 61 years who were supported for 22 to 168 hours with a Biomedicus centrifugal pump, 7 (70%) were weaned from support, there was one hospital death, and 6 patients were discharged from hospital. Two sudden deaths occurred in the first 8 months after discharge. Four patients (40%) were still alive after follow-up of 11-55 months, with no restriction in their daily activities. The centrifugal pump is a very cost-effective support system with survival rates comparable to those of more sophisticated devices in short-term ventricular assistance. PMID:15793049

  4. Training Delivery Systems for Adult Learners. A Bibliography.

    ERIC Educational Resources Information Center

    Florida State Univ., Tallahassee. Center for Instructional Development and Services.

    This bibliography focuses on the training needs of adults and the incorporation of the most effective training delivery systems for adults into job training programs. It includes citations exploring current training practices, methods, and philosophies in both the private sector and the educational system; how each system can learn from the…

  5. Options for temporary mechanical circulatory support

    PubMed Central

    Saffarzadeh, Areo

    2015-01-01

    Temporary mechanical circulatory support (MCS) refers to a group of devices generally used for less than 30 days to maintain adequate organ perfusion by compensating for a failure of the pumping mechanism of the heart. The increased availability and rapid adoption of new temporary MCS strategies necessitate physicians to become familiar with devices placed both percutaneously and via median sternotomy. This review will examine the different options for commonly used temporary MCS devices including intra-aortic balloon pumps (IABPs), veno-arterial-extracorporeal membrane oxygenation (VA-ECMO), TandemHeart® (CardiacAssist, Pittsburg, PA, USA) Impella® and BVS 5000® (both Abiomed Inc., Danvers, MA, USA), CentriMag® and Thoratec percutaneous ventricular assist device (pVAD)® (both Thoratec Corporation, Pleasanton, CA, USA). A specific emphasis will be made to describe relevant mechanisms of action, standard placement strategies, hemodynamic effects, relevant contraindications and complications, and important daily management considerations. PMID:26793330

  6. Mechanical circulatory support in heart failure

    PubMed Central

    Szczurek, Wioletta; Suliga, Kamil; Rempega, Grzegorz; Rajwa, Paweł

    2016-01-01

    The increasing number of end-stage heart failure patients eligible for heart transplant and the disproportionately low number of donor hearts have led to increased interest in ventricular assist devices (VAD). These devices can be used as a bridge to decision, bridge to recovery, or bridge to candidacy. The main advantage of mechanical circulatory support (MCS) is the improvement of organ perfusion and function, which leads to better quality of life and survival. The MCS can also be used as a destination therapy in end-stage heart failure patients who are not eligible for heart transplant. It should be remembered that, despite the tangible benefits, VAD implantation may also be associated with the risk of serious complications, such as bleeding, infection, arrhythmias, blood clots, right ventricular failure, and cardiovascular events. This study presents an up-to-date overview of the current knowledge on the role of MCS in modern medicine. PMID:27516785

  7. Mechanical circulatory support for destination therapy.

    PubMed

    Tozzi, Piergiorgio; Hullin, Roger

    2016-01-01

    Patients with chronic heart failure who are not eligible for heart transplant and whose life expectancy depends mainly on the heart disease may benefit from mechanical circulatory support. Mechanical circulatory support restores adequate cardiac output and organ perfusion and eventually improves patients' clinical condition, quality of life and life expectancy. This treatment is called destination therapy (DT) and we estimate that in Switzerland more than 120 patients per year could benefit from it. In the last 10 years, design of the devices, implantation techniques and prognoses have changed dramatically. The key to successful therapy with a left ventricular assist device is appropriate patient selection, although we are still working on the definition of reliable inclusion and exclusion criteria and optimal timing for surgical implantation. Devices providing best long-term results are continuous flow, rotary or axial blood pumps implanted using minimally invasive techniques on a beating heart. These new devices (Thoratec HeartMate II and HeartWare HVAD) have only a single moving part, and have improved durability with virtually 10 years freedom from mechanical failure. In selected patients, the overall actuarial survival of DT patients is 75% at 1 year and 62% at 2 years, with a clear improvement in quality of life compared with medical management only. Complications include bleeding and infections; their overall incidence is significantly lower than with previous devices and their management is well defined. DT is evolving into an effective and reasonably cost-effective treatment option for a growing population of patients not eligible for heart transplant, showing encouraging survival rates at 2 years and providing clear improvement in quality of life. The future is bright for people suffering from chronic heart failure. PMID:26945160

  8. Snake constriction rapidly induces circulatory arrest in rats.

    PubMed

    Boback, Scott M; McCann, Katelyn J; Wood, Kevin A; McNeal, Patrick M; Blankenship, Emmett L; Zwemer, Charles F

    2015-07-01

    As legless predators, snakes are unique in their ability to immobilize and kill their prey through the process of constriction, and yet how this pressure incapacitates and ultimately kills the prey remains unknown. In this study, we examined the cardiovascular function of anesthetized rats before, during and after being constricted by boas (Boa constrictor) to examine the effect of constriction on the prey's circulatory function. The results demonstrate that within 6 s of being constricted, peripheral arterial blood pressure (PBP) at the femoral artery dropped to 1/2 of baseline values while central venous pressure (CVP) increased 6-fold from baseline during the same time. Electrocardiographic recordings from the anesthetized rat's heart revealed profound bradycardia as heart rate (fH) dropped to nearly half of baseline within 60 s of being constricted, and QRS duration nearly doubled over the same time period. By the end of constriction (mean 6.5±1 min), rat PBP dropped 2.9-fold, fH dropped 3.9-fold, systemic perfusion pressure (SPP=PBP-CVP) dropped 5.7-fold, and 91% of rats (10 of 11) had evidence of cardiac electrical dysfunction. Blood drawn immediately after constriction revealed that, relative to baseline, rats were hyperkalemic (serum potassium levels nearly doubled) and acidotic (blood pH dropped from 7.4 to 7.0). These results are the first to document the physiological response of prey to constriction and support the hypothesis that snake constriction induces rapid prey death due to circulatory arrest. PMID:26202779

  9. Transformation of the Adult Education System in Slovakia

    NASA Astrophysics Data System (ADS)

    Švec, Štefan

    1998-07-01

    This article examines trends in adult education in Slovakia since it became a separate republic in 1993. Economic and social transformations during this period have led to a re-thinking of the adult education system. The author describes four basic modalities for providing adult education in Slovakia: (1) schools and colleges; (2) cultural centres and similar institutions; (3) institutions for vocational training; (4) voluntary organizations such as trade unions, political parties and ethnic minority groups.

  10. Does the use of thiopental provide added cerebral protection during deep hypothermic circulatory arrest?

    PubMed

    Al-Hashimi, Sara; Zaman, Mahvash; Waterworth, Paul; Bilal, Haris

    2013-08-01

    A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was: Does the use of thiopental provide added cerebral protection during deep hypothermic circulatory arrest (DHCA)? Altogether, more than 62 papers were found using the reported search, of which 7 represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. Four of the seven papers used thiopental alongside other neuroprotective methods and agents. The methods included the use of ice packs to the head and core systemic hypothermia. Agents used alongside thiopental included nicardipine and mannitol. Thiopental was found to have the ability to lower oxygen consumption, where oxygen consumption was measured using the phosphocreatinine and adenosine triphosphate ratio. The neuroprotective effect of thiopental was evaluated by assessing the electrical activity of the brain during circulatory arrest, by which it was shown to be advantageous. However, other trials suggested that adding thiopental during circulatory arrest did not provide any extra protection to the brain. The timing of thiopental administration is of importance in order to gain positive outcomes, as it's ability to lower the cerebral energy state may result in unfavourable results if added before hypothermic circulatory arrest, where this may lead to an ischaemic event. We conclude that the use of thiopental during deep hypothermic circulatory arrest is beneficial, but if administered too early, it may replete the cerebral energy state before arrest and prove to be detrimental. PMID:23644730

  11. The European Registry for Patients with Mechanical Circulatory Support (EUROMACS): first annual report.

    PubMed

    de By, Theo M M H; Mohacsi, Paul; Gummert, Jan; Bushnaq, Hasan; Krabatsch, Thomas; Gustafsson, Finn; Leprince, Pascal; Martinelli, Luigi; Meyns, Bart; Morshuis, Michiel; Netuka, Ivan; Potapov, Evgenij; Zittermann, Armin; Delmo Walter, Eva Maria; Hetzer, Roland

    2015-05-01

    The European Registry for Patients with Mechanical Circulatory Support (EUROMACS) was founded on 10 December 2009 with the initiative of Roland Hetzer (Deutsches Herzzentrum Berlin, Berlin, Germany) and Jan Gummert (Herz- und Diabeteszentrum Nordrhein-Westfalen, Bad Oeynhausen, Germany) with 15 other founding international members. It aims to promote scientific research to improve care of end-stage heart failure patients with ventricular assist device or a total artificial heart as long-term mechanical circulatory support. Likewise, the organization aims to provide and maintain a registry of device implantation data and long-term follow-up of patients with mechanical circulatory support. Hence, EUROMACS affiliated itself with Dendrite Clinical Systems Ltd to offer its members a software tool that allows input and analysis of patient clinical data on a daily basis. EUROMACS facilitates further scientific studies by offering research groups access to any available data wherein patients and centres are anonymized. Furthermore, EUROMACS aims to stimulate cooperation with clinical and research institutions and with peer associations involved to further its aims. EUROMACS is the only European-based Registry for Patients with Mechanical Circulatory Support with rapid increase in institutional and individual membership. Because of the expeditious data input, the European Association for Cardiothoracic Surgeons saw the need to optimize the data availability and the significance of the registry to improve care of patients with mechanical circulatory support and its potential contribution to scientific intents; hence, the beginning of their alliance in 2012. This first annual report is designed to provide an overview of EUROMACS' structure, its activities, a first data collection and an insight to its scientific contributions. PMID:25820161

  12. Comparing Adult Learning Systems: An Emerging Political Economy

    ERIC Educational Resources Information Center

    Rees, Gareth

    2013-01-01

    Adult learning systems have come to be dominated by the view that the essential role of adult learning is to generate the high levels of skills deemed necessary for competitiveness and growth in the globalised economy. This 'education gospel' is underpinned by human capital theory (HCT) and its contemporary conceptualisation in terms of…

  13. Systemic vascular function is associated with muscular power in adults

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Age-associated loss of muscular strength and muscular power are critical determinants of loss of physical function and progression to disability in older adults. In this study, we examined the association of systemic vascular function and measures of muscle strength and power in older adults. Measu...

  14. Adult Roles & Functions. Objective Based Evaluation System.

    ERIC Educational Resources Information Center

    West Virginia State Vocational Curriculum Lab., Cedar Lakes.

    This book of objective-based test items is designed to be used with the Adult Roles and Functions curriculum for a non-laboratory home economic course for grades eleven and twelve. It contains item banks for each cognitive objective in the curriculum. In addition, there is a form for the table of specifications to be developed for each unit. This…

  15. The thermal-circulatory ratio (TCR)

    PubMed Central

    Ketko, Itay; Eliyahu, Uri; Epstein, Yoram; Heled, Yuval

    2014-01-01

    Introduction The common practice in the Israel Defense Force is that all exertional heat related injuries victims undergo a heat tolerance test (HTT) as a part of the “return to duty” process. The purpose of this study was to develop a quantitative, supportive physiological index for the assessment of the HTT based on the understanding that heat strain level should combine the thermal and cardiovascular strains. Materials and methods The HTT results of 104 individuals with a history of heat injuries were retrospectively analyzed after randomly divided into two groups (an analysis group and a validation group). Rectal temperature and heart rate were monitored continuously during the test. Using the ratio between those two variables we constructed the TCR (Thermal-Circulatory Ratio) index and defined thresholds for determining heat tolerance based on the HTT. Results Using a TCR value of 0.279 [°C/bpm] or less after completing the 120 min HTT can be used as a significant measure to distinguish between heat tolerance and heat intolerance individuals with sensitivity and specificity of 100% of 89%, respectively. In addition, a TCR value of 0.320 [°C/bpm] or less calculated after 60 min was found as a significant measure to determine heat tolerance with 100% sensitivity and 69% specificity. The latter threshold may assist in significantly shortening the HTT for those individuals whose TCR value matches this criterion. Discussion and conclusion A new index (TCR) that combines the thermal and cardiovascular responses to exercise-heat stress was found to be a valid measure, with high sensitivity and specificity, to support the distinguishing between heat tolerance and heat intolerance individuals following a HTT. Furthermore, the suggested index may enable to shorten the HTT, which will make the test more efficient.

  16. Characterizing the Epidemiology of Perioperative Transfusion-associated Circulatory Overload

    PubMed Central

    Clifford, Leanne; Jia, Qing; Yadav, Hemang; Subramanian, Arun; Wilson, Gregory A.; Murphy, Sean P.; Pathak, Jyotishman; Schroeder, Darrell R.; Ereth, Mark H.; Kor, Daryl J.

    2016-01-01

    Background Transfusion-associated circulatory overload (TACO) is a leading cause of transfusion-related fatalities, but its incidence and associated patient and transfusion characteristics are poorly understood. To inform surgical transfusion practice and to begin mitigating perioperative TACO, the authors aimed to define its epidemiology. Methods In this retrospective cohort study, the medical records of adult patients undergoing noncardiac surgery with general anesthesia during 2004 or 2011 and receiving intraoperative transfusions were screened using an electronic algorithm for identification of TACO. Those patients who were screened as high probability for TACO underwent rigorous manual review. Univariate and multivariate analyses evaluated associations between patient and transfusion characteristics with TACO rates in a before-and-after study design. Results A total of 2,162 and 1,908 patients met study criteria for 2004 and 2011, respectively. The incidence of TACO was 5.5% (119 of 2,162) in 2004 versus 3.0% (57 of 1,908) in 2011 (P < 0.001), with comparable rates for men (4.8% [98 of 2,023]) and women (3.8% [78 of 2,047]) (P = 0.09). Overall, vascular (12.1% [60 of 497]), transplant (8.8% [17 of 193]), and thoracic surgeries (7.2% [10 of 138]) carried the highest TACO rates. Obstetric and gynecologic patients had the lowest rate (1.4% [4 of 295]). The incidence of TACO increased with volume transfused, advancing age, and total intraoperative fluid balance (all P < 0.001). Conclusions The incidence of perioperative TACO is similar to previous estimates in nonsurgical populations. There was a reduction in TACO rate between 2004 and 2011, with incidence patterns remaining comparable in subgroup analyses. Future efforts exploring risk factors for TACO may guide preventive or therapeutic interventions, helping to further mitigate this transfusion complication. PMID:25611653

  17. Description, validation, and modification of the Guyton model for space-flight applications. Part A. Guyton model of circulatory, fluid and electrolyte control. Part B. Modification of the Guyton model for circulatory, fluid and electrolyte control

    NASA Technical Reports Server (NTRS)

    Leonard, J. I.

    1985-01-01

    The mathematical model that has been a cornerstone for the systems analysis of space-flight physiological studies is the Guyton model describing circulatory, fluid and electrolyte regulation. The model and the modifications that are made to permit simulation and analysis of the stress of weightlessness are described.

  18. Teaching Integrative Physiology Using the Quantitative Circulatory Physiology Model and Case Discussion Method: Evaluation of the Learning Experience

    ERIC Educational Resources Information Center

    Rodriguez-Barbero, A.; Lopez-Novoa, J. M.

    2008-01-01

    One of the problems that we have found when teaching human physiology in a Spanish medical school is that the degree of understanding by the students of the integration between organs and systems is rather poor. We attempted to remedy this problem by using a case discussion method together with the Quantitative Circulatory Physiology (QCP)…

  19. Chronic low-dose exposure in the Techa River Cohort: risk of mortality from circulatory diseases.

    PubMed

    Krestinina, Lyudmila Yurievna; Epifanova, Svetlana; Silkin, Stanislav; Mikryukova, Lyudmila; Degteva, Marina; Shagina, Natalia; Akleyev, Alexander

    2013-03-01

    The aim of the present study was to analyze the mortality from circulatory diseases for about 30,000 members of the Techa River cohort over the period 1950-2003, and to investigate how these rates depend on radiation doses. This population received both external and internal exposures from (90)Sr, (89)Sr, (137)Cs, and other uranium fission products as a result of waterborne releases from the Mayak nuclear facility in the Southern Urals region of the Russian Federation. The analysis included individualized estimates of the total (external plus internal) absorbed dose in muscle calculated based on the Techa River Dosimetry System 2009. The cohort-average dose to muscle tissue was 35 mGy, and the maximum dose was 510 mGy. Between 1950 and 2003, 7,595 deaths from circulatory diseases were registered among cohort members with 901,563 person years at risk. Mortality rates in the cohort were analyzed using a simple parametric excess relative risk (ERR) model. For all circulatory diseases, the estimated excess relative risk per 100 mGy with a 15-year lag period was 3.6 % with a 95 % confidence interval of 0.2-7.5 %, and for ischemic heart disease it was 5.6 % with a 95 % confidence interval of 0.1-11.9 %. A linear ERR model provided the best fit. Analyses with a lag period shorter than 15 years from the beginning of exposure did not reveal any significant risk of mortality from either all circulatory diseases or ischemic heart disease. There was no evidence of an increased mortality risk from cerebrovascular disease (p > 0.5). These results should be regarded as preliminary, since they will be updated after adjustment for smoking and alcohol consumption. PMID:23124827

  20. Mechanical Circulatory Support of the Critically Ill Child Awaiting Heart Transplantation

    PubMed Central

    Gazit, Avihu Z; Gandhi, Sanjiv K; C Canter, Charles

    2010-01-01

    The majority of children awaiting heart transplantation require inotropic support, mechanical ventilation, and/or extracorporeal membrane oxygenation (ECMO) support. Unfortunately, due to the limited pool of organs, many of these children do not survive to transplant. Mechanical circulatory support of the failing heart in pediatrics is a new and rapidly developing field world-wide. It is utilized in children with acute congestive heart failure associated with congenital heart disease, cardiomyopathy, and myocarditis, both as a bridge to transplantation and as a bridge to myocardial recovery. The current arsenal of mechanical assist devices available for children is limited to ECMO, intra-aortic balloon counterpulsation, centrifugal pump ventricular assist devices, the DeBakey ventricular assist device Child; the Thoratec ventricular assist device; and the Berlin Heart. In the spring of 2004, five contracts were awarded by the National Heart, Lung and Blood Institute to support preclinical development for a range of pediatric ventricular assist devices and similar circulatory support systems. The support of early development efforts provided by this program is expected to yield several devices that will be ready for clinical trials within the next few years. Our work reviews the current international experience with mechanical circulatory support in children and summarizes our own experience since 2005 with the Berlin Heart, comparing the indications for use, length of support, and outcome between these modalities. PMID:21286278

  1. Circulatory contributors to the phenotype in hereditary hemorrhagic telangiectasia

    PubMed Central

    Shovlin, Claire L.

    2015-01-01

    Hereditary hemorrhagic telangiectasia (HHT) is mechanistically and therapeutically challenging, not only because of the molecular and cellular perturbations that generate vascular abnormalities, but also the modifications to circulatory physiology that result, and are likely to exacerbate vascular injury. First, most HHT patients have visceral arteriovenous malformations (AVMs). Significant visceral AVMs reduce the systemic vascular resistance: supra-normal cardiac outputs are required to maintain arterial blood pressure, and may result in significant pulmonary venous hypertension. Secondly, bleeding from nasal and gastrointestinal telangiectasia leads to iron losses of such magnitude that in most cases, diet is insufficient to meet the ‘hemorrhage adjusted iron requirement.’ Resultant iron deficiency restricts erythropoiesis, leading to anemia and further increases in cardiac output. Low iron levels are also associated with venous and arterial thromboses, elevated Factor VIII, and increased platelet aggregation to circulating 5HT (serotonin). Third, recent data highlight that reduced oxygenation of blood due to pulmonary AVMs results in a graded erythrocytotic response to maintain arterial oxygen content, and higher stroke volumes and/or heart rates to maintain oxygen delivery. Finally, HHT-independent factors such as diet, pregnancy, sepsis, and other intercurrent illnesses also influence vascular structures, hemorrhage, and iron handling in HHT patients. These considerations emphasize the complexity of mechanisms that impact on vascular structures in HHT, and also offer opportunities for targeted therapeutic approaches. PMID:25914716

  2. Simulation of Dilated Heart Failure with Continuous Flow Circulatory Support

    PubMed Central

    Wang, Yajuan; Loghmanpour, Natasha; Vandenberghe, Stijn; Ferreira, Antonio; Keller, Bradley; Gorcsan, John; Antaki, James

    2014-01-01

    Lumped parameter models have been employed for decades to simulate important hemodynamic couplings between a left ventricular assist device (LVAD) and the native circulation. However, these studies seldom consider the pathological descending limb of the Frank-Starling response of the overloaded ventricle. This study introduces a dilated heart failure model featuring a unimodal end systolic pressure-volume relationship (ESPVR) to address this critical shortcoming. The resulting hemodynamic response to mechanical circulatory support are illustrated through numerical simulations of a rotodynamic, continuous flow ventricular assist device (cfVAD) coupled to systemic and pulmonary circulations with baroreflex control. The model further incorporated septal interaction to capture the influence of left ventricular (LV) unloading on right ventricular function. Four heart failure conditions were simulated (LV and bi-ventricular failure with/without pulmonary hypertension) in addition to normal baseline. Several metrics of LV function, including cardiac output and stroke work, exhibited a unimodal response whereby initial unloading improved function, and further unloading depleted preload reserve thereby reducing ventricular output. The concept of extremal loading was introduced to reflect the loading condition in which the intrinsic LV stroke work is maximized. Simulation of bi-ventricular failure with pulmonary hypertension revealed inadequacy of LV support alone. These simulations motivate the implementation of an extremum tracking feedback controller to potentially optimize ventricular recovery. PMID:24465511

  3. Peripheral biomarkers of stroke: Focus on circulatory microRNAs.

    PubMed

    Vijayan, Murali; Reddy, P Hemachandra

    2016-10-01

    Stroke is the second leading cause of death in the world. Stroke occurs when blood flow stops, and that stoppage results in reduced oxygen supply to neurons in the brain. The occurrence of stroke increases with age, but anyone at any age can suffer from stroke. Recent research has implicated multiple cellular changes in stroke patients, including oxidative stress and mitochondrial dysfunction, inflammatory responses, and changes in mRNA and proteins. Recent research has also revealed that stroke is associated with modifiable and non-modifiable risk factors. Stroke can be controlled by modifiable risk factors, including diet, cardiovascular, hypertension, smoking, diabetes, obesity, metabolic syndrome, depression and traumatic brain injury. Stroke is the major risk factor for vascular dementia (VaD) and Alzheimer's disease (AD). The purpose of this article is to review the latest developments in research efforts directed at identifying 1) latest developments in identifying biomarkers in peripheral and central nervous system tissues, 2) changes in microRNAs (miRNAs) in patients with stroke, 3) miRNA profile and function in animal brain, and 4) protein biomarkers in ischemic stroke. This article also reviews research investigating circulatory miRNAs as peripheral biomarkers of stroke. PMID:27503360

  4. Exploring Motivational System Theory within the Context of Adult Education

    ERIC Educational Resources Information Center

    Hutto, Debra Jean

    2013-01-01

    Adult Basic Education (ABE) and the General Equivalency Diploma (GED) programs serve those students who, for whatever reason, have left the educational system without attaining a regular high school diploma. Because of the manner in which they may have left the school system, many have negative emotions and personal agency beliefs hindering their…

  5. SOVIET POLITICAL SCHOOLS, THE COMMUNIST PARTY ADULT INSTRUCTION SYSTEM.

    ERIC Educational Resources Information Center

    MICKIEWICZ, ELLEN PROPPER

    A STUDY WAS MADE OF SOVIET ADULT POLITICAL EDUCATION MAINLY AS IT APPLIES TO RUSSIAN URBAN AREAS, WHERE THE SYSTEM IS MOST HIGHLY DEVELOPED. THIS SYSTEM, AN AGENCY FOR TRANSMITTING POLITICAL DOCTRINE, FORMS A PART OF THE VAST NETWORK OF FORMAL POLITICAL COMMUNICATION, WHICH INCLUDES THE MASS MEDIA, AGITATION, AND COMMUNIST PARTY LEADERSHIP…

  6. Homeobox Protein Hop Functions in the Adult Cardiac Conduction System

    PubMed Central

    Ismat, Fraz A.; Zhang, Maozhen; Kook, Hyun; Huang, Bin; Zhou, Rong; Ferrari, Victor A.; Epstein, Jonathan A.; Patel, Vickas V.

    2006-01-01

    Hop is an unusual homeobox gene expressed in the embryonic and adult heart. Hop acts downstream of Nkx2–5 during development, and Nkx2–5 mutations are associated with cardiac conduction system (CCS) defects. Inactivation of Hop in the mouse is lethal in half of the expected null embryos. Here, we show that Hop is expressed strongly in the adult CCS. Hop−/− adult mice display conduction defects below the atrioventricular node (AVN) as determined by invasive electrophysiological testing. These defects are associated with decreased expression of connexin40. Our results suggest that Hop functions in the adult CCS and demonstrate conservation of molecular hierarchies between embryonic myocardium and the specialized conduction tissue of the mature heart. PMID:15790958

  7. H2S during circulatory shock: some unresolved questions.

    PubMed

    McCook, Oscar; Radermacher, Peter; Volani, Chiara; Asfar, Pierre; Ignatius, Anita; Kemmler, Julia; Möller, Peter; Szabó, Csaba; Whiteman, Matthew; Wood, Mark E; Wang, Rui; Georgieff, Michael; Wachter, Ulrich

    2014-09-15

    Numerous papers have been published on the role of H2S during circulatory shock. Consequently, knowledge about vascular sulfide concentrations may assume major importance, in particular in the context of "acute on chronic disease", i.e., during circulatory shock in animals with pre-existing chronic disease. This review addresses the questions (i) of the "real" sulfide levels during circulatory shock, and (ii) to which extent injury and pre-existing co-morbidity may affect the expression of H2S producing enzymes under these conditions. In the literature there is a huge range on sulfide blood levels during circulatory shock, in part as a result of the different analytical methods used, but also due to the variable of the models and species studied. Clearly, some of the very high levels reported should be questioned in the context of the well-known H2S toxicity. As long as "real" sulfide levels during circulatory shock are unknown and/or undetectable "on line" due to the lack of appropriate techniques, it appears to be premature to correlate the measured blood levels of hydrogen sulfide with the severity of shock or the H2S therapy-related biological outcomes. The available data on the tissue expression of the H2S-releasing enzymes during circulatory shock suggest that a "constitutive" CSE expression may play a crucial role of for the maintenance of organ function, at least in the kidney. The data also indicate that increased CBS and CSE expression, in particular in the lung and the liver, represents an adaptive response to stress states. PMID:24650697

  8. H2S during circulatory shock: Some unresolved questions

    PubMed Central

    McCook, Oscar; Radermacher, Peter; Volani, Chiara; Asfar, Pierre; Ignatius, Anita; Kemmler, Julia; Möller, Peter; Szabó, Csaba; Whiteman, Matthew; Wood, Mark E.; Wang, Rui; Georgieff, Michael; Wachter, Ulrich

    2014-01-01

    Numerous papers have been published on the role of H2S during circulatory shock. Consequently, knowledge about vascular sulfide concentrations may assume major importance, in particular in the context of “acute on chronic disease”, i.e., during circulatory shock in animals with pre-existing chronic disease. This review addresses the questions i) of the “real” sulfide levels during circulatory shock, and, ii) to which extent injury and pre-existing co-morbidity may affect the expression of H2S producing enzymes under these conditions. In the literature there is a huge range on sulfide blood levels during circulatory shock, in part as a result of the different analytical methods used, but also due to the variable of the models and species studied. Clearly, some of the very high levels reported should be questioned in the context of the well-known H2S toxicity. As long as “real” sulfide levels during circulatory shock are unknown and/or undetectable “on line” due to the lack of appropriate techniques, it appears to be premature to correlate the measured blood levels of hydrogen sulfide with the severity of shock or the H2S therapy-related biological outcomes. The available data on the tissue expression of the H2S-releasing enzymes during circulatory shock suggest that a “constitutive” CSE expression may play a crucial role of for the maintenance of organ function, at least in the kidney. The data also indicate that increased CBS and CSE expression, in particular in the lung and the liver, represents an adaptive response to stress states. PMID:24650697

  9. Systems Development in Adult Language Learning: A European Unit/Credit System for Modern Language Learning by Adults.

    ERIC Educational Resources Information Center

    Council for Cultural Cooperation, Strasbourg (France).

    The study prepares the ground for the introduction of a language learning system for adults. Part 1 presents a draft outline of such a system, in which the language material to be learned is organized into units and credits awarded on the completion of each unit. The content is defined with reference to the nature of the learners and their…

  10. System for Inter-Agency Coordination in Adult Education.

    ERIC Educational Resources Information Center

    King, Gordon A.; Regan, Timothy F.

    An innovative system to facilitate inter-agency cooperation in 16 federal agencies concerned with adult basic education is provided. The 16 programs chosen for the study were: (1) Work Incentive Program; (2) Concentrated Employment Program; (3) New Careers; (4) The Cuban Refugee Program; (5) Grants for Community Planning, Services and Training for…

  11. Instructional Videos for Supporting Older Adults Who Use Interactive Systems

    ERIC Educational Resources Information Center

    Gramss, Denise; Struve, Doreen

    2009-01-01

    The study reported in this paper investigated the usefulness of different instructions for guiding inexperienced older adults through interactive systems. It was designed to compare different media in relation to their social as well as their motivational impact on the elderly during the learning process. Precisely, the video was compared with…

  12. Long-Term Mechanical Circulatory Support in Pediatric Patients.

    PubMed

    Sandica, Eugen; Blanz, Ute; Mime, Lotfi Ben; Schultz-Kaizler, Ursula; Kececioglu, Deniz; Haas, Nikolaus; Kirchner, Guenther; Zu Knyphausen, Edzard; Lauenroth, Volker; Morshuis, Michiel

    2016-03-01

    This retrospective study reviews our results regarding the long-term support in pediatric patients using two ventricular assist systems between January 2008 and April 2014. We implanted the Berlin Heart EXCOR in 29 patients (median age 3.4 years [interquartile range (IQR) 0.2-16.5], median weight 13 kg [IQR 4.2-67.2]). Twenty-two patients (75.8%) received a left ventricular assist device. Three patients (10.3%) had single-ventricle physiology. One patient (3.4%) had mechanical mitral valve prosthesis. The HeartWare System was implanted in nine patients. The median age was 15.6 years (IQR 12.2-17.9), and the median weight was 54.9 kg (IQR 27.7-66). In the Berlin Heart group, the median support time was 65 days (IQR 4-619), with 3647 days of cardiac support. Nineteen patients (65.5%) were transplanted, six patients (20.7%) recovered, one patient (3.4%) is on support, and three patients (10.3%) died on support. Survival rate was 89.7%. Fourteen blood pumps had been exchanged. Four patients (13.8%) had local signs of infection, and three patients (10.3%) had neurological complications. In the HeartWare group, the median support time was 180 days (IQR 1-1124), with 2839 days of cardiac support. Four patients (44.4%) had local signs of infection, and three (33.3%) had neurological complications. Eight patients (88.9%) have been transplanted, and one patient (11.1%) died on support. Survival rate was 88.9%. Excellent survival is possible after long-term mechanical circulatory support in patients with two- and single-ventricle physiology with a low rate of adverse events. PMID:26411865

  13. Organ donation after circulatory death: the forgotten donor?

    PubMed

    Rady, Mohamed Y; Verheijde, Joseph L; McGregor, Joan

    2006-01-01

    Donation after circulatory death (DCD) can be performed on neurologically intact donors who do not fulfill neurologic or brain death criteria before circulatory arrest. This commentary focuses on the most controversial donor-related issues anticipated from mandatory implementation of DCD for imminent or cardiac death in hospitals across the USA. We conducted a nonstructured review of selected publications and websites for data extraction and synthesis. The recommended 5 min of circulatory arrest does not universally fulfill the dead donor rule when applied to otherwise neurologically intact donors. Scientific evidence from extracorporeal perfusion in circulatory arrest suggests that the procurement process itself can be the event causing irreversibility in DCD. Legislative abandonment of the dead donor rule to permit the recovery of transplantable organs is necessary in the absence of an adequate scientific foundation for DCD practice. The designation of organ procurement organizations or affiliates to obtain organ donation consent introduces self-serving bias and conflicts of interest that interfere with true informed consent. It is important that donors and their families are not denied a 'good death', and the impact of DCD on quality of end-of-life care has not been satisfactorily addressed to achieve this. PMID:17020597

  14. Delayed diagnosis of adult indolent systemic mastocytosis.

    PubMed

    Mikkelsen, Carsten Sauer; Nybo, Andrew; Arvesen, Kristian Bakke; Holk-Poulsen, Johan

    2014-02-17

    Systemic mastocytosis (SM) is a rare, heterogeneous disorder characterized by infiltration and accumulation of mast cells within multiple organs, most commonly the skin. Given the rarity of the disease and the fact that many of its symptoms are shared by more common disorders, a diagnosis may be delayed or hindered. These patients have an elevated risk of developing potentially life-threatening anaphylactoid reactions, thus underscoring the importance of keeping SM in mind as a differential diagnosis when a patient presents with chronic, itchy skin lesions and a history of multiple allergic reactions to bites, drugs, and anesthesia. We present a case illustrating that features of SM common to many disorders may hinder or delay its diagnosis. PMID:25386326

  15. Delayed Diagnosis of Adult Indolent Systemic Mastocytosis

    PubMed Central

    Mikkelsen, Carsten Sauer; Nybo, Andrew; Arvesen, Kristian Bakke; Holk-Poulsen, Johan

    2014-01-01

    Systemic mastocytosis (SM) is a rare, heterogeneous disorder characterized by infiltration and accumulation of mast cells within multiple organs, most commonly the skin. Given the rarity of the disease and the fact that many of its symptoms are shared by more common disorders, a diagnosis may be delayed or hindered. These patients have an elevated risk of developing potentially life-threatening anaphylactoid reactions, thus underscoring the importance of keeping SM in mind as a differential diagnosis when a patient presents with chronic, itchy skin lesions and a history of multiple allergic reactions to bites, drugs, and anesthesia. We present a case illustrating that features of SM common to many disorders may hinder or delay its diagnosis. PMID:25386326

  16. Circulatory disease mortality in the Massachusetts tuberculosis fluoroscopy cohort study.

    PubMed

    Little, Mark P; Zablotska, Lydia B; Brenner, Alina V; Lipshultz, Steven E

    2016-03-01

    High-dose ionizing radiation is associated with circulatory disease. Risks from lower-dose fractionated exposures, such as from diagnostic radiation procedures, remain unclear. In this study we aimed to ascertain the relationship between fractionated low-to-medium dose radiation exposure and circulatory disease mortality in a cohort of 13,568 tuberculosis patients in Massachusetts, some with fluoroscopy screenings, between 1916 and 1961 and follow-up until the end of 2002. Analysis of mortality was in relation to cumulative thyroid (cerebrovascular) or lung (all other circulatory disease) radiation dose via Poisson regression. Over the full dose range, there was no overall radiation-related excess risk of death from circulatory disease (n = 3221; excess relative risk/Gy -0.023; 95% CI -0.067, 0.028; p = 0.3574). Risk was somewhat elevated in hypertensive heart disease (n = 89; excess relative risk/Gy 0.357; 95% CI -0.043, 1.030, p = 0.0907) and slightly decreased in ischemic heart disease (n = 1950; excess relative risk/Gy -0.077; 95% CI -0.130, -0.012; p = 0.0211). However, under 0.5 Gy, there was a borderline significant increasing trend for all circulatory disease (excess relative risk/Gy 0.345; 95% CI -0.032, 0.764; p = 0.0743) and for ischemic heart disease (excess relative risk/Gy 0.465; 95% CI, -0.032, 1.034, p = 0.0682). Pneumolobectomy increased radiation-associated risk (excess relative risk/Gy 0.252; 95% CI 0.024, 0.579). Fractionation of dose did not modify excess risk. In summary, we found no evidence of radiation-associated excess circulatory death risk overall, but there are indications of excess circulatory death risk at lower doses (<0.5 Gy). Although consistent with other radiation-exposed groups, the indications of higher risk at lower doses are unusual and should be confirmed against other data. PMID:26255039

  17. Longterm results of liver transplantation from donation after circulatory death.

    PubMed

    Blok, Joris J; Detry, Olivier; Putter, Hein; Rogiers, Xavier; Porte, Robert J; van Hoek, Bart; Pirenne, Jacques; Metselaar, Herold J; Lerut, Jan P; Ysebaert, Dirk K; Lucidi, Valerio; Troisi, Roberto I; Samuel, Undine; den Dulk, A Claire; Ringers, Jan; Braat, Andries E

    2016-08-01

    Donation after circulatory death (DCD) liver transplantation (LT) may imply a risk for decreased graft survival, caused by posttransplantation complications such as primary nonfunction or ischemic-type biliary lesions. However, similar survival rates for DCD and donation after brain death (DBD) LT have been reported. The objective of this study is to determine the longterm outcome of DCD LT in the Eurotransplant region corrected for the Eurotransplant donor risk index (ET-DRI). Transplants performed in Belgium and the Netherlands (January 1, 2003 to December 31, 2007) in adult recipients were included. Graft failure was defined as either the date of recipient death or retransplantation whichever occurred first (death-uncensored graft survival). Mean follow-up was 7.2 years. In total, 126 DCD and 1264 DBD LTs were performed. Kaplan-Meier survival analyses showed different graft survival for DBD and DCD at 1 year (77.7% versus 74.8%, respectively; P = 0.71), 5 years (65.6% versus 54.4%, respectively; P = 0.02), and 10 years (47.3% versus 44.2%, respectively; P = 0.55; log-rank P = 0.038). Although there was an overall significant difference, the survival curves almost reach each other after 10 years, which is most likely caused by other risk factors being less in DCD livers. Patient survival was not significantly different (P = 0.59). Multivariate Cox regression analysis showed a hazard ratio of 1.7 (P < 0.001) for DCD (corrected for ET-DRI and recipient factors). First warm ischemia time (WIT), which is the time from the end of circulation until aortic cold perfusion, over 25 minutes was associated with a lower graft survival in univariate analysis of all DCD transplants (P = 0.002). In conclusion, DCD LT has an increased risk for diminished graft survival compared to DBD. There was no significant difference in patient survival. DCD allografts with a first WIT > 25 minutes have an increased risk for a decrease in graft survival. Liver Transplantation 22 1107

  18. Donation after cardio-circulatory death liver transplantation

    PubMed Central

    Le Dinh, Hieu; de Roover, Arnaud; Kaba, Abdour; Lauwick, Séverine; Joris, Jean; Delwaide, Jean; Honoré, Pierre; Meurisse, Michel; Detry, Olivier

    2012-01-01

    The renewed interest in donation after cardio-circulatory death (DCD) started in the 1990s following the limited success of the transplant community to expand the donation after brain-death (DBD) organ supply and following the request of potential DCD families. Since then, DCD organ procurement and transplantation activities have rapidly expanded, particularly for non-vital organs, like kidneys. In liver transplantation (LT), DCD donors are a valuable organ source that helps to decrease the mortality rate on the waiting lists and to increase the availability of organs for transplantation despite a higher risk of early graft dysfunction, more frequent vascular and ischemia-type biliary lesions, higher rates of re-listing and re-transplantation and lower graft survival, which are obviously due to the inevitable warm ischemia occurring during the declaration of death and organ retrieval process. Experimental strategies intervening in both donors and recipients at different phases of the transplantation process have focused on the attenuation of ischemia-reperfusion injury and already gained encouraging results, and some of them have found their way from pre-clinical success into clinical reality. The future of DCD-LT is promising. Concerted efforts should concentrate on the identification of suitable donors (probably Maastricht category III DCD donors), better donor and recipient matching (high risk donors to low risk recipients), use of advanced organ preservation techniques (oxygenated hypothermic machine perfusion, normothermic machine perfusion, venous systemic oxygen persufflation), and pharmacological modulation (probably a multi-factorial biologic modulation strategy) so that DCD liver allografts could be safely utilized and attain equivalent results as DBD-LT. PMID:22969222

  19. Health system strategies supporting transition to adult care

    PubMed Central

    Hepburn, Charlotte Moore; Cohen, Eyal; Bhawra, Jasmin; Weiser, Natalie; Hayeems, Robin Z; Guttmann, Astrid

    2015-01-01

    Background The transition from paediatric to adult care is associated with poor clinical outcomes, increased costs and low patient and family satisfaction. However, little is known about health system strategies to streamline and safeguard care for youth transitioning to adult services. Moreover, the needs of children and youth are often excluded from broader health system reform discussions, leaving this population especially vulnerable to system ‘disintegration’. Objectives (1) To explore the international policy profile of paediatric-to-adult care transitions, and (2) to document policy objectives, initiatives and outcomes for jurisdictions publicly committed to addressing transition issues. Methods An international policy scoping review of all publicly available government documents detailing transition-related strategies was completed using a web-based search. Our analysis included a comparable cohort of nine wealthy Organisation for Economic Co-operation and Development (OECD) jurisdictions with Beveridge-style healthcare systems (deemed those most likely to benefit from system-level transition strategies). Results Few jurisdictions address transition of care issues in either health or broader social policy documents. While many jurisdictions refer to standardised practice guidelines, a few report the intention to use powerful policy levers (including physician remuneration and non-physician investments) to facilitate the uptake of best practice. Most jurisdictions do not address the policy infrastructure required to support successful transitions, and rigorous evaluations of transition strategies are rare. Conclusions Despite the well-documented risks and costs associated with a poor transition from paediatric to adult care, little policy attention has been paid to this issue. We recommend that healthcare providers engage health system planners in the design and evaluation of system-level, policy-sensitive transition strategies. PMID:25688098

  20. Mock Circulatory Loop Compliance Chamber Employing a Novel Real-Time Control Process.

    PubMed

    Taylor, Charles E; Miller, Gerald E

    2012-12-01

    The use of compliance chambers in mock circulatory loop construction is the predominant means of simulating arterial compliance. Utilizing mock circulatory loops as bench test methods for cardiac assist technologies necessitates that they must be capable of reproducing the circulatory conditions that would exist physiologically. Of particular interest is the ability to determine instantaneous compliance of the system, and the ability to change the compliance in real-time. This capability enables continuous battery testing of conditions without stopping the flow to change the compliance chamber settings, and the simulation of dynamic changes in arterial compliance. The method tested involves the use of a compliance chamber utilizing a circular natural latex rubber membrane separating the fluid and air portions of the device. Change in system compliance is affected by the airspace pressure, which creates more reaction force at the membrane to the fluid pressure. A pressure sensor in the fluid portion of the chamber and a displacement sensor monitoring membrane center deflection allow for real-time inputs to the control algorithm. A predefined numerical model correlates the displacement sensor data to the volume displacement of the membrane. The control algorithm involves a tuned π loop maintaining the volume distention of the membrane via regulation of the air space pressure. The proportional integral (PI) controller tuning was achieved by creating a computational model of the compliance chamber using Simulink™ Simscape(®) toolboxes. These toolboxes were used to construct a model of the hydraulic, mechanical, and pneumatic elements in the physical design. Parameter Estimation™ tools and Design Optimization™ methods were employed to determine unknown physical parameters in the system, and tune the process controller used to maintain the compliance setting. It was found that the resulting control architecture was capable of maintaining compliance along a

  1. A mock circulatory loop for designing and evaluating total artificial hearts.

    PubMed

    Love, Holley C; Timms, Daniel L; Nestler, Frank; Frazier, O H; Cohn, William E

    2014-01-01

    A mock circulatory loop was constructed to facilitate total artificial heart development. The loop includes many novel features such as a pressure-regulated tank to simulate exercise conditions, controllable systemic and pulmonary vascular resistance to create left-right flow imbalances as seen in postural change and breathing, and a left atrial suction valve. Dual HeartMate II pumps and the BiVACOR® rotary total artificial heart were used to generate pressure and flow data characterizing the flow loop. PMID:25571281

  2. Energy transmission and power sources for mechanical circulatory support devices to achieve total implantability.

    PubMed

    Wang, Jake X; Smith, Joshua R; Bonde, Pramod

    2014-04-01

    Left ventricular assist device therapy has radically improved congestive heart failure survival with smaller rotary pumps. The driveline used to power today's left ventricular assist devices, however, continues to be a source of infection, traumatic damage, and rehospitalization. Previous attempts to wirelessly power left ventricular assist devices using transcutaneous energy transfer systems have been limited by restrictions on separation distance and alignment between the transmit and receive coils. Resonant electrical energy transfer allows power delivery at larger distances without compromising safety and efficiency. This review covers the efforts to wirelessly power mechanical circulatory assist devices and the progress made in enhancing their energy sources. PMID:24530103

  3. The prevention of circulatory collapse in left atrial myxoma or left atrail thrombus patients.

    PubMed

    Sun, Jie; Ding, Zhengnian

    2016-05-01

    Some patients with myxoma or thrombus may develop to severe hypotension or sudden death. In this article, we hypothesize a clinical scenario that when the myxoma or thrombus blocks in the mitral valve and causes significant hypotension during anesthesia or surgery. Increasing cardiac preload will be an effective preventive method to increasing the mitral valve annulus and decreasing the severity of stenosis, as a result it will prevent circulatory collapse. Our hypothesis will decrease the possibility of lethal mitral valve stenosis induced by left atrial mass blocking the mitral valve area. In addition, we should also maintain a relative slow heart rate and a relative high systemic vascular resistance. PMID:27063074

  4. Clinical review: mechanical circulatory support for cardiogenic shock complicating acute myocardial infarction

    PubMed Central

    2010-01-01

    Acute myocardial infarction is one of the 10 leading reasons for admission to adult critical care units. In-hospital mortality for this condition has remained static in recent years, and this is related primarily to the development of cardiogenic shock. Recent advances in reperfusion therapies have had little impact on the mortality of cardiogenic shock. This may be attributable to the underutilization of life support technology that may assist or completely supplant the patient's own cardiac output until adequate myocardial recovery is established or long-term therapy can be initiated. Clinicians working in the intensive care environment are increasingly likely to be exposed to these technologies. The purpose of this review is to outline the various techniques of mechanical circulatory support and discuss the latest evidence for their use in cardiogenic shock complicating acute myocardial infarction. PMID:21067535

  5. Perspectives of young adults with cerebral palsy on transitioning from pediatric to adult healthcare systems.

    PubMed

    Larivière-Bastien, Danaë; Bell, Emily; Majnemer, Annette; Shevell, Michael; Racine, Eric

    2013-06-01

    Transition from pediatric to adult healthcare is a well-established challenge for individuals with neurodevelopmental disorders like cerebral palsy. With regard to ethics, some of the key aspects to explore include the following: if and how individuals feel respected during the transition process; if and how their values and preferences are developed and integrated within transition; and if and how young patients are prepared to participate in decision making (to be autonomous) within the transition. We carried out a qualitative study on 14 young adults with cerebral palsy. Some participants reported positive experiences. However, several tension points were identified, including before the transition (eg, transition envisaged with fear and apprehension); during the transition (eg, lack of cooperation or communication between providers in the pediatric and adult healthcare systems); and after the transition (eg, feelings of abandonment). We discuss the clinical influence and ethical significance of better capturing ethical values within the transition process and preparing young individuals to engage in discussions about their health and disease management. PMID:23948690

  6. Kidney donation after circulatory death: current evidence and opportunities for pediatric recipients.

    PubMed

    Marlais, Matko; Callaghan, Chris; Marks, Stephen D

    2016-07-01

    Organ donation after circulatory death (DCD) has experienced a revival worldwide over the past 20 years, and is now widely practiced for kidney transplantation. Some previous concerns about these organs such as the high incidence of delayed graft function have been alleviated through evidence from adult studies. There are now a number of large adult cohorts reporting favorable 5-year outcomes for DCD kidney transplants, comparable to kidneys donated after brain death (DBD). This has resulted in a marked increase in the use of DCD kidneys for adult recipients in some countries and an increase in the overall number of kidney transplants. In contrast, the uptake of DCD kidneys for pediatric recipients is still low and concerns still exist over the longer-term outcomes of DCD organs. In view of the data from adult practice and the poor outcomes for children who stay on dialysis, DCD kidney transplantation should be offered as an option for children on the kidney transplant waiting list. PMID:26384332

  7. Diabetes care for emerging adults: transition from pediatric to adult diabetes care systems.

    PubMed

    Lee, Young Ah

    2013-09-01

    With the increasing prevalence of diabetes mellitus in children, transitioning patients from childhood to adulthood are increasing. High-risk behaviors and poor glycemic control during the transition period increase the risk for hypoglycemia and hyperglycemia as well as chronic microvascular and macrovascular complications. Discussions regarding complications and preparations for transition must take place before the actual transition to adult care systems. Pediatric care providers should focus on diabetes self-management skills and prepare at least 1 year prior to the transfer. Pediatric providers should also provide a written summary about previous and current glycemic control, complications and the presence of mental health problems such as disordered eating behaviors and affective disorders. Transition care should be individualized, with an emphasis on diabetes self-management to prevent acute and long-term complications. Regular screening and management of complications should proceed according to pediatric and adult guidelines. Birth control, use of alcohol, smoking and driving should also be discussed. Barriers to self-management and care must be recognized and solutions sought. The goals of transitional care are to effectively transition the diabetic patient from the pediatric to adult care system with less elapsed time in between and to improve post-transition outcome. Previous studies regarding diabetes transitional care programs including patient education programs, medical coordinators and auxiliary service systems reported promising results. However, there is a lack of evidence regarding best practices in transition care. Further studies are needed to provide evidence based transitional care programs that take both medical and psychosocial aspects of diabetes care into consideration. PMID:24904862

  8. For a Socialising Type of Adult Education: Transforming Adult Education into an Autonomous System for the Continuous Resocialisation of Adults.

    ERIC Educational Resources Information Center

    Bogard, Gerald

    This report sets out to establish the need for and to define a type of adult education for the socialization of adults. It arises from the meeting of a steering group responsible for the "Adult Education and Social Change" project, which studied educational practices relating to the long-term unemployed and older people. The key points listed…

  9. Current Status of Mechanical Circulatory Support: A Systematic Review

    PubMed Central

    Spiliopoulos, Kyriakos; Giamouzis, Gregory; Karayannis, George; Karangelis, Dimos; Koutsias, Stelios; Kalogeropoulos, Andreas; Georgiopoulou, Vasiliki; Skoularigis, John; Butler, Javed; Triposkiadis, Filippos

    2012-01-01

    Heart failure is a major public health problem and its management requires a significant amount of health care resources. Even with administration of the best available medical treatment, the mortality associated with the disease remains high. As therapeutical strategies for heart failure have been refined, the number of patients suffering from the disease has expanded dramatically. Although heart transplantation still represents the gold standard therapeutical approach, the implantation of mechanical circulatory support devices (MCSDs) evolved to a well-established management for this disease. The limited applicability of heart transplantation caused by a shortage of donor organs and the concurrent expand of the patient population with end-stage heart failure led to a considerable utilization of MCSDs. This paper outlines the current status of mechanical circulatory support. PMID:22970403

  10. [Electrical properties of limb muscular tissue in acute circulatory hypoxia].

    PubMed

    Kolchev, A I; Nasonkin, O S

    1994-01-01

    The study was undertaken to examine dispersion of the complex electric resistance and capacitive impedance of limb muscular tissue in the frequency range of 1 to 100 kHz in acute circulatory hypoxia caused by blood exfusion from the common carotid artery at 10-50% of the circulatory blood volume (CBV) at the same time local blood flow and oxygen tension in muscles were measured. Blood loss of 10-30% of CBV resulted in increased muscular tissue electric conductivity. Decompensated blood loss was characterized by a steady growth of complex electric resistance and capacitive impedance. There were the greatest changes in electric conductivity in the frequency range of 1-10 kHz. PMID:7824348

  11. Fetal Circulatory Variation in an Acute Incident Causing Bradycardia

    PubMed Central

    Olgan, Safak; Sakinci, Mehmet; Dogan, Nasuh Utku; Cagliyan, Erkan; Altunyurt, Sabahattin

    2014-01-01

    Umbilical artery\\vein, middle cerebral artery, and ductus venosus Doppler velocimetry were performed at 33 weeks of gestation in the settings of an intrauterine growth restricted fetus during a heart rate deceleration. Interestingly, we recorded a sudden onset redistribution of fetal blood flow with fetal bradycardia. Spontaneous normalization of waveforms was observed once fetal heart rate returned to normal. Our case provides evidence to circulatory variation of a human fetus resulting from an acute incident causing bradycardia. PMID:25580322

  12. The adult literacy evaluator: An intelligent computer-aided training system for diagnosing adult illiterates

    NASA Technical Reports Server (NTRS)

    Yaden, David B., Jr.

    1992-01-01

    An important part of NASA's mission involves the secondary application of its technologies in the public and private sectors. One current application being developed is The Adult Literacy Evaluator, a simulation-based diagnostic tool designed to assess the operant literacy abilities of adults having difficulties in learning to read and write. Using ICAT system technology in addition to speech recognition, closed-captioned television (CCTV), live video and other state-of-the art graphics and storage capabilities, this project attempts to overcome the negative effects of adult literacy assessment by allowing the client to interact with an intelligent computer system which simulates real-life literacy activities and materials and which measures literacy performance in the actual context of its use. The specific objectives of the project are as follows: (1) To develop a simulation-based diagnostic tool to assess adults' prior knowledge about reading and writing processes in actual contexts of application; (2) to provide a profile of readers' strengths and weaknesses; and (3) to suggest instructional strategies and materials which can be used as a beginning point for remediation. In the first and developmental phase of the project, descriptions of literacy events and environments are being written and functional literacy documents analyzed for their components. Examples of literacy events and situations being considered included interactions with environmental print (e.g., billboards, street signs, commercial marquees, storefront logos, etc.), functional literacy materials (e.g., newspapers, magazines, telephone books, bills, receipts, etc.) and employment related communication (i.e., job descriptions, application forms, technical manuals, memorandums, newsletters, etc.). Each of these situations and materials is being analyzed for its literacy requirements in terms of written display (i.e., knowledge of printed forms and conventions), meaning demands (i

  13. 78 FR 34995 - Response Systems to Adult Sexual Assault Crimes Panel (Response Systems Panel); Notice of Federal...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-11

    ... of the Secretary Response Systems to Adult Sexual Assault Crimes Panel (Response Systems Panel... Sexual Assault Crimes Panel. DATES: A meeting of the Response Systems to Adult Sexual Assault Crimes... crimes involving adult sexual assault and related offenses under section 920 of title 10, United...

  14. Circulatory response to hyperthermia during acute normovolaemic haemodilution

    NASA Astrophysics Data System (ADS)

    Talwar, Anita; Fahim, M.

    Cats anaesthetized with a mixture of chloralose and urethane were exposed to heat stress in two groups. In the first group (n=10) of control animals, the effect of heat stress on haemodynamic variables was recorded at control haematocrit (HCT) of 42.0+/-1.0%. In a second group, the effect of heat stress was studied after induction of acute normovolaemic haemodilution (HCT of 13.0+/-1.0%). Haemodilution was induced to a maximum of 60% replacement of blood with dextran (mol.wt. 150000). Heat stress was induced by surface heating and core body temperature was raised from 37° C to 42° C. The effect of heat stress and haemodilution on various haemodynamic variables, viz. left ventricular pressure (LVP), left ventricular contractility (LVdP/dtmax), heart rate (HR), cardiac output (CO), arterial blood pressure (ABP), right atrial pressure (RAP), and arterial blood PO2, PCO2 and pH was examined. Haemodilution produced significant (P<0.05) increases in HR and CO but there were no significant (P>0.05) changes in ABP, RAP, LVdP/dtmax and total peripherial resistance (TPR). Hyperthermia caused a significant fall (P<0.05) in TPR. However, the percentage fall in TPR was higher in the control group. On exposure to heat stress, there were significant (P<0.05I increases in HR and CO in both the groups; however, HR and CO values were significantly (P<0.05) higher in the haemodiluted group compared to the control. The latter findings could be due either to the higher basal values of these variables with the fall in HCT or to inefficient cardiovascular regulatory mechanisms. The lack of efficient regulatory control under such severe stress conditions makes the cardiovascular system of anaemic animals more vulnerable to heat stress. In conclusion, the results of the present study showed deleterious effects of heat stress in both the groups. The higher values of HR and CO in the haemodiluted group may be responsible for circulatory failure at low HCT values, indicating a higher risk

  15. Anatomical plasticity in the adult Zebra Finch song system

    PubMed Central

    McDonald, Kathryn S.; Kirn, John R.

    2012-01-01

    In many songbirds, vocal learning-related cellular plasticity was thought to end following a developmental critical period. However, mounting evidence in one such species, the zebra finch, suggests that forms of plasticity common during song learning continue well into adulthood, including a reliance on auditory feedback for song maintenance. This reliance wanes with increasing age, in tandem with age-related increases in fine motor control. We investigated age-related morphological changes in the adult zebra finch song system by focusing on two cortical projection neuron types that a) share a common efferent target, b) are known to exhibit morphological and functional change during song learning, and c) exert opposing influences on song acoustic structure. Neurons in HVC (proper name) and the lateral magnocellular nucleus of the anterior nidopallium (LMAN) both project to the robust nucleus of the arcopallium (RA). During juvenile song learning and adult song maintenance, HVC promotes song syllable stereotypy while LMAN promotes learning and acoustic variability. Following retrograde labeling of these two cell types in adults, there were age-related increases in dendritic arbor in HVC-RA but not LMAN-RA neurons, resulting in an increase in the ratio of HVC-RA:LMAN-RA dendritic arbor. Differential growth of HVC relative to LMAN dendrites may relate to increases in song motor refinement, decreases in the reliance of song on auditory feedback, or both. Despite this differential growth with age, we also show that both cell types retain the capacity for experience-dependent growth. These results may provide insights on mechanisms that promote and constrain adult vocal plasticity. PMID:22473463

  16. Osmotic and hormonal stimulation of the third ventricular region of ducks: antidiuretic, circulatory and local neuronal responses.

    PubMed

    Simon-Oppermann, C; Kanosue, K; Günther, O; Schmid, H

    1989-01-01

    By means of local microperfusion of the 3rd cerebral ventricle, antidiuretic and circulatory responses to stimulations with various hypertonic solutions and norepinephrine were analyzed in conscious ducks. The results suggest ionic rather than osmometric responsiveness of periventricular osmoreceptive elements, which is in line with single unit recordings of periventricular neurons tested in vitro for their osmoresponsiveness. These neurons were located subependymally at the site of greatest responsiveness in vivo, and corresponded to morphologically identified neurons projecting to the neuroendocrine hypothalamo-pituitary system. Antidiuresis was combined with increases in arterial pressure and heart rate in response to hypertonic stimulations with monovalent cations; divalent cations produced long-lasting antidiuresis and equivocal circulatory responses. Norepinephrine elicited antidiuresis which was accompanied by arterial hypotension and bradycardia. Osmotically and norepinephrine induced antidiuresis was combined with increases of plasma ADH concentration. Different modulatory actions of intrinsic adrenergic, angiotensinergic and vasotocinergic neurons are suggested in hypothalamic control of autonomic functions. PMID:2554682

  17. Vaccination of Adult Patients with Systemic Lupus Erythematosus in Portugal

    PubMed Central

    Moraes-Fontes, Maria Francisca; Antunes, Ana Margarida; Gruner, Heidi; Riso, Nuno

    2016-01-01

    In the wake of the Portuguese vaccination program 50th anniversary it seems appropriate to review vaccination in patients with systemic lupus erythematosus. Controversial issues as regards the association between autoimmune diseases, infections, and vaccines are discussed as well as vaccine safety and efficacy issues as regards chronic immunosuppressant (IS) drug therapy. After a brief overview of national policies, specific recommendations are made as regards vaccination for adult patients with SLE with a particular focus on current IS therapy and unmet needs. PMID:27069477

  18. Hemocompatibility of Axial Versus Centrifugal Pump Technology in Mechanical Circulatory Support Devices.

    PubMed

    Schibilsky, David; Lenglinger, Matthias; Avci-Adali, Meltem; Haller, Christoph; Walker, Tobias; Wendel, Hans Peter; Schlensak, Christian

    2015-08-01

    The hemocompatible properties of rotary blood pumps commonly used in mechanical circulatory support (MCS) are widely unknown regarding specific biocompatibility profiles of different pump technologies. Therefore, we analyzed the hemocompatibility indicating markers of an axial flow and a magnetically levitated centrifugal device within an in vitro mock loop. The HeartMate II (HM II; n = 3) device and a CentriMag (CM; n = 3) adult pump were investigated in a human whole blood mock loop for 360 min using the MCS devices as a driving component. Blood samples were analyzed by enzyme-linked immunosorbent assay for markers of coagulation, complement system, and inflammatory response. There was a time-dependent activation of the coagulation (thrombin-antithrombin complexes [TAT]), complement (SC5b-9), and inflammation system (polymorphonuclear [PMN] elastase) in both groups. The mean value of TAT (CM: 4.0 μg/L vs. 29.4 μg/L, P < 0.001; HM II: 4.5 μg/L vs. 232.2 μg/L, P < 0.05) and PMN elastase (CM: 53.4 ng/mL vs. 253.8 ng/mL, P < 0.05; HM II: 28.0 ng/mL vs. 738.8 ng/mL, P < 0.001) significantly increased from baseline until the end of the experiments (360 min). After 360 min, TAT and PMN values were significantly higher in the HM II group compared with the values in the CM adult group. The values of SC5b-9 increased from baseline to 360 min in the CM group (CM: 141.8 ng/mL vs. 967.9 ng/mL, P < 0.05) and the HM II group. However, the increase within the HM II group (97.3 vs. 2462.0, P = 0.06) and the comparison of the 360-min values between CM group and HM II group did not reach significance (P = 0.18). The activation of complement, coagulation, and inflammation system showed a time-dependent manner in both devices. The centrifugal CM device showed significantly lower activation of coagulation and inflammation than that of the HM II axial flow pump. Both HM II and CM have demonstrated an acceptable

  19. 78 FR 25972 - Establishment of the Response Systems to Adult Sexual Crimes Panel

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-03

    ... shall provide recommendations on how to improve the effectiveness of the investigation, prosecution, and..., including the administration of the UCMJ, and the investigation, prosecution, and adjudication of adult... systems for the investigation, prosecution, and adjudication of adult sexual assault crimes....

  20. Sample site selection for tracer studies applying a unidirectional circulatory approach

    SciTech Connect

    Layman, D.K.; Wolfe, R.R.

    1987-08-01

    The optimal arterial or venous sites for infusion and sampling during isotopic tracer studies have not been established. This study determined the relationship of plasma and tissue enrichment (E) when isotopes were infused in an artery and sampled from a vein (av mode) or infused in a vein and sampled from an artery (va mode). Adult dogs were given primed constant infusions of (3-/sup 13/C)lactate, (1-/sup 13/C)leucine, and /sup 14/C-labeled bicarbonate. Simultaneous samples were drawn from the vena cava, aortic arch, and breath. Tissue samples were removed from skeletal muscle, liver, kidney, and gut. Breath samples were analyzed for /sup 14/CO/sub 2/ by liquid scintillation counting and plasma isotopic enrichments of (/sup 13/C)lactate, (/sup 13/C)leucine, and alpha-(/sup 13/C)ketoisocaproate (KIC) were determined by gas chromatography-mass spectrometry. By using the va mode, the plasma E for lactate and leucine were 30-40% above tissue E. The av mode provided an accurate reflection of tissue E for lactate, which equilibrates rapidly with tissues, and a reasonable estimate for leucine, which exchanges more slowly. The isotopic enrichment of plasma KIC more directly reflected tissue leucine E than did plasma leucine E, and KIC enrichment was insensitive to sampling site. We also evaluated theoretically a circulatory model that predicts venous isotopic enrichments when the va mode is used. We conclude that the av mode is optimal but that the problems arising from use of the va mode can be overcome by use of a metabolic product (i.e., KIC) or by calculation of venous specific activity with our circulatory mode.

  1. Central nervous system vasculitis in adults and children.

    PubMed

    Twilt, Marinka; Benseler, Susanne M

    2016-01-01

    Primary angiitis of the central nervous system (PACNS) is an inflammatory brain disease targeting the cerebral blood vessels, leading to a wide spectrum of signs and symptoms, including neurologic deficits, cognitive dysfunction, and psychiatric symptoms. The inflammation could be reversible if diagnosed and treated early. The diagnosis requires the careful consideration and rapid evaluation of systemic underlying conditions and disease mimics. The differential diagnosis is distinctly different for angiography-positive and -negative PACNS subtypes and differs depending on age, so there is childhood PACNS or adult PACNS. Distinct disease subtypes have been described, with characteristic disease course, neuroimaging findings, and histopathologic features. Novel and traditional biomarkers, including von Willebrand factor antigen and cytokine levels, can help diagnose, and define subtype and disease activity. Treatment of PACNS should be tailored to the disease subtypes and clinical symptoms. Beyond immunosuppression it should include medications to control symptoms in order to support and enhance the child's or adult's ability to actively participate in rehabilitation. The mortality of PACNS has decreased; studies determining the morbidity and its determinants are urgently needed. PMID:27112683

  2. Recommendations for donation after circulatory death kidney transplantation in Europe.

    PubMed

    van Heurn, L W Ernest; Talbot, David; Nicholson, Michael L; Akhtar, Mohammed Z; Sanchez-Fructuoso, Ana I; Weekers, Laurent; Barrou, Benoit

    2016-07-01

    Donation after circulatory death (DCD) donors provides an invaluable source for kidneys for transplantation. Over the last decade, we have observed a substantial increase in the number of DCD kidneys, particularly within Europe. We provide an overview of risk factors associated with DCD kidney function and survival and formulate recommendations from the sixth international conference on organ donation in Paris, for best-practice guidelines. A systematic review of the literature was performed using Ovid Medline, Embase and Cochrane databases. Topics are discussed, including donor selection, organ procurement, organ preservation, recipient selection and transplant management. PMID:26340168

  3. Factors associated with gingival inflammation among adults with systemic sclerosis

    PubMed Central

    Yuen, Hon K.; Weng, Yanqiu; Reed, Susan G.; Summerlin, Lisa M.; Silver, Richard M.

    2013-01-01

    OBJECTIVE To identify factors associated with increased gingival inflammation in adults with systemic sclerosis (SSc, scleroderma). METHODS In this cross-sectional study, forty-eight adults with SSc received assessment of gingival inflammation using Löe and Silness gingival index (LSGI), measurement of oral aperture, and evaluation of manual dexterity to perform oral hygiene using the Toothbrushing Ability Test, as well as completion of an oral health-related questionnaire. RESULTS Three explanatory variables in the final multiple predictor models for the LSGI outcome were statistically significant -- manual dexterity to perform oral hygiene, flossing in the evening, and SSc subtype, with higher LSGI score among those with impaired manual dexterity, not flossing in the evening and diffuse form of SSc. In addition, posterior teeth had higher LSGI scores compared to that of the anterior teeth after adjusting for other variables CONCLUSIONS Results suggest that dental health professionals take manual dexterity into consideration when educating patients with SSc to improve their oral hygiene, and educate them on paying more attention on cleaning their posterior teeth and the importance of flossing in the evening -- especially those who only floss once a day or less often. PMID:23611650

  4. Development of an Evaluation System for the Arizona Adult Education Program: Report on Phase I.

    ERIC Educational Resources Information Center

    Sandler, Linda; Wetzel, Linda; Sullivan, Howard

    The Division of Adult Education in the Arizona Department of Education and the Arizona Adult Literacy and Technology Resource Center contracted with the Morrison Institute for Public Policy to develop an evaluation system for Arizona's adult education program. During phase I, the institute analyzed existing program data on Arizona's adult…

  5. Integrated Adult Education Data System. Policy Option Paper on Strategic Recommendation 8. First Edition.

    ERIC Educational Resources Information Center

    Porter, Dennis

    This document addresses the recommendation contained in the 1989 California Strategic Plan for Adult Education for an integrated adult education data system. The recommendation proposes collecting and organizing community adult education information into groups of data on: program services, program delivery, learner characteristics, and learning…

  6. A Follow-up Study of Adult Graduates of the University of Wisconsin System. Technical Report.

    ERIC Educational Resources Information Center

    Mishler, Carol

    A study surveyed University of Wisconsin System adult graduates (age 29 and over at graduation) from traditional campus programs to determine the impact of a bachelor's degree on their lives and work three to five years after graduation. The main interest was job changes experienced by adult graduates. Of 441 adults surveyed, 254 returned the…

  7. The French airbridge for circulatory support in the Carribean†

    PubMed Central

    Lebreton, Guillaume; Sanchez, Bruno; Hennequin, Jean-Luc; Resière, Dabor; Hommel, Didier; Léonard, Christian; Mehdaoui, Hossein; Roques, François

    2012-01-01

    OBJECTIVES We report the assessment and the activities for the first year of our airborne circulatory support mobile unit (CSMU) in the French Caribbean. METHODS From January 2010 to June 2011, 12 patients (mean age = 35.7 years; range: 15–62 years; sex ratio = 1:1) were attended outside Martinique by our CSMU and transferred to our unit by air. RESULTS Eight patients had acute respiratory distress syndrome and were assisted by veno-venous extra corporeal membrane oxygenation (ECMO) four had refractory cardiogenic shock, assisted by extra corporeal life support (ECLS). The average air transfer distance for patients was 912 km (range: 198–1585 km). The average flying time was 124 min (range: 45–255 min). The aircraft used were heliciopter, military transport or private jet. The setting-up of assistance devices and transfer of patients was uneventful. One patient subsequently benefited from heart transplantation after long-term circulatory support. One patient died under ECMO support after 51 days of assistance and another died on the 60th day after withdrawal of ECLS. CONCLUSIONS CSMUs can be very efficient in providing support to patients in refractory shock, when remote from a cardiac surgery centre. The airborne transfer of patients on ECMO/ECLS can be achieved safely, even over long distances. PMID:22659268

  8. Ethical controversies in organ donation after circulatory death.

    PubMed

    2013-05-01

    The persistent mismatch between the supply of and need for transplantable organs has led to efforts to increase the supply, including controlled donation after circulatory death (DCD). Controlled DCD involves organ recovery after the planned withdrawal of life-sustaining treatment and the declaration of death according to the cardiorespiratory criteria. Two central ethical issues in DCD are when organ recovery can begin and how to manage conflicts of interests. The "dead donor rule" should be maintained, and donors in cases of DCD should only be declared dead after the permanent cessation of circulatory function. Permanence is generally established by a 2- to 5-minute waiting period. Given ongoing controversy over whether the cessation must also be irreversible, physicians should not be required to participate in DCD. Because the preparation for organ recovery in DCD begins before the declaration of death, there are potential conflicts between the donor's and recipient's interests. These conflicts can be managed in a variety of ways, including informed consent and separating the various participants' roles. For example, informed consent should be sought for premortem interventions to improve organ viability, and organ procurement organization personnel and members of the transplant team should not be involved in the discontinuation of life-sustaining treatment or the declaration of death. It is also important to emphasize that potential donors in cases of DCD should receive integrated interdisciplinary palliative care, including sedation and analgesia. PMID:23629612

  9. The importance of the renin-angiotensin system in normal cardiovascular homeostasis

    NASA Technical Reports Server (NTRS)

    Haber, E.

    1975-01-01

    Studies were carried out on adult mongrel dogs (20 to 30 kilograms) to investigate the importance of the renin-angiotensin system. Results indicate that the renin-angiotensin system plays a major role in the maintenance of circulatory homeostasis when extracellular fluid volume is depleted. It was also found that angiotensin II concentration, in addition to renal perfusion pressure, is a factor in the regulation of renin release.

  10. Axonal Elongation into Peripheral Nervous System ``Bridges'' after Central Nervous System Injury in Adult Rats

    NASA Astrophysics Data System (ADS)

    David, Samuel; Aguayo, Albert J.

    1981-11-01

    The origin, termination, and length of axonal growth after focal central nervous system injury was examined in adult rats by means of a new experimental model. When peripheral nerve segments were used as ``bridges'' between the medulla and spinal cord, axons from neurons at both these levels grew approximately 30 millimeters. The regenerative potential of these central neurons seems to be expressed when the central nervous system glial environment is changed to that of the peripheral nervous system.

  11. Analysis of circulatory mitochondrial DNA level after cardiac surgery with cardiopulmonary bypass and potential prognostic implications.

    PubMed

    Qin, Chaoyi; Gu, Jun; Qian, Hong; Meng, Wei

    2016-01-01

    Our research letter found that circulatory mtDNA level increased after the end of CPB and positive correlations between mtDNA and peak CRP level, peak BNP level, and peak PCT level, which revealed the prognostic role of perioperative circulatory mtDNA level in patients who underwent cardiopulmonary bypass. PMID:27316503

  12. 9 CFR 309.4 - Livestock showing symptoms of certain metabolic, toxic, nervous, or circulatory disturbances...

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ..., toxic, nervous, or circulatory disturbances, nutritional imbalances, or infectious or parasitic diseases... metabolic, toxic, nervous, or circulatory disturbances, nutritional imbalances, or infectious or parasitic diseases. 309.4 Section 309.4 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT...

  13. The course of circulatory and cerebral recovery after circulatory arrest: influence of pre-arrest, arrest and post-arrest factors.

    PubMed

    Jørgensen, E O; Holm, S

    1999-11-01

    We evaluated the influence of pre-arrest, arrest and post-arrest factors on circulatory and neurological recovery for up to 1 year following circulatory arrest of cardio-pulmonary aetiology in 231 patients. Initially, all patients were unconscious and 106 had some cortical activity recorded in the immediate post-resuscitation EEG (Group I), while 125 had no such activity initially (Group II). The following variables were explored: age, sex, medical history, cause and location of arrest, initial cardiac dysrhythmia, duration of life support, metabolic acidosis, pulse-pressure product and heart pump function capacity early after resuscitation. Outcome measures were duration and quality of circulatory survival, cause of death, neurological recovery and ultimate outcome. First year survival was 33% in Group I and 16% in Group II. Severe heart failure and brain death occurred mainly in Group II. Circulatory recovery was negatively influenced by out-of-hospital arrest, metabolic acidosis and pulse-pressure products below 150. Neurological recovery was negatively influenced by initial dysrhythmias other than ventricular fibrillation, pulse-pressure products below 150, post-arrest heart failure and/or pulmonary complications. It seems that circulatory and cerebral outcomes are mainly determined by the global ischaemic insults sustained during the circulatory arrest period. PMID:10625157

  14. Circulatory mobility in post-Mao China: temporary migrants in Kaiping county, Pearl River Delta region.

    PubMed

    Woon, Y

    1993-01-01

    "Since the 1980s, it has been possible for the Chinese peasant household to diversify its economic base by making use of its social networks to place members in a distant community as migrant workers. Through a microstudy of 50 such migrants in Kaiping County in the Pearl River Delta region, this article illustrates the interplay between macro, meso, and micro factors in the causes and processes of circulatory mobility in post-Mao China. It is found that Hong Kong's search for cheap labor, the PRC's household registration system, and Kaiping's strong localism provide the context in which migrants and their households have to adjust. The particular behavior pattern of these migrants also bears the stamp of their rational household decision-making processes as well as their feelings of moral obligation toward their kin in their community of origin." PMID:12287570

  15. [Circulatory responses to adrenaline administration at rest, during physical loading and under anesthesia].

    PubMed

    Palets, L D; Lissova, O I

    1978-06-01

    In chronic experiments, the effects of 0.5 and 2.5 mcg/kg/min adrenaline infusion on central hemodynamics of conscions and anesthetized dogs were studied. Circulatory reactions elicited by blood volume change and running on treadmill were compared before and during adrenaline infusion. In conscions dogs, infusion of 0.5 mcg/kg/min adrenaline increased cardiac output and central venous pressure, decreased systemic vascular resistance and pumping heart capacity, while mean arterial pressure and heart rate were unchanged. It did not change pumping heart capacity in anesthetized dogs. Infusion of 0.5 mcg/kg/min adrenaline did not change the tendency of hemodynamic reactions on hemorrhage and blood transfusion. Exercise during adrenaline infusion resulted in a more cardiac output increase and lesser heart rate increase than without adrenaline. Infusion of 2.5 mcg/kg/min adrenaline induced more significant increase of arterial pressure in conscions dogs than in anesthetized. PMID:680266

  16. Mechanical circulatory support: strategies and outcomes in pediatric congenital heart disease.

    PubMed

    Kirklin, James K; Bennett Pearce, F; Dabal, Robert J; Carlo, Waldemar F

    2014-01-01

    Patients with acute or progressive heart failure in the setting of congenital heart disease may need mechanical circulatory support (MCS) to enhance survival while awaiting cardiac transplantation. Because the majority of MCS devices are implanted after prior cardiac operations, special precautions are necessary at the time of implant. MCS in single ventricle patients usually requires ventricular and aortic cannulation, with a systemic to pulmonary artery shunt for pulmonary blood flow. Limited outcomes data is available, with less than 15% of pediatric MCS patients having congenital heart disease. The Berlin EXCOR is the only durable device currently available for infants. Neurologic complications are the major cause of mortality, and survival during support is poor for infants <5 kg. Patients post-Fontan with acute cardiac failure and/or respiratory failure are at high risk for death before transplant and should be considered for MCS therapy. Several emerging miniature continuous flow devices will soon broaden the landscape of available pediatric devices. PMID:24725719

  17. Burden of disease in adults admitted to hospital in a rural region of coastal Kenya: an analysis of data from linked clinical and demographic surveillance systems

    PubMed Central

    Etyang, Anthony O; Munge, Kenneth; Bunyasi, Erick W; Matata, Lena; Ndila, Carolyne; Kapesa, Sailoki; Owiti, Maureen; Khandwalla, Iqbal; Brent, Andrew J; Tsofa, Benjamin; Kabibu, Pamela; Morpeth, Susan; Bauni, Evasius; Otiende, Mark; Ojal, John; Ayieko, Philip; Knoll, Maria D; Smeeth, Liam; Williams, Thomas N; Griffiths, Ulla K; Scott, J Anthony G

    2014-01-01

    Summary Background Estimates of the burden of disease in adults in sub-Saharan Africa largely rely on models of sparse data. We aimed to measure the burden of disease in adults living in a rural area of coastal Kenya with use of linked clinical and demographic surveillance data. Methods We used data from 18 712 adults admitted to Kilifi District Hospital (Kilifi, Kenya) between Jan 1, 2007, and Dec 31, 2012, linked to 790 635 person-years of observation within the Kilifi Health and Demographic Surveillance System, to establish the rates and major causes of admission to hospital. These data were also used to model disease-specific disability-adjusted life-years lost in the population. We used geographical mapping software to calculate admission rates stratified by distance from the hospital. Findings The main causes of admission to hospital in women living within 5 km of the hospital were infectious and parasitic diseases (303 per 100 000 person-years of observation), pregnancy-related disorders (239 per 100 000 person-years of observation), and circulatory illnesses (105 per 100 000 person-years of observation). Leading causes of hospital admission in men living within 5 km of the hospital were infectious and parasitic diseases (169 per 100 000 person-years of observation), injuries (135 per 100 000 person-years of observation), and digestive system disorders (112 per 100 000 person-years of observation). HIV-related diseases were the leading cause of disability-adjusted life-years lost (2050 per 100 000 person-years of observation), followed by non-communicable diseases (741 per 100 000 person-years of observation). For every 5 km increase in distance from the hospital, all-cause admission rates decreased by 11% (95% CI 7–14) in men and 20% (17–23) in women. The magnitude of this decline was highest for endocrine disorders in women (35%; 95% CI 22–46) and neoplasms in men (30%; 9–45). Interpretation Adults in rural Kenya face a combined

  18. 78 FR 53429 - Response Systems to Adult Sexual Assault Crimes Panel (Response Systems Panel); Notice of Federal...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-29

    ... of the Secretary Response Systems to Adult Sexual Assault Crimes Panel (Response Systems Panel... Floor, Washington, DC 20001. DATES: A meeting of the Response Systems to Adult Sexual Assault Crimes... sexual assault and related offenses under section 920 of title 10, United States Code (article 120 of...

  19. A biokinetic model for systemic technetium in adult humans

    SciTech Connect

    Leggett, Richard Wayne; Giussani, Augusto

    2015-04-10

    The International Commission on Radiological Protection (ICRP) currently is updating its biokinetic and dosimetric models for internally deposited radionuclides. Technetium (Tc), the lightest element that exists only in radioactive form, has two important isotopes from the standpoint of potential risk to humans: the long-lived isotope 99Tm(T1/2=2.1x105 y) is present in high concentration in nuclear waste, and the short-lived isotope 99mTc (T1/2=6.02 h) is the most commonly used radionuclide in diagnostic nuclear medicine. This paper reviews data on the biological behavior of technetium and proposes a biokinetic model for systemic technetium in the adult human body for use in radiation protection. Compared with the ICRP s current occupational model for systemic technetium, the proposed model provides a more realistic description of the paths of movement of technetium in the body; provides greater consistency with experimental and medical data; and, for most radiosensitive organs, yields substantially different estimates of cumulative activity (total radioactive decays within the organ) following uptake of 99Tm or 99mTc to blood.

  20. A biokinetic model for systemic technetium in adult humans

    DOE PAGESBeta

    Leggett, Richard Wayne; Giussani, Augusto

    2015-04-10

    The International Commission on Radiological Protection (ICRP) currently is updating its biokinetic and dosimetric models for internally deposited radionuclides. Technetium (Tc), the lightest element that exists only in radioactive form, has two important isotopes from the standpoint of potential risk to humans: the long-lived isotope 99Tm(T1/2=2.1x105 y) is present in high concentration in nuclear waste, and the short-lived isotope 99mTc (T1/2=6.02 h) is the most commonly used radionuclide in diagnostic nuclear medicine. This paper reviews data on the biological behavior of technetium and proposes a biokinetic model for systemic technetium in the adult human body for use in radiation protection.more » Compared with the ICRP s current occupational model for systemic technetium, the proposed model provides a more realistic description of the paths of movement of technetium in the body; provides greater consistency with experimental and medical data; and, for most radiosensitive organs, yields substantially different estimates of cumulative activity (total radioactive decays within the organ) following uptake of 99Tm or 99mTc to blood.« less

  1. Pulmonary Hypertension in the Era of Mechanical Circulatory Support.

    PubMed

    Krishnamurthy, Yamini; Cooper, Lauren B; Parikh, Kishan S; Felker, G Michael; Milano, Carmelo A; Rogers, Joseph G; Hernandez, Adrian F; Patel, Chetan B

    2016-01-01

    Left heart disease (LHD) represents the most common cause of pulmonary hypertension (PH), and is associated with worse prognosis compared with LHD without PH. In addition, PH due to LHD may prevent patients from receiving heart transplantation, because of risk of perioperative right ventricular failure. Current literature lacks comprehensive descriptions and management strategies of PH due to LHD. In this review, we summarize the literature that is available to highlight the definition, pathogenesis, and prognosis of PH due to LHD. Furthermore, we discuss the use of mechanical circulatory support (MCS) in this population. Finally, we provide recommendations regarding the management and reassessment of PH due to LHD in the specific context of MCS. PMID:27442856

  2. The prevention of transfusion-associated circulatory overload.

    PubMed

    Alam, Asim; Lin, Yulia; Lima, Ana; Hansen, Mark; Callum, Jeannie L

    2013-04-01

    Transfusion-associated circulatory overload (TACO) is an important and potentially injurious complication of transfusion that is underappreciated by clinicians. Risk factors for TACO include being at an extreme of age, having preexisting cardiac and/or (potentially) renal dysfunction, acute myocardial infarction, and individuals receiving plasma. Keys to preventing TACO, aside from identifying high-risk individuals, should be multifaceted. We advocate for the widespread use of pretransfusion checklists and implementation of nonemergent transfusion protocols. We suggest the regular use of pretransfusion diuretics in high-risk individuals. When a transfusion is required, we believe that "critical" nursing supervision and leadership are instrumental in the coordination of slow transfusion rates on computerized infusion pumps and ensuring patients are appropriately monitored. We believe that using these methodologies on a global scale will prevent many TACO events and minimize the severity when it does occur. PMID:23465703

  3. A MODEL INFORMATION SYSTEM FOR THE ADULT EDUCATION PROFESSION.

    ERIC Educational Resources Information Center

    DECROW, ROGER

    A MODEL OF INFORMATION SERVICES FOR THE ADULT EDUCATION PROFESSION PROVIDES FOR--(1) ACCESS TO THE LITERATURE THROUGH BIBLIOGRAPHIES, REVIEWS, AND MECHANIZED RETRIEVAL, (2) PHYSICAL ACCESS (MAINLY IN MICROFORM), (3) SPECIALIZED INFORMATION SERVICES LINKED WITH ONE ANOTHER AND THE ERIC CLEARINGHOUSE ON ADULT EDUCATION, (4) COORDINATION, RESEARCH,…

  4. No Time To Play: Youthful Offenders in Adult Correctional Systems.

    ERIC Educational Resources Information Center

    Glick, Barry; Sturgeon, William

    The number of juveniles tried as adults increased by 71 percent from 1985 through 1994. A comprehensive look at the growing population of youthful offenders housed in adult facilities and guidance in managing this special needs population is provided. Section 1, "History and Current Realities," includes a brief review of the history of the…

  5. ["Tracking" the magnitude of arterial pressure in the circulatory system].

    PubMed

    Amosov, N M; Beregovskiĭ, B A; Lissova, O I; Palets, B L

    1976-11-01

    Steady--state characteristics of arterial and venous pressure, cardiac output, total peripheral resistance, heart rate, and pumping heart capacity depending on blood volume change were studied in dogs under conditons of rest, exercises, light and deep narcosis. The tracking mean arterial pressure was found to be the main principle of hemodynamic regulation. In unanesthetized animals the tracking is based on heart regulation component mainly, while under light narcosis it is the vascular component. In deep narcosis it is the suppressed tracking principle: arterial pressure change is proportional to blood volume changes. PMID:1022536

  6. Influence of psoriasis on circulatory system function assessed in echocardiography.

    PubMed

    Milaniuk, Sylwia; Pietrzak, Aldona; Mosiewicz, Barbara; Mosiewicz, Jerzy; Reich, Kristian

    2015-12-01

    Psoriasis vulgaris is a chronic disease with a multifactorial pathogenesis. It affects about 2-4 % of the population all over the world. In course of psoriatic arthritis, joints' damages are observed. In patients with psoriasis vulgaris and psoriatic arthritis, there is increased morbidity and mortality caused by cardiovascular diseases observed. The aim of the study is to analyze the echocardiography of patients with psoriasis vulgaris and psoriatic arthritis on the basis of the literature available in PubMed database. Abnormalities found in echocardiography of patients with psoriasis include valvular defects (40.7 % of the patients), left ventricle diastolic dysfunction (27.8 %), and left ventricle hypertrophy (11.1 %). Left ventricle's systolic disorders, increased aorta stiffness index and increased pulmonary artery blood pressure were also observed in this group of patients. PMID:26121943

  7. Respiratory and Circulatory Systems, Science (Experimental): 5363.04.

    ERIC Educational Resources Information Center

    Weiss, Alan; And Others

    This biology course is especially recommended for students interested in a vocation in nursing, medical technology, dental hygiene or other para-medical areas. In part, it is considered a second course in biology. The course includes an intensive in-depth study of the respiratory structures, nerve and chemical control of breathing, gas exchange,…

  8. A Study of the Coordination of the Higher Adult Education Function Within State Systems.

    ERIC Educational Resources Information Center

    Parker, Robert

    The paper reports the findings of a two-tier data survey involving the chief executive officers of State systems of higher education in determining the extent of their coordination-control of higher adult education. The first general phase of the study indicated that 42 of the 50 systems surveyed had responsibility for higher adult education. In…

  9. Developing a National Outcome Reporting System for the Adult Education Program.

    ERIC Educational Resources Information Center

    Condelli, Larry; Kutner, Mark

    This document was developed to help adult education stakeholders involved in efforts to develop/test/implement a national reporting system of outcome measures documenting students' performance in the federally funded adult education program. The report reviews existing/planned accountability systems, examines major issues involved in developing an…

  10. The Arlington Adult Learning System (AALS) Final Report, October 1992-December 1994.

    ERIC Educational Resources Information Center

    Arlington County Public Schools, VA. REEP, Arlington Education and Employment Program.

    The Arlington (Virginia) Adult Learning System (AALS), a program designed to link resources and enhance services of English-as-a-Second-Language (ESL) providers, is described. The AALS is a consortium in which an adult education provider (the public school system) coordinates efforts of its own organization with a community-based organization, a…

  11. Space Radiation Cancer, Circulatory Disease and CNS Risks for Near Earth Asteroid and Mars Missions: Uncertainty Estimates for Never-Smokers

    NASA Technical Reports Server (NTRS)

    Cucinotta, Francis A.; Chappell, Lori J.; Wang, Minli; Kim, Myung-Hee

    2011-01-01

    The uncertainties in estimating the health risks from galactic cosmic rays (GCR) and solar particle events (SPE) are a major limitation to the length of space missions and the evaluation of potential risk mitigation approaches. NASA limits astronaut exposures to a 3% risk of exposure induced cancer death (REID), and protects against uncertainties in risks projections using an assessment of 95% confidence intervals after propagating the error from all model factors (environment and organ exposure, risk coefficients, dose-rate modifiers, and quality factors). Because there are potentially significant late mortality risks from diseases of the circulatory system and central nervous system (CNS) which are less well defined than cancer risks, the cancer REID limit is not necessarily conservative. In this report, we discuss estimates of lifetime risks from space radiation and new estimates of model uncertainties are described. The key updates to the NASA risk projection model are: 1) Revised values for low LET risk coefficients for tissue specific cancer incidence, with incidence rates transported to an average U.S. population to estimate the probability of Risk of Exposure Induced Cancer (REIC) and REID. 2) An analysis of smoking attributable cancer risks for never-smokers that shows significantly reduced lung cancer risk as well as overall cancer risks from radiation compared to risk estimated for the average U.S. population. 3) Derivation of track structure based quality functions depends on particle fluence, charge number, Z and kinetic energy, E. 4) The assignment of a smaller maximum in quality function for leukemia than for solid cancers. 5) The use of the ICRP tissue weights is shown to over-estimate cancer risks from SPEs by a factor of 2 or more. Summing cancer risks for each tissue is recommended as a more accurate approach to estimate SPE cancer risks. 6) Additional considerations on circulatory and CNS disease risks. Our analysis shows that an individual s

  12. Structural design of a newly developed pediatric circulatory assist device for Fontan circulation by using shape memory alloy fiber.

    PubMed

    Shiraishi, Y; Sugai, T K; Tanaka, A; Yoshizawa, M; Yambe, T; Yamada, A; Omran, M H; Shiga, T; Kitano, T; Kamiya, K; Mochizuki, S; Miura, H; Homma, D; Yamagishi, M

    2011-01-01

    Total cavopulmonary connection (TCPC) is commonly applied for the surgical treatment of congenital heart disease such as single ventricle in pediatric patients. Patients with no ventricle in pulmonary circulation are treated along with Fontan algorithm, in which the systemic venous return is diverted directly to the pulmonary artery without passing through subpulmonary ventricle. In order to promote the pulmonary circulation after Fontan procedure, we developed a newly designed pulmonary circulatory assist device by using shape memory alloy fibers. We developed a pulmonary circulatory assist device as a non-blood contacting mechanical support system in pediatric patients with TCPC. The device has been designed to be installed like a cuff around the ePTFE TCPC conduit, which can contract from outside. We employed a covalent type functional anisotropic shape memory alloy fiber (Biometal, Toki Corporation, Tokyo Japan) as a servo actuator of the pulmonary circulatory assist device. The diameter of this fiber was 100 microns, and its contractile frequency was 2-3 Hz. Heat generation with electric current contracts these fibers and the conduit. The maximum contraction ratio of this fiber is about 7% in length. In order to extend its contractile ratio, we fabricated and installed mechanical structural units to control the length of fibers. In this study, we examined basic contractile functions of the device in the mock system. As a result, the internal pressure of the conduit increased to 63 mmHg by the mechanical contraction under the condition of 400 msec-current supply in the mock examination with the overflow tank of 10 mmHg loading. PMID:22256284

  13. Impact of different treatment of whole-body cryotherapy on circulatory parameters.

    PubMed

    Bonomi, Felice Giulio; De Nardi, Massimo; Fappani, Aldo; Zani, Viviana; Banfi, Giuseppe

    2012-04-01

    Cryotherapy is commonly used as a procedure to relieve pain symptoms, particularly in inflammatory diseases, injuries and overuse symptoms. A peculiar form of cold therapy or stimulation was proposed 30 years ago for the treatment of rheumatic diseases. The therapy consists in the exposure to very cold air in special cryochambers. The air is maintained at temperatures between -110 and -160°C. The treatment was named whole-body cryotherapy (WBC). It consists in a brief exposure to extreme cold in a temperature-controlled chamber. It is applied to relieve pain and inflammatory symptoms caused by numerous disorders, particularly those associated with rheumatic conditions, and it is recommended for the treatment of arthritis, fibromyalgia and ankylosing spondylitis. The aim of this study was to investigate the effects of different treatment of WBC on blood pressure (BP) and heart rate (HR) parameters in adult subjects characterized from non-pathological values of BP. Eighty subjects (36 females, 44 males, age range 19-80 years) submitted to 4-17 WBC applications for a total of 816 treatments were recruited. Immediately before and after each WBC application systolic and diastolic BP and HR were measured and recorded. We did not find significant differences in BP and HR (p > 0.05). WBC seems to be safe with respect to unwanted BP and HR alterations for adult patients. An individual monitoring of subjects is recommended over the treatment, but pathological changes of circulatory parameters can be considered rare and occasional. PMID:22310979

  14. Erythrocyte Saturated Fatty Acids and Systemic Inflammation in Adults

    PubMed Central

    Mu, Lin; Mukamal, Kenneth J.; Naqvi, Asghar Z.

    2014-01-01

    Objective The role of saturated fatty acids (SFAs) in chronic disease remains controversial; inflammation is one pathway by which SFAs influence the risk of chronic disease. We aim to investigate the associations between red blood cell (RBC) phospholipid SFAs and systemic inflammation. Methods As part of a randomized controlled trial, we measured RBC phospholipid FA composition among 55 generally healthy adults twice at three-month intervals. We estimated associations of RBC total SFAs and two major SFA subtypes, palmitic and stearic acids, with C-reactive protein (CRP), interleukin-6 (IL-6), white blood count (WBC), and a composite inflammation measure using generalized estimating equations in multivariable FA substitution models. Results Mean (±SD) SFA level across both visits was 45±3% of the total RBC FAs, mainly palmitic (21±1%) and stearic (17±3%) acids. In models adjusted for age, sex, race, smoking, BMI, statin use, aspirin use, transunsaturated FAs, and ω3FAs, SFAs were significantly associated with IL-6 (20% increase per 1 SD increment; 95% CI: 0.03%, 43%; P=0.05) and the composite inflammation measure (P=0.05) and marginally associated with CRP (34% increase; − 1%, 81%; P=0.06), but not associated with WBC. Stearic acid was positively associated with CRP (35% increase; 2%, 79%; P=0.04). Palmitic acid was marginally associated with the composite inflammation measure (P=0.06) and, upon additional ω6FA adjustment, significantly associated with IL-6 (15% increase; 0.4%, 27%; P=0.006). Conclusions RBC SFAs, which represent longer-term dietary intake, are positively associated with inflammation. In particular, palmitic acid was associated with IL-6, and stearic acid was associated with CRP after multivariable adjustment. PMID:25280420

  15. Hot-water heating system having an air eliminator

    SciTech Connect

    Pompei, F.

    1984-06-26

    An improved forced-liquid flow, circulatory system for removing gas entrained or dissolved in the liquid. The system includes a circulatory liquid-flow network and means for forcing the liquid to flow through the circulatory network. A by-pass line is situated around the region where the lowest gas solubility in the liquid occurs in the circulatory network. Such lowest gas solubility occurs at the point of generally highest temperature and lowest pressure, as determined most precisely by Henry's Law. Gas-liquid separator means is located in the by-pass line. The separator means separates the gas from the liquid and expels the gas from the circulatory network.

  16. Optoacoustic measurement of central venous oxygenation for assessment of circulatory shock: clinical study in cardiac surgery patients

    NASA Astrophysics Data System (ADS)

    Petrov, Irene Y.; Prough, Donald S.; Kinsky, Michael; Petrov, Yuriy; Petrov, Andrey; Henkel, S. Nan; Seeton, Roger; Salter, Michael G.; Esenaliev, Rinat O.

    2014-03-01

    Circulatory shock is a dangerous medical condition, in which blood flow cannot provide the necessary amount of oxygen to organs and tissues. Currently, its diagnosis and therapy decisions are based on hemodynamic parameters (heart rate, blood pressure, blood gases) and mental status of a patient, which all have low specificity. Measurement of mixed or central venous blood oxygenation via catheters is more reliable, but highly invasive and associated with complications. Our previous studies in healthy volunteers demonstrated that optoacoustic systems provide non-invasive measurement of blood oxygenation in specific vessels, including central veins. Here we report our first results of a clinical study in coronary artery bypass graft (CABG) surgery patients. We used a medical-grade OPO-based optoacoustic system developed in our laboratory to measure in real time blood oxygenation in the internal jugular vein (IJV) of these patients. A clinical ultrasound imaging system (GE Vivid e) was used for IJV localization. Catheters were placed in the IJV as part of routine care and blood samples taken via the catheters were processed with a CO-oximeter. The optoacoustic oxygenation data were compared to the CO-oximeter readings. Good correlation between the noninvasive and invasive measurements was obtained. The results of these studies suggest that the optoacoustic system can provide accurate, noninvasive measurements of central venous oxygenation that can be used for patients with circulatory shock.

  17. Separation of craniopagus Siamese twins using cardiopulmonary bypass and hypothermic circulatory arrest.

    PubMed

    Cameron, D E; Reitz, B A; Carson, B S; Long, D M; Dufresne, C R; Vander Kolk, C A; Maxwell, L G; Tilghman, D M; Nichols, D G; Wetzel, R C

    1989-11-01

    Occipitally joined craniopagus Siamese twins were separated with the use of cardiopulmonary bypass and hypothermic circulatory arrest. The 7-month-old infants shared a large sagittal venous sinus that precluded conventional neurosurgical approach because of risk of exsanguination and air embolism. After craniotomy and preliminary exposure of the sinus, each twin underwent sternotomy and total cardiopulmonary bypass with deep hypothermia. Hypothermic circulatory arrest allowed safe division and subsequent reconstruction of the sinus remnants. Several unusual problems were encountered, including transfusion of a large blood volume from one extracorporeal circuit to the other through the common venous sinus, deleterious warming of the exposed brain during circulatory arrest, and thrombosis of both pump oxygenators. Both infants survived, although recovery was complicated in each by neurologic injury, cranial wound infection, and hydrocephalus. This case demonstrates the valuable supportive role of cardiopulmonary bypass and hypothermic circulatory arrest in the management of complex surgical problems of otherwise inoperable patients. PMID:2682024

  18. Systemic Family Therapy Using the Reflecting Team: The Experiences of Adults with Learning Disabilities

    ERIC Educational Resources Information Center

    Anslow, Katharine

    2014-01-01

    This research aimed to illuminate the experiences of adults with learning disabilities of the reflecting team, in the context of their systemic family therapy. Five adults with learning disabilities were recruited from one community learning disability team. A qualitative design using interpretative phenomenological analysis (IPA) was appropriate…

  19. Rising to the Literacy Challenge: Building Adult Education Systems in New England.

    ERIC Educational Resources Information Center

    Liebowitz, Marty; Robins, Amy; Rubin, Jerry

    This document describes a research study of the status of basic adult literacy services in New England, particularly the inadequate link between adult basic education (ABE) and work- force preparation programs. The report describes a system that has failed to adapt to the region's increased need for articulation among English as a Second Language…

  20. Methylphenidate Transdermal System in Adults with Past Stimulant Misuse: An Open-Label Trial

    ERIC Educational Resources Information Center

    McRae-Clark, Aimee L.; Brady, Kathleen T.; Hartwell, Karen J.; White, Kathleen; Carter, Rickey E.

    2011-01-01

    Objective: This 8-week, open-label trial assessed the efficacy of methylphenidate transdermal system (MTS) in 14 adult individuals diagnosed with ADHD and with a history of stimulant misuse, abuse, or dependence. Method: The primary efficacy endpoint was the Wender-Reimherr Adult ADHD Scale (WRAADS), and secondary efficacy endpoints included the…

  1. Comprehensive Adult Student Assessment Systems Braille Reading Assessment: An Exploratory Study

    ERIC Educational Resources Information Center

    Posey, Virginia K.; Henderson, Barbara W.

    2012-01-01

    Introduction: This exploratory study determined whether transcribing selected test items on an adult life and work skills reading test into braille could maintain the same approximate scale-score range and maintain fitness within the item response theory model as used by the Comprehensive Adult Student Assessment Systems (CASAS) for developing…

  2. Cardiac-like flow generator for long-term imaging of endothelial cell responses to circulatory pulsatile flow at microscale.

    PubMed

    Chen, Huaying; Cornwell, James; Zhang, Han; Lim, Tse; Resurreccion, Rena; Port, Timothy; Rosengarten, Gary; Nordon, Robert E

    2013-08-01

    In vitro models of circulatory hemodynamics are required to mimic the microcirculation for study of endothelial cell responses to pulsatile shear stress by live cell imaging. This study reports the design, fabrication and characterisation of a microfluidic device that generates cardiac-like flow in a continuous culture system with a circulatory volume of only 2-3 μL. The device mimics a single chamber heart, with the following cardiac phases: (1) closure of the ventricle inlet valve, (2) contraction of the ventricle (systole) followed by opening of the outlet valve and (3) relaxation of the ventricle (diastole) with opening of the inlet valve whilst the outlet valve remains closed. Periodic valve states and ventricular contractions were actuated by microprocessor controlled pneumatics. The time-dependent velocity-field was characterised by micro-particle image velocimetry (μ-PIV). μ-PIV observations were used to help tune electronic timing of valve states and ventricular contractions for synthesis of an arterial pulse waveform to study the effect of pulsatile shear stress on bovine artery endothelial cells (BAECs). BAECs elongated and aligned with the direction of shear stress after 48 h of exposure to a pulsatile waveform with a maximum shear stress of 0.42 Pa. The threshold for BAECs alignment and elongation under steady (non-pulsatile) flow reported by Kadohama et al. (2006) is 0.7-1.4 Pa. These cells respond to transient shear stress because the time average shear stress of the pulse waveform to generate this morphological response was only 0.09 Pa, well below the steady flow threshold. The microfluidic pulse generator can simulate circulatory hemodynamics for live cell imaging of shear-induced signalling pathways. PMID:23727941

  3. Variability in protocols on donation after circulatory death in Europe

    PubMed Central

    2013-01-01

    Introduction Organ donation after circulatory death (DCD) has become an accepted strategy to reduce the shortage of organs for transplantation in many European countries. The use and number of DCD donors varies between countries. The purpose of this study was to evaluate the available protocols for DCD in Europe. Methods We contacted national transplant societies and responsible transplant co-ordinators in the countries that perform DCD to obtain DCD protocols. We compared information on the protocols and additional data including: inclusion and exclusion criteria for donation, legislation, determination of death and preservation methods. Results In ten European countries DCD is performed, eight of which describe the methods in protocols. There are large differences in used DCD categories, legislation and the way death is determined. Protocols differ in the detail in which DCD procedures are described and the way methods are supported by additional consensus statements and ethical frameworks. Conclusions Although DCD is an established strategy to enlarge the donor pool and to contribute to the reduction of the waiting list for transplantation, its potential has not been fully utilized yet. To further promote DCD transplantation, it is important to share expertise and obtain consensus, so that this can be translated into more uniform and solid protocols supported by the competent authorities, transplant and intensive care professionals, which may eventually result in a further promotion of DCD transplantation in Europe. PMID:24090229

  4. Mechanisms of hemorrhage in dengue without circulatory collapse.

    PubMed

    Krishnamurti, C; Kalayanarooj, S; Cutting, M A; Peat, R A; Rothwell, S W; Reid, T J; Green, S; Nisalak, A; Endy, T P; Vaughn, D W; Nimmannitya, S; Innis, B L

    2001-12-01

    To characterize the molecular basis for the hemostatic defects of dengue infections, a study was conducted in Bangkok, Thailand. Febrile children (n = 68) hospitalized with suspected dengue were enrolled before their clinical syndromes were classified as either dengue fever (DF) or dengue hemorrhagic fever (DHF). Hospital course and outcome were recorded; blood was obtained during the febrile illness (S1), after defervescence (S2), and 1 month after onset of disease (S4). Patients were classified as DF (n = 21) and DHF grades 1, 2, and 3; (DHF1, n = 8; DHF2, n = 30; and DHF3, n = 9). All had marked thrombocytopenia. Bleeding scores were assigned on the basis of bleeding site. Although there was no correlation between bleeding scores and pleural effusion index (a measure of vascular leakage) or bleeding scores and platelet counts, there was a correlation between pleural effusion index and platelet counts. Bleeding scores did not correlate with hemostatic data. Activated partial thromboplastin time was prolonged, with trends toward decreased fibrinogen and increased levels of prothrombin fragment F1.2 in the acute-phase samples. However, no factor level was dramatically decreased. We conclude that most patients with DF or DHF, even without overt hemorrhage, have consumptive coagulopathy. Nevertheless, hemorrhage in dengue without circulatory collapse is most likely due to activation of platelets rather than coagulopathy, which is well compensated. Our data suggest that vascular alteration may be the principal factor involved in the association of thrombocytopenia and hemorrhage with disease severity. PMID:11791984

  5. Contemporary mechanical circulatory support therapy for postcardiotomy shock.

    PubMed

    Fukuhara, Shinichi; Takeda, Koji; Garan, Arthur Reshad; Kurlansky, Paul; Hastie, Jonathan; Naka, Yoshifumi; Takayama, Hiroo

    2016-04-01

    Significant progress has been made in the use of mechanical circulatory support (MCS), particularly in the clinical success in durable left ventricular assist device. Short-term MCS has also advanced in the form of venoarterial extracorporeal membrane oxygenation, external centrifugal VADs as well as percutaneous VADs. Postcardiotomy shock (PCS) is a rare clinical entity associated with substantial morbidity and mortality. It is characterized by heart failure that either results in an inability to wean from cardiopulmonary bypass or that occurs in the immediate postoperative period, accounting for the most common indication for MCS. The reported in-hospital mortality of the PCS patients remains high, consistently over 50%, despite ongoing refinements of MCS technology. The optimization of selection criteria and the prompt institution of MCS are likely the keys to improving this persistently high mortality rate. Unfortunately, the lack of a clear definition for PCS in the literature limits scientific analyses and comparison of the existing evidence. To establish the treatment strategy and appropriately manage this challenging disease, substantial and fundamental effort by the cardiovascular society is imperative. PMID:26874519

  6. Palatability of tastes is associated with facial circulatory responses.

    PubMed

    Kashima, Hideaki; Hamada, Yuka; Hayashi, Naoyuki

    2014-03-01

    To examine whether various types of taste stimuli in the oral cavity elicit unique changes in facial skin blood flow (SkBF) according to the palatability perceived by an individual, the facial SkBF was observed by laser speckle flowgraphy in 15 healthy subjects (11 males and 4 females) before and during the ingestion of bitter tea, chilli sauce, coffee, orange juice, soup, and a water control. The heart rate, mean arterial pressure (MAP), and SkBF in the index finger were recorded continuously. Subjects reported their subjective palatability and taste intensity scores after each stimulus. The vascular conductance indexes (CIs) in the face and finger were calculated as ratios of SkBF to MAP. CI in the eyelid increased significantly in response to chilli sauce, orange juice, and soup, whereas CIs in the forehead, nose, and cheek decreased in response to bitter tea. There was a significant correlation between the palatability scores and CI values in the eyelid when changes induced by chilli sauce were excluded. These results suggest that the facial circulatory response reflects the degree of palatability of a foodstuff. PMID:24391145

  7. Development of mechanical circulatory support devices in China.

    PubMed

    Wang, Wei; Zhu, De-Ming; Ding, Wen-Xiang

    2009-11-01

    Myocardial dysfunction leading to low cardiac output syndrome is a common clinical pathophysiological state. Currently, the use of mechanical circulatory support (MCS) is an essential aspect of the treatment of patients with cardiac failure. Several groups in China are engaged in the design and development of MCS devices. These devices can be classified as pulsatile, rotary, and total artificial heart (TAH). There are two types of pulsatile pump, which are driven by air (pneumatic). One of these pumps, the Luo-Ye pump, has been used clinically for short-term support since 1998. The other is a push-plate left ventricular device, which has a variable rate mode. Various rotary devices are classified into axial and centrifugal pumps, depending on the impeller geometry. Most rotary pumps are based on the maglev principle, and some types have been used clinically. Others are still being studied in the laboratory or in animal experiments. Furthermore, certain types of total implantable pump, such as the UJS-III axial pump and the UJS-IV aortic valvo-pump, have been developed. Only one type of TAH has been developed in China. The main constituents of this artificial heart are two axial pumps, two reservoir tanks mimicking the right and left atria, flow meters, two pressure gauges, and a resistance adaptor. Although the development of mechanical assist devices in China is still in a nascent stage, a number of different types of MCS devices are currently being studied. PMID:20021474

  8. Improved Mechanism for Capturing Muscle Power for Circulatory Support

    PubMed Central

    Trumble, Dennis R.; Melvin, David B.; Byrne, Mark T.; Magovern, James A.

    2016-01-01

    Although it is now understood that trained skeletal muscle can generate enough steady-state power to provide significant circulatory support, there are currently no means by which to tap this endogenous energy source to aid the failing heart. To that end, an implantable muscle energy converter (MEC) has been constructed and its function has been improved to optimize durability, anatomic fit, and mechanical efficiency. Bench tests show that MEC transmission losses average less than 10% of total work input and that about 85% of this muscle power is successfully transferred to the working fluid of the pump. Results from canine implant trials confirm excellent biocompatibility and demonstrate that contractile work of the latissimus dorsi muscle—measured to 290 mJ/stroke in one dog—can be transmitted within the body at levels consistent with cardiac assist requirements. These findings suggest that muscle-powered cardiac assist devices are feasible and that efforts to further develop this technology are warranted. PMID:16143010

  9. Ion transport in circulatory and/or septic shock

    SciTech Connect

    Sayeed, M.M.

    1987-05-01

    This review surveys investigations of membrane ion transport in animals in hemorrhagic, endotoxic, or bacteremic shock. The focus of the review is on ion transport studies in the skeletal muscle and liver. Skeletal muscle Na/sup +/-K/sup +/ transport alterations have been shown during the induction of shock via hemorrhage, endotoxin, or live Gram-negative bacteria in the rodent, canine, and primate species. These alterations include impairment of active cellular K/sup +/ accumulation, increased permeability to /sup 24/Na/sup +/ and Cl/sup -/, and membrane depolarization. The ion transport alterations in the skeletal muscle are compatible with movement of extracellular fluid into the intracellular compartment. Such fluid movements can potentially lead to decreases in circulating plasma volume and thus to circulatory deficits in shock. Studies in the liver of rats subjected to hemorrhagic or endotoxic shock indicated the failure of electrogenic Na/sup +/ pump. Although the hepatic cellular membrane permeability to Na/sup +/ relative to permeability to K/sup +/ appeared unaltered in hemorrhagic shock, endotoxic shock caused an increase in permeability to Na/sup +/. Hepatic cellular /sup 45/Ca/sup +/ regulation also appeared to be adversely affected during endotoxic shock. Alterations in hepatic Na/sup +/-K/sup +/ transport and Ca/sup +/ regulation could contribute to impairment in hepatic glucose production during shock. Although mechanisms of altered membrane ion transport during shock states remain unknown, such changes could occur prior to any substantial loss of cellular metabolic energy.

  10. 78 FR 63454 - Response Systems to Adult Sexual Assault Crimes Panel; Notice of Federal Advisory Committee Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-24

    ... of the Secretary Response Systems to Adult Sexual Assault Crimes Panel; Notice of Federal Advisory... Response Systems to Adult Sexual Assault Crimes Panel. DATES: A meeting of the Response Systems to Adult Sexual Assault Crimes Panel (``the Panel'') will be held November 7-8, 2013. The Public Session...

  11. Adult Attitudes toward Alternative Delivery Systems and Industrial Training Outcomes.

    ERIC Educational Resources Information Center

    Richey, Rita C.

    Part of a larger project designed to produce a causal model of variables that impinge upon training interventions and influence adult learning, this research is concerned with learner attitudes toward the way employee training is delivered and the roles these convictions play in learning. Two research models served as a guide for comprehensive…

  12. Zika Kills Vital Nervous System Cells in Adult Mice, Study Finds

    MedlinePlus

    ... page: https://medlineplus.gov/news/fullstory_160505.html Zika Kills Vital Nervous System Cells in Adult Mice, ... 2016 THURSDAY, Aug. 18, 2016 (HealthDay News) -- The Zika virus kills neural stem cells in the brains ...

  13. The effects of chloralose-urethane and sodium pentobarbitone anaesthesia on the local and autonomic components of the circulatory response to arterial hypoxia

    PubMed Central

    Korner, P. I.; Langsford, G.; Starr, D.; Uther, J. B.; Ward, W.; White, S. W.

    1968-01-01

    1. The circulatory and respiratory responses to severe arterial hypoxia were studied in normal rabbits, `de-efferented' rabbits without functioning autonomic effectors, and atropinized animals before anaesthesia and during chloralose-urethane and sodium pentobarbitone anaesthesia. Net systemic autonomic activity and autonomic activity to the heart was assessed from a comparison of the responses of the various preparations. 2. In the normal spontaneously breathing animal each anaesthetic had a similar mode of action, and modified qualitatively the circulatory response present before anaesthesia. In the `de-efferented' animal the circulatory response was determined by the local effects of hypoxia, and was altered only quantitatively during anaesthesia. 3. In the normal unanaesthetized animal the reflex changes in autonomic activity during hypoxia consisted of a large increase in vagal efferent activity, a decrease in cardiac sympatho-adrenal activity, and an increase in total sympatho-adrenal constrictor activity. 4 In hypoxia during anaesthesia the vagal efferent activity no longer increased, but the change in sympatho-adrenal activity to heart and systemic circulation was the same as before anaesthesia in the spontaneously breathing animal. During anaesthesia with controlled ventilation systemic sympatho-adrenal activity increased further, and bradycardia again developed. The bradycardia was now due exclusively to reduction in cardiac sympathetic activity and not to an increase in vagal efferent activity. PMID:5723513

  14. Paediatric mechanical circulatory support with Berlin Heart EXCOR: development and outcome of a 23-year experience.

    PubMed

    Hetzer, Roland; Kaufmann, Friedrich; Delmo Walter, Eva Maria

    2016-08-01

    This paper reviews the development and establishment of the Berlin Heart EXCOR® (BHE®) as a paediatric mechanical circulatory support and reports our entire experience with regard to indications, timing of implantation and explantation and outcome. The Berlin group reported the first successful paediatric bridge to transplantation using a pulsatile pneumatic paracorporeal biventricular assist device, the BHE®, in 1990 in an 8-year-old boy with end-stage heart failure and coarctation of the aorta. This experience prompted them to develop miniaturized pump systems for children through the company Berlin Heart Mediproduct GmbH. The development and production of BHE® to support paediatric patients with heart failure then began. Between 1990 and 2013, the BHE® has been implanted in 122 patients (median age 8.64 years, range 3 days to 17 years) with heart failure, who were inotrope-dependent or switched from extracorporeal membrane oxygenation support or had postcardiotomy low-output syndrome. Thirty-five patients were <1 year old (median 125 days). The aetiology of heart failure included cardiomyopathy in 56 (median age 9.14 years), fulminant myocarditis in 17 (median age 8.2 years), end-stage congenital heart disease in 18 (median age 6.4 years), postcardiotomy heart failure (after correction of congenital heart disease) in 28 (median age 9.6 years) and transplant graft failure in 3 (median age 12.5 years). The overall median duration of implantation was 63.6 (range 1-841) days. Fifty-six children eventually underwent orthotopic heart transplantation. Eighteen patients had myocardial recovery and were weaned successfully. They had entirely normal cardiac function after a range of 4-10 years after surgery. At the time of this report, five patients were still on support, with a duration of 354-369 days. Forty-three patients died on the system from loss of peripheral circulatory resistance, multiorgan damage, sepsis or haemorrhagic or thrombotic complications. Re

  15. Circulatory and Renal Consequences of Pregnancy in Diabetic NOD Mice

    PubMed Central

    Burke, S.D.; Barrette, V.F.; David, S.; Khankin, E. V.; Adams, M.A.; Croy, B.A.

    2011-01-01

    Objectives Women with diabetes have elevated gestational risks for severe hemodynamic complications, including preeclampsia in mid- to late pregnancy. This study employed continuous, chronic radiotelemetry to compare the hemodynamic patterns in non-obese diabetic (NOD) mice who were overtly diabetic or normoglycemic throughout gestation. We hypothesized that overtly diabetic, pregnant NOD mice would develop gestational hypertension and provide understanding of mechanisms in progression of this pathology. Study Design Telemeter-implanted, age-matched NOD females with and without diabetes were assessed for six hemodynamic parameters (mean, systolic, diastolic, pulse pressures, heart rate and activity) prior to mating, over pregnancy and over a 72 hr post-partum interval. Urinalysis, serum biochemistry and renal histopathology were also conducted. Results Pregnant, normoglycemic NOD mice had a hemodynamic profile similar to other inbred strains, despite insulitis. This pattern was characterized by an interval of pre-implantation stability, post implantation decline in arterial pressure to mid gestation, and then a rebound to pre-pregnancy baseline during later gestation. Overtly diabetic NOD mice had a blood pressure profile that was normal until mid-gestation then become mildly hypotensive (−7mmHg, P<0.05), severely bradycardic (−80bpm, P<0.01) and showed signs of acute kidney injury. Pups born to diabetic dams were viable but growth restricted, despite their mothers’ failing health, which did not rebound post-partum (−10% pre-pregnancy pressure and HR, P<0.05). Conclusions Pregnancy accelerates circulatory and renal pathologies in overtly diabetic NOD mice and is characterized by depressed arterial pressure from mid-gestation and birth of growth 45 restricted offspring. PMID:22014504

  16. Organ donation after circulatory death in a university teaching hospital.

    PubMed

    Sidiropoulos, S; Treasure, E; Silvester, W; Opdam, H; Warrillow, S J; Jones, D

    2016-07-01

    Although organ transplantation is well established for end-stage organ failure, many patients die on waiting lists due to insufficient donor numbers. Recently, there has been renewed interest in donation after circulatory death (DCD). In a retrospective observational study we reviewed the screening of patients considered for DCD between March 2007 and December 2012 in our hospital. Overall, 148 patients were screened, 17 of whom were transferred from other hospitals. Ninety-three patients were excluded (53 immediately and 40 after review by donation staff). The 55 DCD patients were younger than those excluded (P=0.007) and they died from hypoxic brain injury (43.6%), intraparenchymal haemorrhage (21.8%) and subarachnoid haemorrhage (14.5%). Antemortem heparin administration and bronchoscopy occurred in 50/53 (94.3%) and 22/55 (40%) of cases, respectively. Forty-eight patients died within 90 minutes and proceeded to donation surgery. Associations with not dying in 90 minutes included spontaneous ventilation mode (P=0.022), absence of noradrenaline infusion (P=0.051) and higher PaO2:FiO2 ratio (P=0.052). The number of brain dead donors did not decrease over the study period. The time interval between admission and death was longer for DCD than for the 45 brain dead donors (5 [3-11] versus 2 [2-3] days; P<0.001), and 95 additional patients received organ transplants due to DCD. Introducing a DCD program can increase potential organ donors without reducing brain dead donors. Antemortem investigations appear to be acceptable to relatives when included in the consent process. PMID:27456178

  17. Association between previously diagnosed circulatory conditions and a dietary inflammatory index.

    PubMed

    Wirth, Michael D; Shivappa, Nitin; Hurley, Thomas G; Hébert, James R

    2016-03-01

    Inflammation is a key contributor to the development or recurrence of circulatory disorders. Diet is a strong modifier of inflammation. It was hypothesized that more pro-inflammatory diets, as indicated by higher Dietary Inflammatory Index (DII) scores, would be associated with self-reported previously diagnosed circulatory disorders using National Health and Nutrition Examination Survey (NHANES) data. This analysis included NHANES respondents from 2005-2010 (n = 15,693). The DII was calculated from micro and macronutrients derived from a single 24-hour recall. Logistic regression, stratified by sex and adjusted for important covariates, was used to determine the odds of previous circulatory disorder diagnoses by quartile of DII scores. Excluding hypertension, which had a prevalence of 30%, the prevalence of any circulatory disorder was 8%. Those in DII quartile 4 were 1.30 (95%CI = 1.06-1.58) times more likely to have a previous circulatory disorder (excluding hypertension) compared to those in DII quartile 1. Similar findings were observed for specific CVDs including congestive heart failure, stroke, and heart attack. Participants in DII quartile 4 were more likely to have a diagnosis of hypertension compared to those in DII quartile 1 (prevalence odds ratio = 1.19, 95%CI = 1.05-1.34). Results tended to be stronger among females. Individuals with a previous circulatory disorder diagnosis from NHANES appear to have more pro-inflammatory diets compared to those without a previous diagnosis. Because inflammation is an important factor related to recurrence of circulatory disorders, the DII could be used in treatment programs to monitor dietary modulators of inflammation among individuals with these conditions. PMID:26923509

  18. Elastin insufficiency predisposes to elevated pulmonary circulatory pressures through changes in elastic artery structure.

    PubMed

    Shifren, Adrian; Durmowicz, Anthony G; Knutsen, Russell H; Faury, Gilles; Mecham, Robert P

    2008-11-01

    Elastin is a major structural component of large elastic arteries and a principal determinant of arterial biomechanical properties. Elastin loss-of-function mutations in humans have been linked to the autosomal-dominant disease supravalvular aortic stenosis, which is characterized by stenotic lesions in both the systemic and pulmonary circulations. To better understand how elastin insufficiency influences the pulmonary circulation, we evaluated pulmonary cardiovascular physiology in a unique set of transgenic and knockout mice with graded vascular elastin dosage (range 45-120% of wild type). The central pulmonary arteries of elastin-insufficient mice had smaller internal diameters (P < 0.0001), thinner walls (P = 0.002), and increased opening angles (P = 0.002) compared with wild-type controls. Pulmonary circulatory pressures, measured by right ventricular catheterization, were significantly elevated in elastin-insufficient mice (P < 0.0001) and showed an inverse correlation with elastin level. Although elastin-insufficient animals exhibited mild to moderate right ventricular hypertrophy (P = 0.0001) and intrapulmonary vascular remodeling, the changes were less than expected, given the high right ventricular pressures, and were attenuated compared with those seen in hypoxia-induced models of pulmonary arterial hypertension. The absence of extensive pathological cardiac remodeling at the high pressures in these animals suggests a developmental adaptation designed to maintain right-sided cardiac output in a vascular system with altered elastin content. PMID:18772328

  19. Up against the System: A Case Study of Young Adult Perspectives Transitioning from Pediatric Palliative Care

    PubMed Central

    Cook, Karen; Jack, Susan; Thabane, Lehana; Browne, Gina

    2013-01-01

    Advances in pediatric care have not provided the interdisciplinary support services required by those young adults with pediatric life-threatening conditions (pedLTCs) who live beyond childhood but have limited expectations to live past early adulthood. These young adults, the first generation to live into adulthood, face multiple challenges transitioning from a plethora of pediatric palliative services to scant adult health services. In a case study, using an innovative bulletin board focus group, we describe the complex interplay of the health, education, and social service sectors in this transition. Our descriptions include system deficits and strengths and the young adults' resilience and coping strategies to overcome those deficits and move forward with their lives. Young adults with pedLTC need knowledgeable providers, coordinated and accessible services, being respected and valued, and services and supports that promote independence. We recommend implementation of multidisciplinary solutions that are focused on young adult priorities to ensure seamless access to resources to support these young adults' health, educational, vocational, and social goals. The input and voice of young adults in the development of these services are imperative to ensure that multisystem services support their needs and life goals. PMID:23997951

  20. Up against the System: A Case Study of Young Adult Perspectives Transitioning from Pediatric Palliative Care.

    PubMed

    Cook, Karen; Siden, Harold; Jack, Susan; Thabane, Lehana; Browne, Gina

    2013-01-01

    Advances in pediatric care have not provided the interdisciplinary support services required by those young adults with pediatric life-threatening conditions (pedLTCs) who live beyond childhood but have limited expectations to live past early adulthood. These young adults, the first generation to live into adulthood, face multiple challenges transitioning from a plethora of pediatric palliative services to scant adult health services. In a case study, using an innovative bulletin board focus group, we describe the complex interplay of the health, education, and social service sectors in this transition. Our descriptions include system deficits and strengths and the young adults' resilience and coping strategies to overcome those deficits and move forward with their lives. Young adults with pedLTC need knowledgeable providers, coordinated and accessible services, being respected and valued, and services and supports that promote independence. We recommend implementation of multidisciplinary solutions that are focused on young adult priorities to ensure seamless access to resources to support these young adults' health, educational, vocational, and social goals. The input and voice of young adults in the development of these services are imperative to ensure that multisystem services support their needs and life goals. PMID:23997951

  1. A Review of Non-Cancer Effects, Especially Circulatory and Ocular Diseases1

    PubMed Central

    Little, Mark P.

    2014-01-01

    There is a well-established association between high doses (> 5 Gy) of ionizing radiation exposure and damage to the heart and coronary arteries, although only recently have studies with high quality individual dosimetry been conducted that would enable quantification of this risk adjusting for concomitant chemotherapy. The association between lower dose exposures and late occurring circulatory disease has only recently begun to emerge in the Japanese atomic bomb survivors and in various occupationally-exposed cohorts, and is still controversial. Excess relative risks per unit dose in moderate and low dose epidemiological studies are somewhat variable, possibly a result of confounding and effect modification by well known (but unobserved) risk factors. Radiation doses of 1 Gy or more are associated with increased risk of posterior subcapsular cataract. Accumulating evidence from the Japanese atomic bomb survivors, Chernobyl liquidators, US astronauts and various other exposed groups suggest that cortical cataracts may also be associated with ionizing radiation, although there is little evidence that nuclear cataracts are radiogenic. The dose response appears to be linear, although modest thresholds (of no more than about 0.6 Gy) cannot be ruled out. A variety of other non-malignant effects have been observed after moderate/low dose exposure in various groups, in particular respiratory and digestive disease and central nervous system (and in particular neuro-cognitive) damage. However, because these are generally only observed in isolated groups, or because the evidence is excessively heterogeneous, these associations must be treated with caution. PMID:23903347

  2. Whole-body vibration influences lower extremity circulatory and neurological function.

    PubMed

    Games, K E; Sefton, J M

    2013-08-01

    Whole-body vibration (WBV) is currently used to enhance performance and treat injuries even though we lack an understanding of how WBV influences physiological processes. An improved understanding of the physiological effects of WBV could lead to protocols to speed healing or treat pathologies. This study examined the acute effects of WBV on peripheral blood perfusion, muscle oxygenation, motoneuron pool excitability, and sensory nerve conduction velocity. Fourteen healthy participants [9 women (21.7 ± 2.4 years); 5 men (20.8 ± 1.1 years)] completed a 5 min bout of WBV (50 Hz, 2 mm amplitude). Measures were assessed pre-treatment and at 0, 5, 10, 15, and 20 min post-treatment. WBV significantly increased superficial skin temperature (P < 0.0005) and total hemoglobin (P = 0.009), had no effect of oxyhemoglobin (P = 0.186), increased deoxyhemoglobin (P < 0.0005), inhibited the soleus Hoffmann reflex (P = 0.007), and had no effect on sural sensory nerve conduction velocity (P = 0.695). These results suggest that an acute bout of WBV influences physiological processes in both the circulatory and the nervous systems. PMID:22107331

  3. A novel culture system for adult porcine intestinal crypts.

    PubMed

    Khalil, Hassan A; Lei, Nan Ye; Brinkley, Garrett; Scott, Andrew; Wang, Jiafang; Kar, Upendra K; Jabaji, Ziyad B; Lewis, Michael; Martín, Martín G; Dunn, James C Y; Stelzner, Matthias G

    2016-07-01

    Porcine models are useful for investigating therapeutic approaches to short bowel syndrome and potentially to intestinal stem cell (ISC) transplantation. Whereas techniques for the culture and genetic manipulation of ISCs from mice and humans are well established, similar methods for porcine stem cells have not been reported. Jejunal crypts were isolated from murine, human, and juvenile and adult porcine small intestine, suspended in Matrigel, and co-cultured with syngeneic intestinal subepithelial myofibroblasts (ISEMFs) or cultured without feeder cells in various culture media. Media containing epidermal growth factor, noggin, and R-spondin 1 (ENR medium) were supplemented with various combinations of Wnt3a- or ISEMF-conditioned medium (CM) and with glycogen synthase kinase 3 inhibitor (GSK3i), and their effects were studied on cultured crypts. Cell lineage differentiation was assessed by immunohistochemistry and quantitative polymerase chain reaction. Cultured porcine cells were serially passaged and transduced with a lentiviral vector. Whereas ENR medium supported murine enteroid growth, it did not sustain porcine crypts beyond 5 days. Supplementation of Wnt3a-CM and GSK3i resulted in the formation of complex porcine enteroids with budding extensions. These enteroids contained a mixture of stem and differentiated cells and were successfully passaged in the presence of GSK3i. Crypts grown in media supplemented with porcine ISEMF-CM formed spheroids that were less well differentiated than enteroids. Enteroids and spheroids were transfected with a lentivirus with high efficiency. Thus, our method maintains juvenile and adult porcine crypt cells long-term in culture. Porcine enteroids and spheroids can be successfully passaged and transduced by using lentiviral vectors. PMID:26928041

  4. Bilingual effects on deployment of the attention system in linguistically and culturally homogeneous children and adults.

    PubMed

    Yang, Sujin; Yang, Hwajin

    2016-06-01

    We investigated the impact of early childhood and adulthood bilingualism on the attention system in a group of linguistically and culturally homogeneous children (5- and 6-year olds) and young adults. We administered the child Attention Network Test (ANT) to 63 English monolingual and Korean-English bilingual children and administered the adult ANT to 39 language- and culture-matched college students. Advantageous bilingual effects on attention were observed for both children and adults in global processing levels of inverse efficiency, response time, and accuracy at a magnitude more pronounced for children than for adults. Differential bilingualism effects were evident at the local network level of executive control and orienting in favor of the adult bilinguals only. Notably, however, bilingual children achieved an adult level of accuracy in the incongruent flanker condition, implying enhanced attentional skills to cope with interferences. Our findings suggest that although both child and adult bilinguals share cognitive advantages in attentional functioning, age-related cognitive and linguistic maturation differentially shapes the outcomes of attentional processing at a local network level. PMID:26930166

  5. Intestinal dendritic cells survey circulatory antigens prior to induction of CD8+ T cells

    PubMed Central

    Chang, Sun Young; Song, Joo-Hye; Guleng, Bayasi; Cotoner, Carmen Alonso; Arihiro, Seiji; Zhao, Yun; Chiang, Hao-Sen; O'Keeffe, Michael; Liao, Gongxian; Karp, Christopher L.; Kweon, Mi-Na; Sharpe, Arlene H.; Bhan, Atul; Terhorst, Cox; Reinecker, Hans-Christian

    2013-01-01

    Circulatory antigens transit through the small intestine via the fenestrated capillaries in the lamina propria prior to entering into the draining lymphatics. But whether or how this process controls mucosal immune responses remains unknown. Here we demonstrate that dendritic cells (DCs) of the lamina propria can sample and process both circulatory and luminal antigens. Surprisingly, antigen cross-presentation by resident CX3CR1+ DCs induced differentiation of precursor cells into CD8+ T cells that expressed interleukin-10 (IL-10), IL-13 and IL-9 and could migrate into adjacent compartments. We conclude that lamina propria CX3CR1+ DCs facilitate the surveillance of circulatory antigens and act as a conduit for the processing of self- and intestinally-absorbed-antigens, leading to the induction of CD8+ T cells, that partake in the control of T cell activation during mucosal immune responses. PMID:23246312

  6. The Effectiveness of the "Picture Exchange Communication System" with Nonspeaking Adults

    ERIC Educational Resources Information Center

    Stoner, Julia B.; Beck, Ann R.; Bock, Stacey Jones; Hickey, Katherine; Kosuwan, Kullaya; Thompson, James R.

    2006-01-01

    "Picture Exchange Communication System" (PECS) training was implemented with 5 nonspeaking adults with mental retardation who were not currently using any type of functional communication system. A modified ABAB, single-subject design was used to assess the effectiveness of PECS in enhancing the functional communication skills of these…

  7. Recommended Policies and Practices for Advancing Indiana's System of Adult Education and Workforce Training

    ERIC Educational Resources Information Center

    National Center for Higher Education Management Systems (NJ1), 2009

    2009-01-01

    With generous support from the Lilly Endowment, the Indiana Chamber has contracted with National Center for Higher Education Management Systems (NCHEMS) to provide a policy framework and specific recommendations for improving the system of adult education and workforce training in Indiana--building on the important initiatives that have already…

  8. The Adult Learner and Performance in Introductory Economics, a Personalized System of Instruction.

    ERIC Educational Resources Information Center

    Sussman, Jeffrey

    1979-01-01

    A study to determine the effectiveness of the personalized system of instruction format used in the introductory economics course at Empire State College is reported. Also addressed are the ability of adult students in the personalized system to learn as much as students in conventional settings, and the explaining and predicting of adult…

  9. Report of the Pilot Test for the National Reporting System for Adult Education.

    ERIC Educational Resources Information Center

    Condelli, Larry; Padilla, Vince; Angeles, January

    The National Reporting System project was designed to establish an outcome-based accountability system for the state-administered, federally funded adult education program. In the pilot test, volunteer states and their local programs compared the feasibility and costs of these three data collection models: (1) local programs collect all the…

  10. The role of retinoids in the adult nervous system and their therapeutic potential.

    PubMed

    Christie, V B; Marder, T B; Whiting, A; Przyborski, S A

    2008-06-01

    The mode of action of retinoids in relation to their activity in the adult central nervous system and the potential of synthetic retinoid analogues is reviewed. Investigation into the activity of such molecules will further our understanding of the retinoid pathway during nervous system development and in various neurological disease states. PMID:18537715

  11. Mental health system historians: adults with schizophrenia describe changes in community mental health care over time.

    PubMed

    Stein, Catherine H; Leith, Jaclyn E; Osborn, Lawrence A; Greenberg, Sarah; Petrowski, Catherine E; Jesse, Samantha; Kraus, Shane W; May, Michael C

    2015-03-01

    This qualitative study examined changes in community mental health care as described by adults diagnosed with schizophrenia with long-term involvement in the mental health system to situate their experiences within the context of mental health reform movements in the United States. A sample of 14 adults with schizophrenia who had been consumers of mental health services from 12 to 40 years completed interviews about their hospital and outpatient experiences over time and factors that contributed most to their mental health. Overall, adults noted gradual changes in mental health care over time that included higher quality of care, more humane treatment, increased partnership with providers, shorter hospital stays, and better conditions in inpatient settings. Regardless of the mental health reform era in which they were hospitalized, participants described negative hospitalization experiences resulting in considerable personal distress, powerlessness, and trauma. Adults with less than 27 years involvement in the system reported relationships with friends and family as most important to their mental health, while adults with more than 27 years involvement reported mental health services and relationships with professionals as the most important factors in their mental health. The sample did not differ in self-reported use of services during their initial and most recent hospitalization experiences, but differences were found in participants' reported use of outpatient services over time. Findings underscore the importance of the lived experience of adults with schizophrenia in grounding current discourse on mental health care reform. PMID:25274147

  12. Prognostic scoring systems for infectious diseases: their applicability to the care of older adults.

    PubMed

    Juthani-Mehta, Manisha; Quagliarello, Vincent J

    2004-03-01

    Physicians often make clinical predictions about individual patients. For many infectious diseases, published prognostic scoring systems (PSSs) can help predict relevant outcomes. Validated PSSs exist for the general adult population for diseases such as pneumonia, endocarditis, meningitis, and bloodstream infection. Although these PSSs have been rigorously derived and validated, they have limited value in the care of older adults, because most studies have involved a heterogeneous adult population with mortality as the primary end point. In the United States, the number of patients who are > or =65 years old is growing, and their health care costs are increasing. Assessment of clinical outcomes other than merely survival (i.e., physical functional ability, cognitive ability, need for nursing home care, and overall quality of life) is required for this population. Some pioneering work has been done to develop PSSs that specifically address the health care needs of older adults. This review will describe existing PSSs and explore areas of further investigation. PMID:14986254

  13. Temporary Mechanical Circulatory Support: A Review of the Options, Indications, and Outcomes

    PubMed Central

    Gilotra, Nisha A; Stevens, Gerin R

    2014-01-01

    Cardiogenic shock remains a challenging disease entity and is associated with significant morbidity and mortality. Temporary mechanical circulatory support (MCS) can be implemented in an acute setting to stabilize acutely ill patients with cardiomyopathy in a variety of clinical situations. Currently, several options exist for temporary MCS. We review the indications, contraindications, clinical applications, and evidences for a variety of temporary circulatory support options, including the intra-aortic balloon pump (IABP), extracorporeal membrane oxygenation (ECMO), CentriMag blood pump, and percutaneous ventricular assist devices (pVADs), specifically the TandemHeart and Impella. PMID:25674024

  14. Theological reflections on donation after circulatory death: the wisdom of Paul Ramsey and Moshe Feinstein.

    PubMed

    Jotkowitz, A

    2008-10-01

    Due to the worldwide shortage of organs for transplantation, there has been an increased use of organs obtained after circulatory death alone. A protocol for this procedure has recently been approved by a major transplant consortium. This development raises serious moral and ethical concerns. Two renowned theologians of the previous generation, Paul Ramsey and Moshe Feinstein, wrote extensively on the ethical issues relating to transplantation, and their work has much relevance to current moral dilemmas. Their writings relating to definition of death, organ transplantation and the care of the terminally ill are briefly presented, and their potential application to the moral problem of organ donation after circulatory death is discussed. PMID:18827098

  15. Dendrimer Brain Uptake and Targeted Therapy for Brain Injury in a Large Animal Model of Hypothermic Circulatory Arrest

    PubMed Central

    2015-01-01

    Treatment of brain injury following circulatory arrest is a challenging health issue with no viable therapeutic options. Based on studies in a clinically relevant large animal (canine) model of hypothermic circulatory arrest (HCA)-induced brain injury, neuroinflammation and excitotoxicity have been identified as key players in mediating the brain injury after HCA. Therapy with large doses of valproic acid (VPA) showed some neuroprotection but was associated with adverse side effects. For the first time in a large animal model, we explored whether systemically administered polyamidoamine (PAMAM) dendrimers could be effective in reaching target cells in the brain and deliver therapeutics. We showed that, upon systemic administration, hydroxyl-terminated PAMAM dendrimers are taken up in the brain of injured animals and selectively localize in the injured neurons and microglia in the brain. The biodistribution in other major organs was similar to that seen in small animal models. We studied systemic dendrimer–drug combination therapy with two clinically approved drugs, N-acetyl cysteine (NAC) (attenuating neuroinflammation) and valproic acid (attenuating excitotoxicity), building on positive outcomes in a rabbit model of perinatal brain injury. We prepared and characterized dendrimer-NAC (D-NAC) and dendrimer-VPA (D-VPA) conjugates in multigram quantities. A glutathione-sensitive linker to enable for fast intracellular release. In preliminary efficacy studies, combination therapy with D-NAC and D-VPA showed promise in this large animal model, producing 24 h neurological deficit score improvements comparable to high dose combination therapy with VPA and NAC, or free VPA, but at one-tenth the dose, while significantly reducing the adverse side effects. Since adverse side effects of drugs are exaggerated in HCA, the reduced side effects with dendrimer conjugates and suggestions of neuroprotection offer promise for these nanoscale drug delivery systems. PMID:24499315

  16. Circulatory osmotic desalination driven by a mild temperature gradient based on lower critical solution temperature (LCST) phase transition materials.

    PubMed

    Mok, Yeongbong; Nakayama, Daichi; Noh, Minwoo; Jang, Sangmok; Kim, Taeho; Lee, Yan

    2013-11-28

    Abrupt changes in effective concentration and osmotic pressure of lower critical solution temperature (LCST) mixtures facilitate the design of a continuous desalination method driven by a mild temperature gradient. We propose a prototype desalination system by circulating LCST mixtures between low and high temperature (low T and high T) units. Water molecules could be drawn from a high-salt solution to the LCST mixture through a semipermeable membrane at a temperature lower than the phase transition temperature, at which the effective osmotic pressure of the LCST mixture is higher than the high-salt solution. After transfer of water to the high T unit where the LCST mixture is phase-separated, the water-rich phase could release the drawn water into a well-diluted solution through the second membrane due to the significant decrease in effective concentration. The solute-rich phase could be recovered in the low T unit via a circulation process. The molar mass, phase transition temperature, and aqueous solubility of the LCST solute could be tuneable for the circulatory osmotic desalination system in which drawing, transfer, release of water, and the separation and recovery of the solutes could proceed simultaneously. Development of a practical desalination system that draws water molecules directly from seawater and produces low-salt water with high purity by mild temperature gradients, possibly induced by sunlight or waste heat, could be attainable by a careful design of the molecular structure and combination of the circulatory desalination systems based on low- and high-molar-mass LCST draw solutes. PMID:24129795

  17. Use of a telehealth system by older adults with hypertension

    PubMed Central

    Czaja, Sara J; Lee, Chin Chin; Arana, Neysari; Nair, Sankaran N; Sharit, Joseph

    2016-01-01

    We conducted a feasibility study of a home telehealth system that monitored blood pressure and bodyweight. A total of 34 participants with hypertension (10 males and 24 females) had the telemedicine system installed in their homes. Their mean age was 72 years and 94% of them self-identified as Hispanic. The telehealth system transmitted blood pressure and bodyweight data to a server. There was also a messaging function that was used to send a daily reminder to the participants. Participants used the telehealth system for six months. Ten participants were lost to follow up and 24 participants completed the entire study. Participants had strong positive perceptions regarding the usability and usefulness of the telemedicine system. Most of them (92%) found the device easy to use and 96% felt that the training they received prepared them to use the device. The providers indicated that use of the system improved their ability to manage their patients. The results of the study suggest that use of the telehealth system for home monitoring in Hispanic patients with hypertension is feasible. PMID:24803275

  18. Accountability in Teenage Dating Violence: A Comparative Examination of Adult Domestic Violence and Juvenile Justice Systems Policies

    ERIC Educational Resources Information Center

    Zosky, Diane L.

    2010-01-01

    Unlike in the adult criminal justice system, where domestic violence policies hold perpetrators accountable for their violence, the juvenile justice system rarely addresses teenage dating violence. Although the adult criminal justice system has pursued policies toward intimate partner violence grounded on a "zero tolerance" ideology, the juvenile…

  19. Ethical Issues in the Use of Extracorporeal Membrane Oxygenation in Controlled Donation After Circulatory Determination of Death.

    PubMed

    Dalle Ave, A L; Shaw, D M; Bernat, J L

    2016-08-01

    The use of donor extracorporeal membrane oxygenation (ECMO) to improve graft outcomes by some controlled donation after circulatory determination of death (cDCDD) programs raises ethical issues. We reviewed cDCDD protocols using ECMO and the relevant ethics literature to analyze these issues. It is not obvious that ECMO in cDCDD improves graft outcomes. In our opinion, ECMO implemented before death can interfere with end-of-life care and damage bodily integrity. By restoring systemic circulation, ECMO risks invalidating the preceding declaration of death if brain and cardiac perfusion is not adequately excluded because of malfunction or misplacement of the supradiaphragmatic aortic occlusion balloon. The use of ECMO is not compatible with the acronym DCDD because circulation is restored after the determination of death. Because of these deficiencies, we concluded that other techniques are preferable, such as rapid recovery or in situ cold infusion. If ECMO is performed, it requires a specific informed consent and transparency. PMID:26999771

  20. The Adult Attachment Projective Picture System: integrating attachment into clinical assessment.

    PubMed

    George, Carol; West, Malcolm

    2011-01-01

    This article summarizes the development and validation of the Adult Attachment Projective System (AAP), a measure we developed from the Bowlby-Ainsworth developmental tradition to assess adult attachment status. The AAP has demonstrated excellent concurrent validity with the Adult Attachment Interview (George, Kaplan, & Main, 1984/1985/1996; Main & Goldwyn, 1985-1994; Main, Goldwyn, & Hesse, 2003), interjudge reliability, and test-retest reliability, with no effects of verbal intelligence or social desirability. The AAP coding and classification system and application in clinical and community samples are summarized. Finally, we introduce the 3 other articles that are part of this Special Section and discuss the use of the AAP in therapeutic assessment and treatment. PMID:21859280

  1. Functional Myotube Formation from Adult Rat Satellite Cells in a Defined Serum-free System

    PubMed Central

    McAleer, Christopher W.; Rumsey, John W.; Stancescu, Maria; Hickman, James J.

    2016-01-01

    This manuscript describes the development of a culture system whereby mature contracting myotubes were formed from adult rat derived satellite cells. Satellite cells, extracted from the Tibialis Anterior (TA) of adult rats, were grown in defined serum-free growth and differentiation media, on a non-biological substrate, N-1[3-trimethoxysilyl propyl] diethylenetriamine. Myotubes were evaluated morphologically and immunocytochemically, using MyHC specific antibodies, as well as functionally using patch clamp electrophysiology to measure ion channel activity. Results indicated the establishment of the rapid expression of adult myosin isoforms that contrasts to their slow development in embryonic cultures. This culture system has applications in the understanding and treatment of age related muscle myopathy, muscular dystrophy, and for skeletal muscle engineering by providing a more relevant phenotype for both in vitro and in vivo applications. PMID:25683642

  2. Scaling approach to study the changes through the gestation of human fetal cardiac and circulatory behaviors.

    PubMed

    Pennati, G; Fumero, R

    2000-04-01

    During human gestation, fetal body size increases considerably and important transformations occur to hemodynamics of the cardiovascular system of the fetus. Vascular compliances and resistances as well as the cardiac function show important changes. In order to investigate these modifications, a mathematical approach based on scaling techniques was developed. Vascular and cardiac parameters of the human fetus were related by allometric equations to the anatomical dimensions of vessels that, in turn, depend on the fetal body weight and the gestational age. A scaling factor (b) was identified for each parameter under study: vascular resistances and flow inertances decrease with gestational age (b= -0.33 for flow inertances) whereas vascular compliances remarkably increase (b= 1.33). Scaling factors were also adopted for the fetal cardiac parameters, according to experimental data on the development of fetal myocardium. Parameter values calculated for each week of the last trimester of the fetal gestation, were tested using a mathematical lumped parameter model, previously developed for a human fetus near the term of the gestation. The validation of the scaling method adopted for the parameters was performed by comparing the results of the simulations with a group of data obtained by Doppler velocimetry at different stages of fetal normal gestation. The adopted allometric equations were appropriate in describing the development of the human fetal circulatory system. The ductus venosus, the ductus arteriosus, and the foramen ovale, that conclude their function at the birth moment, as well as the lungs and the brain, do not follow the general growth rate and require different scaling factors. PMID:10870901

  3. Relationship between fine particulate matter events with respect to synoptic weather patterns and the implications for circulatory and respiratory disease in Taipei, Taiwan.

    PubMed

    Lai, Li-Wei

    2014-01-01

    The aim of the study is to assess the relationship between PM2.5, synoptic weather patterns, and admissions for circulatory and respiratory disease. A PM2.5 event is defined as a day when the daily mean PM2.5 concentration exceeds 65 μg/m(3). PM2.5 events that coincided with the occurrence of PM attributed to Asian dust storm (ADS) and photochemical smog (PCS) were removed from the study in order to focus solely on the health effects from PM2.5. A one-tailed z-test and a relative risk (RR) estimate were performed. Hospital admissions for respiratory diseases were greater than those for circulatory diseases, and asthma-related diseases had a higher impact in the Adults group, and the maximum RR was 1.94 [1.37 2.77] on the first day after the event. It is evident that PM2.5 episodes connected to particular synoptic weather patterns pose a risk to health as large as ADS and PCS events. PMID:24382057

  4. Successful management of cold-induced urticaria during hypothermic circulatory arrest.

    PubMed

    Ellis, Anne K; Saha, Tarit; Arellano, Ramiro; Zajac, Andrew; Payne, Darrin M

    2013-11-01

    Cold-induced urticaria (CIU) is a potentially life-threatening immunologic disorder characterized by swelling and edema of exposed tissue in response to a cold stimulus. We describe the successful management of a patient with a history of severe CIU who required coronary bypass and repair of an ascending aortic aneurysm using hypothermic circulatory arrest. PMID:24182476

  5. 9 CFR 309.4 - Livestock showing symptoms of certain metabolic, toxic, nervous, or circulatory disturbances...

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... diseases. 309.4 Section 309.4 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF..., toxic, nervous, or circulatory disturbances, nutritional imbalances, or infectious or parasitic diseases... the animal is, in fact, infected with such disease. If it is found on such tests to be infected,...

  6. 9 CFR 309.4 - Livestock showing symptoms of certain metabolic, toxic, nervous, or circulatory disturbances...

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... diseases. 309.4 Section 309.4 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF..., toxic, nervous, or circulatory disturbances, nutritional imbalances, or infectious or parasitic diseases... the animal is, in fact, infected with such disease. If it is found on such tests to be infected,...

  7. 9 CFR 309.4 - Livestock showing symptoms of certain metabolic, toxic, nervous, or circulatory disturbances...

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... diseases. 309.4 Section 309.4 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF..., toxic, nervous, or circulatory disturbances, nutritional imbalances, or infectious or parasitic diseases... the animal is, in fact, infected with such disease. If it is found on such tests to be infected,...

  8. 9 CFR 309.4 - Livestock showing symptoms of certain metabolic, toxic, nervous, or circulatory disturbances...

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... diseases. 309.4 Section 309.4 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF..., toxic, nervous, or circulatory disturbances, nutritional imbalances, or infectious or parasitic diseases... the animal is, in fact, infected with such disease. If it is found on such tests to be infected,...

  9. Lung transplantation from donors after circulatory death using portable ex vivo lung perfusion

    PubMed Central

    Bozso, Sabin; Vasanthan, Vishnu; Luc, Jessica GY; Kinaschuk, Katie; Freed, Darren; Nagendran, Jayan

    2015-01-01

    BACKGROUND: Donation after circulatory death is a novel method of increasing the number of donor lungs available for transplantation. Using organs from donors after circulatory death has the potential to increase the number of transplants performed. METHODS: Three bilateral lung transplants from donors after circulatory death were performed over a six-month period. Following organ retrieval, all sets of lungs were placed on a portable ex vivo lung perfusion device for evaluation and preservation. RESULTS: Lung function remained stable during portable ex vivo perfusion, with improvement in partial pressure of oxygen/fraction of inspired oxygen ratios. Mechanical ventilation was discontinued within 48 h for each recipient and no patient stayed in the intensive care unit longer than eight days. There was no postgraft dysfunction at 72 h in two of the three recipients. Ninety-day mortality for all recipients was 0% and all maintain excellent forced expiratory volume in 1 s and forced vital capacity values post-transplantation. CONCLUSION: The authors report excellent results with their initial experience using donors after circulatory death after portable ex vivo lung perfusion. It is hoped this will allow for the most efficient use of available donor lungs, leading to more transplants and fewer deaths for potential recipients on wait lists. PMID:25379654

  10. The Return Circulatory Migrant Student: A Perception of Teachers, School, and Self.

    ERIC Educational Resources Information Center

    Seilhamer, E. Stella; Prewitt-Diaz, Joseph O.

    1983-01-01

    Discusses adjustment problems of Puerto Rican return migrant students (those who return to Puerto Rico after living in the United States for over three years). Compares return migrants' perceptions regarding self, teachers, and school with those of circulatory migrant students (those who constantly shuttle between Puerto Rico and the United…

  11. Energy production per circulatory cycle: a constant in resting land vertebrates?

    PubMed

    Coulson, R A; Herbert, J D

    1984-01-01

    Correcting for differences in blood flow, resting alligators, caimans, lizards, turtles, rats and dogs deaminated amino acids at the same rate. Each produced about 21 calories/kg during one complete circulatory revolution, irrespective of body temperature, size or species. Uniform O2 and substrate A-V differences are responsible for the phenomenon. PMID:6148175

  12. Study report on modification of the long term circulatory model for the simulation of bed rest

    NASA Technical Reports Server (NTRS)

    Leonard, J. I.; Grounds, D. J.

    1977-01-01

    Modifications were made of the circulatory, fluid, and electrolyte control model which was based on the model of Guyton. The modifications included separate leg compartments and the addition of gravity dependency. It was found that these modifications allowed for more accurate bed rest simulation by simulating changes in the orthostatic gradient and simulating the response to the fluid shifts associated with bed rest.

  13. Building Professional Development Systems in Adult Basic Education: Lessons from the Field

    ERIC Educational Resources Information Center

    Belzer, Alisa; Drennon, Cassandra; Smith, Cristine

    2001-01-01

    In Chapter Five, Alisa Belzer, Cassandra Drennon and Cristine Smith provide an overview of the challenges facing state-level professional development systems. The authors begin the chapter with a brief history of professional development in adult basic education, noting shifts in the funding and priority of professional development in the field.…

  14. Contesting Childhood in the US Justice System: The Transfer of Juveniles to Adult Criminal Court

    ERIC Educational Resources Information Center

    Shook, Jeffrey J.

    2005-01-01

    Recent legislative enactments have altered the boundary between US juvenile and criminal justice systems. Youth that were previously adjudicated as juveniles are increasingly being labeled "adults" and tried in the criminal court. This article begins with a review of policy and practice changes in the transfer of children to the criminal court.…

  15. Establishing an Evidence-Based Adult Education System. NCSALL Occasional Paper.

    ERIC Educational Resources Information Center

    Comings, John P.; Beder, Hal; Bingman, Beth; Reder, Stephen; Smith, Cristine

    To benefit from the support of public and private sector leaders and to ensure that all students receive effective services, the adult education system must identify program models that have empirical evidence to support claims of effectiveness. The U.S. Department of Education's Institute of Education Sciences defines evidence-based education as…

  16. The Impact of Five Years of Adult Academic Education in a Selected School System in Louisiana.

    ERIC Educational Resources Information Center

    Bertrand, John Avery

    A study of 486 graduates of the adult academic education program in a Louisiana parish school system investigated whether such a program has a positive effect on its graduates, and whether program inpacts will vary by sex, age, and number of years since completing the program. A special socioeconomic questionnaire was administered in interviews…

  17. Methylphenidate Transdermal System in Adult ADHD and Impact on Emotional and Oppositional Symptoms

    ERIC Educational Resources Information Center

    Marchant, Barrie K.; Reimherr, Frederick W.; Robison, Reid J.; Olsen, John L.; Kondo, Douglas G.

    2011-01-01

    Objective: This trial evaluated the effect of methylphenidate transdermal system (MTS) on the full spectrum of adult symptoms (attention-disorganization, hyperactivity-impulsivity, emotional dysregulation [ED], and oppositional-defiant disorder [ODD]) found in this disorder. Method: This placebo-controlled, double-blind, flexible-dose, crossover…

  18. Support Systems for Injured Workers. Tierra de Oportunidad Module 5. LAES: Latino Adult Education Services Project.

    ERIC Educational Resources Information Center

    Kissam, Ed; Dorsey, Holda

    This module, which may be used as the basis for a workshop or as a special topic unit in an adult basic education or English-as-a-Second-Language (ESL) course, focuses on support systems for injured workers. The following items are included: module overview; list of basic, thinking, interpersonal, information utilization, and other skills…

  19. Analysis of Dose Response for Circulatory Disease After Radiotherapy for Benign Disease

    SciTech Connect

    Little, Mark P.; Kleinerman, Ruth A.; Stovall, Marilyn; Smith, Susan A.; Mabuchi, Kiyohiko

    2012-12-01

    Purpose: To assess the shape of the dose-response for various circulatory disease endpoints, and modifiers by age and time since exposure. Methods and Materials: This was an analysis of the US peptic ulcer data testing for heterogeneity of radiogenic risk by circulatory disease endpoint (ischemic heart, cerebrovascular, other circulatory disease). Results: There were significant excess risks for all circulatory disease, with an excess relative risk Gy{sup -1} of 0.082 (95% CI 0.031-0.140), and ischemic heart disease, with an excess relative risk Gy{sup -1} of 0.102 (95% CI 0.039-0.174) (both p = 0.01), and indications of excess risk for stroke. There were no statistically significant (p > 0.2) differences between risks by endpoint, and few indications of curvature in the dose-response. There were significant (p < 0.001) modifications of relative risk by time since exposure, the magnitude of which did not vary between endpoints (p > 0.2). Risk modifications were similar if analysis was restricted to patients receiving radiation, although the relative risks were slightly larger and the risk of stroke failed to be significant. The slopes of the dose-response were generally consistent with those observed in the Japanese atomic bomb survivors and in occupationally and medically exposed groups. Conclusions: There were excess risks for a variety of circulatory diseases in this dataset, with significant modification of risk by time since exposure. The consistency of the dose-response slopes with those observed in radiotherapeutically treated groups at much higher dose, as well as in lower dose-exposed cohorts such as the Japanese atomic bomb survivors and nuclear workers, implies that there may be little sparing effect of fractionation of dose or low-dose-rate exposure.

  20. Orthostatic Circulatory Disorders: From Nosology to Nuts and Bolts.

    PubMed

    Gutkin, Michael; Stewart, Julian M

    2016-09-01

    When patients complain of altered consciousness or discomfort in the upright posture, either relieved by recumbency or culminating in syncope, physicians may find themselves baffled. There is a wide variety of disorders that cause abnormal regulation of blood pressure and pulse rate in the upright posture. The aim of this focused review is 3-fold. First, to offer a classification (nosology) of these disorders; second, to illuminate the mechanisms that underlie them; and third, to assist the physician in the practical aspects of diagnosis of adult orthostatic hypotension, by extending clinical skills with readily available office technology. PMID:27037712

  1. A cholinergic contribution to the circulatory responses evoked at the onset of handgrip exercise in humans.

    PubMed

    Vianna, Lauro C; Fadel, Paul J; Secher, Niels H; Fisher, James P

    2015-04-01

    A cholinergic (muscarinic) contribution to the initial circulatory response to exercise in humans remains controversial. Herein, we posit that this may be due to exercise mode with a cholinergic contribution being important during isometric handgrip exercise, where the hyperemic response of the muscle is relatively small compared with the onset of leg cycling, where a marked increase in muscle blood flow rapidly occurs as a consequence of multiple redundant mechanisms. We recorded blood pressure (BP; brachial artery), stroke volume (pulse contour analysis), cardiac output, and systemic vascular resistance (SVR) in young healthy males, while performing either 20 s of isometric handgrip contraction at 40% maximum voluntary contraction (protocol 1; n = 9) or 20 s of low-intensity leg cycling exercise (protocol 2; n = 8, 42 ± 8 W). Exercise trials were conducted under control (no drug) conditions and following cholinergic blockade (glycopyrrolate). Under control conditions, isometric handgrip elicited an initial increase in BP (+5 ± 2 mmHg at 3 s and +3 ± 1 mmHg at 10 s, P < 0.05), while SVR dropped after 3 s (-27 ± 6% at 20 s; P < 0.05). Cholinergic blockade abolished the isometric handgrip-induced fall in SVR and, thereby, augmented the pressor response (+13 ± 3 mmHg at 10 s; P < 0.05 vs. control). In contrast, cholinergic blockade had a nonsignificant effect on changes in BP and SVR at the onset of leg cycling exercise. These findings suggest that a cholinergic mechanism is important for the BP and SVR responses at the onset of isometric handgrip exercise in humans. PMID:25589014

  2. Development of a preclinical model of donation after circulatory determination of death for translational application

    PubMed Central

    2014-01-01

    Background Extracorporeal membranous oxygenation is proposed for abdominal organ procurement from donation after circulatory determination of death (DCD). In France, the national Agency of Biomedicine supervises the procurement of kidneys from DCD, specifying the durations of tolerated warm and cold ischemia. However, no study has determined the optimal conditions of this technique. The aim of this work was to develop a preclinical model of DCD using abdominal normothermic oxygenated recirculation (ANOR). In short, our objectives are to characterize the mechanisms involved during ANOR and its impact on abdominal organs. Methods We used Large White pigs weighing between 45 and 55 kg. After 30 minutes of potassium-induced cardiac arrest, the descending thoracic aorta was clamped and ANOR set up between the inferior vena cava and the abdominal aorta for 4 hours. Hemodynamic, respiratory and biochemical parameters were collected. Blood gasometry and biochemistry analysis were performed during the ANOR procedure. Results Six ANOR procedures were performed. The surgical procedure is described and intraoperative parameters and biological data are presented. Pump flow rates were between 2.5 and 3 l/min. Hemodynamic, respiratory, and biochemical objectives were achieved under reproducible conditions. Interestingly, animals remained hemodynamically stable following the targeted protocol. Arterial pH was controlled, and natremia and renal function remained stable 4 hours after the procedure was started. Decreased hemoglobin and serum proteins levels, concomitant with increased lactate dehydrogenase activity, were observed as a consequence of the surgery. The serum potassium level was increased, owing to the extracorporeal circulation circuit. Conclusions Our ANOR model is the closest to clinical conditions reported in the literature and will allow the study of the systemic and abdominal organ impact of this technique. The translational relevance of the pig will permit

  3. Risk of mortality from circulatory diseases in Mayak workers cohort following occupational radiation exposure.

    PubMed

    Azizova, T V; Grigorieva, E S; Hunter, N; Pikulina, M V; Moseeva, M B

    2015-09-01

    Mortality from circulatory diseases (CD) (ICD-9 codes 390-459) was studied in an extended Mayak worker cohort, which included 22,377 workers first employed at the Mayak Production Association in 1948-1982 and followed up to the end of 2008. The enlarged cohort and extended follow-up as compared to the previous analyses provided an increased number of deaths from CD and improved statistical power of this mortality study. The analyses were based on dose estimates provided by a new Mayak Worker Dosimetry System 2008 (MWDS-2008). For the first time in the study of non-cancer effects in this cohort quantitative smoking data (smoking index) were taken into account. A significant increasing trend for CD mortality with increasing dose from external gamma-rays was found after having adjusted for non-radiation factors; the excess relative risk per unit dose (ERR/Gy) was 0.05 (95% confidence interval (CI):  >0, 0.11). Inclusion of an additional adjustment for dose from internal alpha-radiation to the liver resulted in a two-fold increase of ERR/Gy = 0.10 (95% CI: 0.02, 0.21). A significant increasing trend in CD mortality with increasing dose from internal alpha-radiation to the liver was observed (ERR/Gy = 0.27, 95% CI: 0.12, 0.48). However the ERR/Gy decreased and lost its significance after adjusting for dose from external gamma-rays. Results of the current study are in good agreement with risk estimates obtained for the Japanese LSS cohort as well as other studies of cohorts of nuclear workers. PMID:26082993

  4. A review of non-cancer effects, especially circulatory and ocular diseases.

    PubMed

    Little, Mark P

    2013-11-01

    There is a well-established association between high doses (>5 Gy) of ionizing radiation exposure and damage to the heart and coronary arteries, although only recently have studies with high-quality individual dosimetry been conducted that would enable quantification of this risk adjusting for concomitant chemotherapy. The association between lower dose exposures and late occurring circulatory disease has only recently begun to emerge in the Japanese atomic bomb survivors and in various occupationally exposed cohorts and is still controversial. Excess relative risks per unit dose in moderate- and low-dose epidemiological studies are somewhat variable, possibly a result of confounding and effect modification by well-known (but unobserved) risk factors. Radiation doses of 1 Gy or more are associated with increased risk of posterior subcapsular cataract. Accumulating evidence from the Japanese atomic bomb survivors, Chernobyl liquidators, US astronauts, and various other exposed groups suggests that cortical cataracts may also be associated with ionizing radiation, although there is little evidence that nuclear cataracts are radiogenic. The dose-response appears to be linear, although modest thresholds (of no more than about 0.6 Gy) cannot be ruled out. A variety of other non-malignant effects have been observed after moderate/low-dose exposure in various groups, in particular respiratory and digestive disease and central nervous system (and in particular neuro-cognitive) damage. However, because these are generally only observed in isolated groups, or because the evidence is excessively heterogeneous, these associations must be treated with caution. PMID:23903347

  5. Two Scimitar Veins in an Adult

    PubMed Central

    Schwill, Simon; Prete, Jennifer Del; Cooley, Denton A.; Morales, David L.S.

    2010-01-01

    Scimitar syndrome is a rare but serious congenital condition that consists of anomalous pulmonary venous drainage of the right lung to the inferior vena cava. The appearance on chest radiography resembles a curved Turkish sword, or scimitar. Scimitar syndrome is associated with other anomalies, including hypoplasia of the right lung, dextroposition of the heart, anomalous systemic arterial supply to the right lung, and atrial septal defect. Clinical manifestations in infants include severe tachypnea and cyanosis. Adult patients may present with dyspnea and increased fatigue. Few adult cases have been reported in the medical literature. Classical surgical repair involves diversion of the scimitar venous flow into the left atrium with a baffle, requiring the use of cardiopulmonary bypass and deep hypothermic circulatory arrest. Herein, we report the case of a 42-year-old woman with 2 scimitar veins who underwent corrective surgery at our center without the use of cardiopulmonary bypass. We also comment on the importance of a patient's lung hypoplasia in the decision to repair the defect through a right thoracotomy. PMID:20548823

  6. Oligodendrocyte heterogeneity in the mouse juvenile and adult central nervous system.

    PubMed

    Marques, Sueli; Zeisel, Amit; Codeluppi, Simone; van Bruggen, David; Mendanha Falcão, Ana; Xiao, Lin; Li, Huiliang; Häring, Martin; Hochgerner, Hannah; Romanov, Roman A; Gyllborg, Daniel; Muñoz-Manchado, Ana B; La Manno, Gioele; Lönnerberg, Peter; Floriddia, Elisa M; Rezayee, Fatemah; Ernfors, Patrik; Arenas, Ernest; Hjerling-Leffler, Jens; Harkany, Tibor; Richardson, William D; Linnarsson, Sten; Castelo-Branco, Gonçalo

    2016-06-10

    Oligodendrocytes have been considered as a functionally homogeneous population in the central nervous system (CNS). We performed single-cell RNA sequencing on 5072 cells of the oligodendrocyte lineage from 10 regions of the mouse juvenile and adult CNS. Thirteen distinct populations were identified, 12 of which represent a continuum from Pdgfra(+) oligodendrocyte precursor cells (OPCs) to distinct mature oligodendrocytes. Initial stages of differentiation were similar across the juvenile CNS, whereas subsets of mature oligodendrocytes were enriched in specific regions in the adult brain. Newly formed oligodendrocytes were detected in the adult CNS and were responsive to complex motor learning. A second Pdgfra(+) population, distinct from OPCs, was found along vessels. Our study reveals the dynamics of oligodendrocyte differentiation and maturation, uncoupling them at a transcriptional level and highlighting oligodendrocyte heterogeneity in the CNS. PMID:27284195

  7. Targeted B cell therapies in the treatment of adult and pediatric systemic lupus erythematosus.

    PubMed

    Hui-Yuen, J S; Nguyen, S C; Askanase, A D

    2016-09-01

    Belimumab (Benlysta) is a fully-humanized monoclonal antibody that inhibits B-lymphocyte stimulator (also known as B cell activating factor) and was approved by the U.S. Federal Drug Administration and European Medicines Evaluation Agency for treatment in adults with autoantibody-positive systemic lupus erythematosus (SLE). Rituximab (Rituxan) is a chimeric anti-CD20 monoclonal antibody targeting B lymphocytes. This review discusses the key findings of the phase III trials in adults with SLE and of real-world use of belimumab and rituximab in the care of both adult and pediatric SLE patients. It highlights the safety profile of belimumab and rituximab and gives insight into the consideration of these therapies for specific SLE disease states. It concludes with a discussion of the current clinical trials investigating B cell therapies in specific SLE disease states and a look to the future, with ongoing clinical trials. PMID:27497253

  8. Applicability of the International Affective Picture System in Chinese older adults: A validation study.

    PubMed

    Gong, Xianmin; Wang, Dahua

    2016-06-01

    The International Affective Picture System (IAPS) is a standardized tool widely used to induce emotions in psychological studies. The present study examined the reliability and validity of the IAPS in Chinese older adults. A sample consisting of 126 Chinese older adults (86 females; aged 67.3 ± 4.96 years; 13.2 ± 2.75 years of education) was recruited to rate valence and arousal for 942 IAPS pictures. The results showed a satisfactory reliability and validity of the IAPS among these participants. The reliability was supported by high internal consistency and low inter-individual variance of participants' ratings; the validity was supported by high similarities (in rating scores and in the distribution of the pictures in the valence-arousal affective space) and small differences (in mean ratings) between Chinese and German older adults. In conclusion, the study adds supportive evidence to the cross-cultural validity of the IAPS in older adults, and provides a set of normative emotional ratings that could be adopted as a criterion in the selection of emotional pictures in future studies engaging Chinese older adults. Comparison of the IAPS ratings across cultures and ages is also discussed. PMID:27256203

  9. Strength in Numbers: Learning Together in Online Communities--A Learner Support System for Adult First Nation Students and Practitioners

    ERIC Educational Resources Information Center

    Sanguins, Heather

    2015-01-01

    Longstanding calls for return to self-government and continuing alienation of First Nations' youth from mainstream educational systems point to the need for provision of adult education that serves First Nations' needs. An adaptable and culturally coherent learner support system for adult education programs for First Nation students and…

  10. A congenital malformation of the systemic heart complex in Sepia officinalis L. (Cephalopoda)

    NASA Astrophysics Data System (ADS)

    Schipp, R.; von Boletzky, S.; Jakobs, P.; Labourg, P. J.

    1998-03-01

    In semi-adult Sepia officinalis L. (Cephalopoda) from the Bay of Arcachon (France) a congenital malformation of the systemic heart is described by macro-and microscopical methods. It concerns an atypical doubling of the site of insertion at the cephalic aorta at the apical ventricle. Its comparison with the paired anlagen of the systemic heart complex in normal embryogenesis and the central circulatory system of Nautilus gives rise to interpret it as a form of atavism. The possible causal role of mutagenic antifoulings is discussed.

  11. Building a Comprehensive System of Services to Support Adults Living with Long-Term Mechanical Ventilation

    PubMed Central

    Leasa, David; Elson, Stephen

    2016-01-01

    Background. Increasing numbers of individuals require long-term mechanical ventilation (LTMV) in the community. In the South West Local Health Integration Network (LHIN) in Ontario, multiple organizations have come together to design, build, and operate a system to serve adults living with LTMV. Objective. The goal was to develop an integrated approach to meet the health and supportive care needs of adults living with LTMV. Methods. The project was undertaken in three phases: System Design, Implementation Planning, and Implementation. Results. There are both qualitative and quantitative evidences that a multiorganizational system of care is now operational and functioning in a way that previously did not exist. An Oversight Committee and an Operations Management Committee currently support the system of services. A Memorandum of Understanding has been signed by the participating organizations. There is case-based evidence that hospital admissions are being avoided, transitions in care are being thoughtfully planned and executed collaboratively among service providers, and new roles and responsibilities are being accepted within the overall system of care. Conclusion. Addressing the complex and variable needs of adults living with LTMV requires a systems response involving the full continuum of care. PMID:27445527

  12. Building a Comprehensive System of Services to Support Adults Living with Long-Term Mechanical Ventilation.

    PubMed

    Leasa, David; Elson, Stephen

    2016-01-01

    Background. Increasing numbers of individuals require long-term mechanical ventilation (LTMV) in the community. In the South West Local Health Integration Network (LHIN) in Ontario, multiple organizations have come together to design, build, and operate a system to serve adults living with LTMV. Objective. The goal was to develop an integrated approach to meet the health and supportive care needs of adults living with LTMV. Methods. The project was undertaken in three phases: System Design, Implementation Planning, and Implementation. Results. There are both qualitative and quantitative evidences that a multiorganizational system of care is now operational and functioning in a way that previously did not exist. An Oversight Committee and an Operations Management Committee currently support the system of services. A Memorandum of Understanding has been signed by the participating organizations. There is case-based evidence that hospital admissions are being avoided, transitions in care are being thoughtfully planned and executed collaboratively among service providers, and new roles and responsibilities are being accepted within the overall system of care. Conclusion. Addressing the complex and variable needs of adults living with LTMV requires a systems response involving the full continuum of care. PMID:27445527

  13. Use of the adult attachment projective picture system in psychodynamic psychotherapy with a severely traumatized patient

    PubMed Central

    George, Carol; Buchheim, Anna

    2014-01-01

    The following case study is presented to facilitate an understanding of how the attachment information evident from Adult Attachment Projective Picture System (AAP) assessment can be integrated into a psychodynamic perspective in making therapeutic recommendations that integrate an attachment perspective. The Adult Attachment Projective Picture System (AAP) is a valid representational measure of internal representations of attachment based on the analysis of a set of free response picture stimuli designed to systematically activate the attachment system (George and West, 2012). The AAP provides a fruitful diagnostic tool for psychodynamic-oriented clinicians to identify attachment-based deficits and resources for an individual patient in therapy. This paper considers the use of the AAP with a traumatized patient in an inpatient setting and uses a case study to illustrate the components of the AAP that are particularly relevant to a psychodynamic conceptualization. The paper discusses also attachment-based recommendations for intervention. PMID:25140164

  14. The neonate versus adult mammalian immune system in cardiac repair and regeneration.

    PubMed

    Sattler, Susanne; Rosenthal, Nadia

    2016-07-01

    The immune system is a crucial player in tissue homeostasis and wound healing. A sophisticated cascade of events triggered upon injury ensures protection from infection and initiates and orchestrates healing. While the neonatal mammal can readily regenerate damaged tissues, adult regenerative capacity is limited to specific tissue types, and in organs such as the heart, adult wound healing results in fibrotic repair and loss of function. Growing evidence suggests that the immune system greatly influences the balance between regeneration and fibrotic repair. The neonate mammalian immune system has impaired pro-inflammatory function, is prone to T-helper type 2 responses and has an immature adaptive immune system skewed towards regulatory T cells. While these characteristics make infants susceptible to infection and prone to allergies, it may also provide an immunological environment permissive of regeneration. In this review we will give a comprehensive overview of the immune cells involved in healing and regeneration of the heart and explore differences between the adult and neonate immune system that may explain differences in regenerative ability. This article is part of a Special Issue entitled: Cardiomyocyte Biology: Integration of Developmental and Environmental Cues in the Heart edited by Marcus Schaub and Hughes Abriel. PMID:26801961

  15. A possible role for the immune system in adult neurogenesis: new insights from an invertebrate model.

    PubMed

    Harzsch, Steffen; von Bohlen Und Halbach, Oliver

    2016-04-01

    Persistent neurogenesis in the adult brain of both vertebrates and invertebrates was previously considered to be driven by self-renewing neuronal stem cells of ectodermal origin. Recent findings in an invertebrate model challenge this view and instead provide evidence for a recruitment of neuronal precursors from a non-neuronal source. In the brain of adult crayfish, a neurogenic niche was identified that contributes progeny to the adult central olfactory pathway. The niche may function in attracting cells from the hemolymph and transforming them into cells with a neuronal fate. This finding implies that the first-generation neuronal precursors located in the crayfish neurogenic niche are not self-renewing. Evidence is summarized in support of a critical re-evaluation of long-term self-renewal of mammalian neuronal stem cells. Latest findings suggest that a tight link between the immune system and the system driving adult neurogenesis may not only exist in the crayfish but also in mammals. PMID:26739123

  16. Distribution of EphA5 receptor protein in the developing and adult mouse nervous system

    PubMed Central

    Cooper, Margaret A.; Crockett, David P.; Nowakowski, Richard S.; Gale, Nicholas W.; Zhou, Renping

    2009-01-01

    The EphA5 receptor tyrosine kinase plays key roles in axon guidance during development. However, the presence of EphA5 protein in the nervous system has not been fully characterized. To better examine EphA5 localization, mutant mice, in which the EphA5 cytoplasmic domain was replaced with β-galactosidase, were analyzed for both temporal and regional changes in the distribution of EphA5 protein in the developing and adult nervous system. During embryonic development, high levels of EphA5 protein were found in the retina, olfactory bulb, cerebral neocortex, hippocampus, pretectum, tectum, cranial nerve nuclei, and the spinal cord. Variations in intensity were observed as development proceeded. Staining of pretectal nuclei, tectal nuclei, and other areas of the mesencephalon became more diffuse after maturity whereas the cerebral neocortex gained more robust intensity. In the adult, receptor protein continued to be detected in many areas including the olfactory nuclei, neocortex, piriform cortex, induseum griseum, hippocampus, thalamus, amygdala, hypothalamus and septum. In addition, EphA5 protein was found in the claustrum, stria terminalis, barrel cortex, striatal patches, and along discrete axon tracts within the corpus callosum of the adult. These observations suggest that EphA5 function is not limited to the developing mouse brain and may play a role in synaptic plasticity in the adult. PMID:19326470

  17. Childhood onset systemic lupus erythematosus: how is it different from adult SLE?

    PubMed

    Aggarwal, Amita; Srivastava, Puja

    2015-02-01

    About 20% of systemic lupus erythematosus (SLE) starts in childhood and children have less gender bias in favor of females as compared to adults. Systemic manifestations, nephritis, neuro-psychiatric disease and cytopenias are more common in children at presentation than adults. Since most children develop lupus in their early adolescence, dealing with the diagnosis of an unpredictable lifelong disease during this phase of life is challenging. Physicians must recognise specific medical and social needs of this age group, for optimal long-term outcome. Steroids and immunosuppressive drugs are the cornerstone for treatment in children as with adults with lupus. The outcome has improved considerably with these drugs and 10-year survival is nearly 90%. Due to longer life spans more damage accrues in children as compared to adults. Most of the drugs are associated with significant toxicity and the goal of having a drug which reduces disease activity and damage without hampering normal growth, development and fertility is still an elusive one. The current review focuses on clinical and immunological aspects of childhood SLE and how it differs from adulthood SLE. PMID:24965742

  18. Electronic Data Collection and Management System for Global Adult Tobacco Survey

    PubMed Central

    Pujari, Sameer J; Palipudi, Krishna M; Morton, Jeremy; Levinsohn, Jay; Litavecz, Steve; Green, Michael

    2012-01-01

    Introduction: Portable handheld computers and electronic data management systems have been used for national surveys in many high-income countries, however their use in developing countries has been challenging due to varying geographical, economic, climatic, political and cultural environments. In order to monitor and measure global adult tobacco use, the World Health Organization and the US Centers for Disease Control and Prevention initiated the Global Adult Tobacco Survey, a nationally representative household survey of adults, 15 years of age or older, using a standard core questionnaire, sample design, and data collection and management procedures. The Survey has been conducted in 14 low- and middle-income countries, using an electronic data collection and management system. This paper describes implementation of the electronic data collection system and associated findings. Methods: The Survey was based on a comprehensive data management protocol, to enable standardized, globally comparable high quality data collection and management. It included adaptation to specific country needs, selection of appropriate handheld hardware devices, use of open source software, and building country capacity and provide technical support. Results: In its first phase, the Global Adult Tobacco Survey was successfully conducted between 2008 and 2010, using an electronic data collection and management system for interviews in 302,800 households in 14 countries. More than 2,644 handheld computers were fielded and over 2,634 fieldworkers, supervisors and monitors were trained to use them. Questionnaires were developed and programmed in 38 languages and scripts. The global hardware failure rate was < 1% and data loss was almost 0%. Conclusion: Electronic data collection and management systems can be used effectively for conducting nationally representative surveys, particularly in low- and middle-income countries, irrespective of geographical, climatic, political and cultural

  19. Maternal exposure to cadmium during gestation perturbs the vascular system of the adult rat offspring

    SciTech Connect

    Ronco, Ana Maria; Montenegro, Marcela; Castillo, Paula; Urrutia, Manuel; Saez, Daniel; Hirsch, Sandra; Zepeda, Ramiro; Llanos, Miguel N.

    2011-03-01

    Several cardiovascular diseases (CVD) observed in adulthood have been associated with environmental influences during fetal growth. Here, we show that maternal exposure to cadmium, a ubiquitously distributed heavy metal and main component of cigarette smoke is able to induce cardiovascular morpho-functional changes in the offspring at adult age. Heart morphology and vascular reactivity were evaluated in the adult offspring of rats exposed to 30 ppm of cadmium during pregnancy. Echocardiographic examination shows altered heart morphology characterized by a concentric left ventricular hypertrophy. Also, we observed a reduced endothelium-dependent reactivity in isolated aortic rings of adult offspring, while endothelium-independent reactivity remained unaltered. These effects were associated with an increase of hem-oxygenase 1 (HO-1) expression in the aortas of adult offspring. The expression of HO-1 was higher in females than males, a finding likely related to the sex-dependent expression of the vascular cell adhesion molecule 1 (VCAM-1), which was lower in the adult female. All these long-term consequences were observed along with normal birth weights and absence of detectable levels of cadmium in fetal and adult tissues of the offspring. In placental tissues however, cadmium levels were detected and correlated with increased NF-{kappa}B expression - a transcription factor sensitive to inflammation and oxidative stress - suggesting a placentary mechanism that affect genes related to the development of the cardiovascular system. Our results provide, for the first time, direct experimental evidence supporting that exposure to cadmium during pregnancy reprograms cardiovascular development of the offspring which in turn may conduce to a long term increased risk of CVD.

  20. Systemic Vascular Function Is Associated with Muscular Power in Older Adults

    PubMed Central

    Heffernan, Kevin S.; Chalé, Angela; Hau, Cynthia; Cloutier, Gregory J.; Phillips, Edward M.; Warner, Patrick; Nickerson, Heather; Reid, Kieran F.; Kuvin, Jeffrey T.; Fielding, Roger A.

    2012-01-01

    Age-associated loss of muscular strength and muscular power is a critical determinant of loss of physical function and progression to disability in older adults. In this study, we examined the association of systemic vascular function and measures of muscle strength and power in older adults. Measures of vascular endothelial function included brachial artery flow-mediated dilation (FMD) and the pulse wave amplitude reactive hyperemia index (PWA-RHI). Augmentation index (AIx) was taken as a measure of systemic vascular function related to arterial stiffness and wave reflection. Measures of muscular strength included one repetition maximum (1RM) for a bilateral leg press. Peak muscular power was measured during 5 repetitions performed as fast as possible for bilateral leg press at 40% 1RM. Muscular power was associated with brachial FMD (r = 0.43, P < 0.05), PWA-RHI (r = 0.42, P < 0.05), and AIx (r = −0.54, P < 0.05). Muscular strength was not associated with any measure of vascular function. In conclusion, systemic vascular function is associated with lower-limb muscular power but not muscular strength in older adults. Whether loss of muscular power with aging contributes to systemic vascular deconditioning or vascular dysfunction contributes to decrements in muscular power remains to be determined. PMID:22966457

  1. A Smart-Home System to Unobtrusively and Continuously Assess Loneliness in Older Adults.

    PubMed

    Austin, Johanna; Dodge, Hiroko H; Riley, Thomas; Jacobs, Peter G; Thielke, Stephen; Kaye, Jeffrey

    2016-01-01

    Loneliness is a common condition in older adults and is associated with increased morbidity and mortality, decreased sleep quality, and increased risk of cognitive decline. Assessing loneliness in older adults is challenging due to the negative desirability biases associated with being lonely. Thus, it is necessary to develop more objective techniques to assess loneliness in older adults. In this paper, we describe a system to measure loneliness by assessing in-home behavior using wireless motion and contact sensors, phone monitors, and computer software as well as algorithms developed to assess key behaviors of interest. We then present results showing the accuracy of the system in detecting loneliness in a longitudinal study of 16 older adults who agreed to have the sensor platform installed in their own homes for up to 8 months. We show that loneliness is significantly associated with both time out-of-home ([Formula: see text] and [Formula: see text]) and number of computer sessions ([Formula: see text] and [Formula: see text]). [Formula: see text] for the model was 0.35. We also show the model's ability to predict out-of-sample loneliness, demonstrating that the correlation between true loneliness and predicted out-of-sample loneliness is 0.48. When compared with the University of California at Los Angeles loneliness score, the normalized mean absolute error of the predicted loneliness scores was 0.81 and the normalized root mean squared error was 0.91. These results represent first steps toward an unobtrusive, objective method for the prediction of loneliness among older adults, and mark the first time multiple objective behavioral measures that have been related to this key health outcome. PMID:27574577

  2. Durable Mechanical Circulatory Support versus Organ Transplantation: Past, Present, and Future

    PubMed Central

    Anand, Jatin; Singh, Steve K.; Antoun, David G.; Cohn, William E.; Frazier, O. H. (Bud); Mallidi, Hari R.

    2015-01-01

    For more than 30 years, heart transplantation has been a successful therapy for patients with terminal heart failure. Mechanical circulatory support (MCS) was developed as a therapy for end-stage heart failure at a time when cardiac transplantation was not yet a useful treatment modality. With the more successful outcomes of cardiac transplantation in the 1980s, MCS was applied as a bridge to transplantation. Because of donor scarcity and limited long-term survival, heart transplantation has had a trivial impact on the epidemiology of heart failure. Surgical implementation of MCS, both for short- and long-term treatment, affords physicians an opportunity for dramatic expansion of a meaningful therapy for these otherwise mortally ill patients. This review explores the evolution of mechanical circulatory support and its potential for providing long-term therapy, which may address the limitations of cardiac transplantation. PMID:26583140

  3. Is heart transplantation after circulatory death compatible with the dead donor rule?

    PubMed

    Nair-Collins, Michael; Miller, Franklin G

    2016-05-01

    Dalle Ave et al (2016) provide a valuable overview of several protocols for heart transplantation after circulatory death. However, their analysis of the compatibility of heart donation after circulatory death (DCD) with the dead donor rule (DDR) is flawed. Their permanence-based criteria for death, which depart substantially from established law and bioethics, are ad hoc and unfounded. Furthermore, their analysis is self-defeating, because it undercuts the central motivation for DDR as both a legal and a moral constraint, rendering the DDR vacuous and trivial. Rather than devise new and ad hoc criteria for death for the purpose of rendering DCD nominally consistent with DDR, we contend that the best approach is to explicitly abandon DDR. PMID:26984898

  4. [A case of a syndrome resembling PSP after aortic arch replacement under deep hypothermic circulatory arrest].

    PubMed

    Sakiyama, Yusuke; Michizono, Kumiko; Tomari, Shinya; Watanabe, Osamu; Nakahara, Keiichi; Takashima, Hiroshi

    2011-01-01

    A 57-year-old man presented with acute signs and symptoms mimicking PSP (bradykinesia, supranuclear ocular palsy, dysphagia, neck dystonia, and apraxic gait) on the day after a graft replacement surgery, which was performed for aortic arch aneurysm under deep hypothermic circulatory arrest (rectal temperature, 18 degrees C). Dysphagia improved temporarily, but relapsed after a few months. Symptoms did not change during 2 years of antiparkinsonian drug administration. Brain images obtained before the surgery revealed slight atrophy of the midbrain tegmentum and frontal lobes, but the patient was asymptomatic. No findings of cerebral vascular disease and hypoxic encephalopathy were observed on brain images after the surgery. These clinical features resembling PSP might have been caused by deep hypothermia and the patient's predisposition for PSP. This is the first case report in Japan of a syndrome resembling PSP that occurred after aortic arch replacement under deep hypothermic circulatory arrest. PMID:21387699

  5. Estimate of the incidence and importance of circulatory breakthrough in the surgery of cerebral arteriovenous malformations.

    PubMed

    Luessenhop, A J; Ferraz, F M; Rosa, L

    1982-01-01

    Severe hemorrhagic brain swelling has been described occasionally in patients with cerebral AVMs after surgical interruption for feeding arteries, surgical excision, and embolization. The proposed mechanism is an abrupt increase in perfusion pressure in the vasculature of the normal adjacent brain which has lost its capacity to autoregulate. The term circulatory breakthrough has been adopted to describe this. The authors found its incidence to be 3 in 66 patients in a surgical series, but lesser degrees of circulatory breakthrough in smaller lesions may have accounted for most of mortality and morbidity that was encountered. Its importance in embolization is less certain because of the possibility of infarction. It is proposed that better control of this problem by presurgical embolization, surgical staging, and graduated degrees of induced hypotension postsurgery may be necessary if the larger cerebral AVMs are to be excised with mortality and morbidity less than the natural history. PMID:6129586

  6. Gene expression patterns underlying the reinstatement of plasticity in the adult visual system.

    PubMed

    Tiraboschi, Ettore; Guirado, Ramon; Greco, Dario; Auvinen, Petri; Maya-Vetencourt, Jose Fernando; Maffei, Lamberto; Castrén, Eero

    2013-01-01

    The nervous system is highly sensitive to experience during early postnatal life, but this phase of heightened plasticity decreases with age. Recent studies have demonstrated that developmental-like plasticity can be reactivated in the visual cortex of adult animals through environmental or pharmacological manipulations. These findings provide a unique opportunity to study the cellular and molecular mechanisms of adult plasticity. Here we used the monocular deprivation paradigm to investigate large-scale gene expression patterns underlying the reinstatement of plasticity produced by fluoxetine in the adult rat visual cortex. We found changes, confirmed with RT-PCRs, in gene expression in different biological themes, such as chromatin structure remodelling, transcription factors, molecules involved in synaptic plasticity, extracellular matrix, and excitatory and inhibitory neurotransmission. Our findings reveal a key role for several molecules such as the metalloproteases Mmp2 and Mmp9 or the glycoprotein Reelin and open up new insights into the mechanisms underlying the reopening of the critical periods in the adult brain. PMID:23936678

  7. Occlusive ascending aorta and arch atheroma treated with deep hypothermic circulatory arrest and thromboendarterectomy.

    PubMed

    O' Sullivan, Katie E; Early, Sarah A; Lawler, Leo; Hurley, John

    2013-12-01

    We describe an uncommon presentation of severely advanced aortic atherosclerosis in a 48-year old man with a history of hypertension and heavy smoking. Initial presentation with upper limb ischaemia led to the diagnosis of an aortic arch atheroma occluding 90% of the aortic lumen, managed with deep hypothermic circulatory arrest and aortic thromboendarterectomy. To our knowledge, this is the first reported case of atherosclerotic plaque resulting in aortic occlusion and requiring emergent operative intervention. PMID:23956265

  8. Occlusive ascending aorta and arch atheroma treated with deep hypothermic circulatory arrest and thromboendarterectomy

    PubMed Central

    O’ Sullivan, Katie E.; Early, Sarah A.; Lawler, Leo; Hurley, John

    2013-01-01

    We describe an uncommon presentation of severely advanced aortic atherosclerosis in a 48-year old man with a history of hypertension and heavy smoking. Initial presentation with upper limb ischaemia led to the diagnosis of an aortic arch atheroma occluding 90% of the aortic lumen, managed with deep hypothermic circulatory arrest and aortic thromboendarterectomy. To our knowledge, this is the first reported case of atherosclerotic plaque resulting in aortic occlusion and requiring emergent operative intervention. PMID:23956265

  9. Resection of the Aortic Arch with Moderate Hypothermia and Temporary Circulatory Arrest

    PubMed Central

    Speir, Alan M.; Grey, Douglas P.; Cooley, Denton A.

    1982-01-01

    Resection of the aortic arch with the use of moderate hypothermia and temporary circulatory arrest was performed in a 63-year-old woman. The simplified technique is described, along with a brief review of the literature. The patient recovered uneventfully. After this manuscript was prepared, two other patients underwent successful replacement of the aortic arch for aneurysm. These cases are also summarized briefly in an illustrated table. PMID:15226933

  10. Challenges and advances in optimizing liver allografts from donation after circulatory death donors

    PubMed Central

    Sutherland, Andrew Ian; Oniscu, Gabriel C.

    2016-01-01

    In recent years, there has been a shift in the donor demographics with an increase in donation after circulatory death (DCD). Livers obtained from DCD donors are known to have poorer outcomes when compared to donors after brainstem death and currently only a small proportion of DCD livers are used. This review outlines the recent technological developments in liver DCD donation, including clinical studies using normothermic regional perfusion and extracorporal machine perfusion of livers from DCD donors. PMID:27003962

  11. The Impact of Medicaid Expansion on Oral Health Equity for Older Adults: A Systems Perspective

    PubMed Central

    Metcalf, Sara S.; Birenz, Shirley S.; Kunzel, Carol; Wang, Hua; Schrimshaw, Eric W.; Marshall, Stephen E.; Northridge, Mary E.

    2015-01-01

    This paper uses a collaborative, interdisciplinary systems science inquiry to explore implications of Medicaid expansion on achieving oral health equity for older adults. Through an iterative modeling process oriented toward the experiences of both patients and oral health care providers, complex feedback mechanisms for promoting oral health equity are articulated that acknowledge the potential for stigma as well as disparities in oral health care accessibility. Multiple factors mediate the impact of Medicaid expansion on oral health equity. PMID:26457047

  12. A contemporary review of paediatric heart transplantation and mechanical circulatory support.

    PubMed

    Kindel, Steven J; Everitt, Melanie D

    2016-06-01

    Improvements in the care of children with cardiomyopathy, CHDs, and acquired heart disease have led to an increased number of children surviving with advanced heart failure. In addition, the advent of more durable mechanical circulatory support options in children has changed the outcome for many patients who otherwise would have succumbed while waiting for heart transplantation. As a result, more children with end-stage heart failure are being referred for heart transplantation, and there is increased demand for a limited donor organ supply. A review of important publications in the recent years related to paediatric heart failure, transplantation, and mechanical circulatory support show a trend towards pushing the limits of the current therapies to address the needs of this growing population. There have been a number of publications focussing on previously published risk factors perceived as barriers to successful heart transplantation, including elevated pulmonary vascular resistance, medication non-adherence, re-transplantation, transplantation of the failed Fontan patient, and transplantation in an infant or child bridged with mechanical circulatory support. This review will highlight some of these key articles from the last 3 years and describe recent advances in the understanding, diagnosis, and management of children with end-stage heart disease. PMID:26979140

  13. [Comparative study of circulatory response to tracheal intubation with atracurium and succinylcholine].

    PubMed

    Nocite, J R; Serzedo, P S; Zuccolotto, E B; Leães, L F; de Carvalho Júnior, R J

    1990-01-01

    Changes in some circulatory parameters after orotracheal intubation (OTI) were investigated in 40 patients anesthetized with thiopental 5.0 mg.kg-1 and fentanyl 100 micrograms, receiving either atracurium 0.5 mg.kg-1 (n = 20) or succinylcholine 1.0 mg.kg-1 (n = 20) to facilitate intubation. In the succinylcholine group (SC), mean values of SAP, DAP, MAP, and HR rose significantly in relation to control at 30 sec and 2 min after OTI. In the atracurium group (A), mean values of SAP, DAP, and MAP rose significantly at 30 sec after OTI, however, contrary to the SC group, mean values of HR did not rise significantly after OTI. Mean values of the double product HR x SAP rose significantly at 30 sec, 2 min, and 5 min after OTI in the SC group, but only at 30 sec and 2 min after OTI in the A group. The magnitude of elevation of those circulatory parameters studied was always greater in the SC group than in the A group. The authors conclude that atracurium does not modify the nature of circulatory changes after OTI but is associated to such changes in a lesser degree when compared to succinylcholine in a standard induction technique with thiopental/fentanyl. PMID:2103060

  14. Using the brain criterion in organ donation after the circulatory determination of death.

    PubMed

    Dalle Ave, Anne L; Bernat, James L

    2016-06-01

    The UK, France, and Switzerland determine death using the brain criterion even in organ donation after the circulatory determination of death (DCDD), in which the United States and Canada use the circulatory-respiratory criterion. In our analysis of the scientific validity of the brain criterion in DCDD, we concluded that although it may be attractive in theory because it conceptualizes death as a unitary phenomenon, its use in practice is invalid. The preconditions (ie, the absence of reversible causes, such as toxic or metabolic disorders) for determining brain death cannot be met in DCDD. Thus, although brain death tests prove the cessation of tested brain functions, they do not prove that their cessation is irreversible. A stand-off period of 5 to 10 minutes is insufficient to achieve the irreversibility requirement of brain death. Because circulatory cessation inevitably leads to cessation of brain functions, first permanently and then irreversibly, the use of brain criterion is unnecessary to determine death in DCDD. Expanding brain death to permit it to be satisfied by permanent cessation of brain functions is controversial but has been considered as a possible means to declare death in uncontrolled DCDD. PMID:26857329

  15. Extensive thoracoabdominal aortic aneurysm repair using deep hypothermic bypass and circulatory arrest.

    PubMed

    Nishi, Hiroyuki; Miyamoto, Satoru; Minamimura, Hirokazu; Ishikawa, Takumi; Kato, Yasuyuki; Arimoto, Hideki; Ohue, Kensuke; Shimizu, Yoshihiro

    2004-03-01

    We sought to evaluate the safety and usefulness of deep hypothermic cardiopulmonary bypass with intervals of circulatory arrest for extensive thoracoabdominal aortic aneurysms. Between March 1994 and December 2002, 17 patients with Crawford type I and II were reviewed retrospectively. The patients were divided into two groups: group H (hypothermic circulatory arrest, n = 8) and group N (normothermic cardiopulmonary bypass, n = 9). In group H, in-hospital mortality was 12.5%, and that in group N was 11.1%. Operation times were similar between the two groups though the cardiopulmonary bypass time was significantly shorter in group N than in group H (p < 0.05). Postoperative paraplegia occurred in 1 patient of group N. Postoperative renal dysfunction occurred in none of group H except in 1 preoperative dialysis case, whilst it occurred in 6 patients of group N. Postoperative creatinine levels were significantly higher in group N than in group H. Three cases in group H required tracheostomy. Our experience with hypothermic cardiopulmonary bypass and circulatory arrest for diffuse type thoracoabdominal aortic aneurysm confirms the safety and efficacy of this technique. Although respiratory complications remain a problem, the technique is considered to be effective for renal protection. PMID:14977747

  16. Children's and Adults' Memory for Emotional Pictures: Examining Age-Related Patterns Using the Developmental Affective Photo System

    ERIC Educational Resources Information Center

    Cordon, Ingrid M.; Melinder, Annika M. D.; Goodman, Gail S.; Edelstein, Robin S.

    2013-01-01

    Two studies were conducted to examine theoretical questions about children's and adults' memory for emotional visual stimuli. In Study 1, 7- to 9-year-olds and adults (N = 172) participated in the initial creation of the Developmental Affective Photo System (DAPS). Ratings of emotional valence, arousal, and complexity were obtained. In Study 2,…

  17. Transient silencing of Npr3 gene expression improved the circulatory levels of atrial natriuretic peptides and attenuated β-adrenoceptor activation- induced cardiac hypertrophic growth in experimental rats.

    PubMed

    Venkatesan, Balaji; Tumala, Anusha; Subramanian, Vimala; Vellaichamy, Elangovan

    2016-07-01

    Natriuretic peptide receptor-C (NPR-C) is considered as a clearance receptor that maintains the circulatory levels of natriuretic peptides. It has been suggested that augmented expression of NPR-C as a cause for the diminished anti-hypertrophic action of natriuretic peptides in the failing heart. Hence, we sought to determine the level of Npr3 gene (coding for NPR-C) expression in the Isoproterenol (ISO) treated Wistar rats. In addition, we studied the effect of Npr3 gene silencing on the hypertrophic growth. A significant increase in heart weight-to-body weight ratio (HW/BW-24%,P<0.01), an indicator of cardiac hypertrophic growth was observed in the ISO (10mg/kg BW/day,i.p for 7 days) treated rats. As expected, the cardiac NPR-C protein expression was significantly increased by 4 fold as compared to control rats. In parallel, the circulatory atrial natriuretic peptide (ANP) level was significantly decreased (2 fold) in ISO treated rats. Upon treatment with siRNA-Npr3, a significant decrease in the cardiac NPR-C protein expression (70%,P<0.01), HW/BW ratio (70%,P<0.01) and hypertrophic marker genes (α-Sk, β-MHC, c-fos, P<0.01, respectively) mRNA expression were observed. Interestingly, the circulatory ANP level was increased by 1.5 fold in the siRNA-Npr3 treated rats as compared to ISO treated rats. Moreover, the cardiac collagen content, matrixmetalloprotinases-2 (MMP-2) and enzymatic antioxidant status (P<0.01, respectively) were found to be restored back to near normal upon siRNA-Npr3 treatment. Taken together, the results of this study indicates that specific down-regulation of Npr3 gene improves the circulatory levels of ANP and antioxidant system and there by attenuates the β-adrenoceptor over-activation mediated cardiac hypertrophic growth in experimental rats. PMID:27108789

  18. Postembryonic lineages of the Drosophila ventral nervous system: Neuroglian expression reveals the adult hemilineage associated fiber tracts in the adult thoracic neuromeres.

    PubMed

    Shepherd, David; Harris, Robin; Williams, Darren W; Truman, James W

    2016-09-01

    During larval life most of the thoracic neuroblasts (NBs) in Drosophila undergo a second phase of neurogenesis to generate adult-specific neurons that remain in an immature, developmentally stalled state until pupation. Using a combination of MARCM and immunostaining with a neurotactin antibody, Truman et al. (2004; Development 131:5167-5184) identified 24 adult-specific NB lineages within each thoracic hemineuromere of the larval ventral nervous system (VNS), but because of the neurotactin labeling of lineage tracts disappearing early in metamorphosis, they were unable extend the identification of these lineages into the adult. Here we show that immunostaining with an antibody against the cell adhesion molecule neuroglian reveals the same larval secondary lineage projections through metamorphosis and bfy identifying each neuroglian-positive tract at selected stages we have traced the larval hemilineage tracts for all three thoracic neuromeres through metamorphosis into the adult. To validate tract identifications we used the genetic toolkit developed by Harris et al. (2015; Elife 4) to preserve hemilineage-specific GAL4 expression patterns from larval into the adult stage. The immortalized expression proved a powerful confirmation of the analysis of the neuroglian scaffold. This work has enabled us to directly link the secondary, larval NB lineages to their adult counterparts. The data provide an anatomical framework that 1) makes it possible to assign most neurons to their parent lineage and 2) allows more precise definitions of the neuronal organization of the adult VNS based in developmental units/rules. J. Comp. Neurol. 524:2677-2695, 2016. © 2016 The Authors The Journal of Comparative Neurology Published by Wiley Periodicals, Inc. PMID:26878258

  19. The Usability of Electronic Personal Health Record Systems for an Underserved Adult Population

    PubMed Central

    Czaja, Sara J.; Zarcadoolas, Christina; Vaughon, Wendy L.; Lee, Chin Chin; Rockoff, Maxine L.; Levy, Joslyn

    2015-01-01

    Objective The goals of this study were to identify the demands associated with using electronic personal health records (PHRs) and to evaluate the ability of adults of lower socioeconomic status and low health literacy to use PHRs to perform health management activities. Background PHRs are proliferating in clinical practices and health care organizations. These systems offer the potential of increasing the active involvement of patients in health self-management. However, little is known about the actual usability of these tools for health consumers. Method We used task analysis and health literacy load analysis to identify the cognitive and literacy demands inherent in the use of PHRs and evaluated the usability of three currently available PHR systems with a sample of 54 adults. Participants used the systems to perform tasks related to medication management, interpretation of lab/test results, and health maintenance. Data were also gathered on the participants’ perception of the potential value of using a PHR. Results The results indicated that a majority of the participants had difficulty completing the tasks and needed assistance. There was some variability according to task and PHR system. However, most participants perceived the use of PHRs as valuable. Conclusions Although considered a valuable tool by consumers, the use of PHR systems may be challenging for many people. Strategies are needed to enhance the usability of these systems, especially for people with low literacy, low health literacy, or limited technology skills. Application The data from this study have implications for the design of PHRs. PMID:25875437

  20. Reducing Recidivism and Symptoms in Emerging Adults with Serious Mental Health Conditions and Justice System Involvement

    PubMed Central

    Davis, Maryann; Sheidow, Ashli J.; McCart, Michael R.

    2014-01-01

    The peak years of offending in the general population and among those with serious mental health conditions (SMHC) are during emerging adulthood. There currently are no evidence-based interventions for reducing offending behavior among 18–21 year olds, with or without SMHC. This open trial examined outcomes from an adaptation of Multisystemic Therapy (MST), an effective juvenile recidivism reduction intervention, modified for use with emerging adults with SMHC and recent justice system involvement. MST for emerging adults (MST-EA) targets MH symptoms, recidivism, problem substance use, and young adult functional capacities. All study participants (n=41) were aged 17–20 and had a MH diagnosis and recent arrest or incarceration. Implementation outcomes indicated that MST-EA was delivered with strong fidelity, client satisfaction was high, and the majority of participants successfully completed the intervention. Research retention rates also were high. Pre-post analyses revealed significant reductions in participants’ MH symptoms, justice-system involvement, and associations with antisocial peers. PMID:25023764

  1. Growth Arrest Specific 1 (GAS1) Is Abundantly Expressed in the Adult Mouse Central Nervous System

    PubMed Central

    Zarco, Natanael; Bautista, Elizabeth; Cuéllar, Manola; Vergara, Paula; Flores-Rodriguez, Paola; Aguilar-Roblero, Raúl

    2013-01-01

    Growth arrest specific 1 (GAS1) is a pleiotropic protein that induces apoptosis and cell arrest in different tumors, but it is also involved in the development of the nervous system and other tissues and organs. This dual ability is likely caused by its capacity to interact both by inhibiting the intracellular signaling cascade induced by glial cell-line derived neurotrophic factor and by facilitating the activity of the sonic hedgehog pathway. The presence of GAS1 mRNA has been described in adult mouse brain, and here we corroborated this observation. We then proceeded to determine the distribution of the protein in the adult central nervous system (CNS). We detected, by western blot analysis, expression of GAS1 in olfactory bulb, caudate-putamen, cerebral cortex, hippocampus, mesencephalon, medulla oblongata, cerebellum, and cervical spinal cord. To more carefully map the expression of GAS1, we performed double-label immunohistochemistry and noticed expression of GAS1 in neurons in all brain areas examined. We also observed expression of GAS1 in astroglial cells, albeit the pattern of expression was more restricted than that seen in neurons. Briefly, in the present article, we report the widespread distribution and cellular localization of the GAS1 native protein in adult mammalian CNS. PMID:23813868

  2. Approach behavior and sympathetic nervous system reactivity predict substance use in young adults.

    PubMed

    Hinnant, J Benjamin; Forman-Alberti, Alissa B; Freedman, Anna; Byrnes, Lindsay; Degnan, Kathryn A

    2016-07-01

    A behavioral measure of approach (performance on a resource gathering task) in combination with sympathetic nervous system (SNS) reactivity was used to predict substance use in a sample of young adults (n=93). Pre-ejection period reactivity (PEP-R), a cardiac index of SNS reactivity, was recorded during the resource gathering task (task PEP - resting PEP). Higher levels of approach behaviors on the task in combination with less PEP-R (blunted SNS reactivity) predicted the highest levels of substance use. Findings are discussed in the context of behavioral and physiological systems of approach and avoidance. PMID:27178723

  3. Monitoring mobility in older adults using global positioning system (GPS) watches and accelerometers: a feasibility study.

    PubMed

    Webber, Sandra C; Porter, Michelle M

    2009-10-01

    This exploratory study examined the feasibility of using Garmin global positioning system (GPS) watches and ActiGraph accelerometers to monitor walking and other aspects of community mobility in older adults. After accuracy at slow walking speeds was initially determined, 20 older adults (74.4 +/- 4.2 yr) wore the devices for 1 day. Steps, distances, and speeds (on foot and in vehicle) were determined. GPS data acquisition varied from 43 min to over 12 hr, with 55% of participants having more than 8 hr between initial and final data-collection points. When GPS data were acquired without interruptions, detailed mobility information was obtained regarding the timing, distances covered, and speeds reached during trips away from home. Although GPS and accelerometry technology offer promise for monitoring community mobility patterns, new GPS solutions are required that allow for data collection over an extended period of time between indoor and outdoor environments. PMID:19940324

  4. [Mechanical circulatory assist using a miniaturized Archimedes screw].

    PubMed

    von Segesser, L K; Bisang, B; Leskosek, B; Turina, M

    1991-01-01

    An axial flow blood pump (Archimedes screw) for intraarterial left ventricular assist was evaluated in comparison to standard roller pump left heart bypass (LHBP) in 13 bovine experiments (bodyweight 74 +/- 15 kg). Full systemic heparinization (ACT greater than 500 s) was used for LHBP in comparison to limited systemic heparinization (ACT greater than 180 s) for axial. A standard battery of blood samples was taken before and at regular intervals throughout perfusion: (table; see text) Transarterial access and relatively limited blood trauma appear to be the main advantages of the evaluated axial flow blood pump. However, the impossibility to assess the pump flow may be a major problem for the management of the failing left ventricle. PMID:2050534

  5. The Adult Education and Economic Growth Act: Toward a Modern Adult Education System and a More Educated Workforce. [Updated

    ERIC Educational Resources Information Center

    Foster, Marcie

    2012-01-01

    The Adult Education and Economic Growth Act (AEEGA) was introduced in the House of Representatives in June 2011 by Rep. Ruben Hinojosa (TX-15) and in February 2012 in the Senate by Sen. Jim Webb (VA). The Act (H.R. 2226 and S. 2117) would amend the Workforce Investment Act (WIA) to encourage the use and availability of career pathways for…

  6. Consumption of Sugar-Sweetened Beverages Among US Adults in 6 States: Behavioral Risk Factor Surveillance System, 2011

    PubMed Central

    Pan, Liping; Sherry, Bettylou; Blanck, Heidi M.

    2014-01-01

    Introduction Sugar-sweetened beverage (SSB) intake is linked to weight gain. Our objective was to examine state-specific SSB intake and behavioral characteristics associated with SSB intake. Methods We used data from the 2011 Behavioral Risk Factor Surveillance System for 38,978 adults aged 18 years or older from 6 states: Delaware, Hawaii, Iowa, Minnesota, New Jersey, and Wisconsin. Multivariate logistic regression was used to estimate adjusted odds ratios for characteristics associated with SSB intake from regular soda and fruit drinks. Results Overall, 23.9% of adults drank SSBs at least once a day. Odds of drinking SSBs 1 or more times per day were significantly greater among younger adults; males; non-Hispanic blacks; adults with lower education; low-income adults or adults with missing income data; adults living in Delaware, Iowa, and Wisconsin versus those living in Minnesota; adults with fruit intake of less than 1 time a day versus 1 or more times a day; adults who were physically inactive versus highly active adults; and current smokers versus nonsmokers. Odds for drinking SSBs 1 or more times per day were significantly lower among adults with 100% fruit juice intake of less than 1 time per day versus 1 or more times per day and among adults who drank alcohol versus those who did not drink alcohol. Conclusion SSB intake varied by states and certain sociodemographic and behavioral characteristics. States can use findings from this study to tailor efforts to decrease SSB intake and to encourage consumption of more healthful beverages (eg, water) among their high-risk populations. PMID:24762529

  7. Medical causes of admissions to hospital among adults in Africa: a systematic review

    PubMed Central

    Etyang, Anthony O.; Scott, John Anthony Gerard

    2013-01-01

    Background Despite the publication of several studies on the subject, there is significant uncertainty regarding the burden of disease among adults in sub-Saharan Africa (sSA). Objectives To describe the breadth of available data regarding causes of admission to hospital, to systematically analyze the methodological quality of these studies, and to provide recommendations for future research. Design We performed a systematic online and hand-based search for articles describing patterns of medical illnesses in patients admitted to hospitals in sSA between 1950 and 2010. Diseases were grouped into bodily systems using International Classification of Disease (ICD) guidelines. We compared the proportions of admissions and deaths by diagnostic category using χ2. Results Thirty articles, describing 86,307 admissions and 9,695 deaths, met the inclusion criteria. The leading causes of admission were infectious and parasitic diseases (19.8%, 95% confidence interval [CI] 19.6–20.1), respiratory (16.2%, 95% CI 16.0–16.5) and circulatory (11.3%, 95% CI 11.1–11.5) illnesses. The leading causes of death were infectious and parasitic (17.1%, 95% CI 16.4–17.9), circulatory (16%, 95% CI 15.3–16.8) and digestive (16.2%, 95% CI 15.4–16.9). Circulatory diseases increased from 3.9% of all admissions in 1950–59 to 19.9% in 2000–2010 (RR 5.1, 95% CI 4.5–5.8, test for trend p<0.00005). The most prevalent methodological deficiencies, present in two-thirds of studies, were failures to use standardized case definitions and ICD guidelines for classifying illnesses. Conclusions Cardiovascular and infectious diseases are currently the leading causes of admissions and in-hospital deaths in sSA. Methodological deficiencies have limited the usefulness of previous studies in defining national patterns of disease in adults. As African countries pass through demographic and health transition, they need to significantly invest in clinical research capacity to provide an accurate

  8. [The neuromotor functional status of patients with circulatory encephalopathy].

    PubMed

    Ivaniv, A P; Shmakova, I P

    1996-01-01

    The aim of this study was to reveal the secondary neuromuscular disorders in 104 patients with spondylogenic discirculatory encephalopathy and to study the influence of different methods of combined physiotherapy (laser irradiation, troxevasin vacuum-phonophoresis, vacuum-message) on dynamics of electroneuromyographic (ENMG) indices. The application of electroneuromyography (ENMGST-01 apparatus) permitted to establish that pathological neurophysiological phenomena developed in patients progrediently and were qualitatively unstable. It was also determined that combined usage of laser-photobiostimulation and troxevasin vacuum-phonophoresis promoted more steadfast liquidation of neurological signs of the disease as well as the improvement of functional state of neuromotor system. Moreover, the usage of combined ENMG methods significantly contributed to understanding of pathological processes underlying the evaluated neurophysiological syndromes. The authors made the conclusion about high effectiveness and good perspectives of craniocaudal coefficient's application for determination of correlations between clinical state of patients and diagnostic tests' data. PMID:9281282

  9. Towards a Passive Low-Cost In-Home Gait Assessment System for Older Adults

    PubMed Central

    Wang, Fang; Stone, Erik; Skubic, Marjorie; Keller, James M.; Abbott, Carmen; Rantz, Marilyn

    2013-01-01

    In this paper, we propose a webcam-based system for in-home gait assessment of older adults. A methodology has been developed to extract gait parameters including walking speed, step time and step length from a three-dimensional voxel reconstruction, which is built from two calibrated webcam views. The gait parameters are validated with a GAITRite mat and a Vicon motion capture system in the lab with 13 participants and 44 tests, and again with GAITRite for 8 older adults in senior housing. An excellent agreement with intra-class correlation coefficients of 0.99 and repeatability coefficients between 0.7% and 6.6% was found for walking speed, step time and step length given the limitation of frame rate and voxel resolution. The system was further tested with 10 seniors in a scripted scenario representing everyday activities in an unstructured environment. The system results demonstrate the capability of being used as a daily gait assessment tool for fall risk assessment and other medical applications. Furthermore, we found that residents displayed different gait patterns during their clinical GAITRite tests compared to the realistic scenario, namely a mean increase of 21% in walking speed, a mean decrease of 12% in step time, and a mean increase of 6% in step length. These findings provide support for continuous gait assessment in the home for capturing habitual gait. PMID:24235111

  10. Toward a passive low-cost in-home gait assessment system for older adults.

    PubMed

    Wang, Fang; Stone, Erik; Skubic, Marjorie; Keller, James M; Abbott, Carmen; Rantz, Marilyn

    2013-03-01

    In this paper, we propose a webcam-based system for in-home gait assessment of older adults. A methodology has been developed to extract gait parameters including walking speed, step time, and step length from a 3-D voxel reconstruction, which is built from two calibrated webcam views. The gait parameters are validated with a GAITRite mat and a Vicon motion capture system in the laboratory with 13 participants and 44 tests, and again with GAITRite for 8 older adults in senior housing. Excellent agreement with intraclass correlation coefficients of 0.99 and repeatability coefficients between 0.7% and 6.6% was found for walking speed, step time, and step length given the limitation of frame rate and voxel resolution. The system was further tested with ten seniors in a scripted scenario representing everyday activities in an unstructured environment. The system results demonstrate the capability of being used as a daily gait assessment tool for fall risk assessment and other medical applications. Furthermore, we found that residents displayed different gait patterns during their clinical GAITRite tests compared to the realistic scenario, namely a mean increase of 21% in walking speed, a mean decrease of 12% in step time, and a mean increase of 6% in step length. These findings provide support for continuous gait assessment in the home for capturing habitual gait. PMID:24235111

  11. Regulatory System for Stem/Progenitor Cell Niches in the Adult Rodent Pituitary

    PubMed Central

    Yoshida, Saishu; Kato, Takako; Kato, Yukio

    2016-01-01

    The anterior lobe of the pituitary gland is a master endocrine tissue composed of five types of endocrine cells. Although the turnover rate of pituitary endocrine cells is as low as about 1.6% per day, recent studies have demonstrated that Sex-determining region Y-box 2 (SOX2)+-cells exist as pituitary stem/progenitor cells in the adult anterior lobe and contribute to cell regeneration. Notably, SOX2+-pituitary stem/progenitor cells form two types of niches in this tissue: the marginal cell layer (MCL-niche) and the dense cell clusters scattering in the parenchyma (parenchymal-niche). However, little is known about the mechanisms and factors for regulating the pituitary stem/progenitor cell niches, as well as the functional differences between the two types of niches. Elucidation of the regulatory mechanisms in the niches might enable us to understand the cell regeneration system that acts in accordance with physiological demands in the adult pituitary. In this review, so as to reveal the regulatory mechanisms of the two types of niche, we summarize the regulatory factors and their roles in the adult rodent pituitary niches by focusing on three components: soluble factors, cell surface proteins and extracellular matrixes. PMID:26761002

  12. The Effects of Using the International Versus Comprehensive System Rorschach Norms For Children, Adolescents, and Adults.

    PubMed

    Viglione, Donald J; Giromini, Luciano

    2016-01-01

    Currently, there is some debate about whether to use Comprehensive System norms (CS; Exner, 2003 ) or the Composite International Reference Values (CIRV; Meyer, Erdberg, & Shaffer, 2007 ) when interpreting Rorschach Inkblot Method (RIM; Rorschach, 1921 ) protocols administered with the CS method. The goal of this study is to assist clinicians in making this decision by providing information about the effects of choosing one option or the other. Accordingly, this research evaluates the effects of using the CS versus CIRV norms with children, adolescents, and adults. First, we identified 43 variables for which the CS and the CIRV for children and adolescents differ from each other by at least a Cohen's d value of .50. Next, we evaluated whether these divergent variables are the same as those previously identified as divergent for the adult population. Results showed that for both children and adolescents, as well as for adults, relying on CS norms versus CIRV would result in interpretations that are more pathological in terms of (a) perception and thinking, (b) psychological resources and cognitive and emotional abilities, and (c) representations of human relationships. A discussion on the clinical effects of using one versus the other set of norms follows. PMID:26829463

  13. Factors associated with oral hygiene practices among adults with systemic sclerosis

    PubMed Central

    Yuen, Hon K.; Hant, Faye N.; Hatfield, Corey; Summerlin, Lisa M.; Smith, Edwin A.; Silver, Richard M.

    2013-01-01

    OBJECTIVE To identify factors associated with oral hygiene practices in adults with systemic sclerosis (SSc) METHODS In this cross-sectional study, 178 dentate adults with SSc received an oral examination which included measurement of oral aperture, assessment of manual dexterity to perform oral hygiene, as well as completion of the Center of Epidemiological Studies Depression (CES-D) Scale, and an oral health-related questionnaire. RESULTS Multivariable logistic regression modeling showed male, minority and high CES-D scores (i.e., clinically significant symptoms of depression) were associated with less likelihood of participants brushing teeth at least twice daily, but the presence of self-reported dry mouth symptoms increased the likelihood of toothbrushing. Having a dental visit in the past 12 months, and use of an adapted flossing or interdental cleaning device were significantly associated with daily dental flossing; however, having difficulty flossing teeth reduced the likelihood of daily flossing. CONCLUSIONS Overall, demographic variables were strongly associated with toothbrushing frequency, whereas, flossing self-efficacy and barriers were strongly associated with dental flossing frequency in adults with SSc. The results suggest that dental health professionals should take mental health into consideration when educating patients with SSc to improve their oral hygiene, and consider making referrals for patients exhibiting suspected clinically significant depressive symptoms to mental health professionals for further evaluation and treatment. In addition, an appropriate adapted flossing or interdental cleaning device should be recommended to increase dental flossing practices in this patient population. PMID:24128049

  14. Heterogeneous generation of new cells in the adult echinoderm nervous system

    PubMed Central

    Mashanov, Vladimir S.; Zueva, Olga R.; García-Arrarás, José E.

    2015-01-01

    Adult neurogenesis, generation of new functional cells in the mature central nervous system (CNS), has been documented in a number of diverse organisms, ranging from humans to invertebrates. However, the origin and evolution of this phenomenon is still poorly understood for many of the key phylogenetic groups. Echinoderms are one such phylum, positioned as a sister group to chordates within the monophyletic clade Deuterostomia. They are well known for the ability of their adult organs, including the CNS, to completely regenerate after injury. Nothing is known, however, about production of new cells in the nervous tissue under normal physiological conditions in these animals. In this study, we show that new cells are continuously generated in the mature radial nerve cord (RNC) of the sea cucumber Holothuria glaberrima. Importantly, this neurogenic activity is not evenly distributed, but is significantly more extensive in the lateral regions of the RNC than along the midline. Some of the new cells generated in the apical region of the ectoneural neuroepithelium leave their place of origin and migrate basally to populate the neural parenchyma. Gene expression analysis showed that generation of new cells in the adult sea cucumber CNS is associated with transcriptional activity of genes known to be involved in regulation of various aspects of neurogenesis in other animals. Further analysis of one of those genes, the transcription factor Myc, showed that it is expressed, in some, but not all radial glial cells, suggesting heterogeneity of this CNS progenitor cell population in echinoderms. PMID:26441553

  15. Regulatory System for Stem/Progenitor Cell Niches in the Adult Rodent Pituitary.

    PubMed

    Yoshida, Saishu; Kato, Takako; Kato, Yukio

    2016-01-01

    The anterior lobe of the pituitary gland is a master endocrine tissue composed of five types of endocrine cells. Although the turnover rate of pituitary endocrine cells is as low as about 1.6% per day, recent studies have demonstrated that Sex-determining region Y-box 2 (SOX2)⁺-cells exist as pituitary stem/progenitor cells in the adult anterior lobe and contribute to cell regeneration. Notably, SOX2⁺-pituitary stem/progenitor cells form two types of niches in this tissue: the marginal cell layer (MCL-niche) and the dense cell clusters scattering in the parenchyma (parenchymal-niche). However, little is known about the mechanisms and factors for regulating the pituitary stem/progenitor cell niches, as well as the functional differences between the two types of niches. Elucidation of the regulatory mechanisms in the niches might enable us to understand the cell regeneration system that acts in accordance with physiological demands in the adult pituitary. In this review, so as to reveal the regulatory mechanisms of the two types of niche, we summarize the regulatory factors and their roles in the adult rodent pituitary niches by focusing on three components: soluble factors, cell surface proteins and extracellular matrixes. PMID:26761002

  16. Role of thyroid hormone in postnatal circulatory and metabolic adjustments.

    PubMed Central

    Breall, J A; Rudolph, A M; Heymann, M A

    1984-01-01

    To assess the role of the early postnatal surge in plasma thyroid hormone concentrations on cardiovascular and metabolic adaptations, we measured cardiac output, total oxygen consumption, and plasma triiodothyronine (T3) concentrations in three groups of lambs in the first 6 h after delivery. 15 fetal lambs were prepared at gestational ages of 128-129 d by placing catheters in the brachiocephalic artery, descending aorta, distal inferior vena cava, left atrium, and pulmonary artery so that measurements could be made soon after delivery. They were divided into three groups: Group I comprised five control animals; Group II consisted of five fetuses in which thyroidectomy was performed at surgery at 129 d gestation; and Group III consisted of five animals in which thyroidectomy was performed at term gestation during delivery by caesarian section, prior to severing the umbilical cord. The lambs in Group I exhibited a rapid postnatal rise in T3 concentrations, similar to that described previously, reaching a peak value of about 5 ng/ml. Although the postnatal surge in T3 concentration was arrested in Group II and III animals, Group II had no detectable plasma T3, while the Group III animals had T3 concentrations of about 0.8 ng/ml, which were within the range previously reported for term lamb fetuses. The lambs in group II showed 40-50% lower left ventricular outputs (190 vs. 297 ml/kg per min), systemic blood flows (155 vs. 286 ml/kg per min), and oxygen consumptions (9.8 vs. 20.2 ml/kg per min) as compared with Group I animals over the entire 6-h period. The lambs in Group II also had significantly lower heart rates (131 vs. 192 beats/min) and mean systemic arterial pressures (56 vs. 72 torr). However, there were no significant differences for any of these measurements between the Group III and Group I lambs. The reduction in cardiac output in the Group II animals were reflected in a significantly lower blood flow to the peripheral circulation, but there were no

  17. Circulatory adaptation to bimodal respiration in the dipnoan lungfish.

    PubMed

    Fishman, A P; DeLaney, R G; Laurent, P

    1985-08-01

    In the dipnoan lungfish, Protopterus aethiopicus, P. annectens, and Lepidosiren paradoxa, the ductus is a short powerful muscular vascular trunk forming a channel for communication between the systemic and pulmonary circulations. In structure, the dipnoan ductus is very similar to the ductus arteriosus (Botalli) in the mammal. Innervation is abundant, consisting of myelinated and nonmyelinated nerve fibers issuing, at least in part, from the vagus. Neurons are present in the adventitia, and numerous nerve profiles, filled with small agranular vesicles, are closely associated with the myocytes, suggesting strong cholinergic control. Perfusion of the ductus in vitro using hypoxic saline causes it to dilate; conversely it is constricted by alpha-agonists. Dopamine and prostaglandin E2 are potent dilators, whereas the beta-agonist, isoproterenol, and acetylcholine are less powerful. A vasomotor segment has been identified on the pulmonary artery (PAVS) close to its junction with the ductus. Its location and structure are similar to the corresponding segment in amphibians and reptiles. It is innervated by endings filled with small clear vesicles. Granular vesicle cells are also present within the adventitia. The PAVS is constricted by acetylcholine. As in amphibians, alpha-agonists and hypoxic saline are without vasomotor effects. Based on the anatomic and physiological observations, a concept of cyclic perfusion of the gas exchangers in Dipnoi is proposed. During the alternation between air breathing (emersion) and apneic phases (immersion), the pattern of the circulation in the lungfish oscillates between that of a tetrapod and a fish. PMID:4030580

  18. Veno-arterial extracorporeal membrane oxygenation for cardiogenic shock due to myocarditis in adult patients.

    PubMed

    Pozzi, Matteo; Banfi, Carlo; Grinberg, Daniel; Koffel, Catherine; Bendjelid, Karim; Robin, Jacques; Giraud, Raphaël; Obadia, Jean François

    2016-07-01

    Myocarditis is an inflammatory disease of the heart muscle with established histological, immunological and immunohistochemical diagnostic criteria. Different triggers could be advocated as possible etiologies of myocarditis such as viral and non-viral infections, medications, systemic autoimmune diseases and toxic reactions. The spectrum of clinical presentations of myocarditis is broad and varies from subclinical asymptomatic courses to refractory cardiogenic shock. The prognosis of patients with myocarditis depends mainly on the severity of clinical presentation. In particular, myocarditis patients developing cardiogenic shock refractory to optimal maximal medical treatment may benefit from the use of veno-arterial extracorporeal membrane oxygenation (VA-ECMO) as a temporary mechanical circulatory support (MCS). The aim of the present report is to offer a review of the most important articles of the literature showing the results of VA-ECMO in the specific setting of cardiogenic shock due to myocarditis in adult patients. PMID:27499982

  19. Veno-arterial extracorporeal membrane oxygenation for cardiogenic shock due to myocarditis in adult patients

    PubMed Central

    Pozzi, Matteo; Grinberg, Daniel; Koffel, Catherine; Bendjelid, Karim; Robin, Jacques; Giraud, Raphaël; Obadia, Jean François

    2016-01-01

    Myocarditis is an inflammatory disease of the heart muscle with established histological, immunological and immunohistochemical diagnostic criteria. Different triggers could be advocated as possible etiologies of myocarditis such as viral and non-viral infections, medications, systemic autoimmune diseases and toxic reactions. The spectrum of clinical presentations of myocarditis is broad and varies from subclinical asymptomatic courses to refractory cardiogenic shock. The prognosis of patients with myocarditis depends mainly on the severity of clinical presentation. In particular, myocarditis patients developing cardiogenic shock refractory to optimal maximal medical treatment may benefit from the use of veno-arterial extracorporeal membrane oxygenation (VA-ECMO) as a temporary mechanical circulatory support (MCS). The aim of the present report is to offer a review of the most important articles of the literature showing the results of VA-ECMO in the specific setting of cardiogenic shock due to myocarditis in adult patients. PMID:27499982

  20. [Case report - Intraosseous infusion as an alternative solution in the therapy of septicaemia in an adult].

    PubMed

    Lingner, Manuel; Niederer, Oliver; Majolk, Jürgen; Krombholz, Karsten

    2014-02-01

    The intraosseous access can be more often found in the guidelines and recommendations of the medical societies when an peripheral or central venous catheter cannot be established. For the adult this can mostly be found for the cardiopulmonary resuscitation or the patient with major trauma. In pediatrics and neonatology it is a reliable solution for the child in septic shock. In our case a 36 year old presented with an endocarditis and tricuspid valve insufficiency III° by known intravenous drug-abuse and septic shock. It was initially impossible to establish an adequate peripheral or central venous catheter. For this reason a humeral intraosseous access was established. After stabilizing circulatory function and volume replacement a central-venous catheter could be placed and the patient was successfully surgically sanified. We used the EZ-IO((Vidacare Corporation, San Antonio/USA). Appropriate systems should extensively be available in the clinical setting. PMID:24563399

  1. Adult Sickle Cell Quality-of-Life Measurement Information System (ASCQ-Me)

    PubMed Central

    Treadwell, Marsha J.; Hassell, Kathryn; Levine, Roger; Keller, San

    2016-01-01

    Objectives Research-derived evidence about the impact of sickle cell disease (SCD) on the lives of affected adults is lacking. We conducted formative research to provide the basis for a comprehensive description of how SCD affects the lives of adults, with the goal of developing a SCD-specific quality-of-life measurement system. Methods We conducted a comprehensive literature review of patient-reported outcomes, followed by a series of focus groups and structured individual interviews with adults with SCD (n = 122) and their health care providers (n = 15). Results We reviewed 473 abstracts and included 86 articles in the final review. The literature revealed broad categories of the impact of SCD and its treatment on the lives of adults—pain; emotional distress; social-role functioning; overall quality-of-life; and quality of care. We classified 1213 incidents from the focus groups and interviews into a taxonomy (16 domains) that met the criterion for saturation and was demonstrated to be reliable for the classification of incidents. The final conceptual model was built upon the taxonomy. Discussion Our conceptual model was similar to previous models with the effects of pain predominating, interwoven with emotional distress, quality of care, and stigmatization. We found a broad range of emotions reflected, including positive effects of SCD. Items for the quality-of-life measure were derived from the taxonomy and the conceptual model may be of use in generating hypotheses for clinical research and improving understanding for clinicians of the lived experience of adults with SCD. PMID:24300219

  2. Chronic Deep Brain Stimulation of the Hypothalamic Nucleus in Wistar Rats Alters Circulatory Levels of Corticosterone and Proinflammatory Cytokines

    PubMed Central

    Calleja-Castillo, Juan Manuel; De La Cruz-Aguilera, Dora Luz; Manjarrez, Joaquín; Velasco-Velázquez, Marco Antonio; Morales-Espinoza, Gabriel; Moreno-Aguilar, Julia; Hernández, Maria Eugenia; Aguirre-Cruz, Lucinda

    2013-01-01

    Deep brain stimulation (DBS) is a therapeutic option for several diseases, but its effects on HPA axis activity and systemic inflammation are unknown. This study aimed to detect circulatory variations of corticosterone and cytokines levels in Wistar rats, after 21 days of DBS-at the ventrolateral part of the ventromedial hypothalamic nucleus (VMHvl), unilateral cervical vagotomy (UCVgX), or UCVgX plus DBS. We included the respective control (C) and sham (S) groups (n = 6 rats per group). DBS treated rats had higher levels of TNF-α (120%; P < 0.01) and IFN-γ (305%; P < 0.001) but lower corticosterone concentration (48%; P < 0.001) than C and S. UCVgX animals showed increased corticosterone levels (154%; P < 0.001) versus C and S. UCVgX plus DBS increased IL-1β (402%; P < 0.001), IL-6 (160%; P < 0.001), and corsticosterone (178%; P < 0.001 versus 48%; P < 0.001) compared with the C and S groups. Chronic DBS at VMHvl induced a systemic inflammatory response accompanied by a decrease of HPA axis function. UCVgX rats experienced HPA axis hyperactivity as result of vagus nerve injury; however, DBS was unable to block the HPA axis hyperactivity induced by unilateral cervical vagotomy. Further studies are necessary to explore these findings and their clinical implication. PMID:24235973

  3. Comparative structural and functional analysis of the larval and adult dorsal vessel and its role in hemolymph circulation in the mosquito Anopheles gambiae

    PubMed Central

    League, Garrett P.; Onuh, Ogechukwu C.; Hillyer, Julián F.

    2015-01-01

    Hemolymph circulation in insects is driven primarily by the contractile action of a dorsal vessel, which is divided into an abdominal heart and a thoracic aorta. As holometabolous insects, mosquitoes undergo striking morphological and physiological changes during metamorphosis. This study presents a comprehensive structural and functional analysis of the larval and adult dorsal vessel in the malaria mosquito Anopheles gambiae. Using intravital video imaging we show that, unlike the adult heart, the larval heart contracts exclusively in the anterograde direction and does not undergo heartbeat directional reversals. The larval heart contracts 24% slower than the adult heart, and hemolymph travels across the larval dorsal vessel at a velocity that is 68% slower than what is seen in adults. By fluorescently labeling muscle tissue we show that although the general structure of the heart and its ostia are similar across life stages, the heart-associated alary muscles are significantly less robust in larvae. Furthermore, unlike the adult ostia, which are the entry points for hemolymph into the heart, the larval ostia are almost entirely lacking in incurrent function. Instead, hemolymph enters the larval heart through incurrent openings located at the posterior terminus of the heart. These posterior openings are structurally similar across life stages, but in adults have an opposite, excurrent function. Finally, the larval aorta and heart differ significantly in the arrangement of their cardiomyocytes. In summary, this study provides an in-depth developmental comparison of the circulatory system of larval and adult mosquitoes. PMID:25524976

  4. How does the healthcare system affect medication self-management among older adults with multimorbidity?

    PubMed

    Meranius, Martina Summer; Hammar, Lena Marmstål

    2016-03-01

    Individuals with multimorbidity commonly have several concurrent prescriptions and experience healthcare obstacles related to managing different diagnoses and medications. This study aimed to provide a deeper understanding of how older adults with multimorbidity experience medication self-management and how this is affected by the healthcare system. The National Board of Research Ethics approved the study, and 20 older adults with multimorbidity participated in in-depth interviews that were analysed using a hermeneutic approach. Three levels of interpretation emerged. At the first level, lack of participation in healthcare communication hinders adherence and safety, and feeling abandoned to self-care leads to health risk-taking. At the second level, the healthcare organisation is seen as an obstacle to medication self-management. The overall interpretation was a system of repairing 'parts' but not enabling the experience of health. This study shows that the healthcare system is able to treat and relieve an individual's symptoms, but seems unable to help them achieve and promote good health, or to provide the support they need to function in everyday life. PMID:25919419

  5. Central Nervous System Involvement in Adult Acute Lymphoblastic Leukemia: Diagnostic Tools, Prophylaxis, and Therapy

    PubMed Central

    Del Principe, Maria Ilaria; Maurillo, Luca; Buccisano, Francesco; Sconocchia, Giuseppe; Cefalo, Mariagiovanna; De Santis, Giovanna; Di Veroli, Ambra; Ditto, Concetta; Nasso, Daniela; Postorino, Massimiliano; Refrigeri, Marco; Attrotto, Cristina; Del Poeta, Giovanni; Lo-Coco, Francesco; Amadori, Sergio; Venditti, Adriano

    2014-01-01

    In adult patients with acute lymphoblastic leukemia (ALL), Central Nervous System (CNS) involvement is associated with a very poor prognosis. The diagnostic assessment of this condition relies on the use of neuroradiology, conventional cytology (CC) and flow cytometry (FCM). Among these approaches, which is the gold standard it is still a matter of debate. Neuroradiology and CC have a limited sensitivity with a higher rate of false negative results. FCM demonstrated a superior sensitivity over CC, particularly when low levels of CNS infiltrating cells are present. Although prospective studies of a large series of patients are still awaited, a positive finding by FCM appears to anticipate an adverse outcome even if CC shows no infiltration. Current strategies for adult ALL CNS-directed prophylaxis or therapy involve systemic and intrathecal chemotherapy and radiation therapy. An early and frequent intrathecal injection of cytostatic combined with systemic chemotherapy is the most effective strategy to reduce the frequency of CNS involvement. In patients with CNS overt ALL, at diagnosis or upon relapse, allogeneic hematopoietic stem cell transplantation might be considered. This review discusses risk factors, diagnostic techniques for identification of CNS infiltration and modalities of prophylaxis and therapy to manage it. PMID:25408861

  6. Osteoporotic spinal burst fracture in a young adult as first presentation of systemic mastocytosis.

    PubMed

    Ble, Christina; Tsitsopoulos, Parmenion P; Anestis, Dimitrios M; Hadjileontiadou, Sofia; Koletsa, Triantafyllia; Papaioannou, Maria; Tsonidis, Christos

    2016-01-01

    Osteoporotic vertebral fractures are uncommon in young adults and usually indicate an underlying disease. Systemic mastocytosis is a myeloproliferative neoplasm, which can be associated with osteoporosis. A previously healthy 30-year-old man presented with an L4 burst fracture after lifting a heavy object. He was operated with laminectomy and posterior lumbar instrumentation. During surgery, abnormally soft bone was noted. Postoperatively, osteoporosis was confirmed with measurement of bone mineral density. Further investigation revealed elevated serum tryptase levels while bone marrow biopsy findings showed systemic mastocytosis. He was also tested positive for D816V KIT mutation. Treatment with biphosphonates and interferon was initiated. No extraskeletal involvement was noted up to the last checkup, 18 months after the first presentation. Abrupt vertebral fractures in apparently healthy young individuals should raise the suspicion of an underlying pathology. Prompt identification and treatment of systemic mastocytosis is crucial in order to avoid unexpected sequelae. PMID:27141048

  7. Osteoporotic spinal burst fracture in a young adult as first presentation of systemic mastocytosis

    PubMed Central

    Ble, Christina; Tsitsopoulos, Parmenion P.; Anestis, Dimitrios M.; Hadjileontiadou, Sofia; Koletsa, Triantafyllia; Papaioannou, Maria; Tsonidis, Christos

    2016-01-01

    Osteoporotic vertebral fractures are uncommon in young adults and usually indicate an underlying disease. Systemic mastocytosis is a myeloproliferative neoplasm, which can be associated with osteoporosis. A previously healthy 30-year-old man presented with an L4 burst fracture after lifting a heavy object. He was operated with laminectomy and posterior lumbar instrumentation. During surgery, abnormally soft bone was noted. Postoperatively, osteoporosis was confirmed with measurement of bone mineral density. Further investigation revealed elevated serum tryptase levels while bone marrow biopsy findings showed systemic mastocytosis. He was also tested positive for D816V KIT mutation. Treatment with biphosphonates and interferon was initiated. No extraskeletal involvement was noted up to the last checkup, 18 months after the first presentation. Abrupt vertebral fractures in apparently healthy young individuals should raise the suspicion of an underlying pathology. Prompt identification and treatment of systemic mastocytosis is crucial in order to avoid unexpected sequelae. PMID:27141048

  8. Outcomes of patients implanted with a left ventricular assist device at nontransplant mechanical circulatory support centers.

    PubMed

    Katz, Marc R; Dickinson, Michael G; Raval, Nirav Y; Slater, James P; Dean, David A; Zeevi, Gary R; Horn, Evelyn M; Salemi, Arash

    2015-05-01

    The goal of this study was to assess outcomes of patients who underwent implantation of left ventricular assist devices (LVADs) at nontransplantation mechanical circulatory support centers. As the availability of LVADs for advanced heart failure has expanded to nontransplantation mechanical circulatory support centers, concerns have been expressed about maintaining good outcomes. Demographics and outcomes were evaluated in 276 patients with advanced heart failure who underwent implantation of LVADs as bridge to transplantation or destination therapy at 27 open-heart centers. Baseline characteristics, operative mortality, length of stay, readmission rate, adverse events, quality of life, and survival were analyzed. The overall 30-day mortality was 3% (8 of 276), and survival rates at 6, 12, and 24 months, respectively, were 92±2%, 88±3%, and 84±4% for the bridge-to-transplantation group and 81±3%, 70±5%, and 63±6% for the destination therapy group, comparable with results published by the national Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS). The median length of stay for all patients was 21 days. Bleeding was the most frequent adverse event. Stroke occurred in 4% (bridge to transplantation) and 6% (destination therapy) of patients. Quality-of-life measures and 6-minute walk distances showed sustained improvements throughout support. In conclusion, outcomes with LVAD support at open-heart centers are acceptable and comparable with results from the INTERMACS registry. With appropriate teams, training, center commitment, and certification, LVAD therapy is being disseminated in a responsible way to open-heart centers. PMID:25772738

  9. Managing the failing heart: total circulatory assist--a case study.

    PubMed

    Allen, Yvonne; Collins, Rachel; Lester, Charnetta; Savage, Laura; Vijayan, Sajitha

    2009-03-01

    Congestive heart failure remains one of the leading causes of cardiac death and disability. As pharmacological therapies have advanced, patients are living longer and more productive lives. However, at some point, these interventions begin to fail. Circulatory assist devices have revolutionized the management of patients with end-stage heart disease. These devices successfully bridge patients to cardiac transplantation. The Syncardia Total Artificial Heart provides biventricular support for the failing heart. This case study illustrates the challenges of caring for patients with such a device. PMID:19341058

  10. Using an Automated 3D-tracking System to Record Individual and Shoals of Adult Zebrafish

    PubMed Central

    Maaswinkel, Hans; Zhu, Liqun; Weng, Wei

    2013-01-01

    Like many aquatic animals, zebrafish (Danio rerio) moves in a 3D space. It is thus preferable to use a 3D recording system to study its behavior. The presented automatic video tracking system accomplishes this by using a mirror system and a calibration procedure that corrects for the considerable error introduced by the transition of light from water to air. With this system it is possible to record both single and groups of adult zebrafish. Before use, the system has to be calibrated. The system consists of three modules: Recording, Path Reconstruction, and Data Processing. The step-by-step protocols for calibration and using the three modules are presented. Depending on the experimental setup, the system can be used for testing neophobia, white aversion, social cohesion, motor impairments, novel object exploration etc. It is especially promising as a first-step tool to study the effects of drugs or mutations on basic behavioral patterns. The system provides information about vertical and horizontal distribution of the zebrafish, about the xyz-components of kinematic parameters (such as locomotion, velocity, acceleration, and turning angle) and it provides the data necessary to calculate parameters for social cohesions when testing shoals. PMID:24336189

  11. Regional gray matter volume is associated with empathizing and systemizing in young adults.

    PubMed

    Takeuchi, Hikaru; Taki, Yasuyuki; Sassa, Yuko; Hashizume, Hiroshi; Sekiguchi, Atsushi; Fukushima, Ai; Kawashima, Ryuta

    2014-01-01

    Empathizing is defined as the drive to identify the mental states of others for predicting their behavior and responding with an appropriate emotion. Systemizing is defined as the drive to analyze a system in terms of the rules that govern the system in order to predict its behavior. Using voxel-based morphometry and questionnaires in a large sample of normal, right-handed young adults, we investigated the regional gray matter volume (rGMV) correlates of empathizing and systemizing and additionally those of the D score, which is the difference between systemizing and empathizing, to reveal the comprehensive picture of those correlates. Negative rGMV correlates of empathizing and positive rGMV correlates of the D score (formed by the negative correlation between rGMV and empathizing), were found primarily in nodes in the default mode network, mirror neuron system, dorsal anterior cingulate cortex, and the lateral part of the prefrontal cortex together with other areas. Positive rGMV correlates of systemizing and of the D score (formed by the positive correlation between rGMV and systemizing) were found primarily in nodes in the external attention system, middle cingulate cortex, and other regions. Negative rGMV correlates of systemizing were found in an area close to the left posterior insula and putamen. These findings reconcile some previously inconsistent findings, provide other new findings and suggest that these areas contribute to empathizing-systemizing. Furthermore, the negative/positive rGMV correlates of empathizing and positive/negative rGMV correlates of systemizing overlapped substantially. This may be in line with the notion that empathizing and systemizing compete neurally in the brain. PMID:24409308

  12. Brain activity monitoring by compressed spectral array during deep hypothermic circulatory arrest in acute aortic dissection surgery

    PubMed Central

    Budniak, Wiktor; Buczkowski, Piotr; Perek, Bartłomiej; Walczak, Maciej; Tomczyk, Jadwiga; Katarzyński, Sławomir; Jemielity, Marek

    2014-01-01

    Introduction Monitoring the central nervous system during aortic dissection repair may improve the understanding of the intraoperative changes related to its bioactivity. Aim The aim of the study was to evaluate the influence of deep hypothermia on intraoperative brain bioactivity measured by the compressed spectral array (CSA) method and to assess the influence of the operations on postoperative cognitive function. Material and methods The study enrolled 40 patients (31 men and 9 women) at the mean age of 60.2 ± 8.6 years, diagnosed with acute aortic dissection. They underwent emergency operations in deep hypothermic circulatory arrest (DHCA). During the operations, brain bioactivity was monitored with the compressed spectral array method. Results There were no intraoperative deaths. Electrocerebral silence during DHCA was observed in 31 patients (74%). The lowest activity was observed during DHCA: it was 0.01 ± 0.05 nW in the left hemisphere and 0.01 ± 0.03 nW in the right hemisphere. The postoperative results of neurological tests deteriorated statistically significantly (26.9 ± 1.7 points vs. 22.0 ± 1.7 points; p < 0.001), especially among patients who exhibited brain activity during DHCA. Conclusions The compressed spectral array method is clinically useful in monitoring brain bioactivity during emergency operations of acute aortic dissections. Electrocerebral silence occurs in 75% of patients during DHCA. The cognitive function of patients deteriorates significantly after operations with DHCA. PMID:26336458

  13. Performance and Safety of an Integrated Portable Extracorporeal Life Support System for Adults.

    PubMed

    Alwardt, Cory M; Wilson, Donald S; Alore, Michelle L; Lanza, Louis A; Devaleria, Patrick A; Pajaro, Octavio E

    2015-03-01

    Extracorporeal membrane oxygenation (ECMO) is indicated when conventional measures fail to support a patient during cardiac or respiratory failure. Due to the complicated nature of ECMO, patients often require transport to a tertiary care center. This study retrospectively compared the performance of the Cardiohelp™ (Maquet) life support system with a previously used ECMO circuit when transporting adult patients on venoarterial ECMO between facilities. Two ECMO circuits were compared for performance: 1) the Cardiohelp™ (Maquet) life support system and 2) the "standard" circuit consisting of a Thoratec CentriMag centrifugal pump, Maquet Quadrox-D oxygenator, and a Terumo CDI-500 in-line blood gas analyzer. After analyzing data from 16 patients (eight patients supported with each ECMO system), no differences in patient demographics, percentage of patients successfully weaned from ECMO, percentage of patients surviving to discharge, duration supported on the initial ECMO system, or total duration of ECMO were noted. No patient deaths were related to circuit failure or circuit disruptions in either group. Analysis of the performance of the ECMO circuits and the resulting patient status showed few significant differences between ECMO groups (Cardiohelp™ vs. standard circuit) and time points (the first 8 hours vs. a 24-hour time point). The statistically significant differences were not concerning in terms of appropriate medical support or patient safety. Of interest, the transmembrane pressure was significantly lower for the Cardiohelp™ module vs. the standard oxygenator during the first 8 hours (20.1 [5.3] vs. 37.1 [7.1] mmHg; p < .001) and at 24 hours (21.3 [3.8] vs. 34.8 [7.9] mmHg; p = .001). The Cardiohelp™ portable life support system provides safe and reliable support for adult patients on ECMO during interhospital patient transport as compared to the standard circuit. PMID:26390678

  14. A quantitative dynamic systems model of health-related quality of life among older adults

    PubMed Central

    Roppolo, Mattia; Kunnen, E Saskia; van Geert, Paul L; Mulasso, Anna; Rabaglietti, Emanuela

    2015-01-01

    Health-related quality of life (HRQOL) is a person-centered concept. The analysis of HRQOL is highly relevant in the aged population, which is generally suffering from health decline. Starting from a conceptual dynamic systems model that describes the development of HRQOL in individuals over time, this study aims to develop and test a quantitative dynamic systems model, in order to reveal the possible dynamic trends of HRQOL among older adults. The model is tested in different ways: first, with a calibration procedure to test whether the model produces theoretically plausible results, and second, with a preliminary validation procedure using empirical data of 194 older adults. This first validation tested the prediction that given a particular starting point (first empirical data point), the model will generate dynamic trajectories that lead to the observed endpoint (second empirical data point). The analyses reveal that the quantitative model produces theoretically plausible trajectories, thus providing support for the calibration procedure. Furthermore, the analyses of validation show a good fit between empirical and simulated data. In fact, no differences were found in the comparison between empirical and simulated final data for the same subgroup of participants, whereas the comparison between different subgroups of people resulted in significant differences. These data provide an initial basis of evidence for the dynamic nature of HRQOL during the aging process. Therefore, these data may give new theoretical and applied insights into the study of HRQOL and its development with time in the aging population. PMID:26604722

  15. Lineage mapping identifies molecular and architectural similarities between the larval and adult Drosophila central nervous system

    PubMed Central

    Lacin, Haluk; Truman, James W

    2016-01-01

    Neurogenesis in Drosophila occurs in two phases, embryonic and post-embryonic, in which the same set of neuroblasts give rise to the distinct larval and adult nervous systems, respectively. Here, we identified the embryonic neuroblast origin of the adult neuronal lineages in the ventral nervous system via lineage-specific GAL4 lines and molecular markers. Our lineage mapping revealed that neurons born late in the embryonic phase show axonal morphology and transcription factor profiles that are similar to the neurons born post-embryonically from the same neuroblast. Moreover, we identified three thorax-specific neuroblasts not previously characterized and show that HOX genes confine them to the thoracic segments. Two of these, NB2-3 and NB3-4, generate leg motor neurons. The other neuroblast is novel and appears to have arisen recently during insect evolution. Our findings provide a comprehensive view of neurogenesis and show how proliferation of individual neuroblasts is dictated by temporal and spatial cues. DOI: http://dx.doi.org/10.7554/eLife.13399.001 PMID:26975248

  16. The genetic sex-determination system predicts adult sex ratios in tetrapods.

    PubMed

    Pipoly, Ivett; Bókony, Veronika; Kirkpatrick, Mark; Donald, Paul F; Székely, Tamás; Liker, András

    2015-11-01

    The adult sex ratio (ASR) has critical effects on behaviour, ecology and population dynamics, but the causes of variation in ASRs are unclear. Here we assess whether the type of genetic sex determination influences the ASR using data from 344 species in 117 families of tetrapods. We show that taxa with female heterogamety have a significantly more male-biased ASR (proportion of males: 0.55 ± 0.01 (mean ± s.e.m.)) than taxa with male heterogamety (0.43 ± 0.01). The genetic sex-determination system explains 24% of interspecific variation in ASRs in amphibians and 36% in reptiles. We consider several genetic factors that could contribute to this pattern, including meiotic drive and sex-linked deleterious mutations, but further work is needed to quantify their effects. Regardless of the mechanism, the effects of the genetic sex-determination system on the adult sex ratio are likely to have profound effects on the demography and social behaviour of tetrapods. PMID:26444239

  17. A quantitative dynamic systems model of health-related quality of life among older adults.

    PubMed

    Roppolo, Mattia; Kunnen, E Saskia; van Geert, Paul L; Mulasso, Anna; Rabaglietti, Emanuela

    2015-01-01

    Health-related quality of life (HRQOL) is a person-centered concept. The analysis of HRQOL is highly relevant in the aged population, which is generally suffering from health decline. Starting from a conceptual dynamic systems model that describes the development of HRQOL in individuals over time, this study aims to develop and test a quantitative dynamic systems model, in order to reveal the possible dynamic trends of HRQOL among older adults. The model is tested in different ways: first, with a calibration procedure to test whether the model produces theoretically plausible results, and second, with a preliminary validation procedure using empirical data of 194 older adults. This first validation tested the prediction that given a particular starting point (first empirical data point), the model will generate dynamic trajectories that lead to the observed endpoint (second empirical data point). The analyses reveal that the quantitative model produces theoretically plausible trajectories, thus providing support for the calibration procedure. Furthermore, the analyses of validation show a good fit between empirical and simulated data. In fact, no differences were found in the comparison between empirical and simulated final data for the same subgroup of participants, whereas the comparison between different subgroups of people resulted in significant differences. These data provide an initial basis of evidence for the dynamic nature of HRQOL during the aging process. Therefore, these data may give new theoretical and applied insights into the study of HRQOL and its development with time in the aging population. PMID:26604722

  18. Caregiving families within the long-term services and support system for older adults.

    PubMed

    Qualls, Sara Honn

    2016-01-01

    Long-term care services and supports are primarily a family industry that warrants psychologists' involvement through practice, research, and policy advocacy. Families are poorly integrated into service systems despite the dominance of family caregiving work within health care and long-term care. This article positions family caregiving work within the context of family life across the life span, noting overlaps and distinctions between normal family life and caregiving work for older adults whose physical or cognitive challenges require assistance. The prevalence, work, and consequences of family caregiving for older adults are described. Families are identified as key partners in long-term care, despite substantial policy and practice barriers to integrating them into care structures and systems. Policy options for reducing or eliminating barriers are suggested, as are professional practice opportunities for psychologists to support caregiving families. Approaches to assessment and interventions for caregivers across a variety of settings are described. Gaps in research are highlighted, with a focus on how to understand caregiving as embedded within context of family, long-term care services and supports, and health care. Caregiving work presents an imperative for expanding psychologists' engagement in integrating and supporting the families whose caregiving is so critical to a rapidly aging society. (PsycINFO Database Record PMID:27159435

  19. Evaluation of an intelligent wheelchair system for older adults with cognitive impairments

    PubMed Central

    2013-01-01

    Background Older adults are the most prevalent wheelchair users in Canada. Yet, cognitive impairments may prevent an older adult from being allowed to use a powered wheelchair due to safety and usability concerns. To address this issue, an add-on Intelligent Wheelchair System (IWS) was developed to help older adults with cognitive impairments drive a powered wheelchair safely and effectively. When attached to a powered wheelchair, the IWS adds a vision-based anti-collision feature that prevents the wheelchair from hitting obstacles and a navigation assistance feature that plays audio prompts to help users manoeuvre around obstacles. Methods A two stage evaluation was conducted to test the efficacy of the IWS. Stage One: Environment of Use – the IWS’s anti-collision and navigation features were evaluated against objects found in a long-term care facility. Six different collision scenarios (wall, walker, cane, no object, moving and stationary person) and three different navigation scenarios (object on left, object on right, and no object) were performed. Signal detection theory was used to categorize the response of the system in each scenario. Stage Two: User Trials – single-subject research design was used to evaluate the impact of the IWS on older adults with cognitive impairment. Participants were asked to drive a powered wheelchair through a structured obstacle course in two phases: 1) with the IWS and 2) without the IWS. Measurements of safety and usability were taken and compared between the two phases. Visual analysis and phase averages were used to analyze the single-subject data. Results Stage One: The IWS performed correctly for all environmental anti-collision and navigation scenarios. Stage Two: Two participants completed the trials. The IWS was able to limit the number of collisions that occurred with a powered wheelchair and lower the perceived workload for driving a powered wheelchair. However, the objective performance (time to complete course

  20. Extracardiac Pulmonary-Systemic Connection via Persistent Levoatriocardinal Vein in Adults.

    PubMed

    Saremi, Farhood; Ho, Siew Yen

    2016-07-01

    The levoatriocardinal vein is a very rare but clinically important intrathoracic venous anomaly that connects the systemic (cardinal) and pulmonary venous channels. We report 4 adults with pulmonary-systemic venous communications that can explain the morphology of the extracardiac interatrial shunting through the persistent levoatriocardinal vein. We discuss the imaging features of the 2 types of such communications: direct connection of the levoatriocardinal vein (1) with the left atrium and (2) with the left superior pulmonary vein in the absence of obstructive left heart disease. Accurate characterization of these diagnostically challenging cases is important because in addition to hemodynamic imbalance they are at risk of paradoxical embolism. Computed tomography and magnetic resonance imaging are noninvasive imaging techniques that should play increasingly important roles in the evaluation of these anomalies. PMID:27174352

  1. Multiple physical signs detection and decision support system for hospitalized older adults.

    PubMed

    Baig, Mirza Mansoor; GholamHosseini, Hamid; Connolly, Martin J

    2015-10-01

    Health monitoring systems have rapidly evolved during the past two decades and have the potential to change the way healthcare is currently delivered. Smart monitoring systems automate patient monitoring tasks and thereby improve patient workflow management. Moreover, expert systems have the potential to assist clinicians and improve their performance by accurately executing repetitive tasks, to which humans are ill-suited. Clinicians working in hospital wards are responsible for conducting a multitude of tasks which require constant vigilance, and thus the need for a smart decision support system has arisen. In particular, wireless patient monitoring systems are emerging as a low cost, reliable and accurate means of healthcare delivery. Vital signs monitoring systems are rapidly becoming part of today's healthcare delivery. The paradigm has shifted from traditional and manual recording to computer-based electronic records and, further, to handheld devices as versatile and innovative healthcare monitoring systems. The current study focuses on interpreting multiple physical signs and early warning for hospitalized older adults so that severe consequences can be minimized. Data from a total of 30 patients have been collated in New Zealand hospitals under local and national ethics approvals. The system records blood pressure, heart rate (pulse), oxygen saturation (SpO2), ear temperature and blood glucose levels from hospitalized patients and transfers this information to a web-based software application for remote monitoring and further interpretation. Ultimately, this system is aimed to achieve a high level of agreement with clinicians' interpretation when assessing specific physical signs such as bradycardia, tachycardia, hypertension, hypotension, hypoxaemia, fever and hypothermia to generate early warnings. The performance of the vital signs interpretation system was validated through off-line as well as real-time tests with a high level of agreement between the

  2. Expression of Hepatoma-derived growth factor family members in the adult central nervous system

    PubMed Central

    El-Tahir, Heba M; Dietz, Frank; Dringen, Ralf; Schwabe, Kerstin; Strenge, Karen; Kelm, Sørge; Abouzied, Mekky M; Gieselmann, Volkmar; Franken, Sebastian

    2006-01-01

    Background Hepatoma-derived growth factor (HDGF) belongs to a polypeptide family containing five additional members called HDGF related proteins 1–4 (HRP-1 to -4) and Lens epithelial derived growth factor. Whereas some family members such as HDGF and HRP-2 are expressed in a wide range of tissues, the expression of others is very restricted. HRP-1 and -4 are only expressed in testis, HRP-3 only in the nervous system. Here we investigated the expression of HDGF, HRP-2 and HRP-3 in the central nervous system of adult mice on the cellular level by immunohistochemistry. In addition we performed Western blot analysis of various brain regions as well as neuronal and glial cell cultures. Results HDGF was rather evenly expressed throughout all brain regions tested with the lowest expression in the substantia nigra. HRP-2 was strongly expressed in the thalamus, prefrontal and parietal cortex, neurohypophysis, and the cerebellum, HRP-3 in the bulbus olfactorius, piriform cortex and amygdala complex. HDGF and HRP-2 were found to be expressed by neurons, astrocytes and oligodendrocytes. In contrast, strong expression of HRP-3 in the adult nervous system is restricted to neurons, except for very weak expression in oligodendrocytes in the brain stem. Although the majority of neurons are HRP-3 positive, some like cerebellar granule cells are negative. Conclusion The coexpression of HDGF and HRP-2 in glia and neurons as well as the coexpression of all three proteins in many neurons suggests different functions of members of the HDGF protein family in cells of the central nervous system that might include proliferation as well as cell survival. In addition the restricted expression of HRP-3 point to a special function of this family member for neuronal cells. PMID:16430771

  3. Childhood-Onset Disease Predicts Mortality in an Adult Cohort of Patients with Systemic Lupus Erythematosus

    PubMed Central

    Hersh, Aimee O.; Trupin, Laura; Yazdany, Jinoos; Panopalis, Peter; Julian, Laura; Katz, Patricia; Criswell, Lindsey A.; Yelin, Edward

    2013-01-01

    Objective To examine childhood-onset disease as a predictor of mortality in a cohort of adult patients with systemic lupus erythematosus (SLE). Methods Data were derived from the University of California Lupus Outcomes Study, a longitudinal cohort of 957 adult subjects with SLE that includes 98 subjects with childhood-onset SLE. Baseline and follow-up data were obtained via telephone interviews conducted between 2002-2007. The number of deaths during 5 years of follow-up was determined and standardized mortality ratios (SMRs) for the cohort, and across age groups, were calculated. Kaplan-Meier life table analysis was used to compare mortality rates between childhood (defined as SLE diagnosis <18 years) and adult-onset SLE. Multivariate Cox proportional hazard models were used to determine predictors of mortality. Results During the median follow-up period of 48 months, 72 deaths (7.5% of subjects) occurred, including 9 (12.5%) among those with childhood-onset SLE. The overall SMR was 2.5 (CI 2.0-3.2). In Kaplan-Meier survival analysis, after adjusting for age, childhood-onset subjects were at increased risk for mortality throughout the follow-up period (p<0.0001). In a multivariate model adjusting for age, disease duration and other covariates, childhood-onset SLE was independently associated with an increased mortality risk (hazard ratio [HR]: 3.1; 95% confidence interval [CI]: 1.3-7.3), as was low socioeconomic status measured by education (HR: 1.9; 95% CI 1.1-3.2) and end stage renal disease (HR: 2.1; 95% CI 1.1-4.0). Conclusion Childhood-onset SLE was a strong predictor of mortality in this cohort. Interventions are needed to prevent early mortality in this population. PMID:20235215

  4. A case of kidney transplantation using donation after circulatory death with renal calculi

    PubMed Central

    Gao, Baoshan; Zhang, Kun; Guo, Chunjie; Wang, Weigang; Wang, Gang; Wang, Yuantao; Yao, Liyu; Fu, Yaowen; Zhou, Honglan

    2015-01-01

    Donation after circulatory death (DCD) supplies a big percentage of the organ source pool. Compared to living-related donations, donor kidneys from DCD are commonly with lower quality since they inevitably suffer from hypoxia, hypotension, and inadequate organ perfusion during the progression to circulatory arrest. The current case presents a 44-year-old male donor with wide range subarachnoid hemorrhage and multiple skull fracture from a car accident. Multiple stones were detected in his right kidney. We performed a modified ex vivo pyelolithotomy and ureteroscopy on the bench to render a stone-free allograft. We also improved the donor kidney with hypothermic/perfusion preservation machine before renal transplantation. The recipient showed no complications during the first two-month post-operational follow-up. Such a donor kidney with stones may probably be discarded by conventional perspective. Yet, the combination of the ex vivo bench-surgery technique and hypothermic oxygenation/perfusion makes it a qualified donor kidney. Thus we have demonstrated a promising way of saving borderline qualified DCD donor kidneys. PMID:26885172

  5. Circulatory shear flow alters the viability and proliferation of circulating colon cancer cells

    PubMed Central

    Fan, Rong; Emery, Travis; Zhang, Yongguo; Xia, Yuxuan; Sun, Jun; Wan, Jiandi

    2016-01-01

    During cancer metastasis, circulating tumor cells constantly experience hemodynamic shear stress in the circulation. Cellular responses to shear stress including cell viability and proliferation thus play critical roles in cancer metastasis. Here, we developed a microfluidic approach to establish a circulatory microenvironment and studied circulating human colon cancer HCT116 cells in response to a variety of magnitude of shear stress and circulating time. Our results showed that cell viability decreased with the increase of circulating time, but increased with the magnitude of wall shear stress. Proliferation of cells survived from circulation could be maintained when physiologically relevant wall shear stresses were applied. High wall shear stress (60.5 dyne/cm2), however, led to decreased cell proliferation at long circulating time (1 h). We further showed that the expression levels of β-catenin and c-myc, proliferation regulators, were significantly enhanced by increasing wall shear stress. The presented study provides a new insight to the roles of circulatory shear stress in cellular responses of circulating tumor cells in a physiologically relevant model, and thus will be of interest for the study of cancer cell mechanosensing and cancer metastasis. PMID:27255403

  6. Cerebral circulatory and metabolic effects of 5-hydroxytryptamine in anesthetized baboons.

    PubMed Central

    Harper, M A; MacKenzie, E T

    1977-01-01

    1. The cerebral circulatory effects of the intracarotid administration of 5-hydroxytryptamine were examined in anaesthetized baboons. Cerebral blood flow was measured by the intracarotid 133Xe technique, cerebral O2 consumption and glucose uptake were measured as indices of brain metabolism and electrocortical activity was continuously monitored. 2. Despite a marked reduction in the calibre of the internal carotid artery (assessed angiographically), the intracarotid infusion of 5-hydroxytryptamine 0-1 microgram/kg. min did not effect any significant changes in cerebral blood flow, O2 consumption or glucose uptake. 3. Following transient osmotic disruption of the blood-brain barrier with the intracarotid infusion of hypertonic urea, the same dose of 5-hydroxytryptamine effected a marked reduction in cerebral blood flow from 51 +/- 2 to 36 +/- 2 ml./100 g. min (mean +/- S.E.; P less than 0-01). Both indices of cerebral metabolism were reduced significantly and the e.e.g. showed a more pronounced suppression-burst pattern. 4. We postulate that the cerebral circulatory responses to 5-hydroxytryptamine are dependent upon the integrity of the blood-brain barrier and the predominant effect of the intravascular administration of 5-hydroxytryptamine is on cortical activity or metabolism, rather than on cerebrovascular smooth muscle. Images Plate 1 PMID:411921

  7. Circulatory shear flow alters the viability and proliferation of circulating colon cancer cells.

    PubMed

    Fan, Rong; Emery, Travis; Zhang, Yongguo; Xia, Yuxuan; Sun, Jun; Wan, Jiandi

    2016-01-01

    During cancer metastasis, circulating tumor cells constantly experience hemodynamic shear stress in the circulation. Cellular responses to shear stress including cell viability and proliferation thus play critical roles in cancer metastasis. Here, we developed a microfluidic approach to establish a circulatory microenvironment and studied circulating human colon cancer HCT116 cells in response to a variety of magnitude of shear stress and circulating time. Our results showed that cell viability decreased with the increase of circulating time, but increased with the magnitude of wall shear stress. Proliferation of cells survived from circulation could be maintained when physiologically relevant wall shear stresses were applied. High wall shear stress (60.5 dyne/cm(2)), however, led to decreased cell proliferation at long circulating time (1 h). We further showed that the expression levels of β-catenin and c-myc, proliferation regulators, were significantly enhanced by increasing wall shear stress. The presented study provides a new insight to the roles of circulatory shear stress in cellular responses of circulating tumor cells in a physiologically relevant model, and thus will be of interest for the study of cancer cell mechanosensing and cancer metastasis. PMID:27255403

  8. Colloids Versus Albumin in Large Volume Paracentesis to Prevent Circulatory Dysfunction: Evidence-based Case Report.

    PubMed

    Widjaja, Felix F; Khairan, Paramita; Kamelia, Telly; Hasan, Irsan

    2016-04-01

    Large volume paracentesis may cause paracentesis induced circulatory dysfunction (PICD). Albumin is recommended to prevent this abnormality. Meanwhile, the price of albumin is too expensive and there should be another alternative that may prevent PICD. This report aimed to compare albumin to colloids in preventing PICD. Search strategy was done using PubMed, Scopus, Proquest, dan Academic Health Complete from EBSCO with keywords of "ascites", "albumin", "colloid", "dextran", "hydroxyethyl starch", "gelatin", and "paracentesis induced circulatory dysfunction". Articles was limited to randomized clinical trial and meta-analysis with clinical question of "In hepatic cirrhotic patient undergone large volume paracentesis, whether colloids were similar to albumin to prevent PICD". We found one meta-analysis and four randomized clinical trials (RCT). A meta analysis showed that albumin was still superior of which odds ratio 0.34 (0.23-0.51). Three RCTs showed the same results and one RCT showed albumin was not superior than colloids. We conclude that colloids could not constitute albumin to prevent PICD, but colloids still have a role in patient who undergone paracentesis less than five liters. PMID:27550886

  9. Circulatory shear flow alters the viability and proliferation of circulating colon cancer cells

    NASA Astrophysics Data System (ADS)

    Fan, Rong; Emery, Travis; Zhang, Yongguo; Xia, Yuxuan; Sun, Jun; Wan, Jiandi

    2016-06-01

    During cancer metastasis, circulating tumor cells constantly experience hemodynamic shear stress in the circulation. Cellular responses to shear stress including cell viability and proliferation thus play critical roles in cancer metastasis. Here, we developed a microfluidic approach to establish a circulatory microenvironment and studied circulating human colon cancer HCT116 cells in response to a variety of magnitude of shear stress and circulating time. Our results showed that cell viability decreased with the increase of circulating time, but increased with the magnitude of wall shear stress. Proliferation of cells survived from circulation could be maintained when physiologically relevant wall shear stresses were applied. High wall shear stress (60.5 dyne/cm2), however, led to decreased cell proliferation at long circulating time (1 h). We further showed that the expression levels of β-catenin and c-myc, proliferation regulators, were significantly enhanced by increasing wall shear stress. The presented study provides a new insight to the roles of circulatory shear stress in cellular responses of circulating tumor cells in a physiologically relevant model, and thus will be of interest for the study of cancer cell mechanosensing and cancer metastasis.

  10. Rebuttal to: A Critical Analysis of Competency Based Systems in Adult Education.

    ERIC Educational Resources Information Center

    Ratcliff, Sandra

    1984-01-01

    Discusses Michael Collins' critique of competency-based education and differentiates among competency-based education (CBE), competency-based adult education (CBAE), and adult performance level (APL). (JOW)

  11. A dynamic auditory-cognitive system supports speech-in-noise perception in older adults

    PubMed Central

    Anderson, Samira; White-Schwoch, Travis; Parbery-Clark, Alexandra; Kraus, Nina

    2013-01-01

    Understanding speech in noise is one of the most complex activities encountered in everyday life, relying on peripheral hearing, central auditory processing, and cognition. These abilities decline with age, and so older adults are often frustrated by a reduced ability to communicate effectively in noisy environments. Many studies have examined these factors independently; in the last decade, however, the idea of the auditory-cognitive system has emerged, recognizing the need to consider the processing of complex sounds in the context of dynamic neural circuits. Here, we use structural equation modeling to evaluate interacting contributions of peripheral hearing, central processing, cognitive ability, and life experiences to understanding speech in noise. We recruited 120 older adults (ages 55 to 79) and evaluated their peripheral hearing status, cognitive skills, and central processing. We also collected demographic measures of life experiences, such as physical activity, intellectual engagement, and musical training. In our model, central processing and cognitive function predicted a significant proportion of variance in the ability to understand speech in noise. To a lesser extent, life experience predicted hearing-in-noise ability through modulation of brainstem function. Peripheral hearing levels did not significantly contribute to the model. Previous musical experience modulated the relative contributions of cognitive ability and lifestyle factors to hearing in noise. Our models demonstrate the complex interactions required to hear in noise and the importance of targeting cognitive function, lifestyle, and central auditory processing in the management of individuals who are having difficulty hearing in noise. PMID:23541911

  12. A Controlled Study of Autonomic Nervous System Function in Adults with Attention-Deficit/Hyperactivity Disorder Treated with Stimulant Medications: Results of a Pilot Study

    ERIC Educational Resources Information Center

    Schubiner, Howard; Hassunizadeh, Bischan; Kaczynski, Richard

    2006-01-01

    Objective: Despite the fact that autonomic nervous system (ANS) abnormalities are commonly found in adults and predict increased cardiovascular mortality, no studies have assessed ANS function in adults with attention-deficit/hyperactivity disorder (ADHD) taking stimulants. Method: This pilot study evaluated ANS function in adults with ADHD in…

  13. Adult Literacy Learning and Computer Technology: Features of Effective Computer-Assisted Learning Systems.

    ERIC Educational Resources Information Center

    Fahy, Patrick J.

    Computer-assisted learning (CAL) can be used for adults functioning at any academic or grade level. In adult basic education (ABE), CAL can promote greater learning effectiveness and faster progress, concurrent learning and experience with computer literacy skills, privacy, and motivation. Adults who face barriers (financial, geographic, personal,…

  14. Blogs and Social Network Sites as Activity Systems: Exploring Adult Informal Learning Process through Activity Theory Framework

    ERIC Educational Resources Information Center

    Heo, Gyeong Mi; Lee, Romee

    2013-01-01

    This paper uses an Activity Theory framework to explore adult user activities and informal learning processes as reflected in their blogs and social network sites (SNS). Using the assumption that a web-based space is an activity system in which learning occurs, typical features of the components were investigated and each activity system then…

  15. Automated Student and Adult Learner Follow-up System. Final Report for Program Year 1993-94.

    ERIC Educational Resources Information Center

    Texas State Occupational Information Coordinating Committee, Austin.

    The Texas Automated Student and Adult Learner Follow-Up System was developed as part of a larger effort to improve and coordinate the delivery of education and training of a skilled work force. The primary task of the Follow-Up System in Program Year 1993-94 was to obtain outcome information on the former students and participants of the work…

  16. Design and Evaluation of an Interactive Exercise Coaching System for Older Adults: Lessons Learned.

    PubMed

    Ofli, Ferda; Kurillo, Gregorij; Obdržálek, Štěpán; Bajcsy, Ruzena; Jimison, Holly Brugge; Pavel, Misha

    2016-01-01

    Although the positive effects of exercise on the well-being and quality of independent living for older adults are well accepted, many elderly individuals lack access to exercise facilities, or the skills and motivation to perform exercise at home. To provide a more engaging environment that promotes physical activity, various fitness applications have been proposed. Many of the available products, however, are geared toward a younger population and are not appropriate or engaging for an older population. To address these issues, we developed an automated interactive exercise coaching system using the Microsoft Kinect. The coaching system guides users through a series of video exercises, tracks and measures their movements, provides real-time feedback, and records their performance over time. Our system consists of exercises to improve balance, flexibility, strength, and endurance, with the aim of reducing fall risk and improving performance of daily activities. In this paper, we report on the development of the exercise system, discuss the results of our recent field pilot study with six independently living elderly individuals, and highlight the lessons learned relating to the in-home system setup, user tracking, feedback, and exercise performance evaluation. PMID:25594988

  17. Effects of Chronic Dietary Selenomethionine Exposure on the Visual System of Adult and F1 Generation Zebrafish (Danio rerio).

    PubMed

    Raine, Jason C; Lallemand, Lise; Pettem, Connor M; Janz, David M

    2016-09-01

    The effects of chronic dietary selenomethionine (SeMet) exposure on the visual system of adult zebrafish and their progeny were investigated. Adult zebrafish were exposed to measured concentrations of 1.1 (control) and 10.3 µg Se/g dry mass as SeMet for 57 days, then encouraged to breed. Progeny were reared to swim-up and differences in mortality, eye size and visual behaviour were determined. Adult vision was also investigated using behavioural assays. Adults fed the SeMet-spiked diet exhibited significantly fewer positive reactions in the escape response assay when compared to controls. Larvae from adults fed elevated SeMet had smaller eyes and a lower proportion of positive responses in phototaxis, oculomotor and optokinetic response assays compared to controls. These results demonstrate that environmentally relevant elevated dietary SeMet exposure can affect the visual system of both exposed adult zebrafish and their progeny, which could affect fitness and survivability. PMID:27312825

  18. A pilot study using global positioning systems (GPS) devices and surveys to ascertain older adults' travel patterns.

    PubMed

    Yen, Irene H; Leung, Cindy W; Lan, Mars; Sarrafzadeh, Majid; Kayekjian, Karen C; Duru, O Kenrik

    2015-04-01

    Some studies indicate that older adults lead active lives and travel to many destinations including those not in their immediate residential neighborhoods. We used global positioning system (GPS) devices to track the travel patterns of 40 older adults (mean age: 69) in San Francisco and Los Angeles. Study participants wore the GPS devices for 7 days in fall 2010 and winter 2011. We collected survey responses concurrently about travel patterns. GPS data showed a mean of four trips/day, and a mean trip distance of 7.6 km. Survey data indicated that older adults commonly made trips for four activities (e.g., volunteering, work, visiting friends) at least once each week. Older adults regularly travel outside their residential neighborhoods. GPS can document the mode of travel, the path of travel, and the destinations. Surveys can document the purpose of the travel and the impressions or experiences in the specific locations. PMID:24652872

  19. Relationship of Affordable Care Act Implementation to Emergency Department Utilization Among Young Adults

    PubMed Central

    Hernandez-Boussard, Tina; Morrison, Doug; Goldstein, Ben A.; Hsia, Renee Y.

    2016-01-01

    Study objective The 2010 provision of the Patient Protection and Affordable Care Act (ACA) extended eligibility for health insurance for young adults aged 19 to 25 years. It is unclear, however, how expanded coverage changes health care behavior and promotes efficient use of emergency department (ED) services. Our objective was to use population-level emergency department data to characterize any changes in diagnoses seen in ED among young adults since the implementation of the ACA dependent coverage expansion. Methods We performed a difference-in-differences analysis of 2009 to 2011 ED visits from California, Florida, and New York, using all-capture administrative data to determine how the use of ED services changed for clinical categories after the ACA provision among young adults aged 19 to 25 years compared with slightly older adults unaffected by the provision, aged 26 to 31 years. Results We analyzed a total of 10,158,254 ED visits made by 4,734,409 patients. After the implementation of the 2010 ACA provision, young adults had a relative decrease of 0.5% ED visits per 1,000 people compared with the older group. For the majority of diagnostic categories, young adults’ rates and risk of visit did not change relative to that of slightly older adults after the implementation of the ACA. However, although young adults’ ED visits significantly increased for mental illnesses (2.6%) and diseases of the circulatory system (eg, nonspecific chest pain) (4.8%), visits decreased for pregnancy-related diagnoses and diseases of the skin (eg, cellulitis, abscess) compared with that of the older group (3.7% and 3.1%, respectively). Conclusion Our results indicate that increased coverage has kept young adults out of the ED for specific conditions that can be cared for through access to other channels. As EDs face capacity challenges, these results are encouraging and offer insight into what could be expected under further insurance expansions from health care reform. PMID

  20. A Smart-Home System to Unobtrusively and Continuously Assess Loneliness in Older Adults

    PubMed Central

    Dodge, Hiroko H.; Riley, Thomas; Jacobs, Peter G.; Thielke, Stephen; Kaye, Jeffrey

    2016-01-01

    Loneliness is a common condition in older adults and is associated with increased morbidity and mortality, decreased sleep quality, and increased risk of cognitive decline. Assessing loneliness in older adults is challenging due to the negative desirability biases associated with being lonely. Thus, it is necessary to develop more objective techniques to assess loneliness in older adults. In this paper, we describe a system to measure loneliness by assessing in-home behavior using wireless motion and contact sensors, phone monitors, and computer software as well as algorithms developed to assess key behaviors of interest. We then present results showing the accuracy of the system in detecting loneliness in a longitudinal study of 16 older adults who agreed to have the sensor platform installed in their own homes for up to 8 months. We show that loneliness is significantly associated with both time out-of-home (\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{upgreek} \\usepackage{mathrsfs} \\setlength{\\oddsidemargin}{-69pt} \\begin{document} }{}$ {\\beta } = -0.88$ \\end{document} and \\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{upgreek} \\usepackage{mathrsfs} \\setlength{\\oddsidemargin}{-69pt} \\begin{document} }{}$p<0.01$ \\end{document}) and number of computer sessions (\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{upgreek} \\usepackage{mathrsfs} \\setlength{\\oddsidemargin}{-69pt} \\begin{document} }{}$ {\\beta } = 0.78$ \\end{document} and \\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{upgreek} \\usepackage{mathrsfs} \\setlength

  1. Lipoprotein Receptor LRP1 Regulates Leptin Signaling and Energy Homeostasis in the Adult Central Nervous System

    PubMed Central

    Liu, Qiang; Zhang, Juan; Zerbinatti, Celina; Zhan, Yan; Kolber, Benedict J.; Herz, Joachim; Muglia, Louis J.; Bu, Guojun

    2011-01-01

    Obesity is a growing epidemic characterized by excess fat storage in adipocytes. Although lipoprotein receptors play important roles in lipid uptake, their role in controlling food intake and obesity is not known. Here we show that the lipoprotein receptor LRP1 regulates leptin signaling and energy homeostasis. Conditional deletion of the Lrp1 gene in the brain resulted in an obese phenotype characterized by increased food intake, decreased energy consumption, and decreased leptin signaling. LRP1 directly binds to leptin and the leptin receptor complex and is required for leptin receptor phosphorylation and Stat3 activation. We further showed that deletion of the Lrp1 gene specifically in the hypothalamus by Cre lentivirus injection is sufficient to trigger accelerated weight gain. Together, our results demonstrate that the lipoprotein receptor LRP1, which is critical in lipid metabolism, also regulates food intake and energy homeostasis in the adult central nervous system. PMID:21264353

  2. Modular and coordinated expression of immune system regulatory and signaling components in the developing and adult nervous system

    PubMed Central

    Monzón-Sandoval, Jimena; Castillo-Morales, Atahualpa; Crampton, Sean; McKelvey, Laura; Nolan, Aoife; O’Keeffe, Gerard; Gutierrez, Humberto

    2015-01-01

    During development, the nervous system (NS) is assembled and sculpted through a concerted series of neurodevelopmental events orchestrated by a complex genetic programme. While neural-specific gene expression plays a critical part in this process, in recent years, a number of immune-related signaling and regulatory components have also been shown to play key physiological roles in the developing and adult NS. While the involvement of individual immune-related signaling components in neural functions may reflect their ubiquitous character, it may also reflect a much wider, as yet undescribed, genetic network of immune–related molecules acting as an intrinsic component of the neural-specific regulatory machinery that ultimately shapes the NS. In order to gain insights into the scale and wider functional organization of immune-related genetic networks in the NS, we examined the large scale pattern of expression of these genes in the brain. Our results show a highly significant correlated expression and transcriptional clustering among immune-related genes in the developing and adult brain, and this correlation was the highest in the brain when compared to muscle, liver, kidney and endothelial cells. We experimentally tested the regulatory clustering of immune system (IS) genes by using microarray expression profiling in cultures of dissociated neurons stimulated with the pro-inflammatory cytokine TNF-alpha, and found a highly significant enrichment of immune system-related genes among the resulting differentially expressed genes. Our findings strongly suggest a coherent recruitment of entire immune-related genetic regulatory modules by the neural-specific genetic programme that shapes the NS. PMID:26379506

  3. Sex differences in circulatory oxygen transport parameters of sockeye salmon (Oncorhynchus nerka) on the spawning ground.

    PubMed

    Clark, Timothy Darren; Hinch, S G; Taylor, B D; Frappell, P B; Farrell, A P

    2009-07-01

    Upon reaching sexual maturity, several species of male salmonids possess a relative ventricular mass (rM(V)) that may be up to 90% larger than females. This can increase maximum cardiac stroke volume and power output, which may be beneficial to increasing the oxygen transport capacity of male salmonids during the spawning period. It may be further hypothesized, therefore, that other variables within the circulatory oxygen transport cascade, such as blood oxygen-carrying capacity and heart rate, are similarly enhanced in reproductively mature male salmonids. To test this idea, the present study measured a range of circulatory oxygen transport variables in wild male and female sockeye salmon (Oncorhynchus nerka) during their spawning period, following a 150 km migration from the ocean. The rM(V) of male fish was 13% greater than females. Conversely, the haemoglobin concentration ([Hb]) of female fish was 19% higher than males, indicative of a greater blood oxygen-carrying capacity (138 vs. 116 ml O2 l(-1), respectively). Surgically implanted physiological data loggers revealed a similar range in heart rate for both sexes on the spawning ground (20-80 beats min(-1) at 10 degrees C), with a tendency for male fish to spend a greater percentage of time (64%) than females (49%) at heart rates above 50 beats min(-1). Male fish on average consumed significantly more oxygen than females during a 13-h respirometry period. However, routine oxygen consumption rates (.)MO2 ranged between 1.5 and 8.5 mg min(-1) kg(-1) for both sexes, which implies that males did not inherently possess markedly higher routine aerobic energy demands, and suggests that the higher [Hb] of female fish may compensate for the smaller rM(V). These findings reject the hypothesis that all aspects of the circulatory oxygen transport cascade are inherently superior in male sockeye salmon. Instead, it is suggested that any differences in (.)MO2 between sexually mature male and female sockeye salmon can likely

  4. Usefulness of extracorporeal membrane oxygenation using double roller pumps in a low body weight newborn: A novel strategy for mechanical circulatory support in an infant.

    PubMed

    Nakanishi, Keisuke; Kato, Tomoko; Kawasaki, Shiori; Amano, Atsushi

    2016-01-01

    Extracorporeal membrane oxygenation (ECMO) with a centrifugal pump requires a certain flow rate; therefore, its application for low body weight infants is frequently accompanied by oxygenator membrane malfunction and/or inadequate perfusion. To prevent low-flow associated complications, we report a case in which a novel system of dual roller pumps was used. A baby girl with a body mass index 0.25 m(2), who experienced difficulty weaning from cardiopulmonary bypass after a Norwood-like operation, required an ECMO. Concerns for the tube lifespan reduction due to roller pump friction led to the use of a double roller pump circulation. The termination of ECMO during tube exchange is not needed, because circulation is maintained by another roller pump. The novel strategy of ECMO with double roller pumps will allow low perfusion rate to provide adequate circulatory support for low body weight patients. PMID:27011702

  5. Usefulness of extracorporeal membrane oxygenation using double roller pumps in a low body weight newborn: A novel strategy for mechanical circulatory support in an infant

    PubMed Central

    Nakanishi, Keisuke; Kato, Tomoko; Kawasaki, Shiori; Amano, Atsushi

    2016-01-01

    Extracorporeal membrane oxygenation (ECMO) with a centrifugal pump requires a certain flow rate; therefore, its application for low body weight infants is frequently accompanied by oxygenator membrane malfunction and/or inadequate perfusion. To prevent low-flow associated complications, we report a case in which a novel system of dual roller pumps was used. A baby girl with a body mass index 0.25 m2, who experienced difficulty weaning from cardiopulmonary bypass after a Norwood-like operation, required an ECMO. Concerns for the tube lifespan reduction due to roller pump friction led to the use of a double roller pump circulation. The termination of ECMO during tube exchange is not needed, because circulation is maintained by another roller pump. The novel strategy of ECMO with double roller pumps will allow low perfusion rate to provide adequate circulatory support for low body weight patients. PMID:27011702

  6. Ability of newly emerged adult Culex quinquefasciatus (Diptera: Culicidae) mosquitoes to exit belowground stormwater treatment systems via lateral conveyance pipes.

    PubMed

    Metzger, Marco E; Harbison, Justin E; Burns, Joseph E; Hu, Renjie

    2012-03-01

    Culex quinquefasciatus Say mosquitoes flourish in belowground stormwater systems in the southern United States. Recent evidence suggests that oviposition-site-seeking females may have difficulties locating, entering, and ovipositing inside permanent water chambers when surface entry through pickholes in manhole covers are sealed. It remains unknown, however, if newly emerged adults are able to detect cues necessary to exit these partly sealed systems via lateral conveyance pipes or if they perish belowground. Fourth instar Cx. quinquefasciatus were placed within proprietary belowground stormwater treatment systems to determine the percentage of newly emerged adults able to escape treatment chambers via a single lateral conveyance pipe. Overall, 56% of deployed mosquitoes were captured in adult exit traps with an 1:1 male:female ratio. The percentage of adults captured varied significantly among chambers, but was not associated with structural site characteristics such as the chamber depth or the length and course of conveyance pipe to the exit trap. Empirical observations suggested that longbodied cellar spiders, Pholcus phalangioides (Fuesslin), ubiquitous in these structures, may have reduced adult trap capture. Findings demonstrate that newly emerged Cx. quinquefasciatus can exit subterranean chambers under potentially difficult structural conditions but suggest that a portion may perish in the absence of surface exit points in manhole shafts. PMID:22493853

  7. First Annual IMACS Report: A global International Society for Heart and Lung Transplantation Registry for Mechanical Circulatory Support.

    PubMed

    Kirklin, James K; Cantor, Ryan; Mohacsi, Paul; Gummert, Jan; De By, Theo; Hannan, Margaret M; Kormos, Robert L; Schueler, Stephan; Lund, Lars H; Nakatani, Takeshi; Taylor, Rhiannon; Lannon, Jenny

    2016-04-01

    The first annual report of the International Society for Heart and Lung Transplantation (ISHLT) Mechanically Assisted Circulatory Support (IMACS) registry provides global data on 5,942 patients from 31 countries. This initial report focuses on patient demographics, survival, device types, adverse events, competing outcomes, and a risk factor analysis. PMID:26922275

  8. [Central hemodynamics in young and middle-aged patients with the initial manifestations of cerebral circulatory failure].

    PubMed

    Rudenko, A E; Korzhenevskiĭ, L V

    1990-07-01

    The authors studied the indices of general hemodynamics in 53 patients with initial manifestations of cerebro-circulatory insufficiency of young and middle age. Young patients suffering of cerebral atherosclerosis and vegetative-vascular dystonia showed a hyperkinetic type of hemodynamics while the middle-aged with atherosclerosis showed the hypokinetic type evidencing abnormal function of autoregulatory mechanisms. PMID:2238601

  9. Durable mechanical circulatory support in advanced heart failure: a critical care cardiology perspective.

    PubMed

    Lala, Anuradha; Mehra, Mandeep R

    2013-11-01

    Though cardiac transplantation for advanced heart disease patients remains definitive therapy for patients with advanced heart failure, it is challenged by inadequate donor supply, causing durable mechanical circulatory support (MCS) to slowly become a new primary standard. Selecting appropriate patients for MCS involves meeting a number of prespecifications as is required in evaluation for cardiac transplant candidacy. As technology evolves to bring forth more durable smaller devices, selection criteria for appropriate MCS recipients will likely expand to encompass a broader, less sick population. The "Holy Grail" for MCS will be a focus on clinical recovery and explantation of devices rather than the currently more narrowly defined indications of bridge to transplantation or lifetime device therapy. PMID:24188222

  10. Challenges in long-term mechanical circulatory support and biological replacement of the failing heart.

    PubMed

    Lala, Anuradha; Joyce, Emer; Groarke, John D; Mehra, Mandeep R

    2014-01-01

    The burden of advanced heart failure is reaching epidemic proportions. Generally considered for cardiac transplantation, patients often cannot receive this therapy because of their advanced age, comorbidity or the scarcity of donors. Most transplants are concentrated in North America and Europe, with the average center performing fewer than 20 annual transplants. A search for nonbiological means of cardiac support has led to the advent of mechanical circulatory support (MCS), a concept now entrenched as a bridge to transplantation or, for those ineligible for transplantation, as lifetime therapy. In this review we discuss contemporary challenges posed by the changing epidemiology of cardiac transplant and MCS and outline the basis for an understanding of the future of this important therapeutic stance.   PMID:24451651

  11. The Nimbus Hemopump: a new left ventricular assist device that combines myocardial protection with circulatory support.

    PubMed

    Mooney, M R; Mooney, J F; Van Tassel, R A; Goldenberg, I F; Madison, J D; Johnson, K E; Von Ruedon, T; Joyce, L D; Emery, R W; Pritzker, M R

    1990-01-01

    Recent advances in hemodynamic support can allow patients at high risk for cardiovascular collapse to become candidates for coronary interventions. A new axial blood flow pump has recently been developed and made available for clinical testing. This intravascular pump utilizes an Archimedes screw pump rotating at 25,000 rpms to provide a flow of 2 to 3.5 liters/minute. The 7 mm inlet cannula of the cable driven pump is delivered across the aortic valve. The pump discharges blood into the descending aorta. This design does not require a membrane oxygenator. This pump would be expected to: 1) provide circulatory support irrespective of heart arrhythmias; 2) provide left ventricular unloading and 3) lack the fluid and coagulation abnormalities of prolonged cardiopulmonary bypass. This unique device offers great promise to the interventional cardiologist. PMID:10148977

  12. A Case Series of Biventricular Circulatory Support Using Two Ventricular Assist Devices: A Novel Operative Approach.

    PubMed

    Cork, David P; Tran, Hao A; Silva, Jorge; Barnard, Denise; Greenberg, Barry; Adler, Eric D; Pretorius, Victor

    2015-10-01

    Increased use of continuous-flow left ventricular assist devices (LVADs) to treat advanced heart failure has heightened concern for right ventricular failure after LVAD implantation, which is associated with increased morbidity and mortality. Biventricular support is required in up to 30% of LVAD recipients. Currently, no durable long-term right ventricular assist device (RVAD) has been approved other than the Syncardia (Tucson, AZ) total artificial heart. A recent publication reported the placement of continuous flow LVAD in the heavily trabeculated right ventricle; however, this orientation may jeopardize both assist device and right ventricle function. We describe three cases of right-sided mechanical circulatory support with durable RVAD implanted in the right atrium, allowing long-term support with fewer anatomic limitations as compared with right ventricular cannulation. PMID:26434483

  13. Respiratory, circulatory, and neurological responses to hanging: a review of animal models.

    PubMed

    Boghossian, Elie; Clément, Renaud; Redpath, Margaret; Sauvageau, Anny

    2010-09-01

    The pathophysiology of hanging is still poorly understood. This article presents a review of eight animal models: four models of isolated occlusion of the vessels of the neck (group 1), one model of combined tracheal and vessel occlusion (group 2), and three models of true animal hanging (group 3). Occlusion of the airway passages in group 2 did not accelerate respiratory arrest compared to group 1. Cessation of cerebral blood flow, rather than airway obstruction, seems to be the main cause of respiratory decline. In general, muscular movements ceased after 1-3.5 min and early generalized tonic-clonic convulsions were described. Complete circulatory collapse seems to occur between 4 and 8.5 min. These observations from animal models of hanging are compared with the data collected from filmed human hangings. Avenues to improve animal models are discussed. PMID:20487163

  14. Orthotopic Heart Transplantation and Mechanical Circulatory Support in Cancer Survivors: Challenges and Outcomes

    PubMed Central

    Ghosh, Nina; Hilton, John

    2015-01-01

    Chemotherapy-induced cardiomyopathy (CCMP) is a significant cause of morbidity and mortality. Compared to cardiomyopathy due to other causes, anthracycline-induced cardiomyopathy is associated with a worse survival. As cancer survival improves, patients with CCMP can be expected to comprise a significant proportion of patients who may require advanced therapies such as inotropic support, cardiac transplantation, or left ventricular assist device (LVAD). Distinct outcomes related to advanced therapies for end-stage heart failure in this patient population may arise due to unique demographic characteristics and comorbidities. We review recent literature regarding the characteristics of patients who have survived cancer undergoing orthotopic heart transplantation and mechanical circulatory support for end-stage heart failure. The challenges and outcomes of advanced therapies for heart failure related specifically to anthracycline-induced cardiomyopathy are emphasized. PMID:26339241

  15. New classification of donation after circulatory death donors definitions and terminology.

    PubMed

    Thuong, Marie; Ruiz, Angel; Evrard, Patrick; Kuiper, Michael; Boffa, Catherine; Akhtar, Mohammed Z; Neuberger, James; Ploeg, Rutger

    2016-07-01

    In the face of a crisis in organ donation, the transplant community are increasingly utilizing donation after circulatory death (DCD) donors. Over the last 10 years, with the increasing usage of DCD donors, we have seen the introduction in a number of new terms and definitions. We report the results of the 6th International Conference in Organ Donation held in Paris in 2013 and report a consensus agreement of an established expert European Working Group on the definitions and terminology regarding DCD donation, including refinement of the Maastricht definitions. This document forms part of a special series where recommendations are presented for uncontrolled and controlled DCD donation and organ specific guidelines for kidney, pancreas, liver and lung transplantation. An expert panel formed a consensus on definitions and terms aiming to establish consistent usage of terms in DCD donation. PMID:26991858

  16. Liver Transplant From Unexpected Donation After Circulatory Determination of Death Donors: A Challenge in Perioperative Management.

    PubMed

    Blasi, A; Hessheimer, A J; Beltrán, J; Pereira, A; Fernández, J; Balust, J; Martínez-Palli, G; Fuster, J; Navasa, M; García-Valdecasas, J C; Taurá, P; Fondevila, C

    2016-06-01

    Unexpected donation after circulatory determination of death (uDCD) liver transplantation is a complex procedure, in particular when it comes to perioperative recipient management. However, very little has been published to date regarding intraoperative and immediate postoperative care in this setting. Herein, we compare perioperative events in uDCD liver recipients with those of a matched group of donation after brain death liver recipients. We demonstrate that the former group of recipients suffers significantly greater hemodynamic instability and derangements in coagulation following graft reperfusion. Based on our experience, we recommend a proactive recipient management strategy in uDCD liver transplantation that involves early use of vasopressor support; maintaining adequate intraoperative levels of red cells, platelets, and fibrinogen; and routinely administering tranexamic acid before graft reperfusion. PMID:26601629

  17. Caries-risk profiles in Italian adults using computer caries assessment system and ICDAS.

    PubMed

    Carta, Giovanna; Cagetti, Maria Grazia; Cocco, Fabio; Sale, Silvana; Lingström, Peter; Campus, Guglielmo

    2015-01-01

    The aim of this study was to examine the correlation among socio-behavioral factors, caries status and caries risk, calculated through Cariogram, in an adult population. Four hundred eighty subjects (mean age 40.73, SE ± 0.33) randomly selected from the municipal electoral registry consented to participate in the survey. Subjects were examined, and the International Caries Detection Assessment System (ICDAS) index was registered. A highly structured questionnaire was submitted to investigate (1) personal data (i.e., age, gender, educational level, job categorization), (2) life-style behavior (i.e., smoking and dietary habits), and (3) oral health behavior (i.e., tooth brushing, use of fluoride and dental check-up frequency). An evaluation of the mutans streptococci concentration in saliva was also performed. Information on caries-related factors was entered into the Cariogram in order to generate an individual caries risk profile for each subject. Multinomial logistic regression was performed using Cariogram levels as the dependent variable. The possible correlated variables were analyzed using the principal component analysis (PCA). Considering ICDAS scores, 5.62% of the sample had at least an initial decay (ICDAS = 1-2), whereas 40.83% of the sample presented at least one moderate decay (ICDAS = 3-4) and 17.08% a severe decay (ICDAS = 5-6). Decay at ICDAS levels 5-6 and more than 5 missing teeth were statistically associated with Cariogram scores (OR = 2.36, 95%CI = 1.83-3.03 and OR = 1.43, 95%CI = 1.13-1.82, respectively). The results suggest that the Cariogram model was able to identify caries-related factors in an adult population. A direct association among the risk categories from Cariogram, the caries status and some socio-behavioral variables was verified. PMID:26892361

  18. Effect of a Multi-Faceted Intervention on Gingival Health Among Adults with Systemic Sclerosis

    PubMed Central

    Yuen, Hon K.; Weng, Yanqiu; Bandyopadhyay, Dipankar; Reed, Susan G.; Leite, Renata S.; Silver, Richard M.

    2012-01-01

    OBJECTIVE To evaluate the effect of adaptive oral hygiene devices and orofacial exercise to improve gingival health among adults with systemic sclerosis (SSc). METHODS Forty-eight patients with SSc were assigned randomly to the multi-faceted oral health intervention or usual dental care control group. Participants in the intervention group received a rechargeable, powered Oral-B® oscillating-rotating-pulsating toothbrush and a Reach® Access™ Flosser that has a toothbrush-like handle. For those with an oral aperture of less than 40 mm, orofacial exercises were taught. Participants in the control group were each given a manual toothbrush and dental floss. Participants in both groups received instructions and demonstration on the use of the devices, and were requested to perform the respective intervention twice a day for 6 months. Evaluations were at baseline, 3-, and 6-months. The main outcome was gingival index (GI), an indicator of gingival inflammation. RESULTS Both groups showed significant reduction in GI scores at 6 months (Ps<0.005). Reduction in GI scores of the intervention group at 6 months was 20.8% which is considered to be clinically significant. Compared to the control group, the intervention group showed a significant and larger reduction in GI score by 8% at 6 months (P=0.0007). CONCLUSION Results support the use of adaptive devices and orofacial exercise to improve gingival health in adults with SSc when compared to use of manual toothbrushing and finger-held flossing. Recommending and educating patients with SSc to use adaptive devices to clean the tooth surfaces looks promising for long-term oral health improvement. PMID:21586215

  19. Alpha actin isoforms expression in human and rat adult cardiac conduction system.

    PubMed

    Orlandi, Augusto; Hao, Hiroyuki; Ferlosio, Amedeo; Clément, Sophie; Hirota, Seiichi; Spagnoli, Luigi Giusto; Gabbiani, Giulio; Chaponnier, Christine

    2009-04-01

    In the adult heart, cardiac muscle comprises the working myocardium and the conduction system (CS). The latter includes the sinoatrial node (SAN), the internodal tract or bundle (IB), the atrioventricular node (AVN), the atrioventricular bundle (AVB), the bundle branches (BB) and the peripheral Purkinje fibers (PF). Most of the information concerning the phenotypic features of CS tissue derives from the characterization of avian and rodent developing hearts; data concerning the expression of actin isoforms in adult CS cardiomyocytes are scarce. Using specific antibodies, we investigated the distribution of alpha-skeletal (alpha-SKA), alpha-cardiac (alpha-CA), alpha-smooth muscle (alpha-SMA) actin isoforms and other muscle-typical proteins in the CS of human and rat hearts at different ages. SAN and IB cardiomyocytes were characterized by the presence of alpha-SMA, alpha-CA, calponin and caldesmon, whereas alpha-SKA and vimentin were absent. Double immunofluorescence demonstrated the co-localisation of alpha-SMA and alpha-CA in I-bands of SAN cardiomyocytes. AVN, AVB, BB and PF cardiomyocytes were alpha-SMA, calponin, caldesmon and vimentin negative, and alpha-CA and alpha-SKA positive. No substantial differences in actin isoform distribution were observed in human and rat hearts, except for the presence of isolated subendocardial alpha-SMA positive cardiomyocytes co-expressing alpha-CA in the ventricular septum of the rat. Aging did not influence CS cardiomyocyte actin isoform expression profile. These findings support the concept that cardiomyocytes of SAN retain the phenotype of a developing myogenic cell throughout the entire life span. PMID:19281784

  20. Aminoguanidine attenuates the delayed circulatory failure and improves survival in rodent models of endotoxic shock.

    PubMed Central

    Wu, C C; Chen, S J; Szabó, C; Thiemermann, C; Vane, J R

    1995-01-01

    1. We have investigated the effects of aminoguanidine, a relatively selective inhibitor of the cytokine-inducible isoform of nitric oxide synthase (iNOS), on the delayed circulatory failure, vascular hyporeactivity to vasoconstrictor agents, and iNOS activity in a rat model of circulatory shock induced by bacterial endotoxin (E. coli lipopolysaccharide; LPS). In addition, we have evaluated the effect of aminoguanidine on the 24 h survival rate in a murine model of endotoxaemia. 2. Male Wistar rats were anaesthetized and instrumented for the measurement of mean arterial blood pressure (MAP) and heart rate (HR). Injection of LPS (10 mg kg-1, i.v.) resulted in a fall in MAP from 115 +/- 4 mmHg (time 0, control) to 79 +/- 9 mmHg at 180 min (P < 0.05, n = 10). The pressor effect of noradrenaline (NA, 1 microgram kg-1, i.v.) was also significantly reduced at 60, 120 and 180 min after LPS injection. In contrast, animals pretreated with aminoguanidine (15 mg kg-1, i.v., 20 min prior to LPS injection) maintained a significantly higher MAP (at 180 min, 102 +/- 3 mmHg, n = 10, P < 0.05) when compared to rats given only LPS (LPS-rats). Cumulative administration of aminoguanidine (15 mg kg-1 and 45 mg kg-1) given 180 min after LPS caused a dose-related increase in MAP and reversed the hypotension. Aminoguanidine also significantly alleviated the reduction of the pressor response to NA: indeed, at 180 min, the pressor response returned to normal in aminoguanidine pretreated LPS-rats.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7541282

  1. Effects of 12 days exposure to simulated microgravity on central circulatory hemodynamics in the rhesus monkey

    NASA Technical Reports Server (NTRS)

    Convertino, V. A.; Koenig, S. C.; Krotov, V. P.; Fanton, J. W.; Korolkov, V. I.; Trambovetsky, E. V.; Ewert, D. L.; Truzhennikov, A.; Latham, R. D.

    1998-01-01

    Central circulatory hemodynamic responses were measured before and during the initial 9 days of a 12-day 10 degrees head-down tilt (HDT) in 4 flight-sized juvenile rhesus monkeys who were surgically instrumented with a variety of intrathoracic catheters and blood flow sensors to assess the effects of simulated microgravity on central circulatory hemodynamics. Each subject underwent measurements of aortic and left ventricular pressures, and aortic flow before and during HDT as well as during a passive head-up postural test before and after HDT. Heart rate, stroke volume, cardiac output, and left ventricular end-diastolic pressure were measured, and dP/dt and left ventricular elastance was calculated from hemodynamic measurements. The postural test consisted of 5 min of supine baseline control followed by 5 minutes of 90 degrees upright tilt (HUT). Heart rate, stroke volume, cardiac output, and left ventricular end-diastolic pressure showed no consistent alterations during HDT. Left ventricular elastance was reduced in all animals throughout HDT, indicating that cardiac compliance was increased. HDT did not consistently alter left ventricular +dP/dt, indicating no change in cardiac contractility. Heart rate during the post-HDT HUT postural test was elevated compared to pre-HDT while post-HDT cardiac output was decreased by 52% as a result of a 54% reduction in stroke volume throughout HUT. Results from this study using an instrumented rhesus monkey suggest that exposure to microgravity may increase ventricular compliance without alternating cardiac contractility. Our project supported the notion that an invasively-instrumented animal model should be viable for use in spaceflight cardiovascular experiments to assess potential changes in myocardial function and cardiac compliance.

  2. Effects of 12 days exposure to simulated microgravity on central circulatory hemodynamics in the rhesus monkey

    NASA Astrophysics Data System (ADS)

    Convertino, V. A.; Koenig, S. C.; Krotov, V. P.; Fanton, J. W.; Korolkov, V. I.; Trambovetsky, E. V.; Ewert, D. L.; Truzhennikov, A.; Latham, R. D.

    Central circulatory hemodynamic responses were measured before and during the initial 9 days of a 12-day 10 ° head-down tilt (HDT) in 4 flight-sized juvenile rhesus monkeys who were surgically instrumented with a variety of intrathoracic catheters and blood flow sensors to assess the effects of simulated microgravity on central circulatory hemodynamics. Each subject underwent measurements of aortic and left ventricular pressures, and aortic flow before and during HDT as well as during a passive head-up postural test before and after HDT. Heart rate, stroke volume, cardiac output, and left ventricular end-diastolic pressure were measured, and dP/dt and left ventricular elastance was calculated from hemodynamic measurements. The postural test consisted of 5 min of supine baseline control followed by 5 minutes of 90 ° upright tilt (HUT). Heart rate, stroke volume, cardiac output, and left ventricular end-diastolic pressure showed no consistent alterations during HDT. Left ventricular elastance was reduced in all animals throughout HDT, indicating that cardiac compliance was increased. HDT did not consistently alter left ventricular +dP/dt, indicating no change in cardiac contractility. Heart rate during the post-HDT HUT postural test was elevated compared to pre-HDT while post-HDT cardiac output was decreased by 52% as a result of a 54% reduction in stroke volume throughout HUT. Results from this study using an instrumented rhesus monkey suggest that exposure to microgravity may increase ventricular compliance without alterating cardiac contractility. Our project supported the notion that an invasively-instrumented animal model should be viable for use in spaceflight cardiovascular experiments to assess potential changes in myocardial function and cardiac compliance.

  3. Transfusion-associated circulatory overload in orthopedic surgery patients: a multi-institutional study.

    PubMed

    Popovsky, M A; Audet, A M; Andrzejewski, C

    1996-01-01

    Although recognized as a serious complication of hemotherapy, few data are available on the incidence of transfusion-associated circulatory overload (TACO). Detailed demographic and clinical information was obtained from records of 382 Medicare patients undergoing total hip or knee replacements (and receiving transfusions) from January 1992 to December 1993 at five Massachusetts hospitals. Seventy-eight percent of the patients were women with a mean age of 77 years. Thirty-two percent had co-morbidities including myocardial or coronary disease. Transfusion-related complications and comorbidities were identified and reviewed by transfusion experts. Patients were excluded from consideration if non-transfusion factors such as myocardial disease could have contributed to the development of acute pulmonary edema. Four (3 females, 1 male) patients (1.05%) developed TACO postoperatively. Mean age of these patients was 84 years (range, 75-101) versus 77 years for non-TACO. The mean intraoperative estimated blood loss was 375 mL. Each patient received only 1-2 units of red blood cells prior to onset of TACO, and in two cases only autologous blood was used. The mean positive fluid balance was 2,480 mL. The mean pretransfusion hematocrit prior to circulatory overload (CO) was 26.0 percent. Symptoms were reversed with diuretics. Length of stay was significantly prolonged by these incidents. TACO is a frequent and serious event in an orthopedic surgical setting. It is associated with advanced age, increased health care costs, and may occur in the setting of modest transfusion volumes. The utilization of conservative transfusion criteria and fluid management in the perioperative setting may decrease the incidence of this complication in this population. PMID:15387748

  4. Remote Ischemic Preconditioning Reduces Cerebral Oxidative Stress Following Hypothermic Circulatory Arrest in a Porcine Model.

    PubMed

    Arvola, Oiva; Haapanen, Henri; Herajärvi, Johanna; Anttila, Tuomas; Puistola, Ulla; Karihtala, Peeter; Tuominen, Hannu; Anttila, Vesa; Juvonen, Tatu

    2016-01-01

    Remote ischemic precondition has become prominent as one of the most promising methods to mitigate neurological damage following ischemic insult. The purpose of this study was to investigate whether the effects of remote ischemic preconditioning can be seen in the markers of oxidative stress or in redox-regulating enzymes in a porcine model. A total of 12 female piglets were randomly assigned to 2 groups. The study group underwent an intervention of 4 cycles of 5-minute ischemic preconditioning on the right hind leg. All piglets underwent 60-minute hypothermic circulatory arrest. Oxidative stress marker 8-hydroxydeoxyguanosine (8-OHdG) was measured from blood samples with enzyme-linked immunosorbent assay. After 7 days of follow-up, samples from the brain, heart, kidney, and ovary were harvested for histopathologic examination. The immunohistochemical stainings of hypoxia marker hypoxia-inducible factor-1-α, oxidative stress marker 8-OHdG, DNA repair enzyme 8-oxoguanine glycosylase, and antioxidant response regulators nuclear factor erythroid 2-related factor 2 and protein deglycase were analyzed. The level of 8-OHdG referred to baseline was decreased in the sagittal sinus׳ blood samples in the study group after a prolonged deep hypothermic circulatory arrest at 360 minutes after reperfusion. Total histopathologic score was 3.8 (1.8-6.0) in the study group and was 4.4 (2.5-6.5) in the control group (P = 0.72), demonstrating no statistically significant difference in cerebral injury. Our findings demonstrate that the positive effects of remote ischemic preconditioning can be seen in cellular oxidative balance regulators in an animal model after 7 days of preconditioned ischemic insult. PMID:27568144

  5. Trends in adult suicides in New Mexico: utilizing data from the New Mexico violent death reporting system.

    PubMed

    Styka, Anne N; White, David S; Zumwalt, Ross E; Lathrop, Sarah L

    2010-01-01

    Although many suicide prevention programs focus on youth suicides, data indicate the vast majority of suicides occur among adults (18-64 years). In 2005 New Mexico joined the Centers for Disease Control and Prevention's National Violent Death Reporting System, collecting data on suicides, homicides, and unintentional firearm fatalities to better inform state and national prevention programs. We utilized data collected by the New Mexico Violent Death Reporting System in its first 2 years of operation (2005 and 2006) in order to define the demographic patterns of adult suicides in the state and characterize risk factors. A total of 526 suicides occurred among adults during this time, with the majority being male (78.5%) and White non-Hispanic (56.7%). The highest incidence was in adults between 45 and 54 years (28.1%). Firearms were the most commonly used mechanism, and "current depressed mood" the most commonly identified risk factor. High rates of adult suicide indicate the need for targeted prevention programs. PMID:20412156

  6. Increased Plasma Levels of Heparin-Binding Protein on Admission to Intensive Care Are Associated with Respiratory and Circulatory Failure

    PubMed Central

    Tydén, Jonas; Herwald, Heiko; Sjöberg, Folke; Johansson, Joakim

    2016-01-01

    Purpose Heparin-binding protein (HBP) is released by granulocytes and has been shown to increase vascular permeability in experimental investigations. Increased vascular permeability in the lungs can lead to fluid accumulation in alveoli and respiratory failure. A generalized increase in vascular permeability leads to loss of circulating blood volume and circulatory failure. We hypothesized that plasma concentrations of HBP on admission to the intensive care unit (ICU) would be associated with decreased oxygenation or circulatory failure. Methods This is a prospective, observational study in a mixed 8-bed ICU. We investigated concentrations of HBP in plasma at admission to the ICU from 278 patients. Simplified acute physiology score (SAPS) 3 was recorded on admission. Sequential organ failure assessment (SOFA) scores were recorded daily for three days. Results Median SAPS 3 was 58.8 (48–70) and 30-day mortality 64/278 (23%). There was an association between high plasma concentrations of HBP on admission with decreased oxygenation (p<0.001) as well as with circulatory failure (p<0.001), after 48–72 hours in the ICU. There was an association between concentrations of HBP on admission and 30-day mortality (p = 0.002). ROC curves showed areas under the curve of 0,62 for decreased oxygenation, 0,65 for circulatory failure and 0,64 for mortality. Conclusions A high concentration of HBP in plasma on admission to the ICU is associated with respiratory and circulatory failure later during the ICU care period. It is also associated with increased 30-day mortality. Despite being an interesting biomarker for the composite ICU population it´s predictive value at the individual patient level is low. PMID:27007333

  7. Purinergic 2 receptor blockade prevents the responses of group IV afferents to post-contraction circulatory occlusion

    PubMed Central

    Kindig, Angela E; Hayes, Shawn G; Kaufman, Marc P

    2007-01-01

    ATP, by activating purinergic 2 (P2) receptors on group III and IV afferents, is thought to evoke the metabolic component of the exercise pressor reflex. Previously we have shown that injection of PPADS, a P2 receptor antagonist, into the arterial supply of skeletal muscle of decerebrated cats attenuated the responses of group III and IV afferents to static contraction while the muscles were freely perfused. We have now tested the hypothesis that injection of PPADS (10 mg kg−1) attenuated the responses of group III (n = 13) and group IV afferents (n = 9) to post-contraction circulatory occlusion. In the present study, we found that PPADS attenuated the group III afferent responses to static contraction during circulatory occlusion (P < 0.05). Likewise, PPADS abolished the group IV afferent responses to static contraction during occlusion (P = 0.001). During a 1 minute period of post-contraction circulatory occlusion, four of the 13 group III afferents and eight of the nine group IV afferents maintained their increased discharge. A Fischer's exact probability test revealed that more group IV afferents than group III afferents were stimulated by post-contraction circulatory occlusion (P < 0.02). In addition, the nine group IV afferents increased their mean discharge rate over baseline levels during the post-contraction circulatory occlusion period, whereas the 13 group III afferents did not (P < 0.05). PPADS abolished this post-contraction increase in discharge by the group IV afferents (P < 0.05). Our findings suggest that P2 receptors on group IV afferents play a role in evoking the metabolic component of the exercise pressor reflex. PMID:17038431

  8. The systemizing quotient: an investigation of adults with Asperger syndrome or high-functioning autism, and normal sex differences.

    PubMed Central

    Baron-Cohen, Simon; Richler, Jennifer; Bisarya, Dheraj; Gurunathan, Nhishanth; Wheelwright, Sally

    2003-01-01

    Systemizing is the drive to analyse systems or construct systems. A recent model of psychological sex differences suggests that this is a major dimension in which the sexes differ, with males being more drawn to systemize than females. Currently, there are no self-report measures to assess this important dimension. A second major dimension of sex differences is empathizing (the drive to identify mental states and respond to these with an appropriate emotion). Previous studies find females score higher on empathy measures. We report a new self-report questionnaire, the Systemizing Quotient (SQ), for use with adults of normal intelligence. It contains 40 systemizing items and 20 control items. On each systemizing item, a person can score 2, 1 or 0, so the SQ has a maximum score of 80 and a minimum of zero. In Study 1, we measured the SQ of n = 278 adults (114 males, 164 females) from a general population, to test for predicted sex differences (male superiority) in systemizing. All subjects were also given the Empathy Quotient (EQ) to test if previous reports of female superiority would be replicated. In Study 2 we employed the SQ and the EQ with n = 47 adults (33 males, 14 females) with Asperger syndrome (AS) or high-functioning autism (HFA), who are predicted to be either normal or superior at systemizing, but impaired at empathizing. Their scores were compared with n = 47 matched adults from the general population in Study 1. In Study 1, as predicted, normal adult males scored significantly higher than females on the SQ and significantly lower on the EQ. In Study 2, again as predicted, adults with AS/HFA scored significantly higher on the SQ than matched controls, and significantly lower on the EQ than matched controls. The SQ reveals both a sex difference in systemizing in the general population and an unusually strong drive to systemize in AS/HFA. These results are discussed in relation to two linked theories: the 'empathizing-systemizing' (E-S) theory of sex

  9. High efficiency air cycle air conditioning system

    SciTech Connect

    Rannenberg, G. C.

    1985-11-19

    An air cycle air conditioning system is provided with regenerative heat exchangers upstream and downstream of an expansion turbine. A closedloop liquid circulatory system serially connects the two regenerative heat exchangers for regeneration without the bulk associated with air-to-air heat exchange. The liquid circulatory system may also provide heat transport to a remote sink heat exchanger and from a remote load as well as heat exchange within the sink heat exchanger and load for enhanced compactness and efficiency.

  10. Long-circulatory nanoparticles for gemcitabine delivery: Development and investigation of pharmacokinetics and in-vivo anticancer efficacy.

    PubMed

    Khare, Vaibhav; Singh, Amarinder; Mahajan, Girish; Alam, Noor; Kour, Smit; Gupta, Mehak; Kumar, Ajay; Singh, Gurdarshan; Singh, Shashank K; Saxena, Ajit K; Mondhe, Dilip M; Gupta, Prem N

    2016-09-20

    The anticancer potential of gemcitabine, a nucleoside analog, is compromised due to the enzymatic degradation into inactive form leading to the short half-life in systemic circulation. Novel delivery strategies are required to improve therapeutic efficacy of this potential drug. Monomethoxy polyethylene glycol amine-polylactide-co-glycolide (mPEG-PLGA) co-polymer was synthesized and characterized by FTIR and (1)H NMR. Gemcitabine loaded mPEG-PLGA nanoparticles (NPs) were developed and investigated for pharmacokinetic profile and in vivo anticancer activity. The mPEG-PLGA NPs (size: 267±10nm, zeta potential: -17.5±0.2mV) exhibited sustained drug release profile and were found to be compatible with blood. The mPEG-PLGA NPs were able to evade the uptake by macrophages (i.e. THP-1 and J774A) by reducing the adsorption of proteins on the surface of NPs. The enhanced cellular uptake and cell cytotoxicity was observed by mPEG-PLGA NPs in MiaPaCa-2 and MCF-7 cells. The half-life of gemcitabine in mPEG-PLGA NPs was remarkably enhanced (19 folds) than native gemcitabine. Further, the pharmacokinetic modulation of gemcitabine using mPEG-PLGA-NPs was translated in improved anticancer efficacy as compared to native gemcitabine in Ehrlich ascites bearing Balb-c mice. The results demonstrated the potential of long-circulatory nanoparticles in improving the pharmacokinetic profile and in-turn the anticancer efficacy of gemcitabine. PMID:27404580

  11. Validating a Scoring System for the Diagnosis of Smear-Negative Pulmonary Tuberculosis in HIV-Infected Adults

    PubMed Central

    Coimbra, Isabella; Maruza, Magda; Albuquerque, Maria de Fátima Pessoa Militão; Batista, Joanna D’Arc Lyra; Braga, Maria Cynthia; Moura, Líbia Vilela; Miranda-Filho, Demócrito Barros; Montarroyos, Ulisses Ramos; Lacerda, Heloísa Ramos; Rodrigues, Laura Cunha; de Alencar Ximenes, Ricardo Arraes

    2014-01-01

    Background The challenge of diagnosing smear-negative pulmonary TB (tuberculosis) in people living with HIV justifies the use of instruments other than the smear test for diagnosing the disease. Considering the clinical-radiological similarities of TB amongst HIV-infected adults and children, the proposal of this study was to assess the accuracy of a scoring system used to diagnose smear-negative pulmonary TB in children and adolescents, in HIV-infected adults suspected of having smear-negative pulmonary TB. Methods A Phase III validation study aiming to assess the diagnostic accuracy of a scoring system for diagnosing smear-negative pulmonary TB in HIV-infected adults. The study assessed sensitivity, specificity, positive and negative likelihood ratios, and positive and negative predictive values of the scoring system. Three versions of the scoring system were tested. Results From a cohort of 2,382 (HIV-infected adults), 1276 were investigated and 128 were diagnosed with pulmonary TB. Variables associated with the diagnosis of TB were: coughing, weight loss, fever, malnutrition, chest X-ray, and positive tuberculin test. The best diagnostic performance occurred with the scoring system with new scores, with sensitivity = 81.2% (95%-CI 74.5% –88%), specificity = 78% (75.6% –80.4%), PPV = 29.2% (24.5% –33.9%) and NPV = 97.4% (96.4% –98.4%), LR+ = 3.7 (3.4–4.0) and LR− = 0.24 (0.2–0.4). Conclusion The proposed scoring system (with new scores) presented a good capacity for discriminating patients who did not have pulmonary TB, in the studied population. Further studies are necessary in order to validate it, thus permitting the assessment of its use in diagnosing smear-negative pulmonary TB in HIV-infected adults. PMID:24755628

  12. Undifferentiated embryonal sarcoma of the liver in a middle-aged adult with systemic lupus erythematosus

    PubMed Central

    2013-01-01

    Adult primary undifferentiated embryonal sarcoma of the liver (UESL) is a rare disease. While the etiology of UESL remains largely unknown, association with systemic inflammatory disorders has been observed. Here, we report a case of UESL in a 46-year-old woman with systemic lupus erythematosus (SLE) and without chronic hepatitis or liver cirrhosis. Systematic review of the publicly available English language medical literature identified only 27 cases of UESL in patients aged >45 years and none with SLE. Our patient presented with abdominal pain and had a 2-year history of SLE. Abdominal ultrasonography and enhanced computed tomography revealed a solid mass in the right lobe of the liver. Presumptive diagnosis of atypical hepatocellular carcinoma was made and the patient was treated with segmentectomy of S5 and S4a and cholecystectomy. The final diagnosis of UESL was made according to the pathology results. Since SLE patients may be at increased risk of malignancy, it is possible that the SLE pathogenesis may have contributed to the development of UESL in our patient. According to this case, UESL should be considered when SLE patients present with hepatic space-occupying lesions. PMID:24073982

  13. Plasticity in the adult oculomotor system: offline consolidation phase gains in saccade sequence learning.

    PubMed

    Meital, Noya; Korinth, Sebastian Peter; Karni, Avi

    2013-08-28

    When do adults gain in learning an oculomotor sequence? Here we show that oculomotor training can result not only in performance gains within the training session, but also induce robust offline gains in both speed and accuracy. Participants were trained and tested over two consecutive days to perform a sequence of successive saccades. Saccades were directed to four target letters, presented simultaneously at fixed positions. A two alternative-forced choice question, after each trial, ensured that all targets were perceived. Eye tracking measures were tested at the beginning and end of the training session as well as at 24 h post-training. Practice resulted in within-session gains in accuracy and a reduction of target fixation duration (although total trial duration remained unchanged). In addition, the total average path length traveled by the eye increased, reflecting a decrease in undershoot saccades. At 24 h post-training, however, additional gains were expressed in both speed and accuracy of performance; the total trial duration as well as the fixation-position-offsets and the number of corrective saccades decreased. The expression of delayed gains indicates offline skill consolidation processes in the eye-movement control system. Our results show that the optimization of some aspect, specifically saccade speed parameters, of oculomotor sequence performance evolves mainly offline, during the post-training consolidation phase, a pattern suggestive of learning in an expert system. PMID:23867864

  14. Two Adults with Multiple Disabilities Use a Computer-Aided Telephone System to Make Phone Calls Independently

    ERIC Educational Resources Information Center

    Lancioni, Giulio E.; O'Reilly, Mark F.; Singh, Nirbhay N.; Sigafoos, Jeff; Oliva, Doretta; Alberti, Gloria; Lang, Russell

    2011-01-01

    This study extended the assessment of a newly developed computer-aided telephone system with two participants (adults) who presented with blindness or severe visual impairment and motor or motor and intellectual disabilities. For each participant, the study was carried out according to an ABAB design, in which the A represented baseline phases and…

  15. A Kinect-Based System for Physical Rehabilitation: A Pilot Study for Young Adults with Motor Disabilities

    ERIC Educational Resources Information Center

    Chang, Yao-Jen; Chen, Shu-Fang; Huang, Jun-Da

    2011-01-01

    This study assessed the possibility of rehabilitating two young adults with motor impairments using a Kinect-based system in a public school setting. This study was carried out according to an ABAB sequence in which A represented the baseline and B represented intervention phases. Data showed that the two participants significantly increased their…

  16. Effects of Implementing the Picture Exchange Communication System (PECS) with Adults with Developmental Disabilities and Severe Communication Deficits

    ERIC Educational Resources Information Center

    Conklin, Carl G.; Mayer, G. Roy

    2011-01-01

    The purpose of this study is to evaluate the effects of "Picture Exchange Communication System" (PECS) training, using a multiple baseline design on the independent initiations of three adults with developmental disabilities and severe communication deficits. All participants increased their independent initiations, although at different levels of…

  17. Adult English Language Learners' Perceptions of Audience Response Systems (Clickers) as Communication Aides: A Q-Methodology Study

    ERIC Educational Resources Information Center

    Rodriguez, Lisa Ann; Shepard, MaryFriend

    2013-01-01

    This study explored the perceptions of adult English language learners about audience response systems (clickers) as tools to facilitate communication. According to second language acquisition theory, learners' receptive capabilities in the early stages of second language acquisition surpass expressive capabilities, often rendering them silent in…

  18. Adult Perpetrator Gender Asymmetries in Child Sexual Assault Victim Selection: Results from the 2000 National Incident-Based Reporting System

    ERIC Educational Resources Information Center

    McCloskey, Kathy A.; Raphael, Desreen N.

    2005-01-01

    Data from the 2000 National Incident-Based Reporting System (NIBRS) show that while males make up about nine out of every 10 adult sexual assault perpetrators, totaling about 26,878 incidents within the reporting period, females account for about one out of 10 perpetrators, totaling about 1,162 incidents. Male sexual assault perpetrators offend…

  19. The Relationship between Perception and Production in Adult Acquisition of a New Dialect's Phonetic System

    ERIC Educational Resources Information Center

    Ziliak, Zoe Lynn

    2012-01-01

    This study investigates adults' ability to change their phonetic systems in perception and production, specifically upon exposure to a new dialect in adulthood. It further addresses the relative importance of binary biological sex and socially constructed gender in predicting an individual's sociolinguistic variation. Perception and…

  20. A Systems Design for Classification and Utilization of Indian Adult Education for Development Purposes.

    ERIC Educational Resources Information Center

    Stambler, Moses

    There is a growing recognition in India of the significant role nonformal adult education can play in achieving national and individual developmental objectives. Traditional formal education with its greatest benefits for a small elitist group will not contribute significantly toward the resolution of major socioeconomic problems. Adult education…

  1. THE FUNCTIONS AND TRAINING NEEDS OF ADULT EDUCATION DIRECTORS IN PUBLIC SCHOOL SYSTEMS.

    ERIC Educational Resources Information Center

    MADRY, ARTHUR CHESTER

    A QUESTIONNAIRE WAS SENT TO 200 DIRECTORS OF PUBLIC SCHOOL ADULT EDUCATION IN ORDER TO IDENTIFY FUNCTIONS, ROLE, AND SKILLS AND ABILITIES OF ADMINISTRATORS OF ELEMENTARY AND SECONDARY ADULT EDUCATION. RESPONDENTS RATED EACH FUNCTION ON A SCALE FROM ESSENTIAL TO INAPPLICABLE AND COMPETENCIES ON A SIMILAR SCALE. CHIEF PROBLEM AREAS INCLUDED…

  2. Educational and Occupational Counseling and Information Systems for Adults. Conference Report.

    ERIC Educational Resources Information Center

    1976

    Along with the expansion of adult education has come an increased awareness of the needs of adults for information on career development and on the role education can play in that development, and for assistance in locating the specific courses or curricula which meet their needs. This report is directed to policy-makers in Federal and state…

  3. Hearing Aid-Induced Plasticity in the Auditory System of Older Adults: Evidence from Speech Perception

    ERIC Educational Resources Information Center

    Lavie, Limor; Banai, Karen; Karni, Avi; Attias, Joseph

    2015-01-01

    Purpose: We tested whether using hearing aids can improve unaided performance in speech perception tasks in older adults with hearing impairment. Method: Unaided performance was evaluated in dichotic listening and speech-­in-­noise tests in 47 older adults with hearing impairment; 36 participants in 3 study groups were tested before hearing aid…

  4. Test Review: The Comprehensive Adult Student Assessment System (CASAS) Life Skills Reading Tests

    ERIC Educational Resources Information Center

    Gorman, David; Ernst, Megan L.

    2004-01-01

    Lifelong learning has become an important goal of education over the last decade. According to the United States Department of Education (2001), nearly 3 million students over age 17 (excluding those institutionalized) enrolled in adult basic education, adult secondary education, or English as a second language classes in the United States.…

  5. Usability Study of a Computer-Based Self-Management System for Older Adults with Chronic Diseases

    PubMed Central

    Tao, Da

    2012-01-01

    Background Usability can influence patients’ acceptance and adoption of a health information technology. However, little research has been conducted to study the usability of a self-management health care system, especially one geared toward elderly patients. Objective This usability study evaluated a new computer-based self-management system interface for older adults with chronic diseases, using a paper prototype approach. Methods Fifty older adults with different chronic diseases participated. Two usability evaluation methods were involved: (1) a heuristics evaluation and (2) end-user testing with a think-aloud testing method, audio recording, videotaping, and interviewing. A set of usability metrics was employed to determine the overall system usability, including task incompletion rate, task completion time, frequency of error, frequency of help, satisfaction, perceived usefulness, and perceived ease of use. Interviews were used to elicit participants’ comments on the system design. The quantitative data were analyzed using descriptive statistics and the qualitative data were analyzed for content. Results The participants were able to perform the predesigned self-management tasks with the current system design and they expressed mostly positive responses about the perceived usability measures regarding the system interface. However, the heuristics evaluation, performance measures, and interviews revealed a number of usability problems related to system navigation, information search and interpretation, information presentation, and readability. Design recommendations for further system interface modifications were discussed. Conclusions This study verified the usability of the self-management system developed for older adults with chronic diseases. Also, we demonstrated that our usability evaluation approach could be used to quickly and effectively identify usability problems in a health care information system at an early stage of the system development

  6. Integrated client care for frail older adults in the community: preliminary report on a system-wide approach.

    PubMed

    Goldhar, Jodeme; Daub, Stacey; Dhalla, Irfan; Ellison, Philip; Purbhoo, Dipti; Sinha, Samir K

    2014-01-01

    The Toronto Central Community Care Access Centre is leading a collaborative local health integration network systemic change initiative to implement and evaluate a practical model of integrated care for older adults with complex needs. The approach is embedded in the community where older adults and their families live and is designed to first and foremost improve the quality of care while ultimately bending the cost curve. The model is leveraging and aligning existing system resources by bringing together sectors from across the health system to create ways of working that build capacity in the system to be more responsive to this population. Outcomes to date will be discussed and next steps described. The secondary goal was to understand the key elements of this integration that can be scaled locally and across the province. PMID:25591612

  7. Emotion regulation and mental representation of attachment in patients with systemic lupus erythematosus: a study using the Adult Attachment Interview.

    PubMed

    Barbasio, Chiara; Granieri, Antonella

    2013-04-01

    Mental representations of attachment and emotion regulation influence individual patterns of stress response and vulnerability to illness. The present study investigates the adult attachment states of mind of 40 women with systemic lupus erythematosus (SLE) using the Adult Attachment Interview. We also assessed alexithymia using the Toronto Alexithymia Scale and dissociation using the Dissociative Experiences Scale. The results showed a high prevalence of the unresolved state of mind (13 patients, 32.5%) and the entangled state of mind (10 patients, 25%). The alexithymia score also varied significantly as a function of the mental representation of attachment and was modulated by amnestic dissociation. These findings suggest that adult attachment in patients with SLE influences the presence of alexithymic features. Moreover, these also indicate that dissociative states mediate the perception of painful memories and feelings, thus contributing to the partial avoidance of emotions and the failure to fully experience and recognize them. The clinical implications of these findings are also discussed. PMID:23538975

  8. Adult perpetrator gender asymmetries in child sexual assault victim selection: results from the 2000 National Incident-Based Report System.

    PubMed

    McCloskey, Kathy A; Raphael, Desreen N

    2005-01-01

    Data from the 2000 National Incident-Based Reporting System (NIBRS) show that while males make up about nine out of every 10 adult sexual assault perpetrators, totaling about 26,878 incidents within the reporting period, females account for about one out of 10 perpetrators, totaling about 1,162 incidents. Male sexual assault perpetrators offend against child victims about 25% of the time and predominantly choose female child victims, whereas female perpetrators offend against child victims about 40% of the time and choose child victims of both genders equally. Male perpetrators offend against adolescent victims about 40% of the time, and once again tend to choose female adolescent victims. Female perpetrators offend against adolescent victims a comparable amount of time (about 45%), and for forcible offenses (rape, sodomy, sexual assault with an object, and forcible fondling) choose adolescent victims of both genders equally, while for non-forcible offenses (non-forcible incest and statutory rape) they tend to choose predominantly male victims. Finally, adult male sexual assault perpetrators choose adult victims about 36% of the time while female perpetrators choose adult victims only 16% of the time. Implications for professionals are discussed, including recommendations to aid in correct identification of adult perpetrators and child/adolescent victims of sexual assault. PMID:16354646

  9. Attenuating the Systemic Inflammatory Response to Adult Cardiopulmonary Bypass: A Critical Review of the Evidence Base

    PubMed Central

    Landis, R. Clive; Brown, Jeremiah R.; Fitzgerald, David; Likosky, Donald S.; Shore-Lesserson, Linda; Baker, Robert A.; Hammon, John W.

    2014-01-01

    Abstract: A wide range of pharmacological, surgical, and mechanical pump approaches have been studied to attenuate the systemic inflammatory response to cardiopulmonary bypass, yet no systematically based review exists to cover the scope of anti-inflammatory interventions deployed. We therefore conducted an evidence-based review to capture “self-identified” anti-inflammatory interventions among adult cardiopulmonary bypass procedures. To be included, trials had to measure at least one inflammatory mediator and one clinical outcome, specified in the “Outcomes 2010” consensus statement. Ninety-eight papers satisfied inclusion criteria and formed the basis of the review. The review identified 33 different interventions and approaches to attenuate the systemic inflammatory response. However, only a minority of papers (35 of 98 [35.7%]) demonstrated any clinical improvement to one or more of the predefined outcome measures (most frequently myocardial protection or length of intensive care unit stay). No single intervention was supported by strong level A evidence (multiple randomized controlled trials [RCTs] or meta-analysis) for clinical benefit. Interventions at level A evidence included off-pump surgery, minimized circuits, biocompatible circuit coatings, leukocyte filtration, complement C5 inhibition, preoperative aspirin, and corticosteroid prophylaxis. Interventions at level B evidence (single RCT) for minimizing inflammation included nitric oxide donors, C1 esterase inhibition, neutrophil elastase inhibition, propofol, propionyl-L-carnitine, and intensive insulin therapy. A secondary analysis revealed that suppression of at least one inflammatory marker was necessary but not sufficient to confer clinical benefit. The most effective interventions were those that targeted multiple inflammatory pathways. These observations are consistent with a “multiple hit” hypothesis, whereby clinically effective suppression of the systemic inflammatory response

  10. Attenuating the Systemic Inflammatory Response to Adult Cardiopulmonary Bypass: A Critical Review of the Evidence Base.

    PubMed

    Landis, R Clive; Brown, Jeremiah R; Fitzgerald, David; Likosky, Donald S; Shore-Lesserson, Linda; Baker, Robert A; Hammon, John W

    2014-09-01

    A wide range of pharmacological, surgical, and mechanical pump approaches have been studied to attenuate the systemic inflammatory response to cardiopulmonary bypass, yet no systematically based review exists to cover the scope of anti-inflammatory interventions deployed. We therefore conducted an evidence-based review to capture "self-identified" anti-inflammatory interventions among adult cardiopulmonary bypass procedures. To be included, trials had to measure at least one inflammatory mediator and one clinical outcome, specified in the "Outcomes 2010" consensus statement. Ninety-eight papers satisfied inclusion criteria and formed the basis of the review. The review identified 33 different interventions and approaches to attenuate the systemic inflammatory response. However, only a minority of papers (35 of 98 [35.7%]) demonstrated any clinical improvement to one or more of the predefined outcome measures (most frequently myocardial protection or length of intensive care unit stay). No single intervention was supported by strong level A evidence (multiple randomized controlled trials [RCTs] or meta-analysis) for clinical benefit. Interventions at level A evidence included off-pump surgery, minimized circuits, biocompatible circuit coatings, leukocyte filtration, complement C5 inhibition, preoperative aspirin, and corticosteroid prophylaxis. Interventions at level B evidence (single RCT) for minimizing inflammation included nitric oxide donors, C1 esterase inhibition, neutrophil elastase inhibition, propofol, propionyl-L-carnitine, and intensive insulin therapy. A secondary analysis revealed that suppression of at least one inflammatory marker was necessary but not sufficient to confer clinical benefit. The most effective interventions were those that targeted multiple inflammatory pathways. These observations are consistent with a "multiple hit" hypothesis, whereby clinically effective suppression of the systemic inflammatory response requires hitting multiple

  11. The Adult Education and Economic Growth Act (H.R. 2226): Toward a Modern Adult Education System and a More Educated Workforce

    ERIC Educational Resources Information Center

    Foster, Marcie

    2011-01-01

    The Adult Education and Economic Growth Act (AEEGA) was introduced in the House of Representatives in June 2011 by Rep. Ruben Hinojosa (TX-15). The bill (H.R. 2226) would amend the Workforce Investment Act (WIA) to encourage the use and availability of career pathways for low-skilled adults, strengthen the focus of adult education on postsecondary…

  12. [Congenital dilatation of the biliary system in adult: about three clinical cases].

    PubMed

    Ungania, Silvio; Barletta, Nives

    2011-01-01

    The authors refer to three cases of congenital dilatation of the biliary system in an adult, an extremely rare pathology in the West, with no specific symptomatology, and therefore often discovered accidentally and unexpectedly The first patient had suffered from unexplained periods of fever since childhood, the second had only complained of vague abdominal pains a years before diagnosis; for the third, a Romanian woman, it was the first time she complained of a biliary colic. All the patients had an Ultrasound, a CT scan and a MRCP (magnetic resonance cholangiopancretography). Based on the Todani classification, the first and the third case belongs to type IV A, while the second is a type I. In all three patients the pathology was resolved due to an operation entailing disconnection of the biliary-pancreatic tract, with complete surgical removal of the dilated bile ducts followed by a Roux-en-Y hepatico-jejunostomy. Nevertheless the procedures undertaken are not immune to criticism: in the first and second case the diagnostic imagery had not immediately produced a clear interpretation, leading to a delay in the diagnosis and the execution in the first of a not anodyne ERCP; in the third case a colecistectomy was performed as it were as an intermediary measure; finally there was probably omitted a thorough explanation to the patient with regard to a pathology deserving of a careful follow-up for the possible recidivist of the infectious phenomena and above all the onset of the dangerous degeneration carcinomatosa. PMID:22229240

  13. Clinical Characteristics, Pathophysiology, and Management of Noncentral Nervous System Cancer-Related Cognitive Impairment in Adults

    PubMed Central

    Wefel, Jeffrey S.; Kesler, Shelli R.; Noll, Kyle R.; Schagen, Sanne B.

    2014-01-01

    Over the past few decades, a body of research has emerged confirming what many adult patients with noncentral nervous system cancer have long reported—that cancer and its treatment are frequently associated with cancer-related cognitive impairment (CRCI). The severity of CRCI varies, and symptoms can emerge early or late in the disease course. Nonetheless, CRCI is typically mild to moderate in nature and primarily involves the domains of memory, attention, executive functioning, and processing speed. Animal models and novel neuroimaging techniques have begun to unravel the pathophysiologic mechanisms underlying CRCI, including the role of inflammatory cascades, direct neurotoxic effects, damage to progenitor cells, white matter abnormalities, and reduced functional connectivity, among others. Given the paucity of research on CRCI with other cancer populations, this review synthesizes the current literature with a deliberate focus on CRCI within the context of breast cancer. A hypothetical case-study approach is used to illustrate how CRCI often presents clinically and how current science can inform practice. While the literature regarding intervention for CRCI is nascent, behavioral and pharmacologic approaches are discussed. PMID:25483452

  14. Safety and Tolerability of the Easy Vax™ Clinical Epidermal Electroporation System in Healthy Adults

    PubMed Central

    El-Kamary, Samer S; Billington, Melissa; Deitz, Stephen; Colby, Elaina; Rhinehart, Howard; Wu, Yukun; Blackwelder, William; Edelman, Robert; Lee, Albert; King, Alan

    2012-01-01

    DNA vaccines are cost-effective and versatile, though intracellular delivery has been challenging in humans. Alternative delivery modalities such as electroporation have demonstrated improved immune responses, but are painful. In this single-center, double-blind, medical device trial, we evaluated the safety and tolerability of Easy Vax™ dermal electroporation system, alone (without DNA) in healthy adults. Three randomized protocol doses were administered to 10 subjects (80% white, 60% female, mean age: 32.1 years) in each of two areas (total of six doses). Two subjects complained of shooting pain, burning and/or tingling when doses were administered to the forearm region, but not the lateral deltoid regions. Subsequent doses for the remaining eight subjects were restricted to the deltoid regions only. Tolerability pain scores never exceeded 3 of 10 in the 11-Point Pain Rating scale, and 12 of 100 in the Visual Analog Scale (VAS), and lower in follow-up evaluations (P < 0.0001), with no significant difference between the three dosing protocols. Electrical properties of the skin, measured automatically by the device, showed no correlation between pain intensity and skin conductance. In conclusion, the Easy Vax™ electroporation device is safe and well tolerated when administered over the lateral deltoid skin regions in healthy volunteers. PMID:22068424

  15. Video-Game Play Induces Plasticity in the Visual System of Adults with Amblyopia

    PubMed Central

    Li, Roger W.; Ngo, Charlie; Nguyen, Jennie; Levi, Dennis M.

    2011-01-01

    Abnormal visual experience during a sensitive period of development disrupts neuronal circuitry in the visual cortex and results in abnormal spatial vision or amblyopia. Here we examined whether playing video games can induce plasticity in the visual system of adults with amblyopia. Specifically 20 adults with amblyopia (age 15–61 y; visual acuity: 20/25–20/480, with no manifest ocular disease or nystagmus) were recruited and allocated into three intervention groups: action videogame group (n = 10), non-action videogame group (n = 3), and crossover control group (n = 7). Our experiments show that playing video games (both action and non-action games) for a short period of time (40–80 h, 2 h/d) using the amblyopic eye results in a substantial improvement in a wide range of fundamental visual functions, from low-level to high-level, including visual acuity (33%), positional acuity (16%), spatial attention (37%), and stereopsis (54%). Using a cross-over experimental design (first 20 h: occlusion therapy, and the next 40 h: videogame therapy), we can conclude that the improvement cannot be explained simply by eye patching alone. We quantified the limits and the time course of visual plasticity induced by video-game experience. The recovery in visual acuity that we observed is at least 5-fold faster than would be expected from occlusion therapy in childhood amblyopia. We used positional noise and modelling to reveal the neural mechanisms underlying the visual improvements in terms of decreased spatial distortion (7%) and increased processing efficiency (33%). Our study had several limitations: small sample size, lack of randomization, and differences in numbers between groups. A large-scale randomized clinical study is needed to confirm the therapeutic value of video-game treatment in clinical situations. Nonetheless, taken as a pilot study, this work suggests that video-game play may provide important principles for treating amblyopia, and perhaps

  16. Clarification of the circulatory patho-physiology of anaesthesia - implications for high-risk surgical patients.

    PubMed

    Wolff, Christopher B; Green, David W

    2014-12-01

    The paper examines the effects of anaesthesia on circulatory physiology and their implications regarding improvement in perioperative anaesthetic management. Changes to current anaesthetic practice, recommended recently, such as the use of flow monitoring in high risk patients, are already beginning to have an impact in reducing complications but not mortality [1]. Better understanding of the patho-physiology should help improve management even further. Analysis of selected individual clinical trials has been used to illustrate particular areas of patho-physiology and how changes in practice have improved outcome. There is physiological support for the importance of achieving an appropriate rate of oxygen delivery (DO2), particularly following induction of anaesthesia. It is suggested that ensuring adequate DO2 during anaesthesia will avoid development of oxygen debt and hence obviate the need to induce a high, compensatory, DO2 in the post-operative period. In contrast to the usual assumptions underlying strategies requiring a global increase in blood flow [1] by a stroke volume near maximization strategy, blood flow control actually resides entirely at the tissues not at the heart. This is important as the starting point for understanding failed circulatory control as indicated by 'volume dependency'. Local adjustments in blood flow at each individual organ - auto-regulation - normally ensure the appropriate local rate of oxygen supply, i.e. local DO2. Inadequate blood volume leads to impairment of the regulation of blood flow, particularly in the individual tissues with least capable auto-regulatory capability. As demonstrated by many studies, inadequate blood flow first occurs in the gut, brain and kidney. The inadequate blood volume which occurs with induction of anaesthesia is not due to blood volume loss, but probably results from redistribution due to veno-dilation. The increase in venous capacity renders the existing blood volume inadequate to maintain

  17. Liposomal cytarabine for central nervous system embryonal tumors in children and young adults.

    PubMed

    Partap, Sonia; Murphy, Patricia A; Vogel, Hannes; Barnes, Patrick D; Edwards, Michael S B; Fisher, Paul G

    2011-07-01

    To assess the tolerability and efficacy of liposomal cytarabine (LC), an encapsulated, sustained-release, intrathecal (IT) formulation of cytosine arabinoside, in de novo and relapsed central nervous system (CNS) embryonal tumors in children and young adults. We studied retrospectively all patients less than age 30 at our institution treated consecutively with LC for medulloblastoma (MB), primitive neuroectodermal tumor (PNET), and atypical teratoid rhabdoid tumor (ATRT). Seventeen patients received LC (2 mg/kg up to 50 mg, every 2 weeks to monthly) at diagnosis of high-risk CNS embryonal tumor (2 PNET, 3 ATRT) or relapse of MB (12 MB; 9 had leptomeningeal metastases). Sixteen patients received concurrent systemic chemotherapy. A total of 108 doses were administered (IT 82, intraventricular 26) with a mean of six (range 1-16) treatments per patient. Only three administrations were associated with adverse effects of arachnoiditis or headache. None developed malignant cerebrospinal fluid (CSF) cytology while receiving LC. All the six evaluable patients with malignant CSF cytology and treated with at least two doses cleared their CSF (mean 3 doses, range 1-5). Median overall survival in relapse patients was 9.1 months. Five patients (4 de novo and 1 relapsed) remain alive in complete remission for a median 26.8 months from first LC. Liposomal cytarabine is an easily administered, well-tolerated, and active drug in patients with high-risk embryonal neoplasms. One-third of our cohort remains in remission from otherwise fatal diagnoses. Our findings warrant a phase II trial of LC in newly diagnosed or recurrent CNS embryonal tumors. PMID:20859651

  18. An Intelligent Computer-aided Training System (CAT) for Diagnosing Adult Illiterates: Integrating NASA Technology into Workplace Literacy

    NASA Technical Reports Server (NTRS)

    Yaden, David B., Jr.

    1991-01-01

    An important part of NASA's mission involves the secondary application of its technologies in the public and private sectors. One current application being developed is The Adult Literacy Evaluator, a simulation-based diagnostic tool designed to assess the operant literacy abilities of adults having difficulties in learning to read and write. Using Intelligent Computer-Aided Training (ICAT) system technology in addition to speech recognition, closed-captioned television (CCTV), live video and other state-of-the-art graphics and storage capabilities, this project attempts to overcome the negative effects of adult literacy assessment by allowing the client to interact with an intelligent computer system which simulates real-life literacy activities and materials and which measures literacy performance in the actual context of its use. The specific objectives of the project are as follows: (1) to develop a simulation-based diagnostic tool to assess adults' prior knowledge about reading and writing processes in actual contexts of application; (2) to provide a profile of readers' strengths and weaknesses; and (3) to suggest instructional strategies and materials which can be used as a beginning point for remediation. In the first and development phase of the project, descriptions of literacy events and environments are being written and functional literacy documents analyzed for their components. From these descriptions, scripts are being generated which define the interaction between the student, an on-screen guide and the simulated literacy environment.

  19. The “Abdominal Circulatory Pump”: An Auxiliary Heart during Exercise?

    PubMed Central

    Uva, Barbara; Aliverti, Andrea; Bovio, Dario; Kayser, Bengt

    2016-01-01

    Apart from its role as a flow generator for ventilation the diaphragm has a circulatory role. The cyclical abdominal pressure variations from its contractions cause swings in venous return from the splanchnic venous circulation. During exercise the action of the abdominal muscles may enhance this circulatory function of the diaphragm. Eleven healthy subjects (25 ± 7 year, 70 ± 11 kg, 1.78 ± 0.1 m, 3 F) performed plantar flexion exercise at ~4 METs. Changes in body volume (ΔVb) and trunk volume (ΔVtr) were measured simultaneously by double body plethysmography. Volume of blood shifts between trunk and extremities (Vbs) was determined non-invasively as ΔVtr-ΔVb. Three types of breathing were studied: spontaneous (SE), rib cage (RCE, voluntary emphasized inspiratory rib cage breathing), and abdominal (ABE, voluntary active abdominal expiration breathing). During SE and RCE blood was displaced from the extremities into the trunk (on average 0.16 ± 0.33 L and 0.48 ± 0.55 L, p < 0.05 SE vs. RCE), while during ABE it was displaced from the trunk to the extremities (0.22 ± 0.20 L p < 0.001, p < 0.05 RCE and SE vs. ABE respectively). At baseline, Vbs swings (maximum to minimum amplitude) were bimodal and averaged 0.13 ± 0.08 L. During exercise, Vbs swings consistently increased (0.42 ± 0.34 L, 0.40 ± 0.26 L, 0.46 ± 0.21 L, for SE, RCE and ABE respectively, all p < 0.01 vs. baseline). It follows that during leg exercise significant bi-directional blood shifting occurs between the trunk and the extremities. The dynamics and partitioning of these blood shifts strongly depend on the relative predominance of the action of the diaphragm, the rib cage and the abdominal muscles. Depending on the partitioning between respiratory muscles for the act of breathing, the distribution of blood between trunk and extremities can vary by up to 1 L. We conclude that during exercise the abdominal muscles and the diaphragm might play a role of an “auxiliary heart.” PMID

  20. Captures of MFO-resistant Cydia pomonella adults as affected by lure, crop management system and flight.

    PubMed

    Bosch, D; Rodríguez, M A; Avilla, J

    2016-02-01

    The main resistance mechanism of codling moth (Cydia pomonella) in the tree fruit area of Lleida (NE Spain) is multifunction oxidases (MFO). We studied the frequency of MFO-resistant adults captured by different lures, with and without pear ester, and flights in orchards under different crop management systems. The factor year affected codling moth MFO-resistance level, particularly in the untreated orchards, highlighting the great influence of codling moth migration on the spread of resistance in field populations. Chemical treatments and adult flight were also very important but mating disruption technique showed no influence. The second adult flight showed the highest frequency, followed by the first flight and the third flight. In untreated orchards, there were no significant differences in the frequency of MFO-resistant individuals attracted by Combo and BioLure. Red septa lures baited with pear ester (DA) captured sufficient insects only in the first generation of 2010, obtaining a significantly lower proportion of MFO-resistant adults than Combo and BioLure. In the chemically treated orchards, in 2009 BioLure caught a significantly lower proportion of MFO-resistant adults than Combo during the first and third flight, and also than DA during the first flight. No significant differences were found between the lures or flights in 2010. These results cannot support the idea of a higher attractiveness of the pear ester for MFO-resistant adults in the field but do suggest a high influence of the response to the attractant depending on the management of the orchard, particularly with regard to the use of chemical insecticides. PMID:26497943

  1. Mechanical circulatory support with impella to facilitate percutaneous coronary intervention for post-TAVI bilateral coronary obstruction.

    PubMed

    Frisoli, Tiberio M; Guerrero, Mayra; O'Neill, William W

    2016-07-01

    One of the potential complications of transcatheter aortic valve implantation (TAVI) is coronary obstruction (CO), which can occur by displacement of heavily calcified native valve cusps against the coronary ostium. Treatment mandates immediate percutaneous coronary intervention (PCI) to restore coronary flow and improve hemodynamics and if unsuccessful, urgent implementation of circulatory support, commonly extracorporeal, with subsequent surgical revascularization. We report a case of post-TAVI CO for which successful emergent deployment of Impella percutaneous mechanical circulatory support to restore hemodynamic stability facilitated definitive treatment with bilateral PCI. Impella support represents an expeditious, effective, and widely available therapy to complement and facilitate PCI in the treatment of CO complicating TAVI, and may diminish requirement for urgent coronary artery bypass surgery. © 2015 Wiley Periodicals, Inc. PMID:26104838

  2. Skipping Breakfast and Risk of Mortality from Cancer, Circulatory Diseases and All Causes: Findings from the Japan Collaborative Cohort Study

    PubMed Central

    Yokoyama, Yae; Onishi, Kazunari; Hosoda, Takenobu; Amano, Hiroki; Otani, Shinji; Kurozawa, Youichi; Tamakoshi, Akiko

    2016-01-01

    Background Breakfast eating habits are a dietary pattern marker and appear to be a useful predictor of a healthy lifestyle. Many studies have reported the unhealthy effects of skipping breakfast. However, there are few studies on the association between skipping breakfast and mortality. In the present study, we examined the association between skipping breakfast and mortality from cancer, circulatory diseases and all causes using data from a large-scale cohort study, the Japan Collaborative Cohort Study (JACC) Study. Methods A cohort study of 34,128 men and 49,282 women aged 40–79 years was conducted, to explore the association between lifestyle and cancer in Japan. Participants completed a baseline survey during 1988 to 1990 and were followed until the end of 2009. We classified participants into two groups according to dietary habits with respect to eating or skipping breakfast and carried out intergroup comparisons of lifestyle. Multivariate analysis was performed using the Cox proportional hazard regression model. Results There were 5,768 deaths from cancer and 5,133 cases of death owing to circulatory diseases and 17,112 cases for all causes of mortality during the median 19.4 years follow-up. Skipping breakfast was related to unhealthy lifestyle habits. After adjusting for confounding factors, skipping breakfast significantly increased the risk of mortality from circulatory diseases [hazard ratio (HR) = 1.42] and all causes (HR = 1.43) in men and all causes mortality (HR = 1.34) in women. Conclusion Our findings showed that skipping breakfast is associated with increasing risk of mortality from circulatory diseases and all causes among men and all causes mortality among women in Japan. PMID:27046951

  3. The evolution of temporary percutaneous mechanical circulatory support devices: a review of the options and evidence in cardiogenic shock.

    PubMed

    Abnousi, Freddy; Yong, Celina Mei; Fearon, William; Banerjee, Dipanjan

    2015-06-01

    Temporary percutaneous mechanical circulatory support (MCS) devices were introduced in the 1960s and have developed into a diverse portfolio of options currently available for left, right, and biventricular support. Patients undergoing high-risk percutaneous coronary interventions (PCI), patients with acute myocardial infarction (AMI), and patients with cardiogenic shock in particular may benefit from these options. In this review, we will discuss the currently available devices and the evidence supporting their use in cardiogenic shock. PMID:25899658

  4. Mechanism for the acute effects of organophosphate pesticides on the adult 5-HT system.

    PubMed

    Judge, Sarah J; Savy, Claire Y; Campbell, Matthew; Dodds, Rebecca; Gomes, Larissa Kruger; Laws, Grace; Watson, Anna; Blain, Peter G; Morris, Christopher M; Gartside, Sarah E

    2016-02-01

    The neurotransmitter serotonin (5-HT) is involved in mood disorder aetiology and it has been reported that (organophosphate) OP exposure affects 5-HT turnover. The aim of this study was to elucidate the mechanism underlying OP effects on the adult 5-HT system. First, acute in vivo administration of the OP diazinon (0, 1.3, 13 or 39 mg/kg i.p.) to male Hooded Lister rats inhibited the activity of the cholinergic enzyme acetylcholinesterase in blood and in the hippocampus, dorsal raphe nucleus (DRN), striatum and prefrontal cortex. Diazinon-induced cholinesterase inhibition was greatest in the DRN, the brain's major source of 5-HT neurones. Second, acute in vivo diazinon exposure (0 or 39 mg/kg i.p.) increased the basal firing rate of DRN neurones measured ex vivo in brain slices. The excitatory responses of DRN neurones to α1-adrenoceptor or AMPA/kainate receptor activation were not affected by in vivo diazinon exposure but the inhibitory response to 5-HT was attenuated, indicating 5-HT1A autoreceptor down-regulation. Finally, direct application of the diazinon metabolite diazinon oxon to naive rat brain slices increased the firing rate of DRN 5-HT neurones, as did chlorpyrifos-oxon, indicating the effect was not unique to diazinon. The oxon-induced augmentation of firing was blocked by the nicotinic acetylcholine receptor antagonist mecamylamine and the AMPA/kainate glutamate receptor antagonist DNQX. Together these data indicate that 1) acute OP exposure inhibits DRN cholinesterase, leading to acetylcholine accumulation, 2) the acetylcholine activates nicotinic receptors on 5-HT neurones and also on glutamatergic neurones, thus releasing glutamate and activating 5-HT neuronal AMPA/kainate receptors 3) the increase in 5-HT neuronal activity, and resulting 5-HT release, may lead to 5-HT1A autoreceptor down-regulation. This mechanism may be involved in the reported increase in risk of developing anxiety and depression following occupational OP exposure. PMID

  5. Assessment of imidacloprid toxicity on reproductive organ system of adult male rats.

    PubMed

    Bal, Ramazan; Türk, Gaffari; Tuzcu, Mehmet; Yilmaz, Okkes; Kuloglu, Tuncay; Gundogdu, Ramazan; Gür, Seyfettin; Agca, Ali; Ulas, Mustafa; Cambay, Zafer; Tuzcu, Zeynep; Gencoglu, Hasan; Guvenc, Mehmet; Ozsahin, Ayse Dilek; Kocaman, Nevin; Aslan, Abdullah; Etem, Ebru

    2012-01-01

    In the current study it was aimed to investigate the toxicity of low doses of imidacloprid (IMI) on the reproductive organ systems of adult male rats. The treatment groups received 0.5 (IMI-0.5), 2 (IMI-2) or 8 mg IMI/kg body weight by oral gavage (IMI-8) for three months. The deterioration in sperm motility in IMI-8 group and epidydimal sperm concentration in IMI-2 and IMI-8 groups and abnormality in sperm morphology in IMI-8 were significant. The levels of testosterone (T) and GSH decreased significantly in group IMI-8 compared to the control group. Upon treatment with IMI, apoptotic index increased significantly only in germ cells of the seminiferous tubules of IMI-8 group when compared to control. Fragmentation was striking in the seminal DNA from the IMI-8 group, but it was much less obvious in the IMI-2 one. IMI exposure resulted in elevation of all fatty acids analyzed, but the increases were significant only in stearic, oleic, linoleic and arachidonic acids. The ratios of 20:4/20:3 and 20:4/18:2 were decreased and 16:1n-9/16:0 ratio was increased. In conclusion, the present animal experiments revealed that the treatment with IMI at NOAEL dose-levels caused deterioration in sperm parameters, decreased T level, increased apoptosis of germ cells, seminal DNA fragmentation, the depletion of antioxidants and change in disturbance of fatty acid composition. All these changes indicate the suppression of testicular function. PMID:22424069

  6. Matrix metalloproteinases as promising regulators of axonal regrowth in the injured adult zebrafish retinotectal system.

    PubMed

    Lemmens, Kim; Bollaerts, Ilse; Bhumika, Stitipragyan; de Groef, Lies; Van Houcke, Jessie; Darras, Veerle M; Van Hove, Inge; Moons, Lieve

    2016-05-01

    Overcoming the failure of axon regeneration in the mammalian central nervous system (CNS) after injury remains a major challenge, which makes the search for proregenerative molecules essential. Matrix metalloproteinases (MMPs) have been implicated in axonal outgrowth during CNS development and show increased expression levels during vertebrate CNS repair. In mammals, MMPs are believed to alter the suppressive extracellular matrix to become more permissive for axon regrowth. We investigated the role of MMPs in axonal regeneration following optic nerve crush (ONC) in adult zebrafish, which fully recover from such injuries due to a high intrinsic axon growth capacity and a less inhibitory environment. Lowering general retinal MMP activity through intravitreal injections of GM6001 after ONC strongly reduced retinal ganglion cell (RGC) axonal regrowth, without influencing RGC survival. Based on a recently performed transcriptome profiling study, the expression pattern of four MMPs after ONC was determined via combined use of western blotting and immunostainings. Mmp-2 and -13a were increasingly present in RGC somata during axonal regrowth. Moreover, Mmp-2 and -9 became upregulated in regrowing RGC axons and inner plexiform layer (IPL) synapses, respectively. In contrast, after an initial rise in IPL neurites and RGC axons during the injury response, Mmp-14 expression decreased during regeneration. Altogether, a phase-dependent expression pattern for each specific MMP was observed, implicating them in axonal regrowth and inner retina remodeling after injury. In conclusion, these data suggest a novel, neuron-intrinsic function for multiple MMPs in axon regrowth that is distinct from breaking down environmental barriers. J. Comp. Neurol. 524:1472-1493, 2016. © 2015 Wiley Periodicals, Inc. PMID:26509469

  7. Mechanical circulatory assist devices: a primer for critical care and emergency physicians.

    PubMed

    Sen, Ayan; Larson, Joel S; Kashani, Kianoush B; Libricz, Stacy L; Patel, Bhavesh M; Guru, Pramod K; Alwardt, Cory M; Pajaro, Octavio; Farmer, J Christopher

    2016-01-01

    Mechanical circulatory assist devices are now commonly used in the treatment of severe heart failure as bridges to cardiac transplant, as destination therapy for patients who are not transplant candidates, and as bridges to recovery and "decision-making". These devices, which can be used to support the left or right ventricles or both, restore circulation to the tissues, thereby improving organ function. Left ventricular assist devices (LVADs) are the most common support devices. To care for patients with these devices, health care providers in emergency departments (EDs) and intensive care units (ICUs) need to understand the physiology of the devices, the vocabulary of mechanical support, the types of complications patients may have, diagnostic techniques, and decision-making regarding treatment. Patients with LVADs who come to the ED or are admitted to the ICU usually have nonspecific clinical symptoms, most commonly shortness of breath, hypotension, anemia, chest pain, syncope, hemoptysis, gastrointestinal bleeding, jaundice, fever, oliguria and hematuria, altered mental status, headache, seizure, and back pain. Other patients are seen for cardiac arrest, psychiatric issues, sequelae of noncardiac surgery, and trauma. Although most patients have LVADs, some may have biventricular support devices or total artificial hearts. Involving a team of cardiac surgeons, perfusion experts, and heart-failure physicians, as well as ED and ICU physicians and nurses, is critical for managing treatment for these patients and for successful outcomes. This review is designed for critical care providers who may be the first to see these patients in the ED or ICU. PMID:27342573

  8. Comparing Normothermic Machine Perfusion Preservation With Different Perfusates on Porcine Livers From Donors After Circulatory Death.

    PubMed

    Liu, Q; Nassar, A; Farias, K; Buccini, L; Mangino, M J; Baldwin, W; Bennett, A; O'Rourke, C; Iuppa, G; Soliman, B G; Urcuyo-Llanes, D; Okamoto, T; Uso, T D; Fung, J; Abu-Elmagd, K; Miller, C; Quintini, C

    2016-03-01

    The utilization of normothermic machine perfusion (NMP) may be an effective strategy to resuscitate livers from donation after circulatory death (DCD). There is no consensus regarding the efficacy of different perfusates on graft and bile duct viability. The aim of this study was to compare, in an NMP porcine DCD model, the preservation potential of three different perfusates. Twenty porcine livers with 60 min of warm ischemia were separated into four preservation groups: cold storage (CS), NMP with Steen solution (Steen; XVIVO Perfusion Inc., Denver, CO), Steen plus red blood cells (RBCs), or whole blood (WB). All livers were preserved for 10 h and reperfused to simulate transplantation for 24 h. During preservation, the NMP with Steen group presented the highest hepatocellular injury. At reperfusion, the CS group had the lowest bile production and the worst hepatocellular injury compared with all other groups, followed by NMP with Steen; the Steen plus RBC and WB groups presented the best functional and hepatocellular injury outcomes, with WB livers showing lower aspartate aminotransferase release and a trend toward better results for most parameters. Based on our results, a perfusate that contains an oxygen carrier is most effective in a model of NMP porcine DCD livers compared with Steen solution. Specifically, WB-perfused livers showed a trend toward better outcomes compared with Steen plus RBCs. PMID:26663737

  9. Lung Quality and Utilization in Controlled Donation After Circulatory Determination of Death Within the United States.

    PubMed

    Mooney, J J; Hedlin, H; Mohabir, P K; Vazquez, R; Nguyen, J; Ha, R; Chiu, P; Patel, K; Zamora, M R; Weill, D; Nicolls, M R; Dhillon, G S

    2016-04-01

    Although controlled donation after circulatory determination of death (cDCDD) could increase the supply of donor lungs within the United States, the yield of lungs from cDCDD donors remains low compared with donation after neurologic determination of death (DNDD). To explore the reason for low lung yield from cDCDD donors, Scientific Registry of Transplant Recipient data were used to assess the impact of donor lung quality on cDCDD lung utilization by fitting a logistic regression model. The relationship between center volume and cDCDD use was assessed, and the distance between center and donor hospital was calculated by cDCDD status. Recipient survival was compared using a multivariable Cox regression model. Lung utilization was 2.1% for cDCDD donors and 21.4% for DNDD donors. Being a cDCDD donor decreased lung donation (adjusted odds ratio 0.101, 95% confidence interval [CI] 0.085-0.120). A minority of centers have performed cDCDD transplant, with higher volume centers generally performing more cDCDD transplants. There was no difference in center-to-donor distance or recipient survival (adjusted hazard ratio 1.03, 95% CI 0.78-1.37) between cDCDD and DNDD transplants. cDCDD lungs are underutilized compared with DNDD lungs after adjusting for lung quality. Increasing transplant center expertise and commitment to cDCDD lung procurement is needed to improve utilization. PMID:26844673

  10. Mitral Valve Regurgitation in the LVAD-Assisted Heart Studied in a Mock Circulatory Loop.

    PubMed

    May-Newman, K; Fisher, B; Hara, M; Dembitsky, W; Adamson, R

    2016-06-01

    Permanent closure of the aortic valve (AVC) is sometimes performed In LVAD patients, usually when a mechanical valve prosthesis or significant aortic insufficiency is present. Mitral valve regurgitation (MVR) present at the time of LVAD implantation can remain unresolved, representing a limitation for exercise tolerance and a potential predictor of mortality. To investigate the effect of MVR on hemodynamics of the LVAD-supported heart following AVC, studies were performed using a mock circulatory loop. Pressure and flow measured for a range of cardiac function, LVAD speed, and MVR show that cardiac contraction augments aortic pressure by 10-27% over nonpulsatile conditions when the mitral valve functions normally, but decreases with MVR until it reaches the nonpulsatile level. Aortic flow displays a similar trend, demonstrating a 25% decrease from fully functioning to open at 7 krpm, a 5% decrease at 9 krpm, and no observable effect at 11 krpm. Pulsatility decreases with increased LVAD speed and MVR. The data indicate that a modest level of cardiac output (1.5-2 L/min) can be maintained by the native heart through the LVAD when the LVAD is off. These results demonstrate that MVR decreases the augmentation of forward flow by improved cardiac function at lower LVAD speeds. While some level of MVR can be tolerated in LVAD recipients, this condition represents a risk, particularly in those patients that undergo AVC closure, and may warrant repair at the time of surgery. PMID:27008972

  11. The cold effects on circulatory inflammation, thrombosis and vasoconstriction in type 2 diabetic patients.

    PubMed

    Cai, Jing; Meng, Xia; Wang, Cuicui; Chen, Renjie; Zhou, Ji; Xu, Xiaohui; Ha, Sandie; Zhao, Zhuohui; Kan, Haidong

    2016-10-15

    Short-term associations between temperature variation and adverse cardiovascular outcomes have been well documented. However, it remains unclear whether these temperature-related cardiovascular effects are reflected in circulating biomarkers. We aimed to examine the associations between ambient temperature and circulating biomarkers of inflammation, coagulation and vasoconstriction. We collected 207 blood samples from a panel of 35 type 2 diabetes mellitus patients. Sixteen biomarkers of inflammation, coagulation and vasoconstriction were repeatedly measured over six follow-ups. The short-term associations between air temperature and these biomarkers were assessed by mixed-effect models with controls of demographic characteristics and main air pollutants. We found significant and acute effects of temperature on circulatory biomarkers occurred as early as 3h after exposure, peaked at 25-48h and lasted until 72h after exposure. For example, a 1°C decrease in the 25-48h average of air temperature was associated with 2.2%-15.1% increases in biomarkers of inflammation, 1.4%-24.5% of coagulation and 8.2% of vasoconstriction. Our results provided significant evidence that a temperature decline results in a response in biomarkers of inflammation, coagulation and vasoconstriction biomarkers, suggesting them to be the potential biologic mechanisms underlying the cardiovascular effects of temperature variation, and may have implications for disease prevention. PMID:27295598

  12. A National Survey of Mentoring Practices for Young Investigators in Circulatory and Respiratory Health

    PubMed Central

    Mottillo, Salvatore; Boyle, Pierre; Jacobi Cadete, Lindsay D.; Rouleau, Jean-Lucien; Eisenberg, Mark J.

    2016-01-01

    Background. Improving mentorship may help decrease the shortage of young investigators (graduate students, postdoctoral fellows, and new investigators) available to work as independent researchers in cardiovascular and respiratory health. Objectives. To determine (1) the mentoring practices for trainees affiliated with the Canadian Institutes of Health Research (CIHR), Institute of Circulatory and Respiratory Health (ICRH), (2) the positive attributes of mentors, and (3) the recommendations regarding what makes good mentorship. Methods. We conducted a survey and descriptive analysis of young investigators with a CIHR Training and Salary Award from 2010 to 2013 or who submitted an abstract to the ICRH 2014 Young Investigators Forum. Clinicians were compared to nonclinicians. Results. Of 172 participants, 7.0% had no mentor. Only 43.6% had defined goals and 40.7% had defined timelines, while 54.1% had informal forms of mentorship. A significant proportion (33.1%) felt that their current mentorship did not meet their needs. Among clinicians, 22.2% would not have chosen the same mentor again versus 11.4% of nonclinicians. All participants favored mentors who provided guidance on career and work-life balance. Suggestions for improved mentoring included formal mentorship, increased networking, and quality assurance. Conclusion. There is an important need to improve mentoring in cardiovascular and respiratory health.

  13. Assessing Anticoagulation Practice Patterns in Patients on Durable Mechanical Circulatory Support Devices: An International Survey.

    PubMed

    Jennings, Douglas L; Horn, Edward T; Lyster, Haifa; Panos, Anthony L; Teuteberg, Jeffrey J; Lehmkuhl, Hans B; Perez, Alexandra; Shullo, Michael A

    2016-01-01

    Anticoagulation in mechanical circulatory support (MCS) patients dictated by local practice, and therefore uniform standards for management are lacking. To characterize the worldwide variance in anticoagulation and antiplatelet therapy in patients with MCS devices, a 42 item survey was created and distributed electronically in August 2014. The survey assessed the center-perceived thromboembolic risk (minimal, low, moderate, or high) and characterized the antiplatelet and anticoagulant strategies for the Thoratec HeartMate II (HMII) and HeartWare HVAD (HVAD). A total of 83/214 centers (39%) responded: North America (60/152), Europe (18/50), Australia (2/4), and Asia (3/8). Although the most common target international normalized ratio (INR) was 2-3 for both devices, significant variability exists. Anticoagulation intensity tended to be lower with the HMII, with more centers targeting INR values of less than 2.5. Aspirin monotherapy was the most common antiplatelet regimen; however, the HVAD patients were more likely to be on daily aspirin doses over 100 mg. In addition, parenteral bridging was more frequent with the HVAD device. While 43.8% of respondents indicated an increase in the perceived risk of HMII device thrombosis in 2014, intensification of anticoagulation (22%) or antiplatelet (11%) therapy was infrequent. Our findings verify the wide variety of anticoagulation practice patterns between MCS centers. PMID:26309097

  14. Optimization of Centrifugal Pump Characteristic Dimensions for Mechanical Circulatory Support Devices.

    PubMed

    Korakianitis, Theodosios; Rezaienia, Mohammad A; Paul, Gordon M; Rahideh, Akbar; Rothman, Martin T; Mozafari, Sahand

    2016-01-01

    The application of artificial mechanical pumps as heart assist devices impose power and size limitations on the pumping mechanism, and therefore requires careful optimization of pump characteristics. Typically new pumps are designed by relying on the performance of other previously designed pumps of known performance using concepts of fluid dynamic similarity. Such data are readily available for industrial pumps, which operate in Reynolds numbers region of 10. Heart assist pumps operate in Reynolds numbers of 10. There are few data available for the design of centrifugal pumps in this characteristic range. This article develops specific speed versus specific diameter graphs suitable for the design and optimization of these smaller centrifugal pumps concentrating in dimensions suitable for ventricular assist devices (VADs) and mechanical circulatory support (MCS) devices. A combination of experimental and numerical techniques was used to measure and analyze the performance of 100 optimized pumps designed for this application. The data are presented in the traditional Cordier diagram of nondimensional specific speed versus specific diameter. Using these data, nine efficient designs were selected to be manufactured and tested in different operating conditions of flow, pressure, and rotational speed. The nondimensional results presented in this article enable preliminary design of centrifugal pumps for VADs and MCS devices. PMID:27258221

  15. Cerebral venous circulatory disturbance as an informative prognostic marker for neonatal hemorrhagic stroke

    NASA Astrophysics Data System (ADS)

    Semyachkina-Glushkovskaya, Oxana; Pavlov, Alexey; Navolokin, Nikita; Lychagov, Vladislav; Abdurashitov, Arkady; Zinchenko, Ekaterina; Gekaluk, Artemiy; Zhu, Dan; Shi, Rui; Luo, Qingming; Tuchin, Valery

    2016-04-01

    Neonatal hemorrhagic stroke (NHS) is a major problem of future generation's health due to the high rate of death and cognitive disability of newborns after NHS. The incidence of NHS in neonates cannot be predicted by standard diagnostic methods. Therefore, the identification of prognostic markers of NHS is crucial. There is evidence that stress-related alterations of cerebral blood flow (CBF) may contribute to NHS. Here, we assessed the stroke-associated CBF abnormalities for high prognosis of NHS using a new model of NHS induced by sound stress in the pre- and post-stroke state. With this aim, we used interdisciplinary methods such as a histological assay of brain tissues, laser speckle contrast imaging and Doppler coherent tomography to monitor cerebral circulation. Our results suggest that the venous stasis with such symptoms as progressive relaxation of cerebral veins, decrease the velocity of blood flow in them are prognostic markers for a risk of NHS and are an informative platform for a future study of corrections of cerebral venous circulatory disturbance related to NHS.

  16. Should We Reconsider Lung Transplantation Through Uncontrolled Donation After Circulatory Death?

    PubMed Central

    Suzuki, Y.; Tiwari, J. L.; Lee, J.; Diamond, J.M.; Blumenthal, N. P.; Carney, K.; Borders, C.; Strain, J.; Alburger, G.W.; Jackson, D.; Timar, J.; Berg, J.; Hasz, R.D.; Cantu, E.

    2014-01-01

    Lung transplantation through controlled donation after circulatory death (cDCD) has slowly gained universal acceptance with reports of equivalent outcomes to those through donation after brain death. In contrast, uncontrolled DCD (uDCD) lung use is controversial and requires ethical, legal and medical complexities to be addressed in a limited time. Consequently, uDCD lung use has not previously been reported in the United States. Despite these potential barriers, we present a case of a patient with multiple gunshot wounds to the head and the body who was unsuccessfully resuscitated and ultimately became an uDCD donor. A cytomegalovirus positive recipient who had previously consented for CDC high-risk, DCD and participation in the NOVEL trial was transplanted from this uDCD donor, following 3 hours of ex vivo lung perfusion. The postoperative course was uneventful and the recipient was discharged home on day 9. While this case represents a “best-case scenario,” it illustrates a method for potential expansion of the lung allograft pool through uDCD after unsuccessful resuscitation in hospitalized patients. PMID:24712333

  17. Pearls and pitfalls in short-term mechanical circulatory assist: how to avoid and manage complications.

    PubMed

    Mohite, Prashant N; Maunz, Olaf; Simon, Andre R

    2014-10-01

    In today's era, given the worsening risk profiles of patients undergoing cardiac surgery, the increasing number of complex cardiac surgeries, and the increasing number of patients undergoing thoracic organ transplantation, short-term mechanical circulatory assist (MCA) devices are indispensable. MCA devices are capable of supporting heart and lung function and have emerged as potentially lifesaving instruments, but may prove to be as hazardous as helpful due to their inherent tendency toward hemolysis, thromboembolism, and hemorrhage. Although MCA devices are being used regularly at some specialized centers, surgeries involving MCA are not as common as other routine cardiac surgeries, and even though professionals implanting and maintaining short-term MCAs are well acquainted with operating such devices, it is not uncommon to come across complications as a result of minor mistakes committed while dealing with them. Avoiding simple mistakes and taking proper precautions while implanting and maintaining these devices can prevent major catastrophes. We discuss commonly encountered problems and complications during the implantation and maintenance of short-term MCAs and offer reasonable and practical solutions. In addition, crucial issues such as anticoagulation, replacement of the device circuit, and management of the distal perfusion cannula are discussed. Continuous and efficient monitoring of the MCA device and the patient supported on MCA, together with anticipation and avoidance of complications, is key for successful short-term MCA support. PMID:24533589

  18. Usefulness of Deep Hypothermic Circulatory Arrest and Regional Cerebral Perfusion in Children

    PubMed Central

    Guo, Zheng; Hu, Ren-Jie; Zhu, De-Ming; Zhu, Zhong-Qun; Zhang, Hai-Bo

    2013-01-01

    To compare the safety and usefulness of deep hypothermic circulatory arrest (DHCA) and regional cerebral perfusion (RCP) during pediatric open heart surgery. Between January 1, 2004 and September 30, 2012, 1250 children with congenital cardiac defect underwent corrective operation with the DHCA or RCP technique in the Shanghai Children's Medical Center. Of them, 947 cases underwent the operation with the aid of DHCA (DHCA group), and 303 cases with RCP (RCP group). The mean DHCA time was 30.64±15.81 (7–63) minutes and mean RCP time was 36.18±12.86 (10–82) minutes. The mortality rate was 7.18% (68/947) and 6.60% (20/30) in two groups, respectively. The postoperative incidences of temporary and permanent neurological dysfunction were 6.23% (59/947) in the DHCA group and 2.64% (8/303) in the RCP group (p<0.01). The incidence of other complications such as low cardiac output, renal dysfunction, and lung issues are similar in both groups. RCP is a reliable technique for cerebral protection and it facilitates time-consuming corrected procedures for complex congenital cardiac defect repair procedures. PMID:24066266

  19. Hemocompatibility evaluation with experimental and computational fluid dynamic analyses for a monopivot circulatory assist pump.

    PubMed

    Nishida, Masahiro; Maruyama, Osamu; Kosaka, Ryo; Yamane, Takashi; Kogure, Hisato; Kawamura, Hiroshi; Yamamoto, Yoshihiro; Kuwana, Katsuyuki; Sankai, Yoshiyuki; Tsutsui, Tatsuo

    2009-04-01

    The hemocompatibility of a newly developed monopivot circulatory assist pump was evaluated by the computational fluid dynamic (CFD) analyses with the particle tracking velocimetry measurement. Results were compared with those of the hemolysis test and in vitro antithrombogenic test to prevent hemolysis and thrombus formation inside the pump. The results of the CFD analysis and the particle tracking velocimetry had a good agreement with each other. The flow distributions by the CFD analysis indicated that the radial jet out of the impeller was adequately weak so that the wall shear stress was lower than 300 Pa on the volute casing wall. It corresponded with the hemolysis tests results, indicating that the hemolysis level was lower than that of the commercially available pump. However, the flow distributions also indicated that the pivot that was easy to stagnate was washed out, not only by the secondary flow through the back gap of the impeller, but also by the vortices generated by the secondary vanes. It corresponded with the in vitro antithrombogenic test results, indicating that thrombus formation could be removed only by redesigning the geometry of the secondary vanes. PMID:19335415

  20. [Transfusion-related acute lung injury (TRALI) and transfusion-associated circulatory overload (TACO)].

    PubMed

    Okazaki, Hitoshi

    2013-05-01

    In recent years, much attention has been paid to respiratory complications of transfusion. Transfusion related acute lung injury (TRALI) is defined as an acute lung injury that is temporally associated with blood transfusion. TRALI is one of the leading causes of mortality. Although the etiology of TRALI is not fully understood, one of its main causes is thought to be anti-leukocyte antibodies, such as HLA antibody or HNA antibody. A precautionary male-predominant plasma strategy has been implemented in many developed countries, which has resulted in considerable achievements in reducing the incidence of TRALI. Meanwhile, transfusion-associated circulatory overload (TACO) has emerged as a major differential diagnosis of TRALI. TACO is a well-known complication of transfusion, which has been considered not as a side effect of transfusion but a result of erroneous medical practice. It has long been an under-reported complication of transfusion and has not been investigated scientifically. Recent data on transfusion mortality from the Food and Drug Administration revealed that TACO was the second highest cause of death in the United States. Our data also suggested a steep increase in the reported cases of TACO in Japan. Precautionary measures should also be implemented for this emerging complication. PMID:23947178

  1. Circulatory support devices: fundamental aspects and clinical management of bleeding and thrombosis.

    PubMed

    Susen, S; Rauch, A; Van Belle, E; Vincentelli, A; Lenting, P J

    2015-10-01

    Circulatory support devices are increasingly being used to overcome cardiac or respiratory failure. Long-term devices are used either as a 'bridge to transplant' to support patients who are unable to wait any longer for a heart transplant, or, more recently, as 'destination therapy' for older patients suffering from end-stage heart failure and who have contraindications to heart transplantation. Short-term support devices for high-risk percutaneous coronary intervention, or as a 'bridge for decision' for patients suffering from refractory cardiogenic shock, have also been developed. The clinical benefit of such assist devices has been demonstrated in several important studies, but, unfortunately, thrombotic and bleeding complications are two major clinical issues in patients requiring these devices. Overcoming these issues is of major importance to allow the safe and broad use of these devices, and to consider them as true alternatives to heart transplantation. The present review focuses on thrombotic and bleeding complications, and describes how the risk of thrombosis and bleeding may vary according to the clinical indication, but also according to the type of device. We describe the current knowledge of the mechanisms underlying the occurrence of these complications, provide some guidance for choosing the most appropriate anticoagulation regimen to prevent their occurrence for each type of device and indication, and provide some recommendations for the management of patients when the complication occurs. PMID:26302994

  2. A Kinect-based system for physical rehabilitation: a pilot study for young adults with motor disabilities.

    PubMed

    Chang, Yao-Jen; Chen, Shu-Fang; Huang, Jun-Da

    2011-01-01

    This study assessed the possibility of rehabilitating two young adults with motor impairments using a Kinect-based system in a public school setting. This study was carried out according to an ABAB sequence in which A represented the baseline and B represented intervention phases. Data showed that the two participants significantly increased their motivation for physical rehabilitation, thus improving exercise performance during the intervention phases. Practical and developmental implications of the findings are discussed. PMID:21784612

  3. 76 FR 63928 - Circulatory System Devices Panel of the Medical Devices Advisory Committee; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-14

    ... database--The Electronics Unit contains hardware and software to acquire and process signals from the... contains software, which receives data transmitted from the electronics unit, and presents the data...

  4. 77 FR 66847 - Circulatory System Devices Panel of the Medical Devices Advisory Committee; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-07

    ... releasing external pressure during systole to reduce left ventricular workload. On March 9, 1979 (44 FR... class III after receiving no comments on the proposed rule (45 FR 7966, February 5, 1980). In 1987, FDA... been established for the requirement for premarket approval for ECP devices (52 FR 17737, May 11,...

  5. 78 FR 49272 - Circulatory System Devices Panel of the Medical Devices Advisory Committee; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-13

    ... depth of compressions for the duration of CPR. On January 8, 2013 (78 FR 1162), FDA issued a proposed... regulatory history of ECC devices has been discussed as part of the proposed rule (77 FR 36951, June 20, 2012... surgery or a myocardial infarction. The device may have adjustments for impulse strength, duration,...

  6. Biomedical technology transfer: Bioinstrumentation for cardiology, neurology, and the circulatory system

    NASA Technical Reports Server (NTRS)

    1976-01-01

    Developments in applying aerospace medical technology to the design and production of medical equipment and instrumentation are reported. Projects described include intercranial pressure transducers, leg negative pressure devices, a synthetic speech prosthesis for victims of cerebral palsy, and a Doppler blood flow instrument. Commercialization activities for disseminating and utilizing NASA technology, and new biomedical problem areas are discussed.

  7. [Vertigo and peripheral ischemic cochleovestibular syndrome caused by circulatory insufficiency in the vertebrobasilar system].

    PubMed

    Alekseeva, N S; Kirichenko, I M

    2006-01-01

    We studied characteristics of vestibular and acoustic disorders in patients with arterial hypertension, atherosclerosis and vascular dystonia; correlation between peripheral cochleovestibular syndromes (PCVS) and circulation in the major and intracranial arteries, central hemodynamics, organic changes in the brain. We discovered that anomalies and asymmetry in vertebral arteries diameters, stenoses, reduced stroke and minute blood volumes play an essential role in development of PCVS. The latter are rarely accompanied with ischemic foci in the brain. Medication of vascular vertigo consists in administration of an adequate drug. We believe that betaserk is most effective. PMID:16710175

  8. [Reactions of the circulatory system to static load in athletes and persons less well trained].

    PubMed

    Vodop'ianova, M A; Drobotia, N V; Karapetian, G S

    1988-02-01

    Different cardiovascular responses were assessed in untrained men (1 group) and sportsmen (2 group). The 2 group responses were more economic due to effective vascular reactions, whereas in the 1 group the increase of blood flow during exercise was provided ba cardiac output and to a lesser extent by vascular reactions. Physiological value of the responses and vegetative prognostic criteria of fatigue limiting physical work, are discussed. PMID:3371506

  9. Medical Terminology of the Circulatory System. Medical Records. Instructional Unit for the Medical Transcriber.

    ERIC Educational Resources Information Center

    Gosman, Minna L.

    Developed as a result of an analysis of the task of transcribing as practiced in a health facility, this study guide was designed to teach the knowledge and skills required of a medical transcriber. The medical record department was identified as a major occupational area, and a task inventory for medical records was developed and used as a basis…

  10. Active musculoskeletal structures equipped with a circulatory system and a network of ionic polymeric gel muscles

    SciTech Connect

    Shahinpoor, M.; Mojarrad, M.

    1994-12-31

    Presented are descriptions of design and fabrication of an active musculoskeletal structure composed of an artificial human skeleton of 5.3 feet in height. This skeletal structure is further equipped with an artificial heart in the form of a multi-channel computer-controlled fluid pump. The fluid pump may be programmed to selectively pump either an acid, a base or de-ionized water to a network of veins that feed a network of pairs of antagonist contractile synthetic muscles. These muscles are manufactured in the laboratory from polyacrylonitrile (PAN) fiber bundles that are specially designed and packaged inside flexible, hyperelastic latex membranes. Each pair of muscles act as a pair of antagonist actuator similar to the biceps and triceps muscles of the human arm. The initial fabrication indicates that it is possible to dynamically control such active musculoskeletal structures. A model is also presented for the dynamic control of such antagonist muscles. The model is intended to be used to study the human musculoskeletal dynamics.

  11. New horizons for study of the cardiopulmonary and circulatory systems. [image reconstruction techniques

    NASA Technical Reports Server (NTRS)

    Wood, E. H.

    1976-01-01

    The paper discusses the development of computer-controlled three-dimensional reconstruction techniques designed to determine the dynamic changes in the true shape and dimensions of the epi- and endocardial surfaces of the heart, along with variable time base (stop-action to real-time) displays of the transmural distribution of the coronary microcirculation and the three-dimensional anatomy of the macrovasculature in all regions of the body throughout individual cardiac and/or respiratory cycles. A technique for reconstructing a cross section of the heart from multiplanar videoroentgenograms is outlined. The capability of high spatial and high temporal resolution scanning videodensitometry makes possible measurement of the appearance, mean transit and clearance of roentgen opaque substances in three-dimensional space through the myocardium with a degree of simultaneous anatomic and temporal resolution not obtainable by current isotope techniques. The distribution of a variety of selected chemical elements or biologic materials within a body portion can also be determined.

  12. Growth factor enhanced retroviral gene transfer to the adult central nervous system.

    PubMed

    King, L A; Mitrophanous, K A; Clark, L A; Kim, V N; Rohll, J B; Kingsman, A J; Colello, R J

    2000-07-01

    The use of viral vectors for gene delivery into mammalian cells provides a new approach in the treatment of many human diseases. The first viral vector approved for human clinical trials was murine leukemia virus (MLV), which remains the most commonly used vector in clinical trials to date. However, the application of MLV vectors is limited since MLV requires cells to be actively dividing in order for transduction and therefore gene delivery to occur. This limitation precludes the use of MLV for delivering genes to the adult CNS, where very little cell division is occurring. However, we speculated that this inherent limitation of ML V may be overcome by utilizing the known mitogenic effect of growth factors on cells of the CNS. Specifically, an in vivo application of growth factor to the adult brain, if able to induce cell division, could enhance MLV-based gene transfer to the adult brain. We now show that an exogenous application of basic fibroblast growth factor induces cell division in vivo. Under these conditions, where cells of the adult brain are stimulated to divide, MLV-based gene transfer is significantly enhanced. This novel approach precludes any vector modifications and provides a simple and effective way of delivering genes to cells of the adult brain utilizing MLV-based retroviral vectors. PMID:10918476

  13. Profession differences in family focused practice in the adult mental health system.

    PubMed

    Maybery, Darryl; Goodyear, Melinda; O'Hanlon, Brendan; Cuff, Rose; Reupert, Andrea

    2014-12-01

    There is a large gulf between what psychiatric services should (or could) provide and what they do in practice. This article sought to determine practice differences between the differing professions working in adult mental health services in terms of their family focused work. Three hundred and seven adult mental health professionals completed a cross-sectional survey of family focused practices in adult mental health services. Findings highlight that social workers engaged in more family focused practice compared to psychiatric nurses, who performed consistently the lowest on direct family care, compared to both social workers and psychologists. Clear skill, knowledge, and confidence differences are indicated between the professions. The article concludes by offering direction for future profession education and training in family focused practices. PMID:24945363

  14. Quantification of dendritic and axonal growth after injury to the auditory system of the adult cricket Gryllus bimaculatus

    PubMed Central

    Pfister, Alexandra; Johnson, Amy; Ellers, Olaf; Horch, Hadley W.

    2013-01-01

    Dendrite and axon growth and branching during development are regulated by a complex set of intracellular and external signals. However, the cues that maintain or influence adult neuronal morphology are less well understood. Injury and deafferentation tend to have negative effects on adult nervous systems. An interesting example of injury-induced compensatory growth is seen in the cricket, Gryllus bimaculatus. After unilateral loss of an ear in the adult cricket, auditory neurons within the central nervous system (CNS) sprout to compensate for the injury. Specifically, after being deafferented, ascending neurons (AN-1 and AN-2) send dendrites across the midline of the prothoracic ganglion where they receive input from auditory afferents that project through the contralateral auditory nerve (N5). Deafferentation also triggers contralateral N5 axonal growth. In this study, we quantified AN dendritic and N5 axonal growth at 30 h, as well as at 3, 5, 7, 14, and 20 days after deafferentation in adult crickets. Significant differences in the rates of dendritic growth between males and females were noted. In females, dendritic growth rates were non-linear; a rapid burst of dendritic extension in the first few days was followed by a plateau reached at 3 days after deafferentation. In males, however, dendritic growth rates were linear, with dendrites growing steadily over time and reaching lengths, on average, twice as long as in females. On the other hand, rates of N5 axonal growth showed no significant sexual dimorphism and were linear. Within each animal, the growth rates of dendrites and axons were not correlated, indicating that independent factors likely influence dendritic and axonal growth in response to injury in this system. Our findings provide a basis for future study of the cellular features that allow differing dendrite and axon growth patterns as well as sexually dimorphic dendritic growth in response to deafferentation. PMID:23986706

  15. Sexually dimorphic effects of neonatal immune system activation with lipopolysaccharide on the behavioural response to a homotypic adult immune challenge.

    PubMed

    Tenk, Christine M; Kavaliers, Martin; Ossenkopp, Klaus-Peter

    2008-01-01

    Research has shown that acute immune activation during the early postnatal period with the Gram-negative endotoxin, lipopolysaccharide (LPS), alters a variety of physiological and behavioural processes in the adult animal. For example, neonatal LPS exposure affects disease susceptibility later in life, though these effects appear to be modulated by time of exposure, sex, and immune stimulus. The current study examined sex differences in the effect of neonatal LPS treatment on the locomotor activity response to adult LPS administration. Male and female Long-Evans rats were treated systemically with either LPS (50 microg/kg) or saline (0.9%) on postnatal days 3 and 5. Later in adulthood (postnatal day 92), all animals were subjected to an adult LPS challenge and were injected (i.p.) with 200 microg/kg LPS. Two hours after injection, animals were placed in a non-novel open-field and locomotor activity was assessed for 30 min. Body weights were determined both at the time of injection and 24h later to examine LPS-induced weight loss. Adult males treated neonatally with LPS exhibited significantly less horizontal and vertical activity in response to the LPS challenge relative to males treated neonatally with saline. This effect was not observed in females. Thus, the current study provides important evidence of sexual dimorphism in the long-term effects of neonatal LPS exposure on the responses to an adult homotypic immune challenge in rats. These findings have potential clinical significance given that neonatal exposure to pathogens is a fairly common occurrence and Gram-negative bacteria are a common cause of neonatal bacterial infections. PMID:18280690

  16. Visual stimulus parameters seriously compromise the measurement of approximate number system acuity and comparative effects between adults and children.

    PubMed

    Szűcs, Dénes; Nobes, Alison; Devine, Amy; Gabriel, Florence C; Gebuis, Titia

    2013-01-01

    It has been suggested that a simple non-symbolic magnitude comparison task is sufficient to measure the acuity of a putative Approximate Number System (ANS). A proposed measure of the ANS, the so-called "internal Weber fraction" (w), would provide a clear measure of ANS acuity. However, ANS studies have never presented adequate evidence that visual stimulus parameters did not compromise measurements of w to such extent that w is actually driven by visual instead of numerical processes. We therefore investigated this question by testing non-symbolic magnitude discrimination in seven-year-old children and adults. We manipulated/controlled visual parameters in a more stringent manner than usual. As a consequence of these controls, in some trials numerical cues correlated positively with number while in others they correlated negatively with number. This congruency effect strongly correlated with w, which means that congruency effects were probably driving effects in w. Consequently, in both adults and children congruency had a major impact on the fit of the model underlying the computation of w. Furthermore, children showed larger congruency effects than adults. This suggests that ANS tasks are seriously compromised by the visual stimulus parameters, which cannot be controlled. Hence, they are not pure measures of the ANS and some putative w or ratio effect differences between children and adults in previous ANS studies may be due to the differential influence of the visual stimulus parameters in children and adults. In addition, because the resolution of congruency effects relies on inhibitory (interference suppression) function, some previous ANS findings were probably influenced by the developmental state of inhibitory processes especially when comparing children with developmental dyscalculia and typically developing children. PMID:23882245

  17. Efficacy of virtual reality-based balance training versus the Biodex balance system training on the body balance of adults.

    PubMed

    Ibrahim, Manal S; Mattar, Ayman G; Elhafez, Salam M

    2016-01-01

    [Purpose] This study investigated efficacy of virtual reality (VR)-based balance training on enhancing balance and postural reactions of adults as a low-cost new modality compared to the established Biodex Balance System (BBS). [Subjects] Thirty normal adults of both genders were divided randomly into two equal-sized experimental groups of 15: BBS balance training and VR balance training. [Methods] The training programmes were conducted in 12 sessions, three 15-min sessions per week. The Nintendo(®) Wii Fit Plus (NWFP) and its balance board were used to train of the VR group. Each participant answered a questionnaire concerning usability, enjoyment, balance improvement, and fatigue at the end of the training programs. [Results] The study found a significant increase the measure of mean overall balance (OLB) in both groups. No significant difference was found between the groups, but a significant decrease in the mean balance-test time was found for both groups, with no significant difference between the two training methods. The VR programme was rated highly enjoyable by 81.8% of the group. [Conclusion] The Wii Fit Plus system with the balance board as a new VR balance-training technique, can be considered an effective and enjoyable tool for the training of adults' body balance. PMID:26957722

  18. Challenges and Perspectives of the Adult Vocational Training System in Bulgaria

    ERIC Educational Resources Information Center

    Dimitrova, Elka

    2007-01-01

    This article provides a brief review of recent developments and problems in adult training of the employed and unemployed in Bulgaria. It is presented in three parts: information on legislation and the institutions; information on current problems with vocational training of the employed and unemployed; and some future measures for improving…

  19. SYSTEMIC ACTIVITY OF NEONICOTINOIDS INFLUENCES FEEDING BY ADULT BLACK VINE WEEVILS ON VARIOUS SPECIES OF ORNAMENTALS

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The black vine weevil (BVW) is a serious pest of ornamental nursery crops. The larval stage feeds on the roots of ornamental plants and small fruits often stunting or killing the plants. The adults feed on the foliage of ornamental plants. A standard management technique is to apply foliar treatm...

  20. Adult Vocational Education Follow Through. A System for Participant Feedback for Decision Makers. Final Report.

    ERIC Educational Resources Information Center

    White, Thomas R.

    The objectives of this project were (1) to develop participant feedback materials that can be used by local adult vocational education (AVE) administrators for program planning, implementation, and evaluation and (2) to determine why participants enroll in AVE programs. A follow-up survey which contained key items from the follow-through system…