Advanced traveler information system (ATIS) implementation and integration. Task 11, evaluation report

DOT National Transportation Integrated Search

2007-05-16

Advanced Traveler Information Systems (ATIS) are an integral component of the concept of Intelligent Transportation Systems (ITS). ATIS are envisioned to enhance personal mobility, safety and the productivity of transportation. The primary services o...

ATIS Market Research: A Survey of Operational Tests and University and Government Research

DOT National Transportation Integrated Search

1994-03-01

This report outlines research that examines the market for Advanced Traveler Information Systems (ATIS). The report includes detailed descriptions of Pathfinder, TravTek, and SmarTraveler ATIS operational tests. It includes basic background informati...

EFFECT OF SHORT-TERM ART INTERRUPTION ON LEVELS OF INTEGRATED HIV DNA.

PubMed

Strongin, Zachary; Sharaf, Radwa; VanBelzen, D Jake; Jacobson, Jeffrey M; Connick, Elizabeth; Volberding, Paul; Skiest, Daniel J; Gandhi, Rajesh T; Kuritzkes, Daniel R; O'Doherty, Una; Li, Jonathan Z

2018-03-28

Analytic treatment interruption (ATI) studies are required to evaluate strategies aimed at achieving ART-free HIV remission, but the impact of ATI on the viral reservoir remains unclear. We validated a DNA size selection-based assay for measuring levels of integrated HIV DNA and applied it to assess the effects of short-term ATI on the HIV reservoir. Samples from participants from four AIDS Clinical Trials Group (ACTG) ATI studies were assayed for integrated HIV DNA levels. Cryopreserved PBMCs were obtained for 12 participants with available samples pre-ATI and approximately 6 months after ART resumption. Four participants also had samples available during the ATI. The median duration of ATI was 12 weeks. Validation of the HIV Integrated DNA size-Exclusion (HIDE) assay was performed using samples spiked with unintegrated HIV DNA, HIV-infected cell lines, and participant PBMCs. The HIDE assay eliminated 99% of unintegrated HIV DNA species and strongly correlated with the established Alu- gag assay. For the majority of individuals, integrated DNA levels increased during ATI and subsequently declined upon ART resumption. There was no significant difference in levels of integrated HIV DNA between the pre- and post-ATI time points, with the median ratio of post:pre-ATI HIV DNA levels of 0.95. Using a new integrated HIV DNA assay, we found minimal change in the levels of integrated HIV DNA in participants who underwent an ATI followed by 6 months of ART. This suggests that short-term ATI can be conducted without a significant impact on levels of integrated proviral DNA in the peripheral blood. IMPORTANCE Interventions aimed at achieving sustained antiretroviral therapy (ART)-free HIV remission require treatment interruption trials to assess their efficacy. However, these trials are accompanied by safety concerns related to the expansion of the viral reservoir. We validated an assay that uses an automated DNA size-selection platform for quantifying levels of integrated HIV DNA and is less sample- and labor-intensive than current assays. Using stored samples from AIDS Clinical Trials Group studies, we found that short-term ART discontinuation had minimal impact on integrated HIV DNA levels after ART resumption, providing reassurance about the reservoir effects of short-term treatment interruption trials. Copyright © 2018 American Society for Microbiology.

Total energy expenditure of 10- to 12-year-old Japanese children measured using the doubly labeled water method.

PubMed

Komura, Keisuke; Nakae, Satoshi; Hirakawa, Kazufumi; Ebine, Naoyuki; Suzuki, Kazuhiro; Ozawa, Haruo; Yamada, Yosuke; Kimura, Misaka; Ishii, Kojiro

2017-01-01

To establish Japanese children's estimated energy requirements, total energy expenditure (TEE) data measured using the doubly labeled water (DLW) method is needed. This study aimed to 1) obtain basic TEE data from Japanese children measured using DLW (TEE DLW ), 2) compare TEE DLW with TEE estimated by various estimation formulas to calculate their accuracy, and 3) develop a new equation to estimate TEE using body composition and pedometers. TEE was measured using DLW in 56 10- to 12-year-old Japanese children (33 boys, 23 girls). Physical activity level (PAL) was calculated by dividing TEE DLW by estimated resting energy expenditure. To assess their physical activity, participants wore pedometers during the 7-d DLW period. Total body water was calculated from 2 H and 18 O; fat-free mass (FFM) and fat mass (FM) were then determined. In boys and girls of normal weight, TEE DLW was 2067 ± 230 kcal/d and 1830 ± 262 kcal/d, respectively. Average PAL was 1.58 ± 0.17. FFM was strongly related to TEE ( r  = 0.702, p  < 0.01). After adjusting for FFM and FM, step count was significantly associated with TEE ( r  = 0.707, p  < 0.01). The TEE estimation formula used in the Dietary Reference Intakes (DRI) for the United States and Canada estimated TEE DLW with high accuracy (bias: 2.0%) in both sexes. We developed new equations for TEE consisting of FFM and step count, which accounted for 68% and 65% of TEE variance in boys and girls, respectively: boys, 47.1 × FFM (kg) + 0.0568 × step count (steps/d) - 122, and girls, 55.5 × FFM (kg) + 0.0315 × step count (steps/d) - 117. The TEE in 10- to 12-year-old Japanese children measured using DLW was approximately 7% lower for boys and 12% lower for girls compared to the current Japanese DRI. If PAL can be accurately determined, the equation in the DRI for the United States and Canada may be applicable to Japanese children. In addition, TEE could be predicted using FFM and step count.

ATIS Data Collection Guidelines Workshop : who are ATIS customers?

DOT National Transportation Integrated Search

2000-02-09

This workshop presents the results of a study characterizing who are ATIS customers. Metro Online customers are younger than average riders, more educated, and have access to the Internet at home and work or school. Their income, longevity and intens...

Validation of the Arizona Activity Frequency Questionnaire using doubly labeled water.

PubMed

Staten, L K; Taren, D L; Howell, W H; Tobar, M; Poehlman, E T; Hill, A; Reid, P M; Ritenbaugh, C

2001-11-01

Physical activity questionnaires (PAQs) are considered the most cost-efficient method to estimate total energy expenditure (TEE) in epidemiological studies. However, relatively few PAQs have been validated using doubly labeled water (DLW) in women or in samples with diverse ethnic backgrounds. This study was conducted to validate the Arizona Activity Frequency Questionnaire (AAFQ) for estimation of TEE and physical activity energy expenditure (PAEE) over 1 month using DLW as a reference method. Thirty-five relatively sedentary women completed the AAFQ before participating in an 8-d DLW protocol to measure TEE. TEE and PAEE were estimated from the AAFQ by calculating resting metabolic rate (RMR) using the equation of Mifflin et al. (AAFQmif), by measuring RMR using indirect calorimetry (AAFQic), and using MET conversion (AAFQmet). A predictive equation for TEE was generated. The mean +/- SD for TEE and PAEE from DLW were 9847 +/- 2555 kJ x d(-1) and 5578 +/- 2084 kJ x d(-1), respectively. Formulas using RMR to calculate the TEE and PAEE from the AAFQ tended to underestimate TEE and PAEE, whereas those that included only weight tended to overestimate TEE and PAEE. On the basis of the Mifflin et al. equation, the AAFQ tends to underestimate PAEE by 13%. This underestimation may be explained by the low lean body mass of the sample population and by effectiveness of the METs/RMR ratio in the obese. The following predictive equation was calculated: TEE (kJ x d(-1)) = (86.0 * average total daily METs) + (2.23 * RMRmif) - 6726. When the predictive equation is used, TEE calculated from the AAFQ is highly correlated with DLW TEE (adjusted r(2) = 0.70, P < 0.001). The AAFQ is an effective tool for the prediction of TEE and PAEE in epidemiological studies.

Calculation versus measurement of total energy expenditure.

PubMed

van Lanschot, J J; Feenstra, B W; Vermeij, C G; Bruining, H A

1986-11-01

In acutely ill patients both hypo- and hyperalimentation must be avoided by adjusting caloric intake to total energy expenditure (TEE). We determined the discrepancy between basal energy expenditure (BEE) calculated from the basic Harris-Benedict formula and TEE measured by continuous indirect calorimetry in a heterogeneous group of mechanically ventilated surgical patients. We also compared the accuracy of TEE calculated from the corrected Harris-Benedict formula or estimated by intermittent indirect calorimetry to that of TEE measured by continuous indirect calorimetry. The poor correlation between calculated BEE and measured TEE was significantly (p less than .05) improved by a correction factor based on each patient's clinical condition. The mean absolute difference between calculated TEE and measured TEE was 8.9 +/- 9.6 (SD) %. Calculations were significantly (p less than .05) improved by estimating TEE from two 5-min recording periods, which suggests that continuous indirect calorimetry may not always be necessary to guide caloric replacement.

Dynamic mobility applications policy analysis : policy and institutional issues for enabling advanced traveler information services (EnableATIS).

DOT National Transportation Integrated Search

2014-10-01

This report documents policy considerations for Enabling Advanced Traveler Information Services, or EnableATIS. EnableATIS is the traveler information element of the Dynamic Mobility Applications program, and it provides a framework to develop multi-...

47 CFR 25.281 - Automatic Transmitter Identification System (ATIS).

Code of Federal Regulations, 2010 CFR

2010-10-01

... identified through the use of an automatic transmitter identification system as specified below. (a.... (3) The ATIS signal as a minimum shall consist of the following: (i) The FCC assigned earth station... (ATIS). 25.281 Section 25.281 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON...

47 CFR 25.281 - Automatic Transmitter Identification System (ATIS).

Code of Federal Regulations, 2013 CFR

2013-10-01

... identified through the use of an automatic transmitter identification system as specified below. (a.... (3) The ATIS signal as a minimum shall consist of the following: (i) The FCC assigned earth station... (ATIS). 25.281 Section 25.281 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON...

47 CFR 25.281 - Automatic Transmitter Identification System (ATIS).

Code of Federal Regulations, 2012 CFR

2012-10-01

... identified through the use of an automatic transmitter identification system as specified below. (a.... (3) The ATIS signal as a minimum shall consist of the following: (i) The FCC assigned earth station... (ATIS). 25.281 Section 25.281 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON...

47 CFR 25.281 - Automatic Transmitter Identification System (ATIS).

Code of Federal Regulations, 2011 CFR

2011-10-01

... identified through the use of an automatic transmitter identification system as specified below. (a.... (3) The ATIS signal as a minimum shall consist of the following: (i) The FCC assigned earth station... (ATIS). 25.281 Section 25.281 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON...

"We Need to Deploy Them Very Thoughtfully and Carefully": Perceptions of Analytical Treatment Interruptions in HIV Cure Research in the United States-A Qualitative Inquiry.

PubMed

Dubé, Karine; Evans, David; Dee, Lynda; Sylla, Laurie; Taylor, Jeff; Skinner, Asheley; Weiner, Bryan J; Greene, Sandra B; Rennie, Stuart; Tucker, Joseph D

2018-01-01

Strategies to control HIV in the absence of antiretroviral therapy are needed to cure HIV. However, such strategies will require analytical treatment interruptions (ATIs) to determine their efficacy. We investigated how U.S. stakeholders involved in HIV cure research perceive ATIs. We conducted 36 in-depth interviews with three groups of stakeholders: 12 people living with HIV, 11 clinician-researchers, and 13 policy-makers/bioethicists. Qualitative data revealed several themes. First, there was little consensus on when ATIs would be ethically warranted. Second, the most frequent perceived hypothetical motivators for participating in research on ATIs were advancing science and contributing to society. Third, risks related to viral rebound were the most prevalent concerns related to ATIs. Stakeholders suggested ways to minimize the risks of ATIs in HIV cure research. Increased cooperation between scientists and local communities may be useful for minimizing risk. Further ethics research is necessary.

Added value of cardiac computed tomography for evaluation of mechanical aortic valve: Emphasis on evaluation of pannus with surgical findings as standard reference.

PubMed

Suh, Young Joo; Lee, Sak; Im, Dong Jin; Chang, Suyon; Hong, Yoo Jin; Lee, Hye-Jeong; Hur, Jin; Choi, Byoung Wook; Chang, Byung-Chul; Shim, Chi Young; Hong, Geu-Ru; Kim, Young Jin

2016-07-01

The added value of cardiac computed tomography (CT) with transesophageal echocardiography (TEE) for evaluating mechanical aortic valve (AV) dysfunction has not yet been investigated. The purposes of this study were to investigate the added value of cardiac CT for evaluation of mechanical AVs and diagnoses of pannus compared to TEE, with surgical findings of redo-aortic valve replacement (AVR) used as a standard reference. 25 patients who underwent redo-AVR due to mechanical AV dysfunction and cardiac CT before redo-AVR were included. The presence of pannus, encroachment ratio by pannus, and limitation of motion (LOM) were evaluated on CT. The diagnostic performance of pannus detection was compared using TEE, CT, and CT+TEE, with surgical findings as a standard reference. The added value of CT for diagnosing the cause of mechanical AV dysfunction was assessed compared to TTE+TEE. In two patients, CT analysis was not feasible due to severe metallic artifacts. On CT, pannus and LOM were found in 100% (23/23) and 60.9% (14/23). TEE identified pannus in 48.0% of patients (12/25). CT, TEE, and CT+TEE correctly identified pannus with sensitivity of 92.0%, 48.0%, and 92.0%, respectively (P=0.002 for CT vs. TEE). In 11 of 13 cases (84.6%) with inconclusive or negative TEE results for pannus, CT detected the pannus. Among 13 inconclusive cases of TTE+TEE for the cause of mechanical AV dysfunction, CT suggested 6 prosthetic valve obstruction (PVO) by pannus, 4 low-flow low-gradient PVO, and one LOM without significant PVO. Cardiac CT showed added diagnostic value with TEE in the detection of pannus as the cause of mechanical AV dysfunction. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Advanced Traveler Information Systems and Commercial Vehicle Operations Components of the Intelligent Transportation Systems: On-road Evaluation of ATIS Messages

DOT National Transportation Integrated Search

1998-03-01

This report describes the results of an on-road study that examined how Advanced Traveler Information Systems (ATIS) information influences driver behavior. The objective of the study was to develop ATIS design guidelines, primarily for In-Vehicle Si...

On-time reliability impacts of advanced traveler information services (ATIS). Volume II, Extensions and applications of the simulated yoked study concept

DOT National Transportation Integrated Search

2002-03-01

In a simulated yoke study, estimates of roadway travel times are archived from web-based Advanced Traveler Information Systems (ATIS) and used to recreate hypothetical, retrospective paired driving trials between travelers with and without ATIS. Prev...

Transesophageal echocardiography evaluation of the thoracic aorta

PubMed Central

Patil, T. A.; Nierich, Arno

2016-01-01

Transesophageal echocardiography (TEE) can be used to identify risk factors such as aortic atherosclerosis[2] before any sort of surgical manipulations involving aorta and its related structures. TEE has become an important noninvasive tool to diagnose acute thoracic aortic pathologies. TEE evaluation of endoleaks helps early detection and immediate corrective interventions. TEE is an invaluable imaging modality in the management of aortic pathology. TEE has to a large extent improved the patient outcomes. PMID:27762248

Thermophysical Variation within Dune Fields in the Southern Hemisphere of Mars

NASA Astrophysics Data System (ADS)

Courville, S. W.; Putzig, N. E.; Hoover, R.; Fenton, L. K.

2016-12-01

The activity and composition of Martian sand dunes, which are relatively young features, provide insight into the current and recent climate state of Mars. This study investigates small-scale variations of thermophysical properties within dune fields across the southern hemisphere of Mars to better understand near-surface composition. Previous morphological studies of southern hemisphere dune fields on Mars indicate a trend of decreasing activity with increasing latitude. We observe a corresponding trend in thermal properties. To investigate the thermal behavior of the dunes, we use apparent thermal inertia (ATI) derived from the Mars Odyssey's Thermal Emission Imaging System (THEMIS), which has a resolution of 100 meters per pixel. Overlaying THEMIS ATI values on images and digital terrain models from the High Resolution Imaging Science Experiment (HiRISE) allows us to compare ATI with small-scale dune morphology and slopes. In general, we observe three types of ATI behavior: (1) fields with exposed ground between dunes display lower ATI on the dunes themselves, consistent with dunes of relatively low thermal inertia resting upon a wind-resistant consolidated bed with higher thermal inertia; (2) fields with little or no inter-dune exposures exhibit ATI in dune troughs that is 100 tiu or more lower than along crests, counterintuitively suggesting that dune trough material is finer than that along dune crests; and (3) fields with highly degraded dunes typically display uniform ATI values, indicating that their properties do not vary laterally at the resolution of THEMIS images or vertically within a seasonal skin depth. These ATI behaviors correspond to the activity state of the dune field with type 1 being the most active and occurring toward the equator, while type 3 is the least active and found mostly at high southern latitudes. To consider alternative explanations for the ATI variation observed in Type 2 fields, we created thermal models of slopes, lateral mixtures of two particle sizes, and layering of two particle sizes. However, these models are unable to explain the observed ATI, suggesting that the composition and/or activity of these dunes are more complicated than allowed by two-component models.

A review and evaluation of the internal structure and consistency of the Approaches to Teaching Inventory

NASA Astrophysics Data System (ADS)

Harshman, Jordan; Stains, Marilyne

2017-05-01

This study presents a review from 39 studies that provide evidence for the structural validity and internal consistency of the Approaches to Teaching Inventory (ATI). In addition to this review, we evaluate many alternative factor structures on a sample of 267 first- and second-year chemistry faculty members participating in a professional development, a sample of instructors for which the ATI was originally designed. A total of 26 unique factor structures were evaluated. Through robust checking of assumptions, compilations of existing evidence, and new exploratory and confirmatory analyses, we found that there is greater evidence for the structural validity and internal consistency for the 22-item ATI than the 16-item ATI. Additionally, evidence supporting the original two-factor and four-factor structures proposed by the ATI authors (focusing on information transmission and conceptual change) were not reproducible and while alternative models were empirically viable, more theoretical justification is warranted. Recommendations for ATI use and general comments regarding best practices of reporting psychometrics in educational research contexts are discussed.

21 CFR 868.5995 - Tee drain (water trap).

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Tee drain (water trap). 868.5995 Section 868.5995...) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5995 Tee drain (water trap). (a) Identification. A tee drain (water trap) is a device intended to trap and drain water that collects in ventilator...

21 CFR 868.5995 - Tee drain (water trap).

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Tee drain (water trap). 868.5995 Section 868.5995...) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5995 Tee drain (water trap). (a) Identification. A tee drain (water trap) is a device intended to trap and drain water that collects in ventilator...

21 CFR 868.5995 - Tee drain (water trap).

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Tee drain (water trap). 868.5995 Section 868.5995...) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5995 Tee drain (water trap). (a) Identification. A tee drain (water trap) is a device intended to trap and drain water that collects in ventilator...

21 CFR 868.5995 - Tee drain (water trap).

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Tee drain (water trap). 868.5995 Section 868.5995...) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5995 Tee drain (water trap). (a) Identification. A tee drain (water trap) is a device intended to trap and drain water that collects in ventilator...

Development of Human Factors Guidlines for Advanced Traveler Information Systems and Commercial Vehicle Operations: Investigation of ATIS Function Transition and the Effects of an In-Vehicle ATIS on Driver Performance

DOT National Transportation Integrated Search

1999-12-01

The objective of the first experiment reported here was to measure the cognitive demands associated with transitioning across Advanced Traveler Information System (ATIS) functions. This required the development of both objective and subjective indice...

Approaches for quantifying energy intake and %calorie restriction during calorie restriction interventions in humans: the multicenter CALERIE study.

PubMed

Racette, Susan B; Das, Sai Krupa; Bhapkar, Manjushri; Hadley, Evan C; Roberts, Susan B; Ravussin, Eric; Pieper, Carl; DeLany, James P; Kraus, William E; Rochon, James; Redman, Leanne M

2012-02-15

Calorie restriction (CR) is a component of most weight loss interventions and a potential strategy to slow aging. Accurate determination of energy intake and %CR is critical when interpreting the results of CR interventions; this is most accurately achieved using the doubly labeled water method to quantify total energy expenditure (TEE). However, the costs and analytical requirements of this method preclude its repeated use in many clinical trials. Our aims were to determine 1) the optimal TEE assessment time points for quantifying average energy intake and %CR during long-term CR interventions and 2) the optimal approach for quantifying short-term changes in body energy stores to determine energy intake and %CR during 2-wk DLW periods. Adults randomized to a CR intervention in the multicenter CALERIE study underwent measurements of TEE by doubly labeled water and body composition at baseline and months 1, 3, and 6. Average %CR achieved during the intervention was 24.9 ± 8.7%, which was computed using an approach that included four TEE assessment time points (i.e., TEE(baseline, months 1, 3, and 6)) plus the 6-mo change in body composition. Approaches that included fewer TEE assessments yielded %CR values of 23.4 ± 9.0 (TEE(baseline,) months 3 and 6), 25.0 ± 8.7 (TEE(baseline,) months 1 and 6), and 20.9 ± 7.1% (TEE(baseline, month 6)); the latter approach differed significantly from approach 1 (P < 0.001). TEE declined 9.6 ± 9.9% within 2-4 wk of CR beginning and then stabilized. Regression of daily home weights provided the most reliable estimate of short-term change in energy stores. In summary, optimal quantification of energy intake and %CR during weight loss necessitates a TEE measurement within the first month of CR to capture the rapid reduction in TEE.

The relation between atrial septal defect shape, diameter, and area using three-dimensional transoesophageal echocardiography and balloon sizing during percutaneous closure in children.

PubMed

Hascoet, Sébastien; Hadeed, Khaled; Marchal, Pauline; Dulac, Yves; Alacoque, Xavier; Heitz, Francois; Acar, Philippe

2015-07-01

A trans-catheter closure of an atrial septal defect (ASD) is efficient. Balloon sizing (BS) during the catheterization leads to an overestimation of ASD size. Three-dimensional transoesophageal echocardiography (3D-TEE) allows the ASD morphology to be assessed comprehensively. The aim of this study was to assess the relationships between the shape and the measurements of ASDs by 2D-, 3D-TEE, and BS in children. Thirty children who underwent percutaneous closures of a single ASD were enrolled. ASD diameters were measured by 2D-transthoracic echocardiography (TTE), 2D-TEE, 3D-TEE and compared with BS. The ASD area was measured on 3D-TEE images after multi-planar reconstruction. ASD was estimated as round or oval on 3D-TEE 'en-face' view. 2D-TTE, 2D-TEE, and 3D-TEE(max) ASD diameters were well correlated with BS (r = 0.75; 0.80, and 0.85, respectively). Mean diameters were all significantly smaller than the mean BS. The mean difference between the balloon area and 3D-TEE area was 1.6 ± 1.4 cm(2) (P < 0.0001). The mean difference between BS and 3D-TEE(max) diameters was higher in round ASDs than in oval ASDs (4.0 ± 3.3 vs. 1.1 ± 3.3, P = 0.02). With multivariate linear regression analysis, two formulas were built to predict BS. The first model was BS = 1.07 × 3D-TEE(max)- 3.1 × ASDshape + 3. The ASD shape was 0 for round and 1 for oval ASDs. A second model was BS = 4.5 × ASDarea + 11.5. The ASD shape is accurately estimated by 3D-TEE and influences the relationship between echocardiographic measurements and BS. The ASD shape, its maximal diameter and the area assessed by 3D-TEE may be sufficient to determine the device size without BS in children. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please email: journals.permissions@oup.com.

Clinical correlations of infliximab trough levels and antibodies to infliximab in South Korean patients with Crohn’s disease

PubMed Central

Oh, Eun Hye; Ko, Dae-Hyun; Seo, Hyungil; Chang, Kiju; Kim, Gwang-Un; Song, Eun Mi; Seo, Myeongsook; Lee, Ho-Su; Hwang, Sung Wook; Yang, Dong-Hoon; Ye, Byong Duk; Byeon, Jeong-Sik; Myung, Seung-Jae; Yang, Suk-Kyun; Park, Sang Hyoung

2017-01-01

AIM To investigate the clinical implications of infliximab trough levels (IFX-TLs) and antibodies to infliximab (ATI) levels in Crohn’s disease (CD) patients in Asian countries. METHODS IFX-TL and ATI level were measured using prospectively collected samples obtained with informed consent from CD patients being treated at Asan Medical Center, South Korea. We analyzed the correlations between IFX-TLs/ATI levels and the clinical activity of CD (quiescent vs active disease) based on the CD activity index, C-reactive protein level, and physician’s judgment of patients’ clinical status at enrollment. The impact of concomitant immunomodulators was also investigated. RESULTS This study enrolled 138 patients with CD (84 with quiescent and 54 with active disease). In patients with quiescent and active diseases, the median IFX-TLs were 1.423 μg/mL and 0.163 μg/mL, respectively (P < 0.001) and the median ATI levels were 8.064 AU/mL and 11.209 AU/mL, respectively (P < 0.001). In the ATI-negative and -positive groups, the median IFX-TLs were 1.415 μg/mL and 0.141 μg/mL, respectively (P < 0.001). In patients with and without concomitant immunomodulator use, there were no differences in IFX-TLs (0.632 μg/mL and 1.150 μg/mL, respectively; P = 0.274) or ATI levels (8.655 AU/mL and 9.017 AU/mL, respectively; P = 0.083). CONCLUSION IFX-TL/ATI levels were well correlated with the clinical activity in South Korean CD patients. Our findings support the usefulness of IFX-TLs/ATI levels in treating CD patients receiving IFX in clinical practice. PMID:28293096

Skin Perfusion Pressure and the Prevalence of Atherothrombosis in Hemodialysis Patients.

PubMed

Hiratsuka, Maki; Koyama, Katsushi; Yamamoto, Jun; Narita, Aiko; Sasakawa, Yuji; Shimogushi, Hiroya; Ogawa, Atsushi; Kimura, Tomomi; Mizuguchi, Ken; Mizuno, Masashi

2016-02-01

End-stage renal disease is associated with atherothrombosis (ATIS), which, in turn, can promote peripheral arterial occlusive disease (PAOD), coronary artery disease (CAD), and/or cerebrovascular disease (CVD). The aim of this study was to determine whether low plantar skin perfusion pressure (SPP) was related to ATIS among 122 patients receiving maintenance hemodialysis (HD) from March to November 2013 at our outpatient facility. We routinely measured SPP and used the value for analysis. In addition, we retrospectively evaluated the prevalence of ATIS with patients categorized to CAD, CVD, or PAOD groups. Of the 122 outpatients, ATIS was diagnosed in about half (N = 60, 49.2% vs. 62, 50.8%; average SPP, 56.6 vs. 72.9 mm Hg, respectively). These data show that SPP was significantly lower in patients with ATIS (difference, 16.3 mm Hg; P < 0.001) and there was a negative relationship between average SPPs and past history of ATIS complications. When the patients were stratified by the presence of diabetes mellitus, this trend was stronger. Particularly, receiver operating characteristic analysis of HD patients with diabetes revealed a cutoff point of 53.0 mm Hg and an area under the curve value of 0.84, with a sensitivity of 77.0% and specificity of 91.3%. Therefore, we concluded that SPP enables the evaluation of not only local PAOD, but also systemic ATIS. Moreover, we found that a cutoff point of 53.0 mm Hg was useful for detection of ATIS in HD patients. © 2015 International Society for Apheresis, Japanese Society for Apheresis, and Japanese Society for Dialysis Therapy.

Novel method to reduce fishy aftertaste in wine and seafood pairing using alcohol-treated yeast cells.

PubMed

Tsuji, Toshikazu; Kanai, Keiko; Yokoyama, Aki; Tamura, Takayuki; Hanamure, Kenichi; Sasaki, Kanako; Takata, Ryoji; Yoshida, Satoshi

2012-06-20

"Fishy aftertaste" is sometimes perceived in wine consumed with seafood. Iron in wine has been reported to be a key compound that produces fishy aftertaste. However, cost-effective methods to remove iron from wine have not been developed. Here, we describe a cost-effective and safe iron adsorbent consisting of alcohol-treated yeast (ATY) cells based on the observation that nonviable cells adsorbed iron after completion of fermentation. Treatment of cells with more than 40% (v/v) ethanol killed them without compromising their ability to adsorb iron. Drying the ATY cells did not reduce iron adsorption. Use of ATY cells together with phytic acid had a synergistic effect on iron removal. We term this means of removing iron the "ATY-PA" method. Sensory analysis indicated that fishy aftertaste in wine-seafood pairings was not perceived if the wine had been pretreated with both ATY cells and phytic acid.

Increased lipolysis, diminished adipose tissue insulin sensitivity and impaired B-cell function relative to adipose tissue insulin sensitivity in obese youth with impaired glucose tolerance (IGT)

USDA-ARS?s Scientific Manuscript database

Despite evidence of insulin resistance and B-cell dysfunction in glucose metabolism in youth with prediabetes, the relationship between adipose tissue insulin sensitivity (ATIS) and B-cell function remains unknown. We investigated whole-body lipolysis, ATIS and B-cell function relative to ATIS [adip...

Web-Based Environment for Maintaining Legacy Software

NASA Technical Reports Server (NTRS)

Tigges, Michael; Thompson, Nelson; Orr, Mark; Fox, Richard

2007-01-01

Advanced Tool Integration Environment (ATIE) is the name of both a software system and a Web-based environment created by the system for maintaining an archive of legacy software and expertise involved in developing the legacy software. ATIE can also be used in modifying legacy software and developing new software. The information that can be encapsulated in ATIE includes experts documentation, input and output data of tests cases, source code, and compilation scripts. All of this information is available within a common environment and retained in a database for ease of access and recovery by use of powerful search engines. ATIE also accommodates the embedment of supporting software that users require for their work, and even enables access to supporting commercial-off-the-shelf (COTS) software within the flow of the experts work. The flow of work can be captured by saving the sequence of computer programs that the expert uses. A user gains access to ATIE via a Web browser. A modern Web-based graphical user interface promotes efficiency in the retrieval, execution, and modification of legacy code. Thus, ATIE saves time and money in the support of new and pre-existing programs.

Demonstration of infective endocarditis by cardiac CT and transoesophageal echocardiography: comparison with intra-operative findings.

PubMed

Koo, Hyun Jung; Yang, Dong Hyun; Kang, Joon-Won; Lee, Joo Yeon; Kim, Dae-Hee; Song, Jong-Min; Kang, Duk-Hyun; Song, Jae-Kwan; Kim, Joon Bum; Jung, Sung-Ho; Choo, Suk Jung; Chung, Cheol Hyun; Lee, Jae-Won; Lim, Tae-Hwan

2018-02-01

We aimed to compare imaging findings of infective endocarditis between computed tomography (CT) and transoesophageal echocardiography (TEE) using surgical inspection as a reference standard. Forty-nine patients (aged 54 ± 17 years, 69% men) who underwent pre-operative CT and TEE for infective endocarditis were included. Twelve of these patients had prosthetic valve endocarditis. Imaging findings of infective endocarditis were classified as vegetation, leaflet perforation, abscess/pseudoaneurysm, and paravalvular leakage. Diagnostic performances of CT and TEE were evaluated using surgical inspection as a reference standard. Interobserver agreements for CT findings were obtained using Cohen's κ test. The detection rates of infective endocarditis per patient with CT and TEE were 93.9% (46/49) and 95.9% (47/49), respectively. In per-imaging analysis, the sensitivities of CT and TEE were not significantly different for both native and prosthetic valve infective endocarditis (sensitivity: vegetation, 100% in TEE and 90.9% in CT; leaflet perforation, 87.5% in TEE and 50.0% in CT; abscess/pseudoaneurysm, 40.0% in TEE and 60.0% in CT; paravalvular leakage, 100% in TEE and 50.0% in CT). Interobserver agreements for CT findings were substantial or excellent (0.79-0.88). Cardiac CT can accurately demonstrate infective endocarditis in pre-operative patients with a similar diagnostic accuracy to TEE. The interobserver agreements for the CT findings of infective endocarditis were excellent. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2017. For permissions, please email: journals.permissions@oup.com.

Comparison of total energy expenditure between school- and summer-months

PubMed Central

Zinkel, Sarah R. J.; Moe, Martin; Stern, Elizabeth A.; Hubbard, Van S.; Yanovski, Susan Z.; Yanovski, Jack A.; Schoeller, Dale A.

2012-01-01

Objective Recent data reports that youth experience greater weight gain during summer than during school months. We tested the hypothesis that a difference in total energy expenditure (TEE) between school and summer months exists and may contribute to summer weight gain. Subjects and Methods A secondary analysis was performed on cross-sectional TEE data from school-age, sedentary African American and Caucasian youth based in or near the District of Columbia who were at-risk for adult obesity because they had BMI≥85th percentile or had overweight parents. TEE was estimated from 18-O and deuterium measurements during 1-week intervals using urine samples collected after ingestion of doubly-labeled water. Differences in summer and school time TEE were assessed using ANCOVA. The data were adjusted for fat-free mass as determined by deuterium dilution to adjust for the effect of body size on TEE. Results Data were collected from 162 youth (average age 10±2 years, BMI 28±8 kg/m2, and BMI z-score 1.96+0.96). Of these, 96 youth had TEE measured during the school year (September – June); 66 different youths had TEE measured during summer months (June – August). After adjustment for fat-free mass, average summertime TEE was 2450±270 kcal/day and average school-time TEE was 2510±350 kcal/day (p=0.26). Conclusion No difference in TEE was detected between the school year and the summer months. These data suggest that seasonal differences in youth weight gain are not necessarily due to differences in energy expenditures. PMID:23637099

Influence of immunogenicity on the efficacy of longterm treatment of spondyloarthritis with infliximab.

PubMed

Plasencia, Chamaida; Pascual-Salcedo, Dora; Nuño, Laura; Bonilla, Gema; Villalba, Alejandro; Peiteado, Diana; Díez, Jesús; Nagore, Daniel; del Agua, Ainhoa Ruiz; Moral, Rosario; Martin-Mola, Emilio; Balsa, Alejandro

2012-12-01

Infliximab (IFX) is a monoclonal antibody against tumour necrosis factor α that is effective for treating spondyloarthritis (SpA). However, after initial success of the drug some patients lose responsiveness or develop infusion reactions, which may be related to the development of antibodies against the drug. To investigate the clinical relevance of antibodies to infliximab (ATI) formation in patients with SpA undergoing IFX treatment over a prolonged period. 94 patients with SpA treated with IFX from 1999 to 2010 were studied. Their clinical characteristics, serum trough IFX levels and ATI status were evaluated for a mean of 6.99 (95% CI:6.28 to 7.7) years. Clinical activity and improvement were measured using the Ankylosing Spondylitis Disease Activity Score (ASDAS): inactive <1.3, moderate ≥1.3 and <2.1, high ≥2.1-≤3.5, and very high >3.5 at three time points (6 months, 12 months and >4 years). ATI were detected in 24 (25.5%) patients. The patients with ATI had higher ASDAS scores than those without ATI (2.55±0.89 vs 1.79±1.04, p=0.038 at 6 months; 1.95±0.67 vs 1.67±0.71, p=0.042 at 1 year; 2.52±0.99 vs 1.53±0.81, p=0.024 at >4 years). Eleven patients (12%) developed infusion-related reactions, and of these, ATI were present in eight patients (73%). The patients with infusion-related reactions had higher ATI titres (median 12 931 AU/ml, IQR 853-82 437) vs median 2454 AU/ml, IQR 449-7718, p=0.028) and shorter survival (4.25 years vs 8.19 years, p<0.001). ATI development occurred more frequently in the patients not receiving methotrexate (20/58 (34.5%) vs 4/36 (11.1%), p=0.011). In patients with SpA treated with IFX, ATI formation is associated with a poor clinical response, the appearance of infusion reactions and the discontinuation of treatment.

Quantification of antimicrobial consumption in adult cattle on dairy herds in Flanders, Belgium, and associations with udder health, milk quality, and production performance.

PubMed

Stevens, M; Piepers, S; Supré, K; Dewulf, J; De Vliegher, S

2016-03-01

The main objective of this study was to quantify the (compound-specific) antimicrobial consumption (AMC) in adult cattle in a convenience sample of Flemish dairy herds. Antimicrobial consumption data were obtained between 2012 and 2013 by "garbage can audits" and expressed as antimicrobial treatment incidence (ATI), with the unit of the ATI being the number of defined daily doses animal (DDDA) used per 1,000 cow-days. Herds were stratified by DDDA into low-, medium-, and high-consuming herds to study the AMC per route of administration, and associations with parameters reflecting udder health, milk quality, and production performances were examined. The average ATI in adult dairy cattle for all compounds was 20.78 DDDA (per 1,000 cow-days). Large variation existed between herds (ranging from 8.68 to 41.62 DDDA). Fourth-generation cephalosporins were used most (4.99 DDDA), followed by penicillins (3.70 DDDA) and third-generation cephalosporins (2.95 DDDA). The average ATI of the critically important antimicrobials for human health (i.e., third- and fourth-generation cephalosporins and fluoroquinolones according to the World Organisation for Animal Health classification) was somewhat lower than the average ATI of the other antimicrobials (8.59 and 12.18 DDDA, respectively). The average ATI for intramammary treatment of (sub)clinical mastitis, for dry-cow therapy, and for systemically administered antimicrobials was 6.30, 6.89, and 7.44 DDDA, respectively. In low-consuming herds, most antimicrobials were being used for dry-cow therapy, whereas in high-consuming herds, most antimicrobials were being used as injectable or intramammary mastitis therapy. The incidence rate of treated mastitis was positively associated with ATI. Herds that applied blanket dry-cow therapy tended to have a higher ATI than herds in which cows were selectively dried off with long-acting antimicrobials. The ATI decreased with an increasing prevalence of primiparous cows. Copyright © 2016 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Real-time three-dimensional transesophageal echocardiography in the assessment of mechanical prosthetic mitral valve ring thrombosis.

PubMed

Ozkan, Mehmet; Gürsoy, Ozan Mustafa; Astarcıoğlu, Mehmet Ali; Gündüz, Sabahattin; Cakal, Beytullah; Karakoyun, Süleyman; Kalçık, Macit; Kahveci, Gökhan; Duran, Nilüfer Ekşi; Yıldız, Mustafa; Cevik, Cihan

2013-10-01

Although 2-dimensional (2D) transesophageal echocardiography (TEE) is the gold standard for the diagnosis of prosthetic valve thrombosis, nonobstructive clots located on mitral valve rings can be missed. Real-time 3-dimensional (3D) TEE has incremental value in the visualization of mitral prosthesis. The aim of this study was to investigate the utility of real-time 3D TEE in the diagnosis of mitral prosthetic ring thrombosis. The clinical outcomes of these patients in relation to real-time 3D transesophageal echocardiographic findings were analyzed. Of 1,263 patients who underwent echocardiographic studies, 174 patients (37 men, 137 women) with mitral ring thrombosis detected by real-time 3D TEE constituted the main study population. Patients were followed prospectively on oral anticoagulation for 25 ± 7 months. Eighty-nine patients (51%) had thrombi that were missed on 2D TEE and depicted only on real-time 3D TEE. The remaining cases were partially visualized with 2D TEE but completely visualized with real-time 3D TEE. Thirty-seven patients (21%) had thromboembolism. The mean thickness of the ring thrombosis in patients with thromboembolism was greater than that in patients without thromboembolism (3.8 ± 0.9 vs 2.8 ± 0.7 mm, p <0.001). One hundred fifty-five patients (89%) underwent real-time 3D TEE during follow-up. There were no thrombi in 39 patients (25%); 45 (29%) had regression of thrombi, and there was no change in thrombus size in 68 patients (44%). Thrombus size increased in 3 patients (2%). Thrombosis was confirmed surgically and histopathologically in 12 patients (7%). In conclusion, real-time 3D TEE can detect prosthetic mitral ring thrombosis that could be missed on 2D TEE and cause thromboembolic events. Copyright © 2013 Elsevier Inc. All rights reserved.

Optimal prosthesis sizing in transcatheter aortic valve implantation by exclusive use of three-dimensional transoesophageal echocardiography.

PubMed

Kretzschmar, Daniel; Lauten, Alexander; Goebel, Bjoern; Doenst, Torsten; Poerner, Tudor C; Ferrari, Markus; Figulla, Hans R; Hamadanchi, Ali

2016-03-01

The assessment of aortic annular size is critical, and inappropriate sizing is thought to be a main reason of paravalvular aortic regurgitation. Multidetector computed tomograph is associated with the risk of contrast nephropathy. For optimal evaluation of the complex structure of the aortic annulus, three-dimensional (3D)-methods should be used. We therefore sought to determine the value of 3D-transoesophageal echocardiography (3D-TEE) for appropriate sizing. Hundred and one patients (mean age 81·4 years) with symptomatic aortic valve stenosis (AS) and high surgical risk profile (mean log. EuroScore 28·8%) being scheduled for transcatheter aortic valve implantation (TAVI) were included. 2D- and 3D-TEE were performed before the procedure to evaluate the aortic annulus diameter. Maximum, minimum and mean (max diameter + min diameter/2) annulus diameters were 24·7, 23·1 and 23. 9 mm in 3D-TEE and compared to 22·6 mm in 2D-TEE (P<0·001; 0·07; <0·001). The interobserver variability for 3D-TEE was low with a mean difference of 0·18 mm compared to 2D-TEE with 0·59 mm. The application of 3D-TEE caused a change of prosthesis size selection in 40% of patients compared to 2D-TEE. In this study, we implanted three different types of catheter-mounted valves (Edwards-SAPIEN(™) XT valve, CoreValve(™) and JenaValve(™) ). Final angiography confirmed valve competence (mild insufficiency) in 91%, and there was no aortic regurgitation greater than moderate in the follow-up echocardiographic evaluation. Assessment of aortic annulus dimensions for TAVI size selection can safely be performed with 3D-TEE only. Based on our results with significantly higher annulus diameter compared to 2D-TEE, we recommend 3D-TEE to reduce prosthesis undersizing. © 2014 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd.

Diagnosis of malignancy of adult mediastinal tumors by conventional and transesophageal echocardiography.

PubMed

Zhou, Wei-Wei; Wang, Hong-Wei; Liu, Nan-Nan; Li, Jing-Jing; Yuan, Wei; Zhao, Rui; Xiang, Liang-Bi; Qi, Miao

2015-04-20

Transesophageal echocardiography (TEE) is a well-established method for detecting and diagnosing heart tumors. In contrast, its role in assessing the presence, growth and evidence of malignant tumors originating from mediastinal sites remains unclear. The aim of this study was to compare the diagnostic impact of TEE and transthoracic echocardiography (TTE) for determining the localization, growth and malignancy of adult mediastinal tumors (MTs). In a prospective and investigator-blinded study, we evaluated 144 consecutive patients with MT lesions to assess the diagnostic impact of TEE and TTE for detecting the presence of tumors spreading both inside and outside of the heart and for determining infiltration and invasion using pathological examination results as a reference. All tumor lesions were diagnosed and carefully evaluated by biopsy. Biopsy revealed malignant tumors in 79 patients and benign tumors in 65 patients. When compared to histological findings, TEE predicted malignancy from the presence of tumors spreading both inside and outside of the heart and from infiltration and invasion in 49/79 patients (62.0%). TTE predicted malignancy in only 8/79 patients (10.1%, P < 0.005). TEE visualized tumor lesions in 130 patients (90.3%) while the TTE visualized tumor lesions in 110 patients (76.4%) and was less effective at detecting MT lesions (P < 0.001). TTE and TEE could detect anterior MTs and adequately verified MTs (P > 0.05); TEE detected medium MTs better than TTE (P < 0.001). TEE is effective and superior to TTE for predicting the localization and growth of MTs as well as for accessing evidence of tumor malignancy. TTE and TEE were able to detect anterior MTs; TEE was able to detect medium MT better than TTE.

Diagnosis of Malignancy of Adult Mediastinal Tumors by Conventional and Transesophageal Echocardiography

PubMed Central

Zhou, Wei-Wei; Wang, Hong-Wei; Liu, Nan-Nan; Li, Jing-Jing; Yuan, Wei; Zhao, Rui; Xiang, Liang-Bi; Qi, Miao

2015-01-01

Background: Transesophageal echocardiography (TEE) is a well-established method for detecting and diagnosing heart tumors. In contrast, its role in assessing the presence, growth and evidence of malignant tumors originating from mediastinal sites remains unclear. The aim of this study was to compare the diagnostic impact of TEE and transthoracic echocardiography (TTE) for determining the localization, growth and malignancy of adult mediastinal tumors (MTs). Methods: In a prospective and investigator-blinded study, we evaluated 144 consecutive patients with MT lesions to assess the diagnostic impact of TEE and TTE for detecting the presence of tumors spreading both inside and outside of the heart and for determining infiltration and invasion using pathological examination results as a reference. Results: All tumor lesions were diagnosed and carefully evaluated by biopsy. Biopsy revealed malignant tumors in 79 patients and benign tumors in 65 patients. When compared to histological findings, TEE predicted malignancy from the presence of tumors spreading both inside and outside of the heart and from infiltration and invasion in 49/79 patients (62.0%). TTE predicted malignancy in only 8/79 patients (10.1%, P < 0.005). TEE visualized tumor lesions in 130 patients (90.3%) while the TTE visualized tumor lesions in 110 patients (76.4%) and was less effective at detecting MT lesions (P < 0.001). TTE and TEE could detect anterior MTs and adequately verified MTs (P > 0.05); TEE detected medium MTs better than TTE (P < 0.001). Conclusions: TEE is effective and superior to TTE for predicting the localization and growth of MTs as well as for accessing evidence of tumor malignancy. TTE and TEE were able to detect anterior MTs; TEE was able to detect medium MT better than TTE. PMID:25881598

Correlation of Shear Strength Between Longitudial and Transverse Specimens

DTIC Science & Technology

2012-05-17

Transverse Specimens" (2012). University of New Orleans Theses and Dissertations. Paper 1435. http://scholarworks.uno.edu/ td /1435 Report Documentation... ATI ) and they were  the sole providers of this metal during this project.  ATI  called the alloy:  ATI  425; it is very similar  in its properties to...Nie, C.; Dong, P.. Traction Stress Based Shear Strength Definition of Fillet Welds. Pending  Publishing.  [5] ATI  38‐644 Beta Titanium Alloy. Technical

Elimination of A-type inclusion formation enhances cowpox virus replication in mice: implications for orthopoxvirus evolution.

PubMed

Kastenmayer, Robin J; Maruri-Avidal, Liliana; Americo, Jeffrey L; Earl, Patricia L; Weisberg, Andrea S; Moss, Bernard

2014-03-01

Some orthopoxviruses including cowpox virus embed virus particles in dense bodies, comprised of the A-type inclusion (ATI) protein, which may provide long-term environmental protection. This strategy could be beneficial if the host population is sparse or spread is inefficient or indirect. However, the formation of ATI may be neutral or disadvantageous for orthopoxviruses that rely on direct respiratory spread. Disrupted ATI open reading frames in orthopoxviruses such as variola virus, the agent of smallpox, and monkeypox virus suggests that loss of this feature provided positive selection. To test this hypothesis, we constructed cowpox virus mutants with deletion of the ATI gene or another gene required for embedding virions. The ATI deletion mutant caused greater weight loss and higher replication in the respiratory tract than control viruses, supporting our hypothesis. Deletion of the gene for embedding virions had a lesser effect, possibly due to known additional functions of the encoded protein. Published by Elsevier Inc.

ALK Inhibitor Response in Melanomas Expressing EML4-ALK Fusions and Alternate ALK Isoforms.

PubMed

Couts, Kasey L; Bemis, Judson; Turner, Jacqueline A; Bagby, Stacey M; Murphy, Danielle; Christiansen, Jason; Hintzsche, Jennifer D; Le, Anh; Pitts, Todd M; Wells, Keith; Applegate, Allison; Amato, Carol; Multani, Pratik; Chow-Maneval, Edna; Tentler, John J; Shellman, Yiqun G; Rioth, Matthew J; Tan, Aik-Choon; Gonzalez, Rene; Medina, Theresa; Doebele, Robert C; Robinson, William A

2018-01-01

Oncogenic ALK fusions occur in several types of cancer and can be effectively treated with ALK inhibitors; however, ALK fusions and treatment response have not been characterized in malignant melanomas. Recently, a novel isoform of ALK ( ALK ATI ) was reported in 11% of melanomas but the response of melanomas expressing ALK ATI to ALK inhibition has not been well characterized. We analyzed 45 melanoma patient-derived xenograft models for ALK mRNA and protein expression. ALK expression was identified in 11 of 45 (24.4%) melanomas. Ten melanomas express wild-type (wt) ALK and/or ALK ATI and one mucosal melanoma expresses multiple novel EML4-ALK fusion variants. Melanoma cells expressing different ALK variants were tested for response to ALK inhibitors. Whereas the melanoma expressing EML4-ALK were sensitive to ALK inhibitors in vitro and in vivo , the melanomas expressing wt ALK or ALK ATI were not sensitive to ALK inhibitors. In addition, a patient with mucosal melanoma expressing ALK ATI was treated with an ALK/ROS1/TRK inhibitor (entrectinib) on a phase I trial but did not respond. Our results demonstrate ALK fusions occur in malignant melanomas and respond to targeted therapy, whereas melanomas expressing ALK ATI do not respond to ALK inhibitors. Targeting ALK fusions is an effective therapeutic option for a subset of melanoma patients, but additional clinical studies are needed to determine the efficacy of targeted therapies in melanomas expressing wt ALK or ALK ATI Mol Cancer Ther; 17(1); 222-31. ©2017 AACR . ©2017 American Association for Cancer Research.

Investigation of Adaptive-threshold Approaches for Determining Area-Time Integrals from Satellite Infrared Data to Estimate Convective Rain Volumes

NASA Technical Reports Server (NTRS)

Smith, Paul L.; VonderHaar, Thomas H.

1996-01-01

The principal goal of this project is to establish relationships that would allow application of area-time integral (ATI) calculations based upon satellite data to estimate rainfall volumes. The research is being carried out as a collaborative effort between the two participating organizations, with the satellite data analysis to determine values for the ATIs being done primarily by the STC-METSAT scientists and the associated radar data analysis to determine the 'ground-truth' rainfall estimates being done primarily at the South Dakota School of Mines and Technology (SDSM&T). Synthesis of the two separate kinds of data and investigation of the resulting rainfall-versus-ATI relationships is then carried out jointly. The research has been pursued using two different approaches, which for convenience can be designated as the 'fixed-threshold approach' and the 'adaptive-threshold approach'. In the former, an attempt is made to determine a single temperature threshold in the satellite infrared data that would yield ATI values for identifiable cloud clusters which are closely related to the corresponding rainfall amounts as determined by radar. Work on the second, or 'adaptive-threshold', approach for determining the satellite ATI values has explored two avenues: (1) attempt involved choosing IR thresholds to match the satellite ATI values with ones separately calculated from the radar data on a case basis; and (2) an attempt involved a striaghtforward screening analysis to determine the (fixed) offset that would lead to the strongest correlation and lowest standard error of estimate in the relationship between the satellite ATI values and the corresponding rainfall volumes.

Generative Retrieval Improves Learning and Retention of Cardiac Anatomy Using Transesophageal Echocardiography.

PubMed

Kleiman, Amanda M; Forkin, Katherine T; Bechtel, Allison J; Collins, Stephen R; Ma, Jennie Z; Nemergut, Edward C; Huffmyer, Julie L

2017-05-01

Transesophageal echocardiography (TEE) is a valuable monitor for patients undergoing cardiac and noncardiac surgery as it allows for evaluation of cardiovascular compromise in the perioperative period. It is challenging for anesthesiology residents and medical students to learn to use and interpret TEE in the clinical environment. A critical component of learning to use and interpret TEE is a strong grasp of normal cardiovascular ultrasound anatomy. Fifteen fourth-year medical students and 15 post-graduate year (PGY) 1 and 2 anesthesiology residents without prior training in cardiac anesthesia or TEE viewed normal cardiovascular anatomy TEE video clips; participants were randomized to learning cardiac anatomy in generative retrieval (GR) and standard practice (SP) groups. GR participants were required to verbally identify each unlabeled cardiac anatomical structure within 10 seconds of the TEE video appearing on the screen. Then a correctly labeled TEE video clip was shown to the GR participant for 5 more seconds. SP participants viewed the same TEE video clips as GR but there was no requirement for SP participants to generate an answer; for the SP group, each TEE video image was labeled with the correctly identified anatomical structure for the 15 second period. All participants were tested for intermediate (1 week) and late (1 month) retention of normal TEE cardiovascular anatomy. Improvement of intermediate and late retention of TEE cardiovascular anatomy was evaluated using a linear mixed effects model with random intercepts and random slopes. There was no statistically significant difference in baseline score between GR (49% ± 11) and SP (50% ± 12), with mean difference (95% CI) -1.1% (-9.5, 7.3%). At 1 week following the educational intervention, GR (90% ± 5) performed significantly better than SP (82% ± 11), with mean difference (95% CI) 8.1% (1.9, 14.2%); P = .012. This significant increase in scores persisted in the late posttest session at one month (GR: 83% ± 12; SP: 72% ± 12), with mean difference (95% CI) 10.2% (1.3 to 19.1%); P = .026. Mixed effects analysis showed significant improvements in TEE cardiovascular anatomy over time, at 5.9% and 3.5% per week for GR and SP groups respectively (P = .0003), and GR improved marginally faster than SP (P = .065). Medical students and anesthesiology residents inexperienced in the use of TEE showed both improved learning and retention of basic cardiovascular ultrasound anatomy with the incorporation of GR into the educational experience.

Defining and Assessing the Impact to the Combat/Weapon Systems of a Ship Post Major Overhaul

DTIC Science & Technology

2013-06-01

vig ati on...ch  Ra da r ( SP S‐6 7)   Un ne ce ss ary  fo r M iss ion   0 Lik e t o h av e  0.2 5 FA LS E 0 0 Na vig ati on  Da ta  (W SN ‐7 )  Ne ce ss ar y  0.5...E 0 0 Na vig ati on  Di str ibu tio n ( NA VS SI)   Ne ce ss ar y  0.5 Ne ce ss ary   0.5 FA LS E 0 0 Cr itic al  Na vig ati on  D ist rib ut ion

Manual Skill Acquisition During Transesophageal Echocardiography Simulator Training of Cardiology Fellows: A Kinematic Assessment.

PubMed

Matyal, Robina; Montealegre-Gallegos, Mario; Mitchell, John D; Kim, Han; Bergman, Remco; Hawthorne, Katie M; O'Halloran, David; Wong, Vanessa; Hess, Phillip E; Mahmood, Feroze

2015-12-01

To investigate whether a transesophageal echocardiography (TEE) simulator with motion analysis can be used to impart proficiency in TEE in an integrated curriculum-based model. A prospective cohort study. A tertiary-care university hospital. TEE-naïve cardiology fellows. Participants underwent an 8-session multimodal TEE training program. Manual skills were assessed at the end of sessions 2 and 8 using motion analysis of the TEE simulator's probe. At the end of the course, participants performed an intraoperative TEE; their examinations were video captured, and a blinded investigator evaluated the total time and image transitions needed for each view. Results are reported as mean±standard deviation, or median (interquartile range) where appropriate. Eleven fellows completed the knowledge and kinematic portions of the study. Five participants were excluded from the evaluation in the clinical setting because of interim exposure to TEE or having participated in a TEE rotation after the training course. An increase of 12.95% in post-test knowledge scores was observed. From the start to the end of the course, there was a significant reduction (p<0.001 for all) in the number of probe. During clinical performance evaluation, trainees were able to obtain all the required echocardiographic views unassisted but required a longer time and had more probe transitions when compared with an expert. A curriculum-based approach to TEE training for cardiology fellows can be complemented with kinematic analyses to objectify acquisition of manual skills during simulator-based training. Copyright © 2015 Elsevier Inc. All rights reserved.

ADAM-C score: New risk score for predicting diagnostic yield of transesophageal echocardiography after cerebral ischemia.

PubMed

Charbonnel, Clément; Jego, Christophe; Jourda, François; Vinsonneau, Ulric; Garçon, Philippe; Turlotte, Guillaume; Rivière, Jean François; Maurin, Marion; Lubret, Rémy; Meimoun, Patrick; Akret, Chrystelle; Cournot, Maxime; Sokic, Charles; Michel, Laurent; Lescure, Maryse; Kenizou, David; Melay, Marie; Fayard, Maxime; Gallet, Bruno; Fouche, Rémi; Janin-Manificat, Luc; Dijoux, Nicolas; Martin, Anne Céline; Tho-Agostini, Aurélia; Mann, Hubert; Ricard, Cécile; Pico, Fernando; Georges, Jean Louis; Belle, Loïc; Jourdain, Patrick

2018-05-14

The clinical utility of transesophageal echocardiography (TEE) after brain ischemia (BI) remains a matter of debate. We aimed to evaluate the clinical impact of TEE and to build a score that could help physicians to identify which patients should better benefit from TEE. This prospective, multicenter, observational study included patients over 18 years old, hospitalized for BI. TEE findings were judged discriminant if the results showed important information leading to major changes in the management of patients. Most patients with patent foramen ovale were excluded. Variables independently associated with a discriminant TEE were used to build the prediction model. Of the entire population (1479 patients), 255 patients (17%) were classified in the discriminant TEE group. Five parameters were selected as predictors of a discriminant TEE. Accordingly, the ADAM-C score could be calculated as follows: Score = 4 (if age ≥60) + 2 (if diabetes) + 2 (if aortic stenosis from any degrees) + 1 (if multi-territory stroke) + 2 (if history of coronary artery disease). At a threshold lower than 3, the sensitivity, specificity, positive predictive value, and negative predictive value (NPV) of detecting discriminant TEE were 88% (95% CI 85-90), 44% (95% CI 41-47), 21% (95% CI 19-27), and 95% (95% CI 94-97), respectively. A simple score based on clinical and transthoracic echocardiographic parameters can help physicians to identify patients who might not benefit from TEE. Indeed, a score lower than 3 has an interesting NPV of 95% (95% CI 94-97). © 2018 Wiley Periodicals, Inc.

Construction of prestressed concrete single-tee bridge superstructures.

DOT National Transportation Integrated Search

1977-01-01

This report discusses in detail the construction of the first five precast, prestressed concrete, single-tee beam bridge superstructures to be let to contract in Virginia. The data suggest that this single-tee beam enables efficient construction of t...

Integration of trans-esophageal echocardiography with magnetic tracking technology for cardiac interventions

NASA Astrophysics Data System (ADS)

Moore, John T.; Wiles, Andrew D.; Wedlake, Chris; Bainbridge, Daniel; Kiaii, Bob; Trejos, Ana Luisa; Patel, Rajni; Peters, Terry M.

2010-02-01

Trans-esophageal echocardiography (TEE) is a standard component of patient monitoring during most cardiac surgeries. In recent years magnetic tracking systems (MTS) have become sufficiently robust to function effectively in appropriately structured operating room environments. The ability to track a conventional multiplanar 2D TEE transducer in 3D space offers incredible potential by greatly expanding the cumulative field of view of cardiac anatomy beyond the limited field of view provided by 2D and 3D TEE technology. However, there is currently no TEE probe manufactured with MTS technology embedded in the transducer, which means sensors must be attached to the outer surface of the TEE. This leads to potential safety issues for patients, as well as potential damage to the sensor during procedures. This paper presents a standard 2D TEE probe fully integrated with MTS technology. The system is evaluated in an environment free of magnetic and electromagnetic disturbances, as well as a clinical operating room in the presence of a da Vinci robotic system. Our first integrated TEE device is currently being used in animal studies for virtual reality-enhanced ultrasound guidance of intracardiac surgeries, while the "second generation" TEE is in use in a clinical operating room as part of a project to measure perioperative heart shift and optimal port placement for robotic cardiac surgery. We demonstrate excellent system accuracy for both applications.

Further studies to extend and test the area-time-integral technique applied to satellite data

NASA Technical Reports Server (NTRS)

Smith, Paul L.; Vonderhaar, Thomas H.

1993-01-01

The principal goal of this project is to establish relationships that would allow application of area-time integral (ATI) calculations based upon satellite data to estimate rainfall volumes. The research has been pursued using two different approaches, which for convenience can be designated as the 'fixed-threshold approach' and the 'variable-threshold approach'. In the former approach, an attempt is made to determine a single temperature threshold in the satellite infrared data that would yield ATI values for identifiable cloud clusters which are most closely related to the corresponding rainfall amounts. Results thus far have indicated that a strong correlation exists between the rain volumes and the satellite ATI values, but the optimum threshold for this relationship seems to differ from one geographic location to another. The difference is probably related to differences in the basic precipitation mechanisms that dominate in the different regions. The average rainfall rate associated with each cloudy pixel is also found to vary across the spectrum of ATI values. Work on the second, or 'variable-threshold', approach for determining the satellite ATI values was essentially suspended during this period due to exhaustion of project funds. Most of the ATI work thus far has dealt with cloud clusters from the Lagrangian or 'floating-target' point of view. For many purposes, however, the Eulerian or 'fixed-target' perspective is more appropriate. For a very large target area encompassing entire cluster life histories, the rain volume-ATI relationship would obviously be the same in either case. The important question for the Eulerian perspective is how small the fixed area can be made while maintaining consistency in that relationship.

Pilot randomized crossover study comparing the efficacy of transnasal disposable endosheath with standard endoscopy to detect Barrett's esophagus.

PubMed

Shariff, Mohammed K; Varghese, Sibu; O'Donovan, Maria; Abdullahi, Zarah; Liu, Xinxue; Fitzgerald, Rebecca C; di Pietro, Massimiliano

2016-02-01

The transnasal endosheath endoscope is a new disposable technology with potential applicability to the primary care setting. The aim of this study was to evaluate the efficacy of transnasal endosheath endoscopy (TEE) for the detection of Barrett's esophagus, by comparing the diagnostic accuracy of TEE with that of standard endoscopy. This was a prospective, randomized, crossover study performed in a single tertiary referral center. Consecutive patients undergoing surveillance for Barrett's esophagus or referred for diagnostic assessment were recruited. All patients were randomized to undergo TEE followed by standard endoscopy or the reverse. Endoscopy experiences and patient preferences were evaluated using a questionnaire. Endoscopic and histologic diagnosis of Barrett's esophagus, and optical image quality of both endoscopic procedures, were compared. A total of 21 of 25 patients completed the study. TEE had sensitivity and specificity of 100 % for an endoscopic diagnosis of Barrett's esophagus, and of 66.7 % and 100 %, respectively, for the histologic diagnosis of Barrett's esophagus. The mean optical quality of standard endoscopy was significantly better than that of TEE (7.11 ± 0.42 vs. 4.06 ± 0.27; P < 0.0001). However, following endoscopy, patients reported a significantly better experience with TEE compared with standard endoscopy (7.05 ± 0.49 vs. 4.35 ± 0.53; P = 0.0006), with 60 % preferring TEE and 25 % preferring sedated standard endoscopy. In this study, TEE had equal accuracy for an endoscopic diagnosis of Barrett's esophagus compared with standard endoscopy, at the expense of reduced image quality and a lower yield of intestinal metaplasia on biopsy. TEE was better tolerated and preferred by patients. Hence, TEE needs further evaluation in primary care as an initial diagnostic tool. © Georg Thieme Verlag KG Stuttgart · New York.

Total energy expenditure in adults with cerebral palsy as assessed by doubly labeled water.

PubMed

Johnson, R K; Hildreth, H G; Contompasis, S H; Goran, M I

1997-09-01

To characterize total energy expenditure (TEE) in free-living adults with cerebral palsy (CP) using the doubly labeled water technique, and to determine those physiologic variables and characteristics of CP that were markers of TEE in adults with CP. TEE was measured using the doubly labeled water technique in 30 free-living adults with CP (12 women, 18 men). To determine the best markers of TEE, the following factors were examined: CP status, resting metabolic rate (RMR), anthropometric characteristics and body composition by means of dual-energy x-ray absorptiometry (DXA) and skinfold thickness measurements, energy cost of leisure-time activities, and oral-motor impairment. Means +/- standard deviations, t tests, Pearson product-moment correlation coefficients, Spearman rank correlation coefficients, chi 2, stepwise multiple-correlation regression analysis, and analysis of covariance were used to examine the relationships among variables of interest. TEE was highly variable in the sample (mean = 2,455 +/- 622 kcal/day for men and 1,986 +/- 363 kcal/day for women). Stepwise regression analysis showed that TEE was best predicted in the sample by RMR, percentage body fat determined by DXA, ambulation status, and sex (multiple R = .68, P = .003). When practical, easily measured variables were used, TEE was best predicted by height, ambulation status, percentage body fat by skinfold thickness measurements, and sex (multiple R = .61, P. = 018). The contribution of energy expended in physical activity to TEE was significantly higher in the ambulatory subjects than the nonambulatory subjects (25% vs 16%, respectively; P = .009). The high degree of variability in TEE, largely attributable to high interindividual variation in energy expended in physical activity, makes it difficult to provide general guidelines for energy requirements for adults with CP. Because ambulation status was an important predictor of TEE, it must be accounted for in estimating energy requirements in this population.

Comparison of total energy expenditure between school and summer months.

PubMed

Zinkel, S R J; Moe, M; Stern, E A; Hubbard, V S; Yanovski, S Z; Yanovski, J A; Schoeller, D A

2013-10-01

Childhood obesity has increased 3 to 4 fold. Some children gain excess weight in summer. Total energy expenditure increases almost linearly with fat-free mass. A lower total energy expenditure was not detected in summer. Recent data report that the youth experience greater weight gain during summer than during school months. We tested the hypothesis that a difference in total energy expenditure (TEE) between school and summer months exists and may contribute to summer weight gain. A secondary analysis was performed on cross-sectional TEE data from school-age, sedentary African-American and Caucasian youth based in or near the District of Columbia who were at-risk for adult obesity because they had body mass index (BMI) ≥ 85th percentile or had overweight parents. TEE was estimated from 18-O and deuterium measurements during 1-week intervals using urine samples collected after ingestion of doubly labelled water. Differences in summer- and school-time TEE were assessed using analysis of covariance. The data were adjusted for fat-free mass (FFM) as determined by deuterium dilution to adjust for the effect of body size on TEE. Data were collected from 162 youth (average age 10 ± 2 years, BMI 28 ± 8 kg m(-2) and BMI z-score 1.96 + 0.96). Of these, 96 youth had TEE measured during the school year (September-June); 66 different youths had TEE measured during summer months (June-August). After adjustment for FFM, average summertime TEE was 2450 ± 270 kcal d(-1) and average school-time TEE was 2510 ± 350 kcal d(-1) (P = 0.26). No difference in TEE was detected between the school year and the summer months. These data suggest that seasonal differences in youth weight gain are not necessarily due to differences in energy expenditures. © 2013 The Authors. Pediatric Obesity © 2013 International Association for the Study of Obesity.

Transesophageal echocardiography in critically ill acute postoperative infants: comparison of AcuNav intracardiac echocardiographic and microTEE miniaturized transducers.

PubMed

Ferns, Sunita; Komarlu, Rukmini; Van Bergen, Andrew; Multani, Kanwar; Cui, Vivian Wei; Roberson, David A

2012-08-01

Multiple barriers to transthoracic echocardiography are present in critically ill infants immediately after surgery. Transesophageal echocardiography (TEE) is sometimes needed to obtain specific important information that transthoracic echocardiography fails to demonstrate. Formerly, the investigators used the AcuNav intracardiac echocardiographic (ICE) intravascular ultrasound transducer (8 Fr, 2.5 mm, 64-element crystal array, multifrequency [5.5-10 MHz], single longitudinal plane, linear phased array [Siemens Medical Solutions USA, Inc., Mountain View, CA]). Recently, the investigators have also used the microTEE transducer (8-mm transducer tip, 5.2-mm shaft, multifrequency [3-8 MHz], multiplane phased array, 32-element probe [Philips Medical Systems, Andover, MA]). Both transducers have two-dimensional, M-mode, color Doppler, and pulsed-wave and continuous-wave Doppler capabilities. The aim of this study was to compare the efficacy, safety, ease of insertion, capabilities, utilization, and cost of the AcuNav ICE transducer versus those of the microTEE transducer. A retrospective review of all 50 postoperative critically ill infants who underwent TEE using the AcuNav and microTEE in the past 5 years was conducted. TEE was performed as ordered by the attending physician to answer a specific question not answered by transthoracic echocardiography. In all cases, the clinical information sought was obtained. The AcuNav ICE transducer was safe, easy to insert through the transnasal route, and did not require paralysis; however, it had a limited number of echocardiographic views and had greater sterilization cost. The microTEE transducer had greater echocardiographic capabilities and lower sterilization cost; however, it was slightly more difficult to insert, had a few manageable complications, and required more sedation and paralysis. TEE in this setting has increased because of demonstrated efficacy and safety. Both the AcuNav ICE and microTEE transducers are useful and effective in this critical clinical scenario. Copyright © 2012 American Society of Echocardiography. Published by Mosby, Inc. All rights reserved.

Accuracy of a combined heart rate and motion sensor for assessing energy expenditure in free-living adults during a double-blind crossover caffeine trial using doubly labeled water as the reference method.

PubMed

Silva, A M; Santos, D A; Matias, C N; Júdice, P B; Magalhães, J P; Ekelund, U; Sardinha, L B

2015-01-01

A combined heart rate (HR) and motion sensor (Actiheart) has been proposed as an accurate method for assessing total energy expenditure (TEE) and physical activity energy expenditure (PAEE). However, the extent to which factors such as caffeine may affect the accuracy by which the estimated HR-related PAEE contribution will affect TEE and PAEE estimates is unknown. Therefore, we examined the validity of Actiheart in estimating TEE and PAEE in free-living adults under a caffeine trial compared with doubly labeled water (DLW) as reference criterion. Using a double-blind crossover trial (Clinicaltrials.gov ID: #NCT01477294) with two conditions (4-day each with a 3-day-washout period), randomly ordered as caffeine (5 mg/kg per day) and placebo (malt-dextrine) intake, TEE was measured by DLW in 17 physically active men (20-38 years) who were non-caffeine users. In each condition, resting energy expenditure (REE) was assessed by indirect calorimetry and PAEE was calculated as (TEE-(REE+0.1 TEE)). Simultaneously, PAEE and TEE were estimated by Actiheart using an individual calibration (ACC+HRstep). Under caffeine, ACC+HRstep explained 76 and 64% of TEE and PAEE from DLW, respectively; corresponding results for the placebo condition were 82 and 66%. No mean bias was found between ACC+HRstep and DLW for TEE (caffeine:-468 kJ per day; placebo:-407 kJ per day), although PAEE was slightly underestimated (caffeine:-856 kJ per day; placebo:-1147 kJ per day). Similar limits of agreement were observed in both conditions ranging from -2066 to 3002 and from -3488 to 1776 kJ per day for TEE and PAEE, respectively. Regardless of caffeine intake, the combined HR and motion sensor is valid for estimating free-living energy expenditure in a group of healthy men but is less accurate for an individual assessment.

Endothelial-monocyte activating polypeptide II disrupts alveolar epithelial type II to type I cell transdifferentiation

PubMed Central

2012-01-01

Background Distal alveolar morphogenesis is marked by differentiation of alveolar type (AT)-II to AT-I cells that give rise to the primary site of gas exchange, the alveolar/vascular interface. Endothelial-Monocyte Activating Polypeptide (EMAP) II, an endogenous protein with anti-angiogenic properties, profoundly disrupts distal lung neovascularization and alveolar formation during lung morphogenesis, and is robustly expressed in the dysplastic alveolar regions of infants with Bronchopulmonary dysplasia. Determination as to whether EMAP II has a direct or indirect affect on ATII→ATI trans-differentiation has not been explored. Method In a controlled nonvascular environment, an in vitro model of ATII→ATI cell trans-differentiation was utilized to demonstrate the contribution that one vascular mediator has on distal epithelial cell differentiation. Results Here, we show that EMAP II significantly blocked ATII→ATI cell transdifferentiation by increasing cellular apoptosis and inhibiting expression of ATI markers. Moreover, EMAP II-treated ATII cells displayed myofibroblast characteristics, including elevated cellular proliferation, increased actin cytoskeleton stress fibers and Rho-GTPase activity, and increased nuclear:cytoplasmic volume. However, EMAP II-treated cells did not express the myofibroblast markers desmin or αSMA. Conclusion Our findings demonstrate that EMAP II interferes with ATII → ATI transdifferentiation resulting in a proliferating non-myofibroblast cell. These data identify the transdifferentiating alveolar cell as a possible target for EMAP II's induction of alveolar dysplasia. PMID:22214516

Broadening the photoresponsive activity of anatase titanium dioxide particles via decoration with partial gold shells.

PubMed

Khantamat, Orawan; Li, Chien-Hung; Liu, Si-Ping; Liu, Tingting; Lee, Han Ju; Zenasni, Oussama; Lee, Tai-Chou; Cai, Chengzhi; Lee, T Randall

2018-03-01

Titanium dioxide (TiO 2 ) has gained increasing interest in materials research due to its outstanding properties and promising applications in a wide range of fields. From this perspective, we report the synthesis of custom-designed anatase TiO 2 submicrometer particles coated with partial Au shells (ATiO 2 -AuShl). The synthetic strategy used herein yields uniformly shaped monodisperse particles. Amorphous TiO 2 core particles were synthesized using template-free oxidation and hydrolysis of titanium nitride (TiN); subsequent hydrothermal treatment generated anatase TiO 2 (ATiO 2 ) particles. Coating ATiO 2 particles with partial Au shells was accomplished using a simple seeded-growth method. Evaluation of the optical properties of these ATiO 2 -AuShl particles showed that these submicrometer composites exhibited an intense absorption peak for TiO 2 in the UV region (∼326 nm) and a broad extinction band in the visible range (∼650 nm) arising from the incomplete Au shell. These ATiO 2 -AuShl composite particles provide a unique and effective means for broadening the optical response of TiO 2 -based nano- and micron-scale materials. The simplicity of our synthetic method should broaden the application of ATiO 2 -AuShl particles in various visible light-driven technologies. Copyright © 2017 Elsevier Inc. All rights reserved.

Heat Capacity Mapping Mission (HCMM) program: Study of geological structure of Sicily and other Italian areas. [Sardinia and the Gulf of Orosei

NASA Technical Reports Server (NTRS)

Cassinis, R.; Lechi, G. (Principal Investigator); Zilioli, E.; Marini, A.; Brivio, P. A.; Tosi, N.

1981-01-01

The usefulness of thermal inertia mapping in discriminating geolithological units was investigated using Sardinia and the Gulf of Orosei as test sites. Software designed for LANDSAT data were modified and improved for HCMM tapes. A first attempt was made to compare the geological cross section, the topography, the IR radiance, and the thermal inertia along selected profiles of the test site. Thermal inertia profiles appear smoothed in comparison with the thermal radiance. The lowest apparent thermal inertia (ATI) was found on granitic and basaltic outcrops where their image is of sufficient extent, while ATI is higher on carbonatic and dolomitic or moist deposits. Almost every fault is marked by a jump of ATI, the interval being sometimes of the order of one pixel. This seems to demonstrate the ability of ATI to detect contacts or tectonically disturbed zones with a good resolution. It seems more difficult to measure the differences in ATI between homogeneous materials having different lithology. Ground surveys conducted and a simulation model of diurnal temperatures of rocks having different thermal inertia are discussed.

Left ventricular, systemic arterial, and baroreflex responses to ketamine and TEE in chronically instrumented monkeys

NASA Technical Reports Server (NTRS)

Koenig, S. C.; Ludwig, D. A.; Reister, C.; Fanton, J. W.; Ewert, D.; Convertino, V. A.

2001-01-01

Effects of prescribed doses of ketamine five minutes after application and influences of transesophageal echocardiography (TEE) on left ventricular, systemic arterial, and baroreflex responses were investigated to test the hypothesis that ketamine and/or TEE probe insertion alter cardiovascular function. Seven rhesus monkeys were tested under each of four randomly selected experimental conditions: (1) intravenous bolus dose of ketamine (0.5 ml), (2) continuous infusion of ketamine (500 mg/kg/min), (3) continuous infusion of ketamine (500 mg/kg/min) with TEE, and (4) control (no ketamine or TEE). Monkeys were chronically instrumented with a high fidelity, dual-sensor micromanometer to measure left ventricular and aortic pressure and a transit-time ultrasound probe to measure aortic flow. These measures were used to calculate left ventricular function. A 4-element Windkessel lumped-parameter model was used to estimate total peripheral resistance and systemic arterial compliance. Baroreflex response was calculated as the change in R-R interval divided by the change in mean aortic pressure measured during administration of graded concentrations of nitroprusside. The results indicated that five minutes after ketamine application heart rate and left ventricular diastolic compliance decreased while TEE increased aortic systolic and diastolic pressure. We conclude that ketamine may be administered as either a bolus or continuous infusion without affecting cardiovascular function 5 minutes after application while the insertion of a TEE probe will increase aortic pressure. The results for both ketamine and TEE illustrate the classic "Hawthorne Effect," where the observed values are partly a function of the measurement process. Measures of aortic pressure, heart rate, and left ventricular diastolic pressure should be viewed as relative, as opposed to absolute, when organisms are sedated with ketamine or instrumented with a TEE probe.

Daily energy expenditure by five-year-old children, measured by doubly labeled water.

PubMed

Fontvieille, A M; Harper, I T; Ferraro, R T; Spraul, M; Ravussin, E

1993-08-01

Current recommendations for daily energy requirements in 5-year-old children (90 kcal/kg per day) are based on energy intake associated with normal growth. It is not known, however, how these recommendations compare with total free-living energy expenditure (TEE) and how much of TEE is related to physical activity. The TEE and the resting metabolic rate (RMR) were measured in 28 white children, aged 5 years (15 boys, 13 girls; mean (+/- SD) weight 20.1 +/- 3.4 kg; height 113 +/- 6 cm; fat 20% +/- 5%). The TEE was calculated during a 7-day period from urinary elimination rates of deuterium (2H) and heavy oxygen (18O) by using a modification of the two-point slope-intercept method; RMR was measured by a ventilated-hood indirect calorimeter. Physical activity indexes were also collected from questionnaires completed by the parents. Measured TEE was considerably lower than the recommended dietary allowances (1370 +/- 222 kcal/day vs 1807 +/- 310 kcal/day; p < 0.0001), whereas measured RMR was slightly higher than predicted RMR (1001 +/- 119 kcal/day vs 952 +/- 78 kcal/day; p < 0.001). The energy cost of physical activity accounted for only 16% +/- 7% of TEE. An index of activity, assessed as the difference between the measured TEE and the predicted TEE, correlated positively with past-year sport-leisure activity assessed by questionnaire (r = 0.40; p < 0.05). We conclude that measured TEE in 5-year-old children yields lower values (approximately 400 kcal/day) than current estimates. A minute part of this difference (20 to 30 kcal/day) is related to the changes in energy stores during growth, but most seems due to lower-than-expected levels of physical activity. This might be related to increased television viewing, which replaces activities requiring energy.

Assessment of left atrial appendage function by transthoracic pulsed Doppler echocardiography: Comparing against transesophageal interrogation and predicting echocardiographic risk factors for stroke.

PubMed

Wai, Shin Hnin; Kyu, Kyu; Galupo, Mary Joyce; Songco, Geronica G; Kong, William K F; Lee, Chi Hang; Yeo, Tiong Cheng; Poh, Kian Keong

2017-10-01

Transesophageal echocardiographic (TEE) findings of left atrial appendage (LAA) thrombus, spontaneous echo contrast (SEC), and LAA dysfunction are established risk factors of cardioembolic stroke. The semi-invasive nature of TEE limits its utility as a routine risk stratification tool. We aim to correlate TEE and transthoracic echocardiography (TTE) pulsed Doppler measurements of LAA flow velocities and use TTE measurements to predict TEE findings. We prospectively measured pulsed Doppler LAA flow velocities in 103 consecutive patients on TEE and TTE. There was a strong correlation between TEE and TTE LAA emptying velocity (LAA E) (r = .88, P < .001) and a moderate correlation between LAA filling velocities (r = .50, P < .001). TTE LAA E predicted the presence of thrombus or SEC independent of atrial fibrillation (AF). To predict the presence of thrombus or SEC, the optimal TTE LAA E cutoff was ≤30 cm/s in all patients (75% sensitive, 90% specific) and ≤31 cm/s in AF patients (80% sensitive, 79% specific). To predict LAA dysfunction (TEE E ≤ 20 cm/s), the optimal TTE LAA E cutoff was ≤27 cm/s (100% sensitive, 89% specific in all patients and 100% sensitive, 74% specific in AF patients). TTE assessment of LAA function is feasible and correlates well with the more invasive TEE method. It predicts the presence of thrombus, SEC, and LAA dysfunction on TEE. TTE LAA assessment has incremental value in thromboembolic risk stratification and should be utilized more frequently. © 2017, Wiley Periodicals, Inc.

The value of transesophageal echocardiography for embolic strokes of undetermined source

PubMed Central

Katsanos, Aristeidis H.; Bhole, Rohini; Frogoudaki, Alexandra; Giannopoulos, Sotirios; Goyal, Nitin; Vrettou, Agathi-Rosa; Ikonomidis, Ignatios; Paraskevaidis, Ioannis; Pappas, Konstantinos; Parissis, John; Kyritsis, Athanassios P.; Alexandrov, Anne W.; Triantafyllou, Nikos; Malkoff, Marc D.; Voumvourakis, Konstantinos; Alexandrov, Andrei V.

2016-01-01

Objective: Our aim was to evaluate the diagnostic yield of transesophageal echocardiography (TEE) in consecutive patients with ischemic stroke (IS) fulfilling the diagnostic criteria of embolic strokes of undetermined source (ESUS). Methods: We prospectively evaluated consecutive patients with acute IS satisfying ESUS criteria who underwent in-hospital TEE examination in 3 tertiary care stroke centers during a 12-month period. We also performed a systematic review and meta-analysis estimating the cumulative effect of TEE findings on therapeutic management for secondary stroke prevention among different IS subgroups. Results: We identified 61 patients with ESUS who underwent investigation with TEE (mean age 44 ± 12 years, 49% men, median NIH Stroke Scale score = 5 points [interquartile range: 3–8]). TEE revealed additional findings in 52% (95% confidence interval [CI]: 40%–65%) of the study population. TEE findings changed management (initiation of anticoagulation therapy, administration of IV antibiotic therapy, and patent foramen ovale closure) in 10 (16% [95% CI: 9%–28%]) patients. The pooled rate of reported anticoagulation therapy attributed to abnormal TEE findings among 3,562 acute IS patients included in the meta-analysis (12 studies) was 8.7% (95% CI: 7.3%–10.4%). In subgroup analysis, the rates of initiation of anticoagulation therapy on the basis of TEE investigation did not differ (p = 0.315) among patients with cryptogenic stroke (6.9% [95% CI: 4.9%–9.6%]), ESUS (8.1% [95% CI: 3.4%–18.1%]), and IS (9.4% [95% CI: 7.5%–11.8%]). Conclusions: Abnormal TEE findings may decisively affect the selection of appropriate therapeutic strategy in approximately 1 of 7 patients with ESUS. PMID:27488602

The value of transesophageal echocardiography for embolic strokes of undetermined source.

PubMed

Katsanos, Aristeidis H; Bhole, Rohini; Frogoudaki, Alexandra; Giannopoulos, Sotirios; Goyal, Nitin; Vrettou, Agathi-Rosa; Ikonomidis, Ignatios; Paraskevaidis, Ioannis; Pappas, Konstantinos; Parissis, John; Kyritsis, Athanassios P; Alexandrov, Anne W; Triantafyllou, Nikos; Malkoff, Marc D; Voumvourakis, Konstantinos; Alexandrov, Andrei V; Tsivgoulis, Georgios

2016-09-06

Our aim was to evaluate the diagnostic yield of transesophageal echocardiography (TEE) in consecutive patients with ischemic stroke (IS) fulfilling the diagnostic criteria of embolic strokes of undetermined source (ESUS). We prospectively evaluated consecutive patients with acute IS satisfying ESUS criteria who underwent in-hospital TEE examination in 3 tertiary care stroke centers during a 12-month period. We also performed a systematic review and meta-analysis estimating the cumulative effect of TEE findings on therapeutic management for secondary stroke prevention among different IS subgroups. We identified 61 patients with ESUS who underwent investigation with TEE (mean age 44 ± 12 years, 49% men, median NIH Stroke Scale score = 5 points [interquartile range: 3-8]). TEE revealed additional findings in 52% (95% confidence interval [CI]: 40%-65%) of the study population. TEE findings changed management (initiation of anticoagulation therapy, administration of IV antibiotic therapy, and patent foramen ovale closure) in 10 (16% [95% CI: 9%-28%]) patients. The pooled rate of reported anticoagulation therapy attributed to abnormal TEE findings among 3,562 acute IS patients included in the meta-analysis (12 studies) was 8.7% (95% CI: 7.3%-10.4%). In subgroup analysis, the rates of initiation of anticoagulation therapy on the basis of TEE investigation did not differ (p = 0.315) among patients with cryptogenic stroke (6.9% [95% CI: 4.9%-9.6%]), ESUS (8.1% [95% CI: 3.4%-18.1%]), and IS (9.4% [95% CI: 7.5%-11.8%]). Abnormal TEE findings may decisively affect the selection of appropriate therapeutic strategy in approximately 1 of 7 patients with ESUS. © 2016 American Academy of Neurology.

Simultaneous Validation of Seven Physical Activity Questionnaires Used in Japanese Cohorts for Estimating Energy Expenditure: A Doubly Labeled Water Study.

PubMed

Sasai, Hiroyuki; Nakata, Yoshio; Murakami, Haruka; Kawakami, Ryoko; Nakae, Satoshi; Tanaka, Shigeho; Ishikawa-Takata, Kazuko; Yamada, Yosuke; Miyachi, Motohiko

2018-04-28

Physical activity questionnaires (PAQs) used in large-scale Japanese cohorts have rarely been simultaneously validated against the gold standard doubly labeled water (DLW) method. This study examined the validity of seven PAQs used in Japan for estimating energy expenditure against the DLW method. Twenty healthy Japanese adults (9 men; mean age, 32.4 [standard deviation {SD}, 9.4] years, mainly researchers and students) participated in this study. Fifteen-day daily total energy expenditure (TEE) and basal metabolic rate (BMR) were measured using the DLW method and a metabolic chamber, respectively. Activity energy expenditure (AEE) was calculated as TEE - BMR - 0.1 × TEE. Seven PAQs were self-administered to estimate TEE and AEE. The mean measured values of TEE and AEE were 2,294 (SD, 318) kcal/day and 721 (SD, 161) kcal/day, respectively. All of the PAQs indicated moderate-to-strong correlations with the DLW method in TEE (rho = 0.57-0.84). Two PAQs (Japan Public Health Center Study [JPHC]-PAQ Short and JPHC-PAQ Long) showed significant equivalence in TEE and moderate intra-class correlation coefficients (ICC). None of the PAQs showed significantly equivalent AEE estimates, with differences ranging from -547 to 77 kcal/day. Correlations and ICCs in AEE were mostly weak or fair (rho = 0.02-0.54, and ICC = 0.00-0.44). Only JPHC-PAQ Short provided significant and fair agreement with the DLW method. TEE estimated by the PAQs showed moderate or strong correlations with the results of DLW. Two PAQs showed equivalent TEE and moderate agreement. None of the PAQs showed equivalent AEE estimation to the gold standard, with weak-to-fair correlations and agreements. Further studies with larger sample sizes are needed to confirm these findings.

Probing electron delays in above-threshold ionization

DOE PAGES

Zipp, Lucas J.; Natan, Adi; Bucksbaum, Philip H.

2014-11-21

Recent experiments have revealed attosecond delays in the emission of electrons from atoms ionized by extreme UV light, offering a glimpse into the ultrafast nature of light-induced electron dynamics. In this work, we extend these measurements to the strong-field above-threshold ionization (ATI) regime, by measuring delays in the photoemission of electrons from argon in the presence of an intense laser field. We probe the ATI process with a weak coherent reference, at half the laser frequency. The interfering ionization signal reveals the relative spectral phase of adjacent ATI channels, with an equivalent resolution of a few attoseconds. These relative delaysmore » depend on the strong field, and approach zero at higher intensity. Our phase measurements of ATI electrons show how strong fields alter ionization dynamics in atoms.« less

Obstructed bi-leaflet prosthetic mitral valve imaging with real-time three-dimensional transesophageal echocardiography.

PubMed

Shimbo, Mai; Watanabe, Hiroyuki; Kimura, Shunsuke; Terada, Mai; Iino, Takako; Iino, Kenji; Ito, Hiroshi

2015-01-01

Real-time three-dimensional transesophageal echocardiography (RT3D-TEE) can provide unique visualization and better understanding of the relationship among cardiac structures. Here, we report the case of an 85-year-old woman with an obstructed mitral prosthetic valve diagnosed promptly by RT3D-TEE, which clearly showed a leaflet stuck in the closed position. The opening and closing angles of the valve leaflets measured by RT3D-TEE were compatible with those measured by fluoroscopy. Moreover, RT3D-TEE revealed, in the ring of the prosthetic valve, thrombi that were not visible on fluoroscopy. RT3D-TEE might be a valuable diagnostic technique for prosthetic mitral valve thrombosis. © 2014 Wiley Periodicals, Inc.

Insights into the Mechanism of Severe Mitral Regurgitation: RT-3D TEE Guided Management with Pathological Correlation.

PubMed

Anand, Senthil; Hamoud, Naktal; Thompson, Jess; Janardhanan, Rajesh

2015-01-01

Mitral valve perforation is an uncommon but important complication of infective endocarditis. We report a case of a 65-year-old man who was diagnosed to have infective endocarditis of his mitral valve. Through the course of his admission he had a rapid development of hemodynamic instability and pulmonary edema secondary to acutely worsening mitral regurgitation. While the TEE demonstrated an increase in the size of his bacterial vegetation, Real Time 3D TEE was ultimately the imaging modality through which the valve perforation was identified. Through this case report we discuss the advantages that RT-3D TEE has over traditional 2D TEE in the management of valve perforation.

A modification of the trans-oesophageal echocardiography protocol can reduce post-operative dysphagia following cardiac surgery.

PubMed

Chin, J-H; Lee, E-H; Choi, D-K; Choi, I-C

2011-01-01

Use of intra-operative trans-oesophageal echocardiography (TEE) is an independent risk factor for post-operative dysphagia. This study investigated whether modifying the TEE probe-placement protocol could reduce the incidence of post-operative dysphagia. In group I (n = 100), the TEE probe was inserted after anaesthetic induction and remained in place until the completion of surgery. In group II (n = 100), the TEE probe was inserted after anaesthetic induction, the heart was examined, then the probe was removed. The probe was inserted again before weaning from cardiopulmonary bypass and then immediately removed after examination. The incidence of dysphagia was significantly higher in group I than in group II patients (51.1% versus 28.6%). Multivariate regression analysis showed that the length of time that the TEE probe was in the oesophagus was an independent predictor of dysphagia. Modification of the TEE protocol in this way can reduce the incidence of post-operative dysphagia in cardiac surgery patients.

ATIS evaluation framework

DOT National Transportation Integrated Search

2005-04-01

This report documents the results of a series of ITS project evaluations performed for the Washington State Department of Transportation (WSDOT). Five Washington state advanced traveler information system (ATIS) projects selected for federal ITS fund...

Transcranial Doppler and transesophageal echocardiography: comparison of both techniques and prospective clinical relevance of transcranial Doppler in patent foramen ovale detection.

PubMed

Caputi, Luigi; Carriero, Maria Rita; Falcone, Chiara; Parati, Eugenio; Piotti, Patrizia; Materazzo, Carlo; Anzola, Gian Paolo

2009-01-01

Patent foramen ovale (PFO) has been investigated in several conditions apart from cryptogenic ischemic stroke. Contrast transesophageal echocardiography (cTEE) is the gold standard for the diagnosis, although it has some known limitations. Contrast transcranial Doppler (cTCD) allows a semiquantitative estimation of right-to-left shunt (RLS) volume. The aims of our study were to confirm the diagnostic accuracy of cTCD in PFO diagnosis and to compare the abilities of cTCD and cTEE to detect a RLS and PFO, respectively, under normal breathing. The latter could represent an important feature for its clinical significance. A total of 100 consecutive patients (59 women and 41 men, age 46 +/- 12 years) were evaluated after stabilized ischemic stroke/transient ischemic attack, migraine, and lacunae, and before neurosurgery in sitting position. All patients undertook cTEE and cTCD, at rest and under Valsalva maneuver (VM). cTEE under VM was the reference standard. A categorization of patients and a semiquantitative cTCD classification were proposed. In all, 63 of 100 patients had PFO diagnosed by cTEE. A general concordance of up to 90% between both techniques was found. cTCD sensitivity and specificity were 96.8% and 78.4%, respectively. In 17 of 100 patients with cTEE-proven PFO under VM, cTCD and cTEE detected RLS at rest in 75% (95% confidence interval [CI] 62%-85%) and 48% (95% CI 35%-61%) of cases, respectively (P < .001). cTEE disclosed RLS at rest in about 71% (95% CI 9%-42%) of cTCDs showing a "shower-curtain" pattern and only in about 22% (95% CI 52%-85%) of those cTCDs without that pattern. In diagnosing PFO, cTCD has a good accuracy compared with cTEE. To detect a RLS at rest, cTCD appears to be more sensitive than cTEE. The latter resulted positive under normal breathing, mostly in cases of significant RLS at cTCD. Our results point out the impact of cTCD in the evaluation of RLS volume, thus aiding, in association with the anatomic details by cTEE, in the prevention of the occurrence or recurrence of paradoxical embolism in individuals with and without cerebrovascular diseases. The combination of cTEE and cTCD could be considered the real gold standard for PFO in the near future.

Longitudinal change in energy expenditure and effects on energy requirements of the elderly

PubMed Central

2013-01-01

Background Very little is known about the longitudinal changes in energy requirements in late life. The purposes of this study were to: (1) determine the energy requirements in late life and how they changed during a 7 year time-span, (2) determine whether changes in fat free mass (FFM) were related to changes in resting metabolic rate (RMR), and (3) determine the accuracy of predicted total energy expenditure (TEE) to measured TEE. Methods TEE was assessed via doubly labeled water (DLW) technique in older adults in both 1999 (n = 302; age: 74 ± 2.9 yrs) and again in 2006 (n = 87 age: 82 ± 3.1 yrs). RMR was measured with indirect calorimetry, and body composition was assessed with dual-energy x-ray absorptiometry. Results The energy requirements in the 9th decade of life were 2208 ± 376 kcal/d for men and 1814 ± 337 kcal/d for women. This was a significant decrease from the energy requirements in the 8th decade of life in men (2482 ± 476 kcal/d vs. 2208 ± 376 kcal/d) but not in women (1892 ± 271 kcal/d vs. 1814 ± 337 kcal/d). In addition to TEE, RMR, and activity EE (AEE) also decreased in men, but not women, while FFM decreased in both men and women. The changes in FFM were correlated with changes in RMR for men (r = 0.49, p < 0.05) but not for women (r = −0.08, ns). Measured TEE was similar to Dietary Reference Intake (DRI) predicted TEE for men (2208 ± 56 vs. 2305 ± 35 kcal/d) and women (1814 ± 42 vs. 1781 ± 20 kcal/d). However, measured TEE was different than the World Health Organization (WHO) predicted TEE in men (2208 ± 56 vs. 2915 ± 31 kcal/d (p < 0.05)) and women (1814 ± 42 vs. 2315 ± 21 kcal/d (p < 0.05)). Conclusions TEE, RMR and AEE decreased in men, but not women, from the 8th to 9th decade of life. The DRI equation to predict TEE was comparable to measured TEE, while the WHO equation over-predicted TEE in our elderly population. PMID:23742706

[Usefullness of transesophageal echocardiography in early detection of coronary spasm].

PubMed

Sagara, M; Haraguchi, M; Hamu, Y; Isowaki, S; Yoshimura, N

1996-04-01

Intraoperative transesophageal echocardiography (TEE) was performed on a 62-year-old man who underwent abdominal aortic replacement for abdominal aortic aneurysm under general anesthesia combined with epidural anesthesia. Coronary artery spasm occurred after unexpected massive hemorrhage, and TEE showed hypokinesis in the posterior-inferior left ventricular wall. The changes in TEE preceded the ST elevation in the ECG. Bolus infusion of isosorbide dinitrate and continuous infusion of nitroglycerin alleviated these changes. TEE enabled us to detect and evaluate coronary spasm before the appearance of ST changes in ECG.

Energy demand in patients with stroke who are sedated and receiving mechanical ventilation.

PubMed

Bardutzky, Juergen; Georgiadis, Dimitrios; Kollmar, Rainer; Schwarz, Stefan; Schwab, Stefan

2004-02-01

The purpose of this study was 1) to determine the total energy expenditure (TEE) in patients with acute stroke who are sedated and receiving mechanical ventilation; and 2) to compare the TEE between patients with ischemic and hemorrhagic stroke. Thirty-four consecutive nonseptic patients with stroke requiring sedation and mechanical ventilation were prospectively examined; 13 of the patients had experienced spontaneous intracerebral hemorrhage and 21 cerebral ischemia of the middle cerebral artery territory. The TEE was evaluated using continuous indirect calorimetry during the first 5 days after admission to the intensive care unit. The serum albumin concentration was determined on admission and on Day 5. The TEE varied from 1560 +/- 240 to 1623 +/- 251 kcal/day. A highly significant correlation between the TEE and the basal energy expenditure (BEE), as predicted using the Harris-Benedict equation, was observed in both groups. No significant differences in the TEE were detected between the two groups or among the different study days. A highly significant correlation was found between the TEE and the predicted BEE in patients with acute stroke who have been sedated and have received mechanical ventilation. No significant differences were observed between patients with hemorrhagic and ischemic stroke. Further studies are needed to evaluate the effect of tailored feeding on clinical outcome in these patients.

Murine and Human Tissue-Engineered Esophagus Form from Sufficient Stem/Progenitor Cells and Do Not Require Microdesigned Biomaterials

PubMed Central

Spurrier, Ryan Gregory; Speer, Allison L.; Hou, Xiaogang; El-Nachef, Wael N.

2015-01-01

Purpose: Tissue-engineered esophagus (TEE) may serve as a therapeutic replacement for absent foregut. Most prior esophagus studies have favored microdesigned biomaterials and yielded epithelial growth alone. None have generated human TEE with mesenchymal components. We hypothesized that sufficient progenitor cells might only require basic support for successful generation of murine and human TEE. Materials and Methods: Esophageal organoid units (EOUs) were isolated from murine or human esophagi and implanted on a polyglycolic acid/poly-l-lactic acid collagen-coated scaffold in adult allogeneic or immune-deficient mice. Alternatively, EOU were cultured for 10 days in vitro prior to implantation. Results: TEE recapitulated all key components of native esophagus with an epithelium and subjacent muscularis. Differentiated suprabasal and proliferative basal layers of esophageal epithelium, muscle, and nerve were identified. Lineage tracing demonstrated that multiple EOU could contribute to the epithelium and mesenchyme of a single TEE. Cultured murine EOU grew as an expanding sphere of proliferative basal cells on a neuromuscular network that demonstrated spontaneous peristalsis in culture. Subsequently, cultured EOU generated TEE. Conclusions: TEE forms after transplantation of mouse and human organ-specific stem/progenitor cells in vivo on a relatively simple biodegradable scaffold. This is a first step toward future human therapies. PMID:25298083

[Clinical research on the application of trans-esophageal echocardiography in monitoring Nuss surgery].

PubMed

Mou, Ling; Xu, Bing; Lan, Zhixun

2015-04-01

To investigate the validity and safety of trans-esophageal echocardiography (TEE) in monitoring of Nuss surgery. A total of 140 patients with pectus excavatum from Sichuan Provincial People's Hospital underwent Nuss surgery from August, 2011 to Aμgust, 2013. Among them, 72 patients received TEE monitoring while 68 patients didn't. The injury of heart and large vessels by the introducer and Nuss steel bar was observed by intraoperative TEE monitoring under middle-esophageal four chamber view and middle-esophageal aortic short axis view. The operation in all patients had been performed successfully without any severe complications. Satisfactory TEE images were obtained in all patients. The procedure of inserting the inducer and Nuss steel bar behind sternum and steel bar overturn could be seen clearly. No injury in heart and large vessels was detected. Local streak-like hemorrhage in 3 patients was observed under intra-operative TEE screen, but no further new bleeding was found in postoperative TEE examination. The blood was absorbed and couldn't see under trans-thoracic echocardiography in 1 month after the operation. The TEE is a non-invasive monitoring method. It is sensitive to detect the status of the heart and large vessels and can prevent the severe complications due to Nuss surgery.

Effect of analytical treatment interruption and reinitiation of antiretroviral therapy on HIV reservoirs and immunologic parameters in infected individuals.

PubMed

Clarridge, Katherine E; Blazkova, Jana; Einkauf, Kevin; Petrone, Mary; Refsland, Eric W; Justement, J Shawn; Shi, Victoria; Huiting, Erin D; Seamon, Catherine A; Lee, Guinevere Q; Yu, Xu G; Moir, Susan; Sneller, Michael C; Lichterfeld, Mathias; Chun, Tae-Wook

2018-01-01

Therapeutic strategies aimed at achieving antiretroviral therapy (ART)-free HIV remission in infected individuals are under active investigation. Considering the vast majority of HIV-infected individuals experience plasma viral rebound upon cessation of therapy, clinical trials evaluating the efficacy of curative strategies would likely require inclusion of ART interruption. However, it is unclear what impact short-term analytical treatment interruption (ATI) and subsequent reinitiation of ART have on immunologic and virologic parameters of HIV-infected individuals. Here, we show a significant increase of HIV burden in the CD4+ T cells of infected individuals during ATI that was correlated with the level of plasma viral rebound. However, the size of the HIV reservoirs as well as immune parameters, including markers of exhaustion and activation, returned to pre-ATI levels 6-12 months after the study participants resumed ART. Of note, the proportions of near full-length, genome-intact and structurally defective HIV proviral DNA sequences were similar prior to ATI and following reinitiation of ART. In addition, there was no evidence of emergence of antiretroviral drug resistance mutations within intact HIV proviral DNA sequences following reinitiation of ART. These data demonstrate that short-term ATI does not necessarily lead to expansion of the persistent HIV reservoir nor irreparable damages to the immune system in the peripheral blood, warranting the inclusion of ATI in future clinical trials evaluating curative strategies.

Effect of analytical treatment interruption and reinitiation of antiretroviral therapy on HIV reservoirs and immunologic parameters in infected individuals

PubMed Central

Petrone, Mary; Justement, J. Shawn; Shi, Victoria; Huiting, Erin D.; Yu, Xu G.; Moir, Susan; Sneller, Michael C.; Lichterfeld, Mathias

2018-01-01

Therapeutic strategies aimed at achieving antiretroviral therapy (ART)-free HIV remission in infected individuals are under active investigation. Considering the vast majority of HIV-infected individuals experience plasma viral rebound upon cessation of therapy, clinical trials evaluating the efficacy of curative strategies would likely require inclusion of ART interruption. However, it is unclear what impact short-term analytical treatment interruption (ATI) and subsequent reinitiation of ART have on immunologic and virologic parameters of HIV-infected individuals. Here, we show a significant increase of HIV burden in the CD4+ T cells of infected individuals during ATI that was correlated with the level of plasma viral rebound. However, the size of the HIV reservoirs as well as immune parameters, including markers of exhaustion and activation, returned to pre-ATI levels 6–12 months after the study participants resumed ART. Of note, the proportions of near full-length, genome-intact and structurally defective HIV proviral DNA sequences were similar prior to ATI and following reinitiation of ART. In addition, there was no evidence of emergence of antiretroviral drug resistance mutations within intact HIV proviral DNA sequences following reinitiation of ART. These data demonstrate that short-term ATI does not necessarily lead to expansion of the persistent HIV reservoir nor irreparable damages to the immune system in the peripheral blood, warranting the inclusion of ATI in future clinical trials evaluating curative strategies. PMID:29324842

An Empirical Study of the Impact of the Air Transportation Industry Energy Conservation and Emission Reduction Projects on the Local Economy in China.

PubMed

Chen, Yuxiu; Yu, Jian; Li, Li; Li, Linlin; Li, Long; Zhou, Jie; Tsai, Sang-Bing; Chen, Quan

2018-04-20

Green development has been of particular interest to a range of industries worldwide, one of which being the air transportation industry (ATI). The energy conservation and emission reduction (ECER) projects of the ATI have a huge impact on the local economy. In this study, the input-output method was used to analyze the indirect economic impact of the implementation of the ECER projects of the ATI on the local economy of the Beijing-Tianjin-Hebei (BTH) region. We examined the direct benefits, backward spread effects, forward spread effects, and consumption multiplier effects. The final results showed that the comprehensive economic income from 2011⁻2013 in the BTH region reached RMB 4.74 billion. The results revealed that the ECER projects commissioned by the ATI were worth investing from both the economic and social benefits perspectives. To increase the green development effects and promote the sustainable development of the ATI, the special funds provided by the Civil Aviation Administration of China should be invested intensively in basic green technology research and setting green regulating and governance rules.

An Empirical Study of the Impact of the Air Transportation Industry Energy Conservation and Emission Reduction Projects on the Local Economy in China

PubMed Central

Chen, Yuxiu; Yu, Jian; Li, Li; Li, Linlin; Li, Long; Zhou, Jie; Chen, Quan

2018-01-01

Green development has been of particular interest to a range of industries worldwide, one of which being the air transportation industry (ATI). The energy conservation and emission reduction (ECER) projects of the ATI have a huge impact on the local economy. In this study, the input-output method was used to analyze the indirect economic impact of the implementation of the ECER projects of the ATI on the local economy of the Beijing-Tianjin-Hebei (BTH) region. We examined the direct benefits, backward spread effects, forward spread effects, and consumption multiplier effects. The final results showed that the comprehensive economic income from 2011–2013 in the BTH region reached RMB 4.74 billion. The results revealed that the ECER projects commissioned by the ATI were worth investing from both the economic and social benefits perspectives. To increase the green development effects and promote the sustainable development of the ATI, the special funds provided by the Civil Aviation Administration of China should be invested intensively in basic green technology research and setting green regulating and governance rules. PMID:29677160

Methotrexate Reduced TNF Bioactivity in Rheumatoid Arthritis Patients Treated with Infliximab

PubMed Central

Rinaudo-Gaujous, Mélanie; Thomas, Thierry

2017-01-01

Objectives. To evaluate methotrexate effect on tumor necrosis factor (TNF) alpha bioactivity during infliximab (IFX) therapy in rheumatoid arthritis (RA) patients and to correlate TNF bioactivity with antibody towards IFX (ATI) development and RA clinical response. Materials and Methods. Thirty-nine active women RA patients despite conventional synthetic disease modifying antirheumatic drugs (csDMARDs) requiring IFX therapy were enrolled, and clinical data and blood samples were recorded at baseline (W0) and at 6 weeks (W6), W22, and W54 of IFX treatment. TNF bioactivity as well as IFX trough and ATI concentrations were assessed on blood samples. Results. TNF bioactivity decreased from W0 to W54 with a large range from W22 at the time of ATI detection. From W22, TNF bioactivity was lower in presence of methotrexate as csDMARD compared to other csDMARDs. IFX trough concentration increased from W0 to W54 with a large range from W22, similarly to TNF bioactivity. Methotrexate therapy prevented ATI presence at W22 and reduced TNF bioactivity compared to other csDMARDs (p = 0.002). Conclusion. This suggests that methotrexate plays a key role in TNF bioactivity and against ATI development. PMID:28352145

Patent foramen ovale: comparison among diagnostic strategies in cryptogenic stroke and migraine.

PubMed

Zito, Concetta; Dattilo, Giuseppe; Oreto, Giuseppe; Di Bella, Gianluca; Lamari, Annalisa; Iudicello, Raffaella; Trio, Olimpia; Caracciolo, Giuseppe; Coglitore, Sebastiano; Arrigo, Francesco; Carerj, Scipione

2009-05-01

The aim of this study was to compare transthoracic echocardiography (TTE) and transcranial Doppler ultrasonography (TCD) with transesophageal echocardiography (TEE) in order to define the best clinical approach to patent foramen ovale (PFO) detection. In total, 72 consecutive patients (33 men) with a mean age of 49 +/- 13 years were prospectively enrolled. The TEE indication was cryptogenic stroke (36 patients) or migraine (36 patients, 22 with aura). All patients underwent standard TTE, TCD, and TEE examination. For any study, a contrast test was carried on using an agitated saline solution mixed with urea-linked gelatine (Haemaccel), injected as a rapid bolus via a right antecubital vein. A prolonged Valsalva maneuver was performed to improve test sensitivity. TEE identified a PFO in 65% of the whole population: 56.5% in the migraine cohort and 43.5% in the cryptogenic stroke cohort. TTE was able to detect a PFO in 55% of patients positive at TEE (54% negative predictive value, 100% positive predictive value, 55% sensitivity, and 100% specificity). TCD was able to identify a PFO in 97% of patients positive at TEE (89% negative predictive value, 98% positive predictive value, 94% sensitivity, and 96% specificity). In patients with cryptogenic stroke and migraine, there is a fair concordance (k = 0.89) between TCD and TEE in PFO recognition. Accordingly, TCD should be recommended as a simple, noninvasive, and reliable technique, whereas TEE indication should be restricted to selected patients. TTE is a very specific technique, whose major advantage is the ability to detect a large right-to-left shunt, particularly if associated with an atrial septal aneurysm.

Transcranial doppler ultrasonography should it be the first choice for persistent foramen ovale screening?

PubMed Central

2014-01-01

Background Persistent foramen ovale (PFO) is considered a cause of cryptogenic stroke and a risk factor for neurological events in young patients. The reference standard for identifying a PFO is contrast-enhanced transesophageal echocardiography (TEE). The goal of this study was to evaluate the feasibility of transcranial color Doppler (TCD) and its diagnostic sensitivity compared with TEE. Methods We investigated 420 patients admitted to our department with cryptogenic stroke, transient ischemic attacks or other neurological symptoms. All patients underwent TCD and TEE evaluation. TCD and TEE examinations were performed according to a standardized procedure: air-mixed saline was injected into the right antecubital vein three times, while the Doppler signal was recorded during the Valsalva maneuver. During TCD the passage of contrast into the right-middle cerebral artery was recorded 25 seconds following the Valsalva maneuver. Results We detected a right-to-left shunt in 220 patients (52.3%) and no-shunts in 159 patients (37.9%) with both TCD and TEE. In 20 (4.8%) patients TEE did not reveal contrast passage which was then detected by TCD. In 21 (5.0%) patients only TEE revealed a PFO. The feasibility of both methods was 100%. TCD had a sensitivity of 95% and a specificity of 92% in the diagnosis of PFO. Conclusions TCD has a relatively good sensitivity and specificity. TCD and TEE are complementary diagnostic tests for PFO, but TCD should be recommended as the first choice for screening because of its simplicity, non-invasive character, low cost and high feasibility. PMID:24884981

Evaluation of Synthetic Automatic Terminal Information Services (ATIS) Messages

DOT National Transportation Integrated Search

1995-04-01

This report describes an evaluation of the effectivenss of synthetic voice : Automatic Terminal Information Service (ATIS) messages in a simulated : environment. The evaluation was conducted by ARINC and CTA, Incorporated, for : the Federal Aviation ...

Assessing Open-Ended Design Problems

ERIC Educational Resources Information Center

Bartholomew, Scott R.

2017-01-01

Interest in Technology and Engineering Education (TEE) has recently revolved around working to define/redefine who we are, and who we are not; while others in TEE are not interested in a change of identity. An emphasis on design, design education, and design assessment may help clarify the discussion surrounding the future direction of TEE.…

Lycopersicon esculentum Extract Enhances Cognitive Function and Hippocampal Neurogenesis in Aged Mice

PubMed Central

Bae, Jung-Soo; Han, Mira; Shin, Hee Soon; Shon, Dong-Hwa; Lee, Soon-Tae; Shin, Chang-Yup; Lee, Yuri; Lee, Dong Hun; Chung, Jin Ho

2016-01-01

A decrease in adult neurogenesis is associated with the aging process, and this decrease is closely related to memory impairment. Tomato (Lycopersicon esculentum) is a fruit with diverse bioactive nutrients that is consumed worldwide. In this study, we investigated the cognition-enhancing effect of tomato ethanolic extracts (TEE) in aged mice. Six weeks of oral TEE administration in 12-month-old aged mice significantly increased their exploration time of novel objects when compared to vehicle-treated mice. The TEE supplement increased doublecortin (DCX)-positive cells and postsynaptic density-95 (PSD95) expression in mice hippocampus. Moreover, we found an increased expression of brain-derived neurotrophic factor (BDNF) and subsequently-activated extracellular-signal-regulated kinase (ERK)/cAMP response element binding (CREB) signaling pathway in the TEE-supplemented mice hippocampus. In conclusion, the oral administration of TEE exhibits a cognition-enhancing effect, and the putative underlying mechanism is the induction of BDNF signaling-mediated proliferation and synapse formation in the hippocampus. These findings indicate that TEE could be a candidate for treatment of age-related memory impairment and neurodegenerative disorders. PMID:27792185

Lycopersicon esculentum Extract Enhances Cognitive Function and Hippocampal Neurogenesis in Aged Mice.

PubMed

Bae, Jung-Soo; Han, Mira; Shin, Hee Soon; Shon, Dong-Hwa; Lee, Soon-Tae; Shin, Chang-Yup; Lee, Yuri; Lee, Dong Hun; Chung, Jin Ho

2016-10-26

A decrease in adult neurogenesis is associated with the aging process, and this decrease is closely related to memory impairment. Tomato ( Lycopersicon esculentum ) is a fruit with diverse bioactive nutrients that is consumed worldwide. In this study, we investigated the cognition-enhancing effect of tomato ethanolic extracts (TEE) in aged mice. Six weeks of oral TEE administration in 12-month-old aged mice significantly increased their exploration time of novel objects when compared to vehicle-treated mice. The TEE supplement increased doublecortin (DCX)-positive cells and postsynaptic density-95 (PSD95) expression in mice hippocampus. Moreover, we found an increased expression of brain-derived neurotrophic factor (BDNF) and subsequently-activated extracellular-signal-regulated kinase (ERK)/cAMP response element binding (CREB) signaling pathway in the TEE-supplemented mice hippocampus. In conclusion, the oral administration of TEE exhibits a cognition-enhancing effect, and the putative underlying mechanism is the induction of BDNF signaling-mediated proliferation and synapse formation in the hippocampus. These findings indicate that TEE could be a candidate for treatment of age-related memory impairment and neurodegenerative disorders.

Transoesophageal echocardiography in the dog.

PubMed

Domenech, Oriol; Oliveira, Pedro

2013-11-01

Transoesophageal echocardiography (TEE) allows imaging of the heart through the oesophagus using a special transducer mounted on a modified endoscope. The proximity to the heart and minimal intervening structures enables the acquisition of high-resolution images that are consistently superior to routine transthoracic echocardiography and optimal imaging of the heart base anatomy and related structures. TEE provides high-quality real-time imaging free of ionizing radiation, making it an ideal instrument not only for diagnostic purposes, but also for monitoring surgical or minimally invasive cardiac procedures, non-cardiac procedures and critical cases in the intensive care unit. In human medicine, TEE is routinely used in these settings. In veterinary medicine, TEE is increasingly used in referral centres, especially for perioperative assessment and guidance of catheter-based cardiovascular procedures, such as patent ductus arteriosus, balloon valvuloplasty, and atrial and ventricular septal defect occlusion with vascular devices. TEE can also aid in heartworm retrieval procedures. The purpose of this paper is to review the current uses of TEE in veterinary medicine, focusing on technique, indications and complications. Copyright © 2013 Elsevier Ltd. All rights reserved.

The value of real-time three-dimensional transesophageal echocardiography in the assessment of paravalvular leak origin following prosthetic mitral valve replacement.

PubMed

Yildiz, Mustafa; Duran, Nilüfer Ekşi; Gökdeniz, Tayyar; Kaya, Hasan; Ozkan, Mehmet

2009-09-01

Two-dimensional (2D) echocardiographic approaches are not sufficient to determine the origin of paravalvular leak (PVL) that occurs after prosthetic mitral valve replacement (MVR). In this study, we investigated the role of real-time three-dimensional transesophageal echocardiography (RT-3D TEE) in detecting the origin and size of PVL occurring after prosthetic MVR. The study included 13 patients (7 females; 6 males; mean age 56+/-10 years; range 37 to 71 years) who developed PVL within a mean of 8.3+/-3.8 years following mechanical prosthetic MVR. Nine patients (69.2%) had atrial fibrillation, and four patients (30.8%) had normal sinus rhythm. Four patients (30.8%) had hemolysis. Paravalvular leak was mild, moderate, and severe in two, six, and five patients, respectively. Real-time 3D TEE was performed using a 3D matrix-array TEE transducer immediately after detection of PVL on 2D TEE examination. Localization of PVL was made using a clock-wise format in relation to the aortic valve and the size of dehiscence was measured. The mean PVL width measured by 2D TEE was 3.00+/-0.92 mm. The mean length of dehiscence was 13.6+/-8.8 mm, and the mean width was 3.88+/-2.04 mm on RT-3D TEE. The PVLs were mainly localized in the posterior and anterior annular positions between 12 to 03 hours (n=7) and 06 to 09 hours (n=3) on RT-3D TEE, respectively, which corresponded to the posteromedial or anterolateral sectors of the posterior annulus. Considering that only the width of the PVL defect can be assessed by 2D TEE, delineation by RT-3D TEE includes the localization of PVL together with the length and width of the defect.

Transesophageal Speckle-Tracking Echocardiography Improves Right Ventricular Systolic Function Assessment in the Perioperative Setting.

PubMed

Markin, Nicholas W; Chamsi-Pasha, Mohammed; Luo, Jiangtao; Thomas, Walker R; Brakke, Tara R; Porter, Thomas R; Shillcutt, Sasha K

2017-02-01

Perioperative evaluation of right ventricular (RV) systolic function is important to follow intraoperative changes, but it is often not possible to assess with transthoracic echocardiographic (TTE) imaging, because of surgical field constraints. Echocardiographic RV quantification is most commonly performed using tricuspid annular plane systolic excursion (TAPSE), but it is not clear whether this method works with transesophageal echocardiographic (TEE) imaging. This study was performed to evaluate the relationship between TTE and TEE TAPSE distances measured with M-mode imaging and in comparison with speckle-tracking TTE and TEE measurements. Prospective observational TTE and TEE imaging was performed during elective cardiac surgical procedures in 100 subjects. Speckle-tracking echocardiographic TAPSE distances were determined and compared with the TTE M-mode TAPSE standard. Both an experienced and an inexperienced user of the speckle-tracking echocardiographic software evaluated the images, to enable interobserver assessment in 84 subjects. The comparison between TTE M-mode TAPSE and TEE M-mode TAPSE demonstrated significant variability, with a Spearman correlation of 0.5 and a mean variance in measurement of 6.5 mm. There was equivalence within data pairs and correlations between TTE M-mode TAPSE and both speckle-tracking TTE and speckle-tracking TEE TAPSE, with Spearman correlations of 0.65 and 0.65, respectively. The average variance in measurement was 0.6 mm for speckle-tracking TTE TAPSE and 1.5 mm for speckle-tracking TEE TAPSE. Using TTE M-mode TAPSE as a control, TEE M-mode TAPSE results are not accurate and should not be used clinically to evaluate RV systolic function. The relationship between speckle-tracking echocardiographic TAPSE and TTE M-mode TAPSE suggests that in the perioperative setting, speckle-tracking TEE TAPSE might be used to quantitatively evaluate RV systolic function in the absence of TTE imaging. Copyright © 2016 American Society of Echocardiography. Published by Elsevier Inc. All rights reserved.

Aortic valve type and calcification as assessed by transthoracic and transoesophageal echocardiography.

PubMed

Yousry, Mohamed; Rickenlund, Anette; Petrini, Johan; Jenner, Jonas; Liska, Jan; Eriksson, Per; Franco-Cereceda, Anders; Eriksson, Maria J; Caidahl, Kenneth

2015-07-01

Aortic valve calcification (AVC) may predict poor outcome. Bicuspid aortic valve (BAV) leads to several haemodynamic changes accelerating the progress of aortic valve (AV) disease. To compare the diagnostic accuracy of transoesophageal echocardiography (TEE) and transthoracic echocardiography (TTE) in the assessment of aortic valve phenotype and degree of AVC, with intra-operative evaluation as a reference. We examined 169 patients (median age 65 years, 51 women) without significant coronary artery disease undergoing AV and/or aortic root surgery. TTE was performed within a week prior to surgery and TEE at the time of surgery. Compared with surgical AVC assessment, visual evaluation using a 5-grade scoring system and real-time images showed a higher correlation (TTE r = 0·83 and TEE r = 0·82) than visual (TTE r = 0·64 and TEE 0·63) or grey scale mean (GSMn) (TTE r = 0·63 and TEE r = 0·52) assessment of end-diastolic still frames. AVC assessment using real-time images showed high intraclass correlation coefficients (TTE 0·94 and TEE 0·93). With regard to BAV, TEE was superior to TTE with a higher interobserver agreement, sensitivity and specificity (0·86, 92% and 94% versus 0·57, 77% and 82%, respectively). Semi-quantitative AVC assessment of real-time cine loops from both TEE and TTE correlated well with intra-operative evaluation of AVC. Applying a predefined scoring system for AVC evaluation assures a high interobserver correlation. TEE was superior to TTE for evaluation of valve phenotype and should be considered when a diagnosis of BAV is clinically important. © 2014 The Authors. Clinical Physiology and Functional Imaging published by John Wiley & Sons Ltd on behalf of Scandinavian Society of Clinical Physiology and Nuclear Medicine.

The analgesic effects of intrathecal xylazine and detomidine in sheep and their antagonism with systemic atipamezole.

PubMed

Christina Haerdi-Landerer, M; Schlegel, Urs; Neiger-Aeschbacher, Gina

2005-09-01

To evaluate the analgesic and adverse side effects of intrathecal (IT) xylazine (XYL) and detomidine (DET) and the subsequent effects of two doses of intravenous (IV) atipamezole (ATI). Prospective, randomized, cross-over. Five adult healthy female sheep with mean body mass of 55 +/- 2.3 kg. Material and methods Each sheep underwent four treatments: 1) 50 microg kg(-1) XYL IT and 5 microg kg(-1) ATI IV, 2) 50 microg kg(-1) XYL IT and 2.5 microg kg(-1) ATI IV, 3) 10 microg kg(-1) DET IT and 5 microg kg(-1) ATI IV, 4) 10 microg kg(-1) DET IT and 2.5 microg kg(-1) ATI IV. Pain threshold (TH) was tested by applying pulsed and stepwise incremental direct current to the skin overlying the pastern. The current at the point of foot lift was recorded as the TH. Heart rate (HR), mean arterial pressure, arterial oxygen (PO(2)) and carbon dioxide (PCO(2)) tensions were monitored. Outcomes were derived as differences between baseline assessment and measurements after treatment. Two-way anova was used to analyse drug effects, treatment differences between groups were examined with an F-test or Wilcoxon's rank sum test in case of non-parametric data distribution. p was set at 0.05. Both drugs increased the pain TH, caused small increases in PCO(2), and small decreases in HR, the latter was only significant for XYL recipients. Xylazine produced a significantly higher TH, more rapidly and for longer than DET. Atipamezole only significantly affected PaCO(2) in the XYL group 2. The pain TH was not affected in either group after IV ATI. At the doses used, IT XYL, and to a lesser extent DET, induced pastern analgesia. Atipamezole 5 microg kg(-1) IV antagonized some side effects without affecting analgesia. Intrathecal XYL may be useful as an analgesic in sheep. Its safety is increased because IV ATI antagonizes side effects, but not analgesia.

[Aneurysm of the atrial septum diagnosed by trans-esophageal echocardiography].

PubMed

Juszczyk, Z; Attir, A; Kamińska, M

1991-01-01

We report an uncommon case of atrial septal aneurysm associated with mitral valve prolapse. A 28 year old woman was studied with transthoracic and transesophageal echocardiography (TEE). Transthoracic echocardiography suggested mitral valve prolapse. TEE with color mapping was performed. Atrial septal aneurysm and mitral valve prolapse was found. The study has shown that TEE can evaluate accurately some of the anatomic features of atrial septal aneurysm and color flow mapping can provide accurate information about the blood flow in the lesion. We believe that TEE may be the safest and most accurate investigative technique for diagnosing this rare lesion.

Kinetics of Supercritical Water Oxidation. SERDP Compliance Technical Thrust Area

DTIC Science & Technology

1996-01-01

main stream velocity ratio (vj/ Vrx ) and jet-to-main stream diameter ratio) were different for the two tees. As a result, the "fast" tee was providing...Opposed-Flow Tee with no Inserts: Organic/Water Oxidant/Water Feed Feed Flow Conditions: vj (cm/s) 20-64 vj/ Vrx = 0.2-0.25 _ Rej =905-2920 To Reactor...Oxidant/Water Feed New Side-Entry Tee with 0.01" ID inserts: Organic/Water Feed Flow Conditions: vi (cm/s) 775-2,500 vj/ Vrx = 7.5-9.3 Rej =5,700-18,000

Metropolitan Model Deployment Initiative/ATIS Symposium : notes

DOT National Transportation Integrated Search

2000-02-01

The Symposium focuses on ATIS from the MMDIs investment in traveler information and integration. Infrastructure should be in place from the MMDIs for an interest in a regional multi-modal traveler information with the major arterials, freeways ...

ATIS and CVO development objectives and performance requirements

DOT National Transportation Integrated Search

1995-09-01

This report is one of a series of nine reports produced as part of a contract : designed to develop precise, detailed human factors design guidelines for : Advanced Traveler Information Systems (ATIS) and Commercial Vehicle Operations : (CVO). Among ...

Early Deployment Of Atms/Atis For Metropolitan Detroit, Final Report

DOT National Transportation Integrated Search

1994-09-26

TECHNOLOGY, ARCHITECTURE, CONTRACTING, AND DEPLOYMENT RECOMMENDATIONS RESULTING FROM THE STUDY ENABLE MDOT TO BEGIN SYSTEM DESIGN AND CONSTRUCTION. HOWEVER, IN ORDER TO DEMONSTRATE THE IMPLEMENTATION METHODS OF NEW ATMS/ATIS COMPONENTS AND SYSTEM ARC...

The area-time-integral technique to estimate convective rain volumes over areas applied to satellite data - A preliminary investigation

NASA Technical Reports Server (NTRS)

Doneaud, Andre A.; Miller, James R., Jr.; Johnson, L. Ronald; Vonder Haar, Thomas H.; Laybe, Patrick

1987-01-01

The use of the area-time-integral (ATI) technique, based only on satellite data, to estimate convective rain volume over a moving target is examined. The technique is based on the correlation between the radar echo area coverage integrated over the lifetime of the storm and the radar estimated rain volume. The processing of the GOES and radar data collected in 1981 is described. The radar and satellite parameters for six convective clusters from storm events occurring on June 12 and July 2, 1981 are analyzed and compared in terms of time steps and cluster lifetimes. Rain volume is calculated by first using the regression analysis to generate the regression equation used to obtain the ATI; the ATI versus rain volume relation is then employed to compute rain volume. The data reveal that the ATI technique using satellite data is applicable to the calculation of rain volume.

Alternative translation initiation of Caveolin-2 desensitizes insulin signaling through dephosphorylation of insulin receptor by PTP1B and causes insulin resistance.

PubMed

Kwon, Hayeong; Jang, Donghwan; Choi, Moonjeong; Lee, Jaewoong; Jeong, Kyuho; Pak, Yunbae

2018-06-01

Insulin resistance, defined as attenuated sensitivity responding to insulin, impairs insulin action. Direct causes and molecular mechanisms of insulin resistance have thus far remained elusive. Here we show that alternative translation initiation (ATI) of Caveolin-2 (Cav-2) regulates insulin sensitivity. Cav-2β isoform yielded by ATI desensitizes insulin receptor (IR) via dephosphorylation by protein-tyrosine phosphatase 1B (PTP1B), and subsequent endocytosis and lysosomal degradation of IR, causing insulin resistance. Blockage of Cav-2 ATI protects against insulin resistance by preventing Cav-2β-PTP1B-directed IR desensitization, thereby normalizing insulin sensitivity and glucose uptake. Our findings show that Cav-2β is a negative regulator of IR signaling, and identify a mechanism causing insulin resistance through control of insulin sensitivity via Cav-2 ATI. Copyright © 2018 Elsevier B.V. All rights reserved.

Comparison of total energy expenditure assessed by two devices in controlled and free-living conditions.

PubMed

Rousset, Sylvie; Fardet, Anthony; Lacomme, Philippe; Normand, Sylvie; Montaurier, Christophe; Boirie, Yves; Morio, Béatrice

2015-01-01

The objective of this study was to evaluate the validity of total energy expenditure (TEE) provided by Actiheart and Armband. Normal-weight adult volunteers wore both devices either for 17 hours in a calorimetric chamber (CC, n = 49) or for 10 days in free-living conditions (FLC) outside the laboratory (n = 41). The two devices and indirect calorimetry or doubly labelled water, respectively, were used to estimate TEE in the CC group and FLC group. In the CC, the relative value of TEE error was not significant (p > 0.05) for Actiheart but significantly different from zero for Armband, showing TEE underestimation (-4.9%, p < 0.0001). However, the mean absolute values of errors were significantly different between Actiheart and Armband: 8.6% and 6.7%, respectively (p = 0.05). Armband was more accurate for estimating TEE during sleeping, rest, recovery periods and sitting-standing. Actiheart provided better estimation during step and walking. In FLC, no significant error in relative value was detected. Nevertheless, Armband produced smaller errors in absolute value than Actiheart (8.6% vs. 12.8%). The distributions of differences were more scattered around the means, suggesting a higher inter-individual variability in TEE estimated by Actiheart than by Armband. Our results show that both monitors are appropriate for estimating TEE. Armband is more effective than Actiheart at the individual level for daily light-intensity activities.

A new HDL mimetic peptide that stimulates cellular cholesterol efflux with high efficiency greatly reduces atherosclerosis in mice

PubMed Central

Bielicki, John K.; Zhang, Haiyan; Cortez, Yuan; Zheng, Ying; Narayanaswami, Vasanthy; Patel, Arti; Johansson, Jan; Azhar, Salman

2010-01-01

Here, we report the creation of a single-helix peptide (ATI-5261) that stimulates cellular cholesterol efflux with Km molar efficiency approximating native apolipoproteins. Anti-atherosclerosis activity of ATI-5261 was evaluated in LDLR−/− and apolipoprotein (apo)E−/− mice ∼5–7 months of age, following 13–18 weeks on a high-fat Western diet (HFWD). Treatment of fat-fed LDLR−/− mice with daily intraperitoneal injections of ATI-5261 (30 mg/kg) for 6 weeks reduced atherosclerosis by 30%, as judged by lesion area covering the aorta (7.9 ± 2 vs.11.3 ± 2.5% control, P = 0.011) and lipid-content of aortic sinus plaque (25 ± 5.8 vs. 33 ± 4.9% control, P = 0.014). In apoE−/− mice, the peptide administered 30 mg/kg ip on alternate days for 6 weeks reduced atherosclerosis by ∼45% (lesion area = 15 ± 7 vs. 25 ± 8% control, P = 0.00016; plaque lipid-content = 20 ± 6 vs. 32 ± 8% control, P < 0.0001). Similar reductions in atherosclerosis were achieved using ATI-5261:POPC complexes. Single intraperitoneal injection of ATI-5261 increased reverse cholesterol transport from macrophage foam-cells to feces over 24–48 h. In summary, relatively short-term treatment of mice with the potent cholesterol efflux peptide ATI-5261 reduced substantial atherosclerosis. This was achieved using an L-amino acid peptide, in the presence of severe hypercholesterolemia/HFWD, and did not require daily injections or formulation with phospholipids when administered via intraperitoneal injection. PMID:20075422

TEES 2.2: Biomedical Event Extraction for Diverse Corpora

PubMed Central

2015-01-01

Background The Turku Event Extraction System (TEES) is a text mining program developed for the extraction of events, complex biomedical relationships, from scientific literature. Based on a graph-generation approach, the system detects events with the use of a rich feature set built via dependency parsing. The TEES system has achieved record performance in several of the shared tasks of its domain, and continues to be used in a variety of biomedical text mining tasks. Results The TEES system was quickly adapted to the BioNLP'13 Shared Task in order to provide a public baseline for derived systems. An automated approach was developed for learning the underlying annotation rules of event type, allowing immediate adaptation to the various subtasks, and leading to a first place in four out of eight tasks. The system for the automated learning of annotation rules is further enhanced in this paper to the point of requiring no manual adaptation to any of the BioNLP'13 tasks. Further, the scikit-learn machine learning library is integrated into the system, bringing a wide variety of machine learning methods usable with TEES in addition to the default SVM. A scikit-learn ensemble method is also used to analyze the importances of the features in the TEES feature sets. Conclusions The TEES system was introduced for the BioNLP'09 Shared Task and has since then demonstrated good performance in several other shared tasks. By applying the current TEES 2.2 system to multiple corpora from these past shared tasks an overarching analysis of the most promising methods and possible pitfalls in the evolving field of biomedical event extraction are presented. PMID:26551925

Differential transesophageal echocardiographic diagnosis between linear artifacts and intraluminal flap of aortic dissection or disruption.

PubMed

Vignon, P; Spencer, K T; Rambaud, G; Preux, P M; Krauss, D; Balasia, B; Lang, R M

2001-06-01

The relatively low specificity of transesophageal echocardiography (TEE) for the diagnosis of aortic dissection (AD) or traumatic disruption of the aorta (TDA) has been attributed to linear artifacts. We sought to determine the incidence of intra-aortic linear artifacts in a cohort of patients with suspected AD or TDA, to establish the differential TEE diagnostic criteria between these artifacts and true aortic flaps, and to evaluate their impact on TEE diagnostic accuracy. During an 8-year period, patients at high risk of AD (n = 261) or TDA (n = 90) who underwent a TEE study and had confirmed final diagnoses were studied. In an initial retrospective series, linear artifacts were observed within the ascending and descending aorta in 59 of 230 patients (26%) and 17 of 230 patients (7%), respectively. TEE findings associated with linear artifacts in the ascending aorta were as follows: displacement parallel to aortic walls; similar blood flow velocities on both sides; angle with the aortic wall > 85 degrees; and thickness > 2.5 mm. Diagnostic criteria of reverberant images in the descending aorta were as follows: displacement parallel to aortic walls, overimposition of blood flow, and similar blood flow velocities on both sides of the image. In a subsequent prospective series (n = 121), systematic use of these diagnostic criteria resulted in improved TEE specificity for the identification of true intra-aortic flaps. Misleading intra-aortic linear artifacts are frequently observed in patients undergoing a TEE study for suspected AD or TDA. Routine use of the herein-proposed diagnostic criteria promises to further improve TEE diagnostic accuracy in the setting of severely ill patients with potential need for prompt surgery.

Transesophageal echocardiography (TEE) in atrial fibrillation.

PubMed

Thamilarasan, M; Klein, A L

2000-11-01

Transesophageal echocardiography has given new insight into the pathogenesis of the thromboembolic sequelae of AF and expanded the available therapeutic options. Studies to date indicate that TEE-guided cardioversion is a safe and reasonable approach when the clinical situation warrants prompt restoration of sinus rhythm. Whether widespread use of this strategy offers further benefit remains to be established, although there are theoretical advantages to such an approach. The potential for earlier cardioversion using a TEE-guided approach may facilitate the achievement and maintenance of sinus rhythm. In the long term, earlier restoration of sinus rhythm prevents adverse atrial remodeling, lowers embolic risk, and may improve cardiac performance and functional status. Thromboembolic sequelae (either cardioversion-related or as a result of chronic AF) remain the most devastating complications of AF. Every attempt to minimize this risk should be pursued aggressively. Information gathered from TEE has helped to elucidate the mechanisms responsible for postcardioversion embolism and has emphasized the importance of anticoagulation during and after the restoration of sinus rhythm. TEE also has the potential to further risk stratify patients with AF. Ultimately, a subset of patients may be identified who require more intense anticoagulation (i.e., those with dense SEC or thrombus, or persistent thrombus after prolonged anticoagulation) or in whom cardioversion may be deferred entirely. Likewise, TEE also may prove to be useful in identifying patients with a low-clinical risk profile who may be treated with aspirin alone and patients in whom warfarin may be superior. The results of the ACUTE study should help to further define the role of TEE in the management of patients with AF. Additional clinical studies are needed to address some of the issues that have been raised and to allow for optimal use of TEE in this patient population.

Use of Doubly Labeled Water to Validate a Physical Activity Questionnaire Developed for the Japanese Population

PubMed Central

Ishikawa-Takata, Kazuko; Naito, Yoshihiko; Tanaka, Shigeho; Ebine, Naoyuki; Tabata, Izumi

2011-01-01

Background No study has attempted to use the doubly labeled water (DLW) method to validate a physical activity questionnaire administered to a Japanese population. The development and refinement of such questionnaires require that physical activity components related to physical activity level be examined. Methods Among 226 Japanese men and women 20 to 83 years of age, total energy expenditure (TEE) was assessed using the Japan Arteriosclerosis Longitudinal Study Physical Activity Questionnaire (JALSPAQ), and the results were compared with TEE measured by the DLW method as a gold standard. Resting metabolic rate (RMR) was measured using the Douglas Bag method. Results The median TEE by DLW and physical activity level (PAL: TEE/RMR) were 11.21 MJ/day and 1.88, respectively, for men, and 8.42 MJ/day and 1.83 for women. JALSPAQ slightly underestimated TEE: the differences in mean and standard error were −1.15 ± 1.92 MJ/day. JALSPAQ and DLW TEE values were moderately correlated (Spearman correlation = 0.742, P < 0.001; intraclass correlation coefficient = 0.648, P < 0.001), and the 95% limit of agreement was −4.99 to 2.69 MJ. Underestimation of TEE by JALSPAQ was greater in active subjects than in less active subjects. Moderate and vigorous physical activity and physical activity during work (ie, occupational tasks and housework) were strongly related to physical activity level. However, the physical activity components that differentiated sedentary from moderately active subjects were not clear. Conclusions Physical activity level values on JALSPAQ and DLW were weakly correlated. In addition, estimation of TEE in active subjects should be improved, and the use of a questionnaire to differentiate activity in sedentary and moderately active subjects must be reassessed. PMID:21258166

TEES 2.2: Biomedical Event Extraction for Diverse Corpora.

PubMed

Björne, Jari; Salakoski, Tapio

2015-01-01

The Turku Event Extraction System (TEES) is a text mining program developed for the extraction of events, complex biomedical relationships, from scientific literature. Based on a graph-generation approach, the system detects events with the use of a rich feature set built via dependency parsing. The TEES system has achieved record performance in several of the shared tasks of its domain, and continues to be used in a variety of biomedical text mining tasks. The TEES system was quickly adapted to the BioNLP'13 Shared Task in order to provide a public baseline for derived systems. An automated approach was developed for learning the underlying annotation rules of event type, allowing immediate adaptation to the various subtasks, and leading to a first place in four out of eight tasks. The system for the automated learning of annotation rules is further enhanced in this paper to the point of requiring no manual adaptation to any of the BioNLP'13 tasks. Further, the scikit-learn machine learning library is integrated into the system, bringing a wide variety of machine learning methods usable with TEES in addition to the default SVM. A scikit-learn ensemble method is also used to analyze the importances of the features in the TEES feature sets. The TEES system was introduced for the BioNLP'09 Shared Task and has since then demonstrated good performance in several other shared tasks. By applying the current TEES 2.2 system to multiple corpora from these past shared tasks an overarching analysis of the most promising methods and possible pitfalls in the evolving field of biomedical event extraction are presented.

Integrated deployment architecture for predictive real-time traffic routing incorporating human factors considerations.

DOT National Transportation Integrated Search

2014-05-01

As Advanced Traveler Information Systems (ATIS) are being more widely accessed by drivers, understanding drivers behavioral responses to real-time travel information through ATIS and its consequential benefits are important to the widespread deplo...

Communicating with the public using ATIS during disasters : a guide for practitioners.

DOT National Transportation Integrated Search

2007-04-01

Advanced Traveler Information Systems, ATIS, can play an important role in communicating essential information to the public : during disasters. Variable message signs, 511 telephone systems, highway advisory radio, and websites are some of the disse...

Advanced Traveler Information Systems (ATIS) 2.0 Precursor System: Final Report

DOT National Transportation Integrated Search

2018-03-01

Advanced Traveler Information Systems (ATIS) have experienced significant growth since their initial inception in the 1990s. Technologies have continued to evolve at a rapid pace, enabling the integration of advanced solutions for traveler informatio...

Toe thumb: a musculoskeletal disorder related to transesophageal echocardiography.

PubMed

Tewari, Prabhat; Raju, P S N; Neema, P K

2014-01-01

The musculoskeletal disorders (MSD) are common in healthcare providers and those who are doing sonography are also affected. There are reports of MSD in healthcare providers who do transthoracic echocardiography. Transesophageal echocardiography (TEE) is being regularly used in peri-operative setting. We describe MSD of hand in a cardiovascular and thoracic anesthesiologist who has been performing TEE scanning for 10% of his work-time in operating room and critical care area for the last 8 years. As the role of TEE is increasing and many doctors are doing it on a routine basis, the knowledge of association of MSD with TEE and measures to prevent it is important.

Atlanta congestion reduction demonstration. National evaluation : travel demand management (TDM) data test plan.

DOT National Transportation Integrated Search

2001-01-01

Internet-based Advanced Traveler Information Services (ATIS) provide the urban traveler with estimated travel times based on current roadway congestion. Survey research indicates that the vast majority of current ATIS users are satisfied consumers wh...

An Evaluation of Automatic Terminal Information Service (ATIS) Flight Deck Display Presentation Options

DOT National Transportation Integrated Search

1994-04-01

This document describes the first of three studies relating to human factors : aspects in the flight desk display of Automatic Terminal Information Servies : (ATIS). This research is being conducted by the Federal Aviation Administration : (FAA) Tech...

ATR architecture for multisensor fusion

NASA Astrophysics Data System (ADS)

Hamilton, Mark K.; Kipp, Teresa A.

1996-06-01

The work of the U.S. Army Research Laboratory (ARL) in the area of algorithms for the identification of static military targets in single-frame electro-optical (EO) imagery has demonstrated great potential in platform-based automatic target identification (ATI). In this case, the term identification is used to mean being able to tell the difference between two military vehicles -- e.g., the M60 from the T72. ARL's work includes not only single-sensor forward-looking infrared (FLIR) ATI algorithms, but also multi-sensor ATI algorithms. We briefly discuss ARL's hybrid model-based/data-learning strategy for ATI, which represents a significant step forward in ATI algorithm design. For example, in the case of single sensor FLIR it allows the human algorithm designer to build directly into the algorithm knowledge that can be adequately modeled at this time, such as the target geometry which directly translates into the target silhouette in the FLIR realm. In addition, it allows structure that is not currently well understood (i.e., adequately modeled) to be incorporated through automated data-learning algorithms, which in a FLIR directly translates into an internal thermal target structure signature. This paper shows the direct applicability of this strategy to both the single-sensor FLIR as well as the multi-sensor FLIR and laser radar.

Autologous tenocyte implantation into shoulder tendon pathology in an elite swimmer.

PubMed

Schwab, Laura M; Blanch, Peter; Young, Mark

2018-01-01

The use of novel bioengineer treatment techniques such as Autologous Tenocyte Implantation (ATI) have shown promising improvements in both pain ratings and functional outcomes in elbow, gluteal and shoulder tendon pathology. This case will review the injury timeline of ATI intervention in an elite male swimmer with subscapularis tendon pathology and investigate whether ATI has a concomitant healing effect associated with improved functional outcomes. A palmaris longus tendon biopsy was performed and cells were expanded by in-vitro culture. Autologous tenocytes were injected into the subscapularis site identified. Three blinded radiologists reported on pre and post shoulder MRIs using the same 3T MRI protocol. A validated rating scale for severity of tendinopathy (0-3) and degree of tear (0-3) was used and hand-held Dynamometry (HHD) strength was recorded. Independent blinded radiology review demonstrated a significant reduction in tear size and improved tendon morphology. IR strength on HHD returned to baseline strength levels post ATI (231-253N) 6 weeks post intervention. The athlete returned to full training (volume and intensity) pain free and international level competition at 4 months post ATI. An athlete who had previously undergone unsuccessful conservative management demonstrated significant improvement in function and in tendon morphology post intervention. Copyright © 2017 Elsevier Ltd. All rights reserved.

Energy expenditure and activity among Hadza hunter-gatherers.

PubMed

Pontzer, Herman; Raichlen, David A; Wood, Brian M; Emery Thompson, Melissa; Racette, Susan B; Mabulla, Audax Z P; Marlowe, Frank W

2015-01-01

Studies of total energy expenditure, (TEE; kcal/day) among traditional populations have challenged current models relating habitual physical activity to daily energy requirements. Here, we examine the relationship between physical activity and TEE among traditional Hadza hunter-gatherers living in northern Tanzania. Hadza adults were studied at two camps, with minimal intervention so as to monitor energy expenditure and activity during normal daily life. We measured daily walking distance and walking speed using wearable GPS units for 41 adults. For a subset of 30 adults, we measured TEE using doubly labeled water, three indices of work load (foraging return rate, maternal status, and number of dependent children), and urinary biomarkers of metabolic activity and stress (8-hydroxydeoxyguanosine, cortisol, and testosterone). Fat-free mass was the single strongest predictor of TEE among Hadza adults (r(2)  = 0.66, P < 0.001). Hadza men used greater daily walking distances and faster walking speeds compared with that of Hadza women, but neither sex nor any measure of physical activity or work load were correlated with TEE in analyses controlling for fat-free mass. Compared with developed, industrial populations, Hadza adults had similar TEE but elevated levels of metabolic stress as measured by 8-hydroxydeoxyguanosine. Our results indicate that daily physical activity may not predict TEE within traditional hunter-gatherer populations like the Hadza. Instead, adults with high levels of habitual physical activity may adapt by reducing energy allocation to other physiological activity. © 2015 Wiley Periodicals, Inc.

A next generation advanced traveler information precursor system (ATIS 2.0 precursor system) concept of operations.

DOT National Transportation Integrated Search

2016-10-27

Advanced Traveler Information Systems (ATIS) have experienced significant growth since its initial inception in the 1990s. Technologies have continued to evolve at a rapid pace, enabling the integration of advanced solutions for traveler information ...

Atlanta congestion reduction demonstration. National evaluation : cost benefit analysis test plan.

DOT National Transportation Integrated Search

2001-01-01

Initiatives to evaluate the impact of Advanced Traveler Information Services (ATIS) over the last ten years have returned what appears to be contradictory results with respect to the time savings of ATIS users: large perceived time savings reported b...

A next generation advanced traveler information precursor system (ATIS 2.0 precursor system) system requirements.

DOT National Transportation Integrated Search

2016-12-01

Advanced Traveler Information Systems (ATIS) have experienced significant growth since their initial inception in the 1990s. Technologies have continued to evolve at a rapid pace, enabling the integration of advanced solutions for traveler informatio...

Choosing the route to traveler information systems deployment : decision factors for creating public/private business plans

DOT National Transportation Integrated Search

1998-01-01

Advanced traveler information systems (ATIS) are moving beyond the research stage to become fully integrated elements of urban transportation management systems. By definition, ATIS work best when multiple public and private organizations are able to...

A next generation advanced traveler information precursor system (ATIS 2.0 precursor system) use cases report.

DOT National Transportation Integrated Search

2017-05-01

Advanced Traveler Information Systems (ATIS) have experienced significant growth since their initial inception in the 1990s. Technologies have continued to evolve at a rapid pace, enabling the integration of advanced solutions for traveler informatio...

Advanced Traveler Information Service (ATIS) : private sector perceptions and public sector activities

DOT National Transportation Integrated Search

2000-01-01

This paper presents the results of a study by the United States Department of Transportation Volpe Center to determine the nature and extent of the data gap between the needs of private sector Advanced Traveler Information Service (ATIS) provid...

First-in-Man Intrathecal Application of Neurite Growth-Promoting Anti-Nogo-A Antibodies in Acute Spinal Cord Injury.

PubMed

Kucher, Klaus; Johns, Donald; Maier, Doris; Abel, Rainer; Badke, Andreas; Baron, Hagen; Thietje, Roland; Casha, Steven; Meindl, Renate; Gomez-Mancilla, Baltazar; Pfister, Christian; Rupp, Rüdiger; Weidner, Norbert; Mir, Anis; Schwab, Martin E; Curt, Armin

2018-05-01

Neutralization of central nervous system neurite growth inhibitory factors, for example, Nogo-A, is a promising approach to improving recovery following spinal cord injury (SCI). In animal SCI models, intrathecal delivery of anti-Nogo-A antibodies promoted regenerative neurite growth and functional recovery. This first-in-man study assessed the feasibility, safety, tolerability, pharmacokinetics, and preliminary efficacy of the human anti-Nogo-A antibody ATI355 following intrathecal administration in patients with acute, complete traumatic paraplegia and tetraplegia. Patients (N = 52) started treatment 4 to 60 days postinjury. Four consecutive dose-escalation cohorts received 5 to 30 mg/2.5 mL/day continuous intrathecal ATI355 infusion over 24 hours to 28 days. Following pharmacokinetic evaluation, 2 further cohorts received a bolus regimen (6 intrathecal injections of 22.5 and 45 mg/3 mL, respectively, over 4 weeks). ATI355 was well tolerated up to 1-year follow-up. All patients experienced ≥1 adverse events (AEs). The 581 reported AEs were mostly mild and to be expected following acute SCI. Fifteen patients reported 16 serious AEs, none related to ATI355; one bacterial meningitis case was considered related to intrathecal administration. ATI355 serum levels showed dose-dependency, and intersubject cerebrospinal fluid levels were highly variable after infusion and bolus injection. In 1 paraplegic patient, motor scores improved by 8 points. In tetraplegic patients, mean total motor scores increased, with 3/19 gaining >10 points, and 1/19 27 points at Week 48. Conversion from complete to incomplete SCI occurred in 7/19 patients with tetraplegia. ATI335 was well tolerated in humans; efficacy trials using intrathecal antibody administration may be considered in acute SCI.

Effects of an anesthetic mixture of medetomidine, midazolam, and butorphanol in rats-strain difference and antagonism by atipamezole.

PubMed

Kirihara, Yumiko; Takechi, Mayumi; Kurosaki, Kaoru; Kobayashi, Yuta; Saito, Yoji; Takeuchi, Takashi

2016-01-01

An anesthetic mixture of medetomidine (MED), midazolam (MID), and butorphanol (BUT) has been used in laboratory animals. We previously reported that this anesthetic mixture produced closely similar anesthetic effects in BALB/c and C57BL/6J strains. We also demonstrated the efficacy of atipamezole (ATI), an antagonist of MED that produced quick recovery from anesthesia in mice. Anesthetics have various anesthetic effects among animal strains. However, the differences in the effects of anesthetic mixtures in rats are unclear. In the present study, we first examined effects of the abovementioned anesthetic mixture using three different rat strains: Wistar (WST), Sprague-Dawley (SD), and Fischer 344 (F344). Second, we examined how different dosages and optimum injection timing of ATI affected recovery from anesthesia in rats. We used the anesthetic score to measure anesthetic duration and a pulse oximeter to monitor vital signs. We found no significant differences in anesthetic duration among the three different strains. However, recovery from anesthesia in the SD strain took significantly longer than in the other strains. The antagonistic effects of ATI (0.15 mg/kg and 0.75 mg/kg) were equivalent when administered at 30 min after anesthetic mixture administration. The antagonistic effects of ATI 0.75 mg/kg were stronger than those of ATI 0.15 mg/kg at 10 min after anesthetic mixture administration. This anesthetic mixture is a useful drug that can induce similar anesthetic effects in three different strains and has an antagonist, ATI, that makes rats quickly recover from anesthesia. These results may contribute to the welfare of laboratory animals.

Psychosocial distress of part-time occlusion in children with intermittent exotropia.

PubMed

Kim, Ungsoo Samuel; Park, Subin; Yoo, Hee Jeong; Hwang, Jeong-Min

2013-01-01

To evaluate the psychosocial distress of part-time occlusion therapy in intermittent exotropia. A total of 25 children (15 males and 10 females, aged 3 to 7 years, mean age 4.7 years) with intermittent exotropia were enrolled. Behavioral and psychosocial problems were assessed by the Korean Child Behavior Checklist (K-CBCL), which consists of eight categories of withdrawal, somatic problems, depression/anxiety, social problems, thought problems, attention problems, delinquent behavior, and aggressive behavior, and the Amblyopia Treatment Index (ATI). The ATI was designed to evaluate the three factors of compliance, adverse effect, and social stigma. The Parenting Stress Index (PSI) is a parent self-report designed to identify potentially dysfunctional parent-child systems. The K-CBCL was obtained before and after occlusion therapy, and the ATI and PSI were taken from parents only after occlusion therapy. We evaluated the change on the K-CBCL and the correlation between the K-CBCL and ATI. The attention problem assessed by the K-CBCL significantly decreased after occlusion therapy. On the ATI, the social stigma was relatively lower than compliance and adverse effect factors (Likert scale 2.64, 3.11, and 3.11, respectively). The somatic problem assessed by the K-CBCL and compliance on the ATI were significantly correlated (p = 0.014). There was no significant change in percentile scores of each subscale (parental dominant scale and child dominant scale) of the PSI. Total stress index before and after occlusion therapy was 97.16 ± 8.38 and 97.00 ± 8.16 respectively (p = 0.382). Occlusion therapy may influence the psychosocial impact on intermittent exotropia patients. Part-time occlusion significantly decreased the attention problem in children with intermittent strabismus. Children with a high somatic problem score on the KCBCL showed poor compliance to the part-time occlusion.

A Mobile Phone App for Dietary Intake Assessment in Adolescents: An Evaluation Study

PubMed Central

Svensson, Åsa

2015-01-01

Background There is a great need for dietary assessment methods that suit the adolescent lifestyle and give valid intake data. Objective To develop a mobile phone app and evaluate its ability to assess energy intake (EI) and total energy expenditure (TEE) compared with objectively measured TEE. Furthermore, to investigate the impact of factors on reporting accuracy of EI, and to compare dietary intake with a Web-based method. Methods Participants 14 to 16 years of age were recruited from year nine in schools in Gothenburg, Sweden. In total, 81 adolescents used the mobile phone app over 1 to 6 days. TEE was measured with the SenseWear Armband (SWA) during the same or proximate days. Individual factors were assessed with a questionnaire. A total of 15 participants also recorded dietary intake using a Web-based method. Results The mobile phone app underestimated EI by 29% on a group level (P<.001) compared to TEE measured with the SWA, and there was no significant correlation between EI and TEE. Accuracy of EI relative to TEE increased with a weekend day in the record (P=.007) and lower BMI z-score (P=.001). TEE assessed with the mobile phone app was 1.19 times the value of TEE measured by the SWA on a group level (P<.001), and the correlation between the methods was .75 (P<.001). Analysis of physical activity levels (PAL) from the mobile phone app stratified by gender showed that accuracy of the mobile phone app was higher among boys. EI, nutrients, and food groups assessed with the mobile phone app and Web-based method among 15 participants were not significantly different and several were significantly correlated, but strong conclusions cannot be drawn due to the low number of participants. Conclusions By using a mobile phone dietary assessment app, on average 71% of adolescents’ EI was captured. The accuracy of reported dietary intake was higher with lower BMI z-score and if a weekend day was included in the record. The daily question in the mobile phone app about physical activity could accurately rank the participants’ TEE. PMID:26534783

A Mobile Phone App for Dietary Intake Assessment in Adolescents: An Evaluation Study.

PubMed

Svensson, Åsa; Larsson, Christel

2015-11-03

There is a great need for dietary assessment methods that suit the adolescent lifestyle and give valid intake data. To develop a mobile phone app and evaluate its ability to assess energy intake (EI) and total energy expenditure (TEE) compared with objectively measured TEE. Furthermore, to investigate the impact of factors on reporting accuracy of EI, and to compare dietary intake with a Web-based method. Participants 14 to 16 years of age were recruited from year nine in schools in Gothenburg, Sweden. In total, 81 adolescents used the mobile phone app over 1 to 6 days. TEE was measured with the SenseWear Armband (SWA) during the same or proximate days. Individual factors were assessed with a questionnaire. A total of 15 participants also recorded dietary intake using a Web-based method. The mobile phone app underestimated EI by 29% on a group level (P<.001) compared to TEE measured with the SWA, and there was no significant correlation between EI and TEE. Accuracy of EI relative to TEE increased with a weekend day in the record (P=.007) and lower BMI z-score (P=.001). TEE assessed with the mobile phone app was 1.19 times the value of TEE measured by the SWA on a group level (P<.001), and the correlation between the methods was .75 (P<.001). Analysis of physical activity levels (PAL) from the mobile phone app stratified by gender showed that accuracy of the mobile phone app was higher among boys. EI, nutrients, and food groups assessed with the mobile phone app and Web-based method among 15 participants were not significantly different and several were significantly correlated, but strong conclusions cannot be drawn due to the low number of participants. By using a mobile phone dietary assessment app, on average 71% of adolescents' EI was captured. The accuracy of reported dietary intake was higher with lower BMI z-score and if a weekend day was included in the record. The daily question in the mobile phone app about physical activity could accurately rank the participants' TEE.

Estimating aggregate regional user on-time reliability benefit from pre-trip ATIS : Seattle case study

DOT National Transportation Integrated Search

2003-12-01

This study explores the on-time reliability benefits to potential users of a personalized advanced traveler information system (ATIS) providing real-time pre-trip roadway information for the Seattle morning peak period through the application of Heur...

Human factors evaluation of the effectiveness of multi-modality displays in advanced traveler information systems

DOT National Transportation Integrated Search

1999-12-01

To achieve the goals for Advanced Traveler Information Systems (ATIS), significant information will necessarily be provided to the driver. A primary ATIS design issue is the display modality (i.e., visual, auditory, or the combination) selected for p...

Travel time data collection for measurement of advanced traveler information systems accuracy

DOT National Transportation Integrated Search

2003-06-01

The objective of this white paper is to recommend an approach to measuring ATIS travel time accuracy so that ITS planners might have the data they need to make cost effective decisions regarding deployment of surveillance technologies to support ATIS...

Public Acceptance and User Response to ATIS Products and Services: Modeling Framework and Data Requirements

DOT National Transportation Integrated Search

1993-12-01

This report presents a comprehensive modeling framework for user responses to Advanced Traveler Information Systems (ATIS) services and identifies the data needs for the validation of such a framework. The authors present overviews of the framework b...

Understanding key tradeoffs for cost-effective deployment of surveillance to support advanced traveler information systems (ATIS)

DOT National Transportation Integrated Search

2004-04-01

This paper presents the authors' understanding of a key tradeoff in ATIS investment planning: investment in expanding surveillance coverage to additional miles of roadway vs. improving the accuracy of the information provided on roadways already cove...

Property-Guided Synthesis of Aza-Tricyclic Indolines: Development of Gold Catalysis En Route.

PubMed

Barbour, Patrick M; Wang, Wei; Chang, Le; Pickard, Kasey L; Rais, Rana; Slusher, Barbara S; Wang, Xiang

2016-04-28

Antibiotic resistance is a worldwide public health threat that needs to be addressed by improved antibiotic stewardship and continuing development of new chemical entities to treat resistant bacterial infections. Compounds that work alongside known antibiotics as combination therapies offer an efficient and sustainable approach to counteract antibiotic resistance in bacteria. Guided by property-based analysis, a series of aza-tricyclic indolines (ATIs) were synthesized to optimize their physiochemical properties as novel combination therapies with β-lactams to treat methicillin-resistant S. aureus (MRSA) infections. A novel and highly efficient gold-catalyzed tandem cyclization was developed to facilitate the synthesis of these ATIs. One guanidine-containing ATI was discovered to possess both improved anti-MRSA activity and lower mammalian toxicity both in vitro and in vivo. In addition, it also showed significantly enhanced aqueous solubility and metabolic stability. These results indicated that the ATIs are a novel class of anti-MRSA agents suitable for further evaluations as adjuvant therapy in animal model studies.

Identifying environmental features for land management decisions

NASA Technical Reports Server (NTRS)

1983-01-01

Pairs of HCMM day-night thermal infrared (IR) data were selected to examine patterns of surface temperature and thermal inertia (TI) of peninsular Florida. GOES and NOAA-6 thermal IR, as well as National Climatic Center temperatures and rainfall, were also used. The HCMM apparent thermal inertia (ATI) images closely correspond to the General Soil Map of Florida, based on soil drainage classes. Areas with low ATI overlay well-drained soils, such as deep sands and drained organic soils. Areas with high ATI overlay areas with wetlands and bodies of water. The HCMM ATI images also correspond well with GOES-detected winter nocturnal cold-prone areas. Use of HCMM data with Carlson's energy balance model shows both high moisture availability (MA) and high thermal inertia (TI) of wetland-type surfaces and low MA and low TI of upland, well-drained soils. Since soil areas with low TI develop higher temperatures during the day, then antecedent patterns of highest maximum daytime surface temperature can also be used to predict nocturnal cold-prone areas in Florida.

All-MXene-Based Integrated Electrode Constructed by Ti3C2 Nanoribbon Framework Host and Nanosheet Interlayer for High-Energy-Density Li-S Batteries.

PubMed

Dong, Yanfeng; Zheng, Shuanghao; Qin, Jieqiong; Zhao, Xuejun; Shi, Haodong; Wang, Xiaohui; Chen, Jian; Wu, Zhong-Shuai

2018-03-27

High-energy-density lithium-sulfur (Li-S) batteries hold promise for next-generation portable electronic devices, but are facing great challenges in rational construction of high-performance flexible electrodes and innovative cell configurations for actual applications. Here we demonstrated an all-MXene-based flexible and integrated sulfur cathode, enabled by three-dimensional alkalized Ti 3 C 2 MXene nanoribbon (a-Ti 3 C 2 MNR) frameworks as a S/polysulfides host (a-Ti 3 C 2 -S) and two-dimensional delaminated Ti 3 C 2 MXene (d-Ti 3 C 2 ) nanosheets as interlayer on a polypropylene (PP) separator, for high-energy and long-cycle Li-S batteries. Notably, an a-Ti 3 C 2 MNR framework with open interconnected macropores and an exposed surface area guarantees high S loading and fast ionic diffusion for prompt lithiation/delithiation kinetics, and the 2D d-Ti 3 C 2 MXene interlayer remarkably prevents the shuttle effect of lithium polysulfides via both chemical absorption and physical blocking. As a result, the integrated a-Ti 3 C 2 -S/d-Ti 3 C 2 /PP electrode was directly used for Li-S batteries, without the requirement of a metal current collector, and exhibited a high reversible capacity of 1062 mAh g -1 at 0.2 C and enhanced capacity of 632 mAh g -1 after 50 cycles at 0.5 C, outperforming the a-Ti 3 C 2 -S/PP electrode (547 mAh g -1 ) and conventional a-Ti 3 C 2 -S on an Al current collector (a-Ti 3 C 2 -S/Al) (597 mAh g -1 ). Furthermore, the all-MXene-based integrated cathode displayed outstanding rate capacity of 288 mAh g -1 at 10 C and long-life cyclability. Therefore, this proposed strategy of constructing an all-MXene-based cathode can be readily extended to assemble a large number of MXene-derived materials, from a group of 60+ MAX phases, for applications such as various batteries and supercapacitors.

Total energy expenditure in burned children using the doubly labeled water technique

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

Goran, M.I.; Peters, E.J.; Herndon, D.N.

Total energy expenditure (TEE) was measured in 15 burned children with the doubly labeled water technique. Application of the technique in burned children required evaluation of potential errors resulting from nutritional intake altering background enrichments during studies and from the high rate of water turnover relative to CO2 production. Five studies were discarded because of these potential problems. TEE was 1.33 +/- 0.27 times predicted basal energy expenditure (BEE), and in studies where resting energy expenditure (REE) was simultaneously measured, TEE was 1.18 +/- 0.17 times REE, which in turn was 1.16 +/- 0.10 times predicted BEE. TEE was significantlymore » correlated with measured REE (r2 = 0.92) but not with predicted BEE. These studies substantiate the advantage of measuring REE to predict TEE in severely burned patients as opposed to relying on standardized equations. Therefore we recommend that optimal nutritional support will be achieved in convalescent burned children by multiplying REE by an activity factor of 1.2.« less

"The First Tee: Building Character Education." Hearing before the Committee on Education and the Workforce. House of Representatives, One Hundred Sixth Congress, Second Session (June 25, 2002).

ERIC Educational Resources Information Center

Congress of the U.S., Washington, DC. House Committee on Education and the Workforce.

This publication covers the U.S. House of Representatives June 25, 2002, hearing on building character education through the "First Tee" program in U.S. public schools. The First Tee is a youth character-building organization with programs located throughout the country. It provides young people of all backgrounds the opportunity to…

Efficient feature-based 2D/3D registration of transesophageal echocardiography to x-ray fluoroscopy for cardiac interventions

NASA Astrophysics Data System (ADS)

Hatt, Charles R.; Speidel, Michael A.; Raval, Amish N.

2014-03-01

We present a novel 2D/ 3D registration algorithm for fusion between transesophageal echocardiography (TEE) and X-ray fluoroscopy (XRF). The TEE probe is modeled as a subset of 3D gradient and intensity point features, which facilitates efficient 3D-to-2D perspective projection. A novel cost-function, based on a combination of intensity and edge features, evaluates the registration cost value without the need for time-consuming generation of digitally reconstructed radiographs (DRRs). Validation experiments were performed with simulations and phantom data. For simulations, in silica XRF images of a TEE probe were generated in a number of different pose configurations using a previously acquired CT image. Random misregistrations were applied and our method was used to recover the TEE probe pose and compare the result to the ground truth. Phantom experiments were performed by attaching fiducial markers externally to a TEE probe, imaging the probe with an interventional cardiac angiographic x-ray system, and comparing the pose estimated from the external markers to that estimated from the TEE probe using our algorithm. Simulations found a 3D target registration error of 1.08(1.92) mm for biplane (monoplane) geometries, while the phantom experiment found a 2D target registration error of 0.69mm. For phantom experiments, we demonstrated a monoplane tracking frame-rate of 1.38 fps. The proposed feature-based registration method is computationally efficient, resulting in near real-time, accurate image based registration between TEE and XRF.

Validity of 24-h recalls in (pre-)school aged children: comparison of proxy-reported energy intakes with measured energy expenditure.

PubMed

Börnhorst, C; Bel-Serrat, S; Pigeot, I; Huybrechts, I; Ottavaere, C; Sioen, I; De Henauw, S; Mouratidou, T; Mesana, M I; Westerterp, K; Bammann, K; Lissner, L; Eiben, G; Pala, V; Rayson, M; Krogh, V; Moreno, L A

2014-02-01

Little is known about the validity of repeated 24-h dietary recalls (24-HDR) as a measure of total energy intake (EI) in young children. This study aimed to evaluate the validity of proxy-reported EI by comparison with total energy expenditure (TEE) measured by the doubly labeled water (DLW) technique. The agreement between EI and TEE was investigated in 36 (47.2% boys) children aged 4-10 years from Belgium and Spain using subgroup analyses and Bland-Altman plots. Low-energy-reporters (LER), adequate-energy-reporters (AER) and high-energy-reporters (HER) were defined from the ratio of EI over TEE by application of age- and sex-specific cut-off values. There was good agreement between means of EI (1500 kcal/day) and TEE (1523 kcal/day) at group level though in single children, i.e. at the individual level, large differences were observed. Almost perfect agreement between EI and TEE was observed in thin/normal weight children (EI: 1511 kcal/day; TEE: 1513 kcal/day). Even in overweight/obese children the mean difference between EI and TEE was only -86 kcal/day. Among the participants, 28 (78%) were classified as AER, five (14%) as HER and three (8%) as LER. Two proxy-reported 24-HDRs were found to be a valid instrument to assess EI on group level but not on the individual level. Copyright © 2013 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

Estimating activity energy expenditure: how valid are physical activity questionnaires?

PubMed

Neilson, Heather K; Robson, Paula J; Friedenreich, Christine M; Csizmadi, Ilona

2008-02-01

Activity energy expenditure (AEE) is the modifiable component of total energy expenditure (TEE) derived from all activities, both volitional and nonvolitional. Because AEE may affect health, there is interest in its estimation in free-living people. Physical activity questionnaires (PAQs) could be a feasible approach to AEE estimation in large populations, but it is unclear whether or not any PAQ is valid for this purpose. Our aim was to explore the validity of existing PAQs for estimating usual AEE in adults, using doubly labeled water (DLW) as a criterion measure. We reviewed 20 publications that described PAQ-to-DLW comparisons, summarized study design factors, and appraised criterion validity using mean differences (AEE(PAQ) - AEE(DLW), or TEE(PAQ) - TEE(DLW)), 95% limits of agreement, and correlation coefficients (AEE(PAQ) versus AEE(DLW) or TEE(PAQ) versus TEE(DLW)). Only 2 of 23 PAQs assessed most types of activity over the past year and indicated acceptable criterion validity, with mean differences (TEE(PAQ) - TEE(DLW)) of 10% and 2% and correlation coefficients of 0.62 and 0.63, respectively. At the group level, neither overreporting nor underreporting was more prevalent across studies. We speculate that, aside from reporting error, discrepancies between PAQ and DLW estimates may be partly attributable to 1) PAQs not including key activities related to AEE, 2) PAQs and DLW ascertaining different time periods, or 3) inaccurate assignment of metabolic equivalents to self-reported activities. Small sample sizes, use of correlation coefficients, and limited information on individual validity were problematic. Future research should address these issues to clarify the true validity of PAQs for estimating AEE.

Advanced traveler information system (ATIS) implementation and integration : final report

DOT National Transportation Integrated Search

2006-10-01

The ATIS project was a $1.3 million effort sponsored by the Federal Highway Administration and the New York State Department of Transportation. The project began in March, 2003 and completed in May, 2007. The goal of the project was to create a real-...

Aptitude x Treatment Interactions: Implications for Patient Education Research.

ERIC Educational Resources Information Center

Holloway, Richard L.; And Others

1988-01-01

Aptitude treatment interaction (ATI) identifies patient characteristics and optimal instructional treatments, is compatible with psychological theories and clinical approaches, and offers a specific methodology for approaching existing problems in a new way. This article presents studies in which ATI has illuminated patient needs and treatments…

Choosing the route to traveler information systems deployment : decision factors for creating public-private business plans : an action guide

DOT National Transportation Integrated Search

1998-01-01

This document presents a guide designed to help public private partnerships in their efforts to provide Advanced Traveler Information Systems (ATIS) services. It first examines why ATIS can be useful in managing transportation networks and increasing...

Vision and operational concept for enabling advanced traveler information services : market readiness assessment (EnableATIS).

DOT National Transportation Integrated Search

2012-05-01

The purpose of this market readiness assessment is to identify next steps for USDOT to research, demonstrate and advance the objectives of EnableATIS. This will include demonstrating those key concepts that will be within the USDOT and agency sphere ...

Approaches for quantifying energy intake and %calorie restriction during calorie restriction interventions in humans: the multicenter CALERIE study

PubMed Central

Das, Sai Krupa; Bhapkar, Manjushri; Hadley, Evan C.; Roberts, Susan B.; Ravussin, Eric; Pieper, Carl; DeLany, James P.; Kraus, William E.; Rochon, James; Redman, Leanne M.

2012-01-01

Calorie restriction (CR) is a component of most weight loss interventions and a potential strategy to slow aging. Accurate determination of energy intake and %CR is critical when interpreting the results of CR interventions; this is most accurately achieved using the doubly labeled water method to quantify total energy expenditure (TEE). However, the costs and analytical requirements of this method preclude its repeated use in many clinical trials. Our aims were to determine 1) the optimal TEE assessment time points for quantifying average energy intake and %CR during long-term CR interventions and 2) the optimal approach for quantifying short-term changes in body energy stores to determine energy intake and %CR during 2-wk DLW periods. Adults randomized to a CR intervention in the multicenter CALERIE study underwent measurements of TEE by doubly labeled water and body composition at baseline and months 1, 3, and 6. Average %CR achieved during the intervention was 24.9 ± 8.7%, which was computed using an approach that included four TEE assessment time points (i.e., TEEbaseline, months 1, 3, and 6) plus the 6-mo change in body composition. Approaches that included fewer TEE assessments yielded %CR values of 23.4 ± 9.0 (TEEbaseline, months 3 and 6), 25.0 ± 8.7 (TEEbaseline, months 1 and 6), and 20.9 ± 7.1% (TEEbaseline, month 6); the latter approach differed significantly from approach 1 (P < 0.001). TEE declined 9.6 ± 9.9% within 2–4 wk of CR beginning and then stabilized. Regression of daily home weights provided the most reliable estimate of short-term change in energy stores. In summary, optimal quantification of energy intake and %CR during weight loss necessitates a TEE measurement within the first month of CR to capture the rapid reduction in TEE. PMID:22127229

Aortic intracardiac echocardiography-guided septal puncture during mitral valvuloplasty.

PubMed

Akkaya, Emre; Vuruskan, Ertan; Zorlu, Ali; Sincer, Isa; Kucukosmanoglu, Mehmet; Ardic, Idris; Yilmaz, Mehmet Birhan

2014-01-01

Transoesophageal echocardiography (TEE) and venous intracardiac echocardiography (ICE) are traditionally used to visualize the interatrial septum (IAS) and the tenting effect of the fossa ovalis in patients undergoing percutaneous balloon mitral valvuloplasty (PBMV). The aim of the present study was to assess the comparative efficacy and safety of arterial (intra-aortic) ICE and venous ICE, compared with TEE (traditional approach), in the patients undergoing PBMV. TEE, aortic ICE, and venous ICE were consecutively performed in 50 patients (40 ± 9 years, 86% female). The images of intracardiac structures were obtained from both aortic and right atrial loci. The IAS was visualized using TEE, aortic ICE, and venous ICE. The mean mitral valve area was 1.14 ± 0.2 cm(2), and the mean left atrial volume index was 57.5 ± 12 mL/m(2). The mean size of the visualized septal length was 48 ± 5 mm by TEE, 51 ± 5 mm by aortic ICE, and 33 ± 6 mm by venous ICE. The Bland-Altman test indicated that the 95% limits of agreement for the measurement of septal diameter ranged from -11.0 to +5.9 mm (mean -2.5 mm) between TEE and aortic ICE, -2.8 to +33.5 mm (mean +15.3 mm) between TEE and venous ICE, and -36.6 to +0.8 mm (mean -17.9 mm) between venous and aortic ICE. Standard venous ICE generally tended to yield smaller values compared with TEE and aortic ICE for the measurement of septal length. Furthermore, the view of fossa ovalis and 'tenting effect' was optimal in 11 patients on venous ICE; however, the fossa ovalis and tip of the needle were well visualized in all patients on aortic ICE (P < 0.001). There were no major complications with the use of aortic ICE. Aortic ICE is a superior alternative to venous ICE and facilitates trans-septal puncture in patients with mitral stenosis.

Total Energy Expenditure, Energy Intake, and Body Composition in Endurance Athletes Across the Training Season: A Systematic Review.

PubMed

Heydenreich, Juliane; Kayser, Bengt; Schutz, Yves; Melzer, Katarina

2017-12-01

Endurance athletes perform periodized training in order to prepare for main competitions and maximize performance. However, the coupling between alterations of total energy expenditure (TEE), energy intake, and body composition during different seasonal training phases is unclear. So far, no systematic review has assessed fluctuations in TEE, energy intake, and/or body composition in endurance athletes across the training season. The purpose of this study was to (1) systematically analyze TEE, energy intake, and body composition in highly trained athletes of various endurance disciplines and of both sexes and (2) analyze fluctuations in these parameters across the training season. An electronic database search was conducted on the SPORTDiscus and MEDLINE (January 1990-31 January 2015) databases using a combination of relevant keywords. Two independent reviewers identified potentially relevant studies. Where a consensus was not reached, a third reviewer was consulted. Original research articles that examined TEE, energy intake, and/or body composition in 18-40-year-old endurance athletes and reported the seasonal training phases of data assessment were included in the review. Articles were excluded if body composition was assessed by skinfold measurements, TEE was assessed by questionnaires, or data could not be split between the sexes. Two reviewers assessed the quality of studies independently. Data on subject characteristics, TEE, energy intake, and/or body composition were extracted from the included studies. Subjects were categorized according to their sex and endurance discipline and each study allocated a weight within categories based on the number of subjects assessed. Extracted data were used to calculate weighted means and standard deviations for parameters of TEE, energy intake, and/or body composition. From 3589 citations, 321 articles were identified as potentially relevant, with 82 meeting all of the inclusion criteria. TEE of endurance athletes was significantly higher during the competition phase than during the preparation phase (p < 0.001) and significantly higher than energy intake in both phases (p < 0.001). During the competition phase, both body mass and fat-free mass were significantly higher compared to other seasonal training phases (p < 0.05). Limitations of the present study included insufficient data being available for all seasonal training phases and thus low explanatory power of single parameters. Additionally, the classification of the different seasonal training phases has to be discussed. Male and female endurance athletes show important training seasonal fluctuations in TEE, energy intake, and body composition. Therefore, dietary intake recommendations should take into consideration other factors including the actual training load, TEE, and body composition goals of the athlete.

Development of a fish assemblage tolerance index for the National Rivers and Streams Assessment

EPA Science Inventory

Whittier et al (Trans. Amer. Fish. Soc. 136:254-271) developed an assemblage tolerance index (ATI) for stream fishes in the western US based on quantitative tolerance values developed for individual fish and amphibian species. The ATI is conceptually similar to the Hilsenhoff Bi...

Applying An Aptitude-Treatment Interaction Approach to Competency Based Teacher Education.

ERIC Educational Resources Information Center

McNergney, Robert

Aptitude treatment interaction (ATI), as applied to education, measures the interaction of personality factors and experimentally manipulated teaching strategies. ATI research has had dissappointingly inconclusive results so far, but proponents argue that this has been due to imprecise methods, which can be rectified. They believe that…

The evaluation of advanced traveler information services (ATIS) impacts on truck travel time reliability : using the simulated yoked study concept

DOT National Transportation Integrated Search

2004-03-01

The ability of Advanced Traveler Information Systems (ATIS) to improve the on-time reliability of urban truck movements is evaluated through the application of the Heuristic On-Line Web- : Linked Arrival Time Estimation (HOWLATE) methodology. In HOWL...

Public Acceptance and User Response to ATIS Products and Services: The Use of Travel Simulators to Investigate the Response to Traffic Information

DOT National Transportation Integrated Search

1993-12-01

Increasing attention has been paid in recent years to the use of Advanced Traveler Information Systems (ATIS) for alleviating traffic congestion. Understanding user response to traffic, transit, and parking information is important both for designing...

Development of a Scale to Measure Attitudes toward Inclusive Education.

ERIC Educational Resources Information Center

Wilczenski, Felicia L.

1995-01-01

The Attitudes toward Inclusive Education Scale (ATIES) is a measure of positive and negative attitudes toward integrating children with disabilities into regular classes. Results with 445 teachers show that the ATIES defines a unidimensional attitudinal variable and yields interval measures of attitudes toward inclusive education. (SLD)

Transesophageal echocardiography probe shutdown in a patient with hyperthermia.

PubMed

Saluja, Vandana; Singh, Gaganpal; Pandey, Chandrakant

2016-01-01

The use of transesophageal echocardiography (TEE) has been increasing over the past few years. It is considered a semi-invasive monitor and a safe diagnostic device. Though complications are rare, they must be known to operators who frequently perform TEE. TEE probes are known to cause tissue heating and damage on prolonged use. In this case report, we describe shutdown of the transesophageal probe in our patient with high-grade fever.

Transesophageal echocardiography probe shutdown in a patient with hyperthermia

PubMed Central

Saluja, Vandana; Singh, Gaganpal; Pandey, Chandrakant

2016-01-01

The use of transesophageal echocardiography (TEE) has been increasing over the past few years. It is considered a semi-invasive monitor and a safe diagnostic device. Though complications are rare, they must be known to operators who frequently perform TEE. TEE probes are known to cause tissue heating and damage on prolonged use. In this case report, we describe shutdown of the transesophageal probe in our patient with high-grade fever. PMID:26952152

Advanced Technologies and Instrumentation at the National Science Foundation

NASA Astrophysics Data System (ADS)

Kurczynski, Peter; Neff, James E.

2018-01-01

Over its more than thirty-year history, the Advanced Technologies and Instrumentation (ATI) program within the Division of Astronomical Sciences has provided grants to support the development and deployment of detectors and instrumentation for ground-based astronomy. This program has enabled scientific advances in diverse fields from solar physics to exoplanets to cosmology. ATI has provided instrumentation for both small and large observatories from radio through visible wavebands. It has played a role in the early development of major initiatives such as the Large Synoptic Survey Telescope. Technology development for astronomy unfolds over a longer period than the lifetime of a single grant. This review will consider ATI from an historical perspective to assess its impact on astronomy.

Diagnostic accuracy of transesophageal echocardiogram for the detection of patent foramen ovale: a meta-analysis.

PubMed

Mojadidi, Mohammad Khalid; Bogush, Nikolay; Caceres, Jose Diego; Msaouel, Pavlos; Tobis, Jonathan M

2014-07-01

Patent foramen ovale (PFO) is a remnant of the fetal circulation present in 20% of the population. Right-to-left shunting (RLS) through a PFO has been linked to the pathophysiology of stroke, migraine with aura, and hypoxemia. While different imaging modalities including transcranial Doppler, intra-cardiac echo, and transthoracic echo (TTE) have often been used to detect RLS, transesophageal echo (TEE) bubble study remains the gold standard for diagnosing PFO. The aim of this study was to determine the relative accuracy of TEE in the detection of PFO. A systematic review of Medline, using a standard approach for meta-analysis, was performed for all prospective studies assessing accuracy of TEE in the detection of PFO using confirmation by autopsy, cardiac surgery, and/or catheterization as the reference. Search results revealed 3105 studies; 4 met inclusion criteria. A total of 164 patients were included. TEE had a weighted sensitivity of 89.2% (95% CI: 81.1-94.7%) and specificity of 91.4% (95% CI: 82.3-96.8%) to detect PFO. The overall positive likelihood ratio (LR+) was 5.93 (95% CI: 1.30-27.09) and the overall negative likelihood ratio (LR-) was 0.22 (95% CI: 0.08-0.56). While TEE bubble study is considered to be the gold standard modality for diagnosing PFO, some PFOs may still be missed or misdiagnosed. It is important to understand the limitations of TEE and perhaps use other highly sensitive screening tests, such as transcranial doppler (TCD), in conjunction with TEE before scheduling a patient for transcatheter PFO closure. © 2013, Wiley Periodicals, Inc.

Transthoracic contrast echocardiography using vitamin B6 and sodium bicarbonate as contrast agents for the diagnosis of patent foramen ovale.

PubMed

He, Jiang-Chun; Zheng, Jian-Yong; Li, Xin; Yang, Ye; Zhang, Bo-Yang; Chen, Yu; Li, Xian-Feng; Liu, Ying-Ming; Cao, Yi; Zhao, Li; Li, Tian-Chang

2017-08-01

To evaluate the utility of transthoracic contrast echocardiography (cTTE) using vitamin B6 and sodium bicarbonate as contrast agents for diagnosing right-to-left shunt (RLS) caused by patent foramen ovale (PFO) compared to that of transesophageal echocardiography (TEE). We investigated 125 patients admitted to our neurology department with unexplained cerebral infarction and migraine. All patients underwent cTTE using vitamin B6 and sodium bicarbonate as contrast agents, after which they underwent transthoracic echocardiography. The Doppler signal was recorded during the Valsalva maneuver, and TEE examinations were performed. The feasibility, diagnostic sensitivity, and safety of cTTE and TEE for PFO recognition were compared. Evidence of PFO was found in 49 (39.20%) patients with cTTE, more than were detected with TEE (39, 31.20%) (χ 2 =5.0625, P=0.0244). cTTE had a sensitivity of 92.31% and a specificity of 84.88% for diagnosing PFO, showing high concordance with TEE for PFO recognition (κ=0.72). Further, results of a semi-quantitative evaluation of PFO-RLS by cTTE were better than those with TEE (Z=-2.011, P=0.044). No significant adverse reaction was discovered during cTTE examination. cTTE using vitamin B6 and sodium bicarbonate as contrast agents has relatively good sensitivity and specificity for diagnosing RLS caused by PFO when compared with those for TEE. Using vitamin B6 and sodium bicarbonate as contrast agents to perform cTTE is recommended for detecting and diagnosing the PFO due to its simplicity, non-invasive character, low cost, and high feasibility.

Transesophageal echocardiography and intracardiac echocardiography differently predict potential technical challenges or failures of interatrial shunts catheter-based closure.

PubMed

Rigatelli, Gianluca; Rigateli, Gianluca; Cardaioli, Paolo; Braggion, Gabriele; Aggio, Silvio; Giordan, Massimo; Magro, Beatrice; Nascimben, Alberto; Favaro, Alberto; Roncon, Loris; Rincon, Loris

2007-02-01

We sought to prospectively assess the role of transesophageal (TEE) and intracardiac echocardiography (ICE) in detecting potential technical difficulties or failures in patients submitted to interatrial shunts percutaneous closure. We prospectively enrolled 46 consecutive patients (mean age 35+/-28, 8 years, 30 female) referred to our center for catheter-based closure of interatrial shunts. All patients were screened with TEE before the intervention. Patients who met the inclusion criteria underwent ICE study before the closure attempt (40 patients). TEE detected potential technical difficulties in 22.5% (9/40) patients, whereas ICE detected technical difficulties in 32.5% (13/40 patients). In patients with positive TEE/ICE the procedural success (92.4% versus 100% and, P = ns) and follow-up failure rate (7.7% versus 0%, P = ns) were similar to patients with negative TEE/ICE, whereas the fluoroscopy time (7 +/- 1.2 versus 5 +/- 0.7 minutes, P < 0.03), the procedural time (41 +/- 4.1 versus 30 +/- 8.2 minutes, P +/- 0.03), and technical difficulties rate (23.1% versus 0%, P = 0.013) were higher. Differences between ICE and TEE in the evaluation of rims, measurement of ASD or fossa ovalis, and detection of venous valve and embryonic septal membrane remnants impacted on technical challenges and on procedural and fluoroscopy times but did not influence the success rate and follow-up failure rate.

Identification of Left Atrial Appendage Thrombi in Patients With Persistent and Long-Standing Persistent Atrial Fibrillation Using Intra-Cardiac Echocardiography and Cardiac Computed Tomography.

PubMed

Ikegami, Yukinori; Tanimoto, Kojiro; Inagawa, Kohei; Shiraishi, Yasuyuki; Fuse, Jun; Sakamoto, Munehisa; Momiyama, Yukihiko; Takatsuki, Seiji

2017-12-25

Intracardiac echocardiography (ICE) and cardiac computed tomography (CCT), in addition to standard transesophageal echocardiography (TEE), have been used to identify left atrial (LA) thrombi prior to ablation for atrial fibrillation (AF). The clinical advantages of this, however, remain unclear. This study therefore investigated the advantages of additional pre-procedural LA appendage (LAA) thrombus evaluation using ICE and the clinical value of CCT in persistent and long-standing persistent AF.Methods and Results:We analyzed data from 108 consecutive patients with persistent and long-standing persistent AF who were scheduled to undergo AF ablation. TEE was performed within 24 h prior to ablation. ICE was performed for 97 patients in whom a thrombus was not detected on TEE. CCT was performed in 95 patients. Thrombus or sludge was detected on TEE in 11 patients (10.3%), for whom ablation was cancelled. Four additional patients were diagnosed with LAA thrombus on ICE. When TEE and ICE were used as the reference for thrombus detection, the sensitivity, specificity, positive predictive value, and negative predictive value of CCT for identifying contrast defects in the LAA were 100%, 81.0%, 40.7%, and 100%, respectively. ICE combined with TEE increased the detection rate of LAA thrombi in patients with persistent and long-standing persistent AF. Moreover, CCT had high sensitivity and negative predictive value for LAA thrombus detection.

Detection of patent foramen ovale by contrast transesophageal echocardiography.

PubMed

Chen, W J; Kuan, P; Lien, W P; Lin, F Y

1992-06-01

A series of 32 patients undergoing cardiac catheterization and/or operation to document the presence of patent foramen ovale (PFO) were studied. All were examined by contrast transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE) during normal breathing and the Valsalva maneuver. A right-to-left shunt at the atrial level was visualized by contrast TEE in 14 patients during normal breathing and in 20 patients during the Valsalva maneuver. In comparison, contrast TTE revealed this shunt in only eight patients during normal breathing and in 12 patients during the Valsalva maneuver. All of the foramina proved to be patent by contrast TTE were also found by contrast TEE. All but one (19 of 20) patients, shown to have PFO by contrast TEE, could be confirmed at cardiac catheterization and/or operation. Using cardiac catheterization and/or operation as a gold standard, contrast TEE appears to be a more sensitive (100 percent vs 63 percent, p less than 0.005) and accurate (97 percent vs 78 percent, p less than 0.05) method than contrast TTE in the detection of PFO.

Energy requirement assessed by doubly-labeled water method in patients with advanced amyotrophic lateral sclerosis managed by tracheotomy positive pressure ventilation.

PubMed

Ichihara, Noriko; Namba, Kazuyoshi; Ishikawa-Takata, Kazuko; Sekine, Kazunori; Takase, Mitsunori; Kamada, Yuko; Fujii, Seigo

2012-10-01

This study aimed to clarify the energy requirement in patients with amyotrophic lateral sclerosis (ALS) undergoing tracheostomy positive pressure ventilation with tracheostomy. Total energy expenditure (TEE) was measured in 10 hospitalized bedridden ALS patients using the doubly-labeled water (DLW) method. The mean TEE/day and TEE/fat- free mass estimated by DLW method were 934 ± 201 kcal/day and 34.8 ± 5.5 kcal/kg/day, respectively. The mean TEE/resting metabolic rate (RMR) was 0.85 when RMR was estimated by the Harris-Benedict equation, 0.91 by Dietary Reference Intake (DRI), and 0.97 by Ganpule's equation using fat-free mass (FFM). The ratios of TEE to measured RMR were 1.05, 1.15 and 1.23 in three patients. In conclusion, multiplying measured RMR by 1.1 to 1.2 is considered to be appropriate to estimate energy need. However, because it is difficult to measure RMR directly in a clinical setting, an appropriate equation for estimating RMR for ALS patient should be developed.

Development of human factors guidelines for advanced traveler information systems and commercial vehicle operations : task analysis of ATIS/CVO functions

DOT National Transportation Integrated Search

1996-11-01

This working paper documents Task E of the present project, Task Analyses for Advanced Traveler Information Systems (ATIS) and Commercial Vehicle Operations (CVO) systems. The goal of Task E is to conduct detailed analyses of the influence of using A...

Aptitude-Treatment Interaction Research: Implications for Physical Education.

ERIC Educational Resources Information Center

Silverman, Stephen

The aptitude-treatment interaction (ATI) design focuses on teacher effectiveness and on how the effectiveness of the teacher interacts with the stable characteristics of the student. The underlying assumptions of the ATI design are similar to and an extension of other teacher effectiveness research designs, such as the process-product design. The…

48 CFR 246.710-70 - Warranty attachment.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Enterprise Identifier Code Type 0-9—GS1 Company Prefix. D—CAGE. LB—ATIS-0322000. LH—EHIBCC. RH—HIBCC. UN—DUNS... Guarantor Enterprise Identifier Code Type 0-9—GS1 Company Prefix. D—CAGE. LB—ATIS-0322000. LH—EHIBCC. RH... returns Name ** Address line 1 ** Address line 2 ** City/county ** State/province ** Postal code...

Advanced traveler information systems (ATIS) : development and testing of a surveillance and delay advisory system for rural areas, and evaluation of satellite communications system for mayday applications

DOT National Transportation Integrated Search

1999-04-01

In early 1993, the Federal Highway Administration (FHWA) initiated a comprehensive study of rural applications of Advanced Traveler Information Systems (ATIS). The study objectives were to guide Federal programs with respect to Intelligent Transporta...

ENVIRONMENTAL TECHNOLOGY VERIFICATION PROGRAM REPORT: PAINT OVERSPRAY ARRESTOR, ATI A-3000 5P BAG

EPA Science Inventory

The report gives results of March 24-25, 1999, tests of ATI's A-3000 5P Bag paint overspray arrestor (POA) as part of an evaluation of POAs by EPA's Air Pollution Control Technology (APCT) Environmental Technology Verification (ETV) Program. The basic performance factor being ver...

Use of thermal inertia determined by HCMM to predict nocturnal cold prone areas in Florida

NASA Technical Reports Server (NTRS)

Allen, L. H., Jr. (Principal Investigator)

1983-01-01

Pairs of HCMM day-night thermal infrared (IR) data were selected during the 1978-79 winter to examine patterns of surface temperature and thermal inertia (TI) of peninsular Florida. The GOES and NOAA-6 thermal IR, as well as National Climatic Center temperatures and rainfall, were also used. The HCMM apparent thermal inertia (ATI) images closely corresponded to the general soil map of Florida, based on soil drainage classes. Areas with low ATI overlay well-drained soils, such as deep sands and drained organic soils, whereas with high ATI overlay areas with wetlands and bodies of water. The HCMM ATI images also corresponded well with GOES-detected winter nocturnal cold-prone areas. Use of HCMM data with Carlson's energy balance model showed both high moisture availability (MA) and high thermal inertia (TI) of wetland-type surfaces and low MA and low TI of upland, well-drained soils. Since soil areas with low TI develop higher temperatures during the day, then antecedent patterns of highest maximum daytime surface temperature can also be used to predict nocturnal cold-prone areas in Florida.

Multi-static MIMO along track interferometry (ATI)

NASA Astrophysics Data System (ADS)

Knight, Chad; Deming, Ross; Gunther, Jake

2016-05-01

Along-track interferometry (ATI) has the ability to generate high-quality synthetic aperture radar (SAR) images and concurrently detect and estimate the positions of ground moving target indicators (GMTI) with moderate processing requirements. This paper focuses on several different ATI system configurations, with an emphasis on low-cost configurations employing no active electronic scanned array (AESA). The objective system has two transmit phase centers and four receive phase centers and supports agile adaptive radar behavior. The advantages of multistatic, multiple input multiple output (MIMO) ATI system configurations are explored. The two transmit phase centers can employ a ping-pong configuration to provide the multistatic behavior. For example, they can toggle between an up and down linear frequency modulated (LFM) waveform every other pulse. The four receive apertures are considered in simple linear spatial configurations. Simulated examples are examined to understand the trade space and verify the expected results. Finally, actual results are collected with the Space Dynamics Laboratorys (SDL) FlexSAR system in diverse configurations. The theory, as well as the simulated and actual SAR results, are presented and discussed.

QUADrATiC: scalable gene expression connectivity mapping for repurposing FDA-approved therapeutics.

PubMed

O'Reilly, Paul G; Wen, Qing; Bankhead, Peter; Dunne, Philip D; McArt, Darragh G; McPherson, Suzanne; Hamilton, Peter W; Mills, Ken I; Zhang, Shu-Dong

2016-05-04

Gene expression connectivity mapping has proven to be a powerful and flexible tool for research. Its application has been shown in a broad range of research topics, most commonly as a means of identifying potential small molecule compounds, which may be further investigated as candidates for repurposing to treat diseases. The public release of voluminous data from the Library of Integrated Cellular Signatures (LINCS) programme further enhanced the utilities and potentials of gene expression connectivity mapping in biomedicine. We describe QUADrATiC ( http://go.qub.ac.uk/QUADrATiC ), a user-friendly tool for the exploration of gene expression connectivity on the subset of the LINCS data set corresponding to FDA-approved small molecule compounds. It enables the identification of compounds for repurposing therapeutic potentials. The software is designed to cope with the increased volume of data over existing tools, by taking advantage of multicore computing architectures to provide a scalable solution, which may be installed and operated on a range of computers, from laptops to servers. This scalability is provided by the use of the modern concurrent programming paradigm provided by the Akka framework. The QUADrATiC Graphical User Interface (GUI) has been developed using advanced Javascript frameworks, providing novel visualization capabilities for further analysis of connections. There is also a web services interface, allowing integration with other programs or scripts. QUADrATiC has been shown to provide an improvement over existing connectivity map software, in terms of scope (based on the LINCS data set), applicability (using FDA-approved compounds), usability and speed. It offers potential to biological researchers to analyze transcriptional data and generate potential therapeutics for focussed study in the lab. QUADrATiC represents a step change in the process of investigating gene expression connectivity and provides more biologically-relevant results than previous alternative solutions.

Intracardiac versus transesophageal echocardiography for left atrial appendage occlusion with watchman.

PubMed

Frangieh, Antonio H; Alibegovic, Jasmina; Templin, Christian; Gaemperli, Oliver; Obeid, Slayman; Manka, Robert; Holy, Erik W; Maier, Willibald; Lüscher, Thomas F; Binder, Ronald K

2017-08-01

Left atrial appendage occlusion (LAAO) is mostly performed by transesophageal echocardiography (TEE) guidance. Intracardiac echocardiography (ICE) may be an alternative imaging modality for LAAO that precludes the need for general anesthesia or sedation. All consecutive single center, single operator LAAO candidates were analyzed. Baseline clinical and procedural characteristics and in-hospital outcomes were compared between patients in whom a Watchman was implanted with ICE vs. TEE guidance. In 76 consecutive patients the Watchman device was deployed under ICE in 32 patients (42%) and under TEE guidance in 44 patients (58%). Baseline characteristics were comparable between groups, except that patients in the TEE group were older (81 [75-85] years vs. 75 [68-80] years, P = 0.007). Total injected contrast media as well as fluoroscopy time were comparable between groups (90 ml [54-140] vs. 85 ml [80-110], P = 0.86 and 7.9 min [6.4-15.5] vs. 9.8 min [7.0-13.2], P = 0.51, for TEE vs. ICE, respectively). However, time from femoral venous puncture to transseptal puncture and to closure was longer in the ICE group (14 min [7.3-20] vs. 6 min [3.3-11], P = 0.007 and 48 min [40-60] vs. 34.5 min [27-44], P = 0.003, respectively). In the TEE group one patient suffered esophageal erosion with bleeding, which was managed conservatively and one non-LAAO related in-hospital mortality occurred in an 88-year-old patient. Device implantation success rate was 100% in both groups. No device embolization, no significant peri-device leak, no tamponade, no stroke, and no access site bleeding occurred in any patient. Total hospital stay for stand-alone LAAO was comparable between groups (2 days [2-2] vs. 2 days [2-3.3], P = 0.17, in ICE vs. TEE, respectively). ICE guidance for LAAO with the Watchman device is feasible and comparable to TEE and may become the preferred imaging modality for LAAO. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Segmentation of multiple heart cavities in 3-D transesophageal ultrasound images.

PubMed

Haak, Alexander; Vegas-Sánchez-Ferrero, Gonzalo; Mulder, Harriët W; Ren, Ben; Kirişli, Hortense A; Metz, Coert; van Burken, Gerard; van Stralen, Marijn; Pluim, Josien P W; van der Steen, Antonius F W; van Walsum, Theo; Bosch, Johannes G

2015-06-01

Three-dimensional transesophageal echocardiography (TEE) is an excellent modality for real-time visualization of the heart and monitoring of interventions. To improve the usability of 3-D TEE for intervention monitoring and catheter guidance, automated segmentation is desired. However, 3-D TEE segmentation is still a challenging task due to the complex anatomy with multiple cavities, the limited TEE field of view, and typical ultrasound artifacts. We propose to segment all cavities within the TEE view with a multi-cavity active shape model (ASM) in conjunction with a tissue/blood classification based on a gamma mixture model (GMM). 3-D TEE image data of twenty patients were acquired with a Philips X7-2t matrix TEE probe. Tissue probability maps were estimated by a two-class (blood/tissue) GMM. A statistical shape model containing the left ventricle, right ventricle, left atrium, right atrium, and aorta was derived from computed tomography angiography (CTA) segmentations by principal component analysis. ASMs of the whole heart and individual cavities were generated and consecutively fitted to tissue probability maps. First, an average whole-heart model was aligned with the 3-D TEE based on three manually indicated anatomical landmarks. Second, pose and shape of the whole-heart ASM were fitted by a weighted update scheme excluding parts outside of the image sector. Third, pose and shape of ASM for individual heart cavities were initialized by the previous whole heart ASM and updated in a regularized manner to fit the tissue probability maps. The ASM segmentations were validated against manual outlines by two observers and CTA derived segmentations. Dice coefficients and point-to-surface distances were used to determine segmentation accuracy. ASM segmentations were successful in 19 of 20 cases. The median Dice coefficient for all successful segmentations versus the average observer ranged from 90% to 71% compared with an inter-observer range of 95% to 84%. The agreement against the CTA segmentations was slightly lower with a median Dice coefficient between 85% and 57%. In this work, we successfully showed the accuracy and robustness of the proposed multi-cavity segmentation scheme. This is a promising development for intraoperative procedure guidance, e.g., in cardiac electrophysiology.

A Comparison of Learning Environments: All That Glitters... Interim Technical Paper for Period January 1990-July 1991.

ERIC Educational Resources Information Center

Shute, Valerie J.

Aptitude-treatment interactions (ATIs) refer to the covariation between learner characteristic and instructional treatment in relation to some outcome measure. To systematically test for ATI, an intelligent tutoring system instructing in basic principles of electricity was chosen as a complex but controlled learning task. Two learning environments…

Use of thermal inertia determined by HCMM to predict nocturnal cold prone areas in Florida. [Everglades agricultural area and the west north central peninsula

NASA Technical Reports Server (NTRS)

Allen, L. H., Jr. (Principal Investigator); Chen, E.; Martsolf, J. D.; Jones, P. H.

1981-01-01

Surface temperatures derived from HCMM data were compared with to those obtained by GOES satellite and the apparent thermal inertia (ATI) calculated. For two dates, the HCMM temperatures appear to be about 5 C lower than the GOES temperatures. The ATI for excessively-drained to well-drained mineral soils was greater than for drained organic soils possibly because of long periods of low rainfall during late 1980 and early 1981. Organic soils cropped to sugar cane showed lower ATI after a severe killing freeze. With dead leaves, there was less transpiration and more solar radiation probably reached the dark soil surface. This would explain the larger diurnal temperature amplitude observed.

Routine transesophageal echocardiography for the diagnosis of aortic disruption in trauma patients without enlarged mediastinum.

PubMed

Vignon, P; Lagrange, P; Boncoeur, M P; Francois, B; Gastinne, H; Lang, R M

1996-03-01

To assess the value of routine transesophageal echocardiography (TEE) in diagnosing traumatic disruption of the aorta (TDA) in trauma patients presenting without enlarged mediastinum on chest x-ray films. Prospective study. TEE was routinely performed to exclude the presence of TDA in patients who sustained severe trauma secondary to abrupt deceleration collisions and presented with an upper mediastinum of fewer than 8 cm on supine chest x-ray films. Patients were divided into two groups according to the presence (group I) or absence (group II) of mediastinal hematoma diagnosed during TEE examination. Radiographic signs regarded as indicators of the presence of TDA were evaluated in both groups. Among the 40 consecutive patients studied, TEE demonstrated two cases of TDA associated with a mediastinal hematoma that were confirmed by both aortography and surgery. One of the patients had a normal mediastinum on presentation chest x-ray films, and the other only exhibited a blurred aortic knob. Radiographic mediastinal abnormalities suggestive of TDA were observed in 13 patients, but chest x-ray films were unremarkable in 12 patients. Twenty patients had multiple rib fractures. The frequency of chest radiographic abnormalities was not significantly higher in group I (n = 6) when compared with group II patients (n = 34). TEE examination demonstrated a normal thoracic aorta in 35 patients and was nondiagnostic in 3 patients (normal aortography). TEE should be routinely performed in victims of violent deceleration collisions, even in patients presenting apparently normal mediastinum on supine chest radiography.

Association of energy intake and expenditure with obesity: A cross-sectional study of 150 pediatric patients following treatment for leukemia.

PubMed

Srivastava, Richa; Batra, Atul; Dhawan, Deepa; Bakhshi, Sameer

2017-02-01

Increased obesity in leukemia survivors has been attributed to chemotherapy and radiation. Data on total energy intake (TEI) and total energy expenditure (TEE) are lacking in obese childhood leukemia patients after completion of therapy from India. We conducted a cross-sectional study in pediatric acute leukemia patients after completion of therapy wherein energy intake was assessed by 24-hour recall method. TEE was calculated using Harris-Benedict equation, by assessing the physical activity level using Physical Activity Questionnaire for children and basal metabolic rate by World Health Organization equation. Indian Academy of Pediatrics 2015 guidelines for BMI were used for defining overweight and obesity. Nutritional status was assessed in 150 leukemia patients after completion of therapy. Twenty-five percent of leukemia patients after completion of therapy were overweight and obese versus 11% of healthy controls (p = 0.042). The mean ratio of TEI/required energy intake (REI), TEE/required energy expenditure (REE), and (TEI:REI)/(TEE:REE) were significantly higher in overweight and obese group versus nonobese survivors (p < 0.001, p = 0.091, p < 0.001, respectively). Multivariate analysis showed higher income (HR-2.3, p = 0.04), increased TEI/REI (HR-4, p = 0.049) and higher (TEI:REI)/(TEE:REE) (HR-3.1, p = 0.039) to be significant factors predicting obesity. Obesity in leukemia patients after completion of therapy is associated with increased energy intake, causing imbalance between energy intake and TEE in these patients.

Use of transesophageal echocardiography and contrast echocardiography in the evaluation of cardiac masses.

PubMed

Xia, Hongmei; Gan, Ling; Jiang, Yan; Tang, Qi; Zhang, Ping; Tang, Xuefeng; Wen, Li; Liu, Zheng; Gao, Yunhua

2017-06-01

To determine whether the combination of transesophageal echocardiography (TEE) and contrast echocardiography (CE) accurately diagnose suspected cardiac masses using large sample data. Patients with cardiac masses undergoing surgical treatment were enrolled in this study. Routine transthoracic echocardiography (TTE) and TEE examinations were carried out, and CE examinations were carried out when needed. All patients' clinical data and imaging features were retrospectively reviewed. Surgery and histopathology served as the gold standard for diagnosing cardiac masses. A total of 252 consecutive patients were included in this study. Sixteen patients were lost to follow-up and were excluded from the study. The combinations of TEE and CE yielded the correct pathologic diagnosis in 225 of 230 patients (97.8%), while CT yielded the correct pathologic diagnosis in 122 of 141 patients (86.5%), p<0.01. TEE yielded the correct pathologic diagnosis in 219 of 226 patients (96.9%), and CE yielded the correct pathologic diagnosis in 45 of 48 patients (93.8%). TTE alone yielded the correct pathologic diagnosis in 163 of 236 patients (69.1%), p<0.001 for all. TEE imaging provided detailed and precise information regarding cardiovascular morphology, anatomy, hemodynamics and function, and CE provided information regarding tissue characteristics without subjecting patients to radiation exposure. The combination of TEE and CE is feasible for the detection of suspected cardiac masses, especially in diagnosing and differentiating between benign and malignant lesions. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

[Systematic implementation of transthoracic echocardiography, transesophageal echocardiography and 24-hour Holter ECG for the detection of cardiac sources of embolism in patients with stroke or transient ischemic attack. A retrospective study of 220 patients].

PubMed

Vinsonneau, U; Leblanc, A; Buchet, J-F; Pangnarind-Heintz, V; Le Gal, G; Rohel, G; Paleiron, N; Piquemal, M; Blanchard, C; Zagnoli, F; Paule, P

2014-09-01

Embolism of cardiac origin accounts for around 20% of ischemic strokes. ECG and transthoracic echocardiography (TTE) are commonly obtained during the evaluation of patient of ischemic stroke but specific indications for the transesophageal (TEE) echocardiography and 24-hour Holter ECG (Holter) remain uncertain. The aim of this study is to report the contribution of TTE, TEE and Holter performed as a routine during the evaluation of patients with ischemic stroke (IS) or transient ischemic attack (TIA). This is a retrospective single-center study of 220 patients hospitalized between 1st January 2007 and 31st December 2010 for a first IS or TIA. One hundred and forty-three IS and 77 TIA are identified. The average age of patients was 66 years (18-88 years). TTE/TEE/24-hour Holter allowed the diagnosis of cardiac sources of embolism in 135 patents (61.3%). TTE/TEE identified potential source of cardiogenic embolism in 126 patients (52.2%). Twenty four-hour Holter ECG tracked supraventricular arrhythmia in 15 patients (6.7%), 9 (4%) which had non-contributory ultrasound assessment. The systematic implementation of TTE/TEE/Holter is useful for identifying potential sources of cardiogenic embolism. The performance of TEE remains above the TTE. Holter should be recommended because it is a cost effective and non-invasive tool. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Therapeutic implications of transesophageal echocardiography after transthoracic echocardiography on acute stroke patients

PubMed Central

de Abreu, Tiago Tribolet; Mateus, Sonia; Carreteiro, Cecilia; Correia, Jose

2008-01-01

Background The role of transesophageal echocardiography (TEE) in the evaluation of acute stroke patients is still ill-defined. We conducted a prospective observational study to find the prevalence of TEE findings that indicate anticoagulation as beneficial, in acute ischemic stroke patients without indication for anticoagulation based on clinical, electrocardiographic and transthoracic echocardiography (TTE) findings. Methods We prospectively studied all patients referred to our laboratory for TTE and TEE. Patients were excluded if the diagnosis was not acute ischemic stroke or if they had an indication for anticoagulation based on clinical, electrocardiographic, or TTE data. Patients with TEE findings that might indicate anticoagulation as beneficial were identified. Results A total of 84 patients with acute ischemic stroke and without indication for anticoagulation based on clinical and electrocardiographic or TTE data were included in the study. Findings indicating anticoagulation as beneficial were found in 32.1%: spontaneous echo contrast (1.2%), complex aortic atheroma (27.4%), thrombus (8.3%), and simultaneous patent foramen ovale and atrial septal aneurysm (2.4%). Conclusions The results of our study show that TEE can have therapy implications in 32.1% of ischemic stroke patients in sinus rhythm and with TTE with no indication for anticoagulation. PMID:18629351

Forensic testing of a double tee bridge.

DOT National Transportation Integrated Search

2014-12-01

This report describes an investigation to quantify the behavior of precast, prestressed concrete double-tee bridge : girders made with lightweight concrete. As part of the investigation, three bridge girders were salvaged from a : decommissioned brid...

Chronic hyperinsulinemia promotes meta-inflammation and extracellular matrix deposition in adipose tissue: Implications of nitric oxide.

PubMed

Kumar, Durgesh; Shankar, Kripa; Patel, Saraswati; Gupta, Abhishek; Varshney, Salil; Gupta, Sanchita; Rajan, Sujith; Srivastava, Ankita; Vishwakarma, Achchhe Lal; Gaikwad, Anil N

2018-05-10

Various imperative studies support the notion that hyperinsulinemia (HI) itself serves as the common link between adipose tissue inflammation (ATI) and metabolic syndrome. However, the contribution of HI mediated ATI and its metabolic consequences are yet to be explored. We induced chronic HI per se in mice by administration of exogenous insulin for 8 weeks through mini-osmotic pumps. For the reduction of circulating insulin in response to excess calorie intake, we have partially ablated β-cells by using streptozotocin (STZ) in the diet-induced obesity (DIO) and genetic mice models (db/db). Flow cytometry analysis was performed for the quantification of immune cells in stromal vascular fraction (SVF) isolated from epididymal white adipose tissue (eWAT). Our studies demonstrated that chronic HI augmented ATI in terms of elevated pro-inflammatory cells (M1 macrophages and NK-cells) and suppressed anti-inflammatory cells (M2 macrophages, eosinophils and regulatory T-cells). These results were correlated with altered obesity-associated metabolic phenotype. Partial reduction of circulating insulin level attenuated excess calorie-induced ATI and improved insulin sensitivity. Mechanistically, an imbalance in M1 and M2 macrophage proportions in eWAT promoted iNOS (inducible nitric oxide synthase): arginase-1 imbalance that resulted into extracellular matrix (ECM) deposition and insulin resistance (IR) development. However, iNOS -/- mice were protected from HI-induced M1:M2 macrophage imbalance, ECM deposition and IR in adipose tissue. Overall, we conclude that chronic HI per se contributed in ATI and iNOS corroborated ECM deposition. Copyright © 2018. Published by Elsevier B.V.

Guidelines for Conducting a Training Effectiveness Evaluation (TEE). Volume 2. Data Collector’s Manual

DTIC Science & Technology

1985-02-01

D : ■>■■ ’•.’.’. Research Product 85-15 Guidelines for Conducting a Training Effectiveness Evaluation (TEE) Volume II: Data...CONDUCTING A TRAINING EFFECTIVENESS EVALUATION (TEE) VOLUME II: DATA COLLECTOR’S MANUAL 1 t. TV*CO» READ INSTRUCTIONS BEFORE COMWLETWC FORM I...2Q263739A793 3227 52A M. COMTAOLUMQ O’ttCC RAMC AND ADO* CSS Co—and ant U.S. Army Air Defense School ATTN: ATSA-TDI, Ft. Bliss, TX II. RCRORf OATC

The Effect of Perioperative Rescue Transesophageal Echocardiography on the Management of Trauma Patients

PubMed Central

Griffee, Matthew J.; Singleton, Andrew; Zimmerman, Joshua M.; Morgan, David E.; Nirula, Raminder

2018-01-01

To evaluate the effect of rescue transesophageal echocardiography (TEE) on the management of trauma patients, we reviewed imaging and charts of unstable trauma patients at a level I trauma center. Critical rescue TEE findings included acute right ventricular failure, stress cardiomyopathy, type B aortic dissection, mediastinal air, and dynamic left ventricular outflow tract obstruction. Left ventricular filling was classified as low (underfilled) in 57% of all cases. Rescue TEE revealed a variety of new diagnoses and led to a change in resuscitation strategy about half of the time. PMID:27301053

A Community of Writers: Peer Tutor Training for Writing Center Techniques Which Foster Dialogue in the Writing Process.

ERIC Educational Resources Information Center

Houston, Linda; Johnson, Candice

After much trial and error, the Agricultural Technical Institute of the Ohio State University (ATI/OSO) discovered that training of writing lab tutors can best be done through collaboration of the Writing Lab Coordinator with the "Development of Tutor Effectiveness" course offered at the institute. The ATI/OSO main computer lab and…

Interaction Effects Between Selected Cognitive Abilities and Instructional Treatment in Algebra: An ATI Study.

ERIC Educational Resources Information Center

Webb, Leland F.

The purpose of this study was to confirm or deny Carry's findings in an earlier Aptitude Treatment Interaction (ATI) study by implementing his suggestions to: (1) revise instructional treatments, (2) improve the criterion measures, (3) use four predictor tests, (4) add time to criterion measure, and (5) use a theoretical model to identify relevant…

Quantifying assemblage turnover and species contributions at ecologic boundaries.

PubMed

Hayek, Lee-Ann C; Wilson, Brent

2013-01-01

Not all boundaries, whether stratigraphical or geographical, are marked by species-level changes in community composition. For example, paleodata for some sites do not show readily discernible glacial-interglacial contrasts. Rather, the proportional abundances of species can vary subtly between glacials and interglacials. This paper presents a simple quantitative measure of assemblage turnover (assemblage turnover index, ATI) that uses changes in species' proportional abundances to identify intervals of community change. A second, functionally-related index (conditioned-on-boundary index, CoBI) identifies species contributions to the total assemblage turnover. With these measures we examine benthonic foraminiferal assemblages to assess glacial/interglacial contrasts at abyssal depths. Our results indicate that these measures, ATI and CoBI, have potential as sequence stratigraphic tools in abyssal depth deposits. Many peaks in the set of values of ATI coincide with terminations at the end of glaciations and delineate peak-bounded ATI intervals (PATIs) separated by boundaries that approximate to glacial terminations and to transgressions at neritic depths. These measures, however, can be used to evaluate the assemblage turnover and composition at any defined ecological or paleoecological boundary. The section used is from Ocean Drilling Program (OPD) Hole 994C, drilled on the Blake Ridge, offshore SE USA.

A naturally occurring cowpox virus with an ectromelia virus A-type inclusion protein gene displays atypical A-type inclusions.

PubMed

Okeke, Malachy Ifeanyi; Hansen, Hilde; Traavik, Terje

2012-01-01

Human orthopoxvirus (OPV) infections in Europe are usually caused by cowpox virus (CPXV). The genetic heterogeneity of CPXVs may in part be due to recombination with other OPV species. We describe the characterization of an atypical CPXV (CPXV-No-H2) isolated from a human patient in Norway. CPXV-No-H2 was characterized on the basis of A-type inclusion (ATI) phenotype as well as the DNA region containing the p4c and atip open reading frames. CPXV-No-H2 produced atypical V(+/) ATI, in which virions are on the surface of ATI but not within the ATI matrix. Phylogenetic analysis showed that the atip gene of CPXV-No-H2 clustered closely with that of ectromelia virus (ECTV) with a bootstrap support of 100% whereas its p4c gene is diverged compared to homologues in other OPV species. By recombination analysis we identified a putative crossover event at nucleotide 147, downstream the start of the atip gene. Our results suggest that CPXV-No-H2 originated from a recombination between CPXV and ECTV. Our findings are relevant to the evolution of OPVs. Copyright © 2011 Elsevier B.V. All rights reserved.

Ab-initio study of thermodynamic stability, thermoelectric and optical properties of perovskites ATiO3 (A=Pb, Sn)

NASA Astrophysics Data System (ADS)

Noor, N. A.; Mahmood, Q.; Rashid, Muhammad; Ul Haq, Bakhtiar; Laref, A.; Ahmad, S. A.

2018-07-01

The physical behavior of perovskites ATiO3 (A=Pb, Sn) has been explored by using density functional theory based full-potential linearized-augmented-plane-wave plus local-orbital (FP-LAPW+lo) method. The lattice parameters calculated from the optimized structures by using Murnaghan equation of state and Chapin's method have been found in good agreement with the available literature that ensures the reliability of the adopted methodology. Moreover, the optoelectronic and thermoelectric properties have been elaborated by using modified Becke-Johnson exchange potential. The optical behavior has been explored in terms the dielectric constants, refractive indices, absorption spectra and optical loss factors. The absorption spectra of these materials reveal a large absorption in the visible and low ultraviolet part of incident light. The thermoelectric properties of ATiO3 are explained in terms of electrical conductivities, thermal conductivities, power factors, and the specific heat capacities. The ATiO3family of pervoskites has been found to exhibit the bandgaps falling in the visible region of solar spectrum and show high values of thermal efficiency that make them potential multifunctional candidates for optoelectronic and energy harvesting applications.

ATI SAA Annex 3 Button Tensile Test Report I

NASA Technical Reports Server (NTRS)

Tang, Henry H.

2013-01-01

This report documents the results of a study carried out under Splace Act Agreement SAA-EA-10-004 between the National Aeronautics and Space Administration (NASA) and Astro Technology Incorpporated (ATI). NASA and ATI have entered into this agreement to collaborate on the development of technologies that can benefit both the US government space programs and the oil and gas industry. The report documents the results of a test done on an adnesive system for attaching new monitoring sensor devices to pipelines under Annex III of SAA-EA-10-004: "Proof-of-Concept Design and Testing of a Post Installed Sensing Device on Subsea Risers and Pipelines". The tasks of Annex III are to design and test a proof-of-concept sensing device for in-situ installation on pipelines, risers, or other structures deployed in deep water. The function of the sensor device is to measure various signals such as strain, stress and temperature. This study complements the work done, in Annex I of the SAA, on attaching a fiber optic sensing device to pipe via adhesive bonding. Both Annex I and Annex III studies were conducted in the Crew and Thermal System Division (CTSD) at the Johnson Space Center (JSC) in collaboration with ATI.

Evolution at protein ends: major contribution of alternative transcription initiation and termination to the transcriptome and proteome diversity in mammals

PubMed Central

Shabalina, Svetlana A.; Ogurtsov, Aleksey Y.; Spiridonov, Nikolay A.; Koonin, Eugene V.

2014-01-01

Alternative splicing (AS), alternative transcription initiation (ATI) and alternative transcription termination (ATT) create the extraordinary complexity of transcriptomes and make key contributions to the structural and functional diversity of mammalian proteomes. Analysis of mammalian genomic and transcriptomic data shows that contrary to the traditional view, the joint contribution of ATI and ATT to the transcriptome and proteome diversity is quantitatively greater than the contribution of AS. Although the mean numbers of protein-coding constitutive and alternative nucleotides in gene loci are nearly identical, their distribution along the transcripts is highly non-uniform. On average, coding exons in the variable 5′ and 3′ transcript ends that are created by ATI and ATT contain approximately four times more alternative nucleotides than core protein-coding regions that diversify exclusively via AS. Short upstream exons that encompass alternative 5′-untranslated regions and N-termini of proteins evolve under strong nucleotide-level selection whereas in 3′-terminal exons that encode protein C-termini, protein-level selection is significantly stronger. The groups of genes that are subject to ATI and ATT show major differences in biological roles, expression and selection patterns. PMID:24792168

Sooty mangabey genome sequence provides insight into AIDS resistance in a natural SIV host.

PubMed

Palesch, David; Bosinger, Steven E; Tharp, Gregory K; Vanderford, Thomas H; Paiardini, Mirko; Chahroudi, Ann; Johnson, Zachary P; Kirchhoff, Frank; Hahn, Beatrice H; Norgren, Robert B; Patel, Nirav B; Sodora, Donald L; Dawoud, Reem A; Stewart, Caro-Beth; Seepo, Sara M; Harris, R Alan; Liu, Yue; Raveendran, Muthuswamy; Han, Yi; English, Adam; Thomas, Gregg W C; Hahn, Matthew W; Pipes, Lenore; Mason, Christopher E; Muzny, Donna M; Gibbs, Richard A; Sauter, Daniel; Worley, Kim; Rogers, Jeffrey; Silvestri, Guido

2018-01-03

In contrast to infections with human immunodeficiency virus (HIV) in humans and simian immunodeficiency virus (SIV) in macaques, SIV infection of a natural host, sooty mangabeys (Cercocebus atys), is non-pathogenic despite high viraemia. Here we sequenced and assembled the genome of a captive sooty mangabey. We conducted genome-wide comparative analyses of transcript assemblies from C. atys and AIDS-susceptible species, such as humans and macaques, to identify candidates for host genetic factors that influence susceptibility. We identified several immune-related genes in the genome of C. atys that show substantial sequence divergence from macaques or humans. One of these sequence divergences, a C-terminal frameshift in the toll-like receptor-4 (TLR4) gene of C. atys, is associated with a blunted in vitro response to TLR-4 ligands. In addition, we found a major structural change in exons 3-4 of the immune-regulatory protein intercellular adhesion molecule 2 (ICAM-2); expression of this variant leads to reduced cell surface expression of ICAM-2. These data provide a resource for comparative genomic studies of HIV and/or SIV pathogenesis and may help to elucidate the mechanisms by which SIV-infected sooty mangabeys avoid AIDS.

Quantifying Assemblage Turnover and Species Contributions at Ecologic Boundaries

PubMed Central

Hayek, Lee-Ann C.; Wilson, Brent

2013-01-01

Not all boundaries, whether stratigraphical or geographical, are marked by species-level changes in community composition. For example, paleodata for some sites do not show readily discernible glacial-interglacial contrasts. Rather, the proportional abundances of species can vary subtly between glacials and interglacials. This paper presents a simple quantitative measure of assemblage turnover (assemblage turnover index, ATI) that uses changes in species' proportional abundances to identify intervals of community change. A second, functionally-related index (conditioned-on-boundary index, CoBI) identifies species contributions to the total assemblage turnover. With these measures we examine benthonic foraminiferal assemblages to assess glacial/interglacial contrasts at abyssal depths. Our results indicate that these measures, ATI and CoBI, have potential as sequence stratigraphic tools in abyssal depth deposits. Many peaks in the set of values of ATI coincide with terminations at the end of glaciations and delineate peak-bounded ATI intervals (PATIs) separated by boundaries that approximate to glacial terminations and to transgressions at neritic depths. These measures, however, can be used to evaluate the assemblage turnover and composition at any defined ecological or paleoecological boundary. The section used is from Ocean Drilling Program (OPD) Hole 994C, drilled on the Blake Ridge, offshore SE USA. PMID:24130679

Sooty mangabey genome sequence provides insight into AIDS resistance in a natural SIV host

PubMed Central

Palesch, David; Bosinger, Steven E.; Tharp, Gregory K.; Vanderford, Thomas H.; Paiardini, Mirko; Chahroudi, Ann; Johnson, Zachary P.; Kirchhoff, Frank; Hahn, Beatrice H.; Norgren, Robert B.; Patel, Nirav B.; Sodora, Donald L.; Dawoud, Reem A.; Stewart, Caro-Beth; Seepo, Sara M.; Harris, R. Alan; Liu, Yue; Raveendran, Muthuswamy; Han, Yi; English, Adam; Thomas, Gregg W. C.; Hahn, Matthew W.; Pipes, Lenore; Mason, Christopher E.; Muzny, Donna M.; Gibbs, Richard A.; Sauter, Daniel; Worley, Kim; Rogers, Jeffrey; Silvestri, Guido

2018-01-01

In contrast to infections with human immunodeficiency virus (HIV) in humans and simian immunodeficiency virus (SIV) in macaques, SIV infection of a natural host, sooty mangabeys (Cercocebus atys), is non-pathogenic despite high viraemia1. Here we sequenced and assembled the genome of a captive sooty mangabey. We conducted genome-wide comparative analyses of transcript assemblies from C. atys and AIDS-susceptible species, such as humans and macaques, to identify candidates for host genetic factors that influence susceptibility. We identified several immune-related genes in the genome of C. atys that show substantial sequence divergence from macaques or humans. One of these sequence divergences, a C-terminal frameshift in the toll-like receptor-4 (TLR4) gene of C. atys, is associated with a blunted in vitro response to TLR-4 ligands. In addition, we found a major structural change in exons 3–4 of the immune-regulatory protein intercellular adhesion molecule 2 (ICAM-2); expression of this variant leads to reduced cell surface expression of ICAM-2. These data provide a resource for comparative genomic studies of HIV and/or SIV pathogenesis and may help to elucidate the mechanisms by which SIV-infected sooty mangabeys avoid AIDS. PMID:29300007

Evaluation of bursal depth as an indicator of age class of harlequin ducks

USGS Publications Warehouse

Mather, D.D.; Esler, Daniel N.

1999-01-01

We contrasted the estimated age class of recaptured Harlequin Ducks (Histrionicus histrionicus) (n = 255) based on bursal depth with expected age class based on bursal depth at first capture and time since first capture. Although neither estimated nor expected ages can be assumed to be correct, rates of discrepancies between the two for within-year recaptures indicate sampling error, while between-year recaptures test assumptions about rates of bursal involution. Within-year, between-year, and overall discrepancy rates were 10%, 24%, and 18%, respectively. Most (86%) between-year discrepancies occurred for birds expected to be after-third-year (ATY) but estimated to be third-year (TY). Of these ATY-TY discrepancies, 22 of 25 (88%) birds had bursal depths of 2 or 3 mm. Further, five of six between-year recaptures that were known to be ATY but estimated to be TY had 2 mm bursas. Reclassifying birds with 2 or 3 mm bursas as ATY resulted in reduction in between-year (24% to 10%) and overall (18% to 11%) discrepancy rates. We conclude that age determination of Harlequin Ducks based on bursal depth, particularly using our modified criteria, is a relatively consistent and reliable technique.

Benzocaine-induced methemoglobinemia based on the Mayo Clinic experience from 28 478 transesophageal echocardiograms: incidence, outcomes, and predisposing factors.

PubMed

Kane, Garvan C; Hoehn, Suzette M; Behrenbeck, Thomas R; Mulvagh, Sharon L

2007-10-08

The potentially life-threatening condition of methemoglobinemia is characterized by cyanosis, low pulse oximetric readings, and normal arterial Po(2) values. Acquired methemoglobinemia has been linked to the use of the topical anesthetic benzocaine in endoscopic procedures, including transesophageal echocardiography (TEE). Yet, the incidence of benzocaine-induced methemoglobinemia with TEE and the clinical factors associated with its development are unclear. All cases of methemoglobinemia complicating TEE at our institution (from January 1, 1999, to July 1, 2006) were identified by a comprehensive review of medical records and echocardiography and pharmacy databases. During 90 months among 28 478 TEEs, 19 cases of methemoglobinemia were identified, with a mean +/- SD methemoglobin level of 32% +/- 15%. All patients were cyanotic, with low oxygen saturations. Eighteen of 19 patients received methylene blue (mean +/- SD dose, 1.3 +/- 0.4 mg/kg of body weight), with resolution of symptoms and signs. One of 19 cases resolved spontaneously. Compared with a random sample of 190 patients undergoing TEE, the age, sex, body mass index, left ventricular systolic function, and dose of sedation (midazolam hydrochloride, fentanyl citrate, or both) were similar in the 2 groups. However, study patients who developed methemoglobinemia were more likely to be hospitalized (89.5% vs 57.6%, P =.005), be anemic (84.2% vs 44.7%, P =.002), and have active systemic infection (68.4% vs 6.8%; P < .001) at the time of TEE compared with the random control cohort. In a large series of patients undergoing TEE, the incidence of methemoglobinemia is low (1 case per 1499 [0.067%; 95% confidence interval, 0.040%-0.100%]) and has a good outcome if promptly recognized and treated. Clinical factors associated with the development of methemoglobinemia include sepsis, anemia, and hospitalization. Minimizing or avoiding the use of benzocaine in these patients is recommended.

12. View underside of bridge, showing concrete tee beam deck ...

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

12. View underside of bridge, showing concrete tee beam deck spans supported by concrete piles, looking southwest - Colonel Alexander Scammell Memorial Bridge, Spanning Bellamy River at U.S. Route 4, Dover, Strafford County, NH

18. DETAILED OFFSHORE VIEW OF 4TH TEE, LOOKING NORTHWEST, SHOWING ...

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

18. DETAILED OFFSHORE VIEW OF 4TH TEE, LOOKING NORTHWEST, SHOWING TRANSITION FROM WOOD BENTS TO CONCRETE BENTS - Huntington Beach Municipal Pier, Pacific Coast Highway at Main Street, Huntington Beach, Orange County, CA

Accuracy of topological entanglement entropy on finite cylinders.

PubMed

Jiang, Hong-Chen; Singh, Rajiv R P; Balents, Leon

2013-09-06

Topological phases are unique states of matter which support nonlocal excitations which behave as particles with fractional statistics. A universal characterization of gapped topological phases is provided by the topological entanglement entropy (TEE). We study the finite size corrections to the TEE by focusing on systems with a Z2 topological ordered state using density-matrix renormalization group and perturbative series expansions. We find that extrapolations of the TEE based on the Renyi entropies with a Renyi index of n≥2 suffer from much larger finite size corrections than do extrapolations based on the von Neumann entropy. In particular, when the circumference of the cylinder is about ten times the correlation length, the TEE obtained using von Neumann entropy has an error of order 10(-3), while for Renyi entropies it can even exceed 40%. We discuss the relevance of these findings to previous and future searches for topological ordered phases, including quantum spin liquids.

CATS landline installed beneath the river Tees

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

Not Available

Press Construction Ltd. has completed installation of the land portion of a new gas pipeline from the North Sea, including a tunnel beneath the River Tees in the north of England. The work was carried out under a multi-million dollar contract from Amoco (UK) Exploration Co. The pipeline is the land portion of the Central Area Transmission System. The 4.6-mile, 36-in. onshore pipeline connects a valve station at the CATS landfall at Coatham Sands, just south of Tees Bay, to a gas terminal north of the River Tees. This paper reports on the entire CATS system which runs for nearlymore » 250 miles from a riser platform in the Central Graben area of the North Sea to the Coatham Sands landfall and then overland to the gas terminal. The gas will fuel a new combined heat-and-power generating plant on Teesside, currently under construction by Teesside Power.« less

Real-time catheter localization and visualization using three-dimensional echocardiography

NASA Astrophysics Data System (ADS)

Kozlowski, Pawel; Bandaru, Raja Sekhar; D'hooge, Jan; Samset, Eigil

2017-03-01

Real-time three-dimensional transesophageal echocardiography (RT3D-TEE) is increasingly used during minimally invasive cardiac surgeries (MICS). In many cath labs, RT3D-TEE is already one of the requisite tools for image guidance during MICS. However, the visualization of the catheter is not always satisfactory making 3D- TEE challenging to use as the only modality for guidance. We propose a novel technique for better visualization of the catheter along with the cardiac anatomy using TEE alone - exploiting both beamforming and post processing methods. We extended our earlier method called Delay and Standard Deviation (DASD) beamforming to 3D in order to enhance specular reflections. The beam-formed image was further post-processed by the Frangi filter to segment the catheter. Multi-variate visualization techniques enabled us to render both the standard tissue and the DASD beam-formed image on a clinical ultrasound scanner simultaneously. A frame rate of 15 FPS was achieved.

Observation of Drifting Icebergs and Sea Ice from Space by TerraSAR-X and TanDEM-X

NASA Astrophysics Data System (ADS)

Won, Joong-Sun

2017-04-01

Detection and monitoring drifting icebergs and sea ice is of interest across wide range of Arctic and Antarctic coastal studies such as security of navigation, climatic impact, geological impact, etc. It is not easy to discriminate drifting ices from stationary ones, and to measure their drifting speeds. There is a potential to use space-borne SAR for this purpose, but it is difficult to precisely measure because the drift velocity is usually very slow. In this study, we investigate two approaches for discriminating drifting ices on the sea from surrounding static ones and for measuring their range velocity. The first method is to utilize the quad-pol TerraSAR-X which adopts dual receive antenna (DRA), and the second one is to examine the potential use of TanDEM-X bistatic along-track interferometry (ATI). To utilize DRA mode quad-pol SAR as ATI, it is necessary to remove the phase difference of scattering centers between transmitted H- and V-pol signals. By assume that the individual scattering center of returned signal does not change for a few inter-pulse periods, it is possible to measure the Doppler frequency induced by motion through measuring slow-time (or azimuth time) Doppler phase derivative of co-pol or cross-pol pairs. Results applied to TerraSAR-X quad-pol data over the Cape Columbia in the Arctic Ocean are to be presented and discussed. It was successful to detect and measure drift sea ice that was flowing away from the antenna with a velocity of about 0.37 m/s (or 1.4 km/h) to 0.67 m/s (or 2.4 km/h) while neighboring ones were static. A more sophisticated approach would be a bistatic ATI which exploits a long along-track baseline for observation of slowly moving ground objects. TanDEM-X bistatic ATI pairs are examined, which were acquired at an Antarctic coast. The ATI interferograms show an innovative capability of TanDEM-X/TerraSAR-X constellation. An along-track baseline of a few hundred meters is superior to a few meter baseline of DRA mode ATI system. However, topographic phase is inevitably mixed with Doppler phase associated with target motion because of a non-zero perpendicular baseline (or effective baseline). Thus it is necessary to separate target motion components from topographic components that are unknown for icebergs. Here we examine characteristics of the topographic phase of drift sea ice in the bistatic ATI interferograms, and discuss a detouring approach to quick detection of drifting icebergs by TanDEM-X bistatic ATI. The results demonstrate that it would be efficient to detect drifting icebergs and sea ice from space by utilizing high resolution SAR systems while the precise measurement of the drifting speeds requires further studies.

97. VIEW OF PIER EXTENSION WITH RAMP IN FOREGROUND AND ...

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

97. VIEW OF PIER EXTENSION WITH RAMP IN FOREGROUND AND 4TH TEE IN BACKGROUND, LOOKING SOUTHWEST FROM 3RD TEE - Huntington Beach Municipal Pier, Pacific Coast Highway at Main Street, Huntington Beach, Orange County, CA

Materials and Manufacturing Research and Development Capability Assessment of the Southwest Ohio Region

DTIC Science & Technology

2011-09-01

ISO / IEC 17025 :2005, NADCAP Acuren...River Road Brackenridge, PA 250 (724) 224-1000 $4.8B 11,000 ISO -9001, AS- 9100, NADCAP, ISO / IEC 17025 ATI – Allegheny Ludlum (Houston, PA) 501...Western Ave Houston, PA 233 (724) 745-2000 $4.8B 11,000 ISO -9001, AS- 9100, NADCAP, ISO / IEC 17025 ATI – Allegheny Ludlum (Louisville, OH)

Seven Experiment Designs Addressing Problems of Safety and Capacity on Two-Lane Rural Highways : Volume 3. Experimental Design to Evaluate MUTCD and Other Traffic Controls for Highway Construction and Maintenance Operations on Two-Lane Highways

DOT National Transportation Integrated Search

1996-11-01

The purpose of Task A was to conduct a literature review of human factors-applicable articles associated with Advanced Traveler Information Systems (ATIS) and ATIS-related commercial vehicle operations (CVO) systems. Specifically, Task A was to asses...

Establishing the Validity of the Affirmative Training Inventory: Assessing the Relationship between Lesbian, Gay, and Bisexual Affirmative Training and Students' Clinical Competence

ERIC Educational Resources Information Center

Carlson, Thomas Stone; McGeorge, Christi R.; Toomey, Russell B.

2013-01-01

This study established the validity and factor structure of the Affirmative Training Inventory (ATI; T. S. Carlson, C. R. McGeorge & M. Rock, unpublished) as a measure of lesbian, gay, and bisexual (LGB) affirmative clinical training. Additionally, this study examined the latent associations among the subscales of the ATI and the Sexual…

Evaluation of the inverted tee shallow bridge system for use in Kansas

DOT National Transportation Integrated Search

2006-12-01

With the introduction of the pre-stressed concrete Inverted Tee (IT) girders as an alternative to the conventional concrete slab bridges, the distribution of live load in this system required considerable investigation. The approximate equations give...

Three-dimensional transesophageal echocardiography: Principles and clinical applications.

PubMed

Vegas, Annette

2016-10-01

A basic understanding of evolving 3D technology enables the echocardiographer to master the new skills necessary to acquire, manipulate, and interpret 3D datasets. Single button activation of specific 3D imaging modes for both TEE and transthoracic echocardiography (TTE) matrix array probes include (a) live, (b) zoom, (c) full volume (FV), and (d) color Doppler FV. Evaluation of regional LV wall motion by RT 3D TEE is based on a change in LV chamber subvolume over time from altered segmental myocardial contractility. Unlike standard 2D TEE, there is no direct measurement of myocardial thickening or displacement of individual segments.

An update on intraoperative three-dimensional transesophageal echocardiography

PubMed Central

2017-01-01

Transesophageal echocardiography (TEE) was first used routinely in the operating rooms in the 1980s to facilitate surgical decision-making. Since then, TEE has evolved from the standard two-dimensional (2D) exam to include focused real-time three-dimensional (RT-3D) imaging both inside and outside the operating rooms. Improved spatial and temporal resolution due to technological advances has expedited surgical interventions in diseased valves. 3D imaging has also emerged as a crucial adjunct in percutaneous interventions for structural heart disease. With continued advancement in software, RT-3D TEE will continue to impact perioperative decisions. PMID:28540070

Transcanal endoscopic ear surgery for perilymphatic fistula after electric acoustic stimulation.

PubMed

Omichi, Ryotaro; Kariya, Shin; Maeda, Yukihide; Nishizaki, Kazunori

2018-06-01

Transcanal endoscopic ear surgery (TEES) will become a very useful therapeutic option. A perilymphatic fistula (PLF) is defined as sudden sensorineural hearing loss and/or vertigo caused by leakage of the perilymph through a fistula from the oval window and/or round window. We report a case of PLF after electric acoustic stimulation (EAS), a kind of cochlear implant, successfully treated by TEES. A 38-year-old man presented to our hospital with vertigo and hearing loss (HL). His vertigo was induced by Valsalva maneuvers. Eight months ago, he underwent EAS for his right ear for congenital sensorineural HL. Although he maintained his hearing level after EAS, his pure tone audiogram this time showed deterioration of hearing at low frequencies in his right ear. A diagnosis of right PLF was made. After confirming the non-effectiveness of oral prednisolone treatment, PLF repair surgery to patch the oval and round windows by TEES was performed. His vertigo did not recur after the surgery. To the best of our knowledge, this is the first report of PLF repair surgery by TEES without a microscope. The wide-field view of the middle ear by TEES was useful to prevent electrode damage in a PLF patient with a cochlear implant. Copyright © 2017 Elsevier B.V. All rights reserved.

Interaction between wheat alpha-amylase/trypsin bi-functional inhibitor and mammalian digestive enzymes: Kinetic, equilibrium and structural characterization of binding.

PubMed

Cuccioloni, Massimiliano; Mozzicafreddo, Matteo; Ali, Ishtiaq; Bonfili, Laura; Cecarini, Valentina; Eleuteri, Anna Maria; Angeletti, Mauro

2016-12-15

Alpha-amylase/trypsin bi-functional inhibitors (ATIs) are non-gluten protein components of wheat and other cereals that can hypersensitise the human gastrointestinal tract, eventually causing enteropathies in predisposed individuals. These inhibitory proteins can act both directly by targeting specific pro-inflammatory receptors, and indirectly by impairing the activity of digestive enzymes, the latter event causing the accumulation of undigested peptides with potential immunogenic properties. Herein, according to a concerted approach based on in vitro and in silico methods we characterized kinetics, equilibrium parameters and modes of binding of the complexes formed between wheat ATI and two representative mammalian digestive enzymes, namely trypsin and alpha-amylase. Interestingly, we demonstrated ATI to target both enzymes with independent binding sites and with moderately high affinity. Copyright © 2016 Elsevier Ltd. All rights reserved.

A new therapeutic strategy for electrical cardioversion of atrial fibrillation.

PubMed

de Luca, I; Sorino, M; Del Salvatore, B; de Luca, L

2001-11-01

The conventional approach to cardioversion of atrial fibrillation includes a period of anticoagulation with oral anticoagulant therapy (OAT) extending from 3 weeks precardioversion to 4 weeks postcardioversion. The protocol of rapid anticoagulation (such as that of the ACUTE study) consists of a precardioversion transesophageal echocardiography (TEE) followed by OAT for 4 weeks. In the last few years low-molecular-weight heparins have established themselves as a safe and efficacious alternative to traditional antithrombotic therapies. The aim of this study was to demonstrate that the exclusion of thrombi by precardioversion TEE together with the exclusion of atrial stunning by a second TEE performed after 1 week, to date not suggested in the literature, could reduce to 7 days the period of pericardioversion anticoagulation. This therapy would be carried out using low-molecular-weight heparins with no need for biological monitoring and with the possibility of self-administration. We have studied 57 consecutive patients who had atrial fibrillation or flutter with a history of atrial fibrillation lasting > 48 hours. All patients received enoxaparin at a dosage of 100 IU antiXa/kg twice daily before undergoing multiplane TEE. Previous informed consent and ethical committee authorization had been obtained. Twenty-four hours following TEE, in the absence of thrombi and/or spontaneous moderate/severe echocontrast in the atrial chambers, the patients underwent electrical cardioversion and were discharged within 24 hours of sinus rhythm restoration. These patients were prescribed enoxaparin at the indicated dosage twice daily until TEE, performed in an outpatients setting 7 days following cardioversion. In the absence of thrombi and/or atrial and/or left atrial appendage stunning, OAT was terminated. Enoxaparin was associated with OAT for the following 3 weeks if any of the following signs of stunning were present: A wave inferior to the normal value for age at transmitral Doppler; a left atrial appendage emptying velocity < 40 cm/s; the appearance or increase in the severity of spontaneous echocontrast. For all patients, clinical and electrocardiographic follow-up was carried out at 1 month. In one patient TEE was not tolerated and one refused it. In 7 patients cardioversion was not performed: 4 because of the presence of thrombi, 1 because of moderate/severe spontaneous echocontrast and 2 owing to spontaneous cardioversion. Of the remaining 48 patients, cardioversion proved to be efficacious in 38, with sustained sinus rhythm at 1 week in 33 patients. One of these refused the second TEE and of the remaining 32 patients, 24 (75%) showed no signs of stunning at the second TEE and so anticoagulation was terminated. Thus, after 1 week, 75% (24/33) of patients in sinus rhythm could benefit from a shortened anticoagulation therapy which lasted for a mean of only 8.5 days. No patients showed signs of a thromboembolic accident at 1 and 2 months of follow-up. Most patients undergoing electrical cardioversion for atrial fibrillation could benefit from a shorter period of anticoagulation with low-molecular-weight heparins for 1 week if TEE precardioversion and 7 days postcardioversion excludes thrombi and atrial stunning. The management of patients with atrial fibrillation would be greatly simplified.

Interatrial septum motion but not Doppler assessment predicts elevated pulmonary capillary wedge pressure in patients undergoing cardiac surgery.

PubMed

Haji, Darsim L; Ali, Mohamed M; Royse, Alistair; Canty, David J; Clarke, Sandy; Royse, Colin F

2014-10-01

Left atrial pressure and its surrogate, pulmonary capillary wedge pressure (PCWP), are important for determining diastolic function. The role of transthoracic echocardiography (TTE) in assessing diastolic function is well established in awake subjects. The objective was to assess the accuracy of predicting PCWP by TTE and transesophageal echocardiography (TEE) during coronary artery surgery. In 27 adult patients undergoing on-pump coronary artery surgery, simultaneous echocardiographic and hemodynamic measurements were obtained immediately before anesthesia (TTE), after anesthesia and mechanical ventilation (TTE and TEE), during conduit harvest (TEE), and after separation from cardiopulmonary bypass (TEE). Twenty patients had an ejection fraction (EF) of 0.5 or greater. With the exception of E/e' and S/D ratios, echocardiographic values changed over the echocardiographic studies. In patients with low EF, E velocity, deceleration time, pulmonary vein D, S/D, and E/e' ratios correlated well with PCWP before anesthesia. After induction of anesthesia using TTE or TEE, correlations were poor. In normal EF patients, correlations were poor for both TEE and TTE at all five stages. The sensitivity and specificity of echocardiographic values were not high enough to predict raised PCWP except for a fixed curve pattern of interatrial septum (area under the curve 0.89 for PCWP ≥ 17, and 0.98 for ≥ 18 mmHg) and S/D less than 1 (area under the curve 0.74 for PCWP ≥ 17, and 0.78 for ≥ 18 mmHg). Doppler assessment of PCWP was neither sensitive nor specific enough to be clinically useful in anesthetized patients with mechanical ventilation. The fixed curve pattern of the interatrial septum was the best predictor of raised PCWP.

The influence of lidocaine topical anesthesia during transesophageal echocardiography on blood methemoglobin level and risk of methemoglobinemia.

PubMed

Filipiak-Strzecka, Dominika; Kasprzak, Jarosław D; Wiszniewska, Marta; Walusiak-Skorupa, Jolanta; Lipiec, Piotr

2015-04-01

Methemoglobinemia is a relatively rare, but potentially life-threating medical condition, which may be induced by application of topical anaesthetic agents commonly used during endoscopic procedure. The aim of our study was to assess the influence of lidocaine used prior to transesophageal echocardiography (TEE) on the blood level of methemoglobin in vivo. Additionally we attempted to establish the occurrence rate of clinically evident lidocaine-induced methemoglobinemia on the basis of data collected in our institution. We retrospectively analyzed patient records from 3,354 TEEs performed in our echocardiographic laboratory over the course of 13 years in search for clinically evident methemoglobinemia cases. Additionally, 18 consecutive patients referred for TEE were included in the prospective part of our analysis. Blood samples were tested before and 60 min after pre-TEE lidocaine anesthesia application. Information concerning concomitant conditions and pharmacotherapy were also obtained. In 3,354 patients who underwent TEE in our institution no cases of clinically evident methemoglobinemia occurred. In the prospective part of the study, none of 18 patients [16 (89 %) men, mean age 63 ± 13] was diagnosed with either clinical symptoms of methemoglobinemia or exceeded normal blood concentration of methemoglobin. Initial mean methemoglobin level was 0.5 ± 0.1 % with mild, statistically (but not clinically) significant rise to 0.6 ± 0.1 % after 60 min (p = 0.02). Among the analyzed factors only the relation between the proton pump inhibitors intake and methemoglobin blood level rise was identified as statistically relevant (p = 0.03). In adults, pre-TEE lidocaine anesthesia with recommended dosage results in significant increase in methemoglobin blood level, which however does not exceed normal values and does not result in clinically evident methemoglobinemia.

Is CHA2DS2-VASc appropriate for hyperthyroid patients with atrial fibrillation? Implications of adding a transesophageal echocardiography evaluation.

PubMed

de Souza, Marcus Vinicius Leitão; de Fátima Dos Santos Teixeira, Patricia; Vaisman, Mario; Xavier, Sergio Salles

2017-02-01

Anticoagulation remains a controversial issue among hyperthyroid patients with atrial fibrillation (AF). We aimed to evaluate the prevalence of the thrombogenic milieu (TM), detected using transesophageal echocardiography (TEE), among patients with AF related to hyperthyroidism, and to correlate these findings with the clinical embolic risk classification (CHA 2 DS 2 -VASc). CHA 2 DS 2 -VASc score, thyroid hormonal status, time since hyperthyroidism diagnosis, transthoracic echocardiography (TTE) and TEE were assessed in 47 consecutive patients aged between 18 and 65years with AF related to hyperthyroidism. The following TEE parameters defined TM: dense spontaneous echo contrast, thrombi, or left atrial appendage (LAA) blood flow velocities <0.20m/s. Non-classic TM was defined as non-dense SEC plus LAA flow velocity 0.20-0.40m/s. Pulmonary hypertension was present in 39/47 (81.4%) and TM in 22/47 (46.8%) patients. Despite a low CHA 2 DS 2 -VASc score of 0/1, 10 of 19 (52.6%) patients had a TM, whereas 16 of 28 (57.1%) patients with score ≥2 had none. The probability of having a TM did not correlate with CHA 2 DS 2 -VASc scores. On regression binary analysis, hyperthyroidism diagnosed more than 12months previous was independently associated with non-classic TM (p=0.031). Among patients younger than 65years of age with AF related to hyperthyroidism, pulmonary hypertension and TM on TEE were highly prevalent. There was no association between CHA 2 DS 2 -VASc with TEE markers of TM. Thyroid status, especially longer duration of hyperthyroidism might influence thrombogenic abnormalities. TEE adds useful information that may change antithrombotic therapy if otherwise guided solely by clinical risk classification. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

The Validity of US Nutritional Surveillance: USDA's Loss-Adjusted Food Availability Data Series 1971-2010

PubMed Central

Archer, Edward; Thomas, Diana M.; McDonald, Samantha M.; Pavela, Gregory; Lavie, Carl J.; Hill, James O.; Blair, Steven N.

2016-01-01

The purpose of this study was to examine the validity of the 1971-2010 United States Department of Agriculture's (USDA's) loss-adjusted food availability (LAFA) per capita caloric consumption estimates. Estimated total daily energy expenditure (TEE) was calculated for nationally representative samples of US adults, 20-74 years, using the Institute of Medicine's predictive equations with “low-active” (TEE L-ACT) and “sedentary” (TEE SED) physical activity values. TEE estimates were subtracted from LAFA estimates to create disparity values (kcal/d). A validated mathematical model was applied to calculate expected weight change in reference individuals resulting from the disparity. From 1971-2010, the disparity between LAFA and TEE L-ACT varied by 394 kcal/d—(P < 0.001), from −205 kcal/d (95% CI: −214, −196) to +189 kcal/d (95% CI: 168, 209). The disparity between LAFA and TEE SED varied by 412 kcal/d (P < 0.001), from −84 kcal/d (95% CI: −93, −76) to +328 kcal/d (95% CI: 309, 348). Our model suggests that if LAFA estimates were actually consumed, reference individuals would have lost ∼1-4 kg/y from 1971-1980 (an accumulated loss of ∼ 12 to ∼36kg), and gained ∼ 3-7 kg/y from 1988-2010 (an accumulated gain of ∼42 to ∼98 kg). These estimates differed from the actual measured increments of 10 kg and 9 kg in reference men and women, respectively, over the 39-year period. The USDA LAFA data provided inconsistent, divergent estimates of per capita caloric consumption over its 39-year history. The large, variable misestimation suggests that the USDA LAFA per capita caloric intake estimates lack validity and should not be used to inform public policy. PMID:27914522

Comparison of estimates of resting energy expenditure equations in haemodialysis patients.

PubMed

Hung, Rachel; Sridharan, Sivakumar; Farrington, Ken; Davenport, Andrew

2017-04-21

Waste products of metabolism accumulate in patients with chronic kidney disease, and require clearance by haemodialysis (HD). We wished to determine whether there was an association between resting energy expenditure (REE) and total energy expenditure (TEE) in HD patients and body composition. We determined REE by recently validated equations (CKD equation) and compared REE with that estimated by standard equations for REE, and TEE calculated from patient reported physical activity, in HD patients with corresponding body composition measured by dual energy X-ray absorptiometry (DEXA) scanning. We studied 107 patients, 69 male (64.5%), mean age 62.7 ± 15.1 years. The CKD equation REE was 72.5 ± 13.3 watts (W) and TEE 83.2 ± 9.7 W. There was a strong association between REE with body surface area (BSA) (r2 = 0.80), total soft lean and fat lean tissue mass (r2 = 0.69), body mass index (BMI) (r2 = 0.34), all p<0.001. REE estimated using the modified Harris Benedict, Mifflin St. Jeor, Katch McArdle, Bernstein and Robertson equations underestimated REE compared to the CKD equation. TEE was more strongly associated with BSA (r2 = 0.51), appendicular muscle mass (r2 = 0.42), than BMI (r2 = 0.15) all p<0.001.TEE was greater for those employed (104.9 ± 10.7 vs. 83.1 ± 12.3 W, p<0.001), and with no co-morbidity (88.7 ± 14.8 vs. 82.7 ± 12.3 W, p<0.05). Standard equations underestimate REE in HD patients compared to the CKD equation. TEE was greater in those with more skeletal muscle mass, in those who were employed and in those with the least co-morbidity. More metabolically active patients may well require greater dialytic clearances.

In-vivo continuous monitoring of mixed venous oxygen saturation by photoacoustic transesophageal echocardiography (Conference Presentation)

NASA Astrophysics Data System (ADS)

Li, Li; Subramaniam, Balachundhar; Aguirre, Aaron D.; Andrawes, Michael N.; Tearney, Guillermo J.

2016-02-01

Mixed venous oxygen saturation (SvO2), measured from pulmonary arteries, is a gold-standard measure of the dynamic balance between the oxygen supply and demand in the body. In critical care, continuous monitoring of SvO2 plays a vital role in early detection of circulatory shock and guiding goal-oriented resuscitation. In current clinical practice, SvO2 is measured by invasive pulmonary artery catheters (PAC), which are associated with a 10% risk of severe complications. To address the unmet clinical need for a non-invasive SvO2 monitor, we are developing a new technology termed photoacoustic transesophageal echocardiography (PA-TEE). PA-TEE integrates transesophageal echocardiography with photoacoustic oximetry, and enables continuous assessment of SvO2 through an esophageal probe that can be inserted into the body in a minimally invasive manner. We have constructed a clinically translatable PA-TEE prototype, which features a mobile OPO laser, a modified ultrasonography console and a dual-modality esophageal probe. Comprised of a rotatable acoustic array detector, a flexible optical fiber bundle and a light-integrating acoustic lens, the oximetric probe has an outer diameter smaller than 15 mm and will be tolerable for most patients. Through custom-made C++/Qt software, our device acquires and displays ultrasonic and photoacoustic images in real time to guide the deployment of the probe. SvO2 is calculated on-line and updated every second. PA-TEE has now been used to evaluate SvO2 in living swine. Our findings show that changing the fraction of oxygen in the inspired gas modulates SvO2 measured by PA-TEE. Statistic comparison between SvO2 measurements from PA-TEE in vivo the gold-standard laboratorial analysis on blood samples drawn from PACs will be presented.

One-stop shop assessment for atrial septal defect closure using 256-slice coronary CT angiography.

PubMed

Yamasaki, Yuzo; Nagao, Michinobu; Kawanami, Satoshi; Kamitani, Takeshi; Sagiyama, Koji; Yamanouchi, Torahiko; Sakamoto, Ichiro; Yamamura, Kenichiro; Yabuuchi, Hidetake; Honda, Hiroshi

2017-02-01

To investigate the feasibility and accuracy of measurement of the pulmonary to systemic blood flow ratio (Qp/Qs) and defect and rim sizes in secundum atrial septal defects (ASDs) using 256-slice CT, compared to the reference transoesophageal echocardiography (TEE) and right heart catheterization (RHC) measurements. Twenty-three consecutive adult patients with secundum ASDs who underwent retrospective ECG-gated coronary CT angiography (CCTA), TEE and RHC were enrolled in this study. Right ventricular (RV) and left ventricular (LV) stroke volumes (SV) were calculated by biventricular volumetry of CCTA. Qp/Qs-CT was defined as RVSV/LVSV. The sizes of the defect and rim were measured by multi-planar reconstruction CT images. Correlations between Qp/Qs-CT and Qp/Qs-RHC and between the defect diameter obtained by CT and TEE were analyzed by Pearson's coefficient analysis. Rim sizes by CT and TEE were compared by paired t-test. Qp/Qs-CT was significantly correlated with Qp/Qs-RHC (r = 0.83, p < 0.0001), and the defect diameter by CT was significantly correlated with that by TEE (r = 0.95, p < 0.0001). There was no significant difference between CT and TEE in measurements of rim size. 256-slice CCTA allows measuring Qp/Qs and size of defects and rims in patients with secundum ASDs, accomplishing pretreatment evaluation non-invasively and comprehensively. • Quantification of left-to-right shunting can be performed reliably and accurately by CT. • The sizes of defects and rims can be measured accurately using 256-slice CT. • 256-slice CT permits pretreatment evaluation of ASD non-invasively and comprehensively.

Clinical Management of Staphylococcus aureus Bacteremia

PubMed Central

Holland, Thomas L.; Arnold, Christopher; Fowler, Vance G.

2014-01-01

Importance Several management strategies may improve outcomes in patients with Staphylococcus aureus bacteremia (SAB). The strength of evidence supporting these management strategies, however, varies widely. Objective To perform a systematic review of the evidence for two unresolved questions involving management strategies for SAB: 1) is transesophageal echocardiography (TEE) necessary in all cases of SAB; and 2) what is the optimal antibiotic therapy for methicillin resistant Staphylococcus aureus (MRSA) bacteremia? Evidence acquisition A PubMed search from inception through May 2014 was performed to find studies that addressed the role of TEE in SAB. A second search of PubMed, EMBASE, and The Cochrane Library from 1/1/1990 to 5/28/2014 was performed to find studies that addressed antibiotic treatment of MRSA bacteremia. Studies that reported outcomes of systemic antibiotic therapy for MRSA bacteremia were included. All searches were augmented by review of bibliographic references from included studies. The quality of evidence was assessed using the GRADE system by consensus of independent evaluations by at least two authors. Results In 9 studies with a total of 3513 patients, use of TEE was associated with higher rates of diagnosis of endocarditis (14–25%) when compared with TTE (2–14%). Five studies proposed criteria to identify patients in whom TEE might safely be avoided. Only one high-quality trial of antibiotic therapy for MRSA bacteremia was identified from the 83 studies considered. Conclusions and relevance Most contemporary management strategies for SAB are based upon low quality evidence. TEE is indicated in most patients with SAB. It may be possible to identify a subset of SAB patients for whom TEE can be safely avoided. Vancomycin and daptomycin are the first-line antibiotic choices for MRSA bacteremia. Well-designed studies to address the management of SAB are desperately needed. PMID:25268440

Locus of Control & Motivation Strategies for Learning Questionnaire: Predictors of Student Success on the ATI Comprehensive Predictor Exam & NCLEX-RN Examination

ERIC Educational Resources Information Center

Carpenter, Jane H.

2011-01-01

The two purposes of this study were to determine whether locus of control (LOC) was predictive of how a student would perform on the ATI Comprehensive Predictor Exam and the NCLEX-RN, and if the Motivated Strategies for Learning Questionnaire (MSLQ) provided information that would help determine predictors of success on these two exams. The study…

Assessment of Cell Line Models of Primary Human Cells by Raman Spectral Phenotyping

PubMed Central

Swain, Robin J.; Kemp, Sarah J.; Goldstraw, Peter; Tetley, Teresa D.; Stevens, Molly M.

2010-01-01

Abstract Researchers have previously questioned the suitability of cell lines as models for primary cells. In this study, we used Raman microspectroscopy to characterize live A549 cells from a unique molecular biochemical perspective to shed light on their suitability as a model for primary human pulmonary alveolar type II (ATII) cells. We also investigated a recently developed transduced type I (TT1) cell line as a model for alveolar type I (ATI) cells. Single-cell Raman spectra provide unique biomolecular fingerprints that can be used to characterize cellular phenotypes. A multivariate statistical analysis of Raman spectra indicated that the spectra of A549 and TT1 cells are characterized by significantly lower phospholipid content compared to ATII and ATI spectra because their cytoplasm contains fewer surfactant lamellar bodies. Furthermore, we found that A549 spectra are statistically more similar to ATI spectra than to ATII spectra. The spectral variation permitted phenotypic classification of cells based on Raman spectral signatures with >99% accuracy. These results suggest that A549 cells are not a good model for ATII cells, but TT1 cells do provide a reasonable model for ATI cells. The findings have far-reaching implications for the assessment of cell lines as suitable primary cellular models in live cultures. PMID:20409492

Spectral Monitoring of Surfactant Clearance during Alveolar Epithelial Type II Cell Differentiation

PubMed Central

Swain, Robin J.; Kemp, Sarah J.; Goldstraw, Peter; Tetley, Teresa D.; Stevens, Molly M.

2008-01-01

In this study, we report on the noninvasive identification of spectral markers of alveolar type II (ATII) cell differentiation in vitro using Raman microspectroscopy. ATII cells are progenitor cells for alveolar type I (ATI) cells in vivo, and spontaneously differentiate toward an ATI-like phenotype in culture. We analyzed undifferentiated and differentiated primary human ATII cells, and correlated Raman spectral changes to cellular changes in morphology and marker protein synthesis (surfactant protein C, alkaline phosphatase, caveolin-1). Undifferentiated ATII cells demonstrated spectra with strong phospholipid vibrations, arising from alveolar surfactant stored within cytoplasmic lamellar bodies (Lbs). Differentiated ATI-like cells yielded spectra with significantly less lipid content. Factor analysis revealed a phospholipid-dominated spectral component as the main discriminator between the ATII and ATI-like phenotypes. Spectral modeling of the data revealed a significant decrease in the spectral contribution of cellular lipids—specifically phosphatidyl choline, the main constituent of surfactant, as ATII cells differentiate. These observations were consistent with the clearance of surfactant from Lbs as ATII cells differentiate, and were further supported by cytochemical staining for Lbs. These results demonstrate the first spectral characterization of primary human ATII cells, and provide insight into the biochemical properties of alveolar surfactant in its unperturbed cellular environment. PMID:18820234

NAREM Journal. Volume 1, 1978.

ERIC Educational Resources Information Center

Narem Journal, 1978

1978-01-01

Eight articles are included in the journal of the National Association for Remedial Education, Malaysia (NAREM). Chua Tee Tee describes the history and objectives of NAREM. Alec Williams reviews philosophical issues in remedial education. Khoo Phon Sai discusses cognitive, social, and emotional characteristics of slow learners and considers…

Incidental movement, lifestyle-embedded activity and sleep: new frontiers in physical activity assessment.

PubMed

Tremblay, Mark S; Esliger, Dale W; Tremblay, Angelo; Colley, Rachel

2007-01-01

Canadian public health messages relating to physical activity have historically focused on the prescription of purposeful exercise, most often assessing leisure-time physical activity (LTPA). Although LTPA contributes to total energy expenditure (TEE), a large part of the day remains neglected unless one also considers the energy expended outside of purposeful exercise. This paper reviews the potential impact of incidental (non-exercise or non-purposeful) physical activity and lifestyle-embedded activities (chores and incidental walking) upon TEE and indicators of health. Given that incidental movement occurs sporadically throughout the day, this form of energy expenditure is perhaps most vulnerable to increasingly ubiquitous mechanization and automation. The paper also explores the relationship of physical inactivity, including sleep, to physical activity, TEE, and health outcomes. Suggestions are provided for a more comprehensive physical activity recommendation that includes all components of TEE. Objective physical activity monitors with time stamps are considered as a better means to capture and examine human movements over the entire day.

The transesophageal echocardiography simulator based on computed tomography images.

PubMed

Piórkowski, Adam; Kempny, Aleksander

2013-02-01

Simulators are a new tool in education in many fields, including medicine, where they greatly improve familiarity with medical procedures, reduce costs, and, importantly, cause no harm to patients. This is so in the case of transesophageal echocardiography (TEE), in which the use of a simulator facilitates spatial orientation and helps in case studies. The aim of the project described in this paper is to simulate an examination by TEE. This research makes use of available computed tomography data to simulate the corresponding echocardiographic view. This paper describes the essential characteristics that distinguish these two modalities and the key principles of the wave phenomena that should be considered in the simulation process, taking into account the conditions specific to the echocardiography. The construction of the CT2TEE (Web-based TEE simulator) is also presented. The considerations include ray-tracing and ray-casting techniques in the context of ultrasound beam and artifact simulation. An important aspect of the interaction with the user is raised.

Partial anomalous pulmonary venous connection: diagnosis by transesophageal echocardiography.

PubMed

Ammash, N M; Seward, J B; Warnes, C A; Connolly, H M; O'Leary, P W; Danielson, G K

1997-05-01

This study sought to demonstrate that with proper technique, identification of the normal and abnormal pulmonary venous connection can be made with confidence using transesophageal echocardiography (TEE). Partial anomalous pulmonary venous connection (PAPVC) is an uncommon congenital anomaly whose diagnosis has classically been made using angiography. We performed a retrospective review of all patients of all ages with PAPVC diagnosed at the Mayo Clinic who had undergone TEE because of either right ventricular volume overload or suspected intracardiac shunting by transthoracic echocardiography or intraoperatively. A total of 66 PAPVCs were detected in 43 patients (1.5/patient); in 2 additional patients, TEE suggested, but did not diagnose, PAPVCs. Shortness of breath was the most common presenting symptom (42.2%), followed by heart murmur and supraventricular tachycardia. Right-sided anomalous veins were identified in 35 patients (81.4%), left-sided in 7 (16.3%) and bilateral in 1 (2.3%). There was a single anomalous connecting vein in 23 patients (53.5%), two in 18 (41.9%), three in 1 (2.3%) and four in 1 (2.3%). The connecting site was the superior vena cava (SVC) in 39 veins (59.1%), right atrial-SVC junction in 6 (9.1%), right atrium in 8 (12.1%), inferior vena cava in 1 (1.5%) and the coronary sinus in 2 (3.0%). Ten anomalous left pulmonary veins were connected by a vertical vein to the innominate vein (15.1%). Sinus venosus atrial septal defect (ASD) was the most common associated anomaly in 22 patients (49%), followed by ostium secundum ASD in 6 and patent foramen ovale in 4. Fifteen patients had an intact atrial septum. Thirty-one patients (68.8%) underwent surgical repair. PAPVC was confirmed in all patients, including the two whose TEE results were suggestive of PAPVC. All 49 PAPVCs detected by TEE preoperatively were confirmed at the time of operation. TEE is highly diagnostic for PAPVC and can obviate angiography. Accurate anatomic diagnosis may influence the need for medical and surgical management. TEE should be performed in patients with right ventricular volume overload when the precordial examination is inconclusive.

A unique case of "double-orifice aortic valve"-comprehensive assessment by 2-, 3-dimensional, and color Doppler echocardiography.

PubMed

Stirrup, James E; Cowburn, Peter J; Pousios, Dimitrios; Ohri, Sunil K; Shah, Benoy N

2016-09-01

Transesophageal echocardiography (TEE) is a powerful imaging tool for the comprehensive assessment of valvular structure and function. TEE may be of added benefit when anatomy is difficult to delineate accurately by transthoracic echocardiography. In this article, we present 2-, 3-dimensional, and color Doppler TEE images from a male patient with aortic stenosis. A highly unusual and complex pattern of valvular calcification created a functionally "double-orifice" valve. Such an abnormality may have implications for the accuracy of continuous-wave Doppler echocardiography, which assumes a single orifice valve in native aortic valves. © 2016, Wiley Periodicals, Inc.

Diagnosis of the prosthetic heart valve pannus formation with real-time three-dimensional transoesophageal echocardiography.

PubMed

Ozkan, Mehmet; Gündüz, Sabahattin; Yildiz, Mustafa; Duran, Nilüfer Eksi

2010-05-01

Prosthetic heart valve obstruction (PHVO) caused by pannus formation is an uncommon but serious complication. Although two-dimensional transesophageal echocardiography (2D-TEE) is the method of choice in the evaluation of PHVO, visualization of pannus is almost impossible with 2D-TEE. While demonstrating the precise aetiology of PHVO is essential for guiding the therapy, either thrombolysis for valve thrombosis or surgery for pannus formation, more sophisticated imaging techniques are needed in patients with suspected pannus formation. We present real-time 3D-TEE imaging in a patient with mechanical mitral PHVO, clearly demonstrating pannus overgrowth.

Fatigue and shear behavior of HPC bulb-tee girders: final report.

DOT National Transportation Integrated Search

2005-02-01

Five 96-ft. (29.3-m) long, 72-in. (1.83-m) deep, precast, pretensioned bulb-tee girders were tested to evaluate their behavior under flexural fatigue. Three of the girders were also tested to measure their static shear strength. One girder was tested...

Fatigue and shear behavior of HPC bulb-tee girders : interim report.

DOT National Transportation Integrated Search

2003-10-01

Three 96-ft (29.3-m) long, 72-in. (1.83-m) deep, precast, pretensioned bulb-tee girders were tested to evaluate behavior under flexural fatigue and static shear loadings. The three girders had a design concrete compressive strength of 10,000 psi (69....

Intraoperative three-dimensional transesophageal echocardiography for assessing the defect geometries of mitral prosthetic paravalvular leak during transcatheter closure.

PubMed

Wei, Jeng; Yin, Wei-Hsian; Lee, Yung-Tsai; Hsiung, Ming C; Tsai, Shen-Kou; Chuang, Yi Cheng; Ou, Ching-Huei; Chou, Yi-Pen

2015-03-01

Paravalvular leaks (PVLs) are a common complication of prosthetic valve replacement. Use of the transcatheter intervention technique is a suitable alternative in high-risk patients who may not tolerate repeat surgery. Common reasons for failure of this demanding intervention include poor imaging quality and unsuitable anatomy. The purpose of this study was to assess the usefulness and the incremental value of real-time three-dimensional (RT 3D) transesophageal echocardiography (TEE) over two-dimensional (2D) TEE findings in the evaluation of the geometry and track of mitral PVLs during transcatheter closure. Five patients with six mitral PVLs at high risk for repeat surgery underwent transcatheter leak closure. Intraoperative RT 3DTEE was used to assess the location, shape, number, and size of the defects. Transapical approaches were used in all cases with fluoroscopic and RT 3D TEE guidance of the wire and catheter, device positioning, and assessment of residual leak after the procedure. In all of the cases, defects with irregular crescent shapes and distorted tracks were clearly delineated by RT 3D TEE. This was compared to those results obtained through 2D TEE, which was unable to characterize the defects. Three cases showed small leaks, which were completely occluded with a patent ductus arteriosus (PDA) device in two cases, and a muscular ventricular septal defect (mVSD) occluder combined with coil devices in one case. One case involved a large leak and early device embolization of the muscular VSD occluder, which was removed surgically, and demonstrated a crescent-shaped defect. One patient had two releaks 2 months subsequent to the procedure due to two new extended leaks at the tails of the crescent-shaped defect. RT 3D TEE can clearly delineate the geometries of defects in their entirety, including shape, size, and location of the defect and track canal. It would also appear that RT 3D TEE is superior to 2D TEE in the process of guiding the wire through the difficult canal anatomy, facilitating the overall procedure. The small mitral PVLs can be completely occluded, but subsequent complications occurred with large defect closures because of embolization or releak. Therefore, transcatheter closure of PVLs seems to be an attractive alternative for these patients, but newer occluder designs that better conform to leak geometry will be required to improve outcomes. Copyright © 2014. Published by Elsevier Taiwan.

Transepithelial elimination of cutaneous vulval granuloma inguinale.

PubMed

Ramdial, P K; Kharsany, A B; Reddy, R; Chetty, R

2000-11-01

Transepithelial elimination (TEE), a distinct and well-known entity, is a process during which the skin eradicates undesirable or irritative dermal substances through intact epidermis or follicular epithelium by passive or active means. Although TEE is being described in an increasing number and range of pathological processes, to date, TEE of granuloma inguinale (GI) remains unrecorded in the English-language literature. The aims of this study were: 1) To appraise the light microscopic and ultrastructural morphological epidermal changes that are associated with TEE of cutaneous vulval GI; and 2) To determine the role of intra-epidermal leucocytes and histiocytes in the pathogenesis of TEE of vulval GI. This is a retrospective 9-year histopathological review of all cases diagnosed and coded as vulval granuloma inguinale in the Department of Anatomical Pathology, Nelson R. Mandela School of Medicine, University of Natal, Durban, South Africa. Ultrastructural evaluation was performed on selected cases using a Jeol transmission electron microscope. Of 53 skin biopsies from 47 patients with vulval GI, 43 were suitable for the study. The age range of patients was 15-40 years (mean age=22 years). There were eleven papular, twelve nodular, seven verrucous and thirteen ulcerative lesions. Donovan bodies within macrophages, free-lying Donovan bodies and dense aggregates of neutrophils and plasma cells were seen in the dermis of all biopsies. There was consistent overlying pseudoepitheliomatous hyperplasia. The dermal inflammatory infiltrate hugged the dermo-epidermal junction and appeared entrapped between elongated and acanthotic epidermal rete ridges and pegs. Transepidermal neutrophil microabscesses, histiocytes containing Donovan bodies and neutrophilic and histiocytic fragmentation were present. A variable number of free-lying and intra-histiocytic Donovan bodies and neutrophils were present on the surface of the epidermis. On ultrastructural investigation epidermal spongiosis, intracellular oedema, free-lying, intra-neutrophilic and intra-histiocytic Donovan bodies, and intact and degenerating neutrophils and histiocytes were evident between keratinocytes. The degenerative histiocytes demonstrated marked vacuolation, mitochondrial swelling and bacilli within phagolysosomal vacuoles, bound by intact or disrupted limiting membranes. The inflammatory infiltrate at the epitheliomesenchymal interface, pseudoepitheliomatous hyperplasia, intra-epidermal accumulation and disintegration of neutrophils and histiocytes, and the associated release of lytic enzymes, play important contributory roles in TEE of GI. TEE of infectious agents is a poorly recognised mechanism of spread of infectious diseases and represents a public health hazard. In cutaneous vulval GI, TEE is highlighted as a hitherto unrecognised, potential method of spread of Calymmatobacterium granulomatis.

Detection of cardiovascular shunts by transesophageal echocardiography in patients with pulmonary hypertension of unexplained cause.

PubMed

Chen, W J; Chen, J J; Lin, S C; Hwang, J J; Lien, W P

1995-01-01

The purpose of this study was to validate the usefulness of transesophageal echocardiography (TEE) in the assessment of cardiovascular shunts in patients with pulmonary hypertension (PH) of unexplained cause. Twenty-four adult patients, 16 women, 8 men; 15 to 70 years of age, with PH of unexplained cause were studied. All were examined by transthoracic echocardiography (TTE) and TEE. TTE showed the ventricular septal defect in two patients, muscular type in one and perimembranous type in the other. TEE showed the atrial septal defect in eight patients (secundum type in six and primum type in the remaining) and the patient ductus arteriosus in six patients, which were not seen by TTE. The ventricular septal defect shown by TTE was also found by TEE. Patients with a ventricular septal defect were also associated with a patient ductus arteriosus. Among 14 patients with cardiovascular lesions, nine patients displayed a pattern of bidirectional shunt, four a pure left-to-right shunt, and the remaining one a pure right-to-left shunt. All of the cardiovascular defects could be confirmed by passage of the catheter across the defect at cardiac catheterization. In light of PH, transthoracic identification of cardiovascular shunts is difficult because of the low velocity across the defect. In this study, we found that TEE was superior to TTE in detecting and localizing cardiovascular malformations in patient with PH.

Comparison of ground-based and space flight energy expenditure and water turnover in middle-aged healthy male US astronauts

NASA Technical Reports Server (NTRS)

Lane, H. W.; Gretebeck, R. J.; Schoeller, D. A.; Davis-Street, J.; Socki, R. A.; Gibson, E. K.

1997-01-01

Energy requirements during space flight are poorly defined because they depend on metabolic-balance studies, food disappearance, and dietary records. Water turnover has been estimated by balance methods only. The purpose of this study was to determine energy requirements and water turnover for short-term space flights (8-14 d). Subjects were 13 male astronauts aged 36-51 y with normal body mass indexes (BMIs). Total energy expenditure (TEE) was determined during both a ground-based period and space flight and compared with the World Health Organization (WHO) calculations of energy requirements and dietary intake. TEE was not different for the ground-based and the space-flight periods (12.40 +/- 2.83 and 11.70 +/- 1.89 MJ/d, respectively), and the WHO calculation using the moderate activity correction was a good predictor of TEE during space flight. During the ground-based period, energy intake and TEE did not differ, but during space flight energy intake was significantly lower than TEE; body weight was also less at landing than before flight. Water turnover was lower during space flight than during the ground-based period (2.7 +/- 0.6 compared with 3.8 +/- 0.5 L/d), probably because of lower fluid intakes and perspiration loss during flight. This study confirmed that the WHO calculation can be used for male crew members' energy requirements during short space flights.

The use of TEE simulation in teaching basic echocardiography skills to senior anesthesiology residents.

PubMed

Jelacic, Srdjan; Bowdle, Andrew; Togashi, Kei; VonHomeyer, Peter

2013-08-01

The authors evaluated the educational benefits of using a first-generation HeartWorks simulator to teach senior anesthesiology residents basic echocardiography skills. Prospective observational study. A single academic medical center (teaching hospital). Thirty-seven senior (fourth-year) anesthesiology residents participated in this study. Groups of 3 senior anesthesiology residents participated in a single 3-hour tutorial in the simulation laboratory in the authors' institution during their cardiothoracic anesthesiology rotation. A cardiothoracic anesthesiology faculty member demonstrated the use of the transesophageal echocardiography (TEE) simulator and instructed the residents on obtaining standard TEE views of normal anatomy. Prior to the laboratory session, the residents took an online multiple-choice pretest with 25 questions related to safety, probe manipulation, clinical application, and pathology, which was accompanied by echo images of normal cardiac anatomy and video clips of pathology. Three to four weeks after the TEE tutorial, the residents completed an online post-test and evaluation of the teaching session. There was a statistically significant increase in knowledge of normal echocardiographic anatomy (p = 0.04), with an average improvement in normal echocardiographic anatomy scores of 15%. Virtual reality TEE simulation technology was endorsed strongly by residents, produced a statistically significant improvement in knowledge of normal echocardiographic anatomy, and could be effective for teaching basic echocardiography to anesthesiology residents. Copyright © 2013 Elsevier Inc. All rights reserved.

Alternative Models for Individualized Armor Training. Part I. Interim Report: Review and Analysis of the Literature

DTIC Science & Technology

1980-01-01

for an individualized instructional con- text is provided by Giordono (1975), in his discussion of the design of a " non - lockstep educational system...state of ATI research, sum- marized the methodological and theoretical problems that may have inhibited the application of ATI findings to the design ...years. In contrast, systematic modifications based on results obtained through the application of appropriate experimental designs are desired and

Space-Charge Effect on Residual Energy Under Intense Ultrashort Pulse Laser

NASA Astrophysics Data System (ADS)

Chen, Shi-gang; Wang, You-qin; Nie, Xiaebo

1996-12-01

Can the space-charge effect reduce the above-threshold-ionization (ATI) energy? This problem is analyzed by using the technique of multiple-time-scale perturbation. As the optical frequency is much larger than the plasma frequency, the space-charge effect is then reduced to the ponderomotive effect. It is found that the ponderomotive effect on residual energy is great as half plasma period is larger than pulse length, however, it cannot reduce the ATI energy over the whole density range. The relevant experiments are analyzed. Their results support our conclusions. Finally, it is pointed out that for a given pulse laser there may be a density range available for optical field ionization x-ray laser over which only the ATI heating plays role. The project supported by the National Natural Science Foundation of China and the Science Foundation of the Chinese Academy of Engineering Physics

Weaving a Stronger Fabric for Improved Outcomes

ERIC Educational Resources Information Center

Lobry de Bruyn, Lisa; Prior, Julian; Lenehan, Jo

2014-01-01

Purpose: To explain how training and education events (TEEs) can be designed to increase the likelihood of achieving behavioural objectives. Approach: The approach combined both a quantitative review of evaluation surveys undertaken at the time of the TEE, and qualitative telephone interviews with selected attendees (2025% of the total population…

94. VIEW OF PILINGS ON SOUTHEAST SIDE, WITH 4TH TEE ...

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

94. VIEW OF PILINGS ON SOUTHEAST SIDE, WITH 4TH TEE IN THE BACKGROUND, FACING WEST-SOUTHWEST FROM SOUTHEAST CORNER OF THE TACKLE BOX. RAMP OF PIER EXTENSION IS VISIBLE ON RIGHT - Huntington Beach Municipal Pier, Pacific Coast Highway at Main Street, Huntington Beach, Orange County, CA

Pilot Study: Comparison of Sourdough Wheat Bread and Yeast-Fermented Wheat Bread in Individuals with Wheat Sensitivity and Irritable Bowel Syndrome.

PubMed

Laatikainen, Reijo; Koskenpato, Jari; Hongisto, Sanna-Maria; Loponen, Jussi; Poussa, Tuija; Huang, Xin; Sontag-Strohm, Tuula; Salmenkari, Hanne; Korpela, Riitta

2017-11-04

Many patients suspect wheat as being a major trigger of their irritable bowel syndrome (IBS) symptoms. Our aim was to evaluate whether sourdough wheat bread baked without baking improvers and using a long dough fermentation time (>12 h), would result in lower quantities of alpha-amylase/trypsin inhibitors (ATIs) and Fermentable, Oligo-, Di-, Mono-saccharides and Polyols (FODMAPs), and would be better tolerated than yeast-fermented wheat bread for subjects with IBS who have a poor subjective tolerance to wheat. The study was conducted as a randomised double-blind controlled 7-day study ( n = 26). Tetrameric ATI structures were unravelled in both breads vs. baking flour, but the overall reduction in ATIs to their monomeric form was higher in the sourdough bread group. Sourdough bread was also lower in FODMAPs. However, no significant differences in gastrointestinal symptoms and markers of low-grade inflammation were found between the study breads. There were significantly more feelings of tiredness, joint symptoms, and decreased alertness when the participants ate the sourdough bread ( p ≤ 0.03), but these results should be interpreted with caution. Our novel finding was that sourdough baking reduces the quantities of both ATIs and FODMAPs found in wheat. Nonetheless, the sourdough bread was not tolerated better than the yeast-fermented bread.

Esophageal Perforation After Transesophageal Echocardiogram.

PubMed

Shapira, Michael Y.; Hirshberg, Boaz; Agid, Ronit; Zuckerman, Elena; Caraco, Yoseph

1999-02-01

Esophageal rupture after transesophageal echocardiogram (TEE) is a rare but life-threatening complication. Risk factors for perforation include spasm or hypertrophy of the cricopharyngeal sphincter, cervical arthritis, forward and left lateral bending of the distal esophagus, and esophageal disease such as inflammation or neoplasm. We present the case of a 80-year-old woman who developed perforation of her esophagus after TEE. Prior irradiation to the chest due to treatment for breast cancer and subsequent fibrosis probably contributed to this complication. Physicians referring patients for a TEE and physicians performing this procedure should be aware for the risk of perforation. The identification of risk factors and gentle maneuvering of the probe may prevent this severe, life-threatening complication.

Transesophageal echocardiography: first-line imaging for aortic diseases

NASA Technical Reports Server (NTRS)

Yalcin, F.; Thomas, J. D.; Homa, D.; Flachskampf, F. A.

2000-01-01

Transesophageal echocardiography (TEE) is now commonly used to evaluate the thoracic aorta, because it is widely available and provides high-resolution images and flow information by Doppler. This article reviews the essential features on TEE of acute and chronic aortic diseases, such as aortic dissection, aneurysm, and atherosclerosis, and discusses its strengths, weaknesses, and indications.

Propellers: Why Do They Work?

ERIC Educational Resources Information Center

Mitts, Charles R.

2013-01-01

In order for technology and engineering education (T&EE) students to meet the design challenges of this century, T&EE teachers will need to deepen their content pedagogy in the areas of science and math. This raises the question: Will the need to deepen content pedagogy initiate a process of change that transforms technology and engineering…

77 FR 52761 - Notice of Lodging of Consent Decrees Under the Comprehensive Environmental Response, Compensation...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-30

... Corporation, Cyprus Amax Minerals Company, Inc., Blue Tee Corp., and Homestake Mining Company of California... to settle their liability at the Site. Cyprus Mines Corporation, Cyprus Amax Minerals Company, Inc... Corporation, Cyprus Amax Minerals Company, Inc., Blue Tee Corp., and Homestake Mining Company of California...

ADDING GLYCERINE TO ECO-FRIENDLY GOLF TEES TO ACCELERATE BIODEGRADABILITY AND IMPROVE FABRICATION

EPA Science Inventory

It is expected that a suitable combination of DDGS and glycerine with PLA as well as a corresponding blend with corn-starch will be found. These blends will be applicable to a commercial, biodegradable golf tee with superior environmental properties, compared to what is on the...

Multi-point estimation of total energy expenditure: a comparison between zinc-reduction and platinum-equilibration methodologies.

PubMed

Sonko, Bakary J; Miller, Leland V; Jones, Richard H; Donnelly, Joseph E; Jacobsen, Dennis J; Hill, James O; Fennessey, Paul V

2003-12-15

Reducing water to hydrogen gas by zinc or uranium metal for determining D/H ratio is both tedious and time consuming. This has forced most energy metabolism investigators to use the "two-point" technique instead of the "Multi-point" technique for estimating total energy expenditure (TEE). Recently, we purchased a new platinum (Pt)-equilibration system that significantly reduces both time and labor required for D/H ratio determination. In this study, we compared TEE obtained from nine overweight but healthy subjects, estimated using the traditional Zn-reduction method to that obtained from the new Pt-equilibration system. Rate constants, pool spaces, and CO2 production rates obtained from use of the two methodologies were not significantly different. Correlation analysis demonstrated that TEEs estimated using the two methods were significantly correlated (r=0.925, p=0.0001). Sample equilibration time was reduced by 66% compared to those of similar methods. The data demonstrated that the Zn-reduction method could be replaced by the Pt-equilibration method when TEE was estimated using the "Multi-Point" technique. Furthermore, D equilibration time was significantly reduced.

The potential impact of contemporary transthoracic echocardiography on the management of patients with native valve endocarditis: a comparison with transesophageal echocardiography.

PubMed

Casella, Francesco; Rana, Bushra; Casazza, Giovanni; Bhan, Amit; Kapetanakis, Stam; Omigie, Joe; Reiken, Joseph; Monaghan, Mark J

2009-09-01

Between 1987 and 1994, several studies demostrated transthoracic echocardiography (TTE) to be less sensitive than transesophageal echocardiography (TEE) in detecting native valve endocarditis. Recent technologic advances, especially the introduction of harmonic imaging and digital processing and storage, have improved TTE image quality. The aim of this study was to determine the diagnostic accuracy of contemporary TTE. Between 2003 and 2007, 75 patients underwent both TTE and TEE for clinically suspected infective endocarditis. The diagnostic accuracy of TTE was assessed using transesophageal echocardiography as the gold standard for diagnosis of endocarditis. Of the 75 patients in this study, 33 were found to be positive by TEE. The sensitivity for detection of infective endocarditis by TTE was 81.8%. It provided good image quality in 81.5% of cases; in these patients sensitivity was even greater (89.3%). Contemporary TTE has improved the diagnostic accuracy of infective endocarditis by ameliorating image quality; it provides an accurate assessment of endocarditis and may reduce the need for TEE.

Circulating microparticles and the risk of thromboembolic events in Egyptian beta thalassemia patients.

PubMed

Youssry, Ilham; Soliman, Nohair; Ghamrawy, Mona; Samy, Rania Mohamed; Nasr, Amal; Abdel Mohsen, Mohamed; ElShahaat, Mohamed; Bou Fakhredin, Rayan; Taher, Ali

2017-04-01

The presence of elevated numbers of circulating microparticles (MPs) has been hypothesized to be responsible for the occurrence of thromboembolic events (TEEs) in thalassemic patients. Our aim is to evaluate the presence and the thrombotic risk of circulating MPs in thalassemia patients and to determine the difference in MPs between β-thalassemia major (β-TM) and thalassemia intermedia (TI). The percentage of the annexin-labeled MPs, platelet-derived MPs (PMPs), erythrocyte-derived MPs (RMPs), and endothelial-derived MPs (EMPs) was measured by flow cytometry, in 87 thalassemia patients (39 β-TM and 48 TI). By multiple regression analysis, we then assessed the various independent risk factors for the occurrence of TEE. The thalassemic patients who experienced TEE had a significantly higher platelet count, higher percentage of annexin-labeled MPs, and higher percentage of PMPs (p value = 0.014, 0.003, and 0.014, respectively). There was no significant difference between β-TM and TI patients at the level of any of the studied MPs. The predictive risk factors for TEE in thalassemic patients were splenectomy, total and direct bilirubin, the RMPs, and the EMPs (OR = 10.07 (CI = 3.7-27.1), 4.3 (CI = 2.1-8.7), 1.4 (CI = 1.5-6.2), 1.6 (CI = 1.1-2.2), 3.0 (CI = 1.9-4.9), respectively). In conclusion, the elevated numbers of circulating MPs is a risk factor for the TEE in thalassemia patients.

Poor agreement between continuous measurements of energy expenditure and routinely used prediction equations in intensive care unit patients.

PubMed

Reid, Clare L

2007-10-01

A wide variation in 24h energy expenditure has been demonstrated previously in intensive care unit (ICU) patients. The accuracy of equations used to predict energy expenditure in critically ill patients is frequently compared with single or short-duration indirect calorimetry measurements, which may not represent the total energy expenditure (TEE) of these patients. To take into account this variability in energy expenditure, estimates have been compared with continuous indirect calorimetry measurements. Continuous (24h/day for 5 days) indirect calorimetry measurements were made in patients requiring mechanical ventilation for 5 days. The Harris-Benedict, Schofield and Ireton-Jones equations and the American College of Chest Physicians recommendation of 25 kcal/kg/day were used to estimate energy requirements. A total of 192 days of measurements, in 27 patients, were available for comparison with the different equations. Agreement between the equations and measured values was poor. The Harris-Benedict, Schofield and ACCP equations provided more estimates (66%, 66% and 65%, respectively) within 80% and 110% of TEE values. However, each of these equations would have resulted in clinically significant underfeeding (<80% of TEE) in 16%, 15% and 22% of patients, respectively, and overfeeding (>110% of TEE) in 18%, 19% and 13% of patients, respectively. Limits of agreement between the different equations and TEE values were unacceptably wide. Prediction equations may result in significant under or overfeeding in the clinical setting.

Endoscopic ultrasound-guided biliary drainage using a newly designed metal stent with a thin delivery system: a preclinical study in phantom and porcine models.

PubMed

Minaga, Kosuke; Kitano, Masayuki; Itonaga, Masahiro; Imai, Hajime; Miyata, Takeshi; Yamao, Kentaro; Tamura, Takashi; Nuta, Junya; Warigaya, Kenji; Kudo, Masatoshi

2017-12-08

This study was designed to evaluate the feasibility and safety of a newly designed self-expandable metal stent for endoscopic ultrasound-guided biliary drainage (EUS-BD) when it was delivered via three different stent delivery systems: a 7.5Fr delivery catheter with a bullet-shaped tip (7.5Fr-bullet), a 7Fr catheter with a bullet-shaped tip (7Fr-bullet), or a 7Fr catheter with a tee-shaped tip (7Fr-tee). This experimental study utilized a porcine model of biliary dilatation involving ten pigs. In the animal study, technical feasibility and clinical outcomes of the stent when placed with each of the delivery systems were examined. In addition, a phantom model was used to measure the resistance of these delivery systems to advancement. Phantom experiments showed that, compared with 7Fr-bullet, 7Fr-tee had less resistance force to the advancement of the stent delivery system. EUS-BD was technically successful in all ten pigs. Fistulous tract dilation was necessary in 100% (2/2), 75% (3/4), and 0% (0/4) of the pigs that underwent EUS-BD using 7.5Fr-bullet, 7Fr-bullet, and 7Fr-tee, respectively. There were no procedure-related complications. Our newly designed metal stent may be feasible and safe for EUS-BD, particularly when delivered by 7Fr-tee, because it eliminates the need for fistulous tract dilation.

Body size and human energy requirements: Reduced mass-specific total energy expenditure in tall adults.

PubMed

Heymsfield, Steven B; Pietrobelli, Angelo

2010-01-01

Mammalian resting energy expenditure (REE) increases as approximately weight(0.75) while mass-specific REE scales as approximately weight(-0.25). Energy needs for replacing resting losses are thus less relative to weight (W) in large compared with small mammals, a classic observation with biological implications. Human weight scales as approximately height(2) and tall adults thus have a greater weight than their short counterparts. However, it remains unknown if mass-specific energy requirements are less in tall adults; allometric models linking total energy expenditure (TEE) and weight with height (H) are lacking. We tested the hypothesis that mass-specific energy requirements scale inversely to height in adults by evaluating TEE (doubly labeled water) data collected by the National Academy of Sciences. Activity energy expenditure (AEE) was calculated from TEE, REE (indirect calorimetry), and estimated diet-induced energy expenditure. Main analyses focused on nonmorbidly obese subjects < or =50 yrs of age with non-negative AEE values (n = 404), although results were directionally similar for all samples. Allometric models, including age as a covariate, revealed significantly (P < 0.05) greater REE, AEE, and TEE as a function of height (range H(1.5-1.7)) in both men and women. TEE/W scaled negatively to height ( approximately H(-0.7), P < 0.01) with predicted mass-specific TEE (kcal/kg/d) at +/-2 SD for US height lower in tall compared with short men (40.3 vs. 46.5) and women (37.7 vs. 42.7). REE/W also scaled negatively to height in men (P < 0.001) and women (P < 0.01). Results were generally robust across several different analytic strategies. These observations reveal previously unforeseen associations between human stature and energy requirements that have implications for modeling efforts and provide new links to mammalian biology as a whole.

Total energy expenditure, resting metabolic rate and physical activity level in free-living rural elderly men and women from Cuba, Chile and México.

PubMed

Alemán-Mateo, H; Salazar, G; Hernández-Triana, M; Valencia, M E

2006-11-01

The objective of this study was to assess total energy expenditure (TEE), resting metabolic rate (RMR) and physical activity level (PAL), and to estimate energy requirements (ERs) in free-living elderly subjects from Cuba, Chile and Mexico. Cross-sectional study designed to estimate ERs. Rural regions of Cuba, Chile and Mexico. Forty subjects >60 years old were selected to participate in this study. A dose of doubly labeled water (DLW) was administered and urine samples were collected in the following 12-14 days. From the isotopic analysis, TEE was derived. RMR was measured by indirect calorimetry. TEE in Chilean (8.8+/-1.6 MJ/day) and Cuban (8.3+/-1.3 MJ/day) elderly was not different, and was higher for the Mexican group (9.5+/-1.5 MJ/day) (P < 0.0001). RMR was not different between countries. PAL and activity energy expenditure (AEE) were only different between Chile and Mexico (P < 0.002). For the three regions, overall PALs were 1.70+/-0.16 for male and 1.62+/-0.13 for female subjects (P < 0.02), and AEE was 3.05+/-0.66 and 2.27+/-0.66 MJ/day for male and female subjects, respectively (P < 0.001). Predictive equations (MJ/day) were RMR = 1.6447 + 0.05714 x weight (kg) + 0.449 sex (male = 1; female = 0) (R2 = 0.75; SEE = 0.479) and TEE = 3.414 + 0.0795 x weight (kg) + 1.227 x sex (male = 1; female = 0) (R2 = 0.75; SEE = 0.668). There were differences in TEE and PAL owing to sex and region. The average PAL in men was higher than the PAL reported either with factorial approach or with the DLW method in elderly. Predictive ER equations based on RMR and TEE gave very similar results to calculations from the 2004 FAO/WHO/UNU report.

Energy expenditure in professional flat jockeys using doubly labelled water during the racing season: Implications for body weight management.

PubMed

Wilson, George; Lucas, Daloni; Hambly, Catherine; Speakman, John R; Morton, James P; Close, Graeme L

2018-03-01

To formulate individualized dietary strategies for jockeys, it is vital that energy requirements are quantified. We measured total energy expenditure (TEE) over two separate weeks in spring and summer using doubly labelled water in a group of male flat jockeys (n = 8, 36.9 ± 5.7 years, 164 ± 8 cm, 54.6 ± 2.5 kg). Total energy intake (TEI) was self-recorded, as were all riding and structured exercise activity. Mean daily TEE was 10.83 (±2.3) and 10.66 (±1.76) MJ, (p = .61) respectively. Self-reported TEI were 6.03 (±1.7) and 5.37 (±1.1) MJ (p = .40), respectively, and were significantly lower than TEE (p = .01). Mean race rides were 17 (±6) and 13 (±3; p = 0.37) and horses ridden at morning exercise were 8 (±6) and 7 (±4; p = .77) respectively. Additional structured exercise was 76.25 (±95.1) and 52.5 (±80.9) min per week (p = .35), respectively. At the individual level, TEE was related to body mass and the level of non-racing physical activity, but not riding. Physical activity levels for TEE were 1.76 (±0.37) and 1.69 (±0.27; p = .59) and appear modest when compared with other athletes, and similar to age-matched non-athletes, suggesting that conventional sport-specific nutritional recommendations do not appear applicable. The large discrepancy between TEE and TEI suggests significant under reporting of dietary intake. These data now provide an appropriate framework from which to formulate jockey nutritional guidelines to promote the ability to achieve the daily weight target and improve athlete welfare.

Energy requirements of lactating women derived from doubly labeled water and milk energy output.

PubMed

Butte, N F; Wong, W W; Hopkinson, J M

2001-01-01

Instead of using an incremental approach to assess the energy requirements of lactation, a more comprehensive approach may be taken by measuring total energy expenditure (TEE), milk energy output and energy mobilization from tissue stores. The latter approach avoids assumptions regarding energetic efficiency and changes in physical activity and adiposity. The purpose of this study was threefold: to assess the energy requirements of lactation; to compare these estimates with energy requirements in the nonpregnant, nonlactating state and to test for energetic adaptations in basal metabolic rate (BMR) and physical activity during the energy-demanding process of lactation. Milk production and composition, body weight and composition, TEE, BMR and physical activity levels were measured in 24 well-nourished women during exclusive breastfeeding at 3 mo postpartum and after the cessation of breastfeeding at 18 or 24 mo postpartum. TEE was measured by the doubly labeled water method, milk production by 3-d test-weighing, milk energy by bomb calorimetry on a 24-h milk sample, body composition by dual-energy x-ray absorptiometry and BMR by room respiration calorimetry. TEE, BMR and physical activity level (physical activity level = TEE/BMR) did not differ between the lactating and nonlactating state (TEE 10.0 +/- 1.5 versus 10.6 +/- 2.1 MJ/d). Mean milk energy output was equivalent to 2.02 +/- 0.33 MJ/d. Total energy requirements were greater during lactation than afterward (12.0 +/- 1.4 versus 10.6 +/- 2.1 MJ/d, P: = 0.002). Energy mobilization from tissue stores (-0.65 +/- 0.97 MJ/d) resulted in net energy requirements during lactation of 11.4 +/- 1.8 MJ/d. Because adaptations in basal metabolism and physical activity were not evident in these well-nourished women, energy requirements during lactation were met primarily from the diet and only partially by mobilization of tissue stores.

A mitral annulus tracking approach for navigation of off-pump beating heart mitral valve repair.

PubMed

Li, Feng P; Rajchl, Martin; Moore, John; Peters, Terry M

2015-01-01

To develop and validate a real-time mitral valve annulus (MVA) tracking approach based on biplane transesophageal echocardiogram (TEE) data and magnetic tracking systems (MTS) to be used in minimally invasive off-pump beating heart mitral valve repair (MVR). The authors' guidance system consists of three major components: TEE, magnetic tracking system, and an image guidance software platform. TEE provides real-time intraoperative images to show the cardiac motion and intracardiac surgical tools. The magnetic tracking system tracks the TEE probe and the surgical tools. The software platform integrates the TEE image planes and the virtual model of the tools and the MVA model on the screen. The authors' MVA tracking approach, which aims to update the MVA model in near real-time, comprises of three steps: image based gating, predictive reinitialization, and registration based MVA tracking. The image based gating step uses a small patch centered at each MVA point in the TEE images to identify images at optimal cardiac phases for updating the position of the MVA. The predictive reinitialization step uses the position and orientation of the TEE probe provided by the magnetic tracking system to predict the position of the MVA points in the TEE images and uses them for the initialization of the registration component. The registration based MVA tracking step aims to locate the MVA points in the images selected by the image based gating component by performing image based registration. The validation of the MVA tracking approach was performed in a phantom study and a retrospective study on porcine data. In the phantom study, controlled translations were applied to the phantom and the tracked MVA was compared to its "true" position estimated based on a magnetic sensor attached to the phantom. The MVA tracking accuracy was 1.29 ± 0.58 mm when the translation distance is about 1 cm, and increased to 2.85 ± 1.19 mm when the translation distance is about 3 cm. In the study on porcine data, the authors compared the tracked MVA to a manually segmented MVA. The overall accuracy is 2.37 ± 1.67 mm for single plane images and 2.35 ± 1.55 mm for biplane images. The interoperator variation in manual segmentation was 2.32 ± 1.24 mm for single plane images and 1.73 ± 1.18 mm for biplane images. The computational efficiency of the algorithm on a desktop computer with an Intel(®) Xeon(®) CPU @3.47 GHz and an NVIDIA GeForce 690 graphic card is such that the time required for registering four MVA points was about 60 ms. The authors developed a rapid MVA tracking algorithm for use in the guidance of off-pump beating heart transapical mitral valve repair. This approach uses 2D biplane TEE images and was tested on a dynamic heart phantom and interventional porcine image data. Results regarding the accuracy and efficiency of the authors' MVA tracking algorithm are promising, and fulfill the requirements for surgical navigation.

Advanced Sensors Boost Optical Communication, Imaging

NASA Technical Reports Server (NTRS)

2009-01-01

Brooklyn, New York-based Amplification Technologies Inc. (ATI), employed Phase I and II SBIR funding from NASA s Jet Propulsion Laboratory to forward the company's solid-state photomultiplier technology. Under the SBIR, ATI developed a small, energy-efficient, extremely high-gain sensor capable of detecting light down to single photons in the near infrared wavelength range. The company has commercialized this technology in the form of its NIRDAPD photomultiplier, ideal for use in free space optical communications, lidar and ladar, night vision goggles, and other light sensing applications.

Synoptic Aspects of the Climate of Japan: A Preliminary Report

DTIC Science & Technology

1945-08-01

COPY TO* €AJD0» L1 tQISffiiBUTIoN LWTEB TO; COPJ?S OSTA1NA3LE FRO«; SPECIAL JHSTßUCTIONS: ’ UK CADO CONTROL HO: US CLASSIFICATION: ATI NO...confidential Approved for public release; distribution is unlimited. Distribution authorized to DoD only; Administrative/Operational Use ; AUG 1945. Other...FILED UNDER: ORIGINAL LOAN RETURNED TO OWNER (DATE): CAPO CONTROL NO: ATI NO: ABSTRACT 7092k INSPECTED BY: CAÖO-D1 CADO-Pi CAD0-P2, US CAD0

Trouble and Triumph: German Life-Turkish Tradition in Renan Demirkan's "Schwarzer Tee mit drei Stuck Zucker"

ERIC Educational Resources Information Center

Ebert, Reika

2004-01-01

This paper explores Demirkan's narrative strategies in "Schwarzer Tee mit drei Stuck Zucker" to negotiate issues of a life between two cultures and traditions. Based on Bhabha's insights that mainstream culture needs intellectual and artistic infusion from the margins of a society in order to remain vital; and that cultural production…

A loading study of older highway bridges in Virginia. Pt. 3, Concrete tee-beam bridge in Nelson County.

DOT National Transportation Integrated Search

1977-01-01

A 40-foot clear span, standard reinforced tee-beam bridge over the Tye River in Nelson County was tested with a 23-ton, tandem axle test vehicle in July 1976. The test span was one of four identical spans making a total bridge length of 170 feet. Str...

Evaluation of "The First Tee" in Promoting Positive Youth Development: Group Comparisons and Longitudinal Trends

ERIC Educational Resources Information Center

Weiss, Maureen R.; Bolter, Nicole D.; Kipp, Lindsay E.

2016-01-01

Purpose: This manuscript represents the 3rd in a series of articles documenting our longitudinal evaluation of "The First Tee," a physical activity-based youth development program that uses golf as a vehicle for teaching life skills and enhancing developmental outcomes. Previous phases of our project: (a) established initial data-based…

Acute Severe Aortic Regurgitation: Imaging with Pathological Correlation.

PubMed

Janardhanan, Rajesh; Pasha, Ahmed Khurshid

2016-03-01

Acute aortic regurgitation (AR) is an important finding associated with a wide variety of disease processes. Its timely diagnosis is of utmost importance. Delay in diagnosis could prove fatal. We describe a case of acute severe AR that was timely diagnosed using real time three-dimensional (3D) transesophageal echocardiogram (3D TEE). Not only did it diagnose but also the images obtained by 3D TEE clearly matched with the pathologic specimen. Using this sophisticated imaging modality that is mostly available at the tertiary centers helped in the timely diagnosis, which lead to the optimal management saving his life. Echocardiography and especially 3D TEE can diagnose AR very accurately. Surgical intervention is the definitive treatment but medical therapy is utilized to stabilize the patient initially.

Design and Synthesis of 2-Heterocyclyl-3-arylthio-1H-indoles as Potent Tubulin Polymerization and Cell Growth Inhibitors with Improved Metabolic Stability

PubMed Central

La Regina, Giuseppe; Bai, Ruoli; Rensen, Willeke; Coluccia, Antonio; Piscitelli, Francesco; Gatti, Valerio; Bolognesi, Alessio; Lavecchia, Antonio; Granata, Ilaria; Porta, Amalia; Maresca, Bruno; Soriani, Alessandra; Iannitto, Maria Luisa; Mariani, Marisa; Santoni, Angela; Brancale, Andrea; Ferlini, Cristiano; Dondio, Giulio; Varasi, Mario; Mercurio, Ciro; Hamel, Ernest; Lavia, Patrizia; Novellino, Ettore; Silvestri, Romano

2011-01-01

New arylthioindoles (ATIs) were obtained by replacing the 2-alkoxycarbonyl group with a bioisosteric 5-membered heterocycle nucleus. The new ATIs 5, 8, and 10 inhibited tubulin polymerization, reduced cell growth of a panel of human transformed cell lines, and showed higher metabolic stability than the reference ester 3. These compounds induced mitotic arrest and apoptosis at a similar level as combretastatin A-4 and vinblastine and triggered caspase-3 expression in a significant fraction of cells in both p53-proficient and p53-defective cell lines. Importantly, ATIs 5, 8, and 10 were more effective than vinorelbine, vinblastine, and paclitaxel as growth inhibitors of the P-glycoprotein-overexpressing cell line NCI/ADR-RES. Compound 5 was shown to have medium metabolic stability in both human and mouse liver microsomes, in contrast to the rapidly degraded reference ester 3, and a pharmacokinetic profile in the mouse characterized by a low systemic clearance and excellent oral bioavailability. PMID:22044164

The relation of radar to cloud area-time integrals and implications for rain measurements from space

NASA Technical Reports Server (NTRS)

Atlas, David; Bell, Thomas L.

1992-01-01

The relationships between satellite-based and radar-measured area-time integrals (ATI) for convective storms are determined, and both are shown to depend on the climatological conditional mean rain rate and the ratio of the measured cloud area to the actual rain area of the storms. The GOES precipitation index of Arkin (1986) for convective storms, an area-time integral for satellite cloud areas, is shown to be related to the ATI for radar-observed rain areas. The quality of GPI-based rainfall estimates depends on how well the cloud area is related to the rain area and the size of the sampling domain. It is also noted that the use of a GOES cloud ATI in conjunction with the radar area-time integral will improve the accuracy of rainfall estimates and allow such estimates to be made in much smaller space-time domains than the 1-month and 5-deg boxes anticipated for the Tropical Rainfall Measuring Mission.

Strong-field ionization of linear molecules by a bicircular laser field: Symmetry considerations

NASA Astrophysics Data System (ADS)

Gazibegović-Busuladžić, A.; Busuladžić, M.; Hasović, E.; Becker, W.; Milošević, D. B.

2018-04-01

Using the improved molecular strong-field approximation, we investigate (high-order) above-threshold ionization [(H)ATI] of various linear polyatomic molecules by a two-color laser field of frequencies r ω and s ω (with integer numbers r and s ) having coplanar counter-rotating circularly polarized components (a so-called bicircular field). Reflection and rotational symmetries for molecules aligned in the laser-field polarization plane, analyzed for diatomic homonuclear molecules in Phys. Rev. A 95, 033411 (2017), 10.1103/PhysRevA.95.033411, are now considered for diatomic heteronuclear molecules and symmetric and asymmetric linear triatomic molecules. There are additional rotational symmetries for (H)ATI spectra of symmetric linear molecules compared to (H)ATI spectra of the asymmetric ones. It is shown that these symmetries manifest themselves differently for r +s odd and r +s even. For example, HATI spectra for symmetric molecules with r +s even obey inversion symmetry. For ATI spectra of linear molecules, reflection symmetry appears only for certain molecular orientation angles ±90∘-j r 180∘/(r +s ) (j integer). For symmetric linear molecules, reflection symmetry appears also for the angles -j r 180∘/(r +s ) . For perpendicular orientation of molecules with respect to the laser-field polarization plane, the HATI spectra are very similar to those of the atomic targets, i.e., both spectra are characterized by the same type of the (r +s )-fold symmetry.

Control of two-dimensional electronic states at anatase Ti O2(001 ) surface by K adsorption

NASA Astrophysics Data System (ADS)

Yukawa, R.; Minohara, M.; Shiga, D.; Kitamura, M.; Mitsuhashi, T.; Kobayashi, M.; Horiba, K.; Kumigashira, H.

2018-04-01

The nature of the intriguing metallic electronic structures appearing at the surface of anatase titanium dioxide (a-Ti O2 ) remains to be elucidated, mainly owing to the difficulty of controlling the depth distribution of the oxygen vacancies generated by photoirradiation. In this study, K atoms were adsorbed onto the (001) surface of a-Ti O2 to dope electrons into the a-Ti O2 and to confine the electrons in the surface region. The success of the electron doping and its controllability were confirmed by performing in situ angle-resolved photoemission spectroscopy as well as core-level measurements. Clear subband structures were observed in the surface metallic states, indicating the creation of quasi-two-dimensional electron liquid (q2DEL) states in a controllable fashion. With increasing electron doping (K adsorption), the q2DEL states exhibited crossover from polaronic liquid states with multiple phonon-loss structures originating from the long-range Fröhlich interaction to "weakly correlated metallic" states. In the q2DEL states in the weakly correlated metallic region, a kink due to short-range electron-phonon coupling was clearly observed at about 80 ±10 meV . The characteristic energy is smaller than that previously observed for the metallic states of a-Ti O2 with three-dimensional nature (˜110 meV ) . These results suggest that the dominant electron-phonon coupling is modulated by anisotropic carrier screening in the q2DEL states.

Impact of electrocardiogram-gated multi-slice computed tomography-based aortic annular measurement in the evaluation of paravalvular leakage following transcatheter aortic valve replacement: the efficacy of the OverSized AortiC Annular ratio (OSACA ratio) in TAVR.

PubMed

Maeda, Koichi; Kuratani, Toru; Torikai, Kei; Shimamura, Kazuo; Mizote, Isamu; Ichibori, Yasuhiro; Takeda, Yasuharu; Daimon, Takashi; Nakatani, Satoshi; Nanto, Shinsuke; Sawa, Yoshiki

2013-07-01

Even mild paravalvular leakage (PVL) after transcatheter aortic valve replacement (TAVR) is associated with increased late mortality. Electrocardiogram-gated multi-slice computed tomography (MSCT) enables detailed aortic annulus assessment. We describe the impact of MSCT for PVL following TAVR. Congruence between the prosthesis and annulus diameters affects PVL; therefore, we calculated the OverSized AortiC Annular ratio (OSACA ratio) and OSACA (transesophageal echocardiography, TEE) ratio as prosthesis diameter/annulus diameter on MSCT or TEE, respectively, and compared their relationship with PVL ≤ trace following TAVR. Of 36 consecutive patients undergoing TAVR (Group A), the occurrence of PVL ≤ trace (33.3%) was significantly related to the OSACA ratio (p = 0.00020). In receiver-operating characteristics analysis, the cutoff value of 1.03 for the OSACA ratio had the highest sum of sensitivity (75.0%) and specificity (91.7%; AUC = 0.87) with significantly higher discriminatory performance for PVL as compared to the OSACA (TEE) ratio (AUC = 0.69, p = 0.028). In nine consecutive patients (Group B) undergoing TAVR based on guidelines formulated from our experience with Group A, PVL ≤ trace was significantly more frequent (88.9%) than that in Group A (p = 0.0060). The OSACA ratio has a significantly higher discriminatory performance for PVL ≤ trace than the OSACA (TEE) ratio, and aortic annular measurement from MSCT is more accurate than that from TEE. © 2013 Wiley Periodicals, Inc.

Patent foramen ovale: diagnosis with multidetector CT--comparison with transesophageal echocardiography.

PubMed

Kim, Young Jin; Hur, Jin; Shim, Chi-Young; Lee, Hye-Jeong; Ha, Jong-Won; Choe, Kyu Ok; Heo, Ji Hoe; Choi, Eui-Young; Choi, Byoung Wook

2009-01-01

To evaluate the clinical feasibility and accuracy of 64-section multidetector computed tomography (CT) compared with transesophageal echocardiography (TEE) for diagnosis of a patent foramen ovale (PFO). Institutional review board approval was obtained for this retrospective study. The study included 152 consecutive stroke patients (mean age, 61.7 years; 98 men, 54 women) who underwent both cardiac multidetector CT and TEE. Electrocardiographically gated cardiac CT was performed with a 64-section CT scanner by using a saline-chaser contrast agent injection technique. A contrast agent jet from the contrast agent-filled left atrium (LA) to the saline-filled right atrium (RA) and channel-like appearance of the interatrial septum (IAS) were evaluated on axial and oblique sagittal CT images. Two-dimensional and Doppler TEE were performed to detect PFO. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of CT were obtained with TEE as the reference standard. A PFO was present in 26 patients at TEE. On CT images, a left-to-right contrast agent jet toward the inferior vena cava was noted in 21 patients (sensitivity, 73.1%; specificity, 98.4%; PPV, 90.5%; NPV, 94.7%). Channel-like appearance of the IAS was detected in 38 patients (sensitivity, 76.9%; specificity, 85.7%; PPV, 52.6%; NPV, 94.7%). Channel-like appearance of the IAS was noted in all patients who had a contrast agent jet. A contrast agent jet from LA to RA toward the inferior vena cava with channel-like appearance of the IAS on CT images confirms the presence of a PFO. (c) RSNA, 2008.

Experimental testing and modeling analysis of solute mixing at water distribution pipe junctions.

PubMed

Shao, Yu; Jeffrey Yang, Y; Jiang, Lijie; Yu, Tingchao; Shen, Cheng

2014-06-01

Flow dynamics at a pipe junction controls particle trajectories, solute mixing and concentrations in downstream pipes. The effect can lead to different outcomes of water quality modeling and, hence, drinking water management in a distribution network. Here we have investigated solute mixing behavior in pipe junctions of five hydraulic types, for which flow distribution factors and analytical equations for network modeling are proposed. First, based on experiments, the degree of mixing at a cross is found to be a function of flow momentum ratio that defines a junction flow distribution pattern and the degree of departure from complete mixing. Corresponding analytical solutions are also validated using computational-fluid-dynamics (CFD) simulations. Second, the analytical mixing model is further extended to double-Tee junctions. Correspondingly the flow distribution factor is modified to account for hydraulic departure from a cross configuration. For a double-Tee(A) junction, CFD simulations show that the solute mixing depends on flow momentum ratio and connection pipe length, whereas the mixing at double-Tee(B) is well represented by two independent single-Tee junctions with a potential water stagnation zone in between. Notably, double-Tee junctions differ significantly from a cross in solute mixing and transport. However, it is noted that these pipe connections are widely, but incorrectly, simplified as cross junctions of assumed complete solute mixing in network skeletonization and water quality modeling. For the studied pipe junction types, analytical solutions are proposed to characterize the incomplete mixing and hence may allow better water quality simulation in a distribution network. Published by Elsevier Ltd.

Feasibility of the Use of Transesophageal Echocardiography as a Surface Probe for Puncturing and Catheterization of the Internal Jugular Vein: A Randomized Controlled Pilot Study.

PubMed

Teng, Yi; Ou, Mengchan; Yu, Hai

2018-02-01

To compare the transesophageal echocardiography (TEE) probe as a surface probe with the vascular probe for guiding internal jugular vein (IJV) catheterization. Prospective, randomized, controlled pilot study. University hospital. One hundred cardiac surgery patients, including 50 adult and 50 pediatric patients. Patients in the TEE probe group received right IJV catheterization using the TEE probe, while the vascular probe group used the vascular probe for catheterization. The puncture time, first-attempt success rate, quality of the imaging with needle tip positioning, wire positioning, and catheter positioning were recorded. The incidence of complication or any adverse event also was observed. Adult patients: In the vascular probe group, the success rate for first attempt IJV catheterization was 24/25 (96%), while in the TEE probe group, the success rate for first attempt IJV catheterization was 25/25 (100%). There was no statistical difference in the puncture time, image quality, needle tip positioning, wire positioning, and catheter positioning between groups (p > 0.05). Pediatric patients: The success rate for first-attempt IJV catheterization was 100% in both groups, and there were no statistical differences in the puncture time, image quality, and positioning between the 2 groups (p > 0.05). No complications or adverse events were observed in either group. The TEE probe, used as a surface probe, can be used to guide IJV puncturing and catheterization in cardiac surgery patients with favorable feasibility and safety. Copyright © 2018 Elsevier Inc. All rights reserved.

Effect of Diet Composition on Energy Expenditure during Weight Loss: The POUNDS LOST Study

PubMed Central

Bray, George A.; Smith, Steven R.; DeJonge, Lilian; de Souza, Russell; Rood, Jennifer; Champagne, Catherine M.; Laranjo, Nancy; Carey, Vincent; Obarzanek, Eva; Loria, Catherine M.; Anton, Stephen D.; Ryan, Donna H.; Greenway, Frank L.; Williamson, Donald; Sacks, Frank M.

2011-01-01

Background Weight loss reduces energy expenditure, but the contribution of different macronutrients to this change is unclear. Hypothesis We tested the hypothesis that macronutrient composition of the diet might affect the partitioning of energy expenditure during weight loss. Design A sub-study of 99 participants from the POUNDS LOST trial had total energy expenditure (TEE) measured by doubly labeled water and resting energy expenditure (REE) measured by indirect calorimetry at baseline and repeated at 6 months in 89 participants. Participants were randomly assigned to one of 4 diets with either 15% or 25% protein and 20% or 40% fat. Results TEE and REE were positively correlated with each other and with fat free mass and body fat, at baseline and 6 months. The average weight loss of 8.1±0.65 kg (LSmean±SE) reduced TEE by 120±56 kcal/d and REE by 136±18 kcal/d. A greater weight loss at 6 months was associated with a greater decrease in TEE and REE. Participants eating the high fat diet lost significantly more fat free mass (1.52±0.55 kg) than the low fat diet group (p<0.05). Participants eating the low fat diet had significantly higher measures of physical activity than the high fat group. Conclusion A greater weight loss was associated with a larger decrease in both TEE and REE. The low fat diet was associated with significant changes in fat free body mass and energy expenditure from physical activity compared to the high fat diet. PMID:21946707

3D-printed pediatric endoscopic ear surgery simulator for surgical training.

PubMed

Barber, Samuel R; Kozin, Elliott D; Dedmon, Matthew; Lin, Brian M; Lee, Kyuwon; Sinha, Sumi; Black, Nicole; Remenschneider, Aaron K; Lee, Daniel J

2016-11-01

Surgical simulators are designed to improve operative skills and patient safety. Transcanal Endoscopic Ear Surgery (TEES) is a relatively new surgical approach with a slow learning curve due to one-handed dissection. A reusable and customizable 3-dimensional (3D)-printed endoscopic ear surgery simulator may facilitate the development of surgical skills with high fidelity and low cost. Herein, we aim to design, fabricate, and test a low-cost and reusable 3D-printed TEES simulator. The TEES simulator was designed in computer-aided design (CAD) software using anatomic measurements taken from anthropometric studies. Cross sections from external auditory canal samples were traced as vectors and serially combined into a mesh construct. A modified tympanic cavity with a modular testing platform for simulator tasks was incorporated. Components were fabricated using calcium sulfate hemihydrate powder and multiple colored infiltrants via a commercial inkjet 3D-printing service. All components of a left-sided ear were printed to scale. Six right-handed trainees completed three trials each. Mean trial time (n = 3) ranged from 23.03 to 62.77 s using the dominant hand for all dissection. Statistically significant differences between first and last completion time with the dominant hand (p < 0.05) and average completion time for junior and senior residents (p < 0.05) suggest construct validity. A 3D-printed simulator is feasible for TEES simulation. Otolaryngology training programs with access to a 3D printer may readily fabricate a TEES simulator, resulting in inexpensive yet high-fidelity surgical simulation. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Measuring Educators' Attitudes and Beliefs about Evaluation: Construct Validity and Reliability of the Teacher Evaluation Experience Scale

ERIC Educational Resources Information Center

Reddy, Linda A.; Dudek, Christopher M.; Kettler, Ryan J.; Kurz, Alexander; Peters, Stephanie

2016-01-01

This study presents the reliability and validity of the Teacher Evaluation Experience Scale--Teacher Form (TEES-T), a multidimensional measure of educators' attitudes and beliefs about teacher evaluation. Confirmatory factor analyses of data from 583 teachers were conducted on the TEES-T hypothesized five-factor model, as well as on alternative…

Transesophageal Echocardiography and Contrast-TCD in the Detection of a Patent Foramen Ovale: Experience with 111 Patients

NASA Technical Reports Server (NTRS)

Klotzsch, Christof; Janben, Gerhard; Berlit, Peter

1994-01-01

Patent foramen ovale (PFO) is increasingly recognized in association with cryptogenic stroke. Using transesophageal echocardiography (TEE) and transcranial Doppler sonography with ultrasonic contrast medium contrast-(TCD), we evaluated the frequency of a PFO as the fundamental condition of paradoxical embolism in 111 patients after cerebral ischemia. There was a right-left shunt in 50 patients (45%) with TEE. In 31 of 40 patients with stroke of unknown etiology, a PFO was the only detectable finding associated with cerebral ischemia. Using TEE as he "gold standard," the sensitivity of contrast-TCD was 91.3%, specificity 93.8%, and the overall accuracy 92.8%. contrast-TCD failed to detect a right-left shunt in four patients, but there were four other patients with negative TEE and positive contrast-TCD. We conclude that contrast-TCD is a highly sensitive method for detecting a right-left shunt. Its advantages are low cost, its ability to detect single contrast-medium embolism, and control of the Valsalva maneuver by observing the decrease of cerebral blood flow. Evidence of PFO in cryptogenic stroke should prompt a search for a subclinical venous thrombosis as the embolic source.

Real-time 3D transesophageal echocardiography-guided closure of a complicated patent ductus arteriosus in a dog.

PubMed

Doocy, K R; Nelson, D A; Saunders, A B

2017-06-01

Advanced imaging modalities are becoming more widely available in veterinary cardiology, including the use of transesophageal echocardiography (TEE) during occlusion of patent ductus arteriosus (PDA) in dogs. The dog in this report had a complex history of attempted ligation and a large PDA that initially precluded device placement thereby limiting the options for PDA closure. Following a second thoracotomy and partial ligation, the morphology of the PDA was altered and device occlusion was an option. Angiographic assessment of the PDA was limited by the presence of hemoclips, and the direction of ductal flow related to the change in anatomy following ligature placement. Intra-operative TEE, in particular real-time three-dimensional imaging, was pivotal for assessing the PDA morphology, monitoring during the procedure, selecting the device size, and confirming device placement. The TEE images increased operator confidence that the size and location of the device were appropriate before release despite the unusual position. This report highlights the benefit of intra-operative TEE, in particular real-time three-dimensional imaging, for successful PDA occlusion in a complicated case. Copyright © 2017 Elsevier B.V. All rights reserved.

Affordable measurement of human total energy expenditure and body composition using one-tenth dose doubly labelled water.

PubMed

Mann, D V; Ho, C S; Critchley, L; Fok, B S P; Pang, E W H; Lam, C W K; Hjelm, N M

2007-05-01

The doubly labelled water (DLW) method is the technique of choice for measurement of free-living total energy expenditure (TEE) in humans. A major constraint on the clinical applicability of the method has been the expense of the (18)O isotope. We have used a reduced-dose (one-tenth of the currently recommended standard dose) of DLW for the measurement of TEE and body composition in nine healthy adult male volunteers. TEE measured by reduced-dose DLW was positively correlated with resting energy expenditure measured by metabolic cart (r=0.87, P<0.01). Isotope-derived fat mass and body mass index were strongly correlated (r=0.86, P<0.01). In four subjects in whom we performed a complementary evaluation using standard-dose isotope enrichment, the TEE measurements were satisfactorily comparable (mean+/-s.d.: reduced dose 2586+/-155 kcal/day vs standard dose 2843+/-321 kcal/day; mean difference 257+/-265 kcal/day). These data indicate that DLW measurements of human energy expenditure and body composition can be performed at a substantially reduced dose (and cost) of isotope enrichment than is currently employed.

Roles of Transesophageal Echocardiography and Cardiac Computed Tomography for Evaluation of Left Atrial Thrombus and Associated Pathology: A Review and Critical Analysis.

PubMed

Pathan, Faraz; Hecht, Harvey; Narula, Jagat; Marwick, Thomas H

2018-04-01

Evaluation of the left atrium and left atrial appendage for the presence of thrombus prior to cardioversion and pulmonary vein isolation, and of the entire heart for embolic sources in the setting of cryptogenic stroke, has long been standard medical care. Guidelines have uniformly recommended transesophageal echocardiography (TEE) to accomplish these goals. In recent years, computed tomographic angiography has demonstrated diagnostic accuracy similar to that of TEE for the detection of thrombus. Analysis of the pertinent data and relative merits of the 2 technologies leads to the conclusions that: 1) both modalities have some unique, nonoverlapping capabilities that may dictate their use in specific situations; 2) computed tomographic angiography is a reasonable alternative to TEE when the primary aim is to exclude left atrial and left atrial appendage thrombus and in patients in whom the risks associated with TEE outweigh the benefits; and 3) both options should be discussed with the patient in the setting of shared decision making. Copyright © 2018 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Research on Synchronous Coordination Development of Tourism-Economy-Environment System in Qinghai Section of Silk Road

NASA Astrophysics Data System (ADS)

Xue, Huaju

2018-01-01

Using coupling theory in physics, the paper analyzed the relationship of coordinated development of tourism-economy-environment system (abbr. TEES) in Qinghai. Results showed the comprehensive evaluation of Qinghai TEES has been improved greatly from 2000 to 2014. However, coupling degree has still been in the running-in stage and coordination degree only arrives at the primary coordination level, the development of economy and tourism has exceeded the threshold of ecological environment after 2008, and the ecological environment has become the bottleneck restricting the further improvement of coupling coordination. In the future, Qinghai must change its mode of development and focus on industrial upgrading and transformation so as to promote the harmonious and sustainable development of TEES in the Silk Road.

Acute Severe Aortic Regurgitation: Imaging with Pathological Correlation

PubMed Central

Janardhanan, Rajesh; Pasha, Ahmed Khurshid

2016-01-01

Context: Acute aortic regurgitation (AR) is an important finding associated with a wide variety of disease processes. Its timely diagnosis is of utmost importance. Delay in diagnosis could prove fatal. Case Report: We describe a case of acute severe AR that was timely diagnosed using real time three-dimensional (3D) transesophageal echocardiogram (3D TEE). Not only did it diagnose but also the images obtained by 3D TEE clearly matched with the pathologic specimen. Using this sophisticated imaging modality that is mostly available at the tertiary centers helped in the timely diagnosis, which lead to the optimal management saving his life. Conclusion: Echocardiography and especially 3D TEE can diagnose AR very accurately. Surgical intervention is the definitive treatment but medical therapy is utilized to stabilize the patient initially. PMID:27114975

Defense AT And L Magazine. Vol. 47, No. 1, January February 2018

DTIC Science & Technology

2018-01-01

available for em - ployees at all levels to engage with DoD personnel in a non- competitive, structured educational environment. Miscom- munication can...medical, fire, bomb , cyber attack, bio/ chem/rad) • Kidnap/ransom • Infrastructure • Power redundancy • Facilities hardening • Perimeter security...aly sis Th rea ts/ Ha za rd s Ris k i de nt ic ati on Mi tig ati on Em erg en cy op era tio ns Fu nc tio na l re sp on sib ilit ies Cr itic al fun

Metal-Insulator-Metal Diode Process Development for Energy Harvesting Applications

DTIC Science & Technology

2010-04-01

Sputter Tool Dep Method: Sputtering (DC Magnetron ) Recipe: MC_Pt 1640A_TiO2 1000A_Ti 2000A_500C_1a MC_Pt 1640A_TiO2 1000A_Ti 2000A_300C_1a MC_Pt...thin films were sputtered onto silicon substrates with silicon dioxide overlayers. I-V measurements were taken using an electrical characterization...deposition of the entire MIM material stack to be done without breaking the vacuum within a multi-material system DC sputtering tool. A CAD layout of a MIM

Validity and reliability of GPS and LPS for measuring distances covered and sprint mechanical properties in team sports.

PubMed

Hoppe, Matthias W; Baumgart, Christian; Polglaze, Ted; Freiwald, Jürgen

2018-01-01

This study aimed to investigate the validity and reliability of global (GPS) and local (LPS) positioning systems for measuring distances covered and sprint mechanical properties in team sports. Here, we evaluated two recently released 18 Hz GPS and 20 Hz LPS technologies together with one established 10 Hz GPS technology. Six male athletes (age: 27±2 years; VO2max: 48.8±4.7 ml/min/kg) performed outdoors on 10 trials of a team sport-specific circuit that was equipped with double-light timing gates. The circuit included various walking, jogging, and sprinting sections that were performed either in straight-lines or with changes of direction. During the circuit, athletes wore two devices of each positioning system. From the reported and filtered velocity data, the distances covered and sprint mechanical properties (i.e., the theoretical maximal horizontal velocity, force, and power output) were computed. The sprint mechanical properties were modeled via an inverse dynamic approach applied to the center of mass. The validity was determined by comparing the measured and criterion data via the typical error of estimate (TEE), whereas the reliability was examined by comparing the two devices of each technology (i.e., the between-device reliability) via the coefficient of variation (CV). Outliers due to measurement errors were statistically identified and excluded from validity and reliability analyses. The 18 Hz GPS showed better validity and reliability for determining the distances covered (TEE: 1.6-8.0%; CV: 1.1-5.1%) and sprint mechanical properties (TEE: 4.5-14.3%; CV: 3.1-7.5%) than the 10 Hz GPS (TEE: 3.0-12.9%; CV: 2.5-13.0% and TEE: 4.1-23.1%; CV: 3.3-20.0%). However, the 20 Hz LPS demonstrated superior validity and reliability overall (TEE: 1.0-6.0%; CV: 0.7-5.0% and TEE: 2.1-9.2%; CV: 1.6-7.3%). For the 10 Hz GPS, 18 Hz GPS, and 20 Hz LPS, the relative loss of data sets due to measurement errors was 10.0%, 20.0%, and 15.8%, respectively. This study shows that 18 Hz GPS has enhanced validity and reliability for determining movement patterns in team sports compared to 10 Hz GPS, whereas 20 Hz LPS had superior validity and reliability overall. However, compared to 10 Hz GPS, 18 Hz GPS and 20 Hz LPS technologies had more outliers due to measurement errors, which limits their practical applications at this time.

Film Piracy, Organized Crime, and Terrorism

DTIC Science & Technology

2009-01-01

appointed Malaysian Inspector General of Police renewed efforts to fight organized crime by dedicating more resources to Operation Copperhead, originally...opera- tions in Kuala Lumpur.104 The Malaysian government singled out the dragonhead of the Ang Bin Hoey triad, Tee Yam (aka Khoo Tee Yam), as its...interviews with Serious Crime Division of Malaysian Police, August 1, 2005. Getting Down to Cases: Organized Crime and Film Piracy 71 in

Self-monitoring of dietary intake by young women: online food records completed on computer or smartphone are as accurate as paper-based food records but more acceptable.

PubMed

Hutchesson, Melinda J; Rollo, Megan E; Callister, Robin; Collins, Clare E

2015-01-01

Adherence and accuracy of self-monitoring of dietary intake influences success in weight management interventions. Information technologies such as computers and smartphones have the potential to improve adherence and accuracy by reducing the burden associated with monitoring dietary intake using traditional paper-based food records. We evaluated the acceptability and accuracy of three different 7-day food record methods (online accessed via computer, online accessed via smartphone, and paper-based). Young women (N=18; aged 23.4±2.9 years; body mass index 24.0±2.2) completed the three 7-day food records in random order with 7-day washout periods between each method. Total energy expenditure (TEE) was derived from resting energy expenditure (REE) measured by indirect calorimetry and physical activity level (PAL) derived from accelerometers (TEE=REE×PAL). Accuracy of the three methods was assessed by calculating absolute (energy intake [EI]-TEE) and percentage difference (EI/TEE×100) between self-reported EI and TEE. Acceptability was assessed via questionnaire. Mean±standard deviation TEE was 2,185±302 kcal/day and EI was 1,729±249 kcal/day, 1,675±287kcal/day, and 1,682±352 kcal/day for computer, smartphone, and paper records, respectively. There were no significant differences between absolute and percentage differences between EI and TEE for the three methods: computer, -510±389 kcal/day (78%); smartphone, -456±372 kcal/day (80%); and paper, -503±513 kcal/day (79%). Half of participants (n=9) preferred computer recording, 44.4% preferred smartphone, and 5.6% preferred paper-based records. Most participants (89%) least preferred the paper-based record. Because online food records completed on either computer or smartphone were as accurate as paper-based records but more acceptable to young women, they should be considered when self-monitoring of intake is recommended to young women. Copyright © 2015 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Compensatory Changes in Energy Balance Regulation over One Athletic Season.

PubMed

Silva, Analiza M; Matias, Catarina N; Santos, Diana A; Thomas, Diana; Bosy-Westphal, Anja; MüLLER, Manfred J; Heymsfield, Steven B; Sardinha, LUíS B

2017-06-01

Mechanisms in energy balance (EB) regulation may include compensatory changes in energy intake (EI) and metabolic adaption (MA), but information is unavailable in athletes who often change EB components. We aim to investigate EB regulation compensatory mechanisms over one athletic season. Fifty-seven athletes (39 males/18 females; handball, volleyball, basketball, triathlon, and swimming) were evaluated from the beginning to the competitive phase of the season. Resting and total energy expenditure (REE and TEE, respectively) were assessed by indirect calorimetry and doubly labeled water, respectively, and physical activity energy expenditure was determined as TEE - 0.1(TEE) - REE. Fat mass (FM) and fat-free mass (FFM) were evaluated by dual-energy x-ray absorptiometry and changed body energy stores was determined by 1.0(ΔFFM/Δtime) + 9.5(ΔFM/Δtime). EI was derived as TEE + EB. REE was predicted from baseline FFM, FM, sex, and sports. %MA was calculated as 100(measured REE/predicted REE-1) and MA (kcal) as %MA/100 multiplied by baseline measured REE. Average EI minus average physical activity energy expenditure was computed as a proxy of average energy availability, assuming that a constant nonexercise EE occurred over the season. Body mass increased by 0.8 ± 2.5 kg (P < 0.05), but a large individual variability was found ranging from -6.1 to 5.2 kg. The TEE raise (16.8% ± 11.7%) was compensated by an increase EI change (16.3% ± 12.0%) for the whole group (P < 0.05). MA was found in triathletes, sparing 128 ± 168 kcal·d, and basketball players, dissipating 168 ± 205 kcal·d (P < 0.05). MA was associated (P < 0.05) with EB and energy availability (r = 0.356 and r = 0.0644, respectively). TEE increased over the season without relevant mean changes in weight, suggesting that EI compensation likely occurred. The thrifty or spendthrift phenotypes observed among sports and the demanding workloads these athletes are exposed to highlight the need for sport-specific energy requirements.

Role of P-selectin in thromboembolic events in patients with cancer.

PubMed

Fernandes, Lúcio Flávio Barbour; Fregnani, José Humberto T G; Strunz, Célia Maria Cássaro; de Andrade Ramos Nogueira, Adriana; Longatto-Filho, Adhemar

2018-01-01

The objective of the present study was to evaluate the role of P-selectin in patients with cancer with suspected thromboembolic events (TEEs). Patients with cancer have a four times greater risk of developing TEEs. P-selectin is a glycoprotein that has the function of facilitating the interaction (adhesion) of leukocytes with the endothelium, or with platelets. There is a well-defined relationship between P-selectin and thrombosis; however, it is likely that the cut-off value of P-selectin for patients with cancer should be considered differently from that of the general population. In the present report, a prospective cross-sectional study was performed with patients of the Cancer Hospital of Barretos who were suspected of having TEEs. Among the 178 study participants, 167 (93.82%) were suspected of having deep vein thrombosis, while 59 of them (35.33%) were confirmed as such; and 11 (6.18%) were suspected of having pulmonary thromboembolism, while 3 of them were confirmed as such (27.69%). The mean results obtained were: P-selectin, 25.37 ng/ml; and D-dimer, 2,181.22 ng/ml. The P-selectin levels averaged 33.60 ng/ml with the confirmed TEE group compared with 20.40 ng/ml with the unconfirmed TEE group, with a standard deviation of 23.35 compared with 6.92 (P<0.001); and the level of D-dimer was 4,615.38 ng/ml compared with 977.52 ng/ml, with a standard deviation of 6,460.54 compared with 2,145.50 (P<0.001). Multiple logistic regression adjusted for distant metastases and the Eastern Cooperative Oncology Group (ECOG) score (2,3 and 4) were constructed. The cut-off value of P-selectin for patients with cancer was identified to be different from that reported in the literature for the general population, and the models using D-dimer and P-selectin therefore have been demonstrated to be a potentially useful tool to be used in a panel of tests to predict TEEs, either independently or in a prediction score.

Estimation of Free-Living Energy Expenditure by Heart Rate and Movement Sensing: A Doubly-Labelled Water Study.

PubMed

Brage, Søren; Westgate, Kate; Franks, Paul W; Stegle, Oliver; Wright, Antony; Ekelund, Ulf; Wareham, Nicholas J

2015-01-01

Accurate assessment of energy expenditure (EE) is important for the study of energy balance and metabolic disorders. Combined heart rate (HR) and acceleration (ACC) sensing may increase precision of physical activity EE (PAEE) which is the most variable component of total EE (TEE). To evaluate estimates of EE using ACC and HR data with or without individual calibration against doubly-labelled water (DLW) estimates of EE. 23 women and 23 men (22-55 yrs, 48-104 kg, 8-46%body fat) underwent 45-min resting EE (REE) measurement and completed a 20-min treadmill test, an 8-min step test, and a 3-min walk test for individual calibration. ACC and HR were monitored and TEE measured over 14 days using DLW. Diet-induced thermogenesis (DIT) was calculated from food-frequency questionnaire. PAEE (TEE ÷ REE ÷ DIT) and TEE were compared to estimates from ACC and HR using bias, root mean square error (RMSE), and correlation statistics. Mean(SD) measured PAEE and TEE were 66(25) kJ·day(-1)·kg(-1), and 12(2.6) MJ·day(-1), respectively. Estimated PAEE from ACC was 54(15) kJ·day(-1)·kg(-1) (p<0.001), with RMSE 24 kJ·day(-1)·kg(-1) and correlation r = 0.52. PAEE estimated from HR and ACC+HR with treadmill calibration were 67(42) and 69(25) kJ·day(-1)·kg(-1) (bias non-significant), with RMSE 34 and 20 kJ·day(-1)·kg(-1) and correlations r = 0.58 and r = 0.67, respectively. Similar results were obtained with step-calibrated and walk-calibrated models, whereas non-calibrated models were less precise (RMSE: 37 and 24 kJ·day(-1)·kg(-1), r = 0.40 and r = 0.55). TEE models also had high validity, with biases <5%, and correlations r = 0.71 (ACC), r = 0.66-0.76 (HR), and r = 0.76-0.83 (ACC+HR). Both accelerometry and heart rate may be used to estimate EE in adult European men and women, with improved precision if combined and if heart rate is individually calibrated.

Energy expenditure in adults living in developing compared with industrialized countries: a meta-analysis of doubly labeled water studies123

PubMed Central

Dugas, Lara R; Harders, Regina; Merrill, Sarah; Ebersole, Kara; Shoham, David A; Rush, Elaine C; Assah, Felix K; Forrester, Terrence; Durazo-Arvizu, Ramon A; Luke, Amy

2011-01-01

Background: There is an assumption that people in developing countries have a higher total energy expenditure (TEE) and physical activity level (PAL) than do people in developed nations, but few objective data for this assertion exist. Objective: We conducted a meta-analysis of TEE and PAL by using data from countries that have a low or middle human development index (HDI) compared with those with a high HDI to better understand how energy-expenditure variables are associated with development status and population differences in body size. Design: We performed a literature search for studies in which energy expenditure was measured by using doubly labeled water. Mean data on age, weight, body mass index (BMI; in kg/m2), TEE, and PAL were extracted, and HDI status was assessed. Pooled estimates of the mean effect by sex were obtained, and the extent to which age, weight, HDI status, and year of publication explained heterogeneity was assessed. Results: A total of 98 studies (14 studies from low- or middle-HDI countries) that represented 183 cohorts and 4972 individuals were included. Mean (±SE) BMI was lower in countries with a low or middle HDI than in those with a high HDI for both men and women (22.7 ± 1.0 compared with 26.0 ± 0.7, respectively, in men and 24.3 ± 0.7 compared with 26.6 ± 0.4, respectively, in women). In meta-regression models, there was an inverse association of age (P < 0.001) and a positive association of weight (P < 0.001) with TEE for both sexes; there was an association of age only in men with PAL (P < 0.001). There was no association of HDI status with either TEE or PAL. Conclusion: TEE adjusted for weight and age or PAL did not differ significantly between developing and industrialized countries, which calls into question the role of energy expenditure in the cause of obesity at the population level. PMID:21159791

An ectromelia virus profilin homolog interacts with cellular tropomyosin and viral A-type inclusion protein.

PubMed

Butler-Cole, Christine; Wagner, Mary J; Da Silva, Melissa; Brown, Gordon D; Burke, Robert D; Upton, Chris

2007-07-24

Profilins are critical to cytoskeletal dynamics in eukaryotes; however, little is known about their viral counterparts. In this study, a poxviral profilin homolog, ectromelia virus strain Moscow gene 141 (ECTV-PH), was investigated by a variety of experimental and bioinformatics techniques to characterize its interactions with cellular and viral proteins. Profilin-like proteins are encoded by all orthopoxviruses sequenced to date, and share over 90% amino acid (aa) identity. Sequence comparisons show highest similarity to mammalian type 1 profilins; however, a conserved 3 aa deletion in mammalian type 3 and poxviral profilins suggests that these homologs may be more closely related. Structural analysis shows that ECTV-PH can be successfully modelled onto both the profilin 1 crystal structure and profilin 3 homology model, though few of the surface residues thought to be required for binding actin, poly(L-proline), and PIP2 are conserved. Immunoprecipitation and mass spectrometry identified two proteins that interact with ECTV-PH within infected cells: alpha-tropomyosin, a 38 kDa cellular actin-binding protein, and the 84 kDa product of vaccinia virus strain Western Reserve (VACV-WR) 148, which is the truncated VACV counterpart of the orthopoxvirus A-type inclusion (ATI) protein. Western and far-western blots demonstrated that the interaction with alpha-tropomyosin is direct, and immunofluorescence experiments suggest that ECTV-PH and alpha-tropomyosin may colocalize to structures that resemble actin tails and cellular protrusions. Sequence comparisons of the poxviral ATI proteins show that although full-length orthologs are only present in cowpox and ectromelia viruses, an ~ 700 aa truncated ATI protein is conserved in over 90% of sequenced orthopoxviruses. Immunofluorescence studies indicate that ECTV-PH localizes to cytoplasmic inclusion bodies formed by both truncated and full-length versions of the viral ATI protein. Furthermore, colocalization of ECTV-PH and truncated ATI protein to protrusions from the cell surface was observed. These results suggest a role for ECTV-PH in intracellular transport of viral proteins or intercellular spread of the virus. Broader implications include better understanding of the virus-host relationship and mechanisms by which cells organize and control the actin cytoskeleton.

T1alpha/podoplanin shows raft-associated distribution in mouse lung alveolar epithelial E10 cells.

PubMed

Barth, Kathrin; Bläsche, Robert; Kasper, Michael

2010-01-01

T1alpha/(podoplanin) is abundantly expressed in the alveolar epithelial type I cells (ATI) of rodent and human lungs. Caveolin-1 is a classical primary structural protein of plasmalemal invaginations, so-called caveolae, which represent specialized lipid rafts, and which are particularly abundant in ATI cells. The biological functions of T1alpha in the alveolar epithelium are unknown. Here we report on the characteristics of raft domains in the microplicae/microvillar protrusions of ATI cells, which contain T1alpha. Detergent resistant membranes (DRMs) from cell lysates of the mouse epithelial ATI-like cell line E10 were prepared using different detergents followed by flotation in a sucrose gradient and tested by Western and dot blots with raft markers (caveolin-1, GM1) and nonraft markers (transferrin receptor, PDI and beta-Cop). Immunocytochemistry was employed for the localization of T1alpha in E10 cells and in situ in rat lungs. Our biochemical results showed that the solubility or insolubility of T1alpha and caveolin-1 differs in Triton X-100 and Lubrol WX, two distinct non-ionic detergents. Caveolin-1 was unsoluble in both detergents, whereas T1alpha was Triton X-100 soluble but Lubrol WX insoluble. Immunofluorescence double stainings revealed that both proteins were colocalized with GM1, while caveolin-1 and T1alpha were not colocalized in the plasma membrane. Cholesterol depletion modified the segregation of T1alpha in Lubrol WX DRMs. Cellular processes in ultrathin sections of cultured mouse E10 cells were immunogold positive. Immunoelectron microscopy (postembedding) of rat lung tissue revealed the preferential localization of T1alpha on apical microvillar protrusions of ATI cells. We conclude that T1alpha and caveolin-1 are located in distinct plasma membrane microdomains, which differ in their protein-lipid interactions. The raft-associated distribution of T1alpha may have an impact on a specific, not yet clarified function of this protein in the alveolar epithelium. 2010 S. Karger AG, Basel

First in vivo evaluation of a flexible self-apposing left atrial appendage closure device in the canine model.

PubMed

Cheng, Yanping; Conditt, Gerard; Yi, Genghua; Tellez, Armando; Corcoran, Michael; Rousselle, Serge; Kaluza, Greg L; Granada, Juan F

2015-07-01

Aimed to evaluate the feasibility of deployment and healing response of a novel transcatheter left atrial appendage (LAA) occlusion device in the canine model LAA occlusion is proposed to reduce the risk of stroke in atrial fibrillation patients Transseptal puncture and device deployment was guided under fluoroscopy and transesophageal echocardiography (TEE) in five dogs. First, a distal cylindrical bulb occluder was released and secured to the appendage wall with hooks. Subsequently, a proximal sail was unfolded, covering the LAA ostium. Rotational angiography, TEE, and histology outcomes were assessed 30 days following implantation Pre-operative TEE revealed the mean diameter of the LAA ostium to be 17.2 ± 1.6 mm with a depth of 18.5 ± 1.7 mm. The landing zone for the distal bulb was measured to be 12.8 ± 1.3 mm. The mean bulb diameter at implant was 16.8 ± 1.8 mm. Post-operative TEE showed adequate positioning and successful LAA occlusion with all implanted devices. Pericardial effusion requiring pericardiocentesis was seen in one animal following device implantation. At 30 days, TEE revealed full occlusion of all LAA ostia with the exception of a minimal peri-device leak (<3 mm) observed in one animal. No pericardial effusion or device-related thrombus formation was found at termination. Histological analysis confirmed circumferential occlusion of all appendages and complete neointimal coverage on the luminal aspect of the occluder The percutaneous delivery of a novel self-positioning LAA occlusion device is feasible and safe in a canine model. At 30 days, all devices displayed complete healing and occlusion of the LAA without any device related adverse events. © 2015 Wiley Periodicals, Inc.

Total energy expenditure in the Yakut (Sakha) of Siberia as measured by the doubly labeled water method.

PubMed

Snodgrass, J Josh; Leonard, William R; Tarskaia, Larissa A; Schoeller, Dale A

2006-10-01

Populations in transition to a Western lifestyle display increased incidences of obesity, type 2 diabetes, and other chronic diseases; the mechanisms responsible for these changes, however, remain incompletely understood. Although reduced physical activity has been implicated, few studies have accurately quantified energy expenditure in subsistence populations. The aim of the study was to examine the relation of total energy expenditure (TEE) and activity [physical activity level (PAL), activity energy expenditure (AEE), and weight-adjusted AEE (AEE/kg)] with body composition and lifestyle in the Yakut (Sakha), an indigenous high-latitude Siberian group. We measured TEE using doubly labeled water and resting metabolic rate using indirect calorimetry in 28 young adults (14 women and 14 men) from Berdygestiakh, Russia. The men had higher TEE (12,983 compared with 9620 kJ/d; P < 0.01), AEE (5248 compared with 3203 kJ/d; P < 0.05), AEE/kg (72.7 compared with 48.8 kJ . kg(-1) . d(-1); P < 0.05), and PAL (1.7 compared with 1.5; P = 0.09) than did the women, although this may reflect, in part, body size and composition differences. Overweight men and women had modestly higher TEEs than did lean participants; when adjusted for body size, activity levels were not significantly different between the groups. Persons with more traditional lifestyles had higher TEEs and PALs than did persons with more modernized lifestyles; this difference correlated with differences in participation in subsistence activities. Activity levels in the Yakut were lower than those in other subsistence groups, especially the women, and were not significantly different from those in persons in industrialized nations. Persons who participated in more subsistence activities and consumed fewer market foods had significantly higher activity levels.

A descriptive study of step alignment and foot positioning relative to the tee by professional rugby union goal-kickers.

PubMed

Cockcroft, John; Van Den Heever, Dawie

2016-01-01

This study describes foot positioning during the final two steps of the approach to the ball amongst professional rugby goal-kickers. A 3D optical motion capture system was used to test 15 goal-kickers performing 10 goal-kicks. The distance and direction of each step, as well as individual foot contact positions relative to the tee, were measured. The intra- and inter-subject variability was calculated as well as the correlation (Pearson) between the measurements and participant anthropometrics. Inter-subject variability for the final foot position was lowest (placed 0.03 ± 0.07 m behind and 0.33 ± 0.03 m lateral to the tee) and highest for the penultimate step distance (0.666 ± 0.149 m), performed at an angle of 36.1 ± 8.5° external to the final step. The final step length was 1.523 ± 0.124 m, executed at an external angle of 35.5 ± 7.4° to the target line. The intra-subject variability was very low; distances and angles for the 10 kicks varied per participant by 1.6-3.1 cm and 0.7-1.6°, respectively. The results show that even though the participants had variability in their run-up to the tee, final foot position next to the tee was very similar and consistent. Furthermore, the inter- and intra-subject variability could not be attributed to differences in anthropometry. These findings may be useful as normative reference data for coaching, although further work is required to understand the role of other factors such as approach speed and body alignment.

From accuracy to patient outcome and cost-effectiveness evaluations of diagnostic tests and biomarkers: an exemplary modelling study

PubMed Central

2013-01-01

Background Proper evaluation of new diagnostic tests is required to reduce overutilization and to limit potential negative health effects and costs related to testing. A decision analytic modelling approach may be worthwhile when a diagnostic randomized controlled trial is not feasible. We demonstrate this by assessing the cost-effectiveness of modified transesophageal echocardiography (TEE) compared with manual palpation for the detection of atherosclerosis in the ascending aorta. Methods Based on a previous diagnostic accuracy study, actual Dutch reimbursement data, and evidence from literature we developed a Markov decision analytic model. Cost-effectiveness of modified TEE was assessed for a life time horizon and a health care perspective. Prevalence rates of atherosclerosis were age-dependent and low as well as high rates were applied. Probabilistic sensitivity analysis was applied. Results The model synthesized all available evidence on the risk of stroke in cardiac surgery patients. The modified TEE strategy consistently resulted in more adapted surgical procedures and, hence, a lower risk of stroke and a slightly higher number of life-years. With 10% prevalence of atherosclerosis the incremental cost-effectiveness ratio was €4,651 and €481 per quality-adjusted life year in 55-year-old men and women, respectively. In all patients aged 65 years or older the modified TEE strategy was cost saving and resulted in additional health benefits. Conclusions Decision analytic modelling to assess the cost-effectiveness of a new diagnostic test based on characteristics, costs and effects of the test itself and of the subsequent treatment options is both feasible and valuable. Our case study on modified TEE suggests that it may reduce the risk of stroke in cardiac surgery patients older than 55 years at acceptable cost-effectiveness levels. PMID:23368927

Influence of the Quantity of Aortic Valve Calcium on the Agreement Between Automated 3-Dimensional Transesophageal Echocardiography and Multidetector Row Computed Tomography for Aortic Annulus Sizing.

PubMed

Podlesnikar, Tomaz; Prihadi, Edgard A; van Rosendael, Philippe J; Vollema, E Mara; van der Kley, Frank; de Weger, Arend; Ajmone Marsan, Nina; Naji, Franjo; Fras, Zlatko; Bax, Jeroen J; Delgado, Victoria

2018-01-01

Accurate aortic annulus sizing is key for selection of appropriate transcatheter aortic valve implantation (TAVI) prosthesis size. The present study compared novel automated 3-dimensional (3D) transesophageal echocardiography (TEE) software and multidetector row computed tomography (MDCT) for aortic annulus sizing and investigated the influence of the quantity of aortic valve calcium (AVC) on the selection of TAVI prosthesis size. A total of 83 patients with severe aortic stenosis undergoing TAVI were evaluated. Maximal and minimal aortic annulus diameter, perimeter, and area were measured. AVC was assessed with computed tomography. The low and high AVC burden groups were defined according to the median AVC score. Overall, 3D TEE measurements slightly underestimated the aortic annulus dimensions as compared with MDCT (mean differences between maximum, minimum diameter, perimeter, and area: -1.7 mm, 0.5 mm, -2.7 mm, and -13 mm 2 , respectively). The agreement between 3D TEE and MDCT on aortic annulus dimensions was superior among patients with low AVC burden (<3,025 arbitrary units) compared with patients with high AVC burden (≥3,025 arbitrary units). The interobserver variability was excellent for both methods. 3D TEE and MDCT led to the same prosthesis size selection in 88%, 95%, and 81% of patients in the total population, the low, and the high AVC burden group, respectively. In conclusion, the novel automated 3D TEE imaging software allows accurate and highly reproducible measurements of the aortic annulus dimensions and shows excellent agreement with MDCT to determine the TAVI prosthesis size, particularly in patients with low AVC burden. Copyright © 2017 The Author(s). Published by Elsevier Inc. All rights reserved.

A three-dimensional insight into the complexity of flow convergence in mitral regurgitation: adjunctive benefit of anatomic regurgitant orifice area.

PubMed

Chandra, Sonal; Salgo, Ivan S; Sugeng, Lissa; Weinert, Lynn; Settlemier, Scott H; Mor-Avi, Victor; Lang, Roberto M

2011-09-01

Mitral effective regurgitant orifice area (EROA) using the flow convergence (FC) method is used to quantify the severity of mitral regurgitation (MR). However, it is challenging and prone to interobserver variability in complex valvular pathology. We hypothesized that real-time three-dimensional (3D) transesophageal echocardiography (RT3D TEE) derived anatomic regurgitant orifice area (AROA) can be a reasonable adjunct, irrespective of valvular geometry. Our goals were to 1) to determine the regurgitant orifice morphology and distance suitable for FC measurement using 3D computational flow dynamics and finite element analysis (FEA), and (2) to measure AROA from RT3D TEE and compare it with 2D FC derived EROA measurements. We studied 61 patients. EROA was calculated from 2D TEE images using the 2D-FC technique, and AROA was obtained from zoomed RT3DE TEE acquisitions using prototype software. 3D computational fluid dynamics by FEA were applied to 3D TEE images to determine the effects of mitral valve (MV) orifice geometry on FC pattern. 3D FEA analysis revealed that a central regurgitant orifice is suitable for FC measurements at an optimal distance from the orifice but complex MV orifice resulting in eccentric jets yielded nonaxisymmetric isovelocity contours close to the orifice where the assumptions underlying FC are problematic. EROA and AROA measurements correlated well (r = 0.81) with a nonsignificant bias. However, in patients with eccentric MR, the bias was larger than in central MR. Intermeasurement variability was higher for the 2D FC technique than for RT3DE-based measurements. With its superior reproducibility, 3D analysis of the AROA is a useful alternative to quantify MR when 2D FC measurements are challenging.

Left atrial thrombus and dense spontaneous echocardiographic contrast in patients on continuous direct oral anticoagulant therapy undergoing catheter ablation of atrial fibrillation: Comparison of dabigatran, rivaroxaban, and apixaban.

PubMed

Wu, Michael; Gabriels, James; Khan, Mohammad; Shaban, Nada; D'Amato, Salvatore; Liu, Christopher F; Markowitz, Steven M; Ip, James E; Thomas, George; Singh, Parmanand; Lerman, Bruce; Patel, Apoor; Cheung, Jim W

2018-04-01

Left atrial thrombus (LAT) and dense spontaneous echocardiographic contrast (SEC) detected by transesophageal echocardiography (TEE) in patients on continuous direct oral anticoagulants (DOAC) therapy before catheter ablation of atrial fibrillation (AF) or atrial flutter (AFL) have been described. We sought to compare rates of TEE-detected LAT and dense SEC among patients taking different DOACs. We evaluated 609 consecutive patients from 3 tertiary hospitals (median age 65 years; interquartile range 58-71 years; 436 (72%) men) who were on ≥4 weeks of continuous DOAC therapy (dabigatran, n = 166 [27%]; rivaroxaban, n = 257 [42%]; or apixaban, n = 186 [31%]) undergoing TEE before catheter ablation of AF/AFL. Demographic, clinical, and TEE data were collected for each patient. Despite ≥4 weeks of continuous DOAC therapy, 17 patients (2.8%) had LAT and 15 patients (2.5%) had dense SEC detected by TEE. The rates of LAT were 3.0%, 3.5%, and 1.6% for patients on dabigatran, rivaroxaban, and apixaban, respectively (P = .482). The rates of dense SEC were 1.2%, 3.5%, and 2.2% for patients on dabigatran, rivaroxaban, and apixaban, respectively (P = .299). Congestive heart failure (odds ratio 4.4; 95% confidence interval 1.6-12; P = .003) and moderate/severe left atrial enlargement (odds ratio 3.1; 95% confidence interval 1.1-8.6; P = .026) were independent predictors of LAT. In this study, ∼3% of patients on continuous DOAC therapy had LAT detected before catheter ablation of AF/AFL. Specific DOAC therapy did not significantly affect the rates of LAT detection. Copyright © 2017 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

Under-reporting of food intake and body fatness in independent older people: a doubly labelled water study.

PubMed

Pfrimer, Karina; Vilela, Mariana; Resende, Cristina Maria; Scagliusi, Fernanda Baeza; Marchini, Julio Sergio; Lima, Nereida K C; Moriguti, Julio Cesar; Ferriolli, Eduardo

2015-01-01

there are no accurate methods for the assessment of food intake in older populations, under-reporting of intake being highly prevalent. There is controversy about which dietary assessment method and what person's characteristics are associated with greater under-reporting rates. to assess the correlation between under-reporting of energy intake (EI) and different percentages of body fat in independent older people. cross-sectional study. area assisted by the Family Health Program of the Ribeirão Preto Medical School, University of São Paulo, Brazil. one hundred volunteers aged 60-70 years. all volunteers had their body composition assessed by dual-energy x-ray absorptiometry. In second phase, 41 volunteers were evaluated, representing the four quartiles of fat percentage. Total energy expenditure (TEE) was measured by the doubly labelled water method, and EI was assessed by 24-h recalls and a food frequency questionnaire (FFQ). TEE and EI values, EI-to-TEE ratios and EI-TEE values were compared. TEE was 2,220 ± 601 kcal, while the EI was 1,919 ± 602 kcal (24-h recall) and 2,119 ± 670 kcal (FFQ). The proportion of under-reporters was 31 and 40.5%, respectively. Under-reporting was more frequent in subjects with higher percentage of body fat and in females (P < 0.05). under-reporting was more frequent among older persons with higher percentage of body fat in both methods of assessment of food intake. Older persons follow the same profile of under-reporting as younger adults. © The Author 2014. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Cellular Selenoprotein mRNA Tethering via Antisense Interactions with Ebola and HIV-1 mRNAs May Impact Host Selenium Biochemistry.

PubMed

Taylor, Ethan Will; Ruzicka, Jan A; Premadasa, Lakmini; Zhao, Lijun

2016-01-01

Regulation of protein expression by non-coding RNAs typically involves effects on mRNA degradation and/or ribosomal translation. The possibility of virus-host mRNA-mRNA antisense tethering interactions (ATI) as a gain-of-function strategy, via the capture of functional RNA motifs, has not been hitherto considered. We present evidence that ATIs may be exploited by certain RNA viruses in order to tether the mRNAs of host selenoproteins, potentially exploiting the proximity of a captured host selenocysteine insertion sequence (SECIS) element to enable the expression of virally-encoded selenoprotein modules, via translation of in-frame UGA stop codons as selenocysteine. Computational analysis predicts thermodynamically stable ATIs between several widely expressed mammalian selenoprotein mRNAs (e.g., isoforms of thioredoxin reductase) and specific Ebola virus mRNAs, and HIV-1 mRNA, which we demonstrate via DNA gel shift assays. The probable functional significance of these ATIs is further supported by the observation that, in both viruses, they are located in close proximity to highly conserved in-frame UGA stop codons at the 3' end of open reading frames that encode essential viral proteins (the HIV-1 nef protein and the Ebola nucleoprotein). Significantly, in HIV/AIDS patients, an inverse correlation between serum selenium and mortality has been repeatedly documented, and clinical benefits of selenium in the context of multi-micronutrient supplementation have been demonstrated in several well-controlled clinical trials. Hence, in the light of our findings, the possibility of a similar role for selenium in Ebola pathogenesis and treatment merits serious investigation.

Assessing Resistance to Change During Shifting from Legacy to Open Web-Based Systems in the Air Transport Industry

NASA Astrophysics Data System (ADS)

Brewer, Denise

The air transport industry (ATI) is a dynamic, communal, international, and intercultural environment in which the daily operations of airlines, airports, and service providers are dependent on information technology (IT). Many of the IT legacy systems are more than 30 years old, and current regulations and the globally distributed workplace have brought profound changes to the way the ATI community interacts. The purpose of the study was to identify the areas of resistance to change in the ATI community and the corresponding factors in change management requirements that minimize product development delays and lead to a successful and timely shift from legacy to open web-based systems in upgrading ATI operations. The research questions centered on product development team processes as well as the members' perceived need for acceptance of change. A qualitative case study approach rooted in complexity theory was employed using a single case of an intercultural product development team dispersed globally. Qualitative data gathered from questionnaires were organized using Nvivo software, which coded the words and themes. Once coded, themes emerged identifying the areas of resistance within the product development team. Results of follow-up interviews with team members suggests that intercultural relationship building prior to and during project execution; focus on common team goals; and, development of relationships to enhance interpersonal respect, understanding and overall communication help overcome resistance to change. Positive social change in the form of intercultural group effectiveness evidenced in increased team functioning during major project transitions is likely to result when global managers devote time to cultural understanding.

Assessment of regional emphysema, air-trapping and Xenon-ventilation using dual-energy computed tomography in chronic obstructive pulmonary disease patients.

PubMed

Lee, Sang Min; Seo, Joon Beom; Hwang, Hye Jeon; Kim, Namkug; Oh, Sang Young; Lee, Jae Seung; Lee, Sei Won; Oh, Yeon-Mok; Kim, Tae Hoon

2017-07-01

To compare the parenchymal attenuation change between inspiration/expiration CTs with dynamic ventilation change between xenon wash-in (WI) inspiration and wash-out (WO) expiration CTs. 52 prospectively enrolled COPD patients underwent xenon ventilation dual-energy CT during WI and WO periods and pulmonary function tests (PFTs). The parenchymal attenuation parameters (emphysema index (EI), gas-trapping index (GTI) and air-trapping index (ATI)) and xenon ventilation parameters (xenon in WI (Xe-WI), xenon in WO (Xe-WO) and xenon dynamic (Xe-Dyna)) of whole lung and three divided areas (emphysema, hyperinflation and normal) were calculated on virtual non-contrast images and ventilation images. Pearson correlation, linear regression analysis and one-way ANOVA were performed. EI, GTI and ATI showed a significant correlation with Xe-WI, Xe-WO and Xe-Dyna (EI R = -.744, -.562, -.737; GTI R = -.621, -.442, -.629; ATI R = -.600, -.421, -.610, respectively, p < 0.01). All CT parameters showed significant correlation with PFTs except forced vital capacity (FVC). There was a significant difference in GTI, ATI and Xe-Dyna in each lung area (p < 0.01). The parenchymal attenuation change between inspiration/expiration CTs and xenon dynamic change between xenon WI- and WO-CTs correlate significantly. There are alterations in the dynamics of xenon ventilation between areas of emphysema. • The xenon ventilation change correlates with the parenchymal attenuation change. • The xenon ventilation change shows the difference between three lung areas. • The combination of attenuation and xenon can predict more accurate PFTs.

Elasto-Plastic Analysis of Tee Joints Using HOT-SMAC

NASA Technical Reports Server (NTRS)

Arnold, Steve M. (Technical Monitor); Bednarcyk, Brett A.; Yarrington, Phillip W.

2004-01-01

The Higher Order Theory - Structural/Micro Analysis Code (HOT-SMAC) software package is applied to analyze the linearly elastic and elasto-plastic response of adhesively bonded tee joints. Joints of this type are finding an increasing number of applications with the increased use of composite materials within advanced aerospace vehicles, and improved tools for the design and analysis of these joints are needed. The linearly elastic results of the code are validated vs. finite element analysis results from the literature under different loading and boundary conditions, and new results are generated to investigate the inelastic behavior of the tee joint. The comparison with the finite element results indicates that HOT-SMAC is an efficient and accurate alternative to the finite element method and has a great deal of potential as an analysis tool for a wide range of bonded joints.

Rain Volume Estimation over Areas Using Satellite and Radar Data

NASA Technical Reports Server (NTRS)

Doneaud, A. A.; Miller, J. R., Jr.; Johnson, L. R.; Vonderhaar, T. H.; Laybe, P.

1984-01-01

The application of satellite data to a recently developed radar technique used to estimate convective rain volumes over areas on a dry environment (the northern Great Plains) is discussed. The area time integral technique (ATI) provides a means of estimating total rain volumes over fixed and floating target areas of the order of 1,000 to 100,000 km(2) for clusters lasting 40 min. The basis of the method is the existence of a strong correlation between the area coverage integrated over the lifetime of the storm (ATI) and the rain volume. One key element in this technique is that it does not require the consideration of the structure of the radar intensities inside the area coverage to generate rain volumes, but only considers the rain event per se. This fact might reduce or eliminate some sources of error in applying the technique to satellite data. The second key element is that the ATI once determined can be converted to total rain volume by using a constant factor (average rain rate) for a given locale.

A modified ATI technique for nowcasting convective rain volumes over areas. [area-time integrals

NASA Technical Reports Server (NTRS)

Makarau, Amos; Johnson, L. Ronald; Doneaud, Andre A.

1988-01-01

This paper explores the applicability of the area-time-integral (ATI) technique for the estimation of the growth portion only of a convective storm (while the rain volume is computed using the entire life history of the event) and for nowcasting the total rain volume of a convective system at the stage of its maximum development. For these purposes, the ATIs were computed from the digital radar data (for 1981-1982) from the North Dakota Cloud Modification Project, using the maximum echo area (ATIA) no less than 25 dBz, the maximum reflectivity, and the maximum echo height as the end of the growth portion of the convective event. Linear regression analysis demonstrated that correlations between total rain volume or the maximum rain volume versus ATIA were the strongest. The uncertainties obtained were comparable to the uncertainties which typically occur in rain volume estimates obtained from radar data employing Z-R conversion followed by space and time integration. This demonstrates that the total rain volume of a storm can be nowcasted at its maximum stage of development.

Be aware of the Adjusted Treatment Index.

PubMed

Langford, Melvyn

2015-10-01

The authors of the interim report relating to the Review of Operational Productivity in NHS providers, published in June of this year, are, as many will know, developing a set of Adjusted Treatment Index (ATI) metrics, and are also to publish a model of their interpretation of what an estates department should look like in terms of its operational productivity and cost. This article argues that the underlying reason for the past failures was the creation of static 'point-value' metrics similar to the ATIs proposed, and that this can only be overcome by designing and populating a series of non-linear dynamic simulation models with feedback control of an organisation's estate in relation to its asset base and condition with respect to time, together with the resultant financial capital and revenue consequences. It concludes by calling on IHEEM's Council to urgently make representation to the authors of the June 2015 report, and suggests that the Institute's members be fully involved in the design, testing, and interpretation, of the estates model and ATIs. IHEEM's Technology Platforms are ideally placed to play a central role in this.

Integrated Circuit Immunity

NASA Technical Reports Server (NTRS)

Sketoe, J. G.; Clark, Anthony

2000-01-01

This paper presents a DOD E3 program overview on integrated circuit immunity. The topics include: 1) EMI Immunity Testing; 2) Threshold Definition; 3) Bias Tee Function; 4) Bias Tee Calibration Set-Up; 5) EDM Test Figure; 6) EMI Immunity Levels; 7) NAND vs. and Gate Immunity; 8) TTL vs. LS Immunity Levels; 9) TP vs. OC Immunity Levels; 10) 7805 Volt Reg Immunity; and 11) Seventies Chip Set. This paper is presented in viewgraph form.

Guidelines for Conducting a Training Effectiveness Evaluation (TEE). Volume 1. TEE Evaluator’s Handbook

DTIC Science & Technology

1985-02-01

by drawing prerequisite lines, the relationships between all subordinate skills and knowledges and the terminal objective. Thus, for purposes of...functions, tasks, or skills below it, rate the relationship of the performances shown in the superordinate box to those in the subordinate boxes...A useful format for displaying performance relationships between team functions and subordinate tasks or communication and coordination skills

A smartphone-driven methodology for estimating physical activities and energy expenditure in free living conditions.

PubMed

Guidoux, Romain; Duclos, Martine; Fleury, Gérard; Lacomme, Philippe; Lamaudière, Nicolas; Manenq, Pierre-Henri; Paris, Ludivine; Ren, Libo; Rousset, Sylvie

2014-12-01

This paper introduces a function dedicated to the estimation of total energy expenditure (TEE) of daily activities based on data from accelerometers integrated into smartphones. The use of mass-market sensors such as accelerometers offers a promising solution for the general public due to the growing smartphone market over the last decade. The TEE estimation function quality was evaluated using data from intensive numerical experiments based, first, on 12 volunteers equipped with a smartphone and two research sensors (Armband and Actiheart) in controlled conditions (CC) and, then, on 30 other volunteers in free-living conditions (FLC). The TEE given by these two sensors in both conditions and estimated from the metabolic equivalent tasks (MET) in CC served as references during the creation and evaluation of the function. The TEE mean gap in absolute value between the function and the three references was 7.0%, 16.4% and 2.7% in CC, and 17.0% and 23.7% according to Armband and Actiheart, respectively, in FLC. This is the first step in the definition of a new feedback mechanism that promotes self-management and daily-efficiency evaluation of physical activity as part of an information system dedicated to the prevention of chronic diseases. Copyright © 2014 Elsevier Inc. All rights reserved.

Noninvasive Hemodynamic Measurements During Neurosurgical Procedures in Sitting Position.

PubMed

Schramm, Patrick; Tzanova, Irene; Gööck, Tilman; Hagen, Frank; Schmidtmann, Irene; Engelhard, Kristin; Pestel, Gunther

2017-07-01

Neurosurgical procedures in sitting position need advanced cardiovascular monitoring. Transesophageal echocardiography (TEE) to measure cardiac output (CO)/cardiac index (CI) and stroke volume (SV), and invasive arterial blood pressure measurements for systolic (ABPsys), diastolic (ABPdiast) and mean arterial pressure (MAP) are established monitoring technologies for these kind of procedures. A noninvasive device for continuous monitoring of blood pressure and CO based on a modified Penaz technique (volume-clamp method) was introduced recently. In the present study the noninvasive blood pressure measurements were compared with invasive arterial blood pressure monitoring, and the noninvasive CO monitoring to TEE measurements. Measurements of blood pressure and CO were performed in 35 patients before/after giving a fluid bolus and a change from supine to sitting position, start of surgery, and repositioning from sitting to supine at the end of surgery. Data pairs from the noninvasive device (Nexfin HD) versus arterial line measurements (ABPsys, ABPdiast, MAP) and versus TEE (CO, CI, SV) were compared using Bland-Altman analysis and percentage error. All parameters compared (CO, CI, SV, ABPsys, ABPdiast, MAP) showed a large bias and wide limits of agreement. Percentage error was above 30% for all parameters except ABPsys. The noninvasive device based on a modified Penaz technique cannot replace arterial blood pressure monitoring or TEE in anesthetized patients undergoing neurosurgery in sitting position.

Unusual fan shaped ossification in a female fetus with radiological features of boomerang dysplasia

PubMed Central

Odent, S.; Loget, P.; Le Marec, B.; Delezoide, A.; Maroteaux, P.

1999-01-01

We report on a female fetus of 24 weeks whose clinical and radiological findings were compatible with boomerang dysplasia (BD). However, histopathology was unusual with a lateral fan shaped diaphyseal ossification. This has never been described either in typical atelosteogenesis I (AT-I) or in BD. The purpose of this report is to find out if this condition is a separate lethal bone dysplasia or another histological feature of the nosological group of AT-I and BD. 


Keywords: boomerang dysplasia; atelosteogenesis; lethal chondrodysplasia; lethal dwarfism PMID:10227404

Fireproof Hydraulic Brake System.

DTIC Science & Technology

1985-10-01

MLBT elastomer personnel recommended the use of Firestone’s Phosphonitrilic Fluoroelastomer (PNF) for elastomeric O-rings in the CTFE fluid system. C.E...resealed with modified "PNF" (phosphonitrilic fluoroelastomer) elastomer Ŕ" rings. The hoses are PTFE lined for compatibility with the CTFE...Plus 65-42808-6 Nylon Braid )* AN837-8 Elbow (on Truck) 61-11536-1 Tube Assy (Strut/Truck Hose to Truck Tee)* 290 -7. 61-11530-1 Tube Assy (Truck Tee

Live 3D TEE demonstrates and guides the management of prosthetic mitral valve obstruction.

PubMed

Chahal, Mangeet; Pandya, Utpal; Adlakha, Satjit; Khouri, Samer J

2011-08-01

A 43-year-old woman, with a remote history of rheumatic mitral stenosis and a St. Jude prosthetic mitral valve replacement, presented with shortness of breath and palpitations, shortly after a long flight. On admission, atrial fibrillation with a rapid ventricular response was noted in the setting of a long history of noncompliance with her anticoagulation. Transesophageal echocardiography (TEE) demonstrated multiple laminated thrombi in the left atrial appendage. Live three-dimensional (3D) TEE confirmed this diagnosis and demonstrated an immobile posterior leaflet of the mitral prosthesis, which had direct implications in her management. She successfully underwent surgery for mitral valve replacement, left atrial appendage ligation, and a Maze procedure on the following day. The multiple thrombi within the atrial appendage were confirmed intraoperatively and pannus formation was determined to be the etiology of the leaflet immobility. © 2011, Wiley Periodicals, Inc.

Fiber optic illumination of a poly(dimethylsiloxane) sheath flow cuvette for diode laser induced fluorescence detection in capillary electrophoresis.

PubMed

Skinner, Cameron D

2015-02-01

A Tee configuration sheath flow cuvette with square cross-section channels has been produced in PDMS for CE detection. The output of a 1.4 W laser diode operating at 450 nm was focused onto the 300 μm core of a 370 μm od fiber optic whose end was inserted into one arm of the Tee for LIF. The optimal configuration had the fiber optic positioned 500 μm downstream from the intersection and the end of the 35 cm 50 μm id 365 μm od capillary just outside the intersection and in the leg of the Tee, resulting in a 90° configuration. Detection limits of 50 and 3 pM and linear calibrations of at least three orders of magnitude were obtained for Lucifer Yellow and fluorescein, respectively. © 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Comparing Methods for Cardiac Output: Intraoperatively Doppler-Derived Cardiac Output Measured With 3-Dimensional Echocardiography Is Not Interchangeable With Cardiac Output by Pulmonary Catheter Thermodilution.

PubMed

Graeser, Karin; Zemtsovski, Mikhail; Kofoed, Klaus F; Winther-Jensen, Matilde; Nilsson, Jens C; Kjaergaard, Jesper; Møller-Sørensen, Hasse

2018-01-09

Estimation of cardiac output (CO) is essential in the treatment of circulatory unstable patients. CO measured by pulmonary artery catheter thermodilution is considered the gold standard but carries a small risk of severe complications. Stroke volume and CO can be measured by transesophageal echocardiography (TEE), which is widely used during cardiac surgery. We hypothesized that Doppler-derived CO by 3-dimensional (3D) TEE would agree well with CO measured with pulmonary artery catheter thermodilution as a reference method based on accurate measurements of the cross-sectional area of the left ventricular outflow tract. The primary aim was a systematic comparison of CO with Doppler-derived 3D TEE and CO by thermodilution in a broad population of patients undergoing cardiac surgery. A subanalysis was performed comparing cross-sectional area by TEE with cardiac computed tomography (CT) angiography. Sixty-two patients, scheduled for elective heart surgery, were included; 1 was subsequently excluded for logistic reasons. Inclusion criteria were coronary artery bypass surgery (N = 42) and aortic valve replacement (N = 19). Exclusion criteria were chronic atrial fibrillation, left ventricular ejection fraction below 0.40 and intracardiac shunts. Nineteen randomly selected patients had a cardiac CT the day before surgery. All images were stored for blinded post hoc analyses, and Bland-Altman plots were used to assess agreement between measurement methods, defined as the bias (mean difference between methods), limits of agreement (equal to bias ± 2 standard deviations of the bias), and percentage error (limits of agreement divided by the mean of the 2 methods). Precision was determined for the individual methods (equal to 2 standard deviations of the bias between replicate measurements) to determine the acceptable limits of agreement. We found a good precision for Doppler-derived CO measured by 3D TEE, but although the bias for Doppler-derived CO by 3D compared to thermodilution was only 0.3 L/min (confidence interval, 0.04-0.58), there were wide limits of agreement (-1.8 to 2.5 L/min) with a percentage error of 55%. Measurements of cross-sectional area by 3D TEE had low bias of -0.27 cm (confidence interval, -0.45 to -0.08) and a percentage error of 18% compared to cardiac CT angiography. Despite low bias, the wide limits of agreement of Doppler-derived CO by 3D TEE compared to CO by thermodilution will limit clinical application and can therefore not be considered interchangeable with CO obtained by thermodilution. The lack of agreement is not explained by lack of agreement of the 3D technique.

Validity and reliability of GPS and LPS for measuring distances covered and sprint mechanical properties in team sports

PubMed Central

Baumgart, Christian; Polglaze, Ted; Freiwald, Jürgen

2018-01-01

This study aimed to investigate the validity and reliability of global (GPS) and local (LPS) positioning systems for measuring distances covered and sprint mechanical properties in team sports. Here, we evaluated two recently released 18 Hz GPS and 20 Hz LPS technologies together with one established 10 Hz GPS technology. Six male athletes (age: 27±2 years; VO2max: 48.8±4.7 ml/min/kg) performed outdoors on 10 trials of a team sport-specific circuit that was equipped with double-light timing gates. The circuit included various walking, jogging, and sprinting sections that were performed either in straight-lines or with changes of direction. During the circuit, athletes wore two devices of each positioning system. From the reported and filtered velocity data, the distances covered and sprint mechanical properties (i.e., the theoretical maximal horizontal velocity, force, and power output) were computed. The sprint mechanical properties were modeled via an inverse dynamic approach applied to the center of mass. The validity was determined by comparing the measured and criterion data via the typical error of estimate (TEE), whereas the reliability was examined by comparing the two devices of each technology (i.e., the between-device reliability) via the coefficient of variation (CV). Outliers due to measurement errors were statistically identified and excluded from validity and reliability analyses. The 18 Hz GPS showed better validity and reliability for determining the distances covered (TEE: 1.6–8.0%; CV: 1.1–5.1%) and sprint mechanical properties (TEE: 4.5–14.3%; CV: 3.1–7.5%) than the 10 Hz GPS (TEE: 3.0–12.9%; CV: 2.5–13.0% and TEE: 4.1–23.1%; CV: 3.3–20.0%). However, the 20 Hz LPS demonstrated superior validity and reliability overall (TEE: 1.0–6.0%; CV: 0.7–5.0% and TEE: 2.1–9.2%; CV: 1.6–7.3%). For the 10 Hz GPS, 18 Hz GPS, and 20 Hz LPS, the relative loss of data sets due to measurement errors was 10.0%, 20.0%, and 15.8%, respectively. This study shows that 18 Hz GPS has enhanced validity and reliability for determining movement patterns in team sports compared to 10 Hz GPS, whereas 20 Hz LPS had superior validity and reliability overall. However, compared to 10 Hz GPS, 18 Hz GPS and 20 Hz LPS technologies had more outliers due to measurement errors, which limits their practical applications at this time. PMID:29420620

Renal tubular disease in the era of combination antiretroviral therapy.

PubMed

Hamzah, Lisa; Booth, John W; Jose, Sophie; McAdoo, Stephen P; Kumar, Emil A; O'Donnell, Patrick; Hilton, Rachel; Sabin, Caroline; Williams, Deborah I; Jones, Rachael; Post, Frank A

2015-09-10

To describe the spectrum of renal tubular disease (RTD) in HIV-positive patients and its association with exposure to antiretroviral therapy (ART). Review of 265 consecutive renal biopsies from HIV-positive patients attending eight clinics in the United Kingdom between 2000 and 2012. We described the clinical characteristics of patients with RTD and compared current/recent exposure (at the time of, or up to 3 months prior to the date of biopsy) to potentially nephrotoxic ART [tenofovir (TDF), atazanavir (ATV), indinavir (IDV) and lopinavir/ritonavir (LPV/r)]. We also analysed the incidence of RTD in the UK CHIC cohort. Kruskall-Wallis, analysis of variance and Fisher's exact tests were used to evaluate between-group differences. Of the 60 RTD cases, 54 (90%) were included in the analyses. RTD comprised of three distinct patterns: acute tubular injury (ATI, n = 22), tubulo-interstitial nephritis (TIN, n = 20) and interstitial fibrosis and tubular atrophy (IFTA, n = 12). Compared with TIN and IFTA, ATI cases were less likely to be of black ethnicity (10 vs. 42-55%; P = 0.006), more likely to be on ART (100 vs. 55-68%; P = 0.001), with HIV-RNA below 200 copies/ml (100 vs. 54-58%; P < 0.001), and more likely to have current/recent exposure to TDF (P < 0.001). We did not find evidence for an association between exposure to TDF, ATV/r or LPV/r and either TIN or IFTA. RTD was present in approximately 20% of renal biopsies and comprised three distinct injury patterns with considerable clinical overlap. ATI was associated with TDF exposure, although the overall incidence of biopsy-defined ATI was low.

New norms new policies: Did the Adelaide Thinkers in Residence scheme encourage new thinking about promoting well-being and Health in All Policies?

PubMed

Baum, Fran; Lawless, Angela; MacDougall, Colin; Delany, Toni; McDermott, Dennis; Harris, Elizabeth; Williams, Carmel

2015-12-01

Health systems have long been criticised for focussing on curing rather than preventing disease. This paper examines to what extent the Adelaide Thinkers in Residence (ATiR) scheme contributed to the change in norms whereby promoting well-being and a strategy to achieve this - Health in All Policies (HiAP)--was adopted by the South Australian (SA) State Government from 2007. The data presented in this paper are drawn from a five year (2012-2016) detailed mixed methods case study of the SA HiAP initiative which involved document analysis, interviews and workshops with public servants and political actors. We adapt the framework used by Finnemore and Sikkink (1998) which explains how norm changes can lead to political changes in international affairs. We also use Kingdon's concept of policy entrepreneurs to determine whether these ideas moved to an implementable initiative with the help of both a specific ATiR program on HiAP and the broader TiR scheme which promoted a series of innovations relevant to health. The process involved the ATiR reinforcing the work of local norm entrepreneurs with that of powerful external policy entrepreneurs, adapting the discourse about the value of prevention and promoting well-being so that it fitted with the dominant economic one. The powerful organisational platform of the ATiR, which was under the Department of the Premier and Cabinet and linked to the South Australian Strategic Plan (SASP) was used to advance these ideas. The case study offers important lessons for other jurisdictions on how to shift policy to encourage intersectoral approaches to health. Copyright © 2015 Elsevier Ltd. All rights reserved.

Temporal assemblage turnovers of intertidal foraminiferal communities from tropical (SE Caribbean) and temperate (NE England and SW Spain) regions

NASA Astrophysics Data System (ADS)

Costelloe, Ashleigh; Wilson, Brent; Horton, Benjamin P.; Hayek, Lee-Ann C.

2018-05-01

This is the first quantitative study of temporal assemblage turnovers of the relationships between intertidal foraminifera. Time series datasets collected from tropical Caroni Swamp and Claxton Bay (Trinidad, SE Caribbean) and temperate Cowpen Marsh (NE England, U.K.) and Bay of Cadiz (SW Spain) were used. The assemblage turnover index (ATI) examined species interrelationships through comparisons of monthly or biweekly species proportional abundances over one or two years. Species contributing to major assemblage turnovers (ATI > x + σ) were identified using the conditioned on-boundary index (CoBI). Foraminiferal species are heterogeneously distributed within the sediment; multiple sample stations at a study location cumulatively represent the foraminiferal metacommunity and clusters represent foraminiferal assemblages. The ATI and CoBI were applied to the proportional abundances of live specimens recorded for the metacommunity and assemblages at each location. At Caroni Swamp and Claxton Bay, major assemblage turnovers were driven by the most abundant species and the majority coincided with seasonal change or the arrival of the seasonal Orinoco plume in the Gulf of Paria. Seasonal turnovers of the foraminiferal metacommunities at temperate Cowpen Marsh and Bay of Cádiz occurred during the summer and winter. Major assemblage turnovers in the upper Cowpen Marsh occurred in the summer, and the lower marsh in the winter. Foraminiferans are useful bioindicators for monitoring the health of coastal environments. Understanding foraminiferal population dynamics will allow cyclical changes to be differentiated from abrupt and persistent changes, which are related to anthropogenic disturbances or long-term climate change. The ATI and CoBI are useful indices for quantitatively exploring relationships of foraminiferal populations over time.

Cellular Selenoprotein mRNA Tethering via Antisense Interactions with Ebola and HIV-1 mRNAs May Impact Host Selenium Biochemistry

PubMed Central

Taylor, Ethan Will; Ruzicka, Jan A.; Premadasa, Lakmini; Zhao, Lijun

2016-01-01

Regulation of protein expression by non-coding RNAs typically involves effects on mRNA degradation and/or ribosomal translation. The possibility of virus-host mRNA-mRNA antisense tethering interactions (ATI) as a gain-of-function strategy, via the capture of functional RNA motifs, has not been hitherto considered. We present evidence that ATIs may be exploited by certain RNA viruses in order to tether the mRNAs of host selenoproteins, potentially exploiting the proximity of a captured host selenocysteine insertion sequence (SECIS) element to enable the expression of virally-encoded selenoprotein modules, via translation of in-frame UGA stop codons as selenocysteine. Computational analysis predicts thermodynamically stable ATIs between several widely expressed mammalian selenoprotein mRNAs (e.g., isoforms of thioredoxin reductase) and specific Ebola virus mRNAs, and HIV-1 mRNA, which we demonstrate via DNA gel shift assays. The probable functional significance of these ATIs is further supported by the observation that, in both viruses, they are located in close proximity to highly conserved in-frame UGA stop codons at the 3′ end of open reading frames that encode essential viral proteins (the HIV-1 nef protein and the Ebola nucleoprotein). Significantly, in HIV/AIDS patients, an inverse correlation between serum selenium and mortality has been repeatedly documented, and clinical benefits of selenium in the context of multi-micronutrient supplementation have been demonstrated in several well-controlled clinical trials. Hence, in the light of our findings, the possibility of a similar role for selenium in Ebola pathogenesis and treatment merits serious investigation. PMID:26369818

Device-less patent foramen ovale closure by radiofrequency thermal energy.

PubMed

Walpoth, Nazan B; Habermacher, Kathrin; Moarof, Igal; Watson, Sandy; Wahl, Andreas; Windecker, Stephan; Schönenberger, Christa; Meier, Bernhard

2008-02-23

The goal of this study was to assess the feasibility, safety and success of a system which uses radiofrequency energy (RFE) rather than a device for percutaneous closure of patent foramen ovale (PFO). Sixteen patients (10 men, 6 women, mean age 50 years) were included in the study. All of them had a proven PFO with documented right-to-left shunt (RLS) after Valsalva manoeuvre (VM) during transoesophageal echocardiography (TEE). The patients had an average PFO diameter of 6 +/- 2 mm at TEE and an average of 23 +/- 4 microembolic signals (MES) in power M-mode transcranial Doppler sonography (pm-TCD), measured over the middle cerebral artery. An atrial septal aneurysm (ASA) was present in 7 patients (44%). Balloon measurement, performed in all patients, revealed a stretched PFO diameter of 8 +/- 3 mm. In 2 patients (stretched diameter 11 and 14 mm respectively, both with ASA >10 mm), radiofrequency was not applied (PFO too large) and the PFO was closed with an Amplatzer PFO occluder instead. A 6-month follow-up TEE was performed in all patients. There were no serious adverse events during the procedure or at follow-up (12 months average). TEE 6 months after the first RFE procedure showed complete closure of the PFO in 50% of the patients (7/14). Closure appeared to be influenced by PFO diameter, complete closure being achieved in 89% (7/8) with a balloon-stretched diameter < or =7 mm but in none of the patients >7 mm. Only one of the complete closure patients had an ASA. Of the remainder, 4 (29%) had an ASA. Although the PFO was not completely closed in this group, some reduction in the diameter of the PFO and in MES was documented by TEE and pm-TCD with VM. Five of the 7 residual shunt patients received an Amplatzer PFO occluder. Except for one patient with a minimal residual shunt, all showed complete closure of PFO at 6-month follow-up TEE and pm-TCD with VM. The other two refused a closure device. The results confirm that radiofrequency closure of the PFO is safe albeit less efficacious and more complex than device closure. The technique in its current state should not be attempted in patients with a balloon-stretched PFO diameter >7 mm and an ASA.

Estimation of Free-Living Energy Expenditure by Heart Rate and Movement Sensing: A Doubly-Labelled Water Study

PubMed Central

Brage, Søren; Westgate, Kate; Franks, Paul W.; Stegle, Oliver; Wright, Antony; Ekelund, Ulf; Wareham, Nicholas J.

2015-01-01

Background Accurate assessment of energy expenditure (EE) is important for the study of energy balance and metabolic disorders. Combined heart rate (HR) and acceleration (ACC) sensing may increase precision of physical activity EE (PAEE) which is the most variable component of total EE (TEE). Objective To evaluate estimates of EE using ACC and HR data with or without individual calibration against doubly-labelled water (DLW) estimates of EE. Design 23 women and 23 men (22–55 yrs, 48–104 kg, 8–46%body fat) underwent 45-min resting EE (REE) measurement and completed a 20-min treadmill test, an 8-min step test, and a 3-min walk test for individual calibration. ACC and HR were monitored and TEE measured over 14 days using DLW. Diet-induced thermogenesis (DIT) was calculated from food-frequency questionnaire. PAEE (TEE ÷ REE ÷ DIT) and TEE were compared to estimates from ACC and HR using bias, root mean square error (RMSE), and correlation statistics. Results Mean(SD) measured PAEE and TEE were 66(25) kJ·day-1·kg-1, and 12(2.6) MJ·day-1, respectively. Estimated PAEE from ACC was 54(15) kJ·day-1·kg-1 (p<0.001), with RMSE 24 kJ·day-1·kg-1 and correlation r = 0.52. PAEE estimated from HR and ACC+HR with treadmill calibration were 67(42) and 69(25) kJ·day-1·kg-1 (bias non-significant), with RMSE 34 and 20 kJ·day-1·kg-1 and correlations r = 0.58 and r = 0.67, respectively. Similar results were obtained with step-calibrated and walk-calibrated models, whereas non-calibrated models were less precise (RMSE: 37 and 24 kJ·day-1·kg-1, r = 0.40 and r = 0.55). TEE models also had high validity, with biases <5%, and correlations r = 0.71 (ACC), r = 0.66–0.76 (HR), and r = 0.76–0.83 (ACC+HR). Conclusions Both accelerometry and heart rate may be used to estimate EE in adult European men and women, with improved precision if combined and if heart rate is individually calibrated. PMID:26349056

Aortic annulus and ascending aorta: comparison of preoperative and periooperative measurement in patients with aortic stenosis.

PubMed

Smíd, Michal; Ferda, Jirí; Baxa, Jan; Cech, Jakub; Hájek, Tomás; Kreuzberg, Boris; Rokyta, Richard

2010-04-01

Precise determination of the aortic annulus size constitutes an integral part of the preoperative evaluation prior to aortic valve replacement. It enables the estimation of the size of prosthesis to be implanted. Knowledge of the size of the ascending aorta is required in the preoperative analysis and monitoring of its dilation enables the precise timing of the operation. Our goal was to compare the precision of measurement of the aortic annulus and ascending aorta using magnetic resonance (MR), multidetector-row computed tomography (MDCT), transthoracic echocardiography (TTE), and transoesophageal echocardiography (TEE) in patients with degenerative aortic stenosis. A total of 15 patients scheduled to have aortic valve replacement were enrolled into this prospective study. TTE was performed in all patients and was supplemented with TEE, CT and MR in the majority of patients. The values obtained were compared with perioperative measurements. For the measurement of aortic annulus, MR was found to be the most precise technique, followed by MDCT, TTE, and TEE. For the measurement of ascending aorta, MR again was found to be the most precise technique, followed by MDCT, TEE, and TTE. In our study, magnetic resonance was found to be the most precise technique for the measurement of aortic annulus and ascending aorta in patients with severe degenerative aortic stenosis. Copyright (c) 2010 Elsevier Ireland Ltd. All rights reserved.

Mixing at double-Tee junctions with unequal pipe sizes in ...

EPA Pesticide Factsheets

Pipe flow mixing with various solute concentrations and flow rates at pipe junctions is investigated. The degree of mixing affects the spread of contaminants in a water distribution system. Many studies have been conducted on the mixing at the cross junctions. Yet a few have focused on double-Tee junctions of unequal pipe sizes. To investigate the solute mixing at double-Tee junctions with unequal pipe sizes, a series of experiments were conducted in a turbulent regime (Re=12500–50000) with different Reynolds number ratios and connecting pipe lengths. It is shown that dimensionless outlet concentrations depended on mixing mechanism at the impinging interface of junctions. Junction with a larger pipe size ratio is associated with more complete mixing. The inlet Reynolds number ratio affects mixing more strongly than the outlet Reynolds number ratio. Furthermore, the dimensionless connecting pipe length in a double-Tee played an important and complicated role in the flow mixing. Based on these results, two-dimensional isopleth maps were developed for the calculation of normalized north outlet concentration. This journal article is to communicate the research results on pipe juncture mixing, a widespread and important phenomena in distribution system water quality analysis. The research outcome improves EPANET modeling capability for safe water supplies. In addition, the research is one of the outputs from the EPA-MOST bilateral cooperative research Project #1

Novel imaging strategies for the detection of prosthetic heart valve obstruction and endocarditis.

PubMed

Tanis, W; Budde, R P J; van der Bilt, I A C; Delemarre, B; Hoohenkerk, G; van Rooden, J-K; Scholtens, A M; Habets, J; Chamuleau, S

2016-02-01

Prosthetic heart valve (PHV) dysfunction remains difficult to recognise correctly by two-dimensional (2D) transthoracic and transoesophageal echocardiography (TTE/TEE). ECG-triggered multidetector-row computed tomography (MDCT), 18-fluorine-fluorodesoxyglucose positron emission tomography including low-dose CT (FDG-PET) and three-dimensional transoesophageal echocardiography (3D-TEE) may have additional value. This paper reviews the role of these novel imaging tools in the field of PHV obstruction and endocarditis.For acquired PHV obstruction, MDCT is of additional value in mechanical PHVs to differentiate pannus from thrombus as well as to dynamically study leaflet motion and opening/closing angles. For biological PHV obstruction, additional imaging is not beneficial as it does not change patient management. When performed on top of 2D-TTE/TEE, MDCT has additional value for the detection of both vegetations and pseudoaneurysms/abscesses in PHV endocarditis. FDG-PET has no complementary value for the detection of vegetations; however, it appears more sensitive in the early detection of pseudoaneurysms/abscesses. Furthermore, FDG-PET enables the detection of metastatic and primary extra-cardiac infections. Evidence for the additional value of 3D-TEE is scarce.As clinical implications are major, clinicians should have a low threshold to perform additional MDCT in acquired mechanical PHV obstruction. For suspected PHV endocarditis, both FDG-PET and MDCT have complementary value.

[Feasibility and results of transcatheter treatment of patent foramen ovale associated with atrial septal aneurysm. Experience of a general hospital in Mulhouse, France].

PubMed

Roth, O; Jacquemin, L; Kenizou, D; Mettauer, B; Monassier, J-P

2007-11-01

To evaluate the results and the feasibility of the technique of percutaneous closing of patent foramen oval (PFO) with Atrial Septal Aneurysm (ASA) among young patients having presented a cryptogenic cerebral ischemia. Eighteen patients: 14 cryptogenic stroke and 4 TIA with a broad PFO (rank III) and an important ASA (excursion higher than 15 mm) at transesophageal echocardiography (TEE). The average age is 48.2 years: man 61%, women 39%. The patients have little cardiovascular risk factor (0.83/patient) and 38% presented recurrent thromboembolic events. Percutaneous closing is carried out under general anaesthesia with TEE and Amplatzer devices implantation. A control TEE is carried out 6 months after closing. No complication occurred at the time of the procedures. After 72 hours, one patient presented a major complication: one arteriovenous fistula requiring a surgery. Five patients presented a minor complication: two non complicated femoral hematoma, two atrial arrhytmias and one asymptomatic secondary displacement of the device without need for surgery. Seven-teen patients had TEE at six months: the shunt disappeared for 95% from the patients, no thrombus was found. No recurrent thromboembolic event appeared for the 18 patients (median follow-up 19.2 months). The installation of a technique of percutaneous closing of the PFO+ASA is safe and effective.

Oxyresveratrol, a Stilbene Compound from Morus alba L. Twig Extract Active Against Trichophyton rubrum.

PubMed

Lu, Hai-Peng; Jia, Ya-Nan; Peng, Ya-Lin; Yu, Yan; Sun, Si-Long; Yue, Meng-Ting; Pan, Min-Hui; Zeng, Ling-Shu; Xu, Li

2017-12-01

Morus alba L. (mulberry) twig is known to have an inhibitory effect on pathogens in traditional Chinese medicine. In the present study, the dermophytic fungus, Trichophyton rubrum, was used to evaluate the inhibitory effect of total M. alba twig extract and extracts obtained using solvents with different polarities by the method of 96-well MTT colorimetry. The main active substance was isolated and identified by tracking its activity. In addition, the inhibitory effects of active extracts and a single active substance were investigated in combination with miconazole nitrate. Our data indicated that ethyl acetate extracts of mulberry twig (TEE) exhibited a desired inhibitory activity on T. rubrum with the minimum inhibitory concentration (MIC) of 1.000 mg/mL. With activity tracking, the main substance showing antimicrobial activity was oxyresveratrol (OXY), which was isolated from TEE. Its MIC for inhibiting the growth of T. rubrum was 0.500 mg/mL. The combined use of miconazole nitrate and OXY showed a synergistic inhibitory effect, as shown by a significant decrease in the MIC of both components. Based on the OXY content in TEE, the contribution rate of OXY to the inhibitory effect of TEE on T. rubrum was 80.52%, so it was determined to be the main antimicrobial substance in M. alba twig. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

Transesophageal echocardiography in the management of burn patients.

PubMed

Maybauer, Marc O; Asmussen, Sven; Platts, David G; Fraser, John F; Sanfilippo, Filippo; Maybauer, Dirk M

2014-06-01

A systematic review was conducted to assess the level of evidence for the use of transesophageal echocardiography (TEE) in the management of burn patients. We searched any article published before and including June 30, 2013. Our search yielded 118 total publications, 11 met the inclusion criteria of burn injury and TEE. Available studies published in any language were rated and included. At the present time, there are no available systematic reviews/meta-analyses published that met our search criteria. Only a small number of clinical trials, all with a limited number of patients were available. Therefore, a meta-analysis on outcome parameters was not performed. However, the major pathologic findings in burn patients were reduced left ventricular (LV) systolic and diastolic function, mitral valve vegetation, pulmonary hypertension, pericardial effusion, fluid overload, and right heart failure. The advantages of TEE include offering direct assessment of cardiac valve competency, myocardial contractility, and most importantly real time assessment of adequacy of hemodynamic resuscitation and preload in the acute phase of resuscitation, with minimal additional risk. TEE serves multiple diagnostic purposes and is being used to better understand the fluid status and cardiac physiology of the critically ill burn patient. Randomized controlled trials especially on fluid resuscitation and cardiac performance in acute burns are warranted to potentially further improve outcome. Copyright © 2013 Elsevier Ltd and ISBI. All rights reserved.

Role of Negative Trans-Thoracic Echocardiography in the Diagnosis of Infective Endocarditis.

PubMed

Leitman, Marina; Peleg, Eli; Shmueli, Ruthie; Vered, Zvi

2016-07-01

The search for the presence of vegetations in patients with suspected infective endocarditis is a major indication for trans-esophageal echocardiographic (TEE) examinations. Advances in harmonic imaging and ongoing improvement in modern echocardiographic systems allow adequate quality of diagnostic images in most patients. To investigate whether TEE examinations are always necessary for the assessment of patients with suspected infective endocarditis. During 2012-2014 230 trans-thoracic echo (TTE) exams in patients with suspected infective endocarditis were performed at our center. Demographic, epidemiological, clinical and echocardiographic data were collected and analyzed, and the final clinical diagnosis and outcome were determined. Of 230 patients, 24 had definite infective endocarditis by clinical assessment. TEE examination was undertaken in 76 of the 230 patients based on the clinical decision of the attending physician. All TTE exams were classified as: (i) positive, i.e., vegetations present; (ii) clearly negative; or (iii) non-conclusive. Of the 92 with clearly negative TTE exams, 20 underwent TEE and all were negative. All clearly negative patients had native valves, adequate quality images, and in all 92 the final diagnosis was not infective endocarditis. Thus, the negative predictive value of a clearly negative TTE examination was 100%. In patients with native cardiac valves referred for evaluation for infective endocarditis, an adequate quality TTE with clearly negative examination may be sufficient for the diagnosis.

Accuracy assessment of fluoroscopy-transesophageal echocardiography registration

NASA Astrophysics Data System (ADS)

Lang, Pencilla; Seslija, Petar; Bainbridge, Daniel; Guiraudon, Gerard M.; Jones, Doug L.; Chu, Michael W.; Holdsworth, David W.; Peters, Terry M.

2011-03-01

This study assesses the accuracy of a new transesophageal (TEE) ultrasound (US) fluoroscopy registration technique designed to guide percutaneous aortic valve replacement. In this minimally invasive procedure, a valve is inserted into the aortic annulus via a catheter. Navigation and positioning of the valve is guided primarily by intra-operative fluoroscopy. Poor anatomical visualization of the aortic root region can result in incorrect positioning, leading to heart valve embolization, obstruction of the coronary ostia and acute kidney injury. The use of TEE US images to augment intra-operative fluoroscopy provides significant improvements to image-guidance. Registration is achieved using an image-based TEE probe tracking technique and US calibration. TEE probe tracking is accomplished using a single-perspective pose estimation algorithm. Pose estimation from a single image allows registration to be achieved using only images collected in standard OR workflow. Accuracy of this registration technique is assessed using three models: a point target phantom, a cadaveric porcine heart with implanted fiducials, and in-vivo porcine images. Results demonstrate that registration can be achieved with an RMS error of less than 1.5mm, which is within the clinical accuracy requirements of 5mm. US-fluoroscopy registration based on single-perspective pose estimation demonstrates promise as a method for providing guidance to percutaneous aortic valve replacement procedures. Future work will focus on real-time implementation and a visualization system that can be used in the operating room.

Military helicopter cockpit modernization

NASA Astrophysics Data System (ADS)

Hall, Andrew S.

2001-09-01

This paper describes some of the initiatives being progressed by Smiths Aerospace to enhance the operational effectiveness of military helicopters, with particular emphasis on the GWHL Lynx and EH Industries EH101 programs. The areas discussed include engine instrumentation, flight instrumentation and the mission system displays. Various Crew Stations are described which provide a suite of AMLCD displays which: -Integrate information from the aircraft engine, electrical power and hydraulic systems onto 5ATI displays -Integrate primary flight, navigation and mission system sensor information onto large area (61/4' square or 6' by 8') displays -Provide standby attitude and air data information in the event of major system failure on 3ATI displays.

Engineered Zircaloy Cladding Modifications for Improved Accident Tolerance of LWR Nuclear Fuel

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

Heuser, Brent; Stubbins, James; Kozlowski, Tomasz

The DOE NEUP sponsored IRP on accident tolerant fuel (ATF) entitled Engineered Zircaloy Cladding Modifications for Improved Accident Tolerance of LWR Nuclear Fuel involved three academic institutions, Idaho National Laboratory (INL), and ATI Materials (ATI). Detailed descriptions of the work at the University of Illinois (UIUC, prime), the University of Florida (UF), the University of Michigan (UMich), and INL are included in this document as separate sections. This summary provides a synopsis of the work performed across the IRP team. Two ATF solution pathways were initially proposed, coatings on monolithic Zr-based LWR cladding material and selfhealing modifications of Zr-based alloys.more » The coating pathway was extensively investigated, both experimentally and in computations. Experimental activities related to ATF coatings were centered at UIUC, UF, and UMich and involved coating development and testing, and ion irradiation. Neutronic and thermal hydraulic aspects of ATF coatings were the focus of computational work at UIUC and UMich, while materials science aspects were the focus of computational work at UF and INL. ATI provided monolithic Zircaloy 2 and 4 material and a binary Zr-Y alloy material. The selfhealing pathway was investigated with advanced computations only. Beryllium was identified as a valid self-healing additive early in this work. However, all attempts to fabricate a Zr-Be alloy failed. Several avenues of fabrication were explored. ATI ultimately declined our fabrication request over health concerns associated with Be (we note that Be was not part of the original work scope and the ATI SOW). Likewise, Ames Laboratory declined our fabrication request, citing known litigation dating to the 1980s and 1990s involving the U.S. Federal government and U.S. National Laboratory employees involving the use of Be. Materion (formerly, Brush Wellman) also declined our fabrication request, citing the difficulty in working with a highly reactive Zr and Be. International fabrication options were explored in Europe and Asia, but this proved to be impractical, if not impossible. Consequently, experimental investigation of the Zr-Be binary system was dropped and exploration binary Zr-Y binary system was initiated. The motivation behind the Zr-Y system is the known thermodynamic stability of yttria over zirconia.« less

Comparison of resting and total energy expenditure in peritoneal dialysis patients and body composition measured by dual-energy X-ray absorptiometry.

PubMed

El-Kateb, S; Sridharan, S; Farrington, K; Davenport, A

2016-11-01

Under basal resting conditions muscle metabolism is reduced, whereas metabolism increases with physical activity. We wished to determine whether there was an association between resting energy expenditure (REE) and total energy expenditure (TEE) in peritoneal dialysis (PD) patients and lean body mass (LBM). We determined REE and TEE by recently validated equations, using doubly labelled isotopic water, and LBM by dual-energy X-ray absorptiometry (DXA) scanning. We studied 87 patients, 50 male (57.4%), 25 diabetic (28.7%), mean age 60.3±17.6 years, with a median PD treatment of 11.4 (4.7-29.5) months. The mean weight was 70.1±17.7 kg with a REE of 1509±245 kcal/day and TEE 1947±378 kcal/day. REE was associated with body size (weight r=0.78 and body mass index (BMI) r=0.72) and body composition (LBM r=0.77, lean body mass index (LBMI) r=0.76, r=0.62), all P<0.001). For TEE, there was an association with weight r=0.58, BMI r=0.49 and body composition (LBM r=0.64, LBMI (r=0.54), all P<0.001). We compared LBMI measured by DXA and that estimated by the Boer equation using anthropomorphic measurements, which overestimated and underestimated LBM for smaller patients and heavier patients, respectively. Muscle metabolism is reduced at rest and increases with physical activity. Whereas previous reports based on REE did not show any association with LBM, we found an association between both REE and TEE, using a recently validated equation derived from dialysis patients, and LBM measured by DXA scanning. Estimation of muscle mass from anthropomorphic measurements systematically overestimated LBM for small patients and conversely underestimated for heavier patients.

Feasibility and Diagnostic Value of Cardiovascular Magnetic Resonance Imaging After Acute Ischemic Stroke of Undetermined Origin.

PubMed

Haeusler, Karl Georg; Wollboldt, Christian; Bentheim, Laura Zu; Herm, Juliane; Jäger, Sebastian; Kunze, Claudia; Eberle, Holger-Carsten; Deluigi, Claudia Christina; Bruder, Oliver; Malsch, Carolin; Heuschmann, Peter U; Endres, Matthias; Audebert, Heinrich J; Morguet, Andreas J; Jensen, Christoph; Fiebach, Jochen B

2017-05-01

Etiology of acute ischemic stroke remains undetermined (cryptogenic) in about 25% of patients after state-of-the-art diagnostic work-up. One-hundred and three patients with magnetic resonance imaging (MRI)-proven acute ischemic stroke of undetermined origin were prospectively enrolled and underwent 3-T cardiac MRI and magnetic resonance angiography of the aortic arch in addition to state-of-the-art diagnostic work-up, including transesophageal echocardiography (TEE). We analyzed the feasibility, diagnostic accuracy, and added value of cardiovascular MRI (cvMRI) compared with TEE for detecting sources of stroke. Overall, 102 (99.0%) ischemic stroke patients (median 63 years [interquartile range, 53-72], 24% female, median NIHSS (National Institutes of Health Stroke Scale) score on admission 2 [interquartile range, 1-4]) underwent cvMRI and TEE in hospital; 89 (86.4%) patients completed the cvMRI examination. In 93 cryptogenic stroke patients, a high-risk embolic source was found in 9 (8.7%) patients by cvMRI and in 11 (11.8%) patients by echocardiography, respectively. cvMRI and echocardiography findings were consistent in 80 (86.0%) patients, resulting in a degree of agreement of κ=0.24. In 82 patients with cryptogenic stroke according to routine work-up, including TEE, cvMRI identified stroke etiology in additional 5 (6.1%) patients. Late gadolinium enhancement consistent with previous myocardial infarction was found in 13 (14.6%) out of 89 stroke patients completing cvMRI. Only 2 of these 13 patients had known coronary artery disease. Our study demonstrated that cvMRI was feasible in the vast majority of included patients with acute ischemic stroke. The diagnostic information of cvMRI seems to be complementary to TEE but is not replacing echocardiography after acute ischemic stroke. URL: http://www.clinicaltrials.gov. Unique identifier: NCT01917955. © 2017 American Heart Association, Inc.

Pathophysiologic correlates of thromboembolism in nonvalvular atrial fibrillation: I. Reduced flow velocity in the left atrial appendage (The Stroke Prevention in Atrial Fibrillation [SPAF-III] study).

PubMed

Goldman, M E; Pearce, L A; Hart, R G; Zabalgoitia, M; Asinger, R W; Safford, R; Halperin, J L

1999-12-01

Stroke associated with atrial fibrillation (AF) is mainly due to embolism of thrombus formed during stasis of blood in the left atrial appendage (LAA). Pathophysiologic correlates of appendage flow velocity as assessed by transesophageal echocardiography (TEE) in patients with AF have not been defined. To evaluate the hypothesis that reduced velocity is associated with spontaneous echocardiographic contrast and thrombus in the LAA and with clinical embolic events, we measured LAA flow velocity by TEE in 721 patients with nonvalvular AF entering the Stroke Prevention in Atrial Fibrillation (SPAF-III) study. Patient features, TEE findings, and subsequent cardioembolic events were correlated with velocity by multivariate analysis. Patients in AF during TEE displayed lower peak antegrade (emptying) flow velocity (Anu(p)) than those with intermittent AF in sinus rhythm during TEE (33 cm/s vs 61 cm/s, respectively, P <.0001). Anu(p) < 20 cm/s was associated with dense spontaneous echocardiographic contrast (P <.001), appendage thrombus (P <.01), and subsequent cardioembolic events (P <.01). Independent predictors of Anu(p) < 20 cm/s included age (P =.009), systolic blood pressure (P <.001), sustained AF (P =.01), ischemic heart disease (P =.01), and left atrial area (P =.04). Multivariate analysis found both Anu(p) <20 cm/s (relative risk 2.6, P =.02) and clinical risk factors (relative risk 3.3, P =.002) independently associated with LAA thrombus. LAA Anu(p) is reduced in AF and associated with spontaneous echocardiographic contrast, appendage thrombus, and cardioembolic stroke. Systolic hypertension and aortic atherosclerosis, independent clinical predictors of stroke in patients with AF, also correlated with LAA Anu(p). Our results support the role of reduced LAA Anu(p) in the generation of stasis, thrombus formation, and embolism in patients with AF, although other mechanisms also contribute to stroke.

Investigation of Dispersed and Dispersed Annular (rivulet or Thin Film) Flow Phase Separation in Tees.

NASA Astrophysics Data System (ADS)

McCreery, Glenn Ernest

An experimental and analytical investigation of dispersed and dispersed-annular (rivulet or thin film) flow phase separation in tees has been successfully completed. The research was directed at, but is not specific to, determining flow conditions, following a loss of coolant accident, in the large rectangular passageways leading to vacuum buildings in the containment envelope of some CANDU nuclear reactors. The primary objectives of the research were to: (1) obtain experimental data to help formulate and test mechanistic analytical models of phase separation, and (2) develop the analytical models in computer programs which predict phase separation from upstream flow and pressure conditions and downstream and side branch pressure boundary conditions. To meet these objectives an air-water experimental apparatus was constructed, and consists of large air blowers attached to a long rectangular duct leading to a tee in the horizontal plane. A variety of phenomena was investigated including, for comparison with computer predictions, air streamlines and eddy boundary geometry, drop size spectra, macroscopic mass balances, liquid rivulet pathlines, and trajectories of drops of known size and velocity. Four separate computer programs were developed to analyze phase separation. Three of the programs are used sequentially to calculate dispersed mist phase separation in a tee. The fourth is used to calculate rivulet or thin film pathlines. Macroscopic mass balances are calculated from a summation of mass balances for drops with representative sizes (and masses) spaced across the drop size spectrum. The programs are tested against experimental data, and accurately predict gas flow fields, drop trajectories, rivulet pathlines and macroscopic mass balances. In addition to development of the computer programs, analysis was performed to specify the scaling of dispersed mist and rivulet or thin film flow, to investigate pressure losses in tees, and the inter-relationship of loss coefficients, contraction coefficients, and eddy geometry. The important transient effects of liquid storage in eddies were also analyzed.

Geometry of the left ventricular outflow tract assessed by 3D TEE in patients with aortic stenosis: impact of upper septal hypertrophy on measurements of Doppler-derived left ventricular stroke volume.

PubMed

Koto, Dan; Izumo, Masaki; Machida, Takafumi; Suzuki, Kengo; Yoneyama, Kihei; Suzuki, Tomomi; Kamijima, Ryo; Kobayashi, Yasuyuki; Harada, Tomoo; Akashi, Yoshihiro J

2018-05-24

It is unclear how upper septal hypertrophy (USH) affects Doppler-derived left ventricular stroke volume (SV) in patients with AS. The aims of this study were to: (1) validate the accuracy of 3D transesophageal echocardiography (TEE) measurements of the left ventricular outflow tract (LVOT), (2) evaluate the differences in LVOT geometry between AS patients with and without USH, and (3) assess the impact of USH on measurement of SV. In protocol 1, both 3D TEE and multi-detector computed tomography were performed in 20 patients with AS [aortic valve area (AVA) ≤ 1.5 cm 2 ]. Multiplanar reconstruction was used to measure the LVOT short and long diameters in four parts from the tip of the septum to the annulus. In protocol 2, the same 3D TEE measurements were performed in AS patients (AVA ≤ 1.5 cm 2 , n = 129) and controls (n = 30). We also performed 2D and 3D transthoracic echocardiography in all patients. In protocol 1, excellent correlations of LVOT parameters were found between the two modalities. In protocol 2, the USH group had smaller LVOT short and long diameters than the non-USH group. Although no differences in mean pressure gradient, or SV calculated with the 3D method existed between the two groups, the USH group had greater SV calculated with the Doppler method (73 ± 15 vs. 66 ± 15 ml) and aortic valve area (0.89 ± 0.26 vs. 0.73 ± 0.24 cm 2 ) than the non-USH group. 3D TEE can provide a precise assessment of the LVOT in AS. USH affects the LVOT geometry in patients with AS, which might lead to inaccurate assessments of disease severity.

Differentiation of thrombus from pannus as the cause of acquired mechanical prosthetic heart valve obstruction by non-invasive imaging: a review of the literature.

PubMed

Tanis, Wilco; Habets, Jesse; van den Brink, Renee B A; Symersky, Petr; Budde, Ricardo P J; Chamuleau, Steven A J

2014-02-01

For acquired mechanical prosthetic heart valve (PHV) obstruction and suspicion on thrombosis, recently updated European Society of Cardiology guidelines advocate the confirmation of thrombus by transthoracic echocardiography, transesophageal echocardiography (TEE), and fluoroscopy. However, no evidence-based diagnostic algorithm is available for correct thrombus detection, although this is clinically important as fibrinolysis is contraindicated in non-thrombotic obstruction (isolated pannus). Here, we performed a review of the literature in order to propose a diagnostic algorithm. We performed a systematic search in Pubmed and Embase. Included publications were assessed on methodological quality based on the validated Quality Assessment of Diagnostic Accuracy Studies (QUADAS) II checklist. Studies were scarce (n = 15) and the majority were of moderate methodological quality. In total, 238 mechanical PHV's with acquired obstruction and a reliable reference standard were included for the evaluation of the role of fluoroscopy, echocardiography, or multidetector-row computed tomography (MDCT). In acquired PHV obstruction caused by thrombosis, mass detection by TEE and leaflet restriction detected by fluoroscopy were observed in the majority of cases (96 and 100%, respectively). In contrast, in acquired PHV obstruction free of thrombosis (pannus), leaflet restriction detected by fluoroscopy was absent in some cases (17%) and mass detection by TEE was absent in the majority of cases (66%). In case of mass detection by TEE, predictors for obstructive thrombus masses (compared with pannus masses) were leaflet restriction, soft echo density, and increased mass length. In situations of inconclusive echocardiography, MDCT may correctly detect pannus/thrombus based on the morphological aspects and localization. In acquired mechanical PHV obstruction without leaflet restriction and absent mass on TEE, obstructive PHV thrombosis cannot be confirmed and consequently, fibrinolysis is not advised. Based on the literature search and our opinion, a diagnostic algorithm is provided to correctly identify non-thrombotic PHV obstruction, which is highly relevant in daily clinical practice.

The Incidence of Patent Foramen Ovale in 1,000 Consecutive Patients: A Contrast Transesophageal Echocardiography Study

NASA Technical Reports Server (NTRS)

Fisher, Daniel C.; Fisher, Edward A.; Budd, Jacqueline H.; Rosen, Stacey E.; Goldman, Martin E.

1995-01-01

Study objective: Patent foramen ovale (PFO) is present in 10 to 35% of people and has been reported to be an important risk factor for cardioembolic cerebrovascular accidents (CVAs) and transient ischemic attacks (TIAS), especially in younger patients. While contrast transthoracic echocardiography has been used to detect PFO, contrast transesophageal echocardiography (TEE) has a greater sensitivity. Prior studies reported the incidence of PFO in patients presenting with a CVA or TIA. Design: To determine the incidence of PFO in a more general population, we reviewed 1,000 consecutive TEES performed with contrast and color Doppler for the presence of PFO and other cardioembolic risk factors, including atrial septal aneurysm (ASA), aortic plaque, atrial fibrillation (AFib), and atrial thrombi. While imaging with monoplane or biplane TEE, multiple injections of agitated saline solution were injected during cough or Valsalva maneuver to detect flow through a PFO. Patients: There were 482 male and 518 female patients with mean age of 60 + 17 years (range 11 to 93 years). Results: Patent foramen ovale was found in 9.2% of all patients and, though seen in all age groups divided by decade, the incidence in patients aged 40 to 49 years was greater than those aged 70 to 79 years (12.96% vs 6.15%',, p=0.03). Contrast TEE had a much higher detection rate than color Doppler alone. Importantly, there was no greater incidence of PFO in patients with CVA vs thos without CVA, or in male vs female patients. Also, there was a very strong correlation between the presence of ASA and PFO (p<.001). Conclusion: Thus, PFO detected by TEE, frequently seen with ASA, is seen in all age groups and does not in itself present a risk factor for CVA. The association of PFO with peripheral thrombosis and CVA needs further study.

Comparison of a web-based food record tool and a food-frequency questionnaire and objective validation using the doubly labelled water technique in a Swedish middle-aged population.

PubMed

Nybacka, Sanna; Bertéus Forslund, Heléne; Wirfält, Elisabet; Larsson, Ingrid; Ericson, Ulrika; Warensjö Lemming, Eva; Bergström, Göran; Hedblad, Bo; Winkvist, Anna; Lindroos, Anna Karin

2016-01-01

Two web-based dietary assessment tools have been developed for use in large-scale studies: the Riksmaten method (4-d food record) and MiniMeal-Q (food-frequency method). The aim of the present study was to examine the ability of these methods to capture energy intake against objectively measured total energy expenditure (TEE) with the doubly labelled water technique (TEE DLW ), and to compare reported energy and macronutrient intake. This study was conducted within the pilot study of the Swedish CArdioPulmonary bioImage Study (SCAPIS), which included 1111 randomly selected men and women aged 50-64 years from the Gothenburg general population. Of these, 200 were enrolled in the SCAPIS diet substudy. TEE DLW was measured in a subsample ( n 40). Compared with TEE DLW , both methods underestimated energy intake: -2·5 (sd  2·9) MJ with the Riksmaten method; -2·3 (sd 3·6) MJ with MiniMeal-Q. Mean reporting accuracy was 80 and 82 %, respectively. The correlation between reported energy intake and TEE DLW was r 0·4 for the Riksmaten method ( P  < 0·05) and r 0·28 (non-significant) for MiniMeal-Q. Women reported similar average intake of energy and macronutrients in both methods whereas men reported higher intakes with the Riksmaten method. Energy-adjusted correlations ranged from 0·14 (polyunsaturated fat) to 0·77 (alcohol). Bland-Altman plots showed acceptable agreement for energy and energy-adjusted protein and carbohydrate intake, whereas the agreement for fat intake was poorer. According to energy intake data, both methods displayed similar precision on energy intake reporting. However, MiniMeal-Q was less successful in ranking individuals than the Riksmaten method. The development of methods to achieve limited under-reporting is a major challenge for future research.

Comparison of resting energy equations and total energy expenditure in haemodialysis patients and body composition measured by multi-frequency bioimpedance.

PubMed

Oliveira, Ben; Sridharan, Sivakumar; Farrington, Ken; Davenport, Andrew

2017-07-13

Waste products of metabolism are retained in haemodialysis (HD) patients. Cellular metabolism generates energy, and patients with greater energy expenditure may therefore require more dialysis. To determine the amount of dialysis required, equations estimating resting and total energy expenditure (REE,TEE) are required. We compared estimates of REE in HD patients using established equations with a novel equation recently validated in HD patients (HD equation). TEE was derived from REE (HD equation) and estimates of physical activity obtained by questionnaire. REE and TEE relationships with bioimpedance measured body composition were then determined. We studied 317 HD patients; 195 males (61.5%), 123 diabetic (38.9%), mean age 65.0 ± 15.3 and weight 73.1 ± 16.8 kg. REE from HD Equation was 1509 ± 241 kcal/day, which was greater than for Mifflin St Joer 1384 ± 259, Harris-Benedict 1437 ± 244, Katch-McArdle 1345 ± 232 (all p < 0.05 vs HD Equation), but less than Cunningham 1557 ± 236 kcal/day. Bland Altman mean bias ranged from -263 to 55 kcal/day. TEE was 1727 (1558-1976) kcal/day, and on multi-variable analysis was positively associated with skeletal muscle mass (β 23.3, p < 0.001), employment (β 406.5, p < 0.001), low co-morbidity (β 105.1, p = 0.006), and protein nitrogen appearance (β 2.7, p = 0.015), and negatively with age (β -7.9, p < 0.001), and dialysis vintage (β -121.2, p = 0.002). Most standard equations underestimate REE in HD patients compared to the HD Equation. TEE was greater in those with higher skeletal muscle mass and protein nitrogen appearance, lower co-morbidity, age, and dialysis vintage, and the employed. More metabolically active patients may require greater dialytic clearances. This article is protected by copyright. All rights reserved.

Evaluating the morphology of the left atrial appendage by a transesophageal echocardiographic 3-dimensional printed model

PubMed Central

Song, Hongning; Zhou, Qing; Zhang, Lan; Deng, Qing; Wang, Yijia; Hu, Bo; Tan, Tuantuan; Chen, Jinling; Pan, Yiteng; He, Fazhi

2017-01-01

Abstract The novel 3-dimensional printing (3DP) technique has shown its ability to assist personalized cardiac intervention therapy. This study aimed to determine the feasibility of 3D-printed left atrial appendage (LAA) models based on 3D transesophageal echocardiography (3D TEE) data and their application value in treating LAA occlusions. Eighteen patients with transcatheter LAA occlusion, and preprocedure 3D TEE and cardiac computed tomography were enrolled. 3D TEE volumetric data of the LAA were acquired and postprocessed for 3DP. Two types of 3D models of the LAA (ie, hard chamber model and flexible wall model) were printed by a 3D printer. The morphological classification and lobe identification of the LAA were assessed by the 3D chamber model, and LAA dimensions were measured via the 3D wall model. Additionally, a simulation operative rehearsal was performed on the 3D models in cases of challenging LAA morphology for the purpose of understanding the interactions between the device and the model. Three-dimensional TEE volumetric data of the LAA were successfully reprocessed and printed as 3D LAA chamber models and 3D LAA wall models in all patients. The consistency of the morphological classifications of the LAA based on 3D models and cardiac computed tomography was 0.92 (P < .01). The differences between the LAA ostium dimensions and depth measured using the 3D models were not significant from those measured on 3D TEE (P > .05). A simulation occlusion was successfully performed on the 3D model of the 2 challenging cases and compared with the real procedure. The echocardiographic 3DP technique is feasible and accurate in reflecting the spatial morphology of the LAA, which may be promising for the personalized planning of transcatheter LAA occlusion. PMID:28930824

The Role of Basal Forebrain in Rat Somatosensory Cortex: Impact on Cholinergic Innervation, Sensory Information Processing, and Tactile Discrimination

DTIC Science & Technology

1993-05-28

1993 Dissertation and Abstract Approved: Commit tee Chairperson . ,a..w ember ~tee Member tli:u., ;2 9" PQ3 bate Date bate The author...1982; Mesulam et al., 1983; Rye et al., 1984; Saper, 1984). I will refer to the region of the basal forebrain that supplies cholinergic innervation to...topographical organization has been observed for cholinergic projection patterns, with more rostral and medial basal forebrain cell groups supplying

Temporo-mandibular joint dislocation: an unusual complication of transoesophageal echocardiography.

PubMed

Anantharam, Brijesh; Chahal, Navtej; Stephens, Nigel; Senior, Roxy

2010-03-01

Temporo-mandibular joint (TMJ) dislocation is an unusual complication of transoesophageal echocardiography (TEE). We report a rare case of bilateral TMJ dislocation in an 84-year-old man prior to DC cardioversion (DCCV) for atrial flutter. Shortly after TEE and DCCV, the patient complained of bilateral facial pain. An orthopantomogram revealed bilateral TMJ dislocation. A closed reduction was performed by maxillo-facial surgeons under intravenous anaesthesia. Although very uncommon, the physician should be aware of the complication and its management.

Transesophageal Doppler measurement of renal arterial blood flow velocities and indices in children.

PubMed

Zabala, Luis; Ullah, Sana; Pierce, Carol D'Ann; Gautam, Nischal K; Schmitz, Michael L; Sachdeva, Ritu; Craychee, Judith A; Harrison, Dale; Killebrew, Pamela; Bornemeier, Renee A; Prodhan, Parthak

2012-06-01

Doppler-derived renal blood flow indices have been used to assess renal pathologies. However, transesophageal ultrasonography (TEE) has not been previously used to assess these renal variables in pediatric patients. In this study, we (a) assessed whether TEE allows adequate visualization of the renal parenchyma and renal artery, and (b) evaluated the concordance of TEE Doppler-derived renal blood flow measurements/indices compared with a standard transabdominal renal ultrasound (TAU) in children. This prospective cohort study enrolled 28 healthy children between the ages of 1 and 17 years without known renal dysfunction who were undergoing atrial septal defect device closure in the cardiac catheterization laboratory. TEE was used to obtain Doppler renal artery blood velocities (peak systolic velocity, end-diastolic velocity, mean diastolic velocity, resistive index, and pulsatility index), and these values were compared with measurements obtained by TAU. Concordance correlation coefficient (CCC) was used to determine clinically significant agreement between the 2 methods. The Bland-Altman plots were used to determine whether these 2 methods agree sufficiently to be used interchangeably. Statistical significance was accepted at P ≤ 0.05. Obtaining 2-dimensional images of kidney parenchyma and Doppler-derived measurements using TEE in children is feasible. There was statistically significant agreement between the 2 methods for all measurements. The CCC between the 2 imaging techniques was 0.91 for the pulsatility index and 0.66 for the resistive index. These coefficients were sensitive to outliers. When the highest and lowest data points were removed from the analysis, the CCC between the 2 imaging techniques was 0.62 for the pulsatility index and 0.50 for the resistive index. The 95% confidence interval (CI) for pulsatility index was 0.35 to 0.98 and for resistive index was 0.21 to 0.89. The Bland-Altman plots indicate good agreement between the 2 methods; for the pulsatility index, the limits of agreement were -0.80 to 0.53. The correlation of the size of the measurement and the mean difference in methods (-0.14; 95% CI = -0.28, 0.01) was not statistically significant (r = 0.31, P = 0.17). For the resistive index, the limits of agreement were -0.22 to 0.12. The correlation of the size of the measurement and the mean difference in methods (-0.05; 95% CI = -0.09, -0.01) was not statistically significant (r = 0.10, P = 0.65). This study confirms the feasibility of obtaining 2-dimensional images of kidney parenchyma and Doppler-derived measurements using TEE in children. Angle-independent TEE Doppler-derived indices show significant concordance with those derived by TAU. Further studies are required to assess whether this correlation holds true in the presence of renal pathology. This technique has the potential to help modulate intraoperative interventions based on their impact on renal variables and may prove helpful in the perioperative period for children at risk of acute kidney injury.

Preventive health care, 1999 update: 2. Echocardiography for the detection of a cardiac source of embolus in patients with stroke

PubMed Central

Kapral, M K; Silver, F L

1999-01-01

OBJECTIVE: To develop guidelines for the use of echocardiography in the investigation of patients with stroke. OPTIONS: (1) Routine transthoracic echocardiography (TTE); (2) routine transesophageal echocardiography (TEE); (3) routine TTE followed by TEE if the TTE findings are noncontributory; (4) selective TTE or TEE in patients with cardiac disease who would not otherwise receive anticoagulant therapy. OUTCOMES: This article reviews the available evidence on the yield of TTE and TEE in detecting cardiac sources of cerebral emboli in patients with stroke, the effectiveness of treatment for cardiac sources of emboli and the effectiveness of screening echocardiography for secondary stroke prevention. EVIDENCE: MEDLINE was searched for relevant articles published from January 1966 to April 1998; also reviewed were additional articles identified from the bibliographies and citations obtained from experts. BENEFITS, HARMS AND COSTS: Echocardiography can detect intracardiac masses (thrombus, vegetation or tumour) in about 4% (with TTE) to 11% (with TEE) of stroke patients. The yield is lower among patients without clinical evidence of cardiac disease by history, physical examination, electrocardiography or chest radiography (less than 2%) than among patients with clinical evidence of cardiac disease (less than 19%). The risks of echocardiography to patients are small. TTE has virtually no risks, and TEE is associated with cardiac, pulmonary and bleeding complications in 0.18%. Patients with an identified intracardiac thrombus are at increased risk for embolic events (absolute risk uncertain, range 0%-38%), and this appears to be reduced with anticoagulant therapy (absolute risk reduction uncertain). Anticoagulant therapy carries a risk of major hemorrhage of 1% to 3% per year. The overall effectiveness of echocardiography in the prevention of recurrent stroke is unknown. VALUES: The strength of evidence was evaluated using the methods of the Canadian Task Force on Preventive Health Care. RECOMMENDATIONS: There is fair evidence to recommend echocardiography in patients with stroke and clinical evidence of cardiac disease by history, physical examination, electrocardiography or chest radiography (grade B recommendation). There is insufficient evidence to recommend for or against TEE in patients with normal results of TTE (grade C recommendation). There is insufficient evidence to recommend for or against routine echocardiography in patients (including young patients) without clinical cardiac disease (grade C recommendation). Routine echocardiography is not recommended for patients with clinical cardiac disease who have independent indications for or contraindications to anticoagulant therapy (grade D recommendation). There is fair evidence to recommend anticoagulant therapy in patients with stroke and intracardiac thrombus (grade B recommendation). There is insufficient (no) evidence to recommend for or against any specific therapy for patent foramen ovale (grade C recommendation). VALIDATION: The findings of this analysis were reviewed through an iterative process by the members of the Canadian Task Force on Preventive Health Care. PMID:10551199

Vocal Cord Paralysis and Laryngeal Trauma in Cardiac Surgery

PubMed Central

Chen, Yung-Yuan; Chia, Yeo-Yee; Wang, Pa-Chun; Lin, Hsiu-Yen; Tsai, Chiu-Ling; Hou, Shaw-Min

2017-01-01

Background Cardiac surgery – associated iatrogenic laryngeal trauma is often overlooked. We investigated the risk factors of vocal cord paralysis in cardiac surgery. Methods Medical records were reviewed from 169 patients who underwent elective or emergency cardiac surgeries. Patients had transesophageal echocardiography (TEE) placed either under video fiberscopic image guidance (guided group) or blind placement (blind group). Routine postoperative otolaryngologist consultation with video laryngoscopic recording were performed. Results Vocal cord paralyses were found in 18 patients (10.7%; left-13, right-4, bilateral-1). The risk of vocal cord paralysis was associated with emergency operation [odds ratio, 97.5 (95% confidence interval [CI], 2.9 to 366), p = 0.01]. Use of fiberscope-guided TEE [odds ratio, 0.04 (95% CI 0.01 to 0.87), p = 0.04] can effectively reduce vocal cord injury. Conclusions Emergency cardiac surgery increased the risk of vocal cord paralysis. Fiberscope-guided TEE placement is recommended for all patients having cardiac surgery to decrease the risk of severe peri-operative laryngeal trauma. PMID:29167615

Vocal Cord Paralysis and Laryngeal Trauma in Cardiac Surgery.

PubMed

Chen, Yung-Yuan; Chia, Yeo-Yee; Wang, Pa-Chun; Lin, Hsiu-Yen; Tsai, Chiu-Ling; Hou, Shaw-Min

2017-11-01

Cardiac surgery - associated iatrogenic laryngeal trauma is often overlooked. We investigated the risk factors of vocal cord paralysis in cardiac surgery. Medical records were reviewed from 169 patients who underwent elective or emergency cardiac surgeries. Patients had transesophageal echocardiography (TEE) placed either under video fiberscopic image guidance (guided group) or blind placement (blind group). Routine postoperative otolaryngologist consultation with video laryngoscopic recording were performed. Vocal cord paralyses were found in 18 patients (10.7%; left-13, right-4, bilateral-1). The risk of vocal cord paralysis was associated with emergency operation [odds ratio, 97.5 (95% confidence interval [CI], 2.9 to 366), p = 0.01]. Use of fiberscope-guided TEE [odds ratio, 0.04 (95% CI 0.01 to 0.87), p = 0.04] can effectively reduce vocal cord injury. Emergency cardiac surgery increased the risk of vocal cord paralysis. Fiberscope-guided TEE placement is recommended for all patients having cardiac surgery to decrease the risk of severe peri-operative laryngeal trauma.

Echocardiographic Assessment of Heart Valve Prostheses

PubMed Central

Sordelli, Chiara; Severino, Sergio; Ascione, Luigi; Coppolino, Pasquale; Caso, Pio

2014-01-01

Patients submitted to valve replacement with mechanical or biological prosthesis, may present symptoms related either to valvular malfunction or ventricular dysfunction from other causes. Because a clinical examination is not sufficient to evaluate a prosthetic valve, several diagnostic methods have been proposed to assess the functional status of a prosthetic valve. This review provides an overview of echocardiographic and Doppler techniques useful in evaluation of prosthetic heart valves. Compared to native valves, echocardiographic evaluation of prosthetic valves is certainly more complex, both for the examination and the interpretation. Echocardiography also allows discriminating between intra- and/or peri-prosthetic regurgitation, present in the majority of mechanical valves. Transthoracic echocardiography (TTE) requires different angles of the probe with unconventional views. Transesophageal echocardiography (TEE) is the method of choice in presence of technical difficulties. Three-dimensional (3D)-TEE seems to be superior to 2D-TEE, especially in the assessment of paravalvular leak regurgitation (PVL) that it provides improved localization and analysis of the PVL size and shape. PMID:28465917

Automatic detection of cardiac cycle and measurement of the mitral annulus diameter in 4D TEE images

NASA Astrophysics Data System (ADS)

Graser, Bastian; Hien, Maximilian; Rauch, Helmut; Meinzer, Hans-Peter; Heimann, Tobias

2012-02-01

Mitral regurgitation is a wide spread problem. For successful surgical treatment quantification of the mitral annulus, especially its diameter, is essential. Time resolved 3D transesophageal echocardiography (TEE) is suitable for this task. Yet, manual measurement in four dimensions is extremely time consuming, which confirms the need for automatic quantification methods. The method we propose is capable of automatically detecting the cardiac cycle (systole or diastole) for each time step and measuring the mitral annulus diameter. This is done using total variation noise filtering, the graph cut segmentation algorithm and morphological operators. An evaluation took place using expert measurements on 4D TEE data of 13 patients. The cardiac cycle was detected correctly on 78% of all images and the mitral annulus diameter was measured with an average error of 3.08 mm. Its full automatic processing makes the method easy to use in the clinical workflow and it provides the surgeon with helpful information.

[Echographic diagnosis of systolic murmur among 280 young French militaries. Implications for the expertise in military medicine].

PubMed

Vinsonneau, U; Vermeulen, L; Griffet, V; Delluc, A; Paleiron, N; Le Ven, F; Rohel, G; Jobic, Y; Piquemal, M; Mansourati, J; Paule, P

2015-04-01

Clinically discovering a systolic murmur is frequent among the young military population. When this murmur does not sound benign, a transthoracic echocardiography (TTE) is made to detect any cardiopathy, which could cause sudden cardiac death. The aim of this study was to evaluate the interest of systematic TTE in the assessment of any cardiac systolic murmur (CSM) among militaries. We ran a retrospective monocentric study in the "Clermont-Tonnerre" military hospital in Brest. We included all patients sent for TEE, aged 15 to 30 years old, from the 1st January 2010 until the 31st July 2013. Two hundred and eighty TTES assessing CSM were performed. We found 28/280 (10%) echocardiographic abnormalities: 13 were bicuspid aortic valves (4.6%), 6 were ventricular septal defects (2.15%), 3 were atrial septal defects (1.07%), 4 were mild mitral regurgitations (1.43%), one mild pulmonary stenosis (0.35%) and one aortic stenosis (0.35%). No hypertrophic cardiomyopathy was found. Concerning military expertise, 11 (3.92%) patients among these 28 with abnormal TEE were considered unfit for work or "fit for work with limitations". Assessing a cardiac systolic murmur with TEE lead to the diagnosis of a cardiomyopathy in 10% of the case. This study enhances the importance of systematic TEE when a CSM is detected in the young military, in order to determine if those soldiers can still fulfill their military duty. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Patent foramen ovale and atrial septal aneurysm can cause ischemic stroke in patients with antiphospholipid syndrome.

PubMed

Tanaka, Yasutaka; Ueno, Yuji; Miyamoto, Nobukazu; Shimada, Yoshiaki; Tanaka, Ryota; Hattori, Nobutaka; Urabe, Takao

2013-01-01

The purpose of the present study was to evaluate the contributions of embolic etiologies, patent foramen ovale (PFO) and atrial septal aneurysm (ASA) to the pathogenesis of ischemic stroke in patients with antiphospholipid syndrome (APS). We performed transesophageal echocardiography (TEE) examination for consecutive stroke patients who had been diagnosed with APS (APS group) to detect potential embolic sources. APS was diagnosed based on the modified Sapporo criteria. The control stroke group comprised age- and sex-matched cryptogenic stroke patients undergoing TEE. We assessed and compared the clinical characteristics and TEE findings between stroke patients with APS and control stroke groups. Among 582 patients, nine patients (nine women; mean age, 50 ± 18 years) were classified into the APS group. In 137 patients undergoing TEE, 41 age-matched female stroke patients were recruited to the control stroke group. Prevalences of PFO and ASA were significantly higher in the APS group than in the control stroke group (89 vs. 41 %, p = 0.027; 67 vs. 20 %, p = 0.015, respectively). Multiple logistic regression analysis showed that PFO (odds ratio (OR), 13.71; 95 % confidence interval (CI), 1.01-185.62; p = 0.049) and ASA (OR, 8.06; 95 % CI, 1.17-55.59; p = 0.034) were independently associated with the APS group. PFO and ASA were strongly associated with the APS group, and could thus represent potential embolic sources in ischemic stroke patients with APS.

Transapical off-pump mitral valve repair. First experience with the NeoChord system in Poland (report of two cases).

PubMed

Wróbel, Krzysztof; Kurnicka, Katarzyna; Zygier, Marcin; Dyk, Wojciech; Wojdyga, Ryszard; Zieliński, Dariusz; Jarzębska, Małgorzata; Juraszyński, Zbigniew; Lichodziejewska, Barbara; Pruszczyk, Piotr; Biederman, Andrzej; Speziali, Giovanni; Kasten, Uwe

2017-01-01

Artificial chord implantation to repair a flail or prolapsing mitral valve leaflet requires open heart surgery and cardiopulmonary bypass. Transapical off-pump artificial chordae implantation is a new surgical technique proposed to treat degenerative mitral valve regurgitation. The procedure is performed using the NeoChord DS1000 system (NeoChord, Inc., St. Louis Park, MN, USA), which facilitates both implantation and lenght adjustment of the artificial chordae under two (2D)- and three (3D)-dimensional transoesophageal echocardiographic (TEE) guidance on a beating heart. Two male patients aged 60 and 55 years with severe mitral regurgitation due to posterior leaflet prolapse underwent transapical off-pump artificial chordae implantation on September 3, 2015. The procedure was performed by left minithoracotomy under general anaesthesia in a cardiac surgical theatre, using 2D and 3D TEE guidance. Early procedural success as confirmed by 3D TEE was achieved in both patients, with implantation of 6 artificial chordae in the first patient and 3 artificial chordae in the second patient. Both procedures were uneventful, and no postoperative complications were noted. The patients were discharged home on the 8th and 6th postoperative day, respectively. The NeoChord DS1000 system allows both implantation and lenght adjustment of artificial chordae under 2D and 3D TEE guidance on a beating heart. Our initial experience in 2 patients with posterior mitral leaflet prolapse indicates that the procedure is feasible and safe.

Laser stimulation of the acupoint 'Zusanli' (ST.36) on the radiopharmaceutical biodistribution in Wistar rats.

PubMed

Frederico, Éric H F F; Santos, Ailton A; Sá-Caputo, Danubia C C; Neves, Rosane F; Guimarães, Carlos A S; Chang, Shyang; Bernardo-Filho, Mario

2016-03-01

Laser used to stimulate acupoints is called laser acupuncture (LA). It is generally believed that similar clinical responses to manual acupuncture can be achieved. Here we analysed the effects of the laser (904 nm) at the 'Zusanli' acupoint (ST.36) of the stomach meridian on the biodistribution of the radiopharmaceutical Na(99m)TcO4. Wistar rats were divided into control (CG) and experimental groups (EG). The EG were exposed daily to the laser (904 nm) at ST.36 with 1 joule/min (40 mW/cm(2)) for 1 min. The animals of the CG were not exposed to laser at all. On the 8th day after LA, the animals were sedated and Na(99m)TcO4 was administered. After 10 min, the animals were all sacrificed and the organs removed. The radioactivity was counted in each organ to calculate the percentage of radioactivity of the injected dose per gram (%ATI/ g). Comparison of the %ATI/g in EG and CG was performed by Mann-Whitney test. The %ATI/g was significantly increased in the thyroid due to the stimulation of the ST.36 by laser. It is possible to conclude that the stimulation of ST.36 does lead to biological phenomena that interfere with the metabolism of the thyroid.

Prosthetic tricuspid valve dysfunction assessed by three-dimensional transthoracic and transesophageal echocardiography.

PubMed

Yuasa, Toshinori; Takasaki, Kunitsugu; Mizukami, Naoko; Ueya, Nami; Kubota, Kayoko; Horizoe, Yoshihisa; Chaen, Hideto; Kuwahara, Eiji; Kisanuki, Akira; Hamasaki, Shuichi

2013-09-01

A 39-year-old male who had undergone tricuspid valve replacement for severe tricuspid regurgitation was admitted with palpitation and general edema. Two-dimensional (2D) echocardiography showed tricuspid prosthetic valve dysfunction. Additional three-dimensional (3D) transthoracic and transesophageal echocardiography (TEE) could clearly demonstrate the disabilities of the mechanical tricuspid valve. Particularly, 3D TEE demonstrated a mass located on the right ventricular side of the tricuspid prosthesis, which may have caused the stuck disk. This observation was confirmed by intra-operative findings.

Partial rupture of the tricuspid valve after extraction of permanent pacemaker leads: detection by transesophageal echocardiography.

PubMed

Assayag, P; Thuaire, C; Benamer, H; Sebbah, J; Leport, C; Brochet, E

1999-06-01

Traumatic lesions of the tricuspid valve complicating pacemaker lead extractions appear to be rare. We report two cases of partial rupture of the tricuspid valve, following apparently uneventful extraction of permanent ventricular leads, resulting in severe regurgitation and, in one case, chronic heart failure. TEE was useful to identify the traumatic mechanism of tricuspid regurgitation (TR) and the extent of valvular lesions in these patients. Such etiology should be suspected, and TEE performed, in patients developing TR or heart failure late after lead extraction.

Relationship of HIV Reservoir Characteristics with Immune Status and Viral Rebound Kinetics in an HIV Therapeutic Vaccine Study

PubMed Central

Li, Jonathan Z.; Heisey, Andrea; Ahmed, Hayat; Wang, Hongying; Zheng, Lu; Carrington, Mary; Wrin, Terri; Schooley, Robert T.; Lederman, Michael M.; Kuritzkes, Daniel R.

2014-01-01

Objectives To evaluate the impact of therapeutic HIV vaccination on the HIV reservoir, and assess the relationship of the viral reservoir with HIV-specific immune status and viral rebound kinetics. Design Retrospective analysis of ACTG A5197, a randomized, placebo-controlled trial of a therapeutic rAd5 HIV-1 gag vaccine. Methods Participants received vaccine/placebo at weeks 0, 4, and 26 prior to a 16-week analytic treatment interruption (ATI) at week 38. Cell-associated HIV-1 RNA and DNA (CA-RNA and CA-DNA) and HIV-1 residual viremia (RV) were quantified at weeks 0, 8, and 38. HIV-specific CD4+/CD8+ activity were assessed by an intracellular cytokine staining assay. Results At study entry, CA-RNA and CA-DNA levels were correlated inversely with the numbers of HIV-specific CD4+ interferon-γ-producing cells (CA-RNA: r = −0.23, P=0.03 and CA-DNA: r = −0.28, P<0.01, N=93). Therapeutic HIV vaccination induced HIV-specific CD4+ activity, but did not significantly affect levels of CA-RNA or CA-DNA. Vaccine recipients with undetectable RV at week 8 had higher frequencies of HIV-specific CD4+ and CD8+ interferon-γ-producing cells (undetectable versus detectable RV: 277 versus 161 CD4+ cells/106 lymphocytes, P=0.03 and 1326 versus 669 CD8+ cells/106 lymphocytes, P=0.04). Pre-ATI CA-RNA and CA-DNA were associated with post-ATI plasma HIV set point (CA-RNA: r = 0.51, P<0.01 and CA-DNA: r = 0.47, P<0.01). Conclusions Vaccine-induced T-cell responses were associated with a modest transient effect on RV, but more potent immune responses and/or combination treatment with latency-reversing agents are needed to reduce the HIV reservoir. HIV reservoir measures may act as biomarkers of post-ATI viral rebound kinetics. PMID:25254301

Spatiotemporal changes of freezing/thawing indices and their response to recent climate change on the Qinghai-Tibet Plateau from 1980 to 2013

NASA Astrophysics Data System (ADS)

Wu, Tonghua; Qin, Yanhui; Wu, Xiaodong; Li, Ren; Zou, Defu; Xie, Changwei

2018-05-01

The spatial and temporal changes of the ground surface freezing indices (GFIs), ground surface thawing indices (GTIs), air freezing indices (AFIs), and air thawing indices (ATIs) in permafrost and seasonally frozen ground regions of the Qinghai-Tibet Plateau (QTP) were analyzed based on the daily ground surface and air temperatures from 69 meteorological stations using the Mann-Kendall test and Sen's slope estimate. The spatial patterns of the freezing indices (FIs) and thawing indices (TIs) are nearly negatively correlated. On the annual scale, the GFI and GTI are greater than the AFI and ATI in both permafrost and seasonally frozen ground regions. The marked upward and downward trends have been observed for the time series of TI and FI, respectively, since 1998 on the QTP. Moreover, GFI and AFI decrease more significantly in permafrost regions than in seasonally frozen ground regions; the increasing rate of GTI and ATI in the seasonally frozen ground regions is greater than that in the permafrost regions. In permafrost regions, the downward trend of FI is greater than the upward trend of TI. However, the upward trend of TI shows a more drastic change than the FI in the seasonally frozen ground regions. The results indicate that the warming in the permafrost regions is more pronounced in winter than in the other seasons. The summer warming is more pronounced than the other seasons in the seasonally frozen ground regions. The decreasing rate of AFI and GFI increases as the altitude rises, while they decrease with increasing ATI. The average decreasing rate of GFI is greater than that of the AFI in different altitudinal zones. The greatest decrease of FI occurs in permafrost regions in the hinterland of the QTP, which indicates the dominant winter warming in this region. The downward trend of FI and upward trend of TI are responsible for the reported permafrost degradation on the QTP.

Comparison between over-glasses patching and adhesive patching for children with moderate amblyopia: a prospective randomized clinical trial.

PubMed

Kim, Su Jin; Jeon, Hyeshin; Jung, Jae Ho; Lee, Kwang Min; Choi, Hee Young

2018-02-01

To investigate efficacy of over-glasses patching treatment for amblyopic children using visual function improvement and Amblyopia Treatment Index (ATI) changes. In a randomized multi-center controlled clinical trial, 107 children aged 3-7 years with moderate amblyopia (visual acuity in the range of 20/40 to 20/100) were included to receive treatment with either an adhesive skin patch or a fabric over-glasses patch. The patients were prescribed 2 h of patching per day for the sound eye. Best-corrected visual acuity (BCVA) was investigated and ATI questionnaires were collected from parents at 5 weeks and 17 weeks after the initiation of treatment. ATI identifies barriers and problems associated with amblyopia treatment. We compared the changes of visual acuity of amblyopic eyes and ATI scores in two groups. At 17 weeks, the mean visual acuity of the amblyopic eye using Snellen chart improved 3.2 lines in the adhesive patching group and 2.7 lines for an over-glasses patching method that fit over eyeglasses (p = 0.345). A similar proportion of subjects in each group had improvement of ≥ 2 lines (adhesive patching group 67% vs over-glasses patching group 67%, p = 0.372). There was also no difference in treatment burden in each group as measured with the Amblyopia Treatment Index. The only item to demonstrate a significant difference between groups was that related to "Treatment makes the eye or eyelids red" (mean 4.0 ± 1.1 vs 3.0 ± 1.0 at 17 weeks, p = 0.001, for adhesive vs over-glasses patch). Over-glasses patching treatment is a useful option for amblyopia treatment when the patients suffer from adverse effects of using adhesive skin patching.

The effects of dune slopes and material heterogeneity on the thermal behavior of dune fields in Mars' Southern Hemisphere

NASA Astrophysics Data System (ADS)

O'Shea, P. M.; Putzig, N. E.; Van Kooten, S.; Fenton, L. K.

2015-12-01

We analyzed the effects of slopes on the thermal properties of three dune fields in Mars' southern hemisphere. Although slope has important thermal effects, it is not the main driver of observed apparent thermal inertia (ATI) for these dunes. Comparing the ATI seasonal behavior as derived from Thermal Emission Spectrometer (TES) data with that modeled for compositional heterogeneities, we found that TES results correlate best with models of duricrust overlying and/or horizontally mixing with fines. We measured slopes and aspects in digital terrain models created from High Resolution Imaging Science Experiment (HiRISE) images of dunes within Proctor, Kaiser, and Wirtz craters. Using the MARSTHERM web toolset, we incorporated the slopes and aspects together with TES albedo, TES thermal inertia, surface pressure, and TES dust opacity, into models of seasonal ATI. Models that incorporate sub-pixel slopes show seasonal day and night ATI values that differ from the TES results by 0-300 J m-2 K-1 s-½. In addition, the models' day-night differences are opposite in sign from those of the TES results, indicating that factors other than slope are involved. We therefore compared the TES data to model results for a broad range of horizontally mixed and two-layered surfaces to seek other possible controls on the observed data, finding that a surface layer of higher thermal inertia is a likely contributor. However, it is clear from this study that the overall composition and morphology of the dune fields are more complex than currently available models allow. Future work will combine slopes with other model parameters such as multi-layered surfaces and lateral changes in layer thickness. Coupling these improvements with broader seasonal coverage from the Thermal Emission Imaging System (THEMIS) at more thermally favorable times of day would allow more accurate characterization of dune thermal behavior.

Computed tomography measurement of the left atrial appendage for optimal sizing of the Watchman device.

PubMed

Xu, Bo; Betancor, Jorge; Sato, Kimi; Harb, Serge; Abdur Rehman, Karim; Patel, Kunal; Kumar, Arnav; Cremer, Paul C; Jaber, Wael; Rodriguez, L Leonardo; Schoenhagen, Paul; Wazni, Oussama

Percutaneous left atrial appendage (LAA) occlusion is an emerging treatment option for patients with non-valvular atrial fibrillation who cannot tolerate oral anticoagulation. The Watchman device (Boston Scientific Corporation, Natick, MA, USA) is deployed at the ostium of the LAA, and an appropriately sized device is critical for successful occlusion. However, standardized imaging protocols for device sizing have not been established. We investigated the clinical utility of a standardized imaging protocol, with pre-procedural multi-detector cardiac computed tomography (MDCT), and intra-procedural transesophageal echocardiography (TEE), for Watchman device sizing. Patients who underwent Watchman device implantation between 2010 and 2016 at our center, and who had pre-procedural MDCT and intra-procedural TEE were included. MDCT measurements (CTmax, CTmin, CTmean), and TEE measurement (TEEmax) of the LAA ostium were determined for each case, and correlated with the final size of the Watchman device implanted. Demographic data and clinical outcomes were collected. The study included 80 patients (mean age: 75 ± 9.6 years; male: 68%; mean CHA2DS2-VASc score: 4.5 ± 1.4). CTmax of the LAA ostium correlated strongly with the final deployed Watchman device size (Spearman's rho: 0.81, p < 0.001), while TEEmax of the LAA ostium showed only moderate correlation with the final deployed Watchman device size (Spearman's rho: 0.61, p < 0.001). Implantation success rate was 100%. At a mean duration of follow-up of 197 days, there were no device-related complications (device embolization, cardiac perforation and pericardial tamponade). At follow-up, the vast majority of patients (76 patients; 95%) had either no or trivial (≤3 mm) residual peri-device leak on TEE. A standardized imaging protocol for assessment of Watchman device implantation incorporating pre-procedural MDCT and intra-procedural TEE, was associated with excellent procedural outcomes at a mean duration of follow-up of 197 days. Copyright © 2018 Society of Cardiovascular Computed Tomography. Published by Elsevier Inc. All rights reserved.

Prosthesis-patient mismatch after transcatheter aortic valve implantation: impact of 2D-transthoracic echocardiography versus 3D-transesophageal echocardiography.

PubMed

da Silva, Cristina; Sahlen, Anders; Winter, Reidar; Bäck, Magnus; Rück, Andreas; Settergren, Magnus; Manouras, Aristomenis; Shahgaldi, Kambiz

2014-12-01

To investigate the role of 2D-transthoracic echocardiography (2D-TTE) and 3D-transesophageal echocardiography (3D-TEE) in the determination of aortic annulus size prior transcatheter aortic valve implantation (TAVI) and its' impact on the prevalence of patient prosthesis mismatch (PPM). Echocardiography plays an important role in measuring aortic annulus dimension in patients undergoing TAVI. This has great importance since it determines both eligibility for TAVI and selection of prosthesis type and size, and can be potentially important in preventing an inadequate ratio between the prosthetic valvular orifice and the patient's body surface area, concept known as prosthesis-patient mismatch (PPM). A total of 45 patients were studied pre-TAVI: 20 underwent 3D-TEE (men/women 12/8, age 84.8 ± 5.6) and 25 2D-TTE (men/women 9/16, age 84.4 ± 5.4) in order to measure aortic annulus diameter. The presence of PPM was assessed before hospital discharge and after a mean period of 3 months. Moderate PPM was defined as indexed aortic valve area (AVAi) ≤ 0.85 cm(2)/m(2) and severe PPM as AVAi < 0.65 cm(2)/m(2). Immediately post-TAVI, moderate PPM was present in 25 and 28 % of patients worked up using 3D-TEE and 2D-TTE respectively p value = n.s) and severe PPM occurred in 10 % of the patients who underwent 3D-TEE and in 20 % in those with 2D-TTE (p value = n.s). The echocardiographic evaluation 3 months post-TAVI showed 25 % moderate PPM in the 3D-TEE group compared with 24 % in the 2D-TTE group (p value = n.s) and no cases of severe PPM in the 3DTEE group comparing to 20 % in the 2D-TTE group (p = 0.032). Our results indicate a higher incidence of severe PPM in patients who performed 2DTTE compared to those performing 3DTEE prior TAVI. This suggests that the 3D technique should replace the 2DTTE analysis when investigating the aortic annulus diameter in patients undergoing TAVI.

Evaluation of the ability of three physical activity monitors to predict weight change and estimate energy expenditure.

PubMed

Correa, John B; Apolzan, John W; Shepard, Desti N; Heil, Daniel P; Rood, Jennifer C; Martin, Corby K

2016-07-01

Activity monitors such as the Actical accelerometer, the Sensewear armband, and the Intelligent Device for Energy Expenditure and Activity (IDEEA) are commonly validated against gold standards (e.g., doubly labeled water, or DLW) to determine whether they accurately measure total daily energy expenditure (TEE) or activity energy expenditure (AEE). However, little research has assessed whether these parameters or others (e.g., posture allocation) predict body weight change over time. The aims of this study were to (i) test whether estimated energy expenditure or posture allocation from the devices was associated with weight change during and following a low-calorie diet (LCD) and (ii) compare free-living TEE and AEE predictions from the devices against DLW before weight change. Eighty-seven participants from 2 clinical trials wore 2 of the 3 devices simultaneously for 1 week of a 2-week DLW period. Participants then completed an 8-week LCD and were weighed at the start and end of the LCD and 6 and 12 months after the LCD. More time spent walking at baseline, measured by the IDEEA, significantly predicted greater weight loss during the 8-week LCD. Measures of posture allocation demonstrated medium effect sizes in their relationships with weight change. Bland-Altman analyses indicated that the Sensewear and the IDEEA accurately estimated TEE, and the IDEEA accurately measured AEE. The results suggest that the ability of energy expenditure and posture allocation to predict weight change is limited, and the accuracy of TEE and AEE measurements varies across activity monitoring devices, with multi-sensor monitors demonstrating stronger validity.

Patent foramen ovale: detection with nongated multidetector CT.

PubMed

Revel, Marie-Pierre; Faivre, Jean-Baptiste; Letourneau, Thierry; Henon, Hilde; Leys, Didier; Delannoy-Deken, Valérie; Remy-Jardin, Martine; Remy, Jacques

2008-10-01

To evaluate nongated multidetector computed tomography (CT) in the detection of patent foramen ovale (PFO) and atrial septal aneurysm (ASA) in comparison with transesophageal echocardiography (TEE). The study was approved by the institutional review board, and informed consent was obtained from all patients. One hundred five patients (57 men, 48 women; mean age, 53 years) with a recent stroke underwent TEE and multidetector CT on the same day. After injection of a diluted iodinated contrast material, a series of 2.4-mm-thick transverse images centered on the fossa ovalis were acquired in conjunction with release of the Valsalva maneuver. Two independent radiologists considered PFO present if left atrial enhancement was detected visually before enhancement of the pulmonary veins or if an early peak of left atrial enhancement was found at time-attenuation curve analysis. PFO was detected with 98% specificity (95% confidence interval [CI]: 0.91, 0.99). Overall sensitivity was 55% (95% CI: 0.38, 0.70), ranging from 28% for shunts classified as grade 1 at TEE to 91% for those classified as grade 4 at TEE. Interreader agreement was good (kappa = 0.81). Visual assessment was better than time-attenuation curve analysis, which enabled detection of only 15 of the 40 cases of PFO. Multidetector CT depicted only 22% of cases of ASA. The mean effective radiation dose was 2.3 mSv. Nongated multidetector CT can be used to diagnose high-grade shunts through a PFO, with 91% sensitivity and 98% specificity. Thus, PFO detection, in addition to routine CT evaluation of the lungs, could be indicated in patients with unexplained hypoxemia. (c) RSNA, 2008.

Energy Requirement Assessment in Japanese Table Tennis Players Using the Doubly Labeled Water Method.

PubMed

Sagayama, Hiroyuki; Hamaguchi, Genki; Toguchi, Makiko; Ichikawa, Mamiko; Yamada, Yosuke; Ebine, Naoyuki; Higaki, Yasuki; Tanaka, Hiroaki

2017-10-01

Total daily energy expenditure (TEE) and physical activity level (PAL) are important for adequate nutritional management in athletes. The PAL of table tennis has been estimated to about 2.0: it is categorized as a moderateactivity sport (4.0 metabolic equivalents [METs]) in the Compendium of Physical Activities. However, modern table tennis makes high physiological demands. The aims of the current study were to examine (1) TEE and PAL of competitive table tennis players and (2) the physiological demands of various types of table tennis practice. In Experiment 1, we measured TEE and PAL in 10 Japanese college competitive table tennis players (aged 19.9 ± 1.1 years) using the doubly labeled water (DLW) method during training and with an exercise training log and self-reported energy intake. TEE was 15.5 ± 1.9 MJ·day -1 (3695 ± 449 kcal·day -1 ); PAL was 2.53 ± 0.25; and the average training duration was 181 ± 38 min·day -1 . In Experiment 2, we measured METs of five different practices in seven college competition players (20.6 ± 1.2 years). Three practices without footwork were 4.5-5.2 METs, and two practices with footwork were 9.5-11.5 METs. Table tennis practices averaged 7.1 ± 3.2 METS demonstrating similarities with other vigorous racket sports. In conclusion the current Compendium of Physical Activities underestimates the physiological demands of table tennis practice for competition; the estimated energy requirement should be based on DLW method data.

Evaluation of concordance among three cardiac output measurement techniques in adult patients during cardiovascular surgery postoperative care.

PubMed

Muñoz, L; Velandia, A; Reyes, L E; Arevalo-Rodríguez, I; Mejía, C; Asprilla, D; Uribe, D V; Arevalo, J J

2017-12-01

The standard method for cardiac output measuring is thermodilution although it is an invasive technique. Transesophageal Echocardiography (TEE) offers a dynamic and functional alternative to thermodilution. Analyze concordance between two TEE methods and thermodilution for cardiac output assessment. Observational concordance study in cardiovascular surgery patients that required pulmonary artery catheter. TEE cardiac output measurement at both mitral annulus (MA) and left ventricle outflow tract (LVOT) were performed. Results were compared with thermodilution. Correlation was evaluated by Lin's concordance correlation coefficient and Bland-Altman analysis. Statistical analysis was undertaken in STATA 13.0. Twenty-five patients were enrolled. Fifty two percent of patients were male, median age and ejection fraction was 63 years and 35% respectively. Median thermodilution, LVOT and MA -measured cardiac output was 3.25 L/min, 3.46 L/min and 8.4 L/min respectively. Different values between thermodilution and MA measurements were found (Lin concordance=0.071; Confidence Interval 95%=-0.009 to 0.151; Spearman's correlation=0.22) as values between thermodilution and LVOT (Lin concordance=0.232; Confidence Interval 95%=-0.12 a 0.537; Spearman's correlation 0.28). Bland-Altman analysis showed greater difference between MA measurements and thermodilution (DM=-0.408; Bland-Altman Limits=-0.809 to -0.007), than the other echocardiographic findings (DM=0.007; Bland-Altman Limits=-0.441 to 0.428). Results from cardiac output measurement by doppler and 2D-TEE on both MA and LVOT do not correlate with those obtained by thermodilution. Copyright © 2017 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

Patient-specific indirectly 3D printed mitral valves for pre-operative surgical modelling

NASA Astrophysics Data System (ADS)

Ginty, Olivia; Moore, John; Xia, Wenyao; Bainbridge, Dan; Peters, Terry

2017-03-01

Significant mitral valve regurgitation affects over 2% of the population. Over the past few decades, mitral valve (MV) repair has become the preferred treatment option, producing better patient outcomes than MV replacement, but requiring more expertise. Recently, 3D printing has been used to assist surgeons in planning optimal treatments for complex surgery, thus increasing the experience of surgeons and the success of MV repairs. However, while commercially available 3D printers are capable of printing soft, tissue-like material, they cannot replicate the demanding combination of echogenicity, physical flexibility and strength of the mitral valve. In this work, we propose the use of trans-esophageal echocardiography (TEE) 3D image data and inexpensive 3D printing technology to create patient specific mitral valve models. Patient specific 3D TEE images were segmented and used to generate a profile of the mitral valve leaflets. This profile was 3D printed and integrated into a mold to generate a silicone valve model that was placed in a dynamic heart phantom. Our primary goal is to use silicone models to assess different repair options prior to surgery, in the hope of optimizing patient outcomes. As a corollary, a database of patient specific models can then be used as a trainer for new surgeons, using a beating heart simulator to assess success. The current work reports preliminary results, quantifying basic morphological properties. The models were assessed using 3D TEE images, as well as 2D and 3D Doppler images for comparison to the original patient TEE data.

The Sedentary Time and Activity Reporting Questionnaire (STAR-Q): Reliability and Validity Against Doubly Labeled Water and 7-Day Activity Diaries

PubMed Central

Csizmadi, Ilona; Neilson, Heather K.; Kopciuk, Karen A.; Khandwala, Farah; Liu, Andrew; Friedenreich, Christine M.; Yasui, Yutaka; Rabasa-Lhoret, Rémi; Bryant, Heather E.; Lau, David C. W.; Robson, Paula J.

2014-01-01

We determined measurement properties of the Sedentary Time and Activity Reporting Questionnaire (STAR-Q), which was designed to estimate past-month activity energy expenditure (AEE). STAR-Q validity and reliability were assessed in 102 adults in Alberta, Canada (2009–2011), who completed 14-day doubly labeled water (DLW) protocols, 7-day activity diaries on day 15, and the STAR-Q on day 14 and again at 3 and 6 months. Three-month reliability was substantial for total energy expenditure (TEE) and AEE (intraclass correlation coefficients of 0.84 and 0.73, respectively), while 6-month reliability was moderate. STAR-Q-derived TEE and AEE were moderately correlated with DLW estimates (Spearman's ρs of 0.53 and 0.40, respectively; P < 0.001), and on average, the STAR-Q overestimated TEE and AEE (median differences were 367 kcal/day and 293 kcal/day, respectively). Body mass index-, age-, sex-, and season-adjusted concordance correlation coefficients (CCCs) were 0.24 (95% confidence interval (CI): 0.07, 0.36) and 0.21 (95% CI: 0.11, 0.32) for STAR-Q-derived versus DLW-derived TEE and AEE, respectively. Agreement between the diaries and STAR-Q (metabolic equivalent-hours/day) was strongest for occupational sedentary time (adjusted CCC = 0.76, 95% CI: 0.64, 0.85) and overall strenuous activity (adjusted CCC = 0.64, 95% CI: 0.49, 0.76). The STAR-Q demonstrated substantial validity for estimating occupational sedentary time and strenuous activity and fair validity for ranking individuals by AEE. PMID:25038920

Anthelmintic effect of Psidium guajava and Tagetes erecta on wild-type and Levamisole-resistant Caenorhabditis elegans strains.

PubMed

Piña-Vázquez, Denia M; Mayoral-Peña, Zyanya; Gómez-Sánchez, Maricela; Salazar-Olivo, Luis A; Arellano-Carbajal, Fausto

2017-04-18

Psidium guajava and Tagetes erecta have been used traditionally to treat gastrointestinal parasites, but their active metabolites and mechanisms of action remain largely unknown. To evaluate the anthelmintic potential of Psidium guajava and Tagetes erecta extracts on Levamisole-sensitive and Levamisole-resistant strains of the model nematode Caenorhabditis elegans. Aqueous extracts of Psidium guajava (PGE) and Tagetes erecta (TEE) were assayed on locomotion and egg-laying behaviors of the wild-type (N2) and Levamisole-resistant (CB193) strains of Caenorhabditis elegans. Both extracts paralyzed wild-type and Levamisole-resistant nematodes in a dose-dependent manner. In wild-type worms, TEE 25mg/mL induced a 75% paralysis after 8h of treatment and PGE 25mg/mL induced a 100% paralysis after 4h of treatment. PGE exerted a similar paralyzing effect on N2 wild-type and CB193 Levamisole-resistant worms, while TEE only partially paralyzed CB193 worms. TEE 25mg/mL decreased N2 egg-laying by 65% with respect to the untreated control, while PGE did it by 40%. Psidium guajava leaves and Tagetes erecta flower-heads possess hydrosoluble compounds that block the motility of Caenorhabditis elegans by a mechanism different to that of the anthelmintic drug Levamisole. Effects are also observable on oviposition, which was diminished in the wild-type worms. The strong anthelmintic effects in crude extracts of these plants warrants future work to identify their active compounds and to elucidate their molecular mechanisms of action. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

Tricuspid Annular Geometry: A Three-Dimensional Transesophageal Echocardiographic Study

PubMed Central

Mahmood, Feroze; Kim, Han; Chaudary, Bilal; Bergman, Remco; Matyal, Robina; Gerstle, Jeniffer; Gorman, Joseph H.; Gorman, Robert C.; Khabbaz, Kamal R.

2013-01-01

Objective To demonstrate the clinical feasibility of accurately measuring tricuspid annular area by 3-dimensional (3D) transesophageal echocardiography (TEE) and to assess the geometric differences based on the presence of tricuspid regurgitation (TR). Also, the shape of the tricuspid annulus was compared with previous descriptions in the literature. Design Prospective. Setting Tertiary care university hospital. Interventions Three-dimensional TEE. Participants Patients undergoing cardiac surgery. Measurements and Main Results Volumetric data sets from 20 patients were acquired by 3D TEE and prospectively analyzed. Comparisons in annular geometry were made between groups based on the presence of TR. The QLab (Philips Medical Systems, Andover, MA) software package was used to calculate tricuspid annular area by both linear elliptical dimensions and planimetry. Further analyses were performed in the 4D Cardio-View (TomTec Corporation GmBH, Munich, Germany) and MATLAB (Natick, MA) software environments to accurately assess annular shape. It was found that patients with greater TR had an eccentrically dilated annulus with a larger annular area. Also, the area as measured by the linear ellipse method was overestimated as compared to the planimetry method. Furthermore, the irregular saddle-shaped geometry of the tricuspid annulus was confirmed through the mathematic model developed by the authors. Conclusions Three-dimensional TEE can be used to measure the tricuspid annular area in a clinically feasible fashion, with an eccentric dilation seen in patients with TR. The tricuspid annulus shape is complex, with annular high and low points, and annular area calculation based on linear measurements significantly overestimates 3D planimetered area. PMID:23725682

Efficacy of anticoagulation in resolving left atrial and left atrial appendage thrombi: A transesophageal echocardiographic study

NASA Technical Reports Server (NTRS)

Jaber, W. A.; Prior, D. L.; Thamilarasan, M.; Grimm, R. A.; Thomas, J. D.; Klein, A. L.; Asher, C. R.

2000-01-01

BACKGROUND: Transesophageal echocardiography (TEE) is the gold standard for evaluation of the left atrium and the left atrial appendage (LAA) for the presence of thrombi. Anticoagulation is conventionally used for patients with atrial fibrillation to prevent embolization of atrial thrombi. The mechanism of benefit and effectiveness of thrombi resolution with anticoagulation is not well defined. METHODS AND RESULTS: We used a TEE database of 9058 consecutive studies performed between January 1996 and November 1998 to identify all patients with thrombi reported in the left atrium and/or LAA. One hundred seventy-four patients with thrombi in the left atrial cavity (LAC) and LAA were identified (1.9% of transesophageal studies performed). The incidence of LAA thrombi was 6.6 times higher than LAC thrombi (151 vs 23, respectively). Almost all LAC thrombi were visualized on transthoracic echocardiography (90.5%). Mitral valve pathology was associated with LAC location of thrombi (P <.0001), whereas atrial fibrillation or flutter was present in most patients with LAA location of thrombi. Anticoagulation of 47 +/- 18 days was associated with thrombus resolution in 80.1% of the patients on follow-up TEE. Further anticoagulation resulted in limited additional benefit. CONCLUSIONS: LAC thrombi are rare and are usually associated with mitral valve pathology. Transthoracic echocardiography is effective in identifying these thrombi. LAA thrombi occur predominantly in patients with atrial fibrillation or flutter. Short-term anticoagulation achieves a high rate of resolution of LAA and LAC thrombi but does not obviate the need for follow-up TEE.

Evaluation of the ability of three physical activity monitors to predict weight change and estimate energy expenditure

PubMed Central

Correa, John B.; Apolzan, John W.; Shepard, Desti N.; Heil, Daniel P.; Rood, Jennifer C.; Martin, Corby K.

2016-01-01

Activity monitors such as the Actical accelerometer, the Sensewear armband, and the Intelligent Device for Energy Expenditure and Activity (IDEEA) are commonly validated against gold standards (e.g., doubly labeled water, or DLW) to determine whether they accurately measure total daily energy expenditure (TEE) or activity energy expenditure (AEE). However, little research has assessed whether these parameters or others (e.g., posture allocation) predict body weight change over time. The aims of this study were to (i) test whether estimated energy expenditure or posture allocation from the devices was associated with weight change during and following a low-calorie diet (LCD) and (ii) compare free-living TEE and AEE predictions from the devices against DLW before weight change. Eighty-seven participants from 2 clinical trials wore 2 of the 3 devices simultaneously for 1 week of a 2-week DLW period. Participants then completed an 8-week LCD and were weighed at the start and end of the LCD and 6 and 12 months after the LCD. More time spent walking at baseline, measured by the IDEEA, significantly predicted greater weight loss during the 8-week LCD. Measures of posture allocation demonstrated medium effect sizes in their relationships with weight change. Bland–Altman analyses indicated that the Sensewear and the IDEEA accurately estimated TEE, and the IDEEA accurately measured AEE. The results suggest that the ability of energy expenditure and posture allocation to predict weight change is limited, and the accuracy of TEE and AEE measurements varies across activity monitoring devices, with multi-sensor monitors demonstrating stronger validity. PMID:27270210

Exercise Training and Energy Expenditure following Weight Loss

PubMed Central

Hunter, Gary R.; Fisher, Gordon; Neumeier, William H.; Carter, Stephen J.; Plaisance, Eric P.

2015-01-01

Purpose Determine the effects of aerobic or resistance training on activity related energy expenditure (AEE, kcal/d) and physical activity index (ARTE) following weight loss. It was hypothesized that weight loss without exercise training would be accompanied by a decrease in AEE, ARTE, and non-training physical activity energy expenditure (NEAT) and that exercise training would prevent decreases in free living energy expenditure. Methods 140 pre-menopausal women underwent an average of 25 pound weight loss during an 800 kcal/day diet of furnished food. One group aerobically trained 3 times/wk (40 min/d), another resistance trained 3 times/wk (10 exercises/2 sets x10 repetitions) and the third group did not exercise. DXA was used to measure body composition, indirect calorimetry to measure resting (REE) and walking energy expenditure, and doubly labeled water to measure total energy expenditure (TEE). AEE, ARTE, and non-training physical activity energy expenditure (NEAT) were calculated. Results TEE, REE, and NEAT all decreased following weight loss for the no exercise group, but not for the aerobic and resistance trainers. Only REE decreased in the two exercise groups. The resistance trainers increased ARTE. Heart rate and oxygen uptake while walking on the flat and up a grade were consistently related to TEE, AEE, NEAT, and ARTE. Conclusion Exercise training prevents a decrease in energy expenditure, including free living energy expenditure separate from the exercise training, following weight loss. Resistance training increased physical activity, while ease and economy in walking associates with increased TEE, AEE, NEAT, and ARTE. PMID:25606816

Suppression in high-order above-threshold ionization: destructive interference from quantum orbits

NASA Astrophysics Data System (ADS)

Lai, Xuan Yang; Quan, Wei; Yu, Shao Gang; Huang, Yi Yi; Liu, Xiao Jun

2018-05-01

We experimentally study the above-threshold ionization (ATI) spectra of noble gas argon in an intense laser field and focus on a novel suppression structure in the high-order ATI (HATI) spectra. It is found that, when a well-documented resonancelike enhancement feature appears in the HATI spectra, a significant suppression structure is followed in a higher energy region of the spectra. The observation is well reproduced by a numerical solution of the time-dependent Schrödinger equation. In terms of quantum-orbit theory, the observed suppression structure can be ascribed to the destructive interference from longer quantum orbits. Furthermore, an intrinsic relation between the ionization suppression and the ionization enhancement in the HATI spectra is well established.

Choline acetyltransferase immunoreactivity in the human vestibular end-organs.

PubMed

Ishiyama, A; Lopez, I; Wackym, P A

1994-10-01

Acetylcholine (ACh) is believed to play a major role in the efferent vestibular system in several animal models, however no information regarding the role of ACh in the human efferent vestibular system has been published. Post-embedding immunohistochemistry in a hydrophilic resin was used to investigate the choline acetyltransferase immunoreactivity (ChATi) and acetylcholinesterase (AChE) histochemistry in human vestibular end-organs. ChATi and AChE activity was found in numerous bouton-type terminals at the basal area of the vestibular hair cells. These terminals were found to contact type II vestibular hair cells and the afferent chalices surrounding type I hair cells. This study provides the first evidence that the human efferent vestibular axons and terminals are cholinergic.

Underwater Facilities Inspections and Assessments at Philadelphia Naval Shipyard, Philadelphia, Pennsylvania. Volume 1.

DTIC Science & Technology

1983-10-01

NAVAL FACILITIES ENGINEERING COMMAND~ CORPORATION .𔃾CN C 33 pItLAOFLPHI* NAVAL SH4IP-110 PŕiIL -~~NA IA I 1OAQ 4C-14723, C-13041o, C- 13047 4C-1~3046...5ECTION 2 4 8 10 ATI i I 70 30 0 .50SCALE OF FEET GOAHI FCALE CHESAPEAKE DIVISION GRAPIC SALENAVAL FACILITIES ENGINEERING COMMAND C-DLS E.GINEERING...ELEVATION CORE LCC- ATI ~J 45+00 444-50 44+00 493+50 loyo OF V 1 11 FILE’ NV~ 45+0(o / 10 5TA � TIMBER 51NEETIW4& BATTER FILI c 0 - r, - Q Q -Q Q Q -Q- ’~ rP

Rings in above-threshold ionization: A quasiclassical analysis

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

Lewenstein, M.; Kulander, K.C.; Schafer, K.J.

1995-02-01

A generalized strong-field approximation is formulated to describe atoms interacting with intense laser fields. We apply it to determine angular distributions of electrons in above-threshold ionization (ATI). The theory treats the effects of an electron rescattering from its parent ion core in a systematic perturbation series. Probability amplitudes for ionization are interpreted in terms of quasiclassical electron trajectories. We demonstrate that contributions from the direct tunneling processes in the absence of rescattering are not sufficient to describe the observed ATI spectra. We show that the high-energy portion of the spectrum, including recently discovered rings (i.e., complex features in the angularmore » distributions of outgoing electrons) are due to rescattering processes. We compare our quasiclassical results with exact numerical solutions.« less

Primate energy expenditure and life history

PubMed Central

Pontzer, Herman; Raichlen, David A.; Gordon, Adam D.; Schroepfer-Walker, Kara K.; Hare, Brian; O’Neill, Matthew C.; Muldoon, Kathleen M.; Dunsworth, Holly M.; Wood, Brian M.; Isler, Karin; Burkart, Judith; Irwin, Mitchell; Shumaker, Robert W.; Lonsdorf, Elizabeth V.; Ross, Stephen R.

2014-01-01

Humans and other primates are distinct among placental mammals in having exceptionally slow rates of growth, reproduction, and aging. Primates’ slow life history schedules are generally thought to reflect an evolved strategy of allocating energy away from growth and reproduction and toward somatic investment, particularly to the development and maintenance of large brains. Here we examine an alternative explanation: that primates’ slow life histories reflect low total energy expenditure (TEE) (kilocalories per day) relative to other placental mammals. We compared doubly labeled water measurements of TEE among 17 primate species with similar measures for other placental mammals. We found that primates use remarkably little energy each day, expending on average only 50% of the energy expected for a placental mammal of similar mass. Such large differences in TEE are not easily explained by differences in physical activity, and instead appear to reflect systemic metabolic adaptation for low energy expenditures in primates. Indeed, comparisons of wild and captive primate populations indicate similar levels of energy expenditure. Broad interspecific comparisons of growth, reproduction, and maximum life span indicate that primates’ slow metabolic rates contribute to their characteristically slow life histories. PMID:24474770

Cutting efficiency of four different rotary nickel: Titanium instruments

PubMed Central

Cecchin, Doglas; de Sousa-Neto, Manoel Damião; Pécora, Jesus Djalma; Gariba-Silva, Ricardo

2011-01-01

Aim: The aim of this study was to evaluate the cutting efficiency of rotary nickel-titanium (NiTi) instruments K3, NiTi Tee, Profile, and Quantec with taper size 04/25. Materials and Methods: The number of samples was 10 for each group (n = 10). The cutting efficiency was measured by the mass loss from each acrylic resin block after instrumentation of a simulated canal using the Crown-down technique. Results: The analysis of variance (ANOVA) showed that there was a statistically significant difference among the studied groups. The Tukey's test showed that the acrylic resin blocks prepared with instruments K3 (0.00369 ± 0.00022), NiTi Tee (0.00368 ± 0.00023), and Profile (0.00351 ± 0.00026) presented the greatest mass loss, showing no statistically significant difference among them (P < 0.05). The lowest mass loss was found in the blocks prepared with Quantec instruments (0.00311 ± 0.0003) (P < 0.05). Conclusions: It could be concluded that the K3, NiTi Tee, and Profile instruments presented a greater cutting efficiency than the Quantec instruments. PMID:21814349

Echocardiography in Infective Endocarditis: State of the Art.

PubMed

Afonso, Luis; Kottam, Anupama; Reddy, Vivek; Penumetcha, Anirudh

2017-10-25

In this review, we examine the central role of echocardiography in the diagnosis, prognosis, and management of infective endocarditis (IE). 2D transthoracic echocardiography (TTE) and transesophageal echocardiography TEE have complementary roles and are unequivocally the mainstay of diagnostic imaging in IE. The advent of 3D and multiplanar imaging have greatly enhanced the ability of the imager to evaluate cardiac structure and function. Technologic advances in 3D imaging allow for the reconstruction of realistic anatomic images that in turn have positively impacted IE-related surgical planning and intervention. CT and metabolic imaging appear to be emerging as promising ancillary diagnostic tools that could be deployed in select scenarios to circumvent some of the limitations of echocardiography. Our review summarizes the indispensable and central role of various echocardiographic modalities in the management of infective endocarditis. The complementary role of 2D TTE and TEE are discussed and areas where 3D TEE offers incremental value highlighted. An algorithm summarizing a contemporary approach to the workup of endocarditis is provided and major societal guidelines for timing of surgery are reviewed.

The microwave Hall effect measured using a waveguide tee

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

Coppock, J. E.; Anderson, J. R.; Johnson, W. B.

2016-03-14

This paper describes a simple microwave apparatus to measure the Hall effect in semiconductor wafers. The advantage of this technique is that it does not require contacts on the sample or the use of a resonant cavity. Our method consists of placing the semiconductor wafer into a slot cut in an X-band (8–12 GHz) waveguide series tee, injecting microwave power into the two opposite arms of the tee, and measuring the microwave output at the third arm. A magnetic field applied perpendicular to the wafer gives a microwave Hall signal that is linear in the magnetic field and which reverses phasemore » when the magnetic field is reversed. The microwave Hall signal is proportional to the semiconductor mobility, which we compare for calibration purposes with d.c. mobility measurements obtained using the van der Pauw method. We obtain the resistivity by measuring the microwave reflection coefficient of the sample. This paper presents data for silicon and germanium samples doped with boron or phosphorus. The measured mobilities ranged from 270 to 3000 cm{sup 2}/(V s).« less

Skeletal muscle pathology in endurance athletes with acquired training intolerance

PubMed Central

Grobler, L; Collins, M; Lambert, M; Sinclair-Smith, C; Derman, W; St, C; Noakes, T

2004-01-01

Background: It is well established that prolonged, exhaustive endurance exercise is capable of inducing skeletal muscle damage and temporary impairment of muscle function. Although skeletal muscle has a remarkable capacity for repair and adaptation, this may be limited, ultimately resulting in an accumulation of chronic skeletal muscle pathology. Case studies have alluded to an association between long term, high volume endurance training and racing, acquired training intolerance, and chronic skeletal muscle pathology. Objective: To systematically compare the skeletal muscle structural and ultrastructural status of endurance athletes with acquired training intolerance (ATI group) with asymptomatic endurance athletes matched for age and years of endurance training (CON group). Methods: Histological and electron microscopic analyses were carried out on a biopsy sample of the vastus lateralis from 18 ATI and 17 CON endurance athletes. The presence of structural and ultrastructural disruptions was compared between the two groups of athletes. Results: Significantly more athletes in the ATI group than in the CON group presented with fibre size variation (15 v 6; p = 0.006), internal nuclei (9 v 2; p = 0.03), and z disc streaming (6 v 0; p = 0.02). Conclusions: There is an association between increased skeletal muscle disruptions and acquired training intolerance in endurance athletes. Further studies are required to determine the nature of this association and the possible mechanisms involved. PMID:15562162

Adipocyte cannabinoid receptor CB1 regulates energy homeostasis and alternatively activated macrophages

PubMed Central

Mancini, Giacomo; Rey, Alejandro Aparisi; Cardinal, Pierre; Tedesco, Laura; Zingaretti, Cristina Maria; Sassmann, Antonia; Quarta, Carmelo; Schwitter, Claudia; Conrad, Andrea; Wettschureck, Nina; Vemuri, V. Kiran; Makriyannis, Alexandros; Hartwig, Jens; Mendez-Lago, Maria; Monory, Krisztina; Giordano, Antonio; Cinti, Saverio; Marsicano, Giovanni; Offermanns, Stefan; Pagotto, Uberto; Cota, Daniela

2017-01-01

Dysregulated adipocyte physiology leads to imbalanced energy storage, obesity, and associated diseases, imposing a costly burden on current health care. Cannabinoid receptor type-1 (CB1) plays a crucial role in controlling energy metabolism through central and peripheral mechanisms. In this work, adipocyte-specific inducible deletion of the CB1 gene (Ati-CB1–KO) was sufficient to protect adult mice from diet-induced obesity and associated metabolic alterations and to reverse the phenotype in already obese mice. Compared with controls, Ati-CB1–KO mice showed decreased body weight, reduced total adiposity, improved insulin sensitivity, enhanced energy expenditure, and fat depot–specific cellular remodeling toward lowered energy storage capacity and browning of white adipocytes. These changes were associated with an increase in alternatively activated macrophages concomitant with enhanced sympathetic tone in adipose tissue. Remarkably, these alterations preceded the appearance of differences in body weight, highlighting the causal relation between the loss of CB1 and the triggering of metabolic reprogramming in adipose tissues. Finally, the lean phenotype of Ati-CB1–KO mice and the increase in alternatively activated macrophages in adipose tissue were also present at thermoneutral conditions. Our data provide compelling evidence for a crosstalk among adipocytes, immune cells, and the sympathetic nervous system (SNS), wherein CB1 plays a key regulatory role. PMID:29035280

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

Borkar, Tushar; Nag, Soumya; Ren, Yang

Coupled in situ alloying and nitridation of titanium–vanadium alloys, has been achieved by introducing reactive nitrogen gas during the spark plasma sintering (SPS) of blended titanium and vanadium elemental powders, leading to a new class of nitride reinforced titanium alloy composites. The resulting microstructure includes precipitates of the d-TiN phase with the NaCl structure, equiaxed (or globular) precipitates of a nitrogen enriched hcp a(Ti,N) phase with a c/a ratio more than what is expected for pure hcp Ti, and fine scale plate-shaped precipitates of hcp a-Ti, distributed within a bcc b matrix. During SPS processing, the d-TiN phase appears tomore » form at a temperature of 1400 C, while only hcp a(Ti,N) and a-Ti phases form at lower processing temperatures. Consequently, the highest microhardness is exhibited by the composite processed at 1400 C while those processed at 1300 C or below exhibit lower values. Processing at temperatures below 1300 C, resulted in an incomplete alloying of the blend of titanium and vanadium powders. These d-TiN precipitates act as heterogeneous nucleation sites for the a(Ti,N) precipitates that appear to engulf and exhibit an orientation relationship with the nitride phase at the center. Furthermore, fine scale a-Ti plates are precipitated within the nitride precipitates, presumably resulting from the retrograde solubility of nitrogen in titanium.« less

Traumatic colon injuries -- factors that influence surgical management.

PubMed

Jinescu, G; Lica, I; Beuran, M

2013-01-01

This study sought to evaluate current trends in surgical management of colon injuries in a level I urban trauma centre, in the light of our increasing confidence in primary repair. Our retrospective study evaluates the results of 116 patients with colon injuries operated at Bucharest Clinical Emergency Hospital, in the light of some of the most commonly cited factors which could influence the surgeon decision-making process towards primary repair or colostomy. Blunt injuries were more common than penetrating injuries (65% vs. 31%). Significant other injuries occurred in 85 (73%) patients. Primary repair was performed in 95 patients (82%). Fecal diversion was used in 21 patients(18%). Multiple factors influence the decision-making process: shock, fecal contamination, associated injuries and higher scores on the Abdominal Trauma Index (ATI) and Colon Injury Scale (CIS). Colon related intra-abdominal complications occurred in 7% of patients in whom the colon injury was closed primarily and in 14% of patients in whom a stoma was created, ATI having a predictive role in their occurrence. The overall mortality rate was 19%. Primary repair of colon injuries, either by primary suture or resection and anastomosis, is a safe method in the management of the majority of colonic injuries. Colostomy is preferred for patients with ATI ≥ 30 and CIS ≥ 4. Surgical judgment remains the final arbiter in decision making. Celsius.

Detection of right-to-left shunts: comparison between the International Consensus and Spencer Logarithmic Scale criteria.

PubMed

Lao, Annabelle Y; Sharma, Vijay K; Tsivgoulis, Georgios; Frey, James L; Malkoff, Marc D; Navarro, Jose C; Alexandrov, Andrei V

2008-10-01

International Consensus Criteria (ICC) consider right-to-left shunt (RLS) present when Transcranial Doppler (TCD) detects even one microbubble (microB). Spencer Logarithmic Scale (SLS) offers more grades of RLS with detection of >30 microB corresponding to a large shunt. We compared the yield of ICC and SLS in detection and quantification of a large RLS. We prospectively evaluated paradoxical embolism in consecutive patients with ischemic strokes or transient ischemic attack (TIA) using injections of 9 cc saline agitated with 1 cc of air. Results were classified according to ICC [negative (no microB), grade I (1-20 microB), grade II (>20 microB or "shower" appearance of microB), and grade III ("curtain" appearance of microB)] and SLS criteria [negative (no microB), grade I (1-10 microB), grade II (11-30 microB), grade III (31100 microB), grade IV (101300 microB), grade V (>300 microB)]. The RLS size was defined as large (>4 mm) using diameter measurement of the septal defects on transesophageal echocardiography (TEE). TCD comparison to TEE showed 24 true positive, 48 true negative, 4 false positive, and 2 false negative cases (sensitivity 92.3%, specificity 92.3%, positive predictive value (PPV) 85.7%, negative predictive value (NPV) 96%, and accuracy 92.3%) for any RLS presence. Both ICC and SLS were 100% sensitive for detection of large RLS. ICC and SLS criteria yielded a false positive rate of 24.4% and 7.7%, respectively when compared to TEE. Although both grading scales provide agreement as to any shunt presence, using the Spencer Scale grade III or higher can decrease by one-half the number of false positive TCD diagnoses to predict large RLS on TEE.

Low Energy Turnover of Physically Inactive Participants as a Determinant of Insufficient Mineral and Vitamin Intake in NHANES

PubMed Central

Heydenreich, Juliane; Melzer, Katarina; Flury, Céline

2017-01-01

Micronutrient requirements do not scale linearly with physical activity-related energy expenditure (AEE). Inactive persons may have insufficient micronutrient intake because of low energy intake (EI). We extracted data from NHANES 2003–2006 on 4015 adults (53 ± 18 years (mean ± SD), 29 ± 6 kg/m2, 48% women) with valid physical activity (accelerometry) and food intake (2 × 24 h-dietary recall) measures. Total energy expenditure (TEE) was estimated by summing the basal metabolic rate (BMR, Harris-Benedict), AEE, and 10% of TEE for the thermic effect of food, to calculate the physical activity levels (PAL = TEE/BMR). Energy intake (EI) was scaled to match TEE assuming energy balance. Adjusted food intake was then analyzed for energy and micronutrient content and compared to estimated average requirements. The NHANES population was physically insufficiently active. There were 2440 inactive (PAL < 1.4), 1469 lightly to moderately active (PAL1.4 < 1.7), 94 sufficiently active (PAL1.7 < 2.0), and 12 very active participants (PAL ≥ 2.0). The inactive vs. active had significantly lower intake for all micronutrients apart from vitamin A, B12, C, K, and copper (p < 0.05). The inactive participants had insufficient intake for 6/19 micronutrients, while the active participants had insufficient intake for 5/19 (p < 0.05) micronutrients. Multiple linear regression indicated a lower risk for insufficient micronutrient intake for participants with higher PAL and BMI (p < 0.001). Symmetrical up-scaling of PAL and EI to recommended physical activity levels reduced the frequency of micronutrient insufficiencies. It follows that prevalence of insufficient micronutrient intake from food in NHANES might be partly determined by low energy turnover from insufficient PAL. PMID:28708118

The Sedentary Time and Activity Reporting Questionnaire (STAR-Q): reliability and validity against doubly labeled water and 7-day activity diaries.

PubMed

Csizmadi, Ilona; Neilson, Heather K; Kopciuk, Karen A; Khandwala, Farah; Liu, Andrew; Friedenreich, Christine M; Yasui, Yutaka; Rabasa-Lhoret, Rémi; Bryant, Heather E; Lau, David C W; Robson, Paula J

2014-08-15

We determined measurement properties of the Sedentary Time and Activity Reporting Questionnaire (STAR-Q), which was designed to estimate past-month activity energy expenditure (AEE). STAR-Q validity and reliability were assessed in 102 adults in Alberta, Canada (2009-2011), who completed 14-day doubly labeled water (DLW) protocols, 7-day activity diaries on day 15, and the STAR-Q on day 14 and again at 3 and 6 months. Three-month reliability was substantial for total energy expenditure (TEE) and AEE (intraclass correlation coefficients of 0.84 and 0.73, respectively), while 6-month reliability was moderate. STAR-Q-derived TEE and AEE were moderately correlated with DLW estimates (Spearman's ρs of 0.53 and 0.40, respectively; P < 0.001), and on average, the STAR-Q overestimated TEE and AEE (median differences were 367 kcal/day and 293 kcal/day, respectively). Body mass index-, age-, sex-, and season-adjusted concordance correlation coefficients (CCCs) were 0.24 (95% confidence interval (CI): 0.07, 0.36) and 0.21 (95% CI: 0.11, 0.32) for STAR-Q-derived versus DLW-derived TEE and AEE, respectively. Agreement between the diaries and STAR-Q (metabolic equivalent-hours/day) was strongest for occupational sedentary time (adjusted CCC = 0.76, 95% CI: 0.64, 0.85) and overall strenuous activity (adjusted CCC = 0.64, 95% CI: 0.49, 0.76). The STAR-Q demonstrated substantial validity for estimating occupational sedentary time and strenuous activity and fair validity for ranking individuals by AEE. © The Author 2014. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

High resting metabolic rate among Amazonian forager-horticulturalists experiencing high pathogen burden

PubMed Central

Gurven, Michael D.; Trumble, Benjamin C.; Stieglitz, Jonathan; Yetish, Gandhi; Cummings, Daniel; Blackwell, Aaron D.; Beheim, Bret; Kaplan, Hillard S.; Pontzer, Herman

2016-01-01

Objectives Resting metabolic rate (RMR) reflects energetic costs of homeostasis and accounts for 60-75% of total energy expenditure (TEE). Lean mass and physical activity account for much RMR variability, but the impact of prolonged immune activation from infection on human RMR is unclear in naturalistic settings. We evaluate the effects of infection on mass-corrected RMR among Bolivian forager-horticulturalists, and assess whether RMR declines more slowly with age than in hygienic sedentary populations, as might be expected if older adults experience high pathogen burden. Materials and Methods RMR was measured by indirect calorimetry (Fitmate MED, Cosmed) in 1,300 adults aged 20-90 and TEE was measured using doubly labeled water (n= 40). Immune biomarkers, clinical diagnoses and anthropometrics were collected by the Tsimane Health and Life History Project. Results Tsimane have higher RMR and TEE than people in sedentary industrialized populations. Tsimane RMR is 18-47% (women) and 22-40% (men) higher than expected using six standard prediction equations. Tsimane mass-corrected TEE is similarly elevated compared to Westerners. Elevated leukocytes and helminths are associated with excess RMR in multivariate regressions, and jointly result in a predicted excess RMR of 10-15%. After age 40, RMR declines by 69 kcal/decade (p<0.0001). Controlling for lean mass and height accounts for 71% of age-related RMR decline, and adding indicators of infection minimally affects the age slope. The residual level of age-related decline from age 40 is 1.2% per decade. Conclusion High pathogen burden may lead to higher metabolic costs, which may be offset by smaller body mass or other energy-sparing mechanisms. PMID:27375044

Periprocedural intracardiac echocardiography for left atrial appendage closure: a dual-center experience.

PubMed

Berti, Sergio; Paradossi, Umberto; Meucci, Francesco; Trianni, Giuseppe; Tzikas, Apostolos; Rezzaghi, Marco; Stolkova, Miroslava; Palmieri, Cataldo; Mori, Fabio; Santoro, Gennaro

2014-09-01

This dual-center study sought to demonstrate the utility and safety of intracardiac echocardiography (ICE) in providing adequate imaging guidance as an alternative to transesophageal echocardiography (TEE) during Amplatzer Cardiac Plug device implantation. Over 90% of intracardiac thrombi in atrial fibrillation originate from the left atrial appendage (LAA). Patients with contraindications to anticoagulation are potential candidates for LAA percutaneous occlusion. TEE is typically used to guide implantation. ICE-guided percutaneous LAA closure was performed in 121 patients to evaluate the following tasks typically achieved by TEE: assessment of the LAA dimension for device sizing; guidance of transseptal puncture; verification of the delivery sheath position; confirmation of location and stability of the device before and after release and continuous monitoring to detect procedural complications. In 51 consecutive patients, we compared the measurements obtained by ICE and fluoroscopy to choose the size of the device. The device was successfully implanted in 117 patients, yielding a technical success rate of 96.7%. Procedural success was achieved in 113 cases (93.4%). Four major adverse events (3 cardiac tamponades and 1 in-hospital transient ischemic attack) occurred. There was significant correlation in the measurements for device sizing assessed by angiography and ICE (r = 0.94, p < 0.0001). ICE imaging was able to perform the tasks typically provided by TEE during implantation of the Amplatzer Cardiac Plug device for LAA occlusion. Therefore, we provide evidence that the use of ICE offered accurate measurements of LAA dimension in order to select the correct device sizes. Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Reproducibility of a novel echocardiographic 3D automated software for the assessment of mitral valve anatomy.

PubMed

Aquila, Iolanda; González, Ariana; Fernández-Golfín, Covadonga; Rincón, Luis Miguel; Casas, Eduardo; García, Ana; Hinojar, Rocio; Jiménez-Nacher, José Julio; Zamorano, José Luis

2016-05-17

3D transesophageal echocardiography (TEE) is superior to 2D TEE in quantitative anatomic evaluation of the mitral valve (MV) but it shows limitations regarding automatic quantification. Here, we tested the inter-/intra-observer reproducibility of a novel full-automated software in the evaluation of MV anatomy compared to manual 3D assessment. Thirty-six out of 61 screened patients referred to our Cardiac Imaging Unit for TEE were retrospectively included. 3D TEE analysis was performed both manually and with the automated software by two independent operators. Mitral annular area, intercommissural distance, anterior leaflet length and posterior leaflet length were assessed. A significant correlation between both methods was found for all variables: intercommissural diameter (r = 0.84, p < 0.01), mitral annular area (r = 0.94, p > 0, 01), anterior leaflet length (r = 0.83, p < 0.01) and posterior leaflet length (r = 0.67, p < 0.01). Interobserver variability assessed by the intraclass correlation coefficient was superior for the automatic software: intercommisural distance 0.997 vs. 0.76; mitral annular area 0.957 vs. 0.858; anterior leaflet length 0.963 vs. 0.734 and posterior leaflet length 0.936 vs. 0.838. Intraobserver variability was good for both methods with a better level of agreement with the automatic software. The novel 3D automated software is reproducible in MV anatomy assessment. The incorporation of this new tool in clinical MV assessment may improve patient selection and outcomes for MV interventions as well as patient diagnosis and prognosis stratification. Yet, high-quality 3D images are indispensable.

Incidence, Characteristics, and Clinical Course of Device-Related Thrombus After Watchman Left Atrial Appendage Occlusion Device Implantation in Atrial Fibrillation Patients.

PubMed

Kubo, Shunsuke; Mizutani, Yukiko; Meemook, Krissada; Nakajima, Yoshifumi; Hussaini, Asma; Kar, Saibal

2017-12-11

This study investigated characteristics and clinical impact of device-related thrombus formation after Watchman device implantation in atrial fibrillation (AF) patients. Left atrial appendage occlusion using the Watchman device is an effective alternative to anticoagulation for stroke prevention in AF patients. However, device-related thrombus formation remains an important concern after Watchman implantation. From 2006 to 2014, 119 consecutive AF patients underwent Watchman implantation. Transesophageal echocardiographic (TEE) follow-up was scheduled at 45 days, at 6 months, and at 12 months after the procedure. The incidence, characteristics, and clinical course of device-related thrombus formation detected by TEE were assessed. Follow-up TEE identified thrombus formation on the Watchman device in 4 patients (3.4%). The prevalence of chronic AF was 100% in patients with thrombus, which was higher than that for patients without thrombus (40.0%). Deployed device size was numerically larger in patients with thrombus (29.3 ± 3.8 mm vs. 25.7 ± 3.2 mm, respectively). All patients with thrombus discontinued any of the anticoagulant/antiplatelet therapy which was required under the study protocol. After restarting or continuing warfarin and aspirin therapy, complete resolution of the thrombus was achieved in all patients at subsequent follow-up TEE. Warfarin therapy was discontinued within 6 months for all cases, and there was no thrombus recurrence. The mean follow-up duration was 1,456 ± 546 days, with no death, stroke, or systemic embolization events in patients with thrombus. AF burden, device size, and anticoagulant/antiplatelet regimens can be associated with device-related thrombus after Watchman device implantation. Short-term warfarin therapy was effective, and the clinical outcomes were favorable. Copyright © 2017 American College of Cardiology Foundation. All rights reserved.

Exercise Training and Energy Expenditure following Weight Loss.

PubMed

Hunter, Gary R; Fisher, Gordon; Neumeier, William H; Carter, Stephen J; Plaisance, Eric P

2015-09-01

This study aims to determine the effects of aerobic or resistance training on activity-related energy expenditure (AEE; kcal·d(-1)) and physical activity index (activity-related time equivalent (ARTE)) following weight loss. It was hypothesized that weight loss without exercise training would be accompanied by decreases in AEE, ARTE, and nontraining physical activity energy expenditure (nonexercise activity thermogenesis (NEAT)) and that exercise training would prevent decreases in free-living energy expenditure. One hundred forty premenopausal women had an average weight loss of 25 lb during a diet (800 kcal·d(-1)) of furnished food. One group aerobically trained 3 times per week (40 min·d(-1)), another group resistance-trained 3 times per week (10 exercises/2 sets × 10 repetitions), and the third group did not exercise. Dual-energy x-ray absorptiometry was used to measure body composition, indirect calorimetry was used to measure resting energy expenditure (REE) and walking energy expenditure, and doubly labeled water was used to measure total energy expenditure (TEE). AEE, ARTE, and nontraining physical activity energy expenditure (NEAT) were calculated. TEE, REE, and NEAT all decreased following weight loss for the no-exercise group, but not for aerobic and resistance trainers. Only REE decreased in the two exercise groups. Resistance trainers increased ARTE. HR and oxygen uptake while walking on the flat and up a grade were consistently related to TEE, AEE, NEAT, and ARTE. Exercise training prevents a decrease in energy expenditure, including free-living energy expenditure separate from exercise training, following weight loss. Resistance training increases physical activity, whereas economy/ease of walking is associated with increased TEE, AEE, NEAT, and ARTE.

A low-dose, dual-phase cardiovascular CT protocol to assess left atrial appendage anatomy and exclude thrombus prior to left atrial intervention.

PubMed

Lazoura, Olga; Ismail, Tevfik F; Pavitt, Christopher; Lindsay, Alistair; Sriharan, Mona; Rubens, Michael; Padley, Simon; Duncan, Alison; Wong, Tom; Nicol, Edward

2016-02-01

Assessment of the left atrial appendage (LAA) for thrombus and anatomy is important prior to atrial fibrillation (AF) ablation and LAA exclusion. The use of cardiovascular CT (CCT) to detect LAA thrombus has been limited by the high incidence of pseudothrombus on single-pass studies. We evaluated the diagnostic accuracy of a two-phase protocol incorporating a limited low-dose delayed contrast-enhanced examination of the LAA, compared with a single-pass study for LAA morphological assessment, and transesophageal echocardiography (TEE) for the exclusion of thrombus. Consecutive patients (n = 122) undergoing left atrial interventions for AF were assessed. All had a two-phase CCT protocol (first-past scan plus a limited, 60-s delayed scan of the LAA) and TEE. Sensitivity, specificity, diagnostic accuracy, positive (PPV) and negative predictive values (NPV) were calculated for the detection of true thrombus on first-pass and delayed scans, using TEE as the gold standard. Overall, 20/122 (16.4 %) patients had filling defects on the first-pass study. All affected the full delineation of the LAA morphology; 17/20 (85 %) were confirmed as pseudo-filling defects. Three (15 %) were seen on late-pass and confirmed as true thrombi on TEE; a significant improvement in diagnostic performance relative to a single-pass scan (McNemar Chi-square 17, p < 0.001). The sensitivity, specificity, diagnostic accuracy, PPV and NPV was 100, 85.7, 86.1, 15.0 and 100 % respectively for first-pass scans, and 100 % for all parameters for the delayed scans. The median (range) additional radiation dose for the delayed scan was 0.4 (0.2-0.6) mSv. A low-dose delayed scan significantly improves the identification of true LAA anatomy and thrombus in patients undergoing LA intervention.

Subject-specific finite-element modeling of normal aortic valve biomechanics from 3D+t TEE images.

PubMed

Labrosse, Michel R; Beller, Carsten J; Boodhwani, Munir; Hudson, Christopher; Sohmer, Benjamin

2015-02-01

In the past decades, developments in transesophageal echocardiography (TEE) have opened new horizons in reconstructive surgery of the aortic valve (AV), whereby corrections are made to normalize the geometry and function of the valve, and effectively treat leaks. To the best of our knowledge, we propose the first integrated framework to process subject-specific 3D+t TEE AV data, determine age-matched material properties for the aortic and leaflet tissues, build a finite element model of the unpressurized AV, and simulate the AV function throughout a cardiac cycle. For geometric reconstruction purposes, dedicated software was created to acquire the 3-D coordinates of 21 anatomical landmarks of the AV apparatus in a systematic fashion. Measurements from ten 3D+t TEE datasets of normal AVs were assessed for inter- and intra-observer variability. These tests demonstrated mean measurement errors well within the acceptable range. Simulation of a complete cardiac cycle was successful for all ten valves and validated the novel schemes introduced to evaluate age-matched material properties and iteratively scale the unpressurized dimensions of the valves such that, given the determined material properties, the dimensions measured in vivo closely matched those simulated in late diastole. The leaflet coaptation area, describing the quality of the sealing of the valve, was measured directly from the medical images and was also obtained from the simulations; both approaches correlated well. The mechanical stress values obtained from the simulations may be interpreted in a comparative sense whereby higher values are indicative of higher risk of tearing and/or development of calcification. Copyright © 2014 Elsevier B.V. All rights reserved.

Misreporting of energy intake in the elderly using doubly labeled water to measure total energy expenditure and weight change.

PubMed

Shahar, Danit R; Yu, Binbing; Houston, Denise K; Kritchevsky, Stephen B; Newman, Anne B; Sellmeyer, Deborah E; Tylavsky, Frances A; Lee, Jung Sun; Harris, Tamara B

2010-02-01

One of the major problems in dietary assessment is inaccuracy in reporting diet. To examine the association between self-reported energy intake (EI) by food frequency questionnaire (FFQ) and energy expenditure (EE), measured by doubly labeled water (DLW), among older persons. EE was assessed in 298 high-functioning, community-dwelling older adults (70-79 years of age) over a 2-week period using DLW. Dietary intake was assessed using a Block FFQ. The ratio between reported EI and total energy expenditure (TEE) was calculated. Misreporting was defined as follows: participants with an EI/TEE ratio of <0.77 were categorized as low energy reporters, while participants with an EI/TEE ratio >1.28 were categorized as high energy reporters. Participants with an EI/TEE ratio of 0.77-1.28 were categorized as "true" energy reporters. One-year percent weight change prior to EE visit was used as another validation indicator. Participants who were low energy reporters but lost >2% of their body weight were categorized as undereaters. Two hundred ninety-six participants provided both FFQ and DLW measurements. Forty-three percent of participants were low energy reporters; among them, almost 30% lost weight and, therefore, were categorized as undereaters. The undereaters consumed significantly fewer calories. No difference in the frequency of low energy reporting was detected between genders or racial groups. Underreporters had significantly higher body weight than "true" or high reporters. Undereaters tended to have higher body mass index than the underreporters. Undereating is prevalent in the elderly and may be falsely perceived as underreporting. It should be further addressed and characterized in future studies.

Sequential and direct ionic excitation in the strong-field ionization of 1-butene molecules.

PubMed

Schell, Felix; Boguslavskiy, Andrey E; Schulz, Claus Peter; Patchkovskii, Serguei; Vrakking, Marc J J; Stolow, Albert; Mikosch, Jochen

2018-05-18

We study the Strong-Field Ionization (SFI) of the hydrocarbon 1-butene as a function of wavelength using photoion-photoelectron covariance and coincidence spectroscopy. We observe a striking transition in the fragment-associated photoelectron spectra: from a single Above Threshold Ionization (ATI) progression for photon energies less than the cation D0-D1 gap to two ATI progressions for a photon energy greater than this gap. For the first case, electronically excited cations are created by SFI populating the ground cationic state D0, followed by sequential post-ionization excitation. For the second case, direct sub-cycle SFI to the D1 excited cation state contributes significantly. Our experiments access ionization dynamics in a regime where strong-field and resonance-enhanced processes can interplay.

Beyond the static image: Tee Corinne's roles as a pioneering lesbian artist and art historian.

PubMed

Snider, Stefanie

2013-01-01

While Tee Corinne has been widely recognized as a preeminent lesbian and feminist artist of the last forty years, little has been written about her as an artist or art historian in any substantial way. This article attempts to shed light on Corinne's investment in creating explicitly sexual lesbian visual art and art historical writings that put pressure on the categories of artist and art historian between the 1970s and early 2000s. Corinne's work manages to fulfill feminist ideals while also working outside of the norms set up in both the lesbian and mainstream realms of art and art history.

A Protocol for Diagnosis and Management of Aortic Atherosclerosis in Cardiac Surgery Patients

PubMed Central

Brandon Bravo Bruinsma, George J.; Van 't Hof, Arnoud W. J.; Grandjean, Jan G.; Nierich, Arno P.

2017-01-01

In patients undergoing cardiac surgery, use of perioperative screening for aortic atherosclerosis with modified TEE (A-View method) was associated with lower postoperative mortality, but not stroke, as compared to patients operated on without such screening. At the time of clinical implementation and validation, we did not yet standardize the indications for modified TEE and the changes in patient management in the presence of aortic atherosclerosis. Therefore, we designed a protocol, which combined the diagnosis of atherosclerosis of thoracic aorta and the subsequent considerations with respect to the intraoperative management and provides a systematic approach to reduce the risk of cerebral complications. PMID:28852575

Diagnostic significance of three-dimensional echocardiography in asymptomatic unicuspid aortic valve.

PubMed

Mladenovic, Zorica; Vranes, Danijela; Obradovic, Slobodan; Dzudovic, Boris; Angelkov Ristic, Andjelka; Ratkovic, Nenad; Jovic, Zoran; Spasic, Marijan; Maric Kocijancic, Jelena; Djruic, Predrag

2018-06-04

Unicuspid aortic valve (UAV) is a rare congenital anomaly of aorta associated with a faster progress of valvular dysfunction, aortic dilatation and with necessity for more frequent controls and precise evaluation Asymptomatic 35 year old man had abnormal systolic diastolic murmur on aortic valve during routine examination. Initial diagnostic with transthoracic echocardiography (TTE) supposed bicuspid aortic valve, while three-dimensional transesophageal echocardiography (3D TEE) and multidetector computed tomography defined unicuspid, unicomissural aortic valve with moderate aortic stenosis and regurgitation. This case report confirmed that 3D TEE gives us opportunity for early, improved and precise diagnosis of UAV. © 2018 Wiley Periodicals, Inc.

The Rényi entanglement entropy of a general quantum dimer model at the RK point: a highly efficient algorithm.

PubMed

Pei, Jiquan; Han, Steve; Liao, Haijun; Li, Tao

2014-01-22

A highly efficient and simple-to-implement Monte Carlo algorithm is proposed for the evaluation of the Rényi entanglement entropy (REE) of the quantum dimer model (QDM) at the Rokhsar-Kivelson (RK) point. It makes possible the evaluation of REE at the RK point to the thermodynamic limit for a general QDM. We apply the algorithm to a QDM defined on the triangular and the square lattice in two dimensions and the simple and the face centered cubic (fcc) lattice in three dimensions. We find the REE on all these lattices follows perfect linear scaling in the thermodynamic limit, apart from an even-odd oscillation in the case of the square lattice. We also evaluate the topological entanglement entropy (TEE) with both a subtraction and an extrapolation procedure. We find the QDMs on both the triangular and the fcc lattice exhibit robust Z2 topological order. The expected TEE of ln2 is clearly demonstrated in both cases. Our large scale simulation also proves the recently proposed extrapolation procedure in cylindrical geometry to be a highly reliable way to extract the TEE of a topologically ordered system.

Front-end receiver electronics for a matrix transducer for 3-D transesophageal echocardiography.

PubMed

Yu, Zili; Blaak, Sandra; Chang, Zu-yao; Yao, Jiajian; Bosch, Johan G; Prins, Christian; Lancée, Charles T; de Jong, Nico; Pertijs, Michiel A P; Meijer, Gerard C M

2012-07-01

There is a clear clinical need for creating 3-D images of the heart. One promising technique is the use of transesophageal echocardiography (TEE). To enable 3-D TEE, we are developing a miniature ultrasound probe containing a matrix piezoelectric transducer with more than 2000 elements. Because a gastroscopic tube cannot accommodate the cables needed to connect all transducer elements directly to an imaging system, a major challenge is to locally reduce the number of channels, while maintaining a sufficient signal-to-noise ratio. This can be achieved by using front-end receiver electronics bonded to the transducers to provide appropriate signal conditioning in the tip of the probe. This paper presents the design of such electronics, realizing time-gain compensation (TGC) and micro-beamforming using simple, low-power circuits. Prototypes of TGC amplifiers and micro-beamforming cells have been fabricated in 0.35-μm CMOS technology. These prototype chips have been combined on a printed circuit board (PCB) to form an ultrasound-receiver system capable of reading and combining the signals of three transducer elements. Experimental results show that this design is a suitable candidate for 3-D TEE.

Fetal transesophageal echocardiography: clinical introduction as a monitoring tool during cardiac intervention in a human fetus.

PubMed

Kohl, T; Müller, A; Tchatcheva, K; Achenbach, S; Gembruch, U

2005-12-01

Because of insufficient imaging by maternal transabdominal fetal echocardiography (TAE) in a human fetus with aortic atresia, imperforate atrial septum and progressive cardiac failure, we assessed the feasibility of fetal transesophageal echocardiography (TEE) as a monitoring tool during fetal cardiac intervention at 24 + 6 weeks of gestation. Percutaneous fetoscopic intraesophageal deployment of the ultrasound catheter was achieved and did not result in any maternal or fetal complications. Fetal TEE permitted substantially clearer definition of fetal cardiac anatomy and intracardiac device manipulations than conventional maternal TAE. Despite the employment of various devices, no sufficiently large opening could be achieved within the atrial septum. Although the fetus tolerated the procedure remarkably well and satisfactory fetoplacental flow could be documented at the end of the procedure, the fetus died from progressive cardiac failure 3 days after the intervention. Fetoscopic TEE is feasible in the human fetus and permits substantially clearer definition of fetal cardiac anatomy and intracardiac manipulations than conventional maternal TAE. Based on the observation of spontaneous closure of multiple iatrogenic perforations of the atrial septum, specialized devices are required in order to improve the technical success rate of septoplasty methods and hence the survival odds of these high-risk patients.

Evaluation of coated columbium alloy heat shields for space shuttle thermal protection system application. Volume 2, phase 2: Subsize heat shield and small size TPS evaluation

NASA Technical Reports Server (NTRS)

Black, W. E.

1973-01-01

Initially a trade study was conducted of seven heat shield configurations. These were evaluated for structural reliability, fabricability, weight, inspectability, and refurbishability. Two concepts, a tee-stiffened and an open corrugation, were selected as offering the most potential for system success. Fourteen subsize heat shields of a full scale section were fabricated from C-129Y and Cb-752 and silicide coated with R-512E. These subsize panels were subjected to a simulated flight profile representing temperature, local surface pressures, and applied pressure differential loads. All corrugated panels of both alloys sustained 100 cycles without structural or coating failure. All Cb-752/R-512E panels performed well with one panel being successfully repaired after 66 cycles and completing 100 cycles. As a result of this evaluating the Cb-752/R-512E system was selected for hardware application during the subsequent phases. In addition, the tee-stiffened configuration was selected for further development and application in Phase III. This selection was based on an overall assessment of relative weight, cost, and structural performance of the tee-stiffened and open corrugation TPS.

Minnesota leisure time activity questionnaire and doubly labeled water in adolescents.

PubMed

Slinde, Frode; Arvidsson, Daniel; Sjöberg, Agneta; Rossander-Hulthén, Lena

2003-11-01

To validate the energy expenditure estimated from The Minnesota Leisure Time Physical Activity Questionnaire (MLTPAQ) with total energy expenditure (TEE) measured by doubly labeled water (DLW), and to present and examine the validity of an extended version of the MLTPAQ with additional questions about inactivity during leisure time (eMLTPAQ), in a sample of Swedish 15-yr-old adolescents. Thirty-five 15-yr-old adolescents were interviewed using the eMLTPAQ. In addition to anthropometry, indirect calorimetry was measured to assess basal metabolic rate, and TEE was assessed by the DLW method over a 14-d period. Energy expenditure calculated from MLTPAQ correlated well with TEEDLW (r=0.49, P<0.01), and the correlation increased when including questions about inactivity (r=0.73, P<0.01). However, eMLTPAQ underestimated TEE in 34 of the 35 students, with a mean difference between the methods of 2.8 MJ.d(-1) (95% limits of agreement: -0.1 to 5.6 MJ.d(-1)), which mainly was explained by a relative high intensity in the time which remained unreported. eMLTPAQ is valid in ranking adolescents energy expenditure and in describing patterns of leisure time physical activities.

Tension pneumomediastnum: A rare cause of acute intraoperative circulatory collapse in the setting of unremarkable TEE findings.

PubMed

Weaver, Jonathan B; Kumar, Avinash B

2017-02-01

Case report. Operating room. 25YF, ASA IV E who underwent an emergent decompressive craniectomy for refractory intracranial hypertension secondary to acute intracranial hemorhage. A 25Y caucasian female presented with acute intracranial hemorrhage with intraventricular extension secondary to Moya Moya disease. Post admisison, she underwent an emergent decompressive craniectomy for medically refractory intracranial hypertension. Introperatively (post dural closure and bone flap removal) the patient developed acutely worsening peak and plateau pressures followed by pulseless electrical activity necessitating CPR with epinephrine and Vasopressin before return of circulation before return of circulation. Intraoperative TEE done during return of circulation, was essentially non diagnostic, the patient had normal breath sounds throughout, and non-contributory bronchoscopy findings. EKG, arterial blood pressure, heart rate, resp. rate, introperative tranesophageal echocardiogram (TEE), Pulse oximetry, serial arterial blood gases, introperative bronchoscopy, ventilatory peak pressures. A post operative chest CT revealed extensive pneumomediastinum with subcutaneous emphysema. The focussed introperative echocardiogram showed preserved left ventricular function and no evidence of tamponade physiology. Tension pneumomediastinum was the likely etiologic factor for the acute hemodynamic collapse and should be considered in the differential diagnosis of intraoperative circulatory arrest. Copyright © 2016 Elsevier Inc. All rights reserved.

Measurements of Daily Energy Intake and Total Energy Expenditure in People with Dementia in Care Homes: The Use of Wearable Technology.

PubMed

Murphy, J; Holmes, J; Brooks, C

2017-01-01

To estimate daily total energy expenditure (TEE) using a physical activity monitor, combined with dietary assessment of energy intake to assess the relationship between daily energy expenditure and patterns of activity with energy intake in people with dementia living in care homes. A cross-sectional study in care homes in the UK. Twenty residents with confirmed dementia diagnosis were recruited from two care homes that specialised in dementia care. A physical activity monitor (SensewearTM Armband, Body Media, Pittsburgh, PA) was employed to objectively determine total energy expenditure, sleep duration and physical activity. The armband was placed around the left upper triceps for up to 7 days. Energy intake was determined by weighing all food and drink items over 4 days (3 weekdays and 1 weekend day) including measurements of food wastage. The mean age was 78.7 (SD ± 11.8) years, Body Mass Index (BMI) 23.0 (SD ± 4.2) kg/m2; 50% were women. Energy intake (mean 7.4; SD ± 2.6) MJ/d) was correlated with TEE (mean 7.6; SD ± 1.8 MJ/d; r=0.49, p<0.05). Duration of sleeping ranged from 0.4-12.5 (mean 6.1) hrs/d and time spent lying down was 1.3-16.0 (8.3) hrs/d. On average residents spent 17.9 (6.3-23.4) hrs/d undertaking sedentary activity. TEE was correlated with BMI (r=0.52, p<0.05) and body weight (r=0.81, p<0.001) but inversely related to sleep duration (r=-0.59, p<0.01) and time lying down (r=-0.62, p<0.01). Multiple linear regression analysis revealed that after taking BMI, sleep duration and time spent lying down into account, TEE was no longer correlated with energy intake. The results show the extent to which body mass, variable activity and sleep patterns may be contributing to TEE and together with reduced energy intake, energy requirements were not satisfied. Thus wearable technology has the potential to offer real-time monitoring to provide appropriate nutrition management that is more person-centred to prevent weight loss in dementia.

Use of real time three-dimensional transesophageal echocardiography in intracardiac catheter based interventions.

PubMed

Perk, Gila; Lang, Roberto M; Garcia-Fernandez, Miguel Angel; Lodato, Joe; Sugeng, Lissa; Lopez, John; Knight, Brad P; Messika-Zeitoun, David; Shah, Sanjiv; Slater, James; Brochet, Eric; Varkey, Mathew; Hijazi, Ziyad; Marino, Nino; Ruiz, Carlos; Kronzon, Itzhak

2009-08-01

Real-time three-dimensional (RT3D) echocardiography is a recently developed technique that is being increasingly used in echocardiography laboratories. Over the past several years, improvements in transducer technologies have allowed development of a full matrix-array transducer that allows acquisition of pyramidal-shaped data sets. These data sets can be processed online and offline to allow accurate evaluation of cardiac structures, volumes, and mass. More recently, a transesophageal transducer with RT3D capabilities has been developed. This allows acquisition of high-quality RT3D images on transesophageal echocardiography (TEE). Percutaneous catheter-based procedures have gained growing acceptance in the cardiac procedural armamentarium. Advances in technology and technical skills allow increasingly complex procedures to be performed using a catheter-based approach, thus obviating the need for open-heart surgery. The authors used RT3D TEE to guide 72 catheter-based cardiac interventions. The procedures included the occlusion of atrial septal defects or patent foramen ovales (n=25), percutaneous mitral valve repair (e-valve clipping; n=3), mitral balloon valvuloplasty for mitral stenosis (n=10), left atrial appendage obliteration (n=11), left atrial or pulmonary vein ablation for atrial fibrillation (n=5), percutaneous closures of prosthetic valve dehiscence (n=10), percutaneous aortic valve replacement (n=6), and percutaneous closures of ventricular septal defects (n=2). In this review, the authors describe their experience with this technique, the added value over multiplanar two-dimensional TEE, and the pitfalls that were encountered. The main advantages found for the use RT3D TEE during catheter-based interventions were (1) the ability to visualize the entire lengths of intracardiac catheters, including the tips of all catheters and the balloons or devices they carry, along with a clear depiction of their positions in relation to other cardiac structures, and (2) the ability to ability to demonstrate certain structures in an "en face" view, which is not offered by any other currently available real-time imaging technique, enabling appreciation of the exact nature of the lesion that is undergoing intervention. RT3D TEE is a powerful new imaging tool that may become the technique of choice and the standard of care for guidance of selected percutaneous catheter-based procedures.

Depth-resolved registration of transesophageal echo to x-ray fluoroscopy using an inverse geometry fluoroscopy system

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

Hatt, Charles R.; Tomkowiak, Michael T.; Dunkerley, David A. P.

2015-12-15

Purpose: Image registration between standard x-ray fluoroscopy and transesophageal echocardiography (TEE) has recently been proposed. Scanning-beam digital x-ray (SBDX) is an inverse geometry fluoroscopy system designed for cardiac procedures. This study presents a method for 3D registration of SBDX and TEE images based on the tomosynthesis and 3D tracking capabilities of SBDX. Methods: The registration algorithm utilizes the stack of tomosynthetic planes produced by the SBDX system to estimate the physical 3D coordinates of salient key-points on the TEE probe. The key-points are used to arrive at an initial estimate of the probe pose, which is then refined using amore » 2D/3D registration method adapted for inverse geometry fluoroscopy. A phantom study was conducted to evaluate probe pose estimation accuracy relative to the ground truth, as defined by a set of coregistered fiducial markers. This experiment was conducted with varying probe poses and levels of signal difference-to-noise ratio (SDNR). Additional phantom and in vivo studies were performed to evaluate the correspondence of catheter tip positions in TEE and x-ray images following registration of the two modalities. Results: Target registration error (TRE) was used to characterize both pose estimation and registration accuracy. In the study of pose estimation accuracy, successful pose estimates (3D TRE < 5.0 mm) were obtained in 97% of cases when the SDNR was 5.9 or higher in seven out of eight poses. Under these conditions, 3D TRE was 2.32 ± 1.88 mm, and 2D (projection) TRE was 1.61 ± 1.36 mm. Probe localization error along the source-detector axis was 0.87 ± 1.31 mm. For the in vivo experiments, mean 3D TRE ranged from 2.6 to 4.6 mm and mean 2D TRE ranged from 1.1 to 1.6 mm. Anatomy extracted from the echo images appeared well aligned when projected onto the SBDX images. Conclusions: Full 6 DOF image registration between SBDX and TEE is feasible and accurate to within 5 mm. Future studies will focus on real-time implementation and application-specific analysis.« less

Travel Virginia

DOT National Transportation Integrated Search

2000-01-01

Prepared ca. 2000. This report summarizes the results of a fifteen-month study to assess the feasibility of expanding Travel Shenandoah, a pilot rural ATIS service developed for Virginia's Northern Shenandoah Valley, into a comprehensive, statewide s...

Advanced Transportation Institute 2008.

DOT National Transportation Integrated Search

2009-02-01

The seventh version of the Advanced Transportation Institute (ATI-08) was conducted in 2008 to encourage high school students to pursue careers in the field of transportation engineering. The University Transportation Center for Alabama partnered wit...

Advanced Transportation Institute 2009.

DOT National Transportation Integrated Search

2009-09-01

The eighth version of the Advanced Transportation Institute (ATI-09) was conducted in 2009 to encourage high school students to pursue careers in the field of transportation engineering. The University Transportation Center for Alabama partnered with...

511 Virginia evaluation

DOT National Transportation Integrated Search

2004-01-01

This document presents the results of the evaluation of the 511 Virginia Advanced Traveler Information System (ATIS), a system that operates on the I-81 corridor in Virginia. The evaluation focused on the Virginia Department of Transportation's (VDOT...

Intelligent transportation systems and intermodal freight transportation

DOT National Transportation Integrated Search

1998-09-01

Advanced Traveler Information Systems (ATIS) Cross-Cutting report summarizes and interprets the results exclusively of several Field Operational Tests (FOTs) that have traveler information components. The FOTs considered in this report include: Atlan...

GIS Based Application of Advanced Traveler Information System in India

NASA Astrophysics Data System (ADS)

Kumar, P.; Singh, V.

2012-02-01

Developed countries like USA, Canada, Japan, UK, Australia and Germany have adopted advanced traveler information technologies expeditiously in comparison to developing countries. But, unlike developed countries, developing countries face considerable financial and framework constraints. Moreover local traffic, roadway, signalization, demographic, topological and social conditions in developing countries are quite different from those in developed countries. In this paper, a comprehensive framework comprising of system architecture, development methodology and salient features of a developed Advanced Traveler Information System (ATIS) for metropolitan cities in developing countries has been discussed. Development of proposed system is based on integration of two well known information technologies viz. Geographic Information Systems (GIS) and World Wide Web (WWW). Combination of these technologies can be utilized to develop an integrated ATIS that targets different types of travelers like private vehicle owners, transit users and casual outside visitors.

Change in the quantity and acute toxicity of pesticides sold in South African crop sectors, 1994 –1999

PubMed Central

Africa, Algernon; London, Leslie

2009-01-01

BACKGROUND South African pesticide market sales data, for two years, 1994 and 1999, were audited to identify change in total and per hectare mass sold and acute toxicity indicator (ATI) (kg sold/rat oral LD50) in the grape, pome, stone fruit, potato and wheat sectors. RESULTS Total pesticide sales (62%), amount per hectare (42%) and number of active ingredients (23%) increased in 1999 compared to 1994 with the grape fruit sector, the most significant contributor over the two years. Total (14%) and per hectare ATI (19%) decreased in 1999, but not substantially with the potato sector the most significant contributor. CONCLUSIONS Toxic pesticides were still used in 1999 which highlights a need to develop alternative agricultural and non-chemical pest control methods that reduce usage of pesticides. PMID:19185919

River runoff estimates based on remotely sensed surface velocities

NASA Astrophysics Data System (ADS)

Grünler, Steffen; Stammer, Detlef; Romeiser, Roland

2010-05-01

One promising technique for river runoff estimates from space is the retrieval of surface currents on the basis of synthetic aperture radar along-track interferometry (ATI). The German satellite TerraSAR-X, which was launched in June 2007, will permit ATI measurements in an experimental mode. Based on numerical simulations, we present findings of a research project in which the potential of satellite measurements of various parameters with different temporal and spatial sampling characteristics is evaluated. A sampling strategy for river runoff estimates is developed. We address the achievable accuracy and limitations of such estimates for different local flow conditions at selected test site. High-resolution three-dimensional current fields in the Elbe river (Germany) from a numerical model are used as reference data set and input for simulations of a variety of possible measuring and data interpretation strategies to be evaluated. Addressing the problem of aliasing we removed tidal signals from the sampling data. Discharge estimates on the basis of measured surface current fields and river widths from TerraSAR-X are successfully simulated. The differences of the resulted net discharge estimate are between 30-55% for a required continuously observation period of one year. We discuss the applicability of the measuring strategies to a number of major rivers. Further we show results of runoff estimates by the retrieval of surface current fields by real TerraSAR-X ATI data (AS mode) for the Elbe river study area.

Data fusion for delivering advanced traveler information services

DOT National Transportation Integrated Search

2003-05-01

Many transportation professionals have suggested that improved ATIS data fusion techniques and processing will improve the overall quality, timeliness, and usefulness of traveler information. The purpose of this study was four fold. First, conduct a ...

Evaluation framework for 16 earmarked projects in Washington State

DOT National Transportation Integrated Search

2007-05-01

This report documents the results of applying a previously developed, standardized approach for evaluating advanced traveler information systems (ATIS) projects to a much more diverse group of 16 intelligent transportation systems (ITS) projects. The...

Traveling With Success, How Local Governments Use Intelligent Transportation Systems

DOT National Transportation Integrated Search

1995-01-01

ELECTRONIC TOLL COLLECTION AND TRAFFIC MANAGEMENT OR ETC/ETTM, ADVANCED TRAFFIC MANAGEMENT SYSTEMS OR ATMS, ADVANCED TRAVELER INFORMATION SYSTEMS OR ATIS, ELECTRONIC PAYMENTS SYSTEMS, TRAFFIC SIGNAL CONTROL/REAL-TIME ADAPTIVE CONTROL, TRANSIT MANAGEM...

Genesis field operational test : final evaluation report

DOT National Transportation Integrated Search

1997-09-01

This document is the Final Evaluation Report for the Genesis Advanced Traveler Information System (ATIS) Field Operational Test (FOT). Genesis was one of the early projects sponsored by the US Department of Transportation (USDOT) Intelligent Transpor...

Error assessment for emerging traffic data collection devices.

DOT National Transportation Integrated Search

2014-09-01

Providing accurate and reliable travel time information to roadway users is a critical part of Advanced Traffic Management Systems (ATMS) and : Advanced Travelers Information Systems (ATIS). Access to travel time information can significantly influen...

Providing Advanced and Real-Time Travel/Traffic Information to Tourists

DOT National Transportation Integrated Search

1998-10-01

Advanced traveler information systems (ATIS) analyze and communicate information that can enhance travel efficiency, alleviate congestion, and increase safety. In Texas, tourists (i.e., tripmakers unacquainted with the state) constitute an important ...

Pennsylvania Turnpike Commission's advanced traveler information system (ATIS) phase III project

DOT National Transportation Integrated Search

2006-02-14

In October 1998, the Pennsylvania Turnpike Commission (Commission) submitted a Partnership Agreement to the Federal Highway Administration (FHWA) for specific Intelligent Transportation Systems (ITS) activities, and to maximize the involvement of the...

[Fever, atrial fibrillation, and angina pectoris in a 58-year-old man].

PubMed

Groebner, M; Südhoff, T; Doering, M; Kirmayer, M; Nitsch, T; Prügl, L; Römer, W; Wolf, H; Tacke, J; Massoudy, P; Nüsse, T; Elsner, D

2014-05-01

Primary cardiac lymphoma (PCL) respresents a very rare type of cardiac tumour. This report illustrates a case of PCL in an immunocompetent 58-year-old man presenting with atrial fibrillation and febrile syndrome. Comprehensive imaging [computer tomography (CT), cardiac magnetic resonance imaging (cMRI), 3-dimensional transesophageal echocardiography (3D-TEE)] identified a large right atrial tumour, leading to pericardial effusion. Isolated cardiac involvement was confirmed by positron emission tomography (PET)-CT. A diffuse large B-cell lymphoma (DLBCL) was diagnosed based on the results of a TEE-guided biopsy. A normalized PET scan (PETAL study) indicated complete remission following R-CHOP 14 immunochemotherapy. Thus, an interdisciplinary and multimodal approach avoided unnecessary cardiac surgery.

Transesophageal echocardiographic evaluation of baboons during microgravity induced by parabolic flight

NASA Technical Reports Server (NTRS)

Vernalis, Marina N.; Latham, Ricky D.; Fanton, John W.; Geffney, F. Andrew

1993-01-01

Transthoracic echocardiography (TTE) is a feasible method to noninvasively examine cardiac anatomy during parabolic flight. However, transducer placement on the chest wall is very difficult to maintain during transition to microgravity. In addition, TTE requires the use of low frequency transponders which limit resolution. Transesophical echocardiography (TEE) is an established imaging technique which obtains echocardiographic information from the esophagus. It is a safe procedure and provides higher quality images of cardiac structure than obtained with TTE. This study is designed to determine whether TEE was feasible to perform during parabolic flight and to determine whether acute central volume responses occur in acute transition to zero gravity by direct visualization of the cardiac chambers.

Gerbode defect and multivalvular dysfunction: Complex complications in adult congenital heart disease.

PubMed

Ruivo, Catarina; Guardado, Joana; Montenegro Sá, Fernando; Saraiva, Fátima; Antunes, Alexandre; Correia, Joana; Morais, João

2017-07-01

We report a clinical case of a 40-year-old male with surgically corrected congenital heart disease (CHD) 10 years earlier: closure of ostium primum, mitral annuloplasty, and aortic valve and root surgery. The patient was admitted with acute heart failure. Transesophageal echocardiography (TEE) revealed a dysmorphic and severely incompetent aortic valve, a partial tear of the mitral valve cleft repair and annuloplasty ring dehiscence. A true left ventricular-to-right atrial shunt confirmed a direct Gerbode defect. The authors aim to discuss the diagnostic challenge of adult CHD, namely the key role of TEE on septal defects and valve regurgitations description. © 2017, Wiley Periodicals, Inc.

Retrieving current and wind vectors from ATI SAR data: airborne evidence and inversion strategy

NASA Astrophysics Data System (ADS)

Martin, Adrien; Gommenginger, Christine; Chapron, Bertrand; Marquez, José; Doody, Sam

2017-04-01

Conventional and along-track interferometric (ATI) Synthetic Aperture Radar (SAR) sense the motion of the ocean surface by measuring the Doppler shift of reflected signals. Together with the water displacement associated with ocean currents, the SAR measurements are also affected by a Wind-wave induced Artefact Surface Velocity (WASV) caused by the velocity of Bragg scatterers and the orbital velocity of ocean surface gravity waves. The WASV has been modelled theoretically in past studies but has been estimated empirically only once using Envisat ASAR. Here we propose, firstly, to evaluate this WASV from airborne ATI SAR data, secondly, to validate the airborne retrieved surface current after correction of the WASV against HF radar measurements and thirdly to examine the best inversion strategy for a an Ocean Surface Current (OSC) satellite mission to retrieve accurately both the ocean surface current vector (OSCV) and the wind vector in the frame of an OSC satellite mission. The airborne ATI SAR data were acquired in the tidally dominated Irish Sea using a Wavemill-type dual-beam SAR interferometer. A comprehensive collection of airborne Wavemill data acquired in a star pattern over a well-instrumented site made it possible to estimate the magnitude and dependence on azimuth and incidence angle of the WASV. The airborne results compare favourably with those reported for Envisat ASAR, empirical model, which has been used to correct for it. Validation of the current retrieval capabilities of the proof-of-concept has been conducted against HF radar giving a precisions typically better than 0.1 m/s for surface current speed and 7° for direction. Comparisons with POLCOMS (1.8 km) indicate that the model reproduces well the overall temporal evolution but does not capture the high spatial variability of ocean surface currents at the maximum ebb flow. Airborne retrieved currents highlight a short-scale spatial variability up to 100m related to bathymetry channels, which are not observed (HF radar, 4km resolution) or simulated (POLCOMS, 1.8km). The inversion strategy points to the need for accurate measurement of both the backscatter amplitude and the Doppler information (either as a Doppler centroid frequency anomaly for SAR DCA, or as an interferometric phase for ATI) as well as the need for dual polarization capability (VV+HH) for non-ambiguous inversion. Preliminary inversion results show that the retrieval accuracy for OSC velocity better than 10 cm/s can be achieved but that the OSC accuracy is strongly sensitive to the wind direction relative to the antennas orientation. This concept is a unique opportunity to improve our understanding of the air-sea interaction, the ocean submesoscale dynamic and its impact on the oceanic vertical transport. This concept is particularly well fitted for these ocean surface current and wind vectors observations in coastal and polar regions.

[Periprocedural and late complications after percutaneous closure of patent foramen ovale: a single centre experience].

PubMed

Węglarz, Przemysław; Konarska Kuszewska, Ewa; Spisak Borowska, Katarzyna; Machowski, Jerzy; Drzewiecka-Gerber, Agnieszka; Kuszewski, Piotr; Jackson, Christopher L; Opala, Grzegorz; Trusz Gluza, Maria

2012-01-01

Patent foramen ovale (PFO) is a potential risk factor for ischaemic stroke in young individuals. An interventional method of secondary stroke prevention in PFO patients is its percutaneous closure. To assess safety and effectiveness (i.e. lack of residual shunt) of percutaneous PFO closure in patients with history of cryptogenic cerebrovascular event. 149 patients (56 men/93 women), aged 39 ± 12 years, underwent percutaneous PFO closure. The implantation was performed under local anaesthesia, guided by trans-oesophageal echocardiography (TEE) and fluoroscopy. Follow-up trans-thoracic echocardiography (TTE) was performed at 1 month and follow-up TEE at 6-months. In cases of residual shunt, additional TEE was performed after ensuing 6 months. Effective PFO closure (no residual shunt) was achieved in 91.3% patients at 6 months and 95.3% patients at 12 months. In 2 patients transient atrial fibrillation was observed during the procedure. In 2 patients, a puncture site haematoma developed and in 1 patient superficial thrombophlebitis was noted. In 1 patient a small pericardial effusion was observed, which resolved at day 3 post-procedurally, after administration of non-steroidal anti-inflammatory drugs. Percutaneous PFO closure seems to be a safe procedure when performed in a centre with adequate expertise with regard to these procedures.

Rationale and design of the EPISTEME trial: efficacy of post-stroke intensive rosuvastatin treatment for aortogenic embolic stroke.

PubMed

Ueno, Yuji; Yamashiro, Kazuo; Tanaka, Yasutaka; Watanabe, Masao; Shimada, Yoshiaki; Kuroki, Takuma; Miyamoto, Nobukazu; Daimon, Masao; Tanaka, Ryota; Miyauchi, Katsumi; Daida, Hiroyuki; Hattori, Nobutaka; Urabe, Takao

2014-02-01

Large atheromatous aortic plaques (AAPs) are associated with stroke recurrence. Rosuvastatin is a potent lipid-lowering agent and suppresses carotid and coronary artery atherosclerosis. It is unclear whether rosuvastatin has anti-atherogenic effects against AAPs in stroke patients. We designed a clinical trial in stroke patients to analyze changes in AAPs after rosuvastatin treatment using repeated transesophageal echocardiography (TEE). This trial is a prospective randomized open label study. Inclusion criteria were patients were ischemic stroke with hypercholesterolemia and AAPs ≥ 4 mm in thickness. The patients are randomly assigned to either a group treated with 5 mg/day rosuvastatin or a control group. Primary endpoint is the changes in volume and composition of AAPs after 6 months using transesophageal echocardiography (TEE). Biochemical findings are analyzed. By using repeated TEE and binary image analysis, we will be able to compare the dynamic changes in plaque composition of AAPs before and after therapy in the two groups. The EPISTEME trial will provide information on the changes in plaque volume and composition achieved by improvement of lipid profiles with rosuvastatin therapy in stroke patients with aortic atherosclerosis. The results of the study may provide evidence for a therapeutic strategy for aortogenic brain embolism. This study is registered with UMIN-CTR (UMIN000010548).

Development of an accelerometer-based multivariate model to predict free-living energy expenditure in a large military cohort.

PubMed

Horner, Fleur; Bilzon, James L; Rayson, Mark; Blacker, Sam; Richmond, Victoria; Carter, James; Wright, Anthony; Nevill, Alan

2013-01-01

This study developed a multivariate model to predict free-living energy expenditure (EE) in independent military cohorts. Two hundred and eighty-eight individuals (20.6 ± 3.9 years, 67.9 ± 12.0 kg, 1.71 ± 0.10 m) from 10 cohorts wore accelerometers during observation periods of 7 or 10 days. Accelerometer counts (PAC) were recorded at 1-minute epochs. Total energy expenditure (TEE) and physical activity energy expenditure (PAEE) were derived using the doubly labelled water technique. Data were reduced to n = 155 based on wear-time. Associations between PAC and EE were assessed using allometric modelling. Models were derived using multiple log-linear regression analysis and gender differences assessed using analysis of covariance. In all models PAC, height and body mass were related to TEE (P < 0.01). For models predicting TEE (r (2) = 0.65, SE = 462 kcal · d(-1) (13.0%)), PAC explained 4% of the variance. For models predicting PAEE (r (2) = 0.41, SE = 490 kcal · d(-1) (32.0%)), PAC accounted for 6% of the variance. Accelerometry increases the accuracy of EE estimation in military populations. However, the unique nature of military life means accurate prediction of individual free-living EE is highly dependent on anthropometric measurements.

Energy expenditure in caving.

PubMed

Antoni, Giorgia; Marini, Elisabetta; Curreli, Nicoletta; Tuveri, Valerio; Comandini, Ornella; Cabras, Stefano; Gabba, Silvia; Madeddu, Clelia; Crisafulli, Antonio; Rinaldi, Andrea C

2017-01-01

The aim of this study was to determine the energy expenditure of a group of cavers of both genders and different ages and experience during a 10 hour subterranean exploration, using portable metabolimeters. The impact of caving activity on body composition and hydration were also assessed through bioelectrical impedance, and nutritional habits of cavers surveyed. During cave activity, measured total energy expenditure (TEE) was in the range 225-287 kcal/h for women-men (MET = 4.1), respectively; subjects had an energy intake from food in the range 1000-1200 kcal, thus inadequate to restore lost calories. Bayesian statistical analysis estimated the effect of predictive variables on TEE, revealing that experienced subjects had a 5% lower TEE than the less skilled ones and that women required a comparatively larger energy expenditure than men to perform the same task. BIVA (bioelectrical impedance vector analysis) showed that subjects were within the range of normal hydration before and after cave activity, but bioelectrical changes indicated a reduction of extracellular water in men, which might result in hypo-osmolal dehydration in the case of prolonged underground exercise. All these facts should be considered when planning cave explorations, preparing training programs for subjects practising caving, and optimizing a diet for cavers. Further, information gathered through this study could be of value to reduce accidents in caves related to increase in fatigue.

23-year experience on diagnosis and surgical treatment of benign and malignant cardiac tumors.

PubMed

Kośmider, Anna; Jaszewski, Ryszard; Marcinkiewicz, Anna; Bartczak, Karol; Knopik, Jerzy; Ostrowski, Stanisław

2013-10-31

Although myxoma is the most frequent cardiac tumor, other conditions should be taken into consideration in the differential diagnosis. Transthoracic echocardiography (TTE), followed by transesophageal echocardiography (TEE) remain the principal methods for cardiac tumor screening and visualizing. The aim of the study was to compare the diagnostics, surgical treatment and prognosis of malignant and benign cardiac tumors. From 1986 to 2009 there were 121 patients with cardiac tumors operated on in the Cardiac Surgery Clinic of the Medical University in Lodz. Patients were referred to surgery mainly on the basis of the TTE and TEE image. In 4 cases valvular prosthesis implantation or valve repair were carried out. Patients remained under long-term observation in the Cardiac Surgery Outpatient Clinic. Myxoma was diagnosed in 114 cases. Malignancies were discovered in 7 cases. The left atrium was the most frequent localization. The echocardiographic image differed significantly in benign and malignant tumors. The postoperative period was complicated by embolic events or myocardial infarctions. Only malignant tumors were associated with mortality due to cardiovascular events. The survival for malignant tumors was significantly shorter. Short and long-term results of operative treatment are very good for benign tumors in contrast to cardiac malignancies. The TTE and TEE image can be very significant in the final diagnosis.

Metabolic acceleration and the evolution of human brain size and life history.

PubMed

Pontzer, Herman; Brown, Mary H; Raichlen, David A; Dunsworth, Holly; Hare, Brian; Walker, Kara; Luke, Amy; Dugas, Lara R; Durazo-Arvizu, Ramon; Schoeller, Dale; Plange-Rhule, Jacob; Bovet, Pascal; Forrester, Terrence E; Lambert, Estelle V; Thompson, Melissa Emery; Shumaker, Robert W; Ross, Stephen R

2016-05-19

Humans are distinguished from the other living apes in having larger brains and an unusual life history that combines high reproductive output with slow childhood growth and exceptional longevity. This suite of derived traits suggests major changes in energy expenditure and allocation in the human lineage, but direct measures of human and ape metabolism are needed to compare evolved energy strategies among hominoids. Here we used doubly labelled water measurements of total energy expenditure (TEE; kcal day(-1)) in humans, chimpanzees, bonobos, gorillas and orangutans to test the hypothesis that the human lineage has experienced an acceleration in metabolic rate, providing energy for larger brains and faster reproduction without sacrificing maintenance and longevity. In multivariate regressions including body size and physical activity, human TEE exceeded that of chimpanzees and bonobos, gorillas and orangutans by approximately 400, 635 and 820 kcal day(-1), respectively, readily accommodating the cost of humans' greater brain size and reproductive output. Much of the increase in TEE is attributable to humans' greater basal metabolic rate (kcal day(-1)), indicating increased organ metabolic activity. Humans also had the greatest body fat percentage. An increased metabolic rate, along with changes in energy allocation, was crucial in the evolution of human brain size and life history.

Integrated corridor management initiative : demonstration phase evaluation, San Diego traveler response analysis test plan.

DOT National Transportation Integrated Search

1995-10-01

REAL-TIME TRAFFIC INFORMATION, ROUTE GUIDANCE, ROUTE PLANNING, INTELLIGENT VEHICLE INITIATIVE OR IVI ">">KEYWORDS: OPERATIONAL TESTS, TRAVTEK, ADVANCED TRAVELER INFORMATION SYSTEMS OR ATIS, ADVANCED TRAFFIC MANAGEMENT SYSTEMS OR ATMS, INTELLI...

Customer preferences for transit ATIS : research report

DOT National Transportation Integrated Search

2003-08-08

This research report presents findings from 12 workshops in 4 metropolitan areas with 284 transit customers conducted in November 2002 to address the following questions: (1) what kinds of transit information do customers want and expect the agencies...

EU-US standards harmonization task group report : on GeoNetworking.

DOT National Transportation Integrated Search

1996-03-01

TRAVTEK WAS AN OPERATIONAL FIELD TEST OF AN ADVANCED TRAVELER INFORMATION SYSTEMS (ATIS) AND ADVANCED TRAFFIC MANAGEMENT SYSTEMS (ATMS) TECHNOLOGIES. THIS PAPER SUMMARIZESS THE FINDINGS FROM THE SERIES OF STUDIES THAT CONSTITUTED THE TRAVTEK EVALUATI...

47 CFR 87.5 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... station providing communication between a control tower and aircraft. Automatic dependent surveillance... relevant information about the aircraft. Automatic terminal information service-broadcast (ATIS-B). The automatic provision of current, routine information to arriving and departing aircraft throughout a 24-hour...

47 CFR 87.5 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... station providing communication between a control tower and aircraft. Automatic dependent surveillance... relevant information about the aircraft. Automatic terminal information service-broadcast (ATIS-B). The automatic provision of current, routine information to arriving and departing aircraft throughout a 24-hour...

Distribution of efferent cholinergic terminals and alpha-bungarotoxin binding to putative nicotinic acetylcholine receptors in the human vestibular end-organs.

PubMed

Ishiyama, A; Lopez, I; Wackym, P A

1995-11-01

Although acetylcholine (ACh) has been identified as the primary neurotransmitter of the efferent vestibular system in most animals studied, no direct evidence exists that ACh is the efferent neurotransmitter of the human vestibular system. Choline acetyltransferase immunohistochemistry (ChATi), acetylcholinesterase (AChE) histochemistry, and alpha-bungarotoxin binding were used in human vestibular end-organs to address this question. ChATi and AChE activity was found in numerous bouton-type terminals contacting the basal area of type II vestibular hair cells and the afferent chalices surrounding type I hair cells; alpha-bungarotoxin binding suggested the presence of nicotinic acetylcholine receptors on type II vestibular hair cells and on the afferent chalices surrounding type I hair cells. This study provides evidence that the human efferent vestibular axons and terminals are cholinergic and that the receptors receiving this innervation may be nicotinic.

Pharmacogenetic diversification by alternative translation initiation: background channels to the fore.

PubMed

Abbott, G W

2014-02-15

Unanticipated complexity of drug-target interactions creates a headache for those attempting to rationalize and create simple models of antiarrhythmic action, but can also introduce opportunities for increased drug specificity, or for potentially advantageous spatial and temporal variation in drug effects. The newest findings reported by Kisselbach et al. in this issue are a case in point. Building upon previous pioneering work demonstrating that neuronal K 2P 2.1 potassium-selective "background" channels can become permeable to sodium ions depending upon alternative translation initiation (ATI) (Thomas et al., 2008), the Thomas lab now shows that ATI of K 2P 2.1 and K 2P 10.1, which are also expressed in the heart, can cause a fivefold shift in sensitivity to block by the β-receptor (and potassium channel) antagonist, carvedilol (Kisselbach et al., 2014). This article is protected by copyright. All rights reserved.

Assessing lesbian, gay, and bisexual affirmative training in couple and family therapy: establishing the validity of the Faculty Version of the Affirmative Training Inventory.

PubMed

McGeorge, Christi R; Carlson, Thomas S; Toomey, Russell B

2015-01-01

This study established the validity and factor structure of the Faculty Version of the Affirmative Training Inventory (ATI-F), which assesses faculty members' perceptions of the level of lesbian, gay, and bisexual (LGB) affirmative training that occurs in clinical programs. Additionally, this study examined the latent associations among the subscales of the ATI-F and three convergent validity items utilizing a sample of 117 faculty members from accredited family therapy programs. The findings provide empirical support for the relationship between including classroom content on LGB affirmative therapy and faculty members' beliefs about LGB individuals and relationships. Specifically, faculty members who report more positive beliefs about LGB clients appear to be more likely to include LGB affirmative therapy content in the courses they teach. © 2013 American Association for Marriage and Family Therapy.

Mindfulness and Rehabilitation: Teaching Yoga and Meditation to Young Men in an Alternative to Incarceration Program.

PubMed

Barrett, Carla J

2017-11-01

This study used participant/observation and open-ended interviews to understand how male participants (age 18-24 years) benefited from yoga and mindfulness training within an Alternative to Incarceration (ATI) program. Findings suggest that the male participants (age 18-24 years) benefited from the intervention through reductions in stress and improvements in emotion regulation. Several participants noted the importance of the development of an embodied practice for assisting them in managing anger and impulse control. The young men's narratives suggest that mindfulness-based interventions can contribute positively to rehabilitative outcomes within alternative to incarcerations settings, providing complementary benefit to existing ATI programs, especially for clients amenable to mindfulness training. With many jurisdictions expanding rehabilitation-focused interventions for young offenders, service providers should consider the potential positive contributions that mindfulness-based interventions can have for fostering desistance and reducing recidivism among justice system-involved populations.

For Homeless Veterans

MedlinePlus

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3D Assessment of Features Associated With Transvalvular Aortic Regurgitation After TAVR: A Real-Time 3D TEE Study.

PubMed

Shibayama, Kentaro; Mihara, Hirotsugu; Jilaihawi, Hasan; Berdejo, Javier; Harada, Kenji; Itabashi, Yuji; Siegel, Robert; Makkar, Raj R; Shiota, Takahiro

2016-02-01

This study of 3-dimensional (3D) transesophageal echocardiography (TEE) aimed to demonstrate features associated with transvalvular aortic regurgitation (AR) after transcatheter aortic valve replacement (TAVR) and to confirm the fact that a gap between the native aortic annulus and prosthesis is associated with paravalvular AR. The mechanism of AR after TAVR, particularly that of transvalvular AR, has not been evaluated adequately. All patients with severe aortic stenosis who underwent TAVR with the Sapien device (Edwards Lifesciences, Irvine, California) had 3D TEE of the pre-procedural native aortic annulus and the post-procedural prosthetic valve. In the 201 patients studied, the total AR was mild in 67 patients (33%), moderate in 21 patients (10%), and severe in no patients. There were 20 patients with transvalvular AR and 82 patients with paravalvular AR. Fourteen patients had both transvalvular and paravalvular AR. Patients with transvalvular AR had larger prosthetic expansion (p <0.05), a more elliptical prosthetic shape at the prosthetic commissure level (p <0.01) and more anti-anatomical position (p <0.001), which was defined as malposition of the prosthetic commissures in relation to the native commissures, than the patients without transvalvular AR. Age (odds ratio [OR]: 1.05; 95% confidence interval [CI]: 1.01 to 1.09; p < 0.05) and effective area oversizing (OR: 0.97; 95% CI: 0.93 to 0.99, p <0.05) were associated with mild or greater paravalvular AR. 3D TEE successfully demonstrated the features associated with transvalvular AR, such as large prosthetic expansion, elliptical prosthetic shape, and anti-anatomical position of prosthesis. Additionally, effective area oversizing was associated with paravalvular AR. Copyright © 2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Validity of hip-mounted uniaxial accelerometry with heart-rate monitoring vs. triaxial accelerometry in the assessment of free-living energy expenditure in young children: the IDEFICS Validation Study.

PubMed

Ojiambo, Robert; Konstabel, Kenn; Veidebaum, Toomas; Reilly, John; Verbestel, Vera; Huybrechts, Inge; Sioen, Isabelle; Casajús, José A; Moreno, Luis A; Vicente-Rodriguez, German; Bammann, Karin; Tubic, Bojan M; Marild, Staffan; Westerterp, Klaas; Pitsiladis, Yannis P

2012-11-01

One of the aims of Identification and Prevention of Dietary- and Lifestyle-Induced Health Effects in Children and Infants (IDEFICS) validation study is to validate field measures of physical activity (PA) and energy expenditure (EE) in young children. This study compared the validity of uniaxial accelerometry with heart-rate (HR) monitoring vs. triaxial accelerometry against doubly labeled water (DLW) criterion method for assessment of free-living EE in young children. Forty-nine European children (25 female, 24 male) aged 4-10 yr (mean age: 6.9 ± 1.5 yr) were assessed by uniaxial ActiTrainer with HR, uniaxial 3DNX, and triaxial 3DNX accelerometry. Total energy expenditure (TEE) was estimated using DLW over a 1-wk period. The longitudinal axis of both devices and triaxial 3DNX counts per minute (CPM) were significantly (P < 0.05) associated with physical activity level (PAL; r = 0.51 ActiTrainer, r = 0.49 uniaxial-3DNX, and r = 0.42 triaxial Σ3DNX). Eight-six percent of the variance in TEE could be predicted by a model combining body mass (partial r(2) = 71%; P < 0.05), CPM-ActiTrainer (partial r(2) = 11%; P < 0.05), and difference between HR at moderate and sedentary activities (ModHR - SedHR) (partial r(2) = 4%; P < 0.05). The SE of TEE estimate for ActiTrainer and 3DNX models ranged from 0.44 to 0.74 MJ/days or ∼7-11% of the average TEE. The SE of activity-induced energy expenditure (AEE) model estimates ranged from 0.38 to 0.57 MJ/day or 24-26% of the average AEE. It is concluded that the comparative validity of hip-mounted uniaxial and triaxial accelerometers for assessing PA and EE is similar.

Wearable cameras can reduce dietary under-reporting: doubly labelled water validation of a camera-assisted 24 h recall.

PubMed

Gemming, Luke; Rush, Elaine; Maddison, Ralph; Doherty, Aiden; Gant, Nicholas; Utter, Jennifer; Ni Mhurchu, Cliona

2015-01-28

Preliminary research has suggested that wearable cameras may reduce under-reporting of energy intake (EI) in self-reported dietary assessment. The aim of the present study was to test the validity of a wearable camera-assisted 24 h dietary recall against the doubly labelled water (DLW) technique. Total energy expenditure (TEE) was assessed over 15 d using the DLW protocol among forty adults (n 20 males, age 35 (sd 17) years, BMI 27 (sd 4) kg/m2 and n 20 females, age 28 (sd 7) years, BMI 22 (sd 2) kg/m2). EI was assessed using three multiple-pass 24 h dietary recalls (MP24) on days 2-4, 8-10 and 13-15. On the days before each nutrition assessment, participants wore an automated wearable camera (SenseCam (SC)) in free-living conditions. The wearable camera images were viewed by the participants following the completion of the dietary recall, and their changes in self-reported intakes were recorded (MP24+SC). TEE and EI assessed by the MP24 and MP24+SC methods were compared. Among men, the MP24 and MP24+SC measures underestimated TEE by 17 and 9%, respectively (P< 0.001 and P= 0.02). Among women, these measures underestimated TEE by 13 and 7%, respectively (P< 0.001 and P= 0.004). The assistance of the wearable camera (MP24+SC) reduced the magnitude of under-reporting by 8% for men and 6% for women compared with the MP24 alone (P< 0.001 and P< 0.001). The increase in EI was predominantly from the addition of 265 unreported foods (often snacks) as revealed by the participants during the image review. Wearable cameras enhance the accuracy of self-report by providing passive and objective information regarding dietary intake. High-definition image sensors and increased imaging frequency may improve the accuracy further.

The effects of Ramadan fasting on activity and energy expenditure.

PubMed

Lessan, Nader; Saadane, Ilham; Alkaf, Budour; Hambly, Catherine; Buckley, Adam J; Finer, Nick; Speakman, John R; Barakat, Maha T

2018-01-01

Fasting during the month of Ramadan entails abstinence from eating and drinking between dawn and sunset and a major shift in meal times and patterns with associated changes in several hormones and circadian rhythms; whether there are accompanying changes in energy metabolism is unclear. We have investigated the impact of Ramadan fasting on resting metabolic rate (RMR), activity, and total energy expenditure (TEE). Healthy nonobese volunteers (n = 29; 16 women) fasting during Ramadan were recruited. RMR was measured with the use of indirect calorimetry. In subgroups of participants, activity (n = 11; 5 women) and TEE (n = 10; 5 women) in free-living conditions were measured with the use of accelerometers and the doubly labeled water technique, respectively. Body composition was measured with the use of bioelectrical impedance. Measurements were repeated after a wash-out period of between 1 and 2 mo after Ramadan. Nonparametric tests were used for comparative statistics. Ramadan fasting did not result in any change in RMR (mean ± SD: 1365.7 ± 230.2 compared with 1362.9 ± 273.6 kcal/d for Ramadan and post-Ramadan respectively, P = 0.713, n = 29). However, controlling for the effects of age, sex, and body weight, RMR was higher in the first week of Ramadan than in subsequent weeks. During Ramadan, the total number of steps walked were significantly lower (n = 11, P = 0.001), while overall sleeping time was reduced and different sleeping patterns were seen. TEE did not differ significantly between Ramadan and post-Ramadan (mean ± SD: 2224.1 ± 433.7 compared with 2121.0 ± 718.5 kcal/d for Ramadan and post-Ramadan, P = 0.7695, n = 10). Ramadan fasting is associated with reduced activity and sleeping time, but no significant change in RMR or TEE. Reported weight changes with Ramadan in other studies are more likely to be due to differences in food intake. This trial is registered at clinicaltrials.gov as NCT02696421. © 2018 American Society for Nutrition. All rights reserved.

Hours spent and energy expended in physical activity domains: results from the Tomorrow Project cohort in Alberta, Canada.

PubMed

Csizmadi, Ilona; Lo Siou, Geraldine; Friedenreich, Christine M; Owen, Neville; Robson, Paula J

2011-10-10

Knowledge of adult activity patterns across domains of physical activity is essential for the planning of population-based strategies that will increase overall energy expenditure and reduce the risk of obesity and related chronic diseases. We describe domain-specific hours of activity and energy expended among participants in a prospective cohort in Alberta, Canada. The Past Year Total Physical Activity Questionnaire was completed by 15,591 Tomorrow Project® participants, between 2001 and 2005 detailing physical activity type, duration, frequency and intensity. Domain-specific hours of activity and activity-related energy expenditure, expressed as a percent of total energy expenditure (TEE) (Mean (SD); Median (IQR)) are reported across inactive (<1.4), low active (1.4 to 1.59), active (1.6 to 1.89) and very active (≥ 1.9) Physical Activity Level (PAL = TEE:REE) categories. In very active women and amongst all men except those classified as inactive, activity-related energy expenditure comprised primarily occupational activity. Amongst inactive men and women in active, low active and inactive groups, activity-related energy expenditure from household activity was comparable to, or exceeded that for occupational activity. Leisure-time activity-related energy expenditure decreased with decreasing PAL categories; however, even amongst the most active men and women it accounted for less than 10 percent of TEE. When stratified by employment status, leisure-time activity-related energy expenditure was greatest for retired men [mean (SD): 10.8 (8.5) percent of TEE], compared with those who were fully employed, employed part-time or not employed. Transportation-related activity was negligible across all categories of PAL and employment status. For the inactive portion of this population, active non-leisure activities, specifically in the transportation and occupational domains, need to be considered for inclusion in daily routines as a means of increasing population-wide activity levels. Environmental and policy changes to promote active transport and workplace initiatives could increase overall daily energy expenditure through reducing prolonged sitting time.

Daily energy expenditure, cardiorespiratory fitness and glycaemic control in people with type 1 diabetes.

PubMed

Valletta, John Joseph; Chipperfield, Andrew J; Clough, Geraldine F; Byrne, Christopher D

2014-01-01

Encouraging daily physical activity improves cardiorespiratory fitness and many cardiovascular risk factors. However, increasing physical activity often creates a challenge for people with type 1 diabetes, because of difficulties maintaining euglycemia in the face of altered food intake and adjustments to insulin doses. Our aim was to examine the triangular relationship between glucose control measured by continuous glucose monitoring system (CGMS), objective measures of total daily energy expenditure (TEE) recorded by a multi-sensory monitoring device, and cardiorespiratory fitness (CRF), in free-living subjects with type 1 diabetes. Twenty-three individuals (12 women) with type 1 diabetes who were free from micro- and macrovascular complications were recruited. TEE and glucose control were monitored simultaneously for up to 12 days, using a multi-sensory device and CGMS respectively. CRF was recorded as V02 max from a maximal treadmill test with the Bruce protocol. Subjects (mean±SD) were aged 37±11 years, with BMI = 26.5±5.1 kg.m⁻², HbA1c = 7.7±1.3% (61±14 mmol/mol) and V02 max (ml.min⁻¹.kg⁻¹)  = 39.9±8.4 (range 22.4-58.6). TEE (36.3±5.5 kcal.kg⁻¹.day⁻¹) was strongly associated with CRF(39.9±8.4 ml.min⁻¹.kg⁻¹) independently of sex (r = 0.63, p<0.01). However, neither TEE (r = -0.20, p = 0.36) nor CRF (r = -0.20, p = 0.39; adjusted for sex), were significantly associated with mean glycaemia measured by CGMS. Higher levels of energy expenditure (due to a more active lifestyle) are associated with increased cardiorespiratory fitness, but not necessarily better glycaemic control. Since increased levels of energy expenditure and good glycaemic control are both needed to protect against diabetes-related complications our data suggest they need to be achieved independently.

Sample Diluter for Detecting Hypergolic Propellants and Other Toxic or Hazardous Gases

NASA Technical Reports Server (NTRS)

Barile, R. G.; Hodge, T. R.; Meneghelli, B. J.; Gursky, R.; Lueck, D. E.

1997-01-01

Hardware was developed to dilute vapor samples of purged hypergolic propellants (with air) into the range of existing instruments for detection of such toxic vapors. Since these detectors are normally used to monitor at the threshold limit value (TLV), most do not have quantitative capability at percent levels which relate to lower explosion limit (LEL) and fire hazards. For example, the upper limits of Energetic Sciences (ESI) 6000 series detectors used at KSC are 200 parts per million (ppm) for monomethyl hydrazine (MMH) and 500 ppm for nitrogen dioxide (NO2) arising from decomposition of nitrogen tetroxide (N2O4). Orbiter Processing Facility (OPF) personnel servicing Shuttle thrusters need to measure up to 250 ppm MMH and 7500 ppm NO2 with portable, intrinsically safe instruments. Our objective was to quickly fabricate a sample diluter out of existing materials as a temporary measure while other parallel efforts were conducted to provide a commercial or in-house-developed instrument to detect high propellant levels. A 3 to 1 diluter would bring 500 ppm MMH into the range of the existing fuel ESI, and a 30 to 1 diluter would do the same for NO2. In this way, familiar equipment already available would be used, resulting in minimal paperwork, safety, and training impacts and low cost. An MMH vapor sample-diluter was constructed from a 1/4-inch Kynar tee, along with specially designed lengths of sample and dilution tubing. The sample line was 3 feet of Bev-A-Line 4, 1/4 inch tube leading to the straight run of the tee. The side run of the tee had a 17-inch length of Bev-A-Line 4, 1/4-inch tube, for nominal 3 to 1 dilution. A gas sample bag was prepared and assayed at 113 ppm MMH, and diluted vapor sarnples were assayed at 39.5 ppm, or a measured dilution of 2.9 to 1. For NO2, a 316 stainless steel (SS) 1/8-inch tee with 49.5 inches of coiled, 1/8-inch outside diameter (OD) 316 SS tubing was used as the sarnpling end of the dilution system. The side run of the tee was open. The measured dilution ratio, based on the input value of 6,480 ppm NO2 and the average output value of 233 ppm, was 28 to 1. Thus, sample-diluters were successful in diluting concentrated hypergolic propellant vapors, both MMH and N2O4, into the ranges of existing TLV detectors.

Sample Diluter for Detecting Hypergolic Propellants and Other Toxic or Hazardous Gases

NASA Technical Reports Server (NTRS)

Barile, R. G.; Hodge, T. R.; Meneghelli, B. J.; Gursky, R.; Lueck, D. E.

1997-01-01

Hardware was developed to dilute vapor samples of purged hypergolic propellants (with air) into the range of existing instruments for detection of such toxic vapors. Since these detectors are normally used to monitor at the threshold limit value (TLV), most do not have quantitative capability at percent levels which relate to lower explosion limit (LEL) and fire hazards. For example, the upper limits of Energetic Sciences (ESI) 6000 series detectors used at KSC are 200 parts per million (ppm) for monomethyl hydrazine (MMH) and 500 ppm for nitrogen dioxide (NO2) arising from decomposition of nitrogen tetroxide (N2O4). Orbiter Processing Facility (OPF) personnel servicing Shuttle thrusters need to measure up to 250 ppm MMH and 7,500 ppm NO2 with portable, intrinsically safe instruments. Our objective was to quickly fabricate a sample diluter out of existing materials as a temporary measure while other parallel efforts were conducted to provide a commercial or in-house-developed instrument to detect high propellant levels. A 3 to 1 diluter would bring 500 ppm MMH into the range of the existing fuel ESI, and a 30 to 1 diluter would do the same for NO2. In this way, familiar equipment already available would be used, resulting in minimal paperwork, safety, and training impacts and low cost. An MMH vapor sample-diluter was constructed from a 1/4-inch Kynar tee, along with specially designed lengths of sample and dilution tubing. The sample line was 3 feet of Bev-A-Line 4, 1/4-inch tube leading to the straight run of the tee. The side run of the tee had a 17-inch length of Bev-A-Line 4, 1/4-inch tube, for nominal 3 to 1 dilution. A gas sample bag was prepared and assayed at 113 ppm ppm MMH, and diluted vapor samples were assayed at 39.5 ppm, or a measured dilution of 2.9 to 1. For NO2, a 316 stainless steel (SS) 1/8-inch tee with 49.5 inches of coiled, 1/8-inch outside diameter (OD) 316 SS tubing was used as the sampling end of the dilution system. The side run of the tee was open. The measured dilution ratio, based on the input value of 6,480 ppm NO2, and the average output value of 233 ppm, was 28 to 1. Thus, sample-diluters were successful in diluting concentrated hypergolic propellant vapors, both MMH and N2O4 into the ranges of existing TLV detectors.

Center for Women Veterans

MedlinePlus

... Adaptive Sports Program Creative Arts Festival Golden Age Games Summer Sports Clinic Training - Exposure - Experience (TEE) Tournament Wheelchair Games Winter Sports Clinic Locations Hospitals & Clinics Vet Centers ...

[Our experience in the cases with penetrating colonic injuries].

PubMed

Kahya, Mehmet Cemal; Derici, Hayrullah; Cin, Necat; Tatar, Fatma; Peker, Yasin; Genç, Hüdai; Deniz, Vedat; Reyhan, Enver

2006-07-01

In this study, the factors that effect the morbidity and mortality in patients with penetrating colonic injuries were evaluated. Fourty-two patients (37 males, 5 females; mean age 30,1; range 14 to 63 years) with penetrating colonic trauma were evaluated according to age, gender, type of penetrating trauma, location and severity of the colonic injury, associated injury, interval between the trauma and the definitive operation, hemodynamic status, blood transfusion requirement, fecal contamination, surgical procedure, postoperative complication and mortality. Type of the penetrating trauma was stab injury in twenty-eight (67%) patients, and gunshot injury in fourteen (33%) patients. The mean Colon Injury Severity Score was 2,1. The mean Abdominal Trauma Index (ATI) was 17,2 and it was over than 25 in eight (19%) patients. The symptoms of shock were present in eleven (26%) patients at admission. Blood transfusions were applied in sixteen (38%) patients. In twenty-one patients intraabdominal bleeding was observed and it was more than 500 mL in eleven (26%) patients. Primary repair was performed in 36 (86%) of the 42 patients and colostomy was performed in six (14%) patients. Morbidity and mortality rates were 41% and 10% respectively. It was found that morbidity rates were increased in patients with ATI score higher than 25, and mortality rates were increased in patients presenting shock at admission, with the amount of intraabdominal blood more than 500 mL, and who needed three or more units of blood transfusion. The primary repair of the penetrating colon trauma can be performed confidently in the hemodynamically stable patients with ATI score less than 25.

Dissection of mechanisms of Chinese medicinal formula Realgar-Indigo naturalis as an effective treatment for promyelocytic leukemia.

PubMed

Wang, Lan; Zhou, Guang-Biao; Liu, Ping; Song, Jun-Hong; Liang, Yang; Yan, Xiao-Jing; Xu, Fang; Wang, Bing-Shun; Mao, Jian-Hua; Shen, Zhi-Xiang; Chen, Sai-Juan; Chen, Zhu

2008-03-25

To enhance therapeutic efficacy and reduce adverse effects, practitioners of traditional Chinese medicine (TCM) prescribe a combination of plant species/minerals, called formulae, based on clinical experience. Nearly 100,000 formulae have been recorded, but the working mechanisms of most remain unknown. In trying to address the possible beneficial effects of formulae with current biomedical approaches, we use Realgar-Indigo naturalis formula (RIF), which has been proven to be very effective in treating human acute promyelocytic leukemia (APL) as a model. The main components of RIF are realgar, Indigo naturalis, and Salvia miltiorrhiza, with tetraarsenic tetrasulfide (A), indirubin (I), and tanshinone IIA (T) as major active ingredients, respectively. Here, we report that the ATI combination yields synergy in the treatment of a murine APL model in vivo and in the induction of APL cell differentiation in vitro. ATI causes intensified ubiquitination/degradation of promyelocytic leukemia (PML)-retinoic acid receptor alpha (RARalpha) oncoprotein, stronger reprogramming of myeloid differentiation regulators, and enhanced G(1)/G(0) arrest in APL cells through hitting multiple targets compared with the effects of mono- or biagents. Furthermore, ATI intensifies the expression of Aquaglyceroporin 9 and facilitates the transportation of A into APL cells, which in turn enhances A-mediated PML-RARalpha degradation and therapeutic efficacy. Our data also indicate A as the principal component of the formula, whereas T and I serve as adjuvant ingredients. We therefore suggest that dissecting the mode of action of clinically effective formulae at the molecular, cellular, and organism levels may be a good strategy in exploring the value of traditional medicine.

Evidence that intermittent structured treatment interruption, but not immunization with ALVAC-HIV vCP1452, promotes host control of HIV replication: the results of AIDS Clinical Trials Group 5068.

PubMed

Jacobson, Jeffrey M; Pat Bucy, R; Spritzler, John; Saag, Michael S; Eron, Joseph J; Coombs, Robert W; Wang, Rui; Fox, Lawrence; Johnson, Victoria A; Cu-Uvin, Susan; Cohn, Susan E; Mildvan, Donna; O'Neill, Dorothy; Janik, Jennifer; Purdue, Lynette; O'Connor, Deborah K; Vita, Christine Di; Frank, Ian

2006-09-01

The ability to control human immunodeficiency virus (HIV) replication in vivo in the absence of antiretroviral therapy (ART) is a measure of the efficiency of antiviral immunity. In a study of patients with chronic, ART-suppressed HIV infection, AIDS Clinical Trials Group 5068 investigated the effects of immunization with an exogenous HIV vaccine and pulse exposure to the subject's unique viral epitopes, by means of structured treatment interruptions (STIs), on the dynamics of viral rebound during a subsequent analytical treatment interruption (ATI). Ninety-seven subjects receiving stable ART with an HIV-1 RNA load <50 copies/mL and CD4(+) T lymphocyte count >400 cells/mm(3) were randomized to undergo continued ART, STIs, ALVAC-HIV vCP1452 immunization, or STIs and ALVAC-HIV vCP1452 immunization. Subjects in the 2 STI arms had a significantly longer median doubling time in the period of the initial rise of viral load, a significantly lower median peak viral load, a significantly lower median end-of-ATI viral load set point, and a greater proportion of subjects with an end-of-ATI viral load set point <1,000 copies/mL, compared with the subjects in the 2 arms without STIs. With an immunization schedule of 3 sets of 3 weekly injections, ALVAC-HIV vCP1452 did not affect viral load measures. In this randomized, controlled study of intermittent STI as a therapeutic autoimmunization strategy, evidence of enhanced immunologic control of HIV replication was demonstrated.

Spatiotemporal dynamics of actin remodeling and endomembrane trafficking in alveolar epithelial type I cell wound healing

PubMed Central

Godin, Lindsay M.; Vergen, Jorge; Prakash, Y. S.; Pagano, Richard E.

2011-01-01

Alveolar epithelial type I cell (ATI) wounding is prevalent in ventilator-injured lungs and likely contributes to pathogenesis of “barotrauma” and “biotrauma.” In experimental models most wounded alveolar cells repair plasma membrane (PM) defects and survive insults. Considering the force balance between edge energy at the PM wound margins and adhesive interactions of the lipid bilayer with the underlying cytoskeleton (CSK), we tested the hypothesis that subcortical actin depolymerization is a key facilitator of PM repair. Using real-time fluorescence imaging of primary rat ATI transfected with a live cell actin-green fluorescent protein construct (Lifeact-GFP) and loaded with N-rhodamine phosphatidylethanolamine (PE), we examined the spatial and temporal coordination between cytoskeletal remodeling and PM repair following micropuncture. Membrane integrity was inferred from the fluorescence intensity profiles of the cytosolic label calcein AM. Wounding led to rapid depolymerization of the actin CSK near the wound site, concurrent with accumulation of endomembrane-derived N-rhodamine PE. Both responses were sustained until PM integrity was reestablished, which typically occurs between ∼10 and 40 s after micropuncture. Only thereafter did the actin CSK near the wound begin to repolymerize, while the rate of endomembrane lipid accumulation decreased. Between 60 and 90 s after successful PM repair, after translocation of the actin nucleation factor cortactin, a dense actin fiber network formed. In cells that did not survive micropuncture injury, actin remodeling did not occur. These novel results highlight the importance of actin remodeling in ATI cell repair and suggest molecular targets for modulating the repair process. PMID:21216977

Quantitative analysis of polyethylene glycol (PEG) and PEGylated proteins in animal tissues by LC-MS/MS coupled with in-source CID.

PubMed

Gong, Jiachang; Gu, Xiaomei; Achanzar, William E; Chadwick, Kristina D; Gan, Jinping; Brock, Barry J; Kishnani, Narendra S; Humphreys, W Griff; Iyer, Ramaswamy A

2014-08-05

The covalent conjugation of polyethylene glycol (PEG, typical MW > 10k) to therapeutic peptides and proteins is a well-established approach to improve their pharmacokinetic properties and diminish the potential for immunogenicity. Even though PEG is generally considered biologically inert and safe in animals and humans, the slow clearance of large PEGs raises concerns about potential adverse effects resulting from PEG accumulation in tissues following chronic administration, particularly in the central nervous system. The key information relevant to the issue is the disposition and fate of the PEG moiety after repeated dosing with PEGylated proteins. Here, we report a novel quantitative method utilizing LC-MS/MS coupled with in-source CID that is highly selective and sensitive to PEG-related materials. Both (40K)PEG and a tool PEGylated protein (ATI-1072) underwent dissociation in the ionization source of mass spectrometer to generate a series of PEG-specific ions, which were subjected to further dissociation through conventional CID. To demonstrate the potential application of the method to assess PEG biodistribution following PEGylated protein administration, a single dose study of ATI-1072 was conducted in rats. Plasma and various tissues were collected, and the concentrations of both (40K)PEG and ATI-1072 were determined using the LC-MS/MS method. The presence of (40k)PEG in plasma and tissue homogenates suggests the degradation of PEGylated proteins after dose administration to rats, given that free PEG was absent in the dosing solution. The method enables further studies for a thorough characterization of disposition and fate of PEGylated proteins.

Laboratory Evaluation of Dynamic Traffic Assignment Systems: Requirements, Framework, and System Design

DOT National Transportation Integrated Search

1997-01-01

The success of Advanced Traveler Information Systems (ATIS) and Advanced Traffic Management Systems (ATMS) depends on the availability and dissemination of timely and accurate estimates of current and emerging traffic network conditions. Real-time Dy...

IVHS Institutional and Legal Issues Program: Review of the FAST-TRAC Operational Test

DOT National Transportation Integrated Search

1994-06-01

The FAST-TRAC (Faster and Safer Travel through Traffic Routing and Advanced Controls) operational test attempted to integrate advanced traveler information systems (ATIS) and advanced traffic management system (ATMS) technologies in Oakland County, M...

Willingness To Pay For Advanced Traveler Information Systems, Smartraveler Case Study

DOT National Transportation Integrated Search

1997-01-01

THE INTRODUCTION OF NEW ADVANCED TRAVELER INFORMATION SYSTEM (ATIS) PRODUCTS AND SERVICES WILL CREATE A UNIQUE MARKET SITUATION; INITIALLY, TRAVELERS WILL LACK THE INFORMATION WITH WHICH TO EFFECTIVELY EVALUATE THESE PRODUCTS FOR POSSIBLE ADOPTION. S...

Socio-Economic Impact Assessment of Automated Transit Information Systems Technology

DOT National Transportation Integrated Search

1984-03-01

This report is the final product of a program to assess the socio-economic impacts of automated transit information system (ATIS) technology deployments on the transit industry's telephone information/marketing function. In the course of this program...

CVO driver fatigue and complex in-vehicle systems

DOT National Transportation Integrated Search

1997-10-01

As one of a series of studies aimed at gathering data to develop human factors design guidelines for Advanced Traveler Information Systems (ATIS) and Commercial Vehicle Operations (CVO), the present study utilized a driving simulator to study CVO dri...

Seattle wide-area information for travelers (SWIFT) : architecture study

DOT National Transportation Integrated Search

1998-10-19

The SWIFT (Seattle Wide-area Information For Travelers) Field Operational Test was intended to evaluate the performance of a large-scale urban Advanced Traveler Information System (ATIS) deployment in the Seattle area. The unique features of the SWIF...

On-time reliability impacts of advanced traveler information services (ATIS) : Washington, DC case study

DOT National Transportation Integrated Search

1998-09-01

Emissions Management Using ITS Technology report summarizes and interprets the results of three Intelligent Transportation Systems (ITS) Field Operational Tests (FOTs) that evaluated the use of emerging technologies to help authorities measure emissi...

Rural applications of advanced traveler information systems : recommended actions

DOT National Transportation Integrated Search

1997-07-01

The Recommended Action Plan is one in a series of interim documents for the Rural Applications of Advanced Traveler Information Systems (ATIS) project. Based on the investigation of user needs, a technology review, and concept development and assessm...

Autologous tenocyte injection for the treatment of severe, chronic resistant lateral epicondylitis: a pilot study.

PubMed

Wang, Allan; Breidahl, William; Mackie, Katherine E; Lin, Zhen; Qin, An; Chen, Jimin; Zheng, Ming H

2013-12-01

Severe chronic lateral epicondylitis (LE) is associated with degenerative tendon changes, extracellular matrix breakdown, and tendon cell loss. On the basis of positive outcomes from preclinical studies, this study is the first clinical trial of autologous tenocyte injection (ATI) on severe tendinopathy associated with chronic LE. Autologous tenocyte injection is a safe and effective procedure that enables a reduction in pain and improvement in function in resistant LE. Case series; Level of evidence, 4. Patients with severe refractory LE underwent clinical evaluation and magnetic resonance imaging (MRI) before intervention. A patellar tendon needle biopsy was performed under local anesthetic, and tendon cells were expanded by in vitro culture. Tenocytes used for the injection were characterized by flow cytometry and real-time polymerase chain reaction. Autologous tenocytes were injected into the site of tendinopathy identified at the origin of the extensor carpi radialis brevis tendon under ultrasound guidance on a single occasion. Patients underwent serial clinical evaluations and repeat MRI at 12 months after intervention. A total of 20 consecutive patients were included in the study. Three patients withdrew consent after enrollment and before ATI. No adverse event was reported at either biopsy or injection sites. Furthermore, no infection or excessive fibroblastic reaction was found in any patient at the injection site. Clinical evaluation revealed an improvement in mean visual analog scale scores, for a maximum pain score from 5.94 at the initial assessment to 0.76 at 12 months (P < .001). Mean quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) and grip strength scores also significantly improved over the 12-month follow-up (QuickDASH score, 45.88 [baseline] to 3.84; grip strength, 20.17 kg [baseline] to 37.38 kg; P < .001). With use of a validated MRI scoring system, the grade of tendinopathy at the common extensor origin improved significantly by 12 months (P < .001). One patient elected to proceed to surgery 3 months after ATI following a reinjury at work. In this study, patients with chronic LE who had previously undergone an unsuccessful full course of nonoperative treatment showed significantly improved clinical function and structural repair at the origin of the common extensor tendon after ATI. This novel treatment is encouraging for the treatment of tendinopathy and warrants further evaluation.

PTSD in Children and Teens

MedlinePlus

... Adaptive Sports Program Creative Arts Festival Golden Age Games Summer Sports Clinic Training - Exposure - Experience (TEE) Tournament Wheelchair Games Winter Sports Clinic Locations Hospitals & Clinics Vet Centers ...

Profound Obstructive Hypotension From Prone Positioning Documented by Transesophageal Echocardiography in a Patient With Scoliosis: A Case Report.

PubMed

Abcejo, Arnoley S; Diaz Soto, Juan; Castoro, Courtney; Armour, Sarah; Long, Timothy R

2017-08-01

In a healthy 12-year-old female with scoliosis, prone positioning resulted in pressor-refractory cardiovascular collapse. Resumption of supine position immediately improved hemodynamics. Intraoperative transesophageal echocardiography (TEE) revealed a collapsed left atrium and biventricular failure. Repeat prone positioning resulted in a recurrence of hypotension. However, hemodynamic stabilization was restored and maintained by repositioning chest pads caudally. The patient successfully underwent a 6-hour scoliosis repair without perioperative morbidity. With this case, we aim to: (1) reintroduce awareness of this mechanical obstructive cause of reversible hypotension; (2) highlight the use of intraoperative TEE during prone hemodynamic collapse; and (3) suggest an alternative prone positioning technique if chest compression results in hemodynamic instability.

Alternative Physics Examination Questions: Identification and Explanation of Different Discriminating Powers

NASA Astrophysics Data System (ADS)

Forster, Patricia A.

2005-12-01

The issue of unfairness arises in high-stakes public examinations when students choose questions from alternatives that are offered and marks on the alternatives turn out to be discrepant. This paper addresses and defines unfairness and discrepancy in the context of alternative questions in Physics Tertiary Entrance Examinations (TEE) in Western Australia. As well, I present an analysis of question characteristics that explain observed marks-differences. The characteristics mainly relate to the construction of the text of questions, the detail on diagrams, and requirements for calculation. The list of characteristics could inform the setting of compulsory as well as alternative examination questions. The paper includes a brief exploration of results by gender on the alternative Physics TEE questions.

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

Igor V. Litvinyuk, and Itzik Ben-Itzhak

Our principal goal was the experimental demonstration of Laser-Induced Electron Diffraction (LIED). Key steps along the development of this experimental technique have been accomplished and reported in the publications listed in this brief report. We started with measuring 3D electron momenta spectra in aligned nitrogen and oxygen molecules. Chakra Maharjan (Ph.D. student of Lew Cocke) was a lead researcher on this project. Although Chakra succeeded in obtaining those spectra, we were scooped by the publication of identical results in Science by the NRC Ottawa group. Our results were never published as a refereed article, but became a part of Chakra'smore » Ph.D. dissertation. That Science paper was the first experimental demonstration of Laser-Induced Electron Diffraction (LIED). Chakra also worked on wavelength dependence of 3D ATI spectra of atoms and molecules using tunable OPA pulses. Another Ph.D. student, Maia Magrakvelidze (her GRA was funded by the grant), started working on COLTRIMS experiments using OPA pulses (1800 nm wavelength). After some initial experiments it became apparent that COLTRIMS did not yield sufficient count rates of electrons in the high-energy part of the spectrum to see diffraction signatures with acceptable statistics (unfavorable scaling of the electron yield with laser wavelength was partly to blame). Nevertheless, Maia managed to use COLTRIMS and OPA to measure the angular dependence of the tunneling ionization rate in D{sub 2} molecules. Following the initial trial experiments, the decision was made to switch from COLTRIMS to VMI in order to increase the count rates by a factor of {approx}100, which may have given us a chance to see LIED. Research Associate Dr. Sankar De (his salary was funded by the grant), in collaboration with Matthias Kling's group (then at MPQ Garching), proceeded to design a special multi-electrode VMI spectrometer for capturing high-energy ATI electrons and to install it in place of COLTRIMS inside our experimental chamber. That apparatus was later used for the first demonstration of field-free orientation in CO using two-color laser pulses as well as for a series of other experiments, such as pump-probe studies of molecular dynamics with few-cycle laser pulses, control of electron localization in dissociating hydrogen molecules using two-color laser pulses, and ATI spectra of Xe ionized by two-color laser pulses. In parallel, Dipanwita Ray (Ph.D. student of Lew Cocke) worked on measuring angle-resolved ATI spectra of noble gases using a stereo-ATI phasemeter as a TOF electron spectrometer. She observed the angular diffraction structures in 3D ATI spectra of Ar, Kr and Xe, which were interpreted in terms of the Quantitative Rescattering theory newly developed by C.D. Lin. We also attempted to use a much more powerful OPA (five times more energy per pulse than the one we had at JRML) available at the Advanced Laser Light Source (ALLS) in Montreal to observe LIED. Two visits to ALLS by the PI, Igor Litvinyuk, and one visit by the PI's Ph.D. student (Irina Bocharova) were funded by the grant. Though we failed to observe LIED (the repetition rate of the ALLS OPA was too low at only 100 Hz), this international collaboration resulted in several publications on other related subjects, such as the wavelength dependence of laser Coulomb explosion of hydrogen, the wavelength dependence of non-sequential double ionization of neon and argon, the demonstration of charge-resonance enhanced ionization in CO{sub 2}, and the study of non-elastic scattering processes in H{sub 2}. Theoretical efforts to account for the hydrogen Coulomb explosion experiment resulted in another paper by Maia Magrakvelidze as lead author. Although for various reasons we failed to achieve our main goal of observing LIED, we salute the recent success in this endeavor by Lou DiMauro's group (with theoretical support from our KSU colleague C.D. Lin) published in Nature, which validates our approach.« less

User accpetance of ATIS products and services : a report of qualitative research

DOT National Transportation Integrated Search

1992-08-01

In recent years, transportation planning has been experiencing an escalating emphasis towards increasing capacity and improving traffic management on urban streets and arterials to combat the effects of congestion. One measure which has proven to be ...

Driver response to unexpected situations when using and in-vehicle information system

DOT National Transportation Integrated Search

1999-12-01

This investigation is one of a series of studies aimed at investigating Advanced Traveler Information Systems (ATIS) and Commercial Vehicle Operations (CVO) applications and their effect on driver behavior and performance. A field experiment was cond...

Roadway usage patterns : urban case studies - final report

DOT National Transportation Integrated Search

1996-01-01

The Orlando Test Network Study was one of a series of investigations conducted as part of the TravTek operational test of an advanced traveler information and traffic management system (ATIS/ATMS). The TravTek system consisted of the Orlando Traffic ...

The ADVANCE project : formal evaluation of the targeted deployment. Volume 1

DOT National Transportation Integrated Search

1997-01-01

The Advanced Driver and Vehicle Advisory Navigation ConcEpt (ADVANCE) was an in-vehicle advanced traveler information system (ATIS) that operated in the northwest suburbs of Chicago, Illinois. It was designed to provide origin-destination shortest-ti...

National ITS Program Plan Intelligent Transportation Systems Volume I

DOT National Transportation Integrated Search

1995-03-01

ADVANCED TRAVELER INFORMATION SYSTEMS OR ATIS : THE PURPOSE OF THE NATIONAL ITS PROGRAM PLAN IS TO GUIDE THE DEVELOPMENT AND DEPLOYMENT OF INTELLIGENT TRANSPORTATION SYSTEMS (ITS) IN THE UNITED STATES. THIS, THE FIRST EDITION OF THE PLAN WAS A JOINT ...

Presenting hazard warning information to drivers using an advanced traveler information system

DOT National Transportation Integrated Search

1997-02-01

Although Advanced Traveler Information System (ATIS) devices have the potential to improve travel safety, efficiency, and comfort, they represent a new frontier in ground transportation. In order to realize this potential, they must be designed in a ...

Seattle wide-area information for travelers (SWIFT) : consumer acceptance study

DOT National Transportation Integrated Search

1998-10-19

The Seattle Wide-area Information for Travelers (SWIFT) 0perational Test was intended to evaluate the performance of a large-scale, urban Advanced Traveler Information System (ATIS) deployment in the Seattle area. With the majority of the SWIFT syste...

Arterial link travel time estimation using loop detector data : phase 1

DOT National Transportation Integrated Search

1997-11-01

The envisioned operational tests of Advanced Traveler Information Systems (ATIS) and Advanced Traffic Management Systems (ATMS) in the Minneapolis/St. Paul area call for the provision of timely and reliable travel times over an entire rod network. Un...

FRATIS concept of operations : assessment of relevant prior and ongoing research and industry practices.

DOT National Transportation Integrated Search

2012-08-01

This report summarizes the state of the practice in freight-related advanced traveler information systems (ATIS) and assesses their relevance to the development of a Freight Advanced Traveler Information System (FRATIS). The report includes relevant ...

U.S. DOT roadway transportation data business plan (phase 1) : data business plan.

DOT National Transportation Integrated Search

1999-12-01

This report documents the results of an evaluation of satellite communication systems for mayday applications conducted as part of the Rural Applications of Advanced Traveler Information Systems (ATIS) study. It focuses on satellite communications sy...

High temperature lined conduits, elbows and tees

DOEpatents

De Feo, Angelo; Drewniany, Edward

1982-01-01

A high temperature lined conduit comprising, a liner, a flexible insulating refractory blanket around and in contact with the liner, a pipe member around the blanket and spaced therefrom, and castable rigid refractory material between the pipe member and the blanket. Anchors are connected to the inside diameter of the pipe and extend into the castable material. The liner includes male and female slip joint ends for permitting thermal expansion of the liner with respect to the castable material and the pipe member. Elbows and tees of the lined conduit comprise an elbow liner wrapped with insulating refractory blanket material around which is disposed a spaced elbow pipe member with castable refractory material between the blanket material and the elbow pipe member. A reinforcing band is connected to the elbow liner at an intermediate location thereon from which extend a plurality of hollow tubes or pins which extend into the castable material to anchor the lined elbow and permit thermal expansion. A method of fabricating the high temperature lined conduit, elbows and tees is also disclosed which utilizes a polyethylene layer over the refractory blanket after it has been compressed to maintain the refractory blanket in a compressed condition until the castable material is in place. Hot gases are then directed through the interior of the liner for evaporating the polyethylene and setting the castable material which permits the compressed blanket to come into close contact with the castable material.

Energy expenditure in caving

PubMed Central

Antoni, Giorgia; Marini, Elisabetta; Curreli, Nicoletta; Tuveri, Valerio; Comandini, Ornella; Cabras, Stefano; Gabba, Silvia; Madeddu, Clelia; Crisafulli, Antonio

2017-01-01

The aim of this study was to determine the energy expenditure of a group of cavers of both genders and different ages and experience during a 10 hour subterranean exploration, using portable metabolimeters. The impact of caving activity on body composition and hydration were also assessed through bioelectrical impedance, and nutritional habits of cavers surveyed. During cave activity, measured total energy expenditure (TEE) was in the range 225–287 kcal/h for women-men (MET = 4.1), respectively; subjects had an energy intake from food in the range 1000–1200 kcal, thus inadequate to restore lost calories. Bayesian statistical analysis estimated the effect of predictive variables on TEE, revealing that experienced subjects had a 5% lower TEE than the less skilled ones and that women required a comparatively larger energy expenditure than men to perform the same task. BIVA (bioelectrical impedance vector analysis) showed that subjects were within the range of normal hydration before and after cave activity, but bioelectrical changes indicated a reduction of extracellular water in men, which might result in hypo-osmolal dehydration in the case of prolonged underground exercise. All these facts should be considered when planning cave explorations, preparing training programs for subjects practising caving, and optimizing a diet for cavers. Further, information gathered through this study could be of value to reduce accidents in caves related to increase in fatigue. PMID:28158208

A Proposed Maneuver to Guide Transseptal Puncture Using Real-Time Three-Dimensional Transesophageal Echocardiography: Pilot Study.

PubMed

Mahmoud, Hani M; Al-Ghamdi, Mohammed A; Ghabashi, Abdullah E; Anwar, Ashraf M

2015-01-01

Aim of Study. To assess the feasibility of a new proposed maneuver "RATLe-90" using real-time three-dimensional transesophageal echocardiography (RT-3DTEE) for anatomically oriented visualization of the interatrial septum (IAS) in guiding the transseptal puncture TSP. Methods. The study included 20 patients (mean age, 60.2 ± 6.7 years; 60% males) who underwent TSP for different indications. RT-3DTEE was used to guide TSP. The proposed maneuver RATLe-90 (Rotate-Anticlockwise-Tilt-Left-90) was applied in all cases to have the anatomically oriented en face view of the IAS from the right atrial (RA) aspect. Having this anatomically oriented view, we guided the TSP catheter towards the proper puncture site according to the planned procedure. Results. Using the RATLe-90 maneuver, the anatomically oriented en face view of the IAS from the RA was obtained in all patients. We were able to guide the puncture catheter to the proper puncture site on the IAS. The 3D images obtained were clearly understood by both echocardiographers and interventionists. The RATLe-90 maneuver acquisition time was 19.9 ± 1.6 seconds. The time-to-tent was 64.8 ± 16.3 seconds. Less TEE probe manipulations were needed while guiding the TSP. Conclusions. Application of RT3D-TEE during TSP using RATLe-90 maneuver is feasible with shorter fluoroscopy time and minimizing TEE probe manipulations.

Self-compensation in arsenic doping of CdTe

DOE PAGES

Ablekim, Tursun; Swain, Santosh K.; Yin, Wan -Jian; ...

2017-07-04

Efficient p-type doping in CdTe has remained a critical challenge for decades, limiting the performance of CdTe-based semiconductor devices. Arsenic is a promising p-type dopant; however, reproducible doping with high concentration is difficult and carrier lifetime is low. We systematically studied defect structures in As-doped CdTe using high-purity single crystal wafers to investigate the mechanisms that limit p-type doping. Two As-doped CdTe with varying acceptor density and two undoped CdTe were grown in Cd-rich and Te-rich environments. The defect structures were investigated by thermoelectric-effect spectroscopy (TEES), and first-principles calculations were used for identifying and assigning the experimentally observed defects. Measurementsmore » revealed activation of As is very low in both As-doped samples with very short lifetimes indicating strong compensation and the presence of significant carrier trapping defects. Defect studies suggest two acceptors and one donor level were introduced by As doping with activation energies at ~88 meV, ~293 meV and ~377 meV. In particular, the peak shown at ~162 K in the TEES spectra is very prominent in both As-doped samples, indicating a signature of AX-center donors. In conclusion, the AX-centers are believed to be responsible for most of the compensation because of their low formation energy and very prominent peak intensity in TEES spectra.« less