Sample records for av conduction system

  1. Catheter ablation as a treatment of atrioventricular block.

    PubMed

    Tuohy, Stephen; Saliba, Walid; Pai, Manjunath; Tchou, Patrick

    2018-01-01

    Symptomatic second-degree atrioventricular (AV) block is typically treated by implantation of a pacemaker. An otherwise healthy AV conduction system can nevertheless develop AV block due to interference from junctional extrasystoles. When present with a high burden, these can produce debilitating symptoms from AV block despite an underlying normal AV node and His-Purkinje system properties. The purpose of this study was to describe a catheter ablation approach for alleviating symptomatic AV block due to a ventricular nodal pathway interfering with AV conduction. Common clinical monitoring techniques such as Holter and event recorders were used. Standard electrophysiological study techniques using multipolar recording and ablation catheters were utilized during procedures. A 55-year-old woman presented with highly symptomatic, high-burden second-degree AV block due to concealed and manifest junctional premature beats. Electrophysiological characteristics indicated interference of AV conduction due to a concealed ventricular nodal pathway as the cause of the AV block. The patient's AV nodal and His-Purkinje system conduction characteristics were otherwise normal. Radiofrequency catheter ablation of the pathway was successful in restoring normal AV conduction and eliminating her clinical symptoms. Pathways inserting into the AV junction can interfere with AV conduction. When present at a high burden, this type of AV block can be highly symptomatic. Catheter ablation techniques can be used to alleviate this type of AV block and restore normal AV conduction. Copyright © 2017 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

  2. A Simple Dissection Method for the Conduction System of the Human Heart

    ERIC Educational Resources Information Center

    Yanagawa, Nariaki; Nakajima, Yuji

    2009-01-01

    A simple dissection guide for the conduction system of the human heart is shown. The atrioventricular (AV) node, AV bundle, and right bundle branch were identified in a formaldehyde-fixed human heart. The sinu-atrial (SA) node could not be found, but the region in which SA node was contained was identified using the SA nodal artery. Gross…

  3. Heparan sulfate storage in the cardiac conduction system triggers atrioventricular block.

    PubMed

    Kato, Rie; Miyahara, Hiroaki; Kawano, Tatsuya; Matsuzuka, Atsuko; Noda, Kimiko; Izumi, Tatsuro

    2017-05-01

    To elucidate the novel biological functions of heparan sulfate (HS) by clinic-pathologically studying a patient with paroxysmal atrioventricular (AV) block. A long-surviving male patient with Sanfilippo syndrome type A presented with paroxysmal AV block at age 33years. He then survived another 2.5years after the onset of paroxysmal AV block and pacemaker implantation. His cardiac histopathological examination at autopsy showed HS storage in the cardiac conduction system (CCS), especially in the atrioventricular node (AVN)-His bundle branches. HS storage in the CCS might trigger AV block, arising from below the AVN-His bundle branches. This is the first description to indicate that HS might be an essential constituent of life-long CCS plasticity and that its storage in the CCS results in AV block. Copyright © 2017 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

  4. Systems Analysis of NASA Aviation Safety Program: Final Report

    NASA Technical Reports Server (NTRS)

    Jones, Sharon M.; Reveley, Mary S.; Withrow, Colleen A.; Evans, Joni K.; Barr, Lawrence; Leone, Karen

    2013-01-01

    A three-month study (February to April 2010) of the NASA Aviation Safety (AvSafe) program was conducted. This study comprised three components: (1) a statistical analysis of currently available civilian subsonic aircraft data from the National Transportation Safety Board (NTSB), the Federal Aviation Administration (FAA), and the Aviation Safety Information Analysis and Sharing (ASIAS) system to identify any significant or overlooked aviation safety issues; (2) a high-level qualitative identification of future safety risks, with an assessment of the potential impact of the NASA AvSafe research on the National Airspace System (NAS) based on these risks; and (3) a detailed, top-down analysis of the NASA AvSafe program using an established and peer-reviewed systems analysis methodology. The statistical analysis identified the top aviation "tall poles" based on NTSB accident and FAA incident data from 1997 to 2006. A separate examination of medical helicopter accidents in the United States was also conducted. Multiple external sources were used to develop a compilation of ten "tall poles" in future safety issues/risks. The top-down analysis of the AvSafe was conducted by using a modification of the Gibson methodology. Of the 17 challenging safety issues that were identified, 11 were directly addressed by the AvSafe program research portfolio.

  5. Radiotherapy as a cause of complete atrioventricular block in Hodgkin's disease. An electrophysiological-pathological correlation

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

    Cohen, S.I.; Bharati, S.; Glass, J.

    1981-04-01

    A 20-year-old man contracted Hodgkin's disease and was treated with mantle radiotherapy. Heart block developed 11 years later. Electrocardiograms revealed predominant atrioventricular (AV) block and occasional AV conduction. Intracardiac electrograms demonstrated that the site of AV block was above the level of the His bundle. A permanent transvenous pacemaker was implanted. Seven months later the patient died of complications from cryptococcal meningitis. Pathological study of the heart revealed marked arteriosclerosis with fibrosis of the epicardium, myocardium, and endocardium. Examination of the conduction system revealed extensive arteriolosclerosis of the sinoatrial node and its approaches. In addition, there was marked fibrosis ofmore » the approaches to the AV node, the AV bundle, and both bundle branches. There was no evidence of Hodgkin's disease. This case documents the rare occurrence of AV block due to tissue destruction by radiotherapy. There was a good correlation between block proximal to the His bundle recording site and fibrosis of the approaches to the AV node.« less

  6. Radiotherapy as a cause of complete atrioventricular block in Hodgkin's disease: an electrophysiological-pathological correlation

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

    Cohen, S.I.; Bharati, S.; Glass, J.

    1981-04-01

    A 20-year-old man contracted Hodgkin's disease and was treated with mantle radiotherapy. Heart block developed 11 years later. Electrocardiograms revealed predominant atrioventricular (AV) block and occasional AV conduction. Intracardiac electrograms demonstrated that the site of AV block was above the level of the His bundle. A permanent transvenous pacemaker was implanted. Seven months later the patient died of complications from cryptococcal meningitis. Pathological study of the heart revealed marked arteriosclerosis with fibrosis of the epicardium, myocardium, and endocardium. Examination of the conduction system revealed extensive arteriolosclerosis of the sinoatrial node and its approaches. In addition, there was marked fibrosis ofmore » the approaches to the AV node, the AV bundle, and both bundle branches. There was no evidence of Hodgkin's disease. This case documents the rare occurrence of AV block due to tissue destruction by radiotherapy. There was a good correlation between block proximal to the His bundle recording site and fibrosis of the approaches to the AV node.« less

  7. Functional, Anatomical, and Molecular Investigation of the Cardiac Conduction System and Arrhythmogenic Atrioventricular Ring Tissue in the Rat Heart

    PubMed Central

    Atkinson, Andrew J.; Logantha, Sunil Jit R. J.; Hao, Guoliang; Yanni, Joseph; Fedorenko, Olga; Sinha, Aditi; Gilbert, Stephen H.; Benson, Alan P.; Buckley, David L.; Anderson, Robert H.; Boyett, Mark R.; Dobrzynski, Halina

    2013-01-01

    Background The cardiac conduction system consists of the sinus node, nodal extensions, atrioventricular (AV) node, penetrating bundle, bundle branches, and Purkinje fibers. Node‐like AV ring tissue also exists at the AV junctions, and the right and left rings unite at the retroaortic node. The study aims were to (1) construct a 3‐dimensional anatomical model of the AV rings and retroaortic node, (2) map electrical activation in the right ring and study its action potential characteristics, and (3) examine gene expression in the right ring and retroaortic node. Methods and Results Three‐dimensional reconstruction (based on magnetic resonance imaging, histology, and immunohistochemistry) showed the extent and organization of the specialized tissues (eg, how the AV rings form the right and left nodal extensions into the AV node). Multiextracellular electrode array and microelectrode mapping of isolated right ring preparations revealed robust spontaneous activity with characteristic diastolic depolarization. Using laser microdissection gene expression measured at the mRNA level (using quantitative PCR) and protein level (using immunohistochemistry and Western blotting) showed that the right ring and retroaortic node, like the sinus node and AV node but, unlike ventricular muscle, had statistically significant higher expression of key transcription factors (including Tbx3, Msx2, and Id2) and ion channels (including HCN4, Cav3.1, Cav3.2, Kv1.5, SK1, Kir3.1, and Kir3.4) and lower expression of other key ion channels (Nav1.5 and Kir2.1). Conclusions The AV rings and retroaortic node possess gene expression profiles similar to that of the AV node. Ion channel expression and electrophysiological recordings show the AV rings could act as ectopic pacemakers and a source of atrial tachycardia. PMID:24356527

  8. Unexpected delayed complete atrioventricular block after Cardioband implantation.

    PubMed

    Sorini Dini, Carlotta; Landi, Daniele; Meucci, Francesco; Di Mario, Carlo

    2018-03-06

    The Cardioband system is a transcatheter direct annuloplasty device that is implanted in patients with severe symptomatic functional mitral regurgitation (MR) due to annulus dilatation and high surgical risk. This device covers the posterior two-thirds of the annulus, from the anterolateral to the posteromedial commissure, implanted in close proximity of the left circumflex artery, atrioventricular (AV) conduction system, and coronary sinus. We present the case of an 80-year-old-gentleman with prohibitive surgical risk, treated with Cardioband implantation for functional MR with an evident P1-P2 cleft and P2-P3 indentation, a relative contraindication to MitraClip implantation. We achieved procedural success with significative mitral annulus reduction (30% anteroposterior reduction from 37 to 26 mm) and MR reduction (from grade 4 to grade 1-2). A late onset Mobitz 2 AV block developed after 26 hr and evolved to complete AV block in the following day, requiring definitive biventricular pacemaker (PM). Less than 200 Cardioband implantations have been performed but, to our knowledge, this is the first reported AV block, possibly facilitated by the pre-existing bifascicular block, suggesting the opportunity of prolonged ECG monitoring after Cardioband like any other mechanical transcatheter structural intervention possibly affecting the AV conduction system. © 2018 Wiley Periodicals, Inc.

  9. Visualizing anatomical evidences on atrioventricular conduction system for TAVI.

    PubMed

    Kawashima, Tomokazu; Sato, Fumi

    2014-06-01

    Visualizing the anatomy of the atrioventricular (AV) conduction axis substantiates that there is remarkable inter-individual variation at the macro- and microscopic levels, and that the atrioventricular bundle and left bundle branch are located more anteriorly, distally, and cranially and much closer to the aortic root complex than previously thought. The AV conduction system may therefore be compromised during implantation of a transcatheter aortic valve prosthesis, which may account for the relatively high incidence of new cardiac conduction abnormalities when conventional prosthetic valves are used. The design of the newer JenaValve® may afford advantages over more conventional valves by avoiding the high-risk implantation area and the potential for coronary ostia obstruction. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  10. About the specialized myocardial conducting tissue.

    PubMed

    de Micheli Serra, Alfredo; Iturralde Torres, Pedro; Aranda Fraustro, Alberto

    2013-01-01

    The chronological succession of discoveries on the location and structure of the atrio-ventricular conducting system are described. The starting point of this system is located in the sinus atrial node, identified by the English scientists A. Keith and M. W. Flack in 1907. The atrioventricular conducting system was pointed out by the Swiss physician Wilhelm His Jr. in 1893. The atrioventricular node (AV) was first identified by the Japanese pathologist Sumao Tawara and his German professor Ludwig Aschoff in 1906. Likewise the structure and routes of the three internodal bundles are described. These bundles include: Bachmann's bundle (1916) connecting the right with the left atrium and the AV node; the middle Wenckebach's bundle (1910) and the posterior or Thörel's bundle (1910), extending from the region of the sinus atrial node towards the posterior margin of the AV node. Lastly, the ventricular left and right conduction systems are detailed. These include the main trunk and their peripheral subdivisions with respective networks. Regarding the controversial existence of the left middle subdivision, it can exist in animal and human hearts. Nevertheless, an intermediate left septal network of specialized fibers seems to act as a functional equivalent of this subdivision. Copyright © 2012 Instituto Nacional de Cardiología Ignacio Chávez. Published by Masson Doyma México S.A. All rights reserved.

  11. Three Dimensional Visualization of Human Cardiac Conduction Tissue in Whole Heart Specimens by High-Resolution Phase-Contrast CT Imaging Using Synchrotron Radiation.

    PubMed

    Shinohara, Gen; Morita, Kiyozo; Hoshino, Masato; Ko, Yoshihiro; Tsukube, Takuro; Kaneko, Yukihiro; Morishita, Hiroyuki; Oshima, Yoshihiro; Matsuhisa, Hironori; Iwaki, Ryuma; Takahashi, Masashi; Matsuyama, Takaaki; Hashimoto, Kazuhiro; Yagi, Naoto

    2016-11-01

    The feasibility of synchrotron radiation-based phase-contrast computed tomography (PCCT) for visualization of the atrioventricular (AV) conduction axis in human whole heart specimens was tested using four postmortem structurally normal newborn hearts obtained at autopsy. A PCCT imaging system at the beamline BL20B2 in a SPring-8 synchrotron radiation facility was used. The PCCT imaging of the conduction system was performed with "virtual" slicing of the three-dimensional reconstructed images. For histological verification, specimens were cut into planes similar to the PCCT images, then cut into 5-μm serial sections and stained with Masson's trichrome. In PCCT images of all four of the whole hearts of newborns, the AV conduction axis was distinguished as a low-density structure, which was serially traceable from the compact node to the penetrating bundle within the central fibrous body, and to the branching bundle into the left and right bundle branches. This was verified by histological serial sectioning. This is the first demonstration that visualization of the AV conduction axis within human whole heart specimens is feasible with PCCT. © The Author(s) 2016.

  12. A 2:1 AV rhythm: an adverse effect of a long AV delay during DDI pacing and its prevention by the ventricular intrinsic preference algorithm in DDD mode.

    PubMed

    Minamiguchi, Hitoshi; Oginosawa, Yasushi; Kohno, Ritsuko; Tamura, Masahito; Takeuchi, Masaaki; Otsuji, Yutaka; Abe, Haruhiko

    2012-07-01

    A 91-year-old woman received a dual-chamber pacemaker for sick sinus syndrome and intermittently abnormal atrioventricular (AV) conduction. The pacemaker was set in DDI mode with a 350-ms AV delay to preserve intrinsic ventricular activity. She complained of palpitation during AV sequential pacing. The electrocardiogram showed a 2:1 AV rhythm from 1:1 ventriculoatrial (VA) conduction during ventricular pacing in DDI mode with a long AV interval. After reprogramming of the pacemaker in DDD mode with a 250-ms AV interval and additional 100-ms prolongation of the AV interval by the ventricular intrinsic preference function, VA conduction disappeared and the patient's symptom were alleviated without increasing unnecessary right ventricular pacing. ©2011, The Authors. Journal compilation ©2011 Wiley Periodicals, Inc.

  13. Pacemaker mediated tachycardia as a complication of the autointrinsic conduction search function.

    PubMed

    Dennis, Malcolm J; Sparks, Paul B

    2004-06-01

    The autointrinsic conduction search (AICS) option, featured on some DDD pacemakers, performs periodic assessments of atrioventricular (AV) conduction capability during a single beat AV delay extension. Demonstration of ventricular conduction during the prolonged AV delay, permits ongoing AV delay extension if the patient's intrinsic conduction is preferred to ventricular pacing. A case is presented where the wide separation of atrial and ventricular pacing during the conduction search permitted retrograde ventriculoatrial conduction, precipitating pacemaker mediated tachycardia (PMT) on seven occasions in one patient. Two onset patterns are reported, both attributable to the AICS option. Recommendations for prevention strategies are made.

  14. A quantitative description of normal AV nodal conduction curve in man.

    PubMed

    Teague, S; Collins, S; Wu, D; Denes, P; Rosen, K; Arzbaecher, R

    1976-01-01

    The AV nodal conduction curve generated by the atrial extrastimulus technique has been described only qualitatively in man, making clinical comparison of known normal curves with those of suspected AV nodal dysfunction difficult. Also, the effects of physiological and pharmacological interventions have not been quantifiable. In 50 patients with normal AV conduction as defined by normal AH (less than 130 ms), normal AV nodal effective and functional refractory periods (less than 380 and less than 500 ms), and absence of demonstrable dual AV nodal pathways, we found that conduction curves (at sinus rhythm or longest paced cycle length) can be described by an exponential equation of the form delta = Ae-Bx. In this equation, delta is the increase in AV nodal conduction time of an extrastimulus compared to that of a regular beat and x is extrastimulus interval. The natural logarithm of this equation is linear in the semilogarithmic plane, thus permitting the constants A and B to be easily determined by a least-squares regression analysis with a hand calculator.

  15. Monophasic action potentials of right atrium and electrophysiological properties of AV conducting system in patients with hypothyroidism.

    PubMed Central

    Gavrilescu, S; Luca, C; Streian, C; Lungu, G; Deutsch, G

    1976-01-01

    In 12 patients with manifest hypothyroidism right atrial monophasic action potentials showed a significant prolongation in comparison with data from normal or euthyroid patients. Atrial effective refractory periods were also significantly prolonged. After thyroid treatment the monophasic action potential duration and the effective refractory period of the right atrium were within normal ranges. In 6 hypothyroid patients studies of AV conduction with the aid of His bundle electrography and atrial pacing showed a supraHisian conduction delay which was manifest in one case and latent in another two. InfraHisian conduction delay was encountered in 2 cases. PMID:1008978

  16. Paroxysmal atrioventricular block: Electrophysiological mechanism of phase 4 conduction block in the His-Purkinje system: A comparison with phase 3 block.

    PubMed

    Shenasa, Mohammad; Josephson, Mark E; Wit, Andrew L

    2017-11-01

    Paroxysmal atrioventricular (A-V) block is relatively rare, and due to its transient nature, it is often under recognized. It is often triggered by atrial, junctional, or ventricular premature beats, and occurs in the presence of a diseased His-Purkinje system (HPS). Here, we present a 45-year-old white male who was admitted for observation due to recurrent syncope and near-syncope, who had paroxysmal A-V block. The likely cellular electrophysiological mechanisms(s) of paroxysmal A-V block and its differential diagnosis and management are discussed. Continuous electrocardiographic monitoring was done while the patient was in the cardiac unit. Multiple episodes of paroxysmal A-V block were documented in this case. All episodes were initiated and terminated with atrial/junctional premature beats. The patient underwent permanent pacemaker implantation and has remained asymptomatic since then. Paroxysmal A-V block is rare and often causes syncope or near-syncope. Permanent pacemaker implantation is indicated according to the current guidelines. Paroxysmal A-V block occurs in the setting of diseased HPS and is bradycardia-dependent. The detailed electrophysiological mechanisms, which involve phase 4 diastolic depolarization, and differential diagnosis are discussed. © 2017 Wiley Periodicals, Inc.

  17. Acquired heart block: a possible complication of patent ductus arteriosus in a preterm infant.

    PubMed

    Grasser, Monika; Döhlemann, Christoph; Mittal, Rashmi; Till, Holger; Dietz, Hans-Georg; Münch, Georg; Holzinger, Andreas

    2008-01-01

    A large patent ductus arteriosus (PDA) is a frequently encountered clinical problem in extremely low birth weight (ELBW) infants. It leads to an increased pulmonary blood flow and in a decreased or reversed diastolic flow in the systemic circulation, resulting in complications. Here we report a possible complication of PDA not previously published. On day 8 of life, a male ELBW infant (birth weight 650 g) born at a gestational age of 23 weeks and 3 days developed an atrioventricular block (AV block). The heart rate dropped from 168/min to 90/min, and the ECG showed a Wenckebach second-degree AV block and intraventricular conduction disturbances. Echocardiography demonstrated a PDA with a large left-to-right shunt and large left atrium and left ventricle with high contractility. Within several minutes after surgical closure of the PDA, the heart rate increased, and after 30 min the AV block had improved to a 1:1 conduction ratio. Echocardiography after 2 h revealed a significant decrease of the left ventricular and atrial dimensions. Within 12 h, the AV block completely reversed together with the intraventricular conduction disturbances. We suggest that PDA with a large left-to-right shunt and left ventricular volume overload may lead to an AV block in an ELBW infant. Surgical closure of the PDA may be indicated. (c) 2007 S. Karger AG, Basel.

  18. Synchronous ventricular pacing with direct capture of the atrioventricular conduction system: Functional anatomy, terminology, and challenges.

    PubMed

    Mulpuru, Siva K; Cha, Yong-Mei; Asirvatham, Samuel J

    2016-11-01

    Right ventricular apical pacing is associated with an increased incidence of heart failure, atrial fibrillation, and overall mortality. As a result, pacing the ventricles in a manner that closely mimics normal AV conduction with an intact His-Purkinje system has been explored. Recently, the sustainable benefits of selective His-bundle stimulation have been demonstrated and proposed as the preferred method of ventricular stimulation for appropriate patients. Ideally, conduction system pacing should be selective without myocardial capture, overcome distal bundle branch block when present, and not compromise tricuspid valve function. Contemporary literature on conduction system pacing is confusing largely because of inconsistent terminology and, at times, anatomically inaccurate terms used interchangeably for nonsynonymous anatomic sites. In this review, we discuss the functional anatomy of AV conduction access with specific emphasis on terminology, relationship to the membranous septum, tricuspid valve tissue, and proximity to atrial or ventricular myocardium. The potential benefits of each specific site as well as associated unique difficulties with those sites are described. Copyright © 2016 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

  19. Pacemaker dependency after transcatheter aortic valve implantation with the self-expanding Medtronic CoreValve System.

    PubMed

    van der Boon, Robert M A; Van Mieghem, Nicolas M; Theuns, Dominic A; Nuis, Rutger-Jan; Nauta, Sjoerd T; Serruys, Patrick W; Jordaens, Luc; van Domburg, Ron T; de Jaegere, Peter P T

    2013-09-30

    To determine pacemaker (PM) dependency at follow-up visit in patients who underwent new permanent pacemaker implantation (PPI) following transcatheter aortic valve implantation (TAVI). Single center prospective observational study including 167 patients without previous PM implantation who underwent TAVI with the self-expanding Medtronic CoreValve System (MCS) between November 2005 and February 2011. PM dependency was defined by the presence of a high degree atrioventricular block (HDAVB; second [AV2] and third degree [AV3B]), or a slow (<30 bpm) or absent ventricular escape rhythm during follow-up PM interrogation. A total of 36 patients (21.6%) received a new PM following TAVI. The indication for PM was AV2B (n=2, 5.6%), AV3B (n=28, 77.8%), postoperative symptomatic bradycardia (n=3, 8.3%), brady-tachy syndrome (n=1, 2.8%), atrial fibrilation with slow response (n=1, 2.8%) and left bundle branch block (n=1, 2.8%). Long term follow-up was complete for all patients and ranged from 1 to 40 months (median (IQR): 11.5 (5.0-18.0 months). Of those patients with a HDAVB, 16 out of the 30 patients (53.3%) were PM independent at follow-up visit (complete or partial resolution of the AV conduction abnormality). Overall, 20 out of the 36 patients (55.6%) who received a new PM following TAVI were PM independent at follow-up. Partial and even complete resolution of peri-operative AV conduction abnormalities after MCS valve implantation occurred in more than half of the patients. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  20. Near-field multiple traps of paraxial acoustic vortices with strengthened gradient force generated by sector transducer array

    NASA Astrophysics Data System (ADS)

    Wang, Qingdong; Li, Yuzhi; Ma, Qingyu; Guo, Gepu; Tu, Juan; Zhang, Dong

    2018-01-01

    In order to improve the capability of particle trapping close to the source plane, theoretical and experimental studies on near-field multiple traps of paraxial acoustic vortices (AVs) with a strengthened acoustic gradient force (AGF) generated by a sector transducer array were conducted. By applying the integration of point source radiation, numerical simulations for the acoustic fields generated by the sector transducer array were conducted and compared with those produced by the circular transducer array. It was proved that strengthened AGFs of near-field multiple AVs with higher peak pressures and smaller vortex radii could be produced by the sector transducer array with a small topological charge. The axial distributions of the equivalent potential gradient indicated that the AGFs of paraxial AVs in the near field were much higher than those in the far field, and the distances at the near-field vortex antinodes were also proved to be the ideal trapping positions with relatively higher AGFs. With the established 8-channel AV generation system, theoretical studies were also verified by the experimental measurements of pressure and phase for AVs with various topological charges. The formation of near-field multiple paraxial AVs was verified by the cross-sectional circular pressure distributions with perfect phase spirals around central pressure nulls, and was also proved by the vortex nodes and antinodes along the center axis. The favorable results demonstrated the feasibility of generating near-field multiple traps of paraxial AVs with strengthened AGF using the sector transducer array, and suggested the potential applications of close-range particle trapping in biomedical engineering.

  1. Deep-level stereoscopic multiple traps of acoustic vortices

    NASA Astrophysics Data System (ADS)

    Li, Yuzhi; Guo, Gepu; Ma, Qingyu; Tu, Juan; Zhang, Dong

    2017-04-01

    Based on the radiation pattern of a planar piston transducer, the mechanisms underlying the generation of axially controllable deep-level stereoscopic multiple traps of acoustic vortices (AV) using sparse directional sources were proposed with explicit formulae. Numerical simulations for the axial and cross-sectional distributions of acoustic pressure and phase were conducted for various ka (product of the wave number and the radius of transducer) values at the frequency of 1 MHz. It was demonstrated that, for bigger ka, besides the main-AV (M-AV) generated by the main lobes of the sources, cone-shaped side-AV (S-AV) produced by the side lobes were closer to the source plane at a relatively lower pressure. Corresponding to the radiation angles of pressure nulls between the main lobe and the side lobes of the sources, vortex valleys with nearly pressure zero could be generated on the central axis to form multiple traps, based on Gor'kov potential theory. The number and locations of vortex valleys could be controlled accurately by the adjustment of ka. With the established eight-source AV generation system, the existence of the axially controllable multiple traps was verified by the measured M-AV and S-AVs as well as the corresponding vortex valleys. The favorable results provided the feasibility of deep-level stereoscopic control of AV and suggested potential application of multiple traps for particle manipulation in the area of biomedical engineering.

  2. [Changes of heart electrophysiological parameters after destruction of epicardial subplexuses that innervate sinoatrial node].

    PubMed

    Kulboka, Arūnas; Veikutis, Vincentas; Pauza, Dainius Haroldas; Lekas, Raimundas

    2003-01-01

    The aims of present study were to verify the topography of the intracardiac nerve subplexuses (INS) by using electrophysiological methods, its relations with sinoatrial (SA) node function and to investigate possibility of selective surgical SA node denervation. Fifteen mongrel dogs of either sex weighing 8 to 15 kg were used for electrophysiological studies. Both cervical vagosympathetic trunks were isolated and crushed by tight ligatures. Nervus subplexuses destructions were performed by cryocoagulation in three zones located around the right superior vena cava: ventral, lateral and dorsal. The sinus rhythm, SA node function recovery time, AV node conductivity, AV node and atrial effective refractory period were measured. Five experiments in each of three zones were performed. Experimental data show that destruction of the epicardial nerves has different effect on electrophysiological parameters. After destruction of the anterior zone of the right atrium the sinus rhythm decreased on an average by 11.6%; SA node function recovery time prolonged by 7.2%; AV node conductivity decreased by 13.1%; AV node effective refractory period prolonged by 12.9% and atrial effective refractory period, by 10.9 %. Measurements of electrophysiological parameters after intravenous injection of atropine sulphate show that sinus rhythm decreased on an average by 23.4%; SA node function recovery time increased by 9.1%; the conductivity of AV node decreased by 10.2%; AV node effective refractory period prolonged by 15.4% and atrial effective refractory period, by 13.2%. After destruction of the intracardiac nerves of the lateral zone, the sinus rhythm decreased by 15.7%; SA node function recovery time increased by 16.3%; AV node conductivity decreased by 8.3%; AV node effective refractory period and atrial effective refractory period prolonged by 11.9% and 10.0%, respectively. After the atropine sulphate intravenous injection, the sinus rhythm decreased on an average by 7.1%, SA node function recovery time prolonged by 7.1%, AV conductivity decreased by 9.1%, AV node effective refractory period increased by 12.4%, and atrial effective refractory period prolonged by 12.5%. After destruction of the nerves in the dorsal zone the changes of electrophysiological parameters were opposite to those obtained after destruction of the nerve tracts in the anterior or lateral zones: the sinus rhythm increased on an average by 4.3%; SA node function recovery time shortened by 8.8%; AV conductivity increased by 9.7%; AV node and atrial effective refractory period decreased by 12.3% and 12.1%, respectively. After intravenous atropine sulphate infusion, sinus rhythm decreased on an average by 8.3%; SA node function recovery time prolonged by 9.6%; AV node conductivity decreased by 5%; AV node and atrial effective refractory period prolonged by 4.2% and 5.2%, respectively. The average changes of electrophysiological parameters before and after INS destruction shows that cryocoagulation of ventral and lateral zones eliminates the effects of sympathetic tone to SA and AV nodal activity. Cryocoagulation of dorsal zone eliminates the effects of nervus vagus to both nodal structures. These findings shows the possibility alter or correct SA node function by making selective surgical SA node denervation.

  3. Optimal pacing for right ventricular and biventricular devices: minimizing, maximizing, and right ventricular/left ventricular site considerations.

    PubMed

    Gillis, Anne M

    2014-10-01

    The results from numerous clinical studies provide guidance for optimizing outcomes related to RV or biventricular pacing in the pacemaker and ICD populations. (1) Programming algorithms to minimize RV pacing is imperative in patients with dual-chamber pacemakers who have intrinsic AV conduction or intermittent AV conduction block. (2) Dual-chamber ICDs should be avoided in candidates without an indication for bradycardia pacing. (3) Alternate RV septal pacing sites may be considered at the time of pacemaker implantation. (4) Biventricular pacing may be beneficial in some patients with mild LV dysfunction. (5) LV lead placement at the site of latest LV activation is desirable. (6) Programming CRT systems to achieve biventricular/LV pacing >98.5% is important. (7) Protocols for AV and VV optimization in patients with CRT are not recommended after device implantation but may be considered for CRT nonresponders. (8) Novel algorithms to maximize the benefit of CRT are in evolution further.

  4. Inverse Relationship Between Membranous Septal Length and the Risk of Atrioventricular Block in Patients Undergoing Transcatheter Aortic Valve Implantation.

    PubMed

    Hamdan, Ashraf; Guetta, Victor; Klempfner, Robert; Konen, Eli; Raanani, Ehud; Glikson, Michael; Goitein, Orly; Segev, Amit; Barbash, Israel; Fefer, Paul; Spiegelstein, Dan; Goldenberg, Ilan; Schwammenthal, Ehud

    2015-08-17

    This study sought to examine whether imaging of the atrioventricular (AV) membranous septum (MS) by computed tomography (CT) can be used to identify patient-specific anatomic risk of high-degree AV block and permanent pacemaker (PPM) implantation before transcatheter aortic valve implantation (TAVI) with self-expandable valves. MS length represents an anatomic surrogate of the distance between the aortic annulus and the bundle of His and may therefore be inversely related to the risk of conduction system abnormalities after TAVI. Seventy-three consecutive patients with severe aortic stenosis underwent contrast-enhanced CT before TAVI. The aortic annulus, aortic valve, and AV junction were assessed, and MS length was measured in the coronal view. In 13 patients (18%), high-degree AV block developed, and 21 patients (29%) received a PPM. Multivariable logistic regression analysis revealed MS length as the most powerful pre-procedural independent predictor of high-degree AV block (odds ratio [OR]: 1.35, 95% confidence interval [CI]: 1.1 to 1.7, p = 0.01) and PPM implantation (OR: 1.43, 95% CI: 1.1 to 1.8, p = 0.002). When taking into account pre- and post-procedural parameters, the difference between MS length and implantation depth emerged as the most powerful independent predictor of high-degree AV block (OR: 1.4, 95% CI: 1.2 to 1.7, p < 0.001), whereas the difference between MS length and implantation depth and calcification in the basal septum were the most powerful independent predictors of PPM implantation (OR: 1.39, 95% CI: 1.2 to 1.7, p < 0.001 and OR: 4.9, 95% CI: 1.2 to 20.5, p = 0.03; respectively). Short MS, insufficient difference between MS length and implantation depth, and the presence of calcification in the basal septum, factors that may all facilitate mechanical compression of the conduction tissue by the implanted valve, predict conduction abnormalities after TAVI with self-expandable valves. CT assessment of membranous septal anatomy provides unique pre-procedural information about the patient-specific propensity for the risk of AV block. Copyright © 2015 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  5. Impact of a pharmacy student-driven medication delivery service at hospital discharge.

    PubMed

    Rogers, Jacalyn; Pai, Vinita; Merandi, Jenna; Catt, Char; Cole, Justin; Yarosz, Shannon; Wehr, Allison; Durkin, Kayla; Kaczor, Chet

    2017-03-01

    A pharmacy student-driven discharge service developed for patients to reduce the number of medication errors on after-visit summaries (AVSs) is discussed. An audit of AVS documents was conducted before the implementation period (September 3 to October 23, 2013) to identify medication errors. As part of the audit, a pharmacist review of the discharge medication list was completed to determine the number and types of errors that occurred. A student-driven discharge service with AVS review was developed in collaboration with nursing and medical residents. Students reviewed a patient's AVS, delivered the discharge prescriptions to bedside, and conducted medication reconciliation with the patient and family. The AVS audit was conducted after implementation of these services to assess the impact on medication errors. It was observed that 72% (108 of 150) of AVSs contained at least 1 error before discharge and AVS review. During the 2-month postimplementation period (September 3 to October 23, 2014), this decreased to 27% (34 of 127), resulting in a 52% absolute reduction in the number of AVSs with at least 1 medication error ( p < 0.0001). The most common error was as-needed medication with no indication, which decreased from 55% in the preimplementation audit to 16% in the postimplementation audit. Prescribing to Nationwide Children's Hospital's outpatient pharmacy increased from 57% in the preimplementation period to 73% in the postimplementation period for the general pediatrics service. A pharmacy student-driven discharge and medication delivery service reduced the number of AVSs and increased access to medications for patients. Copyright © 2017 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  6. Diphenylhydantoin and lidocaine modification of A-V conduction in halothane-anesthetized dogs.

    PubMed

    Atlee, J L; Homer, L D; Tobey, R E

    1975-07-01

    The effect of halothane on A-V conduction was evaluated in gods during atrial pacing using the technique of His-bundle electrocardiography. In addition, the effects of lidocaine and diphenylkydantoin (DPH) on A-V conuction were examined during halothane anesthesia. Effects of these drugs on three subintervals of A-V conduction were compared. These included the -H (stimulus atifact of His-bundle deflection-atrioventricular conduction), H-Q (His-budnle deflection onset of QRS complex-His-Purkinje conduction), and H-S intervals(His-bundle delfection to end of QRS COmplex-total intraventricular conduction). Linear regression best described the relationship between duration of interval (P-H, H-V,and H-S) and heart rate during incremental increases in the atrial paced rate. Data from these experiments were fitted to a multiple lenear regression model that predicted the effect of increasing concentrations of halothan, lidocaine, and DPH on slope and intercept coefficients. In creasing concentrations of halothan ( 30 and 45 mg/100 ml arterial). Both lidocaine and DPH further depressed conduction at all levels of halothan anesthesia. The P-H interval was particularly sensitive todrug effefts. This may represent potentiation of the normal slowing of conduction through the AVnode in response to incremental increases in heart rate (fatigue response.) We conclude thatboth lidocaine and DPH fail to reverse the depressant effect of halothane on A-V conduction. This may explain their ineffectiveness in treating certain types of arrhythmias during halothane anesthesia.

  7. Superoxide activates a GDP-sensitive proton conductance in skeletal muscle mitochondria from king penguin (Aptenodytes patagonicus).

    PubMed

    Talbot, Darren A; Hanuise, Nicolas; Rey, Benjamin; Rouanet, Jean-Louis; Duchamp, Claude; Brand, Martin D

    2003-12-26

    We present the partial nucleotide sequence of the avian uncoupling protein (avUCP) gene from king penguin (Aptenodytes patagonicus), showing that the protein is 88-92% identical to chicken (Gallus gallus), turkey (Meleagris gallopavo), and hummingbird (Eupetomena macroura). We show that superoxide activates the proton conductance of mitochondria isolated from king penguin skeletal muscle. GDP abolishes the superoxide-activated proton conductance, indicating that it is mediated via avUCP. In the absence of superoxide there is no GDP-sensitive component of the proton conductance from penguin muscle mitochondria demonstrating that avUCP plays no role in the basal proton leak.

  8. Impact of transforming growth factor-beta1 on atrioventricular node conduction modification by injected autologous fibroblasts in the canine heart.

    PubMed

    Bunch, T Jared; Mahapatra, Srijoy; Bruce, G Keith; Johnson, Susan B; Miller, Dylan V; Horne, Benjamin D; Wang, Xiao-Li; Lee, Hon-Chi; Caplice, Noel M; Packer, Douglas L

    2006-05-30

    Atrioventricular (AV) nodal ablation for management of atrial fibrillation (AF) is irreversible and requires permanent pacemaker implantation. We hypothesized that as an alternative, implantation of autologous fibroblasts in the perinodal region would focally modify AV nodal conduction and that this modulation would be enhanced by pretreatment with transforming growth factor-beta1 (TGF-beta1), a stimulant of fibroblasts. Skin biopsies were taken from 12 mongrel dogs, and derived fibroblasts were dissociated and grown in culture for 2 weeks. Multiple injections (0.25 mL) were made through an 8F NOGA catheter along the fast/slow AV nodal pathways as guided by an electroanatomic mapping system. Seven dogs received fibroblasts alone (1x10(6) cells/mL), 7 dogs received TGF-beta1 (5 microg), 4 dogs received fibroblasts and TGF-beta1 (1x10(6) cells/mL+5 microg), and 4 dogs received saline only. AV node function was assessed at baseline and after 4 weeks. Saline (80 mL) with assigned therapy (0.25 mL per injection) was injected into the peri-AV nodal region in each dog. At baseline, the AH interval (66+/-3 ms) and the average RR interval (331+/-17 ms) in pacing-induced AF were similar in each cohort. The increase in AH interval in normal sinus rhythm was longer after fibroblast (23+/-4 versus 5+/-5 ms; P=0.05) and fibroblast plus TGF-beta1 (50+/-5 versus 5+/-5 ms; P<0.001) injections than with saline alone, with similar findings during high right atrium and distal coronary sinus pacing. The AH interval was not significantly increased after TGF-beta1 injections. The AH interval was significantly longer after fibroblast plus TGF-beta1 injections than with either therapy (TGF-beta1 or fibroblasts) alone. The RR interval during AF was increased in dogs that received fibroblasts alone (110+/-36 versus -41+/-34 ms) and to a greater extent with the addition of TGF-beta1 (294+/-108 versus -41+/-34 ms). No AV block was seen in any cohort at 4 weeks. Labeled fibroblasts that expressed vimentin were identified in all dogs that received cell injections at 4 weeks. AV nodal modification can be achieved with injected fibroblasts without the creation of AV block. The effect on AV node conduction is substantially enhanced by pretreatment of fibroblasts with TGF-beta1. These data have therapeutic potential for the management of rapid ventricular rate during AF without pacemaker implantation.

  9. Performance of a specific algorithm to minimize right ventricular pacing: A multicenter study.

    PubMed

    Strik, Marc; Defaye, Pascal; Eschalier, Romain; Mondoly, Pierre; Frontera, Antonio; Ritter, Philippe; Haïssaguerre, Michel; Ploux, Sylvain; Ellenbogen, Kenneth A; Bordachar, Pierre

    2016-06-01

    In Boston Scientific dual-chamber devices, the RYTHMIQ algorithm aims to minimize right ventricular pacing. We evaluated the performance of this algorithm determining (1) the appropriateness of the switch from the AAI(R) mode with backup VVI pacing to the DDD(R) mode in case of suspected loss of atrioventricular (AV) conduction and (2) the rate of recorded pacemaker-mediated tachycardia (PMT) when AV hysteresis searches for restored AV conduction. In this multicenter study, we included 157 patients with a Boston Scientific dual-chamber device (40 pacemakers and 117 implantable cardioverter-defibrillators) without permanent AV conduction disorder and with the RYTHMIQ algorithm activated. We reviewed the last 10 remote monitoring-transmitted RYTHMIQ and PMT episodes. We analyzed 1266 episodes of switch in 142 patients (90%): 207 (16%) were appropriate and corresponded to loss of AV conduction, and 1059 (84%) were inappropriate, of which 701 (66%) were related to compensatory pause (premature atrial contraction, 7%; premature ventricular contraction, 597 (56%); or both, 27 (3%)) or to a premature ventricular contraction falling in the post-atrial pacing ventricular refractory period interval (219, 21%) and 94 (10%) were related to pacemaker dysfunction. One hundred fifty-four PMT episodes were diagnosed in 27 patients (17%). In 85 (69%) of correctly diagnosed episodes, the onset of PMT was directly related to the algorithm-related prolongation of the AV delay, promoting AV dissociation and retrograde conduction. This study highlights some of the limitations of the RYTHMIQ algorithm: high rate of inappropriate switch and high rate of induction of PMT. This may have clinical implications in terms of selection of patients and may suggest required changes in the algorithm architecture. Copyright © 2016 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

  10. Laboratory evaluation of the pointing stability of the ASPS Vernier System

    NASA Technical Reports Server (NTRS)

    1980-01-01

    The annular suspension and pointing system (ASPS) is an end-mount experiment pointing system designed for use in the space shuttle. The results of the ASPS Vernier System (AVS) pointing stability tests conducted in a laboratory environment are documented. A simulated zero-G suspension was used to support the test payload in the laboratory. The AVS and the suspension were modelled and incorporated into a simulation of the laboratory test. Error sources were identified and pointing stability sensitivities were determined via simulation. Statistical predictions of laboratory test performance were derived and compared to actual laboratory test results. The predicted mean pointing stability during simulated shuttle disturbances was 1.22 arc seconds; the actual mean laboratory test pointing stability was 1.36 arc seconds. The successful prediction of laboratory test results provides increased confidence in the analytical understanding of the AVS magnetic bearing technology and allows confident prediction of in-flight performance. Computer simulations of ASPS, operating in the shuttle disturbance environment, predict in-flight pointing stability errors less than 0.01 arc seconds.

  11. Short-term outcomes after Fab antivenom therapy for severe crotaline snakebite.

    PubMed

    Lavonas, Eric J; Kokko, Jamie; Schaeffer, Tammi H; Mlynarchek, Sara L; Bogdan, Gregory M; Dart, Richard C

    2011-02-01

    We seek to determine the short-term outcomes associated with the use of Crotalidae polyvalent immune Fab (ovine) (CroFab; FabAV) therapy for severe crotaline snake envenomation and to better define the incidence of hypersensitivity reactions associated with FabAV use. We conducted a multicenter observational case series study of patients who received FabAV at 17 US hospitals in 2002 to 2004. A 7-point score incorporating local, systemic, and hematologic venom effects was used to grade envenomation severity before and after FabAV therapy. The primary outcome for response to therapy was the change in overall envenomation severity after FabAV administration. The primary safety outcomes were the rates of immediate hypersensitivity reactions and serum sickness. The outcome-evaluable population included 209 patients, of whom 28 had severe envenomation. All severely envenomated patients improved after receiving FabAV. The median severity scores of severely envenomated patients were 5 (interquartile range [IQR] 5 to 5) before FabAV, 1 (IQR 1 to 2) at the last FabAV loading dose, and 1 (IQR 0 to 1) at the last clinical observation. The proportion of patients with progressive pain, progressive swelling, cardiovascular effects, respiratory effects, neurologic effects, gastrointestinal effects, coagulopathy, and thrombocytopenia all improved after FabAV therapy. The safety population included 247 patients. Immediate hypersensitivity reactions were reported in 6.1% (95% confidence interval 3.4% to 9.8%) of patients. Serum sickness was reported in 5% (95% confidence interval 0.6% to 17%) of patients with a minimum of 6 days of follow-up after the last dose of FabAV. FabAV therapy is associated with clinical improvement in severe crotaline snake envenomation. Immediate hypersensitivity and serum sickness rates may be less than described in the FabAV prescribing information. Copyright © 2010. Published by Mosby, Inc.

  12. Simulation of Cardiac Arrhythmias Using a 2D Heterogeneous Whole Heart Model

    PubMed Central

    Balakrishnan, Minimol; Chakravarthy, V. Srinivasa; Guhathakurta, Soma

    2015-01-01

    Simulation studies of cardiac arrhythmias at the whole heart level with electrocardiogram (ECG) gives an understanding of how the underlying cell and tissue level changes manifest as rhythm disturbances in the ECG. We present a 2D whole heart model (WHM2D) which can accommodate variations at the cellular level and can generate the ECG waveform. It is shown that, by varying cellular-level parameters like the gap junction conductance (GJC), excitability, action potential duration (APD) and frequency of oscillations of the auto-rhythmic cell in WHM2D a large variety of cardiac arrhythmias can be generated including sinus tachycardia, sinus bradycardia, sinus arrhythmia, sinus pause, junctional rhythm, Wolf Parkinson White syndrome and all types of AV conduction blocks. WHM2D includes key components of the electrical conduction system of the heart like the SA (Sino atrial) node cells, fast conducting intranodal pathways, slow conducting atriovenctricular (AV) node, bundle of His cells, Purkinje network, atrial, and ventricular myocardial cells. SA nodal cells, AV nodal cells, bundle of His cells, and Purkinje cells are represented by the Fitzhugh-Nagumo (FN) model which is a reduced model of the Hodgkin-Huxley neuron model. The atrial and ventricular myocardial cells are modeled by the Aliev-Panfilov (AP) two-variable model proposed for cardiac excitation. WHM2D can prove to be a valuable clinical tool for understanding cardiac arrhythmias. PMID:26733873

  13. Cardiac Conduction through Engineered Tissue

    PubMed Central

    Choi, Yeong-Hoon; Stamm, Christof; Hammer, Peter E.; Kwaku, Kevin F.; Marler, Jennifer J.; Friehs, Ingeborg; Jones, Mara; Rader, Christine M.; Roy, Nathalie; Eddy, Mau-Thek; Triedman, John K.; Walsh, Edward P.; McGowan, Francis X.; del Nido, Pedro J.; Cowan, Douglas B.

    2006-01-01

    In children, interruption of cardiac atrioventricular (AV) electrical conduction can result from congenital defects, surgical interventions, and maternal autoimmune diseases during pregnancy. Complete AV conduction block is typically treated by implanting an electronic pacemaker device, although long-term pacing therapy in pediatric patients has significant complications. As a first step toward developing a substitute treatment, we implanted engineered tissue constructs in rat hearts to create an alternative AV conduction pathway. We found that skeletal muscle-derived cells in the constructs exhibited sustained electrical coupling through persistent expression and function of gap junction proteins. Using fluorescence in situ hybridization and polymerase chain reaction analyses, myogenic cells in the constructs were shown to survive in the AV groove of implanted hearts for the duration of the animal’s natural life. Perfusion of hearts with fluorescently labeled lectin demonstrated that implanted tissues became vascularized and immunostaining verified the presence of proteins important in electromechanical integration of myogenic cells with surrounding recipient rat cardiomyocytes. Finally, using optical mapping and electrophysiological analyses, we provide evidence of permanent AV conduction through the implant in one-third of recipient animals. Our experiments provide a proof-of-principle that engineered tissue constructs can function as an electrical conduit and, ultimately, may offer a substitute treatment to conventional pacing therapy. PMID:16816362

  14. A microcomputer system for on-line study of atrioventricular node accommodation.

    PubMed

    Jenkins, J R; Clemo, H F; Belardinelli, L

    1987-11-01

    An automated on-line programmable stimulator and interval measurement system was developed to study atrioventricular node (AVN) accommodation. This dedicated microcomputer system measures and stores the stimulus-to-His bundle (S-H) interval from His bundle electrogram (HBE) recordings. Interval measurements for each beat are accurate to within 500 microsecond. This user-controlled system has been used to stimulate at any rate up to 6.5 Hz and to measure intervals up to 125 ms in isolated perfused guinea pig hearts. A built-in timer-reset mechanism prevents failure of the system in the absence of a His potential (i.e., 2:1 AV block). It may be modified for use in clinical studies or other experimental systems and has the ability to measure other physiological intervals. The system provides the precision in pacing and accuracy in the measurement of AVN conduction time that is necessary for meaningful analysis of AVN accommodation and has the simplicity of design and use that is not available in previously described systems. Furthermore, this computer system can be used not only in studies involving AV conduction, but also in any setting where programmed stimulation and interval measurement and recording need to be performed simultaneously.

  15. An Overview of the NASA Aviation Safety Program Propulsion Health Monitoring Element

    NASA Technical Reports Server (NTRS)

    Simon, Donald L.

    2000-01-01

    The NASA Aviation Safety Program (AvSP) has been initiated with aggressive goals to reduce the civil aviation accident rate, To meet these goals, several technology investment areas have been identified including a sub-element in propulsion health monitoring (PHM). Specific AvSP PHM objectives are to develop and validate propulsion system health monitoring technologies designed to prevent engine malfunctions from occurring in flight, and to mitigate detrimental effects in the event an in-flight malfunction does occur. A review of available propulsion system safety information was conducted to help prioritize PHM areas to focus on under the AvSP. It is noted that when a propulsion malfunction is involved in an aviation accident or incident, it is often a contributing factor rather than the sole cause for the event. Challenging aspects of the development and implementation of PHM technology such as cost, weight, robustness, and reliability are discussed. Specific technology plans are overviewed including vibration diagnostics, model-based controls and diagnostics, advanced instrumentation, and general aviation propulsion system health monitoring technology. Propulsion system health monitoring, in addition to engine design, inspection, maintenance, and pilot training and awareness, is intrinsic to enhancing aviation propulsion system safety.

  16. How TSPSM Implementation has Evolved at AV-8B

    DTIC Science & Technology

    2008-05-01

    How TSPSM Implementation Has Evolved at AV-8B Chris Rickets AV-8B Joint Systems/Software Support Activity (JSSA) Brad Hodgins NAVAIR Systems...members need to be involved) NAVAIR Software/Systems Support Center (NSSC) Slide 40 Contact Information • Chris Rickets (AV-8B Sr. Software Engr...phone: (760) 939-5838 – e-mail: chris rickets @navy mil . . • Brad Hodgins (NAVAIR TSP Coach supporting AV-8B ) – phone: (760) 939-0666/4446 – e

  17. Atrioventricular and intraventricular block after transcatheter aortic valve implantation.

    PubMed

    Lee, Jane J; Goldschlager, Nora; Mahadevan, Vaikom S

    2018-06-24

    Aortic stenosis is the most common valvular heart disease in industrialized countries and the most common cause of left ventricular outflow tract (LVOT) obstruction. Transcatheter aortic valve replacement (TAVR) is an alternative to surgical aortic valve replacement for intermediate to high-risk surgical candidates with symptomatic severe aortic stenosis. Conduction system abnormalities, including atrioventricular (AV) and intraventricular (IV) block, are the most common complication of TAVR. In this review, we aim to explore the anatomical issues relevant to atrioventricular block, the relevant clinical and procedural aspects, and the management and long-term implications of AV and IV block.

  18. Electrophysiologic effects of a novel selective adenosine A1 agonist (CVT-510) on atrioventricular nodal conduction in humans.

    PubMed

    Lerman, B B; Ellenbogen, K A; Kadish, A; Platia, E; Stein, K M; Markowitz, S M; Mittal, S; Slotwiner, D J; Scheiner, M; Iwai, S; Belardinelli, L; Jerling, M; Shreeniwas, R; Wolff, A A

    2001-07-01

    CVT-510, N-(3(R)-tetrahydrofuranyl)-6-aminopurine riboside, is a selective A(1)-adenosine receptor agonist with potential potent antiarrhythmic effects in tachycardias involving the atrioventricular (AV) node. This study, the first in humans, was designed to determine the effects of CVT-510 on AV nodal conduction and hemodynamics. Patients in sinus rhythm with normal AV nodal function at electrophysiologic study (n = 32) received a single intravenous bolus of CVT-510. AH and HV intervals were measured during sinus rhythm and during atrial pacing at 1, 5, 10, 15, 20, 30, 45, and 60 minutes after the bolus. Increasing doses of CVT-510 (0.3 to 10 microg/kg) caused a dose-dependent increase in the AH interval. At 1 minute, a dose of 10 microg/kg increased the AH interval during sinus rhythm from 93 +/- 23 msec to 114 +/- 37 msec, p = 0.01 and from 114 +/- 31 msec to 146 +/- 44 msec during atrial pacing at 600 msec, p = 0.003). The AH interval returned to baseline by 20 minutes. CVT-510 at doses of 0.3 to 10 microg/kg had no effect on sinus rate, HV interval, or systemic blood pressure, and was not associated with serious adverse effects. At doses of 15 and 30 microg/kg, CVT-510 produced transient second/third degree AV heart block in all four patients treated. One of these patients also had a prolonged sedative effect that was reversed with aminophylline. CVT-510 promptly prolongs AV nodal conduction and does not affect sinus rate or blood pressure. Selective stimulation of the A(1)-adenosine receptor by CVT-510 may be useful for immediate control of heart rate in atrial fibrillation/flutter and to convert paroxysmal supraventricular tachycardia to sinus rhythm, while avoiding vasodilatation mediated by the A(2)-adenosine receptor, as well as the vasodepressor and negative inotropic effects associated with beta-adrenergic receptor blockade and/or calcium channel blockers.

  19. A field investigation of the relationship between zinc and acid volatile sulfide concentrations in freshwater sediments

    USGS Publications Warehouse

    Ankley, Gerald T.; Liber, Karsten; Call, Daniel J.; Markee, Thomas P.; Canfield, Timothy J.; Ingersoll, Christopher G.

    1996-01-01

    Understanding relationships between cationic metals such as cadmium, copper, nickel, lead and zinc, and amorphous iron sulfides, measured as acid volatile sulfide (AVS), is key to predicting metal bioavailability and toxicity insediments. The objective of the present study was to assess seasonal and spatial variations of AVS in freshwater sediments contaminated with zinc. Sediments were sampled from three streams with varying levels of zinc contamination at two different times, March and June of 1995, representing cold- and warm-weather situations. Interstitial (pore) water concentrations of zinc, and solid phase concentrations of AVS and zinc were measured in surficial and deep sediment horizons. Toxicity tests (10-d) with the amphipodHyalella azteca were conducted using intact cores. Sediment zinc concentrations from six sites within the primary test stream differed by about five-fold, and also varied seasonally. Acid volatile sulfide concentrations were generally lower than those of zinc, and pore water zinc concentrations typically were elevated. There was a positive correlation between solid-phase AVS and zinc concentrations, suggesting that the system was dominated by zinc, as opposed to iron sulfides. In contrast to expectations arising from some studies of seasonal variations of AVS in iron-dominated systems, AVS concentrations were smaller in June than in March. However, this was likely due to a major storm event and associated sediment scouring before the June sampling, rather than to seasonal processes related to variations in temperature and dissolved oxygen. Based upon an indirect analysis of depth variations in AVS, there was some indication that zinc sulfide might be less prone to oxidation than iron sulfide. There was a strong correlation between toxicity of the sediment samples toH. azteca and interstitial water concentrations of zinc; however, the possible contribution of other contaminants to sediment toxicity cannot be dismissed.

  20. Alternative Fuels Data Center

    Science.gov Websites

    , and Department of Professional and Financial Regulation to develop, test, and operate AVs for public transportation use. An AV is defined as any vehicle that is equipped with a technology that has the capability to operate the vehicle without the direct control of the driver. A municipality that conducts an AV pilot

  1. In-Service Evaluation of the Turbulence Auto-PIREP System and Enhanced Turbulence Radar Technologies

    NASA Technical Reports Server (NTRS)

    Prince, Jason B.; Buck, Bill K.; Robinson, Paul A.; Ryan, Tim

    2007-01-01

    From August 2003 to December 2006, In-Service Evaluations (ISE) of the Turbulence Auto-PIREP System (TAPS) and Enhanced Turbulence (E-Turb) Radar, technologies developed in NASA's Turbulence Prediction and Warning System (TPAWS) element of its Aviation Safety and Security Program (AvSSP), were conducted. NASA and AeroTech Research established an industry team comprising AeroTech, Delta Air Lines, Rockwell Collins, and ARINC to conduct the ISEs. The technologies were installed on Delta aircraft and their effectiveness was evaluated in day-to-day operations. This report documents the establishment and conduct of the ISEs and presents results and feedback from various users.

  2. Cardiorespiratory interactions in patients with atrial flutter.

    PubMed

    Masè, Michela; Disertori, Marcello; Ravelli, Flavia

    2009-01-01

    Respiratory sinus arrhythmia (RSA) is generally known as the autonomically mediated modulation of the sinus node pacemaker frequency in synchrony with respiration. Cardiorespiratory interactions have been largely investigated during sinus rhythm, whereas little is known about interactions during reentrant arrhythmias. In this study, cardiorespiratory interactions at the atrial and ventricular level were investigated during atrial flutter (AFL), a supraventricular arrhythmia based on a reentry, by using cross-spectral analysis and computer modeling. The coherence and phase between respiration and atrial (gamma(AA)(2), phi(AA)) and ventricular (gamma(RR)(2), phi(RR)) interval series were estimated in 20 patients with typical AFL (68.0 +/- 8.8 yr) and some degree of atrioventricular (AV) conduction block. In all patients, atrial intervals displayed oscillations strongly coupled and in phase with respiration (gamma(AA)(2)= 0.97 +/- 0.05, phi(AA) = 0.71 +/- 0.31 rad), corresponding to a paradoxical lengthening of intervals during inspiration. The modulation pattern was frequency independent, with in-phase oscillations and short time delays (0.40 +/- 0.15 s) for respiratory frequencies in the range 0.1-0.4 Hz. Ventricular patterns were affected by AV conduction type. In patients with fixed AV conduction, ventricular intervals displayed oscillations strongly coupled (gamma(RR)(2)= 0.97 +/- 0.03) and in phase with respiration (phi(RR) = 1.08 +/- 0.80 rad). Differently, in patients with variable AV conduction, respiratory oscillations were secondary to Wencheback rhythmicity, resulting in a decreased level of coupling (gamma(RR)(2)= 0.50 +/- 0.21). Simulations with a simplified model of AV conduction showed ventricular patterns to originate from the combination of a respiratory modulated atrial input with the functional properties of the AV node. The paradoxical frequency-independent modulation pattern of atrial interval, the short time delays, and the complexity of ventricular rhythm characterize respiratory arrhythmia during AFL and distinguish it from normal RSA. These peculiar features can be explained by assuming a direct mechanical action of respiration on AFL reentrant circuit.

  3. Intermittent bradyarrhythmia in a Hispaniolan Amazon parrot (Amazona ventralis).

    PubMed

    Rembert, Melanie S; Smith, Julie A; Strickland, Keith N; Tully, Thomas N

    2008-03-01

    A clinically normal 2-year-old Hispaniolan Amazon parrot (Amazona ventralis) was found to have periodic second-degree atrioventricular (AV) block with variable nodal conductions while anesthetized with isoflurane during a thermal-support research project. Arrhythmias were observed on 5 successive weekly electrocardiograms. A complete cardiac evaluation, including a diagnostic electrocardiogram, revealed intermittent bradyarrhythmias ranging from a 2:1 to a 7:1 second-degree AV block, with concurrent hypotensive episodes during the nodal blocks. Results of a complete blood cell count, plasma biochemical profile, blood gas analysis, and atropine-response test, as well as radiography and auscultation, revealed no obvious cause for the arrhythmias. Echocardiography demonstrated cardiac wall thickness, chamber size, and systolic function similar to other psittacine birds. On return to the colony, the parrot continued to be outwardly asymptomatic despite the dramatic conduction disturbances. Although cardiac arrhythmias, including second-degree AV block, have been widely reported in birds, the wide variation of nodal conductions, the intermittent nature, and an arrhythmia with a 7:1 second-degree AV block that spontaneously reverts to normal as seen in this case have not been well documented in parrots.

  4. A comparison of an A1 adenosine receptor agonist (CVT-510) with diltiazem for slowing of AV nodal conduction in guinea-pig

    PubMed Central

    Snowdy, Stephen; Liang, Hui Xiu; Blackburn, Brent; Lum, Robert; Nelson, Marek; Wang, Lisa; Pfister, Jürg; Sharma, Bhavender P; Wolff, Andrew; Belardinelli, Luiz

    1999-01-01

    The purpose of this study was to compare the pharmacological properties (i.e. the AV nodal depressant, vasodilator, and inotropic effects) of two AV nodal blocking agents belonging to different drug classes; a novel A1 adenosine receptor (A1 receptor) agonist, N-(3(R)-tetrahydrofuranyl)-6-aminopurine riboside (CVT-510), and the prototypical calcium channel blocker diltiazem.In the atrial-paced isolated heart, CVT-510 was approximately 5 fold more potent to prolong the stimulus-to-His bundle (S–H interval), a measure of slowing AV nodal conduction (EC50=41 nM) than to increase coronary conductance (EC50=200 nM). At concentrations of CVT-510 (40 nM) and diltiazem (1 μM) that caused equal prolongation of S–H interval (∼10 ms), diltiazem, but not CVT-510, significantly reduced left ventricular developed pressure (LVP) and markedly increased coronary conductance. CVT-510 shortened atrial (EC50=73 nM) but not the ventricular monophasic action potentials (MAP).In atrial-paced anaesthetized guinea-pigs, intravenous infusions of CVT-510 and diltiazem caused nearly equal prolongations of P–R interval. However, diltiazem, but not CVT-510, significantly reduced mean arterial blood pressure.Both CVT-510 and diltiazem prolonged S–H interval, i.e., slowed AV nodal conduction. However, the A1 receptor-selective agonist CVT-510 did so without causing the negative inotropic, vasodilator, and hypotensive effects associated with diltiazem. Because CVT-510 did not affect the ventricular action potential, it is unlikely that this agonist will have a proarrythmic action in ventricular myocardium. PMID:10051130

  5. MyoR Modulates Cardiac Conduction by Repressing Gata4

    PubMed Central

    Harris, John P.; Bhakta, Minoti; Bezprozvannaya, Svetlana; Wang, Lin; Lubczyk, Christina; Olson, Eric N.

    2014-01-01

    The cardiac conduction system coordinates electrical activation through a series of interconnected structures, including the atrioventricular node (AVN), the central connection point that delays impulse propagation to optimize cardiac performance. Although recent studies have uncovered important molecular details of AVN formation, relatively little is known about the transcriptional mechanisms that regulate AV delay, the primary function of the mature AVN. We identify here MyoR as a novel transcription factor expressed in Cx30.2+ cells of the AVN. We show that MyoR specifically inhibits a Cx30.2 enhancer required for AVN-specific gene expression. Furthermore, we demonstrate that MyoR interacts directly with Gata4 to mediate transcriptional repression. Our studies reveal that MyoR contains two nonequivalent repression domains. While the MyoR C-terminal repression domain inhibits transcription in a context-dependent manner, the N-terminal repression domain can function in a heterologous context to convert the Hand2 activator into a repressor. In addition, we show that genetic deletion of MyoR in mice increases Cx30.2 expression by 50% and prolongs AV delay by 13%. Taken together, we conclude that MyoR modulates a Gata4-dependent regulatory circuit that establishes proper AV delay, and these findings may have wider implications for the variability of cardiac rhythm observed in the general population. PMID:25487574

  6. [Estimation of the atrioventricular time interval by pulse Doppler in the normal fetal heart].

    PubMed

    Hamela-Olkowska, Anita; Dangel, Joanna

    2009-08-01

    To assess normative values of the fetal atrioventricular (AV) time interval by pulse-wave Doppler methods on 5-chamber view. Fetal echocardiography exams were performed using Acuson Sequoia 512 in 140 singleton fetuses at 18 to 40 weeks of gestation with sinus rhythm and normal cardiac and extracardiac anatomy. Pulsed Doppler derived AV intervals were measured from left ventricular inflow/outflow view using transabdominal convex 3.5-6 MHz probe. The values of AV time interval ranged from 100 to 150 ms (mean 123 +/- 11.2). The AV interval was negatively correlated with the heart rhythm (p<0.001). Fetal heart rate decreased as gestation progressed (p<0.001). Thus, the AV intervals increased with the age of gestation (p=0.007). However, in the same subgroup of the fetal heart rate there was no relation between AV intervals and gestational age. Therefore, the AV intervals showed only the heart rate dependence. The 95th percentiles of AV intervals according to FHR ranged from 135 to 148 ms. 1. The AV interval duration was negatively correlated with the heart rhythm. 2. Measurement of AV time interval is easy to perform and has a good reproducibility. It may be used for the fetal heart block screening in anti-Ro and anti-La positive pregnancies. 3. Normative values established in the study may help obstetricians in assessing fetal abnormalities of the AV conduction.

  7. An ALE meta-analysis on the audiovisual integration of speech signals.

    PubMed

    Erickson, Laura C; Heeg, Elizabeth; Rauschecker, Josef P; Turkeltaub, Peter E

    2014-11-01

    The brain improves speech processing through the integration of audiovisual (AV) signals. Situations involving AV speech integration may be crudely dichotomized into those where auditory and visual inputs contain (1) equivalent, complementary signals (validating AV speech) or (2) inconsistent, different signals (conflicting AV speech). This simple framework may allow the systematic examination of broad commonalities and differences between AV neural processes engaged by various experimental paradigms frequently used to study AV speech integration. We conducted an activation likelihood estimation metaanalysis of 22 functional imaging studies comprising 33 experiments, 311 subjects, and 347 foci examining "conflicting" versus "validating" AV speech. Experimental paradigms included content congruency, timing synchrony, and perceptual measures, such as the McGurk effect or synchrony judgments, across AV speech stimulus types (sublexical to sentence). Colocalization of conflicting AV speech experiments revealed consistency across at least two contrast types (e.g., synchrony and congruency) in a network of dorsal stream regions in the frontal, parietal, and temporal lobes. There was consistency across all contrast types (synchrony, congruency, and percept) in the bilateral posterior superior/middle temporal cortex. Although fewer studies were available, validating AV speech experiments were localized to other regions, such as ventral stream visual areas in the occipital and inferior temporal cortex. These results suggest that while equivalent, complementary AV speech signals may evoke activity in regions related to the corroboration of sensory input, conflicting AV speech signals recruit widespread dorsal stream areas likely involved in the resolution of conflicting sensory signals. Copyright © 2014 Wiley Periodicals, Inc.

  8. Development of autonomous vehicles’ testing system

    NASA Astrophysics Data System (ADS)

    Ivanov, A. M.; Shadrin, S. S.

    2018-02-01

    This article describes overview of automated and, in perspective, autonomous vehicles’ (AV) implementation risks. Set of activities, actual before the use of AVs on public roads, minimizing negative technical and social problems of AVs’ implementation is presented. Classification of vehicle’s automated control systems operating conditions is formulated. Groups of tests for AVs are developed and justified, sequence of AVs’ testing system formation is proposed.

  9. Evaluation of a patient-centered after visit summary in primary care.

    PubMed

    Federman, Alex D; Jandorf, Lina; DeLuca, Joseph; Gover, Mary; Sanchez Munoz, Angela; Chen, Li; Wolf, Michael S; Kannry, Joseph

    2018-03-06

    To test the impact of a redesigned, patient-centered after visit summary (AVS) on patients' and clinicians' ratings of and experience with the document. We conducted a difference-in-differences (DiD) evaluation of the impact of the redesigned AVS before and after its introduction in an academic primary care practice compared to a concurrent control practice. Outcomes included ratings of the features of the AVS. The intervention site had 118 and 98 patients in the pre- and post-intervention periods and the control site had 99 and 105, respectively. In adjusted DiD analysis, introduction of the patient-centered AVS in the intervention site increased patient reports that the AVS was an effective reminder for taking medications (p = .004) and of receipt of the AVS from clinicians (p = .002). However, they were more likely to perceive it as too long (p = .04). There were no significant changes in overall rating of the AVS by clinicians or their likelihood of providing it to patients. A patient-centered AVS increased the number of patients receiving it and reporting that it would help them remember to take their medications. Improvements in the patient-centeredness of the AVS may improve its usefulness as a document to support self-management in primary care. Copyright © 2018. Published by Elsevier B.V.

  10. Development of a Bayesian Belief Network Runway Incursion Model

    NASA Technical Reports Server (NTRS)

    Green, Lawrence L.

    2014-01-01

    In a previous paper, a statistical analysis of runway incursion (RI) events was conducted to ascertain their relevance to the top ten Technical Challenges (TC) of the National Aeronautics and Space Administration (NASA) Aviation Safety Program (AvSP). The study revealed connections to perhaps several of the AvSP top ten TC. That data also identified several primary causes and contributing factors for RI events that served as the basis for developing a system-level Bayesian Belief Network (BBN) model for RI events. The system-level BBN model will allow NASA to generically model the causes of RI events and to assess the effectiveness of technology products being developed under NASA funding. These products are intended to reduce the frequency of RI events in particular, and to improve runway safety in general. The development, structure and assessment of that BBN for RI events by a Subject Matter Expert panel are documented in this paper.

  11. Id4 functions downstream of Bmp signaling to restrict TCF function in endocardial cells during atrioventricular valve development.

    PubMed

    Ahuja, Suchit; Dogra, Deepika; Stainier, Didier Y R; Reischauer, Sven

    2016-04-01

    The atrioventricular canal (AVC) connects the atrial and ventricular chambers of the heart and its formation is critical for the development of the cardiac valves, chamber septation and formation of the cardiac conduction system. Consequently, problems in AVC formation can lead to congenital defects ranging from cardiac arrhythmia to incomplete cardiac septation. While our knowledge about early heart tube formation is relatively comprehensive, much remains to be investigated about the genes that regulate AVC formation. Here we identify a new role for the basic helix-loop-helix factor Id4 in zebrafish AVC valve development and function. id4 is first expressed in the AVC endocardium and later becomes more highly expressed in the atrial chamber. TALEN induced inactivation of id4 causes retrograde blood flow at the AV canal under heat induced stress conditions, indicating defects in AV valve function. At the molecular level, we found that id4 inactivation causes misexpression of several genes important for AVC and AV valve formation including bmp4 and spp1. We further show that id4 appears to control the number of endocardial cells that contribute to the AV valves by regulating Wnt signaling in the developing AVC endocardium. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. Interlaboratory comparison of measurements of acid-volatile sulfide and simultaneously extracted nickel in spiked sediments

    USGS Publications Warehouse

    Brumbaugh, William G.; Hammerschmidt, Chad R.; Zanella, Luciana; Rogevich, Emily; Salata, Gregory; Bolek, Radoslaw

    2011-01-01

    An interlaboratory comparison of acid-volatile sulfide (AVS) and simultaneously extracted nickel (SEM_Ni) measurements of sediments was conducted among five independent laboratories. Relative standard deviations for the seven test samples ranged from 5.6 to 71% (mean = 25%) for AVS and from 5.5 to 15% (mean = 10%) for SEM_Ni. These results are in stark contrast to a recently published study that indicated AVS and SEM analyses were highly variable among laboratories.

  13. The Threat of Aerobic Vaginitis to Pregnancy and Neonatal Morbidity.

    PubMed

    Kaambo, Eveline; Africa, Charlene W J

    2017-06-01

    Aerobic vaginitis (AV) is an endogenous opportunistic infection brought about by the disruption of the normal vaginal microbiota. Its early diagnosis and treatment during pregnancy may reduce the risk of negative pregnancy outcomes. The aim of this review was to report on the aerobic bacteria most prevalent in AV and to provide evidence of the threat of untreated AV on pregnancy outcomes. More than 300 papers on preterm delivery were extracted from several research domains and filtered to include only AV-associated bacteria such as Staphylococcus aureus, Enterococcus faecalis, Escherichia coli and Group B streptococci and their association with adverse pregnancy outcomes. Due to the diverse sample groups, study techniques and outcomes, a meta-analysis was not conducted. The review revealed that the association of AV with adverse pregnancy outcomes has not been as widely researched as bacterial vaginosis (BV) and needs further investigation. Furthermore, the frequent misdiagnosis of AV coupled with the emerging antimicrobial resistance associated with bacteria implicated in AV and neonatal nosocomial infections pose a problem for prophylaxis and treatment to reduce the risk of maternal and neonatal morbidity and mortality.

  14. Alternative Fuels Data Center

    Science.gov Websites

    Support for Automated Vehicle (AV) Testing and Operation Effective September 1, 2017, Texas state agencies must support the testing and operation of AVs. AV usage is authorized if the driving system

  15. Visualization and Tracking of Parallel CFD Simulations

    NASA Technical Reports Server (NTRS)

    Vaziri, Arsi; Kremenetsky, Mark

    1995-01-01

    We describe a system for interactive visualization and tracking of a 3-D unsteady computational fluid dynamics (CFD) simulation on a parallel computer. CM/AVS, a distributed, parallel implementation of a visualization environment (AVS) runs on the CM-5 parallel supercomputer. A CFD solver is run as a CM/AVS module on the CM-5. Data communication between the solver, other parallel visualization modules, and a graphics workstation, which is running AVS, are handled by CM/AVS. Partitioning of the visualization task, between CM-5 and the workstation, can be done interactively in the visual programming environment provided by AVS. Flow solver parameters can also be altered by programmable interactive widgets. This system partially removes the requirement of storing large solution files at frequent time steps, a characteristic of the traditional 'simulate (yields) store (yields) visualize' post-processing approach.

  16. The effect of atrial pacing site on electrophysiological properties of the atrioventricular junction and induction of atrioventricular nodal reentry in patients with typical atrioventricular nodal reentrant tachycardia.

    PubMed

    Kiedrowicz, Radosław M; Kaźmierczak, Jarosław; Wielusiński, Maciej

    2017-01-01

    Clinical studies in humans have shown the site of atrial stimulation to influence atrioventricular (AV) conduction times and refractory periods, the demonstration of dual AV nodal (AVN) pathways, and induction of AVN reentry. These studies often found conflicting results. Moreover, among enrolled patients a minority of them were found to have AVN reentrant tachycardia (AVNRT). The purpose of this study was to investigate the effect of right and left atrial pacing on the electrophysiological properties of the AV junction in the typical AVNRT population. Ninety-two consecutive patients with typical AVNRT were included. Atrial pacing was performed from the high right atrium (HRA) and the left atrium via the proximal coronary sinus (CS). Stimulation from either the HRA or the CS could result in dual AVN physiology and AVNRT. No site-dependent differences in the ease of induction of dual AVN pathways with variability of initiation from either site were found. However, AVNRT was easier to induce from the HRA. With CS pacing the leftward but not the rightward AVN approaches were the entry point to the AV node because of significantly shorter AH conduction times compared to HRA pacing. Conduction over the leftward AVN extensions could initiate the tachycardia with significantly shorter critical AH interval compared to conduction over the rightward AVN extensions; however, the AH interval during AVNRT and its cycle length were not significantly different. Rightward and leftward AVN extensions are regular features of the AV node. Their different electrophysiological properties lead to variation in the demonstration of discontinuous AVN conduction and AVNRT during right and left atrial pacing. Despite the observation that the left AVN extensions could compose the entry point to the reentrant circuit, there is no evidence that they constitute the critical component of sustained typical AVNRT.

  17. [Intravenous ablation of the atrio-ventricular junction in patients with supraventricular tachyarrhythmias].

    PubMed

    Drzewiecki, J; Trusz-Gluza, M; Wnuk-Wojnar, A; Jaklik, A; Czerwiński, C; Filipecki, A; Szydło, K; Ciemniewski, Z; Giec, L

    1993-01-01

    Since the first successful therapeutic DC ablation of the AV junction in 1986, we have treated 20 symptomatic patients with drug-refractory supraventricular tachyarrhythmias (average of 6 antiarrhythmic drugs prior to the ablation attempt). The primary rhythm disturbances necessitating ablation were: AV nodal reentrant tachycardia (50% of pts), atrial flutter or fibrillation, with an uncontrolled rapid ventricular response (40%), atrioventricular reentrant tachycardia using an accessory pathway (20%), atrial tachycardia (10%), and junctional reciprocating tachycardia (5%). Percutaneous catheter ablation of the AV junction was made by Gallagher's method. The USCI 4-polar catheter (7F) was used in 40% of pts, and bipolar Cordis catheter (5F) in the remaining 60%. 70% of pts received either one or two shocks, usually of 200 or 300 J during one session. Another 25% received stored cumulative energy from 800 to 1200 J (in two sessions), and one patient--1800 J (during three sessions). In 85% of pts, the immediate post-ablation conduction was third-degree AV block with the escape pacemaker, ranging from 20 to 50 beats/min., which was infra-His in 57%, and supra-His in 43% of pts. In 15% of pts were either first-degree AV block (10%) or normal AV conduction (5%). A His bundle deflection more than 0.2 mV was predictive of successful production of third-degree AV block. Except a mild and transient increase of indicating enzymes (CPK and CPK-MB) we did not observe any other serious complications directly related to the ablalation procedure. Follow-up study included 19 pts (time range from 2 to 56 months, mean 28).(ABSTRACT TRUNCATED AT 250 WORDS)

  18. Comparison of aviary, barn and conventional cage raising of chickens on laying performance and egg quality.

    PubMed

    Ahammed, M; Chae, B J; Lohakare, J; Keohavong, B; Lee, M H; Lee, S J; Kim, D M; Lee, J Y; Ohh, S J

    2014-08-01

    This study intended to compare the productive performance of three different layer raising systems; conventional cage (CC), barn (BR) and aviary (AV). The AV is welfare bestowed housing that allows free locomotion for birds within the BR. The BR allows bird's free locomotion inside BR but without multilevel structures. Both pullets and cockerels were housed together in both AV and BR, but only pullets in CC. Seventeen weeks old Lohmann Brown Lite (n = 800) pullets were housed in AV during this study. The same age layer pullets were simultaneously assigned to either at CC or BR to compare egg production performance with AV. The duration of experiment was 40 weeks (from 21st to 60th week). There were no remarkable differences in egg production, hen day egg production (HDEP) and average egg weight among three rearing systems. First 20 weeks (phase-1) average HDEP (%) of AV, CC, and BR were 85.9, 88.8, 87.1 and average egg weights (g) were 57.5, 59.9, and 56.9 respectively. Those of the remaining 20 weeks (phase-2) were 87.1, 87.9, 85.5 and 64.2, 63.0 62.1, respectively. Daily feed intakes (122 g, 110 g, 125 g); feed conversion ratio (2.4, 2.1, 2.5) and daily egg mass (53.9 g, 54.4 g, 52.8 g) data from AV, CC, and BR were not influenced significantly by the respective raising systems. Daily feed intake of layers in both AV (124 g) and BR (127 g) tended to be higher than that in CC (113 g) during phase-2. Overall, exterior egg quality (dirty and cracked eggs) in both phases was superior in BR compared with AV and CC, whereas CC generated intermediate results. This study indicated that the HDEP per se in AV and BR were not significantly different from that in CC. The study implied that the facility depreciation cost for AV and cost for increased feed intake in AV compared to CC are believed to be critical to evaluate the cost effectiveness of egg production in AV.

  19. Comparison of Aviary, Barn and Conventional Cage Raising of Chickens on Laying Performance and Egg Quality

    PubMed Central

    Ahammed, M.; Chae, B. J.; Lohakare, J.; Keohavong, B.; Lee, M. H.; Lee, S. J.; Kim, D. M.; Lee, J. Y.; Ohh, S. J.

    2014-01-01

    This study intended to compare the productive performance of three different layer raising systems; conventional cage (CC), barn (BR) and aviary (AV). The AV is welfare bestowed housing that allows free locomotion for birds within the BR. The BR allows bird’s free locomotion inside BR but without multilevel structures. Both pullets and cockerels were housed together in both AV and BR, but only pullets in CC. Seventeen weeks old Lohmann Brown Lite (n = 800) pullets were housed in AV during this study. The same age layer pullets were simultaneously assigned to either at CC or BR to compare egg production performance with AV. The duration of experiment was 40 weeks (from 21st to 60th week). There were no remarkable differences in egg production, hen day egg production (HDEP) and average egg weight among three rearing systems. First 20 weeks (phase-1) average HDEP (%) of AV, CC, and BR were 85.9, 88.8, 87.1 and average egg weights (g) were 57.5, 59.9, and 56.9 respectively. Those of the remaining 20 weeks (phase-2) were 87.1, 87.9, 85.5 and 64.2, 63.0 62.1, respectively. Daily feed intakes (122 g, 110 g, 125 g); feed conversion ratio (2.4, 2.1, 2.5) and daily egg mass (53.9 g, 54.4 g, 52.8 g) data from AV, CC, and BR were not influenced significantly by the respective raising systems. Daily feed intake of layers in both AV (124 g) and BR (127 g) tended to be higher than that in CC (113 g) during phase-2. Overall, exterior egg quality (dirty and cracked eggs) in both phases was superior in BR compared with AV and CC, whereas CC generated intermediate results. This study indicated that the HDEP per se in AV and BR were not significantly different from that in CC. The study implied that the facility depreciation cost for AV and cost for increased feed intake in AV compared to CC are believed to be critical to evaluate the cost effectiveness of egg production in AV. PMID:25083115

  20. Microcomputer-based artificial vision support system for real-time image processing for camera-driven visual prostheses

    NASA Astrophysics Data System (ADS)

    Fink, Wolfgang; You, Cindy X.; Tarbell, Mark A.

    2010-01-01

    It is difficult to predict exactly what blind subjects with camera-driven visual prostheses (e.g., retinal implants) can perceive. Thus, it is prudent to offer them a wide variety of image processing filters and the capability to engage these filters repeatedly in any user-defined order to enhance their visual perception. To attain true portability, we employ a commercial off-the-shelf battery-powered general purpose Linux microprocessor platform to create the microcomputer-based artificial vision support system (μAVS2) for real-time image processing. Truly standalone, μAVS2 is smaller than a deck of playing cards, lightweight, fast, and equipped with USB, RS-232 and Ethernet interfaces. Image processing filters on μAVS2 operate in a user-defined linear sequential-loop fashion, resulting in vastly reduced memory and CPU requirements during execution. μAVS2 imports raw video frames from a USB or IP camera, performs image processing, and issues the processed data over an outbound Internet TCP/IP or RS-232 connection to the visual prosthesis system. Hence, μAVS2 affords users of current and future visual prostheses independent mobility and the capability to customize the visual perception generated. Additionally, μAVS2 can easily be reconfigured for other prosthetic systems. Testing of μAVS2 with actual retinal implant carriers is envisioned in the near future.

  1. Microcomputer-based artificial vision support system for real-time image processing for camera-driven visual prostheses.

    PubMed

    Fink, Wolfgang; You, Cindy X; Tarbell, Mark A

    2010-01-01

    It is difficult to predict exactly what blind subjects with camera-driven visual prostheses (e.g., retinal implants) can perceive. Thus, it is prudent to offer them a wide variety of image processing filters and the capability to engage these filters repeatedly in any user-defined order to enhance their visual perception. To attain true portability, we employ a commercial off-the-shelf battery-powered general purpose Linux microprocessor platform to create the microcomputer-based artificial vision support system (microAVS(2)) for real-time image processing. Truly standalone, microAVS(2) is smaller than a deck of playing cards, lightweight, fast, and equipped with USB, RS-232 and Ethernet interfaces. Image processing filters on microAVS(2) operate in a user-defined linear sequential-loop fashion, resulting in vastly reduced memory and CPU requirements during execution. MiccroAVS(2) imports raw video frames from a USB or IP camera, performs image processing, and issues the processed data over an outbound Internet TCP/IP or RS-232 connection to the visual prosthesis system. Hence, microAVS(2) affords users of current and future visual prostheses independent mobility and the capability to customize the visual perception generated. Additionally, microAVS(2) can easily be reconfigured for other prosthetic systems. Testing of microAVS(2) with actual retinal implant carriers is envisioned in the near future.

  2. A New Availability-Payment Model for Pricing Performance-Based Logistics Contracts

    DTIC Science & Technology

    2014-05-01

    Petri   net ) is used to  capture concurrency and  synchronization...properties of the  system. Petri   Net Available IN 1`A failure indication IN Down Repair Shop IN Down Replace Order IN Replace Order U costs PC (1,2) time...action (expTime(50*w)); INT Repairs AV Replaces AV AV av.req AV DOWNTIME 0 INT 0 INT Manufacturer Quantity Inventory 5 Quantity stock Cost Book

  3. Expression of host defense peptides in the intestine of Eimeria-challenged chickens.

    PubMed

    Su, S; Dwyer, D M; Miska, K B; Fetterer, R H; Jenkins, M C; Wong, E A

    2017-07-01

    Avian coccidiosis is caused by the intracellular protozoan Eimeria, which produces intestinal lesions leading to weight gain depression. Current control methods include vaccination and anticoccidial drugs. An alternative approach involves modulating the immune system. The objective of this study was to profile the expression of host defense peptides such as avian beta-defensins (AvBDs) and liver expressed antimicrobial peptide 2 (LEAP2), which are part of the innate immune system. The mRNA expression of AvBD family members 1, 6, 8, 10, 11, 12, and 13 and LEAP2 was examined in chickens challenged with either E. acervulina, E. maxima, or E. tenella. The duodenum, jejunum, ileum, and ceca were collected 7 d post challenge. In study 1, E. acervulina challenge resulted in down-regulation of AvBD1, AvBD6, AvBD10, AvBD11, AvBD12, and AvBD13 in the duodenum. E. maxima challenge caused down-regulation of AvBD6, AvBD10, and AvBD11 in the duodenum, down-regulation of AvBD10 in the jejunum, but up-regulation of AvBD8 and AvBD13 in the ceca. E. tenella challenge showed no change in AvBD expression in any tissue. In study 2, which involved challenge with only E. maxima, there was down-regulation of AvBD1 in the ileum, AvBD11 in the jejunum and ileum, and LEAP2 in all 3 segments of the small intestine. The expression of LEAP2 was further examined by in situ hybridization in the jejunum of chickens from study 2. LEAP2 mRNA was expressed similarly in the enterocytes lining the villi, but not in the crypts of control and Eimeria challenged chickens. The lengths of the villi in the Eimeria challenged chickens were less than those in the control chickens, which may in part account for the observed down-regulation of LEAP2 mRNA quantified by PCR. Overall, the AvBD response to Eimeria challenge was not consistent; whereas LEAP2 was consistently down-regulated, which suggests that LEAP2 plays an important role in modulating an Eimeria infection. Published by Oxford University Press on behalf of Poultry Science Association 2017.

  4. A Comparison of the AVS-9 and the Panoramic Night Vision Goggles During Rotorcraft Hover and Landing

    NASA Technical Reports Server (NTRS)

    Szoboszlay, Zoltan; Haworth, Loran; Simpson, Carol

    2000-01-01

    A flight test was conducted to assess any differences in pilot-vehicle performance and pilot opinion between the use of a current generation night vision goggle (the AVS-9) and one variant of the prototype panoramic night vision goggle (the PNVGII). The panoramic goggle has more than double the horizontal field-of-view of the AVS-9, but reduced image quality. Overall the panoramic goggles compared well to the AVS-9 goggles. However, pilot comment and data are consistent with the assertion that some of the benefits of additional field-of-view with the panoramic goggles were negated by the reduced image quality of the particular variant of the panoramic goggles tested.

  5. JOVIAL J73 Automated Verification System - Study Phase

    DTIC Science & Technology

    1980-08-01

    capabil- ities for the tool, and the high-level design of the tool are also described. Future capabilities for the tool are identified. -N CONTENTS...Implemented Test Tools 3-22 4 FUNCTIONAL DESCRIPTION OF Ji3AVS 4-1 4.1 Summary of Capabilities 4-3 4.2 J 3.AVS Operat . 4-11 5 DESIGN OF J73AVS 5-1 6...Both JOVIAL languages are primarily designed for command and control system programming. They are es- pecially well suited to large systems requiring

  6. Autoverification process improvement by Six Sigma approach: Clinical chemistry & immunoassay.

    PubMed

    Randell, Edward W; Short, Garry; Lee, Natasha; Beresford, Allison; Spencer, Margaret; Kennell, Marina; Moores, Zoë; Parry, David

    2018-05-01

    This study examines effectiveness of a project to enhance an autoverification (AV) system through application of Six Sigma (DMAIC) process improvement strategies. Similar AV systems set up at three sites underwent examination and modification to produce improved systems while monitoring proportions of samples autoverified, the time required for manual review and verification, sample processing time, and examining characteristics of tests not autoverified. This information was used to identify areas for improvement and monitor the impact of changes. Use of reference range based criteria had the greatest impact on the proportion of tests autoverified. To improve AV process, reference range based criteria was replaced with extreme value limits based on a 99.5% test result interval, delta check criteria were broadened, and new specimen consistency rules were implemented. Decision guidance tools were also developed to assist staff using the AV system. The mean proportion of tests and samples autoverified improved from <62% for samples and <80% for tests, to >90% for samples and >95% for tests across all three sites. The new AV system significantly decreased turn-around time and total sample review time (to about a third), however, time spent for manual review of held samples almost tripled. There was no evidence of compromise to the quality of testing process and <1% of samples held for exceeding delta check or extreme limits required corrective action. The Six Sigma (DMAIC) process improvement methodology was successfully applied to AV systems resulting in an increase in overall test and sample AV by >90%, improved turn-around time, reduced time for manual verification, and with no obvious compromise to quality or error detection. Copyright © 2018 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  7. A NEW CLINICAL PREDICTION CRITERION ACCURATELY DETERMINES A SUBSET OF PATIENTS WITH BILATERAL PRIMARY ALDOSTERONISM BEFORE ADRENAL VENOUS SAMPLING.

    PubMed

    Kocjan, Tomaz; Janez, Andrej; Stankovic, Milenko; Vidmar, Gaj; Jensterle, Mojca

    2016-05-01

    Adrenal venous sampling (AVS) is the only available method to distinguish bilateral from unilateral primary aldosteronism (PA). AVS has several drawbacks, so it is reasonable to avoid this procedure when the results would not affect clinical management. Our objective was to identify a clinical criterion that can reliably predict nonlateralized AVS as a surrogate for bilateral PA that is not treated surgically. A retrospective diagnostic cross-sectional study conducted at Slovenian national endocrine referral center included 69 consecutive patients (mean age 56 ± 8 years, 21 females) with PA who underwent AVS. PA was confirmed with the saline infusion test (SIT). AVS was performed sequentially during continuous adrenocorticotrophic hormone (ACTH) infusion. The main outcome measures were variables associated with nonlateralized AVS to derive a clinical prediction rule. Sixty-seven (97%) patients had a successful AVS and were included in the statistical analysis. A total of 39 (58%) patients had nonlateralized AVS. The combined criterion of serum potassium ≥3.5 mmol/L, post-SIT aldosterone <18 ng/dL, and either no or bilateral tumor found on computed tomography (CT) imaging had perfect estimated specificity (and thus 100% positive predictive value) for bilateral PA, saving an estimated 16% of the patients (11/67) from unnecessary AVS. The best overall classification accuracy (50/67 = 75%) was achieved using the post-SIT aldosterone level <18 ng/dL alone, which yielded 74% sensitivity and 75% specificity for predicting nonlateralized AVS. Our clinical prediction criterion appears to accurately determine a subset of patients with bilateral PA who could avoid unnecessary AVS and immediately commence with medical treatment.

  8. Physician Perceptions and Beliefs about Generating and Providing a Clinical Summary of the Office Visit.

    PubMed

    Emani, S; Ting, D Y; Healey, M; Lipsitz, S R; Ramelson, H; Suric, V; Bates, D W

    2015-01-01

    A core measure of the meaningful use of EHR incentive program is the generation and provision of the clinical summary of the office visit, or the after visit summary (AVS), to patients. However, little research has been conducted on physician perceptions and beliefs about the AVS. Evaluate physician perceptions and beliefs about the AVS and the effect of the AVS on workload, patient outcomes, and the care the physician delivers. A cross-sectional online survey of physicians at two academic medical centers (AMCs) in the northeast who are participating in the meaningful use EHR incentive program. Of the 1 795 physicians at both AMCs participating in the incentive program, 853 completed the survey for a response rate of 47.5%. Eighty percent of the respondents reported that the AVS was easy (very easy or quite easy or somewhat easy) to generate and provide to patients. Nonetheless, more than three-fourths of the respondents reported a negative effect of generating and providing the AVS on workload of office staff (78%) and workload of physicians (76%). Primary care physicians had more positive beliefs about the effect of the AVS on patient outcomes than specialists (p<0.001) and also had more positive beliefs about the effect of the AVS on the care they delivered than specialists (p<0.001). Achieving the core meaningful use measure of generating and providing the AVS was easy for physicians but it did not necessarily translate into positive beliefs about the effect of the AVS on patient outcomes or the care the physician delivered. Physicians also had negative beliefs about the effect of the AVS on workload. To promote positive beliefs among physicians around the AVS, organizations should obtain physician input into the design and implementation of the AVS and develop strategies to mitigate its negative impacts on workload.

  9. Physician Perceptions and Beliefs about Generating and Providing a Clinical Summary of the Office Visit

    PubMed Central

    Ting, D.Y.; Healey, M.; Lipsitz, S.R.; Ramelson, H.; Suric, V.; Bates, D.W.

    2015-01-01

    Summary Background A core measure of the meaningful use of EHR incentive program is the generation and provision of the clinical summary of the office visit, or the after visit summary (AVS), to patients. However, little research has been conducted on physician perceptions and beliefs about the AVS. Objectives Evaluate physician perceptions and beliefs about the AVS and the effect of the AVS on workload, patient outcomes, and the care the physician delivers. Methods A cross-sectional online survey of physicians at two academic medical centers (AMCs) in the northeast who are participating in the meaningful use EHR incentive program. Results Of the 1 795 physicians at both AMCs participating in the incentive program, 853 completed the survey for a response rate of 47.5%. Eighty percent of the respondents reported that the AVS was easy (very easy or quite easy or somewhat easy) to generate and provide to patients. Nonetheless, more than three-fourths of the respondents reported a negative effect of generating and providing the AVS on workload of office staff (78%) and workload of physicians (76%). Primary care physicians had more positive beliefs about the effect of the AVS on patient outcomes than specialists (p<0.001) and also had more positive beliefs about the effect of the AVS on the care they delivered than specialists (p<0.001). Conclusions Achieving the core meaningful use measure of generating and providing the AVS was easy for physicians but it did not necessarily translate into positive beliefs about the effect of the AVS on patient outcomes or the care the physician delivered. Physicians also had negative beliefs about the effect of the AVS on workload. To promote positive beliefs among physicians around the AVS, organizations should obtain physician input into the design and implementation of the AVS and develop strategies to mitigate its negative impacts on workload. PMID:26448799

  10. The initial zones of the atrioventricular node: really neglected anatomical features of potential clinical significance?

    PubMed

    Kozłowski, D; Kozłowska, M; Kosiński, A; Woźniak, P; Piwko, G; Kamiński, R; Grzybiak, M; Poland, G Raczak

    2007-11-01

    The constant evolution of medical knowledge and accompanying development of diagnostic and treatment possibilities for arrhythmias and conduction disturbances has reawakened interest in the structure and function of the conduction system of the human heart, especially in the region of the atrioventricular (AV) junction and within the junction itself. Of the large number of studies dealing with the AV junction few focus on the initial zones of the AV node. These were described for the first time by Tawara in 1906. Similarly, Anderson et al. distinguished two origins of the AV node, the left one running towards the basis of the mitral valve and the right one leading towards the tricuspid valve. The differences in length and scale could be the result of the adoption of different reference points. The study was carried out on the material of 50 human hearts, of both sexes and ranging in age from 22 to 93, which were fixed in 10% formalin and 98% ethanol solution. The tissue obtained was fixed in the 10% formalin solution and, after being sunk in the paraffin, was cut into layers of about 10 mum thick. According to the age of the hearts, every 10(th) or 6(th) section was stained by the Masson-Goldner method. The preparations were examined under a LEICA 2000 and BIOLAR 2 microscope at magnifications of 2x to 400x. Each of the 50 examined hearts contained the atrioventricular node and its initial parts. We observed that the initial zone of the AV node is created by an assembly of cells typical for a conduction system that can create three groups that are initially independent of each other and are always arranged around the AV nodal artery. In all the hearts examined we found at least two initial parts of the node: the superior and inferior. These two groups were present in 45 hearts (90%). In the last 5 cases (10%) there was also a middle group. No cases were found either with a single initial group or without any initial groups. In the sections examined the superior group appeared to be first in 27 hearts (54%), while in 23 cases (46%) the inferior group was first. The length of each group was measured from its first appearance to its first direct contact with the second part. The length of the superior part varied from 0.15 to 2.91 mm (mean 0.90 +/- 0.6 mm), the inferior from 0.11 to 2.41 mm (mean 0.88 +/- 0.6 mm) and the middle from 0.67 to 2.21 mm (mean 1.04 +/- 0.7 mm). As mentioned above, in all 50 hearts there was a direct connection between the atrial muscle and the upper origin of AV node. Furthermore, in all sections (100%) the same part of the interatrial septal muscle was connected to the compact part of the node. Additionally, in 3 cases (6%) we were able to observe direct connections between the muscle fibres running from the fasciculus limbicus inferior to the initial zone of the AV node: in 2 cases (4%) with the superior group and in 1 case (2%) with the inferior group. In 8% of the material the atrial muscle of the supra-orificial zone made direct contact with the superior initial group and the compact zone of the node and in 10% there was contact between the suborificial muscle and the inferior group and the compact part of the node. This configuration was not observed in relation to the middle and inferior groups.

  11. AV3V lesions attenuate the cardiovascular responses produced by blood-borne excitatory amino acid analogs

    NASA Technical Reports Server (NTRS)

    Whalen, E. J.; Beltz, T. G.; Lewis, S. J.; Johnson, A. K.

    1999-01-01

    Systemic injections of the excitatory amino acid (EAA) analogs, kainic acid (KA) and N-methyl-D-aspartate (NMDA), produce a pressor response in conscious rats that is caused by a centrally mediated activation of sympathetic drive and the release of arginine vasopressin (AVP). This study tested the hypothesis that the tissue surrounding the anteroventral part of the third ventricle (AV3V) plays a role in the expression of the pressor responses produced by systemically injected EAA analogs. Specifically, we examined whether prior electrolytic ablation of the AV3V region would affect the pressor responses to KA and NMDA (1 mg/kg iv) in conscious rats. The KA-induced pressor response was smaller in AV3V-lesioned than in sham-lesioned rats (11 +/- 2 vs. 29 +/- 2 mmHg; P < 0.05). After ganglion blockade, KA produced a pressor response in sham-lesioned but not AV3V-lesioned rats (+27 +/- 3 vs. +1 +/- 2 mmHg; P < 0.05). The KA-induced pressor response in ganglion-blocked sham-lesioned rats was abolished by a vasopressin V1-receptor antagonist. Similar results were obtained with NMDA. The pressor response to AVP (10 ng/kg iv) was slightly smaller in AV3V-lesioned than in sham-lesioned ganglion-blocked rats (45 +/- 3 vs. 57 +/- 4 mmHg; P < 0.05). This study demonstrates that the pressor responses to systemically injected EAA analogs are smaller in AV3V-lesioned rats. The EAA analogs may produce pressor responses by stimulation of EAA receptors in the AV3V region, or the AV3V region may play an important role in the expression of these responses.

  12. Simulation system of arrhythmia using ActiveX control.

    PubMed

    Takeuchi, Akihiro; Hirose, Minoru; Hamada, Atsushi; Ikeda, Noriaki

    2005-07-01

    A simulation system for arrhythmias has been developed using Windows-based software technology, ActiveX control. The cardiac module consists of six cells, the sinus, atrium, AV node, ventricle, and ectopic foci. The physiological properties of the cells, the automaticity and conduction delay, were modelled, respectively, by the phase response curve and the excitability recovery curve. Cell functions were implemented in the ActiveX control and incorporated into the cardiac module. The system draws the ECG sequence as a ladder diagram in real time. The system interactively shows diverse arrhythmias for various user settings of the cell function and bidirectional conduction between the cells. Users are able to experiment virtually by setting up a so-called electrophysiological stimulation. This system is useful for learning and for teaching the interaction between the cells and arrhythmias.

  13. Analysis of Aviation Safety Reporting System Incident Data Associated With the Technical Challenges of the Vehicle Systems Safety Technology Project

    NASA Technical Reports Server (NTRS)

    Withrow, Colleen A.; Reveley, Mary S.

    2014-01-01

    This analysis was conducted to support the Vehicle Systems Safety Technology (VSST) Project of the Aviation Safety Program (AVsP) milestone VSST4.2.1.01, "Identification of VSST-Related Trends." In particular, this is a review of incident data from the NASA Aviation Safety Reporting System (ASRS). The following three VSST-related technical challenges (TCs) were the focus of the incidents searched in the ASRS database: (1) Vechicle health assurance, (2) Effective crew-system interactions and decisions in all conditions; and (3) Aircraft loss of control prevention, mitigation, and recovery.

  14. Minimizing right ventricular pacing in pacemaker patients with intact and compromised atrioventricular conduction : Results from the EVITA Trial.

    PubMed

    Bauer, A; Vermeulen, J; Toivonen, L; Voitk, J; Barr, C; Peytchev, P

    2015-12-01

    Unnecessary ventricular pacing is associated with increased morbidity and mortality. Over the years different algorithms have been developed to reduce right ventricular pacing. Goal of the present study was to test the efficacy of the ventricular intrinsic preference (VIP) algorithm in patients with atrioventricular intact (AVi) and atrioventricular compromised (AVc) AV-conduction. Evaluation of VIP feature in pacemaker patients (EVITA) was a multicenter, prospective, randomized trial (Trials.gov Identifier: NCT00366158). In total, 389 patients were randomized to AVc group: n = 140/132 VIP OFF/VIP On, AVi group: n = 54/63 VIP OFF/VIP ON). One-month post-implantation AV conduction testing (AVc: PR/AR interval > 210 ms) was performed. Follow-up visits occurred 6 and 12 months after DDD-pacemaker implantation. In AVi and AVc-patients initiation of the VIP feature significantly reduced incidence of ventricular pacing (AVi: 53 ± 38 vs. 9 ± 21%, p = 0.0001; AVc: 79 ± 31 vs. 28 ± 35%, p = 0.0001). DDD-pacemaker implantation per se significantly reduced incidence of AF in VIP ON (AVi 27 vs. 0%, p < 0.0001; AVc 29 vs. 3%, p < 0.0001) and VIP OFF patients (AVi 43 vs. 4%, p < 0.0001; AVc 33 vs. 3, p < 0.0001), without significant differences between VIP ON and OFF groups (p > 0.05). In the AVc group activation of VIP significantly reduced incidence of adverse events (AE). All-cause mortality was not significantly different in VIP ON (n = 5) and VIP OFF (n = 4, p > 0.05) patients. AV search hysteresis (VIP) markedly reduces ventricular pacing both in patients with normal AV conduction and in patients with prolonged PR interval or intermittent AV block.

  15. Positive and negative gain exceeding unity magnitude in silicon quantum well metal-oxide-semiconductor transistors

    NASA Astrophysics Data System (ADS)

    Hu, Gangyi; Wijesinghe, Udumbara; Naquin, Clint; Maggio, Ken; Edwards, H. L.; Lee, Mark

    2017-10-01

    Intrinsic gain (AV) measurements on Si quantum well (QW) n-channel metal-oxide-semiconductor (NMOS) transistors show that these devices can have |AV| > 1 in quantum transport negative transconductance (NTC) operation at room temperature. QW NMOS devices were fabricated using an industrial 45 nm technology node process incorporating ion implanted potential barriers to define a lateral QW in the conduction channel under the gate. While NTC at room temperature arising from transport through gate-controlled QW bound states has been previously established, it was unknown whether the quantum NTC mechanism could support gain magnitude exceeding unity. Bias conditions were found giving both positive and negative AV with |AV| > 1 at room temperature. This result means that QW NMOS devices could be useful in amplifier and oscillator applications.

  16. 77 FR 70185 - Notice of Proposed Information Collection for 1029-0119

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-23

    ... System (AVS) handbook. OSM is requesting a 3-year term of approval for this collection. This collection... automated Applicant/Violator System (AVS) and the contractor must be eligible under the regulations...

  17. Congenital and childhood atrioventricular blocks: pathophysiology and contemporary management.

    PubMed

    Baruteau, Alban-Elouen; Pass, Robert H; Thambo, Jean-Benoit; Behaghel, Albin; Le Pennec, Solène; Perdreau, Elodie; Combes, Nicolas; Liberman, Leonardo; McLeod, Christopher J

    2016-09-01

    Atrioventricular block is classified as congenital if diagnosed in utero, at birth, or within the first month of life. The pathophysiological process is believed to be due to immune-mediated injury of the conduction system, which occurs as a result of transplacental passage of maternal anti-SSA/Ro-SSB/La antibodies. Childhood atrioventricular block is therefore diagnosed between the first month and the 18th year of life. Genetic variants in multiple genes have been described to date in the pathogenesis of inherited progressive cardiac conduction disorders. Indications and techniques of cardiac pacing have also evolved to allow safe permanent cardiac pacing in almost all patients, including those with structural heart abnormalities. Early diagnosis and appropriate management are critical in many cases in order to prevent sudden death, and this review critically assesses our current understanding of the pathogenetic mechanisms, clinical course, and optimal management of congenital and childhood AV block. • Prevalence of congenital heart block of 1 per 15,000 to 20,000 live births. AV block is defined as congenital if diagnosed in utero, at birth, or within the first month of life, whereas childhood AV block is diagnosed between the first month and the 18th year of life. As a result of several different etiologies, congenital and childhood atrioventricular block may occur in an entirely structurally normal heart or in association with concomitant congenital heart disease. Cardiac pacing is indicated in symptomatic patients and has several prophylactic indications in asymptomatic patients to prevent sudden death. • Autoimmune, congenital AV block is associated with a high neonatal mortality rate and development of dilated cardiomyopathy in 5 to 30 % cases. What is New: • Several genes including SCN5A have been implicated in autosomal dominant forms of familial progressive cardiac conduction disorders. • Leadless pacemaker technology and gene therapy for biological pacing are promising research fields. In utero percutaneous pacing appears to be at high risk and needs further development before it can be adopted into routine clinical practice. Cardiac resynchronization therapy is of proven value in case of pacing-induced cardiomyopathy.

  18. Laboratory toxicity and benthic invertebrate field colonization of Upper Columbia River sediments: finding adverse effects using multiple lines of evidence.

    PubMed

    Fairchild, J F; Kemble, N E; Allert, A L; Brumbaugh, W G; Ingersoll, C G; Dowling, B; Gruenenfelder, C; Roland, J L

    2012-07-01

    From 1930 to 1995, the Upper Columbia River (UCR) of northeast Washington State received approximately 12 million metric tons of smelter slag and associated effluents from a large smelter facility located in Trail, British Columbia, approximately 10 km north of the United States-Canadian border. Studies conducted during the past two decades have demonstrated the presence of toxic concentrations of heavy metals in slag-based sandy sediments, including cadmium, copper, zinc, and lead in the UCR area as well as the downstream reservoir portion of Lake Roosevelt. We conducted standardized whole-sediment toxicity tests with the amphipod Hyalella azteca (28-day) and the midge Chironomus dilutus (10-day) on 11 samples, including both UCR and study-specific reference sediments. Metal concentrations in sediments were modeled for potential toxicity using three approaches: (1) probable effects quotients (PEQs) based on total recoverable metals (TRMs) and simultaneously extracted metals (SEMs); (2) SEMs corrected for acid-volatile sulfides (AVS; i.e., ∑SEM - AVS); and (3) ∑SEM - AVS normalized to the fractional organic carbon (f(oc)) (i.e., ∑SEM - AVS/f(oc)). The most highly metal-contaminated sample (∑PEQ(TRM) = 132; ∑PEQ(SEM) = 54; ∑SEM - AVS = 323; and ∑SEM - AVS/(foc) = 64,600 umol/g) from the UCR was dominated by weathered slag sediment particles and resulted in 80% mortality and 94% decrease in biomass of amphipods; in addition, this sample significantly decreased growth of midge by 10%. The traditional ∑AVS - SEM, uncorrected for organic carbon, was the most accurate approach for estimating the effects of metals in the UCR. Treatment of the toxic slag sediment with 20% Resinex SIR-300 metal-chelating resin significantly decreased the toxicity of the sample. Samples ∑SEM - AVS > 244 was not toxic to amphipods or midge in laboratory testing, indicating that this value may be an approximate threshold for effects in the UCR. In situ benthic invertebrate colonization studies in an experimental pond (8-week duration) indicated that two of the most metal-contaminated UCR sediments (dominated by high levels of sand-sized slag particles) exhibited decreased invertebrate colonization compared with sand-based reference sediments. Field-exposed SIR-300 resin samples also exhibited decreased invertebrate colonization numbers compared with reference materials, which may indicate behavioral avoidance of this material under field conditions. Multiple lines of evidence (analytical chemistry, laboratory toxicity, and field colonization results), along with findings from previous studies, indicate that high metal concentrations associated with slag-enriched sediments in the UCR are likely to adversely impact the growth and survival of native benthic invertebrate communities. Additional laboratory toxicity testing, refinement of the applications of sediment benchmarks for metal toxicity, and in situ benthic invertebrate studies will assist in better defining the spatial extent, temporal variations, and ecological impacts of metal-contaminated sediments in the UCR system.

  19. Genome-Wide DNA Methylation Analysis and Epigenetic Variations Associated with Congenital Aortic Valve Stenosis (AVS).

    PubMed

    Radhakrishna, Uppala; Albayrak, Samet; Alpay-Savasan, Zeynep; Zeb, Amna; Turkoglu, Onur; Sobolewski, Paul; Bahado-Singh, Ray O

    2016-01-01

    Congenital heart defect (CHD) is the most common cause of death from congenital anomaly. Among several candidate epigenetic mechanisms, DNA methylation may play an important role in the etiology of CHDs. We conducted a genome-wide DNA methylation analysis using an Illumina Infinium 450k human methylation assay in a cohort of 24 newborns who had aortic valve stenosis (AVS), with gestational-age matched controls. The study identified significantly-altered CpG methylation at 59 sites in 52 genes in AVS subjects as compared to controls (either hypermethylated or demethylated). Gene Ontology analysis identified biological processes and functions for these genes including positive regulation of receptor-mediated endocytosis. Consistent with prior clinical data, the molecular function categories as determined using DAVID identified low-density lipoprotein receptor binding, lipoprotein receptor binding and identical protein binding to be over-represented in the AVS group. A significant epigenetic change in the APOA5 and PCSK9 genes known to be involved in AVS was also observed. A large number CpG methylation sites individually demonstrated good to excellent diagnostic accuracy for the prediction of AVS status, thus raising possibility of molecular screening markers for this disorder. Using epigenetic analysis we were able to identify genes significantly involved in the pathogenesis of AVS.

  20. Genome-Wide DNA Methylation Analysis and Epigenetic Variations Associated with Congenital Aortic Valve Stenosis (AVS)

    PubMed Central

    Radhakrishna, Uppala; Albayrak, Samet; Alpay-Savasan, Zeynep; Zeb, Amna; Turkoglu, Onur; Sobolewski, Paul; Bahado-Singh, Ray O.

    2016-01-01

    Congenital heart defect (CHD) is the most common cause of death from congenital anomaly. Among several candidate epigenetic mechanisms, DNA methylation may play an important role in the etiology of CHDs. We conducted a genome-wide DNA methylation analysis using an Illumina Infinium 450k human methylation assay in a cohort of 24 newborns who had aortic valve stenosis (AVS), with gestational-age matched controls. The study identified significantly-altered CpG methylation at 59 sites in 52 genes in AVS subjects as compared to controls (either hypermethylated or demethylated). Gene Ontology analysis identified biological processes and functions for these genes including positive regulation of receptor-mediated endocytosis. Consistent with prior clinical data, the molecular function categories as determined using DAVID identified low-density lipoprotein receptor binding, lipoprotein receptor binding and identical protein binding to be over-represented in the AVS group. A significant epigenetic change in the APOA5 and PCSK9 genes known to be involved in AVS was also observed. A large number CpG methylation sites individually demonstrated good to excellent diagnostic accuracy for the prediction of AVS status, thus raising possibility of molecular screening markers for this disorder. Using epigenetic analysis we were able to identify genes significantly involved in the pathogenesis of AVS. PMID:27152866

  1. Neuromorphic audio-visual sensor fusion on a sound-localizing robot.

    PubMed

    Chan, Vincent Yue-Sek; Jin, Craig T; van Schaik, André

    2012-01-01

    This paper presents the first robotic system featuring audio-visual (AV) sensor fusion with neuromorphic sensors. We combine a pair of silicon cochleae and a silicon retina on a robotic platform to allow the robot to learn sound localization through self motion and visual feedback, using an adaptive ITD-based sound localization algorithm. After training, the robot can localize sound sources (white or pink noise) in a reverberant environment with an RMS error of 4-5° in azimuth. We also investigate the AV source binding problem and an experiment is conducted to test the effectiveness of matching an audio event with a corresponding visual event based on their onset time. Despite the simplicity of this method and a large number of false visual events in the background, a correct match can be made 75% of the time during the experiment.

  2. Long-Term Outcome of Single-Chamber Atrial Pacing Compared with Dual-Chamber Pacing in Patients with Sinus-Node Dysfunction and Intact Atrioventricular Node Conduction

    PubMed Central

    Kim, Won Ho; Joung, Boyoung; Shim, Jaemin; Park, Jong Sung; Hwang, Eui-Seock; Pak, Hui-Nam; Kim, Sungsoon

    2010-01-01

    Purpose The optimal pacing mode with either single chamber atrial pacemaker (AAI or AAIR) or dual chamber pacemaker (DDD or DDDR) is still not clear in sinus-node dysfunction (SND) and intact atrioventricular (AV) conduction. Materials and Methods Patients who were implanted with permanent pacemaker using AAI(R) (n = 73) or DDD(R) (n = 113) were compared. Results The baseline characteristics were comparable between the two groups, with a mean follow-up duration of 69 months. The incidence of death did not show statistical difference. However, the incidence of hospitalization for congestive heart failure (CHF) was significantly lower in the AAI(R) group (0%) than the DDD(R) group (8.8%, p = 0.03). Also, atrial fibrillation (AF) was found in 2.8% in the AAI(R) group, which was statistically different from 15.2% of patients in the DDD(R) group (p = 0.01). Four patients (5.5%) with AAI(R) developed AV block, and subsequently switched to DDD(R) pacing. The risk of AF was lower in the patients implanted with AAI(R) than those with DDD(R) [hazard ratio (HR), 0.84; 95% confidence interval, 0.72 to 0.97, p = 0.02]. Conclusion In patients with SND and intact AV conduction, AAI(R) pacing can achieve a better clinical outcome in terms of occurrence of CHF and AF than DDD(R) pacing. These findings support AAI(R) pacing as the preferred pacing mode in patients with SND and intact AV conduction. PMID:20879047

  3. Influences on copper bioaccumulation, growth, and survival of the midge, Chironomus tentans, in metal-contaminated sediments

    USGS Publications Warehouse

    Besser, John M.; Kubitz, Jody A.; Ingersoll, Chris G.; Braselton, W. Emmett; Giesy, John P.

    1995-01-01

    Sediment bioassays with larvae of the midge, Chironomus tentans, were used to evaluate influences on the bioavailability and toxicity of copper (Cu) in sediments with a wide range of concentrations of metals, acid-volatile sulfide (AVS), and other physicochemical characteristics. Sediments were collected from sixteen lakes in Michigan, USA, and from twelve sites in the Clark Fork River drainage of Montana, USA, which are contaminated with metals from mining activities and from other anthropogenic sources. Bioassays with C. tentans larvae were conducted for ten days in a static-renewal test system, with endpoints of survival, growth, and metal bioaccumulation. Bioaccumulation of copper (Cu) was strongly correlated with Cu concentrations in porewater, and was increased significantly at Cu concentrations less than those affecting growth or survival. Midge survival and growth were not significantly correlated with concentrations of Cu in sediment or porewater, and were poorly predicted by ratios of acid-extractable metals to AVS in sediments. Principal components analysis indicated that Cu concentrations in porewater and bioaccumulation of Cu by midge larvae were influenced by AVS, sediment organic carbon, and porewater pH, and that toxicity was associated with high concentrations of Cu, high concentrations of zinc (Zn) and ammonia. No toxicity was observed in several sediments which contained low concentrations of AVS and high concentrations of Cu and Zn. In sediments which contain little AVS, bioavailability of metals may be controlled by constituents other than sulfides, such as organic matter and metal hydrous oxides. These results indicate that assessments of toxicity in metal-contaminated sediments should evaluate the importance of metal-binding phases other than sulfides, and the possible contributions of ammonia or other toxicants to toxicity in sediment bioassays.

  4. Seismic properties and mineral crystallographic preferred orientations from EBSD data: Results from a crustal-scale detachment system, Aegean region

    NASA Astrophysics Data System (ADS)

    Cossette, Élise; Schneider, David; Audet, Pascal; Grasemann, Bernhard; Habler, Gerlinde

    2015-05-01

    The crystallographic preferred orientations (CPOs) were measured on a suite of samples representative of different structural depths along the West Cycladic Detachment System, Greece. Electron backscatter diffraction (EBSD) analyses were conducted on calcitic and mica schists, impure quartzites, and a blueschist, and the average seismic properties of the rocks were calculated with the Voigt-Reuss-Hill average of the single minerals' elastic stiffness tensor. The calcitic and quartzitic rocks have P- and S-wave velocity anisotropies (AVp, AVs) averaging 8.1% and 7.1%, respectively. The anisotropy increases with depth represented by the blueschist, with AVp averaging 20.3% and AVs averaging 14.5%, due to the content of aligned glaucophane and mica, which strongly control the seismic properties of the rocks. Localised anisotropies of very high magnitudes are caused by the presence of mica schists as they possess the strongest anisotropies, with values of ~ 25% for AVp and AVs. The direction of the fast and slow P-wave velocities occurs parallel and perpendicular to the foliation, respectively, for most samples. The fast propagation has the same NE-SW orientation as the lithospheric stretching direction experienced in the Cyclades since the Late Oligocene. The maximum shear wave anisotropy is subhorizontal, similarly concordant with mineral alignment that developed during extension in the Aegean. Radial anisotropy in the Aegean mid-crust is strongly favoured to azimuthal anisotropy by our results.

  5. Evaluation of spring wheat cultivars to fungicide application for control of stripe rust in 2016

    USDA-ARS?s Scientific Manuscript database

    To evaluate spring wheat cultivars grown in the U.S. Pacific Northwest to fungicide application for control of stripe rust and assess their yield loss caused by the disease, this study was conducted in a field near Pullman, WA. Spring wheat genotype ‘Avocet S’ (AvS) was used as a susceptible check, ...

  6. Patient with Wolff-Parkinson-White syndrome with intermittent pre-excitation under subarachnoid block for urological surgery

    PubMed Central

    Garg, Rakesh; Sinha, Renu; Nishad, PK

    2011-01-01

    Wolff-Parkinson-White (WPW) syndrome is one of the pre-excitation syndromes in which activation of an accessory atrioventricular (AV) conduction pathway leads to bypass the AV node and cause earlier ventricular activation than the normal pathway. We report a patient with intermittent WPW syndrome who repeatedly manifested pre-excitation after subarachnoid block. PMID:21712875

  7. Non-invasive evaluation of the effect of metoprolol on the atrioventricular node during permanent atrial fibrillation.

    PubMed

    Corino, Valentina D A; Sandberg, Frida; Platonov, Pyotr G; Mainardi, Luca T; Ulimoen, Sara R; Enger, Steve; Tveit, Arnljot; Sörnmo, Leif

    2014-11-01

    During atrial fibrillation (AF), conventional electrophysiological techniques for assessment of refractory period or conduction velocity of the atrioventricular (AV) node cannot be used. We aimed at evaluating changes in AV nodal properties during administration of metoprolol from electrocardiogram data, and to support our findings with simulated data based on results from an electrophysiological study. Sixty patients (age 71 ± 9 years, 42 men) with permanent AF were included in the RATe control in Atrial Fibrillation (RATAF) study. Two 15 min segments, during baseline and metoprolol administration, starting at 2 pm were analysed in this study. Atrial fibrillatory rate (AFR), heart rate (HR), and AV nodal parameters were assessed. The AV nodal parameters account for the probability of an impulse not taking the fast pathway, the absolute refractory periods of the slow and fast pathways (aRPs and aRPf), representing the functional refractory period, and their respective prolongation in refractory period. In addition, simulated RR series were generated that mimic metoprolol administration through prolonged AV conduction interval and AV node effective refractory period. During metoprolol administration, AFR and HR were significantly decreased and aRP was significantly prolonged in both pathways (aRPs: 337 ± 60 vs. 398 ± 79 ms, P < 0.01; aRPf: 430 ± 91 vs. 517 ± 100 ms, P < 0.01). Similar results were found for the simulated RR series, both aRPs and aRPf being prolonged with metoprolol (aRPs: 413 ± 33 vs. 437 ± 43 ms, P = 0.01; aRPf: 465 ± 40 vs. 502 ± 69 ms, P = 0.02). The AV nodal parameters reflect expected changes after metoprolol administration, i.e. a prolongation in functional refractory period. The simulations confirmed that aRPs and aRPf may serve as an estimate of the functional refractory period. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2014. For permissions please email: journals.permissions@oup.com.

  8. A contemporary view of atrioventricular nodal physiology.

    PubMed

    Markowitz, Steven M; Lerman, Bruce B

    2018-06-16

    In delaying transmission of the cardiac impulse from the atria to the ventricles, the atrioventricular (AV) node serves a critical function in augmenting ventricular filling during diastole and limiting the ventricular response during atrial tachyarrhythmias. The complex structure of the nodal region, however, also provides the substrate for reentrant rhythms. Recent discoveries have elucidated the cellular basis and anatomical determinants of slow conduction in the node. Based on analysis of gap junction proteins, distinct structural components of the AV node have been defined, including the compact node, right and left inferior nodal extensions, the lower nodal bundle, and transitional tissue. Emerging evidence supports the role of the inferior nodal extensions in mediating slow pathway conduction. The most common form of reentry involving the node, slow-fast AV nodal reentrant tachycardia (AVNRT), utilizes the inferior nodal extensions for anterograde slow pathway conduction; the structures responsible for retrograde fast pathway activation in the superior septum are less well defined and likely heterogeneous. Atypical forms of AVNRT arise from circuits that activate at least one of the inferior extensions in the retrograde direction.

  9. [Simulated study of algal fatty acid degradation in hypoxia seawater-sediment interface along China coastal area].

    PubMed

    Sui, Wei-Wei; Ding, Hai-Bing; Yang, Gui-Peng; Lu, Xiao-Lan; Li, Wen-Juan; Sun, Li-Qun

    2013-11-01

    Series of laboratory incubation experiments were conducted to simulate degradation of organic matter in sediment-seawater interface in hypoxia enviroments along China coastal area. Under four different redox conditions (oxygen saturation: 100%, 50%, 25% and 0%), degradations of seveal biomarkers originated from Skeletonema costatum, a typical red tide alage along China coastal area were tracked. By analyzing concentrations of four fatty acid biomarkers [14:0, 16:0, 16:1(7) and 20:5] obtained at various sampling time, results showed that their concentrations decreased significantly after 2-3 weeks' incubation. Then, their concentrations changed very slowly or very little. However, degradation of the four fatty acids varied dramatically in different incubation systems. Fatty acids 14:0, 16:1(7) and 20:5 were degraded completely in all incubation systems after two-month incubation, but 25% to 35% of 16:0 was reserved in the systems. Based on multi-G model, degradations of the four fatty acids were quantively described. The results indicated that all four fatty acids had fast-degraded and slow-degraded fractions. Their degradation rate constants (k(av)) ranged from 0.079 to 0.84 d(-1). The fastest degradation of 14:0 and 16:1 (7) occurred under 25% oxygen concentrations. For these two compounds, in the fastest degradation system, their k(av), values were 2.3 folds and 1.7 folds higher than those in the slowest degradation system [50% oxygen saturation for 14:0 and 100% oxygen saturation for 16:1(7)] respectively. The 16:0 was degraded fastest under the anoxic condition and slowest under the 50% oxygen saturation. The ratio of the two k(av)s was 2.1. The k(av)s of 20:5 had a positive relationship with oxygen saturations. Results of this study suggested that besides oxgen saturations, structure and features of organic compounds, roles of microbe in the envrioments and etc. might affect degradations of fatty acids in S. costatum in hypoxia sediment-seawater interface along China coastal area.

  10. Efficacy of cellulose triacetate dialyzer and polysulfone synthetic hemofilter for continuous venovenous hemofiltration in acute renal failure.

    PubMed

    Pichaiwong, Warangkana; Leelahavanichkul, Asada; Eiam-ong, Somchai

    2006-08-01

    To compare the clearance performances and biocompatibility between the modified cellulose membrane and the standard synthetic membrane in continuous renal replacement therapy (CRRT). Seventeen patients with acute renal failure (ARF) were treated with separated continuous veno venous hemofiltration (CVVH) system conducted with the pre-dilution mode. The modified cellulose used was a Sureflux150E (cellulose triacetate) and the standard synthetic membranes used was an AV-400. Blood and replacement flow rate were kept at 100 and 20 mL/min, respectively. Ultrafiltraion rate was 1,200 mL/hr. Samplings of blood and ultrafiltrate were collected at baseline, 2, 8, 16, and 24 hr. Patients in both methods could similarly tolerate CRRT with only minor complications. Sureflux 150E and AV-400 provided comparable values of sieving coefficients and clearances of small solutes. The albumin loss in ultrafiltrate by Sureflux 150E was greater than AV-400. The values of life span and biocompatability of both hemofilters were not different. Because of the excellent efficacy and the much cheaper cost, the modified cellulose membrane could be an appropriate alternative to standard synthetic membrane in CRRT.

  11. Influence of acid volatile sulfide and metal concentrations on metal bioavailability to marine invertebrates in contaminated sediments

    USGS Publications Warehouse

    Lee, B.-G.; Lee, J.-S.; Luoma, S.N.; Choi, H.J.; Koh, C.-H.

    2000-01-01

    An 18-day microcosm study was conducted to evaluate the influence of acid volatile sulfides (AVS) and metal additions on bioaccumulation from sediments of Cd, Ni, and Zn in two clams (Macoma balthica and Potamocorbula amurensis) and three marine polychaetes (Neanthes arenaceodentata, Heteromastus filiformis, and Spiophanes missionensis). Manipulation of AVS by oxidation of naturally anoxic sediments allowed use of metal concentrations typical of nature and evaluation of processes important to chronic metal exposure. A vertical sediment column similar to that often found in nature was used to facilitate realistic biological behavior. Results showed that AVS or porewater (PW) metals controlled bioaccumulation in only 2 of 15 metal-animal combinations. Bioaccumulation of all three metals by the bivalves was related significantly to metal concentrations extracted from sediments (SEM) but not to [SEM - AVS] or PW metals. SEM predominantly influenced bioaccumulation of Ni and Zn in N. arenaceodentata, but Cd bioaccumulation followed PW Cd concentrations. SEM controlled tissue concentrations of all three metals in H. filiformis and S. missionensis, with minor influences from metal-sulfide chemistry. Significant bioaccumulation occurred when SEM was only a small fraction of AVS in several treatments. Three factors appeared to contribute to the differences between these bioaccumulation results and the results from toxicity tests reported previously: differences in experimental design, dietary uptake, and biological attributes of the species, including mode and depth of feeding.An 18-day microcosm study was conducted to evaluate the influence of acid volatile sulfides (AVS) and metal additions on bioaccumulation from sediments of Cd, Ni, and Zn in two clams (Macoma balthica and Potamocorbula amurensis) and three marine polychaetes (Neanthes arenaceodentata, Heteromastus filiformis, and Spiophanes missionensis). Manipulation of AVS by oxidation of naturally anoxic sediments allowed use of metal concentrations typical of nature and evaluation of processes important to chronic metal exposure. A vertical sediment column similar to that often found in nature was used to facilitate realistic biological behavior. Results showed that AVS or porewater (PW) metals controlled bioaccumulation in only 2 of 15 metal-animal combinations. Bioaccumulation of all three metals by the bivalves was related significantly to metal concentrations extracted from sediments (SEM) but not to [SEM - AVS] or PW metals. SEM predominantly influenced bioaccumulation of Ni and Zn in N. arenaceodentata, but Cd bioaccumulation followed PW Cd concentrations. SEM controlled tissue concentrations of all three metals in H. filiformis and S. missionensis, with minor influences from metal-sulfide chemistry. Significant bioaccumulation occurred when SEM was only a small fraction of AVS in several treatments. Three factors appeared to contribute to the differences between these bioaccumulation results and the results from toxicity tests reported previously: differences in experimental design, dietary uptake, and biological attributes of the species, including mode and depth of feeding.Microcosms were used to simulate environmentally realistic metal, acid volatile sulfide (AVS), and geochemical gradients in sediments to evaluate effects of metal bioavailability. The 18-d study involved five test species: two bivalves and three polychaetes. Two series of experiments were designed to evaluate the effects of metal concentration and AVS on bioaccumulation, respectively. The metals of interest were cadmium, nickel, and zinc. Results showed that the concentrations of pore-water Cd, Ni, and Zn were controlled by the concentration of AVS. Organisms bioaccumulated significant amounts of metals from the sediments when the simultaneously extracted metal was only a small fraction of the AVS. Bioavailability increased linearly with the sediment metal concentration irrespective of AVS or pore-w

  12. [A case of severe bradycardia and AV block during administration of propofol].

    PubMed

    Takase, Hajime; Kudoh, Akira; Takazawa, Tomoko

    2003-09-01

    A 69-yr-old man underwent emergency laparotomy. He was in endotoxic shock. Preoperative evaluation including a full blood count, chest X-ray and ECG were normal. Body temperature was 37.4 degrees C. Preoperative arterial pressure was 140/80 mmHg and heart rate 65 bpm. Anesthesia was induced with ketamine 100 mg, propofol 20 mg, fentanyl 50 micrograms and vecuronium 4 mg and maintained with propofol 4 mg.kg-1.hr-1 and fentanyl. Soon after opening the abdominal peritoneum, severe bradycardia (< 20 bpm) occurred, but it was effectively treated by ephedrine 16 mg. After that, surgery was performed uneventfully. In the intensive care unit (ICU), the patient developed four episodes of severe atrioventricular (AV) block after stimulation of the trachea by suction drainage under sedation with propofol, although there was no AV block during sedation with ketamine and propofol. After stopping propofol, the AV block was no longer observed. He was discharged from the ICU on the 12th postoperative day. Postoperative Holter ECG and echocardiography showed no abnormalities. It is likely that stimulation of the trachea triggered vagovagal reflex and propofol prolonged AV conduction, causing the AV block.

  13. Assessment of the NASA AvSTAR Project Plan

    NASA Technical Reports Server (NTRS)

    Ulrey, Michael L.; Haraldsdottir, Aslaug; Berge, Matthew E.; Hopperstad, Craig A.; Schwab, Robert W.

    2004-01-01

    This report is a preliminary evaluation of NASA's proposed Aviation System Technology Advanced Research (AvSTAR) Program during the early stages of its definition, in the first half of the year 2001. This evaluation focuses on how well the program goals address the needs of the U.S. National Airspace System, the technical feasibility of the program goals, and the logistical feasibility of the program plan. This report also provides recommendations on how the AvSTAR program could be strengthened and improved. This document has two appendices.

  14. Effects of acid-volatile sulfide on metal bioavailability and toxicity to midge (Chironomus tentans) larvae in black shale sediments

    USGS Publications Warehouse

    Ogendi, G.M.; Brumbaugh, W.G.; Hannigan, R.E.; Farris, J.L.

    2007-01-01

    Metal bioavailability and toxicity to aquatic organisms are greatly affected by variables such as pH, hardness, organic matter, and sediment acid-volatile sulfide (AVS). Sediment AVS, which reduces metal bioavailability and toxicity by binding and immobilizing metals as insoluble sulfides, has been studied intensely in recent years. Few studies, however, have determined the spatial variability of AVS and its interaction with simultaneously extracted metals (SEM) in sediments containing elevated concentrations of metals resulting from natural geochemical processes, such as weathering of black shales. We collected four sediment samples from each of four headwater bedrock streams in northcentral Arkansa (USA; three black shale-draining streams and one limestone-draining stream). We conducted 10-d acute whole-sediment toxicity tests using the midge Chironomus tentans and performed analyses for AVS, total metals, SEMs, and organic carbon. Most of the sediments from shale-draining streams had similar total metal and SEM concentrations but considerable differences in organic carbon and AVS. Zinc was the leading contributor to the SEM molar sum, averaging between 68 and 74%, whereas lead and cadmium contributed less than 3%. The AVS concentration was very low in all but two samples from one of the shale streams, and the sum of the SEM concentrations was in molar excess of AVS for all shale stream sediments. No significant differences in mean AVS concentrations between sediments collected from shale-draining or limestone-draining sites were noted (p > 0.05). Midge survival and growth in black shale-derived sediments were significantly less (p < 0.001) than that of limestone-derived sediments. On the whole, either SEM alone or SEM-AVS explained the total variation in midge survival and growth about equally well. However, survival and growth were significantly greater (p < 0.05) in the two sediment samples that contained measurable AVS compared with the two sediments from the same stream that contained negligible AVS. ?? 2007 SETAC.

  15. Impact of audio/visual systems on pediatric sedation in magnetic resonance imaging.

    PubMed

    Lemaire, Colette; Moran, Gerald R; Swan, Hans

    2009-09-01

    To evaluate the use of an audio/visual (A/V) system in pediatric patients as an alternative to sedation in magnetic resonance imaging (MRI) in terms of wait times, image quality, and patient experience. Pediatric MRI examinations from April 8 to August 11, 2008 were compared to those 1 year prior to the installation of the A/V system. Data collected included age, requisition receive date, scan date, and whether sedation was used. A posttest questionnaire was used to evaluate patient experience. Image quality was assessed by two radiologists. Over the 4 months in 2008 there was an increase of 7.2% (115; P < 0.05) of pediatric patients scanned and a decrease of 15.4%, (67; P = 0.32) requiring sedation. The average sedation wait time decreased by 33% (5.8 months) (P < 0.05). Overall, the most positively affected group was the 4-10 years. The questionnaire resulted in 84% of participants expressing a positive reaction to the A/V system. Radiological evaluation revealed no changes in image quality between A/V users and sedates. The A/V system was a successful method to reduce patient motion and obtain a quality diagnostic MRI without the use of sedation in pediatric patients. It provided a safer option, a positive experience, and decreased wait times.

  16. Eddy-current non-inertial displacement sensing for underwater infrasound measurements.

    PubMed

    Donskoy, Dimitri M; Cray, Benjamin A

    2011-06-01

    A non-inertial sensing approach for an Acoustic Vector Sensor (AVS), which utilizes eddy-current displacement sensors and operates well at Ultra-Low Frequencies (ULF), is described here. In the past, most ULF measurements (from mHertz to approximately 10 Hertz) have been conducted using heavy geophones or seismometers that must be installed on the seafloor; these sensors are not suitable for water column measurements. Currently, there are no readily available compact and affordable underwater AVS that operate within this frequency region. Test results have confirmed the validity of the proposed eddy-current AVS design and have demonstrated high acoustic sensitivity. © 2011 Acoustical Society of America

  17. Second-degree atrioventricular block.

    PubMed

    Zipes, D P

    1979-09-01

    1) While it is possible only one type of second-degree AV block exists electrophysiologically, the available data do not justify such a conclusion and it would seem more appropriate to remain a "splitter," and advocate separation and definition of multiple mechanisms, than to be a "lumper," and embrace a unitary concept. 2) The clinical classification of type I and type II AV block, based on present scalar electrocardiographic criteria, for the most part accurately differentiates clinically important categories of patients. Such a classification is descriptive, but serves a useful function and should be preserved, taking into account the caveats mentioned above. The site of block generally determines the clinical course for the patient. For most examples of AV block, the type I and type II classification in present use is based on the site of block. Because block in the His-Purkinje system is preceded by small or nonmeasurable increments, it is called type II AV block; but the very fact that it is preceded by small increments is because it occurs in the His-Purkinje system. Similar logic can be applied to type I AV block in the AV node. Exceptions do occur. If the site of AV block cannot be distinguished with certainity from the scalar ECG, an electrophysiologic study will generally reveal the answer.

  18. Creating Engaging Online Learning Material with the JSAV JavaScript Algorithm Visualization Library

    ERIC Educational Resources Information Center

    Karavirta, Ville; Shaffer, Clifford A.

    2016-01-01

    Data Structures and Algorithms are a central part of Computer Science. Due to their abstract and dynamic nature, they are a difficult topic to learn for many students. To alleviate these learning difficulties, instructors have turned to algorithm visualizations (AV) and AV systems. Research has shown that especially engaging AVs can have an impact…

  19. Reduction of right ventricular pacing with advanced atrioventricular search hysteresis: results of the PREVENT study.

    PubMed

    Kolb, Christof; Schmidt, Roland; Dietl, Josef U; Weyerbrock, Sonja; Morgenstern, Martin; Fleckenstein, Martin; Beier, Thomas; Von Bary, Christian; Mackes, Karl G; Widmaier, Jochen; Kreuzer, Jörg; Semmler, Verena; Zrenner, Bernhard

    2011-08-01

    Right ventricular pacing predisposes to the development of heart failure and atrial fibrillation. Automatic atrioventricular search hysteresis (AVSH) is a commonly used strategy to decrease the percentage of right ventricular pacing (%VP) in patients without permanent AV block, but the results have not been optimal. The randomized, crossover PREVENT study evaluated whether an enhanced AVSH with two new features can reduce %VP compared with standard AVSH. The new features are the repetitive hysteresis [switch from extended to basic AV delay after a consistent loss of intrinsic AV conduction (IAVC) lasting for six consecutive atrial cycles] and the scan hysteresis (periodic IAVC search extension over six consecutive atrial cycles). Both standard AVSH and enhanced AVSH performed a periodic IAVC search every 180 cardiac cycles and operated with a basic AV-delay of 225 ms and a rate-independent maximum AV-delay of 300 ms for paced and sensed atrial events. Among 178 patients, 53.4% had no evidence of AV block at enrollment and 46.6% had history of intermittent AV block. The median %VP was decreased by enhanced AVSH compared to standard AVSH (4.0% vs 5.5%, P < 0.001), particularly in patients with a history of AV block (21.4% vs 25.5%, P < 0.001). The primary study hypothesis that 25% of all patients would experience > 20% relative %VP reduction was not met as 46 (25.8%) patients (95% confidence interval, 20.5-31.8%) presented such relative reduction. The enhanced AVSH algorithm reduces %VP compared with standard AVSH in patients with intermittent AV block. ©2011, The Authors. Journal compilation ©2011 Wiley Periodicals, Inc.

  20. Pacemaker Dependency after Cardiac Surgery: A Systematic Review of Current Evidence.

    PubMed

    Steyers, Curtis M; Khera, Rohan; Bhave, Prashant

    2015-01-01

    Severe postoperative conduction disturbances requiring permanent pacemaker implantation frequently occur following cardiac surgery. Little is known about the long-term pacing requirements and risk factors for pacemaker dependency in this population. We performed a systematic review of the literature addressing rates and predictors of pacemaker dependency in patients requiring permanent pacemaker implantation after cardiac surgery. Using a comprehensive search of the Medline, Web of Science and EMBASE databases, studies were selected for review based on predetermined inclusion and exclusion criteria. A total of 8 studies addressing the endpoint of pacemaker-dependency were identified, while 3 studies were found that addressed the recovery of atrioventricular (AV) conduction endpoint. There were 10 unique studies with a total of 780 patients. Mean follow-up ranged from 6-72 months. Pacemaker dependency rates ranged from 32%-91% and recovery of AV conduction ranged from 16%-42%. There was significant heterogeneity with respect to the definition of pacemaker dependency. Several patient and procedure-specific variables were found to be independently associated with pacemaker dependency, but these were not consistent between studies. Pacemaker dependency following cardiac surgery occurs with variable frequency. While individual studies have identified various perioperative risk factors for pacemaker dependency and non-resolution of AV conduction disease, results have been inconsistent. Well-conducted studies using a uniform definition of pacemaker dependency might identify patients who will benefit most from early permanent pacemaker implantation after cardiac surgery.

  1. Designing algorithm visualization on mobile platform: The proposed guidelines

    NASA Astrophysics Data System (ADS)

    Supli, A. A.; Shiratuddin, N.

    2017-09-01

    This paper entails an ongoing study about the design guidelines of algorithm visualization (AV) on mobile platform, helping students learning data structures and algorithm (DSA) subject effectively. Our previous review indicated that design guidelines of AV on mobile platform are still few. Mostly, previous guidelines of AV are developed for AV on desktop and website platform. In fact, mobile learning has been proved to enhance engagement in learning circumstances, and thus effect student's performance. In addition, the researchers highly recommend including UI design and Interactivity in designing effective AV system. However, the discussions of these two aspects in previous AV design guidelines are not comprehensive. The UI design in this paper describes the arrangement of AV features in mobile environment, whereas interactivity is about the active learning strategy features based on learning experiences (how to engage learners). Thus, this study main objective is to propose design guidelines of AV on mobile platform (AVOMP) that entails comprehensively UI design and interactivity aspects. These guidelines are developed through content analysis and comparative analysis from various related studies. These guidelines are useful for AV designers to help them constructing AVOMP for various topics on DSA.

  2. Accelerated Evaluation of Automated Vehicles Safety in Lane-Change Scenarios Based on Importance Sampling Techniques

    PubMed Central

    Zhao, Ding; Lam, Henry; Peng, Huei; Bao, Shan; LeBlanc, David J.; Nobukawa, Kazutoshi; Pan, Christopher S.

    2016-01-01

    Automated vehicles (AVs) must be thoroughly evaluated before their release and deployment. A widely used evaluation approach is the Naturalistic-Field Operational Test (N-FOT), which tests prototype vehicles directly on the public roads. Due to the low exposure to safety-critical scenarios, N-FOTs are time consuming and expensive to conduct. In this paper, we propose an accelerated evaluation approach for AVs. The results can be used to generate motions of the other primary vehicles to accelerate the verification of AVs in simulations and controlled experiments. Frontal collision due to unsafe cut-ins is the target crash type of this paper. Human-controlled vehicles making unsafe lane changes are modeled as the primary disturbance to AVs based on data collected by the University of Michigan Safety Pilot Model Deployment Program. The cut-in scenarios are generated based on skewed statistics of collected human driver behaviors, which generate risky testing scenarios while preserving the statistical information so that the safety benefits of AVs in nonaccelerated cases can be accurately estimated. The cross-entropy method is used to recursively search for the optimal skewing parameters. The frequencies of the occurrences of conflicts, crashes, and injuries are estimated for a modeled AV, and the achieved accelerated rate is around 2000 to 20 000. In other words, in the accelerated simulations, driving for 1000 miles will expose the AV with challenging scenarios that will take about 2 to 20 million miles of real-world driving to encounter. This technique thus has the potential to greatly reduce the development and validation time for AVs. PMID:27840592

  3. Accelerated Evaluation of Automated Vehicles Safety in Lane-Change Scenarios Based on Importance Sampling Techniques.

    PubMed

    Zhao, Ding; Lam, Henry; Peng, Huei; Bao, Shan; LeBlanc, David J; Nobukawa, Kazutoshi; Pan, Christopher S

    2017-03-01

    Automated vehicles (AVs) must be thoroughly evaluated before their release and deployment. A widely used evaluation approach is the Naturalistic-Field Operational Test (N-FOT), which tests prototype vehicles directly on the public roads. Due to the low exposure to safety-critical scenarios, N-FOTs are time consuming and expensive to conduct. In this paper, we propose an accelerated evaluation approach for AVs. The results can be used to generate motions of the other primary vehicles to accelerate the verification of AVs in simulations and controlled experiments. Frontal collision due to unsafe cut-ins is the target crash type of this paper. Human-controlled vehicles making unsafe lane changes are modeled as the primary disturbance to AVs based on data collected by the University of Michigan Safety Pilot Model Deployment Program. The cut-in scenarios are generated based on skewed statistics of collected human driver behaviors, which generate risky testing scenarios while preserving the statistical information so that the safety benefits of AVs in nonaccelerated cases can be accurately estimated. The cross-entropy method is used to recursively search for the optimal skewing parameters. The frequencies of the occurrences of conflicts, crashes, and injuries are estimated for a modeled AV, and the achieved accelerated rate is around 2000 to 20 000. In other words, in the accelerated simulations, driving for 1000 miles will expose the AV with challenging scenarios that will take about 2 to 20 million miles of real-world driving to encounter. This technique thus has the potential to greatly reduce the development and validation time for AVs.

  4. Interfacing the Defense Standard Ammunition Computer System and the Air Force Combat Ammunition System: A Search for an Alternate Method.

    DTIC Science & Technology

    1985-09-01

    S. Barnes, for all the guidance received throughout this effort, and to my reader, Capt Rich Mabe , for his suggestions which helped me organize the...Pentagon AV225-0568 Washington DC 4. Capt Thomas James AFLMC/LGY AV446-4524 Gunter AFS AL 5. Herman Stein JDSSC/C321 Pentagon AV227-5762 Washington DC...Division, McLean VA, undated. 37. Itze, Capt Joe, ESD/ALSE. Telephone interview. Hanscom AFB MA, 30 May 1985. 38. James , Capt Thomas G., Computer

  5. Imaging of VMAT2 binding sites in the brain by (18)F-AV-133: the effect of a pseudo-carrier.

    PubMed

    Zhu, Lin; Qiao, Hongwen; Lieberman, Brian P; Wu, Jingxiao; Liu, Yajing; Pan, Zhongyun; Ploessl, Karl; Choi, Seok Rye; Chan, Piu; Kung, Hank F

    2012-10-01

    Recently, 9-[(18)F]fluoropropyl-(+)-dihydrotetrabenazine ((18)F-AV-133) was reported as a new vesicular monoamine transporter (VMAT2) imaging agent for diagnosis of Parkinson's disease (PD). To shorten the preparation of (18)F-AV-133 and to make it more widely available, we evaluated a simple, rapid purification with a solid-phase extraction method (SPE) using an Oasis HLB cartridge instead of high pressure liquid chromatography (HPLC). The SPE method produced doses containing a pseudo-carrier, 9-hydroxypropyl-(+)-dihydrotetrabenazine (AV-149). To test the possible side effects of this pseudo-carrier, comparative dynamic PET scans of the brains of normal monkeys (2 each) and uni-laterally 6-OH-dopamine-lesioned PD monkeys (2 each) were performed using (18)F-AV-133 doses prepared by either SPE (containing pseudo-carrier) or HPLC (containing no pseudo-carrier). Autoradiographs of post mortem monkey brain sections were evaluated to confirm the relative (18)F-AV-133 uptake in the PD monkey brains and the effects of the pseudo-carrier on VMAT2 binding. The radiochemical purity of the (18)F-AV-133, whether prepared by SPE or by HPLC, was excellent (>99%). PET scans of normal and PD monkey brains showed an expected reduction of VMAT2 in the lesioned areas of the striatum. It was not affected by the presence of the pseudo-carrier, AV-149 (maximally 250 μg/dose). The reduced uptake in the striatum of the lesioned monkey brains was confirmed by autoradiography. Ex vivo inhibition studies of (18)F-AV-133 binding in rat brains, conducted with increasing amounts of AV-149, suggested that at the highest concentration (3.5mg/kg) the VMAT2 binding in the striatum was only moderately blocked (20% reduction). The pseudo-carrier, AV-149, did not affect the (18)F-AV-133/PET imaging of VMAT2 binding sites in normal or uni-laterally lesioned monkey brains. The new streamlined SPE purification method will enable (18)F-AV-133 to be widely available for routine clinical application in determining changes in monoamine neurons for patient with movement disorders or other psychiatric illnesses. Copyright © 2012 Elsevier Inc. All rights reserved.

  6. Comfort and exertion while using filtering facepiece respirators with exhalation valve and an active venting system among male military personnel.

    PubMed

    Seng, Melvin; Wee, Liang En; Zhao, Xiahong; Cook, Alex R; Chia, Sin Eng; Lee, Vernon J

    2017-07-06

    This study aimed to determine if disposable filtering facepiece respirators (FFRs), with exhalation valve (EV) and a novel active venting system (AVS), provided greater perceived comfort and exertion when compared to standard N95 FFRs without these features among male military personnel performing prolonged essential outdoor duties. We used a randomised open-label controlled crossover study design to compare three FFR options: (a) standard FFR; (b) FFR with EV; and (c) FFR with EV+AVS. Male military personnel aged between 18 and 20 years completed a questionnaire at the beginning (baseline), after two hours of standardised non-strenuous outdoor duty and after 12 hours of duty divided into two-hour work-rest cycles. Participants rated the degree of discomfort, exertion and symptoms using a five-point Likert scale. The association between outcomes and the types of FFR was assessed using a multivariate ordered probit mixed-effects model. For a majority of the symptoms, study participants rated FFR with EV and FFR with EV+AVS with significantly better scores than standard FFR. Both FFR with EV and FFR with EV+AVS had significantly less discomfort (FFR with EV+AVS: 91.1%; FFR with EV: 57.6%) and exertion (FFR with EV+AVS: 83.5%; FFR with EV: 34.4%) than standard FFR. FFR with EV+AVS also had significantly better scores for exertion (53.4%) and comfort (39.4%) when compared to FFR with EV. Usage of FFR with EV+AVS resulted in significantly reduced symptoms, discomfort and exertion when compared to FFR with EV and standard FFR.

  7. The effectiveness of ID readers and remote age verification in enhancing compliance with the legal age limit for alcohol.

    PubMed

    Van Hoof, Joris J

    2017-04-01

    Currently, two different age verification systems (AVS) are implemented to enhance compliance with legal age limits for the sale of alcohol in the Netherlands. In this study, we tested the operational procedures and effectiveness of ID readers and remote age verification technology in supermarkets during the sale of alcohol. Following a trained alcohol purchase protocol, eight mystery shoppers (both underage and in the branch's reference age) conducted 132 alcohol purchase attempts in stores that were equipped with ID readers or remote age verification or were part of a control group. In stores equipped with an ID reader, 34% of the purchases were conducted without any mistakes (full compliance). In stores with remote age verification, full compliance was achieved in 87% of the cases. The control group reached 57% compliance, which is in line with the national average. Stores with ID readers perform worse than stores with remote age verification, and also worse than stores without any AVS. For both systems, in addition to effectiveness, public support and user friendliness need to be investigated. This study shows that remote age verification technology is a promising intervention that increases vendor compliance during the sales of age restricted products. © The Author 2016. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

  8. Randomized, Double-blind, Active-controlled Study Evaluating the Safety and Immunogenicity of Three Vaccination Schedules and Two Dose Levels of AV7909 Vaccine for Anthrax Post-exposure Prophylaxis in Healthy Adults

    PubMed Central

    Hopkins, Robert J.; Kalsi, Gurdyal; Montalvo-Lugo, Victor M.; Sharma, Mona; Wu, Yukun; Muse, Derek D.; Sheldon, Eric.A.; Hampel, Frank C.; Lemiale, Laurence

    2016-01-01

    AV7909 vaccine being developed for post-exposure prophylaxis of anthrax disease may require fewer vaccinations and reduced amount of antigen to achieve an accelerated immune response over BioThrax® (Anthrax Vaccine Adsorbed). A phase 2, randomized, double-blind, BioThrax vacccine-controlled study was conducted to evaluate the safety and immunogenicity of three intramuscular vaccination schedules and two dose levels of AV7909 in 168 healthy adults. Subjects were randomized at a 4:3:2:4:2 ratio to 5 groups: 1) AV7909 on Days 0/14; 2) AV7909 on Days 0/28; 3) AV7909 on Days 0/14/28; 4) half dose AV7909 on Days 0/14/28; and 5) BioThrax vaccine on Days 0/14/28. Vaccinations in all groups were well tolerated. The incidences of adverse events (AEs) were 79% for AV7909 subjects and 65% for BioThrax subjects; 92% of AV7909 subjects and 87% of BioThrax subjects having AEs reported Grade 1-2 AEs. No serious AEs were assessed as potentially vaccine-related, and no AEs of potential autoimmune etiology were reported. There was no discernible pattern indicative of a safety concern across groups in the incidence or severity of reactogenicity events. Groups 2, 3, and 4 achieved success for the primary endpoint, demonstrated by a lower 95% confidence limit of the percentage of subjects with protective toxin neutralizing antibody NF50 values (≥ 0.56) to be ≥ 40% at Day 63. Group 1 marginally missed the criterion (lower bound 95% confidence limit of 39.5%). Immune responses were above this threshold for Groups 1, 3 and 4 at Day 28 and all groups at Day 42. Further study of an AV7909 two-dose schedule given 2 weeks apart is warranted in light of the favorable tolerability profile and immunogenicity response relative to three doses of BioThrax vaccine, as well as preliminary data from nonclinical studies indicating similar immune responses correlate with higher survival for AV7909 than BioThrax vaccine. PMID:26979136

  9. Impact of high-dose atorvastatin therapy and clinical risk factors on incident aortic valve stenosis in patients with cardiovascular disease (from TNT, IDEAL, and SPARCL).

    PubMed

    Arsenault, Benoit J; Boekholdt, S Matthijs; Mora, Samia; DeMicco, David A; Bao, Weihang; Tardif, Jean-Claude; Amarenco, Pierre; Pedersen, Terje; Barter, Philip; Waters, David D

    2014-04-15

    Clinical trials have not provided evidence for a role of statin therapy in reducing aortic valve stenosis (AVS) severity in patients with documented AVS. However, whether statin therapy could prevent the onset of AVS is unknown. Our objectives were (1) to compare the incidence rates of AVS among patients treated with high-dose versus usual-dose statin or placebo and (2) to identify clinical risk factors associated with the development of AVS. We conducted post hoc analyses in 23,508 participants from 3 large-scale multicenter atorvastatin randomized blinded clinical trials: Treating to New Targets, the Incremental Decrease in End Points Through Aggressive Lipid Lowering, and the Stroke Prevention by Aggressive Reduction in Cholesterol Levels. The main outcome measure was the incidence of clinical AVS over a median follow-up of 4.9 years (82 cases). Among patients who developed AVS, 39 (47.6%) were treated with atorvastatin 80 mg and 43 (52.4%) were treated with lower dose statin (atorvastatin 10 mg in Treating to New Targets, simvastatin 20 to 40 mg in Incremental Decrease in End Points Through Aggressive Lipid Lowering, or placebo in Stroke Prevention by Aggressive Reduction in Cholesterol Levels; hazard ratio [HR] 0.91, 95% confidence interval [CI] 0.59 to 1.41, p=0.67). In multivariate analyses forcing treatment, sex, and race into the model, factors that were significantly associated with AVS included age (HR 2.17, 95% CI 1.61 to 2.93, p<0.0001 per 1-SD increment), diabetes (HR 1.67, 95% CI 1.00 to 2.80, p=0.05), vitamin K antagonist use (HR 3.25, 95% CI 2.06 to 5.16, p<0.0001), and previous statin use (HR 2.65, 95% CI 1.54 to 4.60, p=0.0008). In conclusion, random allocation to high-dose versus usual-dose statin therapy or placebo did not impact the incidence of AVS among patients without known AVS. Age, diabetes, vitamin K antagonists, and previous statin use were significant predictors of incident AVS in these high-risk patients. Copyright © 2014 Elsevier Inc. All rights reserved.

  10. Increasing T-type calcium channel activity by β-adrenergic stimulation contributes to β-adrenergic regulation of heart rates.

    PubMed

    Li, Yingxin; Zhang, Xiaoxiao; Zhang, Chen; Zhang, Xiaoying; Li, Ying; Qi, Zhao; Szeto, Christopher; Tang, Mingxin; Peng, Yizhi; Molkentin, Jeffery D; Houser, Steven R; Xie, Mingxing; Chen, Xiongwen

    2018-04-01

    Cav3.1 T-type Ca 2+ channel current (I Ca-T ) contributes to heart rate genesis but is not known to contribute to heart rate regulation by the sympathetic/β-adrenergic system (SAS). We show that the loss of Cav3.1 makes the beating rates of the heart in vivo and perfused hearts ex vivo, as well as sinoatrial node cells, less sensitive to β-adrenergic stimulation; it also renders less conduction acceleration through the atrioventricular node by β-adrenergic stimulation. Increasing Cav3.1 in cardiomyocytes has the opposite effects. I Ca-T in sinoatrial nodal cells can be upregulated by β-adrenergic stimulation. The results of the present study add a new contribution to heart rate regulation by the SAS system and provide potential new mechanisms for the dysregulation of heart rate and conduction by the SAS in the heart. T-type Ca 2+ channel can be a target for heart disease treatments that aim to slow down the heart rate ABSTRACT: Cav3.1 (α 1G ) T-type Ca 2+ channel (TTCC) is expressed in mouse sinoatrial node cells (SANCs) and atrioventricular (AV) nodal cells and contributes to heart rate (HR) genesis and AV conduction. However, its role in HR regulation and AV conduction acceleration by the β-adrenergic system (SAS) is unclear. In the present study, L- (I Ca-L ) and T-type (I Ca-T ) Ca 2+ currents were recorded in SANCs from Cav3.1 transgenic (TG) and knockout (KO), and control mice. I Ca-T was absent in KO SANCs but enhanced in TG SANCs. In anaesthetized animals, different doses of isoproterenol (ISO) were infused via the jugular vein and the HR was recorded. The EC 50 of the HR response to ISO was lower in TG mice but higher in KO mice, and the maximal percentage of HR increase by ISO was greater in TG mice but less in KO mice. In Langendorff-perfused hearts, ISO increased HR and shortened PR intervals to a greater extent in TG but to a less extent in KO hearts. KO SANCs had significantly slower spontaneous beating rates than control SANCs before and after ISO; TG SANCs had similar basal beating rates as control SANCs probably as a result of decreased I Ca-L but a greater response to ISO than control SANCs. I Ca-T in SANCs was significantly increased by ISO. I Ca-T upregulation by β-adrenergic stimulation contributes to HR and conduction regulation by the SAS. TTCC can be a target for slowing the HR. © 2017 The Authors. The Journal of Physiology © 2017 The Physiological Society.

  11. Simulator Study of Helmet-Mounted Symbology System Concepts in Degraded Visual Environments.

    PubMed

    Cheung, Bob; McKinley, Richard A; Steels, Brad; Sceviour, Robert; Cosman, Vaughn; Holst, Peter

    2015-07-01

    A sudden loss of external visual cues during critical phases of flight results in spatial disorientation. This is due to undetected horizontal and vertical drift when there is little tolerance for error and correction delay as the helicopter is close to the ground. Three helmet-mounted symbology system concepts were investigated in the simulator as potential solutions for the legacy Griffon helicopters. Thirteen Royal Canadian Air Force (RCAF) Griffon pilots were exposed to the Helmet Display Tracking System for Degraded Visual Environments (HDTS), the BrownOut Symbology System (BOSS), and the current RCAF AVS7 symbology system. For each symbology system, the pilot performed a two-stage departure and a single-stage approach. The presentation order of the symbology systems was randomized. Objective performance metrics included aircraft speed, altitude, attitude, and distance from the landing point. Subjective measurements included situation awareness, mental effort, perceived performance, perceptual cue rating, and NASA Task Load Index. Repeated measures analysis of variance and subsequent planned comparison for all the objective and subjective measurements were performed between the AVS7, HDTS, and BOSS. Our results demonstrated that HDTS and BOSS showed general improvement over AVS7 in two-stage departure. However, only HDTS performed significantly better in heading error than AVS7. During the single-stage approach, BOSS performed worse than AVS7 in heading root mean square error, and only HDTS performed significantly better in distance to landing point and approach heading than the others. Both the HDTS and BOSS possess their own limitations; however, HDTS is the pilots' preferred flight display.

  12. Pittsburgh Compound B and AV-1451 positron emission tomography assessment of molecular pathologies of Alzheimer's disease in progressive supranuclear palsy.

    PubMed

    Whitwell, Jennifer L; Ahlskog, J Eric; Tosakulwong, Nirubol; Senjem, Matthew L; Spychalla, Anthony J; Petersen, Ronald C; Jack, Clifford R; Lowe, Val J; Josephs, Keith A

    2018-03-01

    Little is known about Alzheimer's disease molecular proteins, beta-amyloid and paired helical filament (PHF) tau, in progressive supranuclear palsy (PSP). Recent techniques have been developed to allow for investigations of these proteins in PSP. We determined the frequency of beta-amyloid deposition in PSP, and whether beta-amyloid deposition in PSP is associated with PHF-tau deposition pattern, or clinical features. Thirty probable PSP participants underwent MRI, [ 18 F]AV-1451 PET and Pittsburgh compound B (PiB) PET. Apolipoprotein (APOE) genotyping was also performed. A global PiB standard-uptake value ratio (SUVR) was calculated. AV-1451 SUVRs were calculated for a set of Alzheimer's disease (AD)-related regions and a set of PSP-related regions. Voxel-level analyses were conducted to assess for differences in AV-1451 uptake patterns and MRI atrophy between PiB(+) and PiB(-) cases compared to 60 normal PiB(-) controls. Statistical testing for correlations and associations between variables of interest were also performed. Twelve subjects (40%) showed beta-amyloid deposition. Higher PiB SUVR correlated with older age but not with AV-1451 SUVR in the AD- or PSP-related regions. Higher AV-1451 SUVR in AD-related regions was associated with higher AV-1451 SUVR in PSP-related regions. We found little evidence for beta-amyloid related differences in clinical metrics, proportion of APOE e4 carriers, pattern of AV-1451 uptake, or pattern of atrophy. Beta-amyloid deposition occurs in a relatively high proportion of PSP subjects. Unlike in Alzheimer's disease, however, there is little evidence that beta-amyloid, and PHF-tau, play a significant role in neurodegeneration in PSP. Copyright © 2017 Elsevier Ltd. All rights reserved.

  13. Pacemaker Dependency after Cardiac Surgery: A Systematic Review of Current Evidence

    PubMed Central

    2015-01-01

    Background Severe postoperative conduction disturbances requiring permanent pacemaker implantation frequently occur following cardiac surgery. Little is known about the long-term pacing requirements and risk factors for pacemaker dependency in this population. Methods We performed a systematic review of the literature addressing rates and predictors of pacemaker dependency in patients requiring permanent pacemaker implantation after cardiac surgery. Using a comprehensive search of the Medline, Web of Science and EMBASE databases, studies were selected for review based on predetermined inclusion and exclusion criteria. Results A total of 8 studies addressing the endpoint of pacemaker-dependency were identified, while 3 studies were found that addressed the recovery of atrioventricular (AV) conduction endpoint. There were 10 unique studies with a total of 780 patients. Mean follow-up ranged from 6–72 months. Pacemaker dependency rates ranged from 32%-91% and recovery of AV conduction ranged from 16%-42%. There was significant heterogeneity with respect to the definition of pacemaker dependency. Several patient and procedure-specific variables were found to be independently associated with pacemaker dependency, but these were not consistent between studies. Conclusions Pacemaker dependency following cardiac surgery occurs with variable frequency. While individual studies have identified various perioperative risk factors for pacemaker dependency and non-resolution of AV conduction disease, results have been inconsistent. Well-conducted studies using a uniform definition of pacemaker dependency might identify patients who will benefit most from early permanent pacemaker implantation after cardiac surgery. PMID:26470027

  14. Cardiac arrhythmias during or after epileptic seizures

    PubMed Central

    van der Lende, Marije; Surges, Rainer; Sander, Josemir W; Thijs, Roland D

    2016-01-01

    Seizure-related cardiac arrhythmias are frequently reported and have been implicated as potential pathomechanisms of Sudden Unexpected Death in Epilepsy (SUDEP). We attempted to identify clinical profiles associated with various (post)ictal cardiac arrhythmias. We conducted a systematic search from the first date available to July 2013 on the combination of two terms: ‘cardiac arrhythmias’ and ‘epilepsy’. The databases searched were PubMed, Embase (OVID version), Web of Science and COCHRANE Library. We attempted to identify all case reports and case series. We identified seven distinct patterns of (post)ictal cardiac arrhythmias: ictal asystole (103 cases), postictal asystole (13 cases), ictal bradycardia (25 cases), ictal atrioventricular (AV)-conduction block (11 cases), postictal AV-conduction block (2 cases), (post)ictal atrial flutter/atrial fibrillation (14 cases) and postictal ventricular fibrillation (3 cases). Ictal asystole had a mean prevalence of 0.318% (95% CI 0.316% to 0.320%) in people with refractory epilepsy who underwent video-EEG monitoring. Ictal asystole, bradycardia and AV-conduction block were self-limiting in all but one of the cases and seen during focal dyscognitive seizures. Seizure onset was mostly temporal (91%) without consistent lateralisation. Postictal arrhythmias were mostly found following convulsive seizures and often associated with (near) SUDEP. The contrasting clinical profiles of ictal and postictal arrhythmias suggest different pathomechanisms. Postictal rather than ictal arrhythmias seem of greater importance to the pathophysiology of SUDEP. PMID:26038597

  15. Development of an Advanced Aidman Vision Screener (AVS) for selective assessment of outer and inner laser induced retinal injury

    NASA Astrophysics Data System (ADS)

    Boye, Michael W.; Zwick, Harry; Stuck, Bruce E.; Edsall, Peter R.; Akers, Andre

    2007-02-01

    The need for tools that can assist in evaluating visual function is an essential and a growing requirement as lasers on the modern battlefield mature and proliferate. The requirement for rapid and sensitive vision assessment under field conditions produced the USAMRD Aidman Vision Screener (AVS), designed to be used as a field diagnostic tool for assessing laser induced retinal damage. In this paper, we describe additions to the AVS designed to provide a more sensitive assessment of laser induced retinal dysfunction. The AVS incorporates spectral LogMar Acuity targets without and with neural opponent chromatic backgrounds. Thus, it provides the capability of detecting selective photoreceptor damage and its functional consequences at the level of both the outer and inner retina. Modifications to the original achromatic AVS have been implemented to detect selective cone system dysfunction by providing LogMar acuity Landolt rings associated with the peak spectral absorption regions of the S (short), M (middle), and L (long) wavelength cone photoreceptor systems. Evaluation of inner retinal dysfunction associated with selective outer cone damage employs LogMar spectral acuity charts with backgrounds that are neurally opponent. Thus, the AVS provides the capability to assess the effect of selective cone dysfunction on the normal neural balance at the level of the inner retinal interactions. Test and opponent background spectra have been optimized by using color space metrics. A minimal number of three AVS evaluations will be utilized to provide an estimate of false alarm level.

  16. Role of shear wave sonoelastography in differentiation between focal breast lesions.

    PubMed

    Dobruch-Sobczak, Katarzyna; Nowicki, Andrzej

    2015-02-01

    Our goal in this study was to evaluate the relevance of shear wave sonoelastography (SWE) in the differential diagnosis of masses in the breast with respect to ultrasound (US). US and SWE were performed (Aixplorer System, SuperSonic Imagine, Aix en Provence, France) in 76 women (aged 24 to 85) with 84 lesions (43 malignant, 41 benign). The study included BI-RADS-US (Breast Imaging Reporting and Data System for Ultrsound) category 3-5 lesions. In elastograms, the following values were calculated: mean elasticity in lesions (E(av.l)) and in fat tissue (E(av.f.)) and maximal (E(max.adj.)) and mean (E(av.adj.)) elasticity in lesions and adjacent tissues. The sensitivity and specificity of the BI-RADS category 4a/4b cutoff value were 97.7% and 90.2%. For an E(av.adj.) of 68.5 kPa, the cutoff sensitivity was 86.1% and the specificity was 87.8%, and for an E(max.adj.) of 124.1 kPa, 74.4% and 92.7%, respectively. For BI-RADS-US category 3 lesions, E(av.l), E(max.adj.) and E(av.adj.) were below cutoff levels. On the basis of our findings, E(av.adj.) had lower sensitivity and specificity compared with US. Emax.adj. improved the specificity of breast US with loss of sensitivity. Copyright © 2015 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

  17. MURC, a Muscle-Restricted Coiled-Coil Protein That Modulates the Rho/ROCK Pathway, Induces Cardiac Dysfunction and Conduction Disturbance▿

    PubMed Central

    Ogata, Takehiro; Ueyama, Tomomi; Isodono, Koji; Tagawa, Masashi; Takehara, Naofumi; Kawashima, Tsuneaki; Harada, Koichiro; Takahashi, Tomosaburo; Shioi, Tetsuo; Matsubara, Hiroaki; Oh, Hidemasa

    2008-01-01

    We identified a novel muscle-restricted putative coiled-coil protein, MURC, which is evolutionarily conserved from frog to human. MURC was localized to the cytoplasm with accumulation in the Z-line of the sarcomere in the murine adult heart. MURC mRNA expression in the heart increased during the developmental process from the embryonic stage to adulthood. In response to pressure overload, MURC mRNA expression increased in the hypertrophied heart. Using the yeast two-hybrid system, we identified the serum deprivation response (SDPR) protein, a phosphatidylserine-binding protein, as a MURC-binding protein. MURC induced activation of the RhoA/ROCK pathway, which modulated serum response factor-mediated atrial natriuretic peptide (ANP) expression and myofibrillar organization. SDPR augmented MURC-induced transactivation of the ANP promoter in cardiomyocytes, and RNA interference of SDPR attenuated the action of MURC on the ANP promoter. Transgenic mice expressing cardiac-specific MURC (Tg-MURC) exhibited cardiac contractile dysfunction and atrioventricular (AV) conduction disturbances with atrial chamber enlargement, reduced thickness of the ventricular wall, and interstitial fibrosis. Spontaneous episodes of atrial fibrillation and AV block were observed in Tg-MURC mice. These findings indicate that MURC modulates RhoA signaling and that MURC plays an important role in the development of cardiac dysfunction and conduction disturbance with increased vulnerability to atrial arrhythmias. PMID:18332105

  18. MURC, a muscle-restricted coiled-coil protein that modulates the Rho/ROCK pathway, induces cardiac dysfunction and conduction disturbance.

    PubMed

    Ogata, Takehiro; Ueyama, Tomomi; Isodono, Koji; Tagawa, Masashi; Takehara, Naofumi; Kawashima, Tsuneaki; Harada, Koichiro; Takahashi, Tomosaburo; Shioi, Tetsuo; Matsubara, Hiroaki; Oh, Hidemasa

    2008-05-01

    We identified a novel muscle-restricted putative coiled-coil protein, MURC, which is evolutionarily conserved from frog to human. MURC was localized to the cytoplasm with accumulation in the Z-line of the sarcomere in the murine adult heart. MURC mRNA expression in the heart increased during the developmental process from the embryonic stage to adulthood. In response to pressure overload, MURC mRNA expression increased in the hypertrophied heart. Using the yeast two-hybrid system, we identified the serum deprivation response (SDPR) protein, a phosphatidylserine-binding protein, as a MURC-binding protein. MURC induced activation of the RhoA/ROCK pathway, which modulated serum response factor-mediated atrial natriuretic peptide (ANP) expression and myofibrillar organization. SDPR augmented MURC-induced transactivation of the ANP promoter in cardiomyocytes, and RNA interference of SDPR attenuated the action of MURC on the ANP promoter. Transgenic mice expressing cardiac-specific MURC (Tg-MURC) exhibited cardiac contractile dysfunction and atrioventricular (AV) conduction disturbances with atrial chamber enlargement, reduced thickness of the ventricular wall, and interstitial fibrosis. Spontaneous episodes of atrial fibrillation and AV block were observed in Tg-MURC mice. These findings indicate that MURC modulates RhoA signaling and that MURC plays an important role in the development of cardiac dysfunction and conduction disturbance with increased vulnerability to atrial arrhythmias.

  19. Crotaline Fab antivenom appears to be effective in cases of severe North American pit viper envenomation: An integrative review

    PubMed Central

    Lavonas, Eric J; Schaeffer, Tammi H; Kokko, Jamie; Mlynarchek, Sara L; Bogdan, Gregory M

    2009-01-01

    Background In 2000, the United States Food and Drug Administration approved Crotalidae Polyvalent Immune Fab (Ovine) (hereafter, FabAV), "for the management of patients with minimal to moderate North American Crotalid envenomation." Because whole-IgG pit viper antivenom is no longer available in the United States, FabAV is currently the only specific treatment option available to United States clinicians treating snakebite victims of any severity. No clinical trial data are available concerning the effectiveness of FabAV for treatment of severe snakebite, but several published articles describe its use in this setting. Methods We performed a comprehensive review of the English-language medical literature to identify all publications (1996 to July, 2008) containing data about the administration of FabAV. Two trained reviewers separately extracted case-level data concerning the administration of FabAV to patients with severe envenomation by North American crotaline snakes to a standardized form. Descriptive statistics were used. In addition, we hand-searched the US National Poison Data System reports for the years 2000–2006 to identify and describe any reports of death that occurred after FabAV administration. Results The literature review found 147 unique publications regarding FabAV. Twenty-four evaluable cases of severe human envenomation treated with FabAV were identified in 19 publications. Seven cases were described in five cohort studies, and 17 cases were described in 14 single patient case reports or non-cohort case series. Sixty-five specific severe venom effects were reported in these 24 patients, of which 50 effects (77%) improved or resolved after FabAV therapy. Initial control of all severe venom effects was achieved in 12 patients (50%). The rate at which initial control was achieved was significantly higher among patients reported in the cohort series than in the case series and non-cohort reports (100% vs. 29%, P = 0.005). The median dose of FabAV used to obtain initial control was 6 vials (range: 4 – 18 vials). Nine patients had severe venom effects that persisted despite FabAV therapy. Recurrent and/or delayed-onset severe defibrination syndrome occurred in 12 patients, most of whom did not receive recommended maintenance FabAV dosing. No patient developed systemic bleeding. Conclusion In this structured literature review, FabAV appears to be effective in the management of severe crotaline snake envenomation. Incomplete response to therapy, recurrence of venom effects, and delayed-onset venom effects were reported in case reports, but not reported in cohort studies. PMID:19545426

  20. Seasonal AVS-SEM relationship in sediments and potential bioavailability of metals in industrialized estuary, southeastern Brazil.

    PubMed

    Nizoli, Erico Casare; Luiz-Silva, Wanilson

    2012-04-01

    In anoxic sediments, as those found in estuaries, the mobility of metals can be controlled by the formation of stable sulfide complexes. The potential bioavailability of a metal can then be predicted on the basis of the acid volatile sulfide (AVS) and simultaneously extracted metals (SEM) criterion. Distributions of AVS and SEM (Hg, Cu, Pb, Cd, Zn, and Ni) along the sediment profiles were determined seasonally for three rivers that constitute the Santos-Cubatão estuarine system (SE Brazil), which is located in one of the most industrialized areas of Latin America. AVS and SEM concentrations varied significantly, from 0.04 to 31.9 μmol g(-1) and 0.086-6.659 μmol g(-1), respectively. The highest AVS levels in sediments were detected in the winter, whereas high SEM values predominated in the summer. Considering SEM-AVS molar differences as a parameter to evaluate potential bioavailability, sediments nearest to the industrial area represent higher risk to biota, especially during the summer. It is due to relatively low AVS values and not necessarily high concentrations of metals.

  1. [F-18]-AV-1451 binding correlates with postmortem neurofibrillary tangle Braak staging.

    PubMed

    Marquié, Marta; Siao Tick Chong, Michael; Antón-Fernández, Alejandro; Verwer, Eline E; Sáez-Calveras, Nil; Meltzer, Avery C; Ramanan, Prianca; Amaral, Ana C; Gonzalez, Jose; Normandin, Marc D; Frosch, Matthew P; Gómez-Isla, Teresa

    2017-10-01

    [F-18]-AV-1451, a PET tracer specifically developed to detect brain neurofibrillary tau pathology, has the potential to facilitate accurate diagnosis of Alzheimer's disease (AD), staging of brain tau burden and monitoring disease progression. Recent PET studies show that patients with mild cognitive impairment and AD dementia exhibit significantly higher in vivo [F-18]-AV-1451 retention than cognitively normal controls. Importantly, PET patterns of [F-18]-AV-1451 correlate well with disease severity and seem to match the predicted topographic Braak staging of neurofibrillary tangles (NFTs) in AD, although this awaits confirmation. We studied the correlation of autoradiographic binding patterns of [F-18]-AV-1451 and the stereotypical spatiotemporal pattern of progression of NFTs using legacy postmortem brain samples representing different Braak NFT stages (I-VI). We performed [F-18]-AV-1451 phosphor-screen autoradiography and quantitative tau measurements (stereologically based NFT counts and biochemical analysis of tau pathology) in three brain regions (entorhinal cortex, superior temporal sulcus and visual cortex) in a total of 22 cases: low Braak (I-II, n = 6), intermediate Braak (III-IV, n = 7) and high Braak (V-VI, n = 9). Strong and selective [F-18]-AV-1451 binding was detected in all tangle-containing regions matching precisely the observed pattern of PHF-tau immunostaining across the different Braak stages. As expected, no signal was detected in the white matter or other non-tangle containing regions. Quantification of [F-18]-AV-1451 binding was very significantly correlated with the number of NFTs present in each brain region and with the total tau and phospho-tau content as reported by Western blot and ELISA. [F-18]-AV-1451 is a promising biomarker for in vivo quantification of brain tau burden in AD. Neuroimaging-pathologic studies conducted on postmortem material from individuals imaged while alive are now needed to confirm these observations.

  2. Fabrication, Characterization, and Biological Activity of Avermectin Nano-delivery Systems with Different Particle Sizes

    NASA Astrophysics Data System (ADS)

    Wang, Anqi; Wang, Yan; Sun, Changjiao; Wang, Chunxin; Cui, Bo; Zhao, Xiang; Zeng, Zhanghua; Yao, Junwei; Yang, Dongsheng; Liu, Guoqiang; Cui, Haixin

    2018-01-01

    Nano-delivery systems for the active ingredients of pesticides can improve the utilization rates of pesticides and prolong their control effects. This is due to the nanocarrier envelope and controlled release function. However, particles containing active ingredients in controlled release pesticide formulations are generally large and have wide size distributions. There have been limited studies about the effect of particle size on the controlled release properties and biological activities of pesticide delivery systems. In the current study, avermectin (Av) nano-delivery systems were constructed with different particle sizes and their performances were evaluated. The Av release rate in the nano-delivery system could be effectively controlled by changing the particle size. The biological activity increased with decreasing particle size. These results suggest that Av nano-delivery systems can significantly improve the controllable release, photostability, and biological activity, which will improve efficiency and reduce pesticide residues.

  3. Systematic Review: Audiovisual Interventions for Reducing Preoperative Anxiety in Children Undergoing Elective Surgery

    PubMed Central

    Van Lieshout, Ryan J.; Schmidt, Louis A.; Dobson, Kathleen G.; Buckley, Norman

    2016-01-01

    Objective To examine the effectiveness of Audiovisual (AV) interventions at reducing preoperative anxiety and its associated outcomes in children undergoing elective surgery. Methods A systematic review of randomized controlled trials (RCTs) and nonrandomized studies where the primary outcome was children’s preoperative anxiety was conducted. Secondary outcomes included postoperative pain, behavioral changes, recovery, induction compliance, satisfaction, and cost-effectiveness. The risk of bias of each study was assessed. Results In all, 18 studies were identified. A meta-analytic approach and narrative synthesis of findings were used to summarize the results of the studies. Conclusions This systematic review suggests that AV interventions can be effective in reducing children’s preoperative anxiety. Videos, multi-faceted programs, and interactive games appear to be most effective, whereas music therapy and Internet programs are less effective. While AV interventions appear potentially useful, adequately powered RCTs are required to conclusively pinpoint the components and mechanisms of the most effective AV interventions and guide practice. PMID:26476281

  4. Chronic toxicity of nickel-spiked freshwater sediments: variation in toxicity among eight invertebrate taxa and eight sediments

    USGS Publications Warehouse

    Besser, John M.; Brumbaugh, William G.; Ingersoll, Christopher G.; Ivey, Chris D.; Kunz, James L.; Kemble, Nile E.; Schlekat, Christian E.; Garman, Emily R.

    2013-01-01

    This study evaluated the chronic toxicity of Ni-spiked freshwater sediments to benthic invertebrates. A 2-step spiking procedure (spiking and sediment dilution) and a 2-stage equilibration period (10 wk anaerobic and 1 wk aerobic) were used to spike 8 freshwater sediments with wide ranges of acid-volatile sulfide (AVS; 0.94–38 µmol/g) and total organic carbon (TOC; 0.42–10%). Chronic sediment toxicity tests were conducted with 8 invertebrates (Hyalella azteca, Gammarus pseudolimnaeus, Chironomus riparius, Chironomus dilutus, Hexagenia sp., Lumbriculus variegatus, Tubifex tubifex, and Lampsilis siliquoidea) in 2 spiked sediments. Nickel toxicity thresholds estimated from species-sensitivity distributions were 97 µg/g and 752 µg/g (total recoverable Ni; dry wt basis) for sediments with low and high concentrations of AVS and TOC, respectively. Sensitive species were tested with 6 additional sediments. The 20% effect concentrations (EC20s) for Hyalella and Gammarus, but not Hexagenia, were consistent with US Environmental Protection Agency benchmarks based on Ni in porewater and in simultaneously extracted metals (SEM) normalized to AVS and TOC. For Hexagenia, sediment EC20s increased at less than an equimolar basis with increased AVS, and toxicity occurred in several sediments with Ni concentrations in SEM less than AVS. The authors hypothesize that circulation of oxygenated water by Hexagenia led to oxidation of AVS in burrows, creating microenvironments with high Ni exposure. Despite these unexpected results, a strong relationship between Hexagenia EC20s and AVS could provide a basis for conservative site-specific sediment quality guidelines for Ni.

  5. Chronic toxicity of nickel-spiked freshwater sediments: variation in toxicity among eight invertebrate taxa and eight sediments.

    PubMed

    Besser, John M; Brumbaugh, William G; Ingersoll, Christopher G; Ivey, Chris D; Kunz, James L; Kemble, Nile E; Schlekat, Christian E; Garman, Emily Rogevich

    2013-11-01

    This study evaluated the chronic toxicity of Ni-spiked freshwater sediments to benthic invertebrates. A 2-step spiking procedure (spiking and sediment dilution) and a 2-stage equilibration period (10 wk anaerobic and 1 wk aerobic) were used to spike 8 freshwater sediments with wide ranges of acid-volatile sulfide (AVS; 0.94-38 µmol/g) and total organic carbon (TOC; 0.42-10%). Chronic sediment toxicity tests were conducted with 8 invertebrates (Hyalella azteca, Gammarus pseudolimnaeus, Chironomus riparius, Chironomus dilutus, Hexagenia sp., Lumbriculus variegatus, Tubifex tubifex, and Lampsilis siliquoidea) in 2 spiked sediments. Nickel toxicity thresholds estimated from species-sensitivity distributions were 97 µg/g and 752 µg/g (total recoverable Ni; dry wt basis) for sediments with low and high concentrations of AVS and TOC, respectively. Sensitive species were tested with 6 additional sediments. The 20% effect concentrations (EC20s) for Hyalella and Gammarus, but not Hexagenia, were consistent with US Environmental Protection Agency benchmarks based on Ni in porewater and in simultaneously extracted metals (SEM) normalized to AVS and TOC. For Hexagenia, sediment EC20s increased at less than an equimolar basis with increased AVS, and toxicity occurred in several sediments with Ni concentrations in SEM less than AVS. The authors hypothesize that circulation of oxygenated water by Hexagenia led to oxidation of AVS in burrows, creating microenvironments with high Ni exposure. Despite these unexpected results, a strong relationship between Hexagenia EC20s and AVS could provide a basis for conservative site-specific sediment quality guidelines for Ni. © 2013 SETAC.

  6. AVS as a GUI for ADAM

    NASA Astrophysics Data System (ADS)

    Terrett, D. L.

    The basis of this report is 2 days spent with an AVS expert from DEC's CERN project office attempting to convert an ADAM application into an AVS module. The experiment was successful in that we succeeded in running a KAPPA application (ADD) as a module in an AVS network without modifying the applications program code in any way. We took many short cuts and it became clear that doing the job properly would be a major exercise, but we learned enough to know that the job is feasible and gained a clear idea of what the final system would look like and what it would be capable of.

  7. Get the Most out of Your AV System Dollar. Part II

    ERIC Educational Resources Information Center

    Wadsworth, Raymond H.

    1974-01-01

    Describes how to save money when designing AV facilities; excellent viewing from all seats is achieved by applying certain basic principles to the design of the room and the selection of the equipment. (Author/MLF)

  8. Randomized, double-blind, active-controlled study evaluating the safety and immunogenicity of three vaccination schedules and two dose levels of AV7909 vaccine for anthrax post-exposure prophylaxis in healthy adults.

    PubMed

    Hopkins, Robert J; Kalsi, Gurdyal; Montalvo-Lugo, Victor M; Sharma, Mona; Wu, Yukun; Muse, Derek D; Sheldon, Eric A; Hampel, Frank C; Lemiale, Laurence

    2016-04-19

    AV7909 vaccine being developed for post-exposure prophylaxis of anthrax disease may require fewer vaccinations and reduced amount of antigen to achieve an accelerated immune response over BioThrax(®) (Anthrax Vaccine Adsorbed). A phase 2, randomized, double-blind, BioThrax vacccine-controlled study was conducted to evaluate the safety and immunogenicity of three intramuscular vaccination schedules and two dose levels of AV7909 in 168 healthy adults. Subjects were randomized at a 4:3:2:4:2 ratio to 5 groups: (1) AV7909 on Days 0/14; (2) AV7909 on Days 0/28; (3) AV7909 on Days 0/14/28; (4) half dose AV7909 on Days 0/14/28; and (5) BioThrax vaccine on Days 0/14/28. Vaccinations in all groups were well tolerated. The incidences of adverse events (AEs) were 79% for AV7909 subjects and 65% for BioThrax subjects; 92% of AV7909 subjects and 87% of BioThrax subjects having AEs reported Grade 1-2 AEs. No serious AEs were assessed as potentially vaccine-related, and no AEs of potential autoimmune etiology were reported. There was no discernible pattern indicative of a safety concern across groups in the incidence or severity of reactogenicity events. Groups 2-4 achieved success for the primary endpoint, demonstrated by a lower 95% confidence limit of the percentage of subjects with protective toxin neutralizing antibody NF50 values (≥0.56) to be ≥40% at Day 63. Group 1 marginally missed the criterion (lower bound 95% confidence limit of 39.5%). Immune responses were above this threshold for Groups 1, 3 and 4 at Day 28 and all groups at Day 42. Further study of an AV7909 two-dose schedule given 2 weeks apart is warranted in light of the favorable tolerability profile and immunogenicity response relative to three doses of BioThrax vaccine, as well as preliminary data from nonclinical studies indicating similar immune responses correlate with higher survival for AV7909 than BioThrax vaccine. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  9. Polysialic acid blocks mononuclear phagocyte reactivity, inhibits complement activation, and protects from vascular damage in the retina.

    PubMed

    Karlstetter, Marcus; Kopatz, Jens; Aslanidis, Alexander; Shahraz, Anahita; Caramoy, Albert; Linnartz-Gerlach, Bettina; Lin, Yuchen; Lückoff, Anika; Fauser, Sascha; Düker, Katharina; Claude, Janine; Wang, Yiner; Ackermann, Johannes; Schmidt, Tobias; Hornung, Veit; Skerka, Christine; Langmann, Thomas; Neumann, Harald

    2017-02-01

    Age-related macular degeneration (AMD) is a major cause of blindness in the elderly population. Its pathophysiology is linked to reactive oxygen species (ROS) and activation of the complement system. Sialic acid polymers prevent ROS production of human mononuclear phagocytes via the inhibitory sialic acid-binding immunoglobulin-like lectin-11 (SIGLEC11) receptor. Here, we show that low-dose intravitreal injection of low molecular weight polysialic acid with average degree of polymerization 20 (polySia avDP20) in humanized transgenic mice expressing SIGLEC11 on mononuclear phagocytes reduced their reactivity and vascular leakage induced by laser coagulation. Furthermore, polySia avDP20 prevented deposition of the membrane attack complex in both SIGLEC11 transgenic and wild-type animals. In vitro, polySia avDP20 showed two independent, but synergistic effects on the innate immune system. First, polySia avDP20 prevented tumor necrosis factor-α, vascular endothelial growth factor A, and superoxide production by SIGLEC11-positive phagocytes. Second, polySia avDP20 directly interfered with complement activation. Our data provide evidence that polySia avDP20 ameliorates laser-induced damage in the retina and thus is a promising candidate to prevent AMD-related inflammation and angiogenesis. © 2016 The Authors. Published under the terms of the CC BY 4.0 license.

  10. Directly ventricular septal defect closure without using arteriovenous wire loop: Our adult case series using transarterial retrograde approach

    PubMed Central

    Pekel, Nihat; Ercan, Ertuğrul; Özpelit, Mehmet Emre; Özyurtlu, Ferhat; Yılmaz, Akar; Topaloğlu, Caner; Saygı, Serkan; Yakan, Serkan; Tengiz, İstemihan

    2017-01-01

    Objective: The standard transcatheter ventricular septal defects (VSD) closure procedure is established with arteriovenous (AV) loop and is called as antegrade approach. The directly retrograde transarterial VSD closure without using AV loop might be better option as shortens the procedure time and decreases radiation exposure. Methods: Our series consist of twelve sequential adult cases with congenital VSDs (seven with perimembranous, four with muscular, one with postoperative residuel VSD). The mean age was 26.9 (Range 18–58), the mean height was 168.75 cm (Range 155–185cm), and the mean body mass index was 23.4 (Range 17.3–28.4). Maximum and minimum defect sizes were 10 and 5 mm and the mean defect size was 6.24 mm. The procedure was performed with left heart catheterization and advancing the delivery sheath over the stiff exchange wire then VSD occlusion from left side. Results: The defects were successfully closed with this technique in eleven patients. In sixth patient, the defect could not be cannulated by the delivery sheath, as the tip of the sheath did not reach the defect and VSD was closed with same sheath by standard transvenous approach using AV loop. We didn’t encounter any complication releated to semilunar or atrioventricular valves. Atrioventricular conduction system was not affected by the procedure in any patients. The median procedure and fluoroscopy times were 66 and 16.5 minutes respectively. Conclusion: Transarterial retrograde VSD closure without using AV loop simplifies the procedure, decreases the radiation exposure, and shortens the procedure time. The only limitation in adult patients is delivery sheath length. PMID:28315566

  11. Navy Libraries’ Information Storage and Retrieval System. Proceedings of the CONSATL Workshop and Meeting (38th), 23-25 April 1980,

    DTIC Science & Technology

    1981-04-01

    1606 David Taylor Naval Ship R&D Center (202)227- 1307 Mary Jane Brewster Naval Research Laboratory Donald R. Erickson AV 297-3425 Naval Sea Systems...Marshal Hughes Nannette M. Pope Naval Surface Weapons Center Armed Forces Radiobiology Research AV 249-8994 Institute (703)663-8994 (301)295- 0428

  12. Hearing Lips and Seeing Voices: How Cortical Areas Supporting Speech Production Mediate Audiovisual Speech Perception

    PubMed Central

    Skipper, Jeremy I.; van Wassenhove, Virginie; Nusbaum, Howard C.; Small, Steven L.

    2009-01-01

    Observing a speaker’s mouth profoundly influences speech perception. For example, listeners perceive an “illusory” “ta” when the video of a face producing /ka/ is dubbed onto an audio /pa/. Here, we show how cortical areas supporting speech production mediate this illusory percept and audiovisual (AV) speech perception more generally. Specifically, cortical activity during AV speech perception occurs in many of the same areas that are active during speech production. We find that different perceptions of the same syllable and the perception of different syllables are associated with different distributions of activity in frontal motor areas involved in speech production. Activity patterns in these frontal motor areas resulting from the illusory “ta” percept are more similar to the activity patterns evoked by AV/ta/ than they are to patterns evoked by AV/pa/ or AV/ka/. In contrast to the activity in frontal motor areas, stimulus-evoked activity for the illusory “ta” in auditory and somatosensory areas and visual areas initially resembles activity evoked by AV/pa/ and AV/ka/, respectively. Ultimately, though, activity in these regions comes to resemble activity evoked by AV/ta/. Together, these results suggest that AV speech elicits in the listener a motor plan for the production of the phoneme that the speaker might have been attempting to produce, and that feedback in the form of efference copy from the motor system ultimately influences the phonetic interpretation. PMID:17218482

  13. Development of a Bayesian Belief Network Runway Incursion and Excursion Model

    NASA Technical Reports Server (NTRS)

    Green, Lawrence L.

    2014-01-01

    In a previous work, a statistical analysis of runway incursion (RI) event data was conducted to ascertain the relevance of this data to the top ten Technical Challenges (TC) of the National Aeronautics and Space Administration (NASA) Aviation Safety Program (AvSP). The study revealed connections to several of the AvSP top ten TC and identified numerous primary causes and contributing factors of RI events. The statistical analysis served as the basis for developing a system-level Bayesian Belief Network (BBN) model for RI events, also previously reported. Through literature searches and data analysis, this RI event network has now been extended to also model runway excursion (RE) events. These RI and RE event networks have been further modified and vetted by a Subject Matter Expert (SME) panel. The combined system-level BBN model will allow NASA to generically model the causes of RI and RE events and to assess the effectiveness of technology products being developed under NASA funding. These products are intended to reduce the frequency of runway safety incidents/accidents, and to improve runway safety in general. The development and structure of the BBN for both RI and RE events are documented in this paper.

  14. Supplementation with two probiotic strains, Lactobacillus curvatus HY7601 and Lactobacillus plantarum KY1032, reduces fasting triglycerides and enhances apolipoprotein A-V levels in non-diabetic subjects with hypertriglyceridemia.

    PubMed

    Ahn, Hyeon Yeong; Kim, Minjoo; Chae, Jey Sook; Ahn, Young-Tae; Sim, Jae-Hun; Choi, Il-Dong; Lee, Sang-Hyun; Lee, Jong Ho

    2015-08-01

    Previous studies have indicated that supplementation with probiotics might improve lipid metabolism. The objective of the study was to evaluate the effect of supplementation with probiotic strains Lactobacillus curvatus (L. curvatus) HY7601 and Lactobacillus plantarum (L. plantarum) KY1032 on triglyceride (TG) and apolipoprotein A-V (apo A-V) levels. A randomized, double-blinded, placebo-controlled study was conducted with 128 non-diabetic subjects with hypertriglyceridemia. Over a 12-week test period, the probiotic group consumed 2 g/day of a powdered supplement containing L. curvatus HY7601 and L. plantarum KY1032, whereas the placebo group consumed a powder lacking probiotics. After the treatment, the probiotic group showed an 18.3% (P < 0.001) reduction in TGs and increases of 21.1% (P = 0.001) and 15.6% (P < 0.001) in the apo A-V and LDL particle size, respectively. The probiotic group had a significant reduction in TGs (P = 0.040) and increases in the plasma apo A-V (P = 0.003) and LDL particle size (P < 0.001) compared with the placebo group. In the probiotic group, the reduction in the TG levels was negatively correlated with changes in the apo A-V and baseline TGs, regardless of the APOA5 -1131T > C genotype. The consumption of two probiotic strains for 12 weeks reduced TGs and increased the apo A-V and LDL particle size in hypertriglyceridemic subjects. This effect was more pronounced in subjects with higher levels of fasting TGs regardless of their APOA5 -1131T > C genotype. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  15. Effects of sediment characteristics on the toxicity of chromium(III) and chromium(VI) to the amphipod, Hyalella azteca

    USGS Publications Warehouse

    Besser, J.M.; Brumbaugh, W.G.; Kemble, N.E.; May, T.W.; Ingersoll, C.G.

    2004-01-01

    We evaluated the influence of sediment characteristics, acid-volatile sulfide (AVS) and organic matter (OM), on the toxicity of chromium (Cr) in freshwater sediments. We conducted chronic (28-42-d) toxicity tests with the amphipod Hyalella azteca exposed to Cr(VI) and Cr(III) in water and in spiked sediments. Waterborne Cr(VI) caused reduced survival of amphipods with a median lethal concentration (LC50) of 40 ??g/L. Cr(VI) spiked into test sediments with differing levels of AVS resulted in graded decreases in AVS and sediment OM. Only Cr(VI)-spiked sediments with low AVS concentrations (<1 ??mol/g) caused significant amphipod mortality. Waterborne Cr(III) concentrations near solubility limits caused decreased survival of amphipods at pH 7 and pH 8 but not at pH 6. Sediments spiked with high levels of Cr(III) did not affect amphipod survival but had minor effects on growth and inconsistent effects on reproduction. Pore waters of some Cr(III)-spiked sediments contained measurable concentrations of Cr(VI), but observed toxic effects did not correspond closely to Cr concentrations in sediment or pore waters. Our results indicate that risks of Cr toxicity are low in freshwater sediments containing substantial concentrations of AVS.

  16. Audiovisual integration supports face-name associative memory formation.

    PubMed

    Lee, Hweeling; Stirnberg, Rüdiger; Stöcker, Tony; Axmacher, Nikolai

    2017-10-01

    Prior multisensory experience influences how we perceive our environment, and hence how memories are encoded for subsequent retrieval. This study investigated if audiovisual (AV) integration and associative memory formation rely on overlapping or distinct processes. Our functional magnetic resonance imaging results demonstrate that the neural mechanisms underlying AV integration and associative memory overlap substantially. In particular, activity in anterior superior temporal sulcus (STS) is increased during AV integration and also determines the success of novel AV face-name association formation. Dynamic causal modeling results further demonstrate how the anterior STS interacts with the associative memory system to facilitate successful memory formation for AV face-name associations. Specifically, the connection of fusiform gyrus to anterior STS is enhanced while the reverse connection is reduced when participants subsequently remembered both face and name. Collectively, our results demonstrate how multisensory associative memories can be formed for subsequent retrieval.

  17. Early-onset Lyme carditis with concurrent disseminated erythema migrans.

    PubMed

    Patel, Kinjan P; Farjo, Peter D; Juskowich, Joy J; Hama Amin, Ali; Mills, James D

    2017-01-01

    Lyme disease is an infection that is estimated to affect over 300,000 people in the United States annually. Typically, it presents with erythema migrans (EM), an annular rash at the site of tick attachment, within 3 to 30 days of inoculation. Untreated patients may progress to early disseminated disease. A further complication, Lyme carditis is rare but may occur several weeks later. It commonly manifests as a variable atrioventricular (AV) conduction block, with a high-grade AV block occurring in only 1% of untreated patients. This case demonstrates an unusually early presentation of Lyme carditis with complete heart block. A 21-year-old male was transferred from an outside emergency department (ED) for possible pacemaker placement due to symptomatic third-degree AV block. Four days earlier the patient presented to the outside ED with fever, chills, and unrecognized EM on his right neck. He was discharged with antipyretics, but no antibiotic therapy. On the day of transfer, he returned with persistent fevers, EM now on his trunk and upper extremities, lightheadedness, and substernal chest pressure. An electrocardiogram revealed the third-degree AV block leading to transfer. Upon arrival, the patient was promptly diagnosed with Lyme carditis. Pacemaker implantation was deferred, and intravenous (IV) ceftriaxone was initiated. Within 48 hours his third-degree AV block improved to a first-degree block. By this time, his EM had also resolved. He was discharged with oral doxycycline and a 30-day event monitor, which ultimately showed persistent first-degree AV block. This case reinforces a unique presentation of Lyme carditis. Disseminated EM and Lyme carditis may present concurrently within 2 weeks of tick attachment. Early recognition and treatment is important for preventing progression to disseminated infection. Lyme-associated AV block will reverse within 48 to 72 hours of initiating IV antibiotic therapy and will not require pacemaker implantation. Lyme carditis should be considered in patients without heart disease who present with any degree of AV block.

  18. [Permanent cardiac pacing for chronic symptomatic atrioventricular block in uremic hemodialysed patients. A prospective study].

    PubMed

    Arsenescu, Cătălina; Georgescu, G I M; Covic, A; Briotă, Laura

    2002-01-01

    Though sudden cardiac death accounts for as much as 15% of all cause mortality in uremia, reports concerning advanced A-V block, requiring permanent cardiac pacing in end-stage renal disease (ESRD) hemodialysed (HD) patients are very few. This is the first long term prospective study reporting on systematic permanent pacemaker implantation, in a cohort of ESRD patients from a single HD unit. Between 01/06/1997 and 30/12/2001, 396 pacemakers were inserted for advanced, symptomatic A-V block in our institution, including 5 in ESRD, HD patients (M/F--4/1, age 47-73, M +/- SD--61 +/- 12 years) from a single dialysis center, treating 137 patients during the study period. Thus, the incidence and prevalence of A-V defects treated by permanent pacing in uremic patients was 0.81% and 3.65% respectively. Conversely, the incidence and prevalence of ESRD treated by hemodialysis, among patients with advanced A-V conduction disturbances, requiring permanent pacing were 0.28% and 1.26%. Mitral valve calcifications were present in all patients; 3 subjects also had extensive aortic valve calcifications. Left ventricular hypertrophy (echocardiographic Framingham criteria) was present in 4 patients, but the systolic function (ejection fraction and fractional shortening index) was normal in all cases, although a clinical picture of chronic heart failure was seen in 3 subjects preoperatively. A-V conduction defects were attributed to extensive metastatic calcifications, involving the cardiac squeleton, consecutive to severe hyperparathyroidism and inadvertent use of calcitriol and calcium carbonate as phosphate binders. No technical difficulties, short or long-term complications related to pacemaker implantation (4 VVI and 1 VVD devices) were encountered. Acute threshold and sensing values were similar with those of non-uremic patients. During follow-up, one patients died from a non cardiac death. If optimal hemodialysis is provided, benefits of permanent pacing are equal in uremic or non uremic patients and pacemaker implantation should be instituted as a prompt life-saving method in all dialysis patients with chronic symptomatic advanced A-V blocks.

  19. Conduction Abnormalities and Permanent Pacemaker Implantation After Transcatheter Aortic Valve Replacement Using the Repositionable LOTUS Device: The United Kingdom Experience.

    PubMed

    Rampat, Rajiv; Khawaja, M Zeeshan; Hilling-Smith, Roland; Byrne, Jonathan; MacCarthy, Philip; Blackman, Daniel J; Krishnamurthy, Arvindra; Gunarathne, Ashan; Kovac, Jan; Banning, Adrian; Kharbanda, Raj; Firoozi, Sami; Brecker, Stephen; Redwood, Simon; Bapat, Vinayak; Mullen, Michael; Aggarwal, Suneil; Manoharan, Ganesh; Spence, Mark S; Khogali, Saib; Dooley, Maureen; Cockburn, James; de Belder, Adam; Trivedi, Uday; Hildick-Smith, David

    2017-06-26

    The authors report the incidence of pacemaker implantation up to hospital discharge and the factors influencing pacing rate following implantation of the LOTUS bioprosthesis (Boston Scientific, Natick, Massachusetts) in the United Kingdom. Transcatheter aortic valve replacement (TAVR) is associated with a significant need for permanent pacemaker implantation. Pacing rates vary according to the device used. The REPRISE II (Repositionable Percutaneous Replacement of Stenotic Aortic Valve Through Implantation of Lotus Valve System) trial reported a pacing rate of 29% at 30 days after implantation of the LOTUS device. Data were collected retrospectively on 228 patients who had the LOTUS device implanted between March 2013 and February 2015 across 10 centers in the United Kingdom. Twenty-seven patients (12%) had pacemakers implanted pre-procedure and were excluded from the analysis. Patients were aged 81.2 ± 7.7 years; 50.7% were male. The mean pre-procedural QRS duration was 101.7 ± 20.4 ms. More than one-half of the cohort (n = 111, 55%) developed new left bundle branch block (LBBB) following the procedure. Permanent pacemakers were implanted in 64 patients (32%) with a median time to insertion of 3.0 ± 3.4 days. Chief indications for pacing were atrioventricular (AV) block (n = 46, 72%), or LBBB with 1st degree AV block (n = 11, 17%). Amongst those who received a pacemaker following TAVR the pre-procedural electrocardiogram findings included: No conduction disturbance (n = 41, 64%); 1st degree AV block (n = 10, 16%); right bundle branch block (n = 6, 9%) and LBBB (n = 5, 8%). LBBB (but not permanent pacemaker) occurred more frequently in patients who had balloon aortic valvuloplasty before TAVR (odds ratio [OR]: 1.25; p = 0.03). Pre-procedural conduction abnormality (composite of 1st degree AV block, hemiblock, right bundle branch block, LBBB) was independently associated with the need for permanent pacemaker (OR: 2.54; p = 0.048). The absence of aortic valve calcification was also associated with a higher pacing rate (OR: 0.55; p = 0.031). Multivariate regression analysis did not show an independent association between depth of implant, valve oversizing, balloon post-dilatation, and the need for pacing post-procedure. Following implantation of the repositionable LOTUS valve, 55% of patients developed LBBB and 32% of patients required a pacemaker during their index hospital admission. Patients with pre-procedural conduction disturbance and non-calcified aortic valves were more likely to need pacing. No other anatomic features were identified with increased pacing requirement with the LOTUS device. Crown Copyright © 2017. Published by Elsevier Inc. All rights reserved.

  20. Influence of commercial (Fluka) naphthenic acids on acid volatile sulfide (AVS) production and divalent metal precipitation.

    PubMed

    McQueen, Andrew D; Kinley, Ciera M; Rodgers, John H; Friesen, Vanessa; Bergsveinson, Jordyn; Haakensen, Monique C

    2016-12-01

    Energy-derived waters containing naphthenic acids (NAs) are complex mixtures often comprising a suite of potentially problematic constituents (e.g. organics, metals, and metalloids) that need treatment prior to beneficial use, including release to receiving aquatic systems. It has previously been suggested that NAs can have biostatic or biocidal properties that could inhibit microbially driven processes (e.g. dissimilatory sulfate reduction) used to transfer or transform metals in passive treatment systems (i.e. constructed wetlands). The overall objective of this study was to measure the effects of a commercially available (Fluka) NA on sulfate-reducing bacteria (SRB), production of sulfides (as acid-volatile sulfides [AVS]), and precipitation of divalent metals (i.e. Cu, Ni, Zn). These endpoints were assessed following 21-d aqueous exposures of NAs using bench-scale reactors. After 21-days, AVS molar concentrations were not statistically different (p<0.0001; α=0.05) among NA treatments (10, 20, 40, 60, and 80mg NA/L) and an untreated control (no NAs). Extent of AVS production was sufficient in all NA treatments to achieve ∑SEM:AVS <1, indicating that conditions were conducive for treatment of metals, with sulfide ligands in excess of SEM (Cu, Ni, and Zn). In addition, no adverse effects to SRB (in terms of density, relative abundance, and diversity) were measured following exposures of a commercial NA. In this bench-scale study, dissimilatory sulfate reduction and subsequent metal precipitation were not vulnerable to NAs, indicating passive treatment systems utilizing sulfide production (AVS) could be used to treat metals occurring in NAs affected waters. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Randomized, double-blind, placebo-controlled, safety and immunogenicity study of 4 formulations of Anthrax Vaccine Adsorbed plus CPG 7909 (AV7909) in healthy adult volunteers.

    PubMed

    Hopkins, Robert J; Daczkowski, Nancy F; Kaptur, Paulina E; Muse, Derek; Sheldon, Eric; LaForce, Craig; Sari, Suha; Rudge, Thomas L; Bernton, Edward

    2013-06-26

    A new anthrax vaccine that could accelerate the immune response and possibly reduce the number of injections needed for protection would be desirable in a post-exposure setting. This Phase 1 study compared the safety and immunogenicity of 2 IM doses (Days 0 and 14) of 4 formulations of AV7909 (AVA plus CPG 7909) with 2 IM doses of BioThrax(®) (Anthrax Vaccine Adsorbed) and 2 IM doses of saline placebo administered on Days 0 and 14. A total of 105 healthy adults 18-50 years of age were randomized to 1 of 6 study groups: BioThrax (0.5 mL), AV7909 Formulation 1 (0.5 mL AVA+0.5mg CPG 7909), AV7909 Formulation 2 (0.5 mL AVA+0.25mg CPG 7909), AV7909 Formulation 3 (0.25 mL AVA+0.5mg CPG 7909), AV7909 Formulation 4 (0.25 mL AVA+0.25mg CPG 7909), or saline placebo (0.5 mL). All randomized subjects received at least 1 vaccination, and 100 subjects completed the trial. After 2 doses, mean peak normalized toxin neutralizing antibody responses (TNA NF50) in the AV7909 groups were higher than in the BioThrax group. Differences among the 4 AV7909 groups were not statistically significant. Subjects who received AV7909 reached peak titers on Day 28 vs. Day 35 in the BioThrax group. The most common adverse events (AEs) in the BioThrax and AV7909 groups assessed as related to vaccination were injection site reactions. Transient lymphopenia was observed after the first dose in each AV7909 group. Frequencies of injection site and systemic reactions recorded by subjects in diaries for 7 days after each injection were highest with AV7909 Formulation 1. No AEs of special interest (autoimmune events) were observed in the study. Further studies of doses and dosing regimens are planned to assess the immunogenicity and reactogenicity of AV7909. Copyright © 2013 Elsevier Ltd. All rights reserved.

  2. Clinical Characteristics of Aerobic Vaginitis and Its Association to Vaginal Candidiasis, Trichomonas Vaginitis and Bacterial Vaginosis

    PubMed Central

    Jahic, Mahira; Mulavdic, Mirsada; Nurkic, Jasmina; Jahic, Elmir; Nurkic, Midhat

    2013-01-01

    ABSTRACT Aim of the work: Examine clinical characteristics of aerobic vaginitis and mixed infection for the purpose of better diagnostic accuracy and treatment efficiency. Materials and methods: Prospective research has been conducted at Clinic for Gynecology and Obstetrics, Department for Microbiology and Pathology at Polyclinic for laboratory diagnostic and Gynecology and Obstetrics Department at Health Center Sapna. Examination included 100 examinees with the signs of vaginitis. Examination consisted of: anamnesis, clinical, gynecological and microbiological examination of vaginal smear. Results: The average age of the examinees was 32,62±2,6. Examining vaginal smears of the examinees with signs of vaginitis in 96% (N-96) different microorganisms have been isolated, while in 4% (N-4) findings were normal. AV has been found in 51% (N-51) of the examinees, Candida albicans in 17% (N-17), BV in 15% (N-15), Trichomonas vaginalis in 13% (N-13). In 21% (N-21) AV was diagnosed alone while associated with other agents in 30% (N-30). Most common causes of AV are E. coli (N-55) and E. faecalis (N-52). AV and Candida albicanis have been found in (13/30, 43%), Trichomonas vaginalis in (9/30, 30%) and BV (8/30, 26%). Vaginal secretion is in 70,05% (N-36) yellow coloured, red vagina wall is recorded in 31,13% (N-16) and pruritus in 72,54% (N-37). Increased pH value of vagina found in 94,10% (N-48). The average pH value of vaginal environment was 5,15±0,54 and in associated presence of AV and VVC, TV and BV was 5,29±0,56 which is higher value considering presence of AV alone but that is not statistically significant difference (p>0,05). Amino-odor test was positive in 29,94% (N-15) of associated infections. Lactobacilli are absent, while leukocytes are increased in 100% (N-51) of the examinees with AV. Conclusion: AV is vaginal infection similar to other vaginal infections. It is important to be careful while diagnosing because the treatment of AV differentiates from treatment of other vaginitis. PMID:25568514

  3. Clinical characteristics of aerobic vaginitis and its association to vaginal candidiasis, trichomonas vaginitis and bacterial vaginosis.

    PubMed

    Jahic, Mahira; Mulavdic, Mirsada; Nurkic, Jasmina; Jahic, Elmir; Nurkic, Midhat

    2013-12-01

    Examine clinical characteristics of aerobic vaginitis and mixed infection for the purpose of better diagnostic accuracy and treatment efficiency. Prospective research has been conducted at Clinic for Gynecology and Obstetrics, Department for Microbiology and Pathology at Polyclinic for laboratory diagnostic and Gynecology and Obstetrics Department at Health Center Sapna. Examination included 100 examinees with the signs of vaginitis. anamnesis, clinical, gynecological and microbiological examination of vaginal smear. The average age of the examinees was 32,62±2,6. Examining vaginal smears of the examinees with signs of vaginitis in 96% (N-96) different microorganisms have been isolated, while in 4% (N-4) findings were normal. AV has been found in 51% (N-51) of the examinees, Candida albicans in 17% (N-17), BV in 15% (N-15), Trichomonas vaginalis in 13% (N-13). In 21% (N-21) AV was diagnosed alone while associated with other agents in 30% (N-30). Most common causes of AV are E. coli (N-55) and E. faecalis (N-52). AV and Candida albicanis have been found in (13/30, 43%), Trichomonas vaginalis in (9/30, 30%) and BV (8/30, 26%). Vaginal secretion is in 70,05% (N-36) yellow coloured, red vagina wall is recorded in 31,13% (N-16) and pruritus in 72,54% (N-37). Increased pH value of vagina found in 94,10% (N-48). The average pH value of vaginal environment was 5,15±0,54 and in associated presence of AV and VVC, TV and BV was 5,29±0,56 which is higher value considering presence of AV alone but that is not statistically significant difference (p>0,05). Amino-odor test was positive in 29,94% (N-15) of associated infections. Lactobacilli are absent, while leukocytes are increased in 100% (N-51) of the examinees with AV. AV is vaginal infection similar to other vaginal infections. It is important to be careful while diagnosing because the treatment of AV differentiates from treatment of other vaginitis.

  4. Role of the anterior region of the third ventricle in the cardiovascular responses produced by systemic injection of a nitric oxide synthase inhibitor

    NASA Technical Reports Server (NTRS)

    Lewis, S. J.; Whalen, E. J.; Beltz, T. G.; Johnson, A. K.

    1999-01-01

    This study examined whether a prior electrolytic lesion of the tissue surrounding the anteroventral third ventricle (AV3V) would affect the increase in mean arterial blood pressure (MAP) and the fall in heart rate (HR) produced by systemic injection of the nitric oxide synthesis (NOS) inhibitor, NG-nitro-L-arginine methyl ester (L-NAME; 25 micromol/kg, i.v.) in conscious rats. L-NAME produced a smaller increase in MAP in AV3V-lesion than in sham-lesion rats (+19+/-3 vs. +40+/-3 mmHg, respectively; P<0.05). In contrast, L-NAME produced similar falls in HR in the AV3V-lesion and sham-lesion rats (-103+/-15 vs. -97+/-8 bpm, respectively; P<0.05). These findings demonstrate that the L-NAME-induced pressor response is dependent upon the integrity of the AV3V region, whereas the L-NAME-induced bradycardia is not. Copyright 1999 Elsevier Science B. V.

  5. Investigation of the Dynamics of Magnetic Vortices and Antivortices Using Micromagnetic Simulations

    NASA Astrophysics Data System (ADS)

    Asmat-Uceda, Martin Antonio

    This thesis is focused on investigating the dynamic properties of spin textures in patterned magnetic structures by using micromagnetic simulations. These textures become particularly relevant at sub-micron length scales where the interplay between magnetostatic and exchange energy leads to unique properties that are of great interest both from a fundamental perspective and for the development of new technologies. Two different systems, a magnetic antivortex (AV) stabilized in the intersection of perpendicular microwires, and three interacting vortices in an equilateral arrangement, were considered for this study. For the first system, the AV, the formation process and the excitation spectra were investigated. Since the AV is a metastable state, the design of a host structure capable of stabilizing it requires careful consideration and it is desirable to have general guidelines that could help to optimize the AV formation rate. The role of the shape anisotropy and the field dependence of the AV formation process is discussed in detail. Micromagnetic simulations along with magneto-optical Kerr effect and magnetic force microscopy measurements demonstrated that the asymmetry in the structure can be used to promote the formation of such AV's and that regions with lower shape anisotropy lead the reversal process, while simulations of the dynamic response show that when the system is excited with in-plane and out-of-plane external magnetic fields, normal modes with azimuthal and radial characteristics are found, respectively, in addition to the low frequency gyrotropic mode. The modes are influenced by the spin texture in the intersection, which offers additional possibilities for manipulating spin waves (SW). For the second system, three interacting vortices are simulated and compared with a simple analytical model that considers only dipolar interactions. It was found that when a fitting parameter is introduced to the model, the main features of the simulations are captured better than more complex models, which suggest that this simple framework can be used to accurately model more complex vortex networks.

  6. Reduction of opioid withdrawal and potentiation of acute opioid analgesia by systemic AV411 (ibudilast)

    PubMed Central

    Hutchinson, Mark R.; Lewis, Susannah S.; Coats, Benjamen D.; Skyba, David A.; Crysdale, Nicole Y.; Berkelhammer, Debra L.; Brzeski, Anita; Northcutt, Alexis; Vietz, Christine M.; Judd, Charles M.; Maier, Steven F.; Watkins, Linda R.; Johnson, Kirk W.

    2009-01-01

    Morphine-induced glial proinflammatory responses have been documented to contribute to tolerance to opioid analgesia. Here, we examined whether drugs previously shown to suppress glial proinflammatory responses can alter other clinically relevant opioid effects; namely, withdrawal or acute analgesia. AV411 (ibudilast) and minocycline, drugs with distinct mechanisms of action that result in attenuation of glial proinflammatory responses, each reduced naloxone-precipitated withdrawal. Analysis of brain nuclei associated with opioid withdrawal revealed that morphine altered expression of glial activation markers, cytokines, chemokines, and a neurotrophic factor. AV411 attenuated many of these morphine-induced effects. AV411 also protected against spontaneous withdrawal-induced hyperactivity and weight loss recorded across a 12-day timecourse. Notably, in the spontaneous withdrawal study, AV411 treatment was delayed relative to the start of the morphine regimen so to also test whether AV411 could still be effective in the face of established morphine dependence, which it was. AV411 did not simply attenuate all opioid effects, as co-administering AV411 with morphine or oxycodone caused 3-to-5-fold increases in acute analgesic potency, as revealed by leftward shifts in the analgesic dose response curves. Timecourse analyses revealed that plasma morphine levels were not altered by AV411, suggestive that potentiated analgesia was not simply due to prolongation of morphine exposure or increased plasma concentrations. These data support and extend similar potentiation of acute opioid analgesia by minocycline, again providing converging lines of evidence of glial involvement. Hence, suppression of glial proinflammatory responses can significantly reduce opioid withdrawal, whilst improving analgesia. PMID:18938237

  7. Outcome of adrenal vein sampling performed during concurrent mineralocorticoid receptor antagonist therapy.

    PubMed

    Haase, Matthias; Riester, Anna; Kröpil, Patric; Hahner, Stefanie; Degenhart, Christoph; Willenberg, Holger S; Reincke, Martin

    2014-12-01

    Pharmacological inhibition of mineralocorticoid receptor (MR) signaling in patients with primary aldosteronism (PA) reestablishes aldosterone synthesis by nondiseased zona glomerulosa cells through activation of the renin-angiotensin-aldosterone system. In this context, current guidelines recommend discontinuing MR blockade for diagnostic procedures, including adrenal vein sampling (AVS). Discontinuation of MR blockade in high-risk patients may be harmful because of uncontrolled hypertension and severe hypokalemia. We hypothesize that MR antagonist therapy can be continued during AVS as long as renin levels remain suppressed. The objective of this study was to assess the validity of AVS results in the context of MR antagonistic therapy. We retrospectively analyzed all AVS studies in Munich (since 2008) and Düsseldorf (since 2011) and identified four of 237 (1.7%) patients with PA who underwent AVS while treated with an MR antagonist. Adrenalectomy was recommended based on the results of AVS in all four patients. After adrenalectomy, follow-up data were obtained to confirm improvement or remission of PA. Main outcome measures included blood pressure values, daily defined doses of antihypertensive medication, as well as levels of aldosterone, renin, and potassium, and the aldosterone/renin ratio. In all patients, renin remained low or suppressed during AVS despite MR antagonist treatment. AVS clearly demonstrated unilateral aldosterone excess in each case. After adrenalectomy, all patients showed remission of PA as demonstrated by blood pressure values, potassium levels, and the aldosterone/renin ratio. In selected cases of PA, MR antagonist therapy might be continued during AVS, provided that renin values remain low.

  8. Awareness and Use of the After-Visit Summary Through a Patient Portal: Evaluation of Patient Characteristics and an Application of the Theory of Planned Behavior.

    PubMed

    Emani, Srinivas; Healey, Michael; Ting, David Y; Lipsitz, Stuart R; Ramelson, Harley; Suric, Vladimir; Bates, David W

    2016-04-13

    Patient portals are being used to provide a clinical summary of the office visit or the after-visit summary (AVS) to patients. There has been relatively little research on the characteristics of patients who access the AVS through a patient portal and their beliefs about the AVS. The aim was to (1) assess the characteristics of patients who are aware of and access the AVS through a patient portal and (2) apply the Theory of Planned Behavior (TPB) to predict behavioral intention of patients toward accessing the AVS provided through a patient portal. We developed a survey capturing the components of TPB (beliefs, attitude, perceived norm, and perceived behavioral control). Over a 6-month period, patients with a patient portal account with an office visit in the previous week were identified using our organization's scheduling system. These patients were sent an email about the study and a link to the survey via their portal account. We applied univariate statistical analysis (Pearson chi-square and 1-way ANOVA) to assess differences among groups (aware/unaware of AVS and accessed/did not access AVS). We reported means and standard deviations to depict belief strengths and presented correlations between beliefs and attitude, perceived norm, and perceived behavioral control. We used hierarchical regression analysis to predict behavioral intention toward accessing the AVS through the patient portal. Of the 23,336 patients who were sent the survey, 5370 responded for a response rate of 23.01%. Overall, 76.52% (4109/5370) were aware that the AVS was available through the patient portal and 54.71% of those (2248/4109) accessed the AVS within 5 days of the office visit. Patients who accessed the AVS had a greater number of sessions with the portal (mean 119, SD 221.5) than those who did not access the AVS (mean 79.1, SD 123.3, P<.001); the difference was not significant for awareness of the AVS. The strongest behavioral beliefs with accessing the AVS were being able to track visits and tests (mean 2.53, SD 1.00) followed by having medical information more readily accessible (mean 2.48, SD 1.07). In all, 56.7% of the variance in intention to access the AVS through the portal was accounted for by attitude, perceived norm, and perceived behavioral control. Most users of a patient portal were aware that the AVS was accessible through the portal. Patients had stronger beliefs about accessing the AVS with the goal of timely and efficient access of information than with engaging in their health care. Interventions to improve patient access of the AVS can focus on providers promoting patient beliefs about the value of the AVS for tracking tests and visits, and timely and efficient access of information.

  9. Awareness and Use of the After-Visit Summary Through a Patient Portal: Evaluation of Patient Characteristics and an Application of the Theory of Planned Behavior

    PubMed Central

    Healey, Michael; Ting, David Y; Lipsitz, Stuart R; Ramelson, Harley; Suric, Vladimir; Bates, David W

    2016-01-01

    Background Patient portals are being used to provide a clinical summary of the office visit or the after-visit summary (AVS) to patients. There has been relatively little research on the characteristics of patients who access the AVS through a patient portal and their beliefs about the AVS. Objective The aim was to (1) assess the characteristics of patients who are aware of and access the AVS through a patient portal and (2) apply the Theory of Planned Behavior (TPB) to predict behavioral intention of patients toward accessing the AVS provided through a patient portal. Methods We developed a survey capturing the components of TPB (beliefs, attitude, perceived norm, and perceived behavioral control). Over a 6-month period, patients with a patient portal account with an office visit in the previous week were identified using our organization’s scheduling system. These patients were sent an email about the study and a link to the survey via their portal account. We applied univariate statistical analysis (Pearson chi-square and 1-way ANOVA) to assess differences among groups (aware/unaware of AVS and accessed/did not access AVS). We reported means and standard deviations to depict belief strengths and presented correlations between beliefs and attitude, perceived norm, and perceived behavioral control. We used hierarchical regression analysis to predict behavioral intention toward accessing the AVS through the patient portal. Results Of the 23,336 patients who were sent the survey, 5370 responded for a response rate of 23.01%. Overall, 76.52% (4109/5370) were aware that the AVS was available through the patient portal and 54.71% of those (2248/4109) accessed the AVS within 5 days of the office visit. Patients who accessed the AVS had a greater number of sessions with the portal (mean 119, SD 221.5) than those who did not access the AVS (mean 79.1, SD 123.3, P<.001); the difference was not significant for awareness of the AVS. The strongest behavioral beliefs with accessing the AVS were being able to track visits and tests (mean 2.53, SD 1.00) followed by having medical information more readily accessible (mean 2.48, SD 1.07). In all, 56.7% of the variance in intention to access the AVS through the portal was accounted for by attitude, perceived norm, and perceived behavioral control. Conclusions Most users of a patient portal were aware that the AVS was accessible through the portal. Patients had stronger beliefs about accessing the AVS with the goal of timely and efficient access of information than with engaging in their health care. Interventions to improve patient access of the AVS can focus on providers promoting patient beliefs about the value of the AVS for tracking tests and visits, and timely and efficient access of information. PMID:27076485

  10. Man as a Meter.

    ERIC Educational Resources Information Center

    Snoonian, Deborah

    2002-01-01

    Describes the main lecture hall at the University of Michigan's Taubman College of Architecture and Urban Planning, which contains state-of-the-art computing, sound, lighting, and projection systems. This working audiovisual (AV) laboratory allows its designer, professor Mojtaba Navvab, to teach the basics of environmental technology and AV design…

  11. Neurophysiology underlying influence of stimulus reliability on audiovisual integration.

    PubMed

    Shatzer, Hannah; Shen, Stanley; Kerlin, Jess R; Pitt, Mark A; Shahin, Antoine J

    2018-01-24

    We tested the predictions of the dynamic reweighting model (DRM) of audiovisual (AV) speech integration, which posits that spectrotemporally reliable (informative) AV speech stimuli induce a reweighting of processing from low-level to high-level auditory networks. This reweighting decreases sensitivity to acoustic onsets and in turn increases tolerance to AV onset asynchronies (AVOA). EEG was recorded while subjects watched videos of a speaker uttering trisyllabic nonwords that varied in spectrotemporal reliability and asynchrony of the visual and auditory inputs. Subjects judged the stimuli as in-sync or out-of-sync. Results showed that subjects exhibited greater AVOA tolerance for non-blurred than blurred visual speech and for less than more degraded acoustic speech. Increased AVOA tolerance was reflected in reduced amplitude of the P1-P2 auditory evoked potentials, a neurophysiological indication of reduced sensitivity to acoustic onsets and successful AV integration. There was also sustained visual alpha band (8-14 Hz) suppression (desynchronization) following acoustic speech onsets for non-blurred vs. blurred visual speech, consistent with continuous engagement of the visual system as the speech unfolds. The current findings suggest that increased spectrotemporal reliability of acoustic and visual speech promotes robust AV integration, partly by suppressing sensitivity to acoustic onsets, in support of the DRM's reweighting mechanism. Increased visual signal reliability also sustains the engagement of the visual system with the auditory system to maintain alignment of information across modalities. © 2018 Federation of European Neuroscience Societies and John Wiley & Sons Ltd.

  12. Crotalidae polyvalent immune Fab (ovine) antivenom is efficacious for envenomations by Southern Pacific rattlesnakes (Crotalus helleri).

    PubMed

    Bush, Sean P; Green, Steven M; Moynihan, James A; Hayes, William K; Cardwell, Michael D

    2002-12-01

    Southern Pacific rattlesnake (Crotalus helleri ) venom is not 1 of the 4 venoms used to produce Crotalidae polyvalent immune Fab (ovine) (CroFab; FabAV). There is currently no published clinical experience regarding the efficacy of this new antivenom for confirmed C helleri envenomation, and animal data suggest greatly diminished efficacy. We assessed the efficacy of FabAV for patients with confirmed C helleri envenomation. We conducted a prospective observational study of 23 consecutive rattlesnake envenomations that were treated with FabAV at our center. Patients were excluded if the species of snake could not be confirmed, if FabAV antivenom was not given, or if Antivenin (Crotalidae) polyvalent (equine) was given. We collected serial physical examination and laboratory data over a 24-hour period to serially evaluate the severity score and performed follow-up to evaluate delayed reactions. There were 15 patients who received FabAV and had the species of rattlesnake confirmed (9 C helleri, 4 C scutulatus scutulatus, 1 C mitchellii pyrrhus, 1 C ruber ruber ). C helleri envenomations demonstrated similar improvement in serial snakebite severity scores to those of other species. Three patients treated with scheduled dosing had recurrence of progressive swelling (2 C helleri and 1 C mitchellii pyrrhus ) during the 24-hour study period. We observed similar improvement in FabAV-treated patients with C helleri envenomation compared with those of other species and conclude that this treatment in standard doses appears efficacious for bites by this species. Progressive swelling may recur despite scheduled dosing.

  13. Prevalence of Clonorchis sinensis Metacercariae in Freshwater Fish from Three Latitudinal Regions of the Korean Peninsula

    PubMed Central

    Cho, Shin-Hyeong; Na, Byoung-Kuk; Kim, Tong-Soo; Kong, Yoon; Eom, Keeseon; Seok, Won-Seok; Lee, Taejoon

    2011-01-01

    A large-scale survey was conducted to investigate the infection status of fresh water fishes with Clonorchis sinensis metacercariae (CsMc) in 3 wide regions, which were tentatively divided by latitudinal levels of the Korean peninsula. A total of 4,071 freshwater fishes were collected from 3 regions, i.e., northern (Gangwon-do: 1,543 fish), middle (Chungcheongbuk-do and Gyeongsangbuk-do: 1,167 fish), and southern areas (Jeollanam-do, Ulsan-si, and Gyeongsangnam-do: 1,361 fish). Each fish was examined by the artificial digestion method from 2003 to 2010. In northern areas, only 11 (0.7%) fish of 2 species, Pungtungia herzi and Squalidus japonicus coreanus from Hantan-gang, Cheolwon-gun, Gangwon-do were infected with av. 2.6 CsMc. In middle areas, 149 (12.8%) fish were infected with av. 164 CsMc. In southern areas, 538 (39.5%) fish were infected with av. 159 CsMc. In the analysis of endemicity in 3 regions with an index fish, P. herzi, 9 (6.2%) of 146 P. herzi from northern areas were infected with av. 2.8 CsMc. In middle areas, 34 (31.8%) of 107 P. herzi were infected with av. 215 CsMc, and in southern areas, 158 (92.9%) of 170 P. herzi were infected with av. 409 CsMc. From these results, it has been confirmed that the infection status of fish with CsMc is obviously different among the 3 latitudinal regions of the Korean peninsula with higher prevalence and burden in southern regions. PMID:22355206

  14. 49 CFR 238.427 - Suspension system.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... no greater than 0.3g single event, peak-to-peak over a one second period; and (iii) Limit the... expressed by the square root of (aL 2 +aV 2) to no greater than 0.6g, where aL may not exceed 0.3g and aV...

  15. 49 CFR 238.427 - Suspension system.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... no greater than 0.3g single event, peak-to-peak over a one second period; and (iii) Limit the... expressed by the square root of (aL 2 +aV 2) to no greater than 0.6g, where aL may not exceed 0.3g and aV...

  16. Assessment of groundwater and soil quality degradation using multivariate and geostatistical analyses, Dakhla Oasis, Egypt

    NASA Astrophysics Data System (ADS)

    Masoud, Alaa A.; El-Horiny, Mohamed M.; Atwia, Mohamed G.; Gemail, Khaled S.; Koike, Katsuaki

    2018-06-01

    Salinization of groundwater and soil resources has long been a serious environmental hazard in arid regions. This study was conducted to investigate and document the factors controlling such salinization and their inter-relationships in the Dakhla Oasis (Egypt). To accomplish this, 60 groundwater samples and 31 soil samples were collected in February 2014. Factor analysis (FA) and hierarchical cluster analysis (HCA) were integrated with geostatistical analyses to characterize the chemical properties of groundwater and soil and their spatial patterns, identify the factors controlling the pattern variability, and clarify the salinization mechanism. Groundwater quality standards revealed emergence of salinization (av. 885.8 mg/L) and extreme occurrences of Fe2+ (av. 17.22 mg/L) and Mn2+ (av. 2.38 mg/L). Soils were highly salt-affected (av. 15.2 dS m-1) and slightly alkaline (av. pH = 7.7). Evaporation and ion-exchange processes governed the evolution of two main water types: Na-Cl (52%) and Ca-Mg-Cl (47%), respectively. Salinization leads the chemical variability of both resources. Distinctive patterns of slight salinization marked the northern part and intense salinization marked the middle and southern parts. Congruence in the resources clusters confirmed common geology, soil types, and urban and agricultural practices. Minimizing the environmental and socioeconomic impacts of the resources salinization urges the need for better understanding of the hydrochemical characteristics and prediction of quality changes.

  17. Effect of breed body size and the muscular hypertrophy gene in the production and carcass traits of concentrate-finished yearling bulls.

    PubMed

    Martínez, A; Aldai, N; Celaya, R; Osoro, K

    2010-04-01

    To examine the extent of the effect of muscular hypertrophy character in beef of northern-Spanish breeds, animal performance and carcass characteristics of 152 finishing steers from 5 genotypes were studied: 32 yearling bulls from a rustic Asturiana de la Montaña (AM) breed, 96 yearling bulls from Asturiana de los Valles (AV) breed, divided in 3 groups depending on the presence of the gene responsible for double-muscling (i.e., 32 AV mh/mh, 32 AV mh/+, 32 AV +/+), and 24 yearling bulls from AM x AV cross were used. Each genotype was composed of 8 animals per year (4 animals per pen) for 4 yr, except for the AM x AV genotype, which was only evaluated in the last 3 yr of the experiment. All animals were fed indoors with concentrate meal and barley straw ad libitum. Average daily gains in AV animals (1.41 kg/d) were greater (P < 0.01) than in AM (1.12 kg/d), whereas AM x AV were intermediate (1.29 kg/d) to these. No significant differences (P = 0.604) in ADG were found among the 3 AV genotypes. Longer fattening periods (P < 0.001) were taken for AM animals to reach acceptable BW at slaughter. Double-muscled animals (AV mh/mh) were found to have the best feed efficiencies when expressed as G:F (P < 0.001). However, residual feed intake calculated on a daily basis showed a greater efficiency in AV mh/mh and AM than in other genotypes. Carcasses from double-muscled animals had greater BW, yield, conformation and compactness index, and less fat cover than the other genotypes (P < 0.001). Carcasses from AM breed were the lightest and had the worst conformation, whereas those from AM x AV generally presented intermediate characteristics between AV and AM. Double-muscled animals had the greatest LM weight and area. The sixth-rib dissection revealed a greater percentage of muscle (84.6%) and decreased percentages of subcutaneous fat (1.1%), intermuscular fat (4.7%), bone (8.5%), and other tissues (1.2%) in AV mh/mh compared with other genotypes. Water-holding capacity was greatest in AM and least in AV mh/mh. In conclusion, double-muscled AV bulls would provide the greatest economic returns at intensive feeding systems because of their greater efficiency, reduced feeding costs, greater carcass weight and conformation, and greater lean yields, though some LM characteristics (reduced fat content and water-holding capacity) could negatively affect the sensory attributes of the meat compared with other genotypes with greater fatness.

  18. Programming Cardiac Resynchronization Therapy for Electrical Synchrony: Reaching Beyond Left Bundle Branch Block and Left Ventricular Activation Delay.

    PubMed

    Varma, Niraj; O'Donnell, David; Bassiouny, Mohammed; Ritter, Philippe; Pappone, Carlo; Mangual, Jan; Cantillon, Daniel; Badie, Nima; Thibault, Bernard; Wisnoskey, Brian

    2018-02-06

    QRS narrowing following cardiac resynchronization therapy with biventricular (BiV) or left ventricular (LV) pacing is likely affected by patient-specific conduction characteristics (PR, qLV, LV-paced propagation interval), making a universal programming strategy likely ineffective. We tested these factors using a novel, device-based algorithm (SyncAV) that automatically adjusts paced atrioventricular delay (default or programmable offset) according to intrinsic atrioventricular conduction. Seventy-five patients undergoing cardiac resynchronization therapy (age 66±11 years; 65% male; 32% with ischemic cardiomyopathy; LV ejection fraction 28±8%; QRS duration 162±16 ms) with intact atrioventricular conduction (PR interval 194±34, range 128-300 ms), left bundle branch block, and optimized LV lead position were studied at implant. QRS duration (QRSd) reduction was compared for the following pacing configurations: nominal simultaneous BiV (Mode I: paced/sensed atrioventricular delay=140/110 ms), BiV+SyncAV with 50 ms offset (Mode II), BiV+SyncAV with offset that minimized QRSd (Mode III), or LV-only pacing+SyncAV with 50 ms offset (Mode IV). The intrinsic QRSd (162±16 ms) was reduced to 142±17 ms (-11.8%) by Mode I, 136±14 ms (-15.6%) by Mode IV, and 132±13 ms (-17.8%) by Mode II. Mode III yielded the shortest overall QRSd (123±12 ms, -23.9% [ P <0.001 versus all modes]) and was the only configuration without QRSd prolongation in any patient. QRS narrowing occurred regardless of QRSd, PR, or LV-paced intervals, or underlying ischemic disease. Post-implant electrical optimization in already well-selected patients with left bundle branch block and optimized LV lead position is facilitated by patient-tailored BiV pacing adjusted to intrinsic atrioventricular timing using an automatic device-based algorithm. © 2018 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

  19. Agricultural vehicles and rural road safety: tackling a persistent problem.

    PubMed

    Jaarsma, Catharinus F; De Vries, Jasper R

    2014-01-01

    Crashes involving agricultural vehicles (AVs) on public roads are an increasing road safety problem. We aim to analyze developments in the appearance and severity of these accidents, identify influencing factors, and draw lessons for possible interventions for accident prevention within the context of modern mechanized agriculture. To analyze developments in the appearance of accidents we use a subset of accidents with AVs involved on public roads in The Netherlands aggregated per year for 1987-2010. To identify and explore preventive measures we use an in-depth study of the Dutch Safety Board. With a study of international literature we put our findings in a wider context. During this time span, Dutch annual averages show 15 registered fatal accidents involving AVs, 93 with hospitalization and 137 with slight injuries. For nonfatal accidents, the numbers are decreasing over time. This decrease is proportionate to the reduction in the total number of traffic victims. For fatalities, however, the number is stable, increasing its proportion in all traffic fatalities from 1 in 1987 to 2 percent in 2010. Related to the number of inhabitants, this number is 2 times the value in the UK and 3 times the value in the United States. Influencing factors can be related to the 3 road system components (AV, driver, and infrastructure). Weak points for AVs are the view from the driver's seat, visibility at night, permitted vehicle width, and crash aggressivity (large kinetic energy of the AV) that is transferred to other road users in case of a collision. Important factors identified for the driver are poor risk perception and high risk acceptance, in combination with speeding, dysfunctional use such as the use of AVs as modes of transport to and from school, and driving on public roads without protecting or removing protruding and sharp components. For infrastructure, the focus is on road design and separation of AVs from other motor vehicles. Lessons to be learned follow from these accident factors. For AV drivers, a driver's training focusing on driving behavior in the presence of vulnerable road users and concluding with an examination is advised. For vehicle safety, actual practice in The Netherlands is inadequate for control of proper maintenance. Some permanent requirements for the AV are insufficiently specific (view) or effective (lighting) and too generous (width). For infrastructure, a wide range of measures is available. A targeted approach to all road system components is urgently needed to avoid a further worsening of existing problems and to reduce the above proportional role of AVs in road danger. Supplemental materials are available for this article. Go to the publisher's online edition of Traffic Injury Prevention to view the supplemental file.

  20. Tracheal intubation prevented with administration of Fab antivenom after severe crotaline envenomation.

    PubMed

    Bebarta, Vikhyat S; Ferre, Robinson M; Peck, Michael

    2010-07-01

    Crotaline snake envenomations are common, but severe crotaline envenomations are infrequent. Death from severe envenomation is usually from upper airway edema and respiratory failure. Published reports of severe respiratory compromise and anaphylactoid reactions are rare. Currently, FabAV (Crotalidae polyvalent immune Fab [Ovine] [CroFab]) is the mainstay of crotaline envenomation treatment; however, FabAV has been approved for only mild and moderate envenomations. We describe a case of a male with severe systemic effects and airway compromise after crotaline envenomation. The patient's systemic effects and upper airway edema substantially improved after antivenom infusion and before epinephrine administration. Endotracheal intubation was averted, clinical deterioration was avoided, and improvement occurred after prompt FabAV use. Fab antivenom likely prevented endotracheal intubation in our case of severe crotaline envenomation. Published by Elsevier Inc.

  1. Golgi-Resident GTPase Rab30 Promotes the Biogenesis of Pathogen-Containing Autophagosomes

    PubMed Central

    Oda, Seiichiro; Nozawa, Takashi; Nozawa-Minowa, Atsuko; Tanaka, Misako; Aikawa, Chihiro; Harada, Hiroyuki; Nakagawa, Ichiro

    2016-01-01

    Autophagy acts as a host-defense system against pathogenic microorganisms such as Group A Streptococcus (GAS). Autophagy is a membrane-mediated degradation system that is regulated by intracellular membrane trafficking regulators, including small GTPase Rab proteins. Here, we identified Rab30 as a novel regulator of GAS-containing autophagosome-like vacuoles (GcAVs). We found that Rab30, a Golgi-resident Rab, was recruited to GcAVs in response to autophagy induction by GAS infection in epithelial cells. Rab30 recruitment was dependent upon its GTPase activity. In addition, the knockdown of Rab30 expression significantly reduced GcAV formation efficiency and impaired intracellular GAS degradation. Rab30 normally functions to maintain the structural integrity of the Golgi complex, but GcAV formation occurred even when the Golgi apparatus was disrupted. Although Rab30 also colocalized with a starvation-induced autophagosome, Rab30 was not required for autophagosome formation during starvation. These results suggest that Rab30 mediates autophagy against GAS independently of its normal cellular role in the structural maintenance of the Golgi apparatus, and autophagosome biogenesis during bacterial infection involves specific Rab GTPases. PMID:26771875

  2. Periventricular anteroventral third ventricle lesions diminish the pressor response produced by systemic injection of the N-methyl-D-aspartate receptor antagonist MK-801

    NASA Technical Reports Server (NTRS)

    Whalen, E. J.; Beltz, T. G.; Lewis, S. J.; Johnson, A. K.

    1999-01-01

    This study examined whether electrolytic ablation of the periventricular anteroventral third ventricle (AV3V) would affect the increases in mean arterial blood pressure (MAP) and heart rate (HR) in conscious rats produced by systemic injection of the centrally acting N-methyl-D-aspartate (NMDA) receptor ion-channel blocker, (+)-5-methyl-10,11-dihydro-5H-dibenzo[a,d]cyclohepten-5, 10-imine (MK-801; 250 microgram/kg, i.v.). MK-801 produced a smaller increase in MAP in rats with AV3V lesions than in sham-lesion rats (+36+/-2% vs. +52+/-5%, respectively, P<0.05). In contrast, MK-801 produced similar increases in HR in the AV3V- and sham-lesion rats (+28+/-3% vs. +22+/-4%, respectively, P>0.05). These findings demonstrate that the MK-801-induced pressor response is dependent upon the integrity of the AV3V region, whereas the MK-801-induced tachycardia is not. Copyright 1999 Elsevier Science B.V.

  3. Recovery of Ventriculo-Atrial Conduction after Adrenaline in Patients Implanted with Pacemakers.

    PubMed

    Cismaru, Gabriel; Gusetu, Gabriel; Muresan, Lucian; Rosu, Radu; Andronache, Marius; Matuz, Roxana; Puiu, Mihai; Mester, Petru; Miclaus, Maria; Pop, Dana; Mircea, Petru Adrian; Zdrenghea, Dumitru

    2015-07-01

    Ventriculo-atrial (VA) conduction can have negative consequences for patients with implanted pacemakers and defibrillators. There is concern whether impaired VA conduction could recover during stressful situations. Although the influence of isoproterenol and atropine are well established, the effect of adrenaline has not been studied systematically. The objective of this study was to determine if adrenaline can facilitate recovery of VA conduction in patients implanted with pacemakers. A prospective study was conducted on 61 consecutive patients during a 4-month period (April-July 2014). The presence of VA conduction was assessed during the pacemaker implantation procedure. In case of an impaired VA conduction, adrenaline infusio was used as a stress surrogate to test conduction recovery. The indications for pacemaker implantation were: sinus node dysfunction in 18 patients, atrioventricular (AV) block in 40 patients, binodal dysfunction (sinus node+ AV node) in two patients and other (carotid sinus syndrome) in one patient. In the basal state, 15/61 (24.6%) presented spontaneous VA conduction and 46/61 (75.4%) had no VA conduction. After administration of adrenaline, there was VA conduction recovery in 5/46 (10.9%) patients. Adrenaline infusion produced recovery of VA conduction in 10.9% of patients with absent VA conduction in a basal state. Recovery of VA conduction during physiological or pathological stresses could be responsible for the pacemaker syndrome, PMT episodes, or certain implantable cardiac defibrillator detection issues. © 2015 Wiley Periodicals, Inc.

  4. Management and outcome of topical beta-blockerinduced atrioventricular block

    PubMed Central

    Özcan, Kazım Serhan; Güngör, Barış; Tekkeşin, Ahmet İlker; Altay, Servet; Ekmekçi, Ahmet; Toprak, Ercan; Yıldırım, Ersin; Çalık, Nazmi; Alper, Ahmet Taha; Gürkan, Kadir; Erdinler, İzzet; Osmonov, Damirbek

    2015-01-01

    Summary Background Topical beta-blockers have a well-established role in the treatment of glaucoma. We aimed to investigate the outcome of patients who developed symptomatic atrioventricular (AV) block induced by topical beta-blockers. Methods All patients admitted or discharged from our institution, the Siyami Ersek Training and Research Hospital, between January 2009 and January 2013 with a diagnosis of AV block were included in the study. Subjects using ophthalmic beta-blockers were recruited and followed for permanent pacemaker requirement during hospitalisation and for three months after discontinuation of the drug. A permanent pacemaker was implanted in patients in whom AV block persisted beyond 72 hours or recurred during the follow-up period. Results A total of 1 122 patients were hospitalised with a diagnosis of AV block and a permanent pacemaker was implanted in 946 cases (84.3%) during the study period. Thirteen patients using ophthalmic beta-blockers for the treatment of glaucoma and no other rate-limiting drugs were included in the study. On electrocardiography, eight patients had complete AV block and five had high-degree AV block. The ophthalmic beta-blockers used were timolol in seven patients (55%), betaxolol in four (30%), and cartelol in two cases (15%). The mean duration of ophthalmic beta-blocker treatment was 30.1 ± 15.9 months. After drug discontinuation, in 10 patients the block persisted and a permanent pacemaker was implanted. During follow up, one more patient required pacemaker implantation. Therefore in total, pacemakers were implanted in 11 out of 13 patients (84.6%). The pacemaker implantation rate did not differ according to the type of topical beta-blocker used (p = 0.37). The presence of infra-nodal block on electrocardiography was associated with higher rates of pacemaker implantation. Conclusion Our results indicate that topical beta-blockers for the treatment of glaucoma may cause severe conduction abnormalities and when AV block occurs, pacemaker implantation is required in a high percentage of the patients. PMID:26659434

  5. Audiovisual biofeedback improves image quality and reduces scan time for respiratory-gated 3D MRI

    NASA Astrophysics Data System (ADS)

    Lee, D.; Greer, P. B.; Arm, J.; Keall, P.; Kim, T.

    2014-03-01

    The purpose of this study was to test the hypothesis that audiovisual (AV) biofeedback can improve image quality and reduce scan time for respiratory-gated 3D thoracic MRI. For five healthy human subjects respiratory motion guidance in MR scans was provided using an AV biofeedback system, utilizing real-time respiratory motion signals. To investigate the improvement of respiratory-gated 3D MR images between free breathing (FB) and AV biofeedback (AV), each subject underwent two imaging sessions. Respiratory-related motion artifacts and imaging time were qualitatively evaluated in addition to the reproducibility of external (abdominal) motion. In the results, 3D MR images in AV biofeedback showed more anatomic information such as a clear distinction of diaphragm, lung lobes and sharper organ boundaries. The scan time was reduced from 401±215 s in FB to 334±94 s in AV (p-value 0.36). The root mean square variation of the displacement and period of the abdominal motion was reduced from 0.4±0.22 cm and 2.8±2.5 s in FB to 0.1±0.15 cm and 0.9±1.3 s in AV (p-value of displacement <0.01 and p-value of period 0.12). This study demonstrated that audiovisual biofeedback improves image quality and reduces scan time for respiratory-gated 3D MRI. These results suggest that AV biofeedback has the potential to be a useful motion management tool in medical imaging and radiation therapy procedures.

  6. Analysis of Runway Incursion Data

    NASA Technical Reports Server (NTRS)

    Green, Lawrence L.

    2013-01-01

    A statistical analysis of runway incursion (RI) events was conducted to ascertain relevance to the top ten challenges of the National Aeronautics and Space Administration Aviation Safety Program (AvSP). The information contained in the RI database was found to contain data that may be relevant to several of the AvSP top ten challenges. When combined with other data from the FAA documenting air traffic volume from calendar year 2000 through 2011, the structure of a predictive model emerges that can be used to forecast the frequency of RI events at various airports for various classes of aircraft and under various environmental conditions.

  7. Modeling and Analyzing Intrusion Attempts to a Computer Network Operating in a Defense in Depth Posture

    DTIC Science & Technology

    2004-09-01

    protection. Firewalls, Intrusion Detection Systems (IDS’s), Anti-Virus (AV) software , and routers are such tools used. In recent years, computer security...associated with operating systems, application software , and computing hardware. When IDS’s are utilized on a host computer or network, there are two...primary approaches to detecting and / or preventing attacks. Traditional IDS’s, like most AV software , rely on known “signatures” to detect attacks

  8. Trazodone and Omeprazole Interaction causing Frequent Second-Degree Mobitz Type 1 Atrioventricular (AV) Block (Wenckebach Phenomenon) and Syncope: A Case Report and Literature Review

    PubMed Central

    Akinseye, Oluwaseun A.; Alfishawy, Mostafa; Radparvar, Farshid; Bakshi, Sanjiv

    2015-01-01

    Patient: Male, 54 Final Diagnosis: Trazodone and omeprazole interaction causing second-degree Mobitz type 1 AV block and syncope Symptoms: Syncope Medication: — Clinical Procedure: Trazodone and omeprazole withheld Specialty: Cardiology Objective: Unexpected drug reaction Background: This case report highlights serious cardiovascular adverse effects with a conventional dose of trazodone as a result of its potential interaction with omeprazole. Case Report: A 54-year-old man who was a former smoker, with dyslipidemia, coronary artery disease, and anxiety disorder developed lightheadedness and syncope the morning of admission. He was taking trazodone 50 mg daily, omeprazole 20 mg daily, and simvastatin 20 mg at bedtime. He doubled the dose of trazodone 50 mg on the night prior to presentation to calm his anxiety. An electrocardiogram revealed sinus rhythm at 60 beats per minute and second-degree Mobitz type 1 atrioventricular (AV) block with 5:4 AV conduction. Results of basic metabolic panel, thyroid-stimulating hormone, and chest radiograph were normal. A transthoracic echocardiogram revealed aortic valve sclerosis. We tested for Lyme disease given his history of hunting in the woods 8 months prior to presentation, but the titer was negative. Trazodone and omeprazole were discontinued. By the 3rd day of medication discontinuation, all symptoms had resolved and the frequency of second-degree AV Mobitz type 1 AV block had decreased to once per hour. Conclusions: Due diligence and meticulous attention to detail needs to be exercised to uncover drug interactions as potential causes of lethal and nonlethal patient symptomatology, as in this case of syncope caused by concomitant use of trazodone and a widely prescribed medication, omeprazole. PMID:26017199

  9. HINTS to diagnose stroke in the acute vestibular syndrome: three-step bedside oculomotor examination more sensitive than early MRI diffusion-weighted imaging.

    PubMed

    Kattah, Jorge C; Talkad, Arun V; Wang, David Z; Hsieh, Yu-Hsiang; Newman-Toker, David E

    2009-11-01

    Acute vestibular syndrome (AVS) is often due to vestibular neuritis but can result from vertebrobasilar strokes. Misdiagnosis of posterior fossa infarcts in emergency care settings is frequent. Bedside oculomotor findings may reliably identify stroke in AVS, but prospective studies have been lacking. The authors conducted a prospective, cross-sectional study at an academic hospital. Consecutive patients with AVS (vertigo, nystagmus, nausea/vomiting, head-motion intolerance, unsteady gait) with >or=1 stroke risk factor underwent structured examination, including horizontal head impulse test of vestibulo-ocular reflex function, observation of nystagmus in different gaze positions, and prism cross-cover test of ocular alignment. All underwent neuroimaging and admission (generally <72 hours after symptom onset). Strokes were diagnosed by MRI or CT. Peripheral lesions were diagnosed by normal MRI and clinical follow-up. One hundred one high-risk patients with AVS included 25 peripheral and 76 central lesions (69 ischemic strokes, 4 hemorrhages, 3 other). The presence of normal horizontal head impulse test, direction-changing nystagmus in eccentric gaze, or skew deviation (vertical ocular misalignment) was 100% sensitive and 96% specific for stroke. Skew was present in 17% and associated with brainstem lesions (4% peripheral, 4% pure cerebellar, 30% brainstem involvement; chi(2), P=0.003). Skew correctly predicted lateral pontine stroke in 2 of 3 cases in which an abnormal horizontal head impulse test erroneously suggested peripheral localization. Initial MRI diffusion-weighted imaging was falsely negative in 12% (all <48 hours after symptom onset). Skew predicts brainstem involvement in AVS and can identify stroke when an abnormal horizontal head impulse test falsely suggests a peripheral lesion. A 3-step bedside oculomotor examination (HINTS: Head-Impulse-Nystagmus-Test-of-Skew) appears more sensitive for stroke than early MRI in AVS.

  10. Photophysical insights on effect of gold nanoparticles over fullerene-porphyrin interaction in solution.

    PubMed

    Mitra, Ratul; Bauri, Ajoy K; Banerjee, Shrabanti; Bhattacharya, Sumanta

    2014-11-11

    The present article reports the role of gold nanoparticles, i.e., AuNp (having diameter ∼2-4nm), in non-covalent interaction between fullerenes (C60 and C70) and a monoporphyrin (1) in toluene. Both UV-vis and fluorescence measurements reveal considerable reduction in the average value of binding constant (Kav) for the C70-1 system (KC70-1(av)=19,300 dm3 mol(-1)) in presence of AuNp, i.e., KC70-1-AuNp(av)=13,515 dm3 mol(-1) although no such phenomenon is observed in case of C60-1 system, viz., KC60-1(av)=1445 dm3 mol(-1) and KC60-1-AuNp(av)=1210 dm3 mol(-1). DLS study reveals sizeable amount of increase in the particle size of C70-1-AuNp nanocomposite, i.e., ∼105 nm, compared to C60-1-AgNp system, e.g., ∼5.5 nm which gives very good support in favor of decrease in the value of Kav for the former system. SEM study reveals that nanoparticles are dispersed in larger extent in case of C70-1-AuNp system. Time-resolved fluorescence study envisages that deactivation of the excited singlet state of 1 by C70 takes place at a faster rate in comparison to C60 in presence of gold nanoparticles. Copyright © 2014 Elsevier B.V. All rights reserved.

  11. Being First Matters: Topographical Representational Similarity Analysis of ERP Signals Reveals Separate Networks for Audiovisual Temporal Binding Depending on the Leading Sense.

    PubMed

    Cecere, Roberto; Gross, Joachim; Willis, Ashleigh; Thut, Gregor

    2017-05-24

    In multisensory integration, processing in one sensory modality is enhanced by complementary information from other modalities. Intersensory timing is crucial in this process because only inputs reaching the brain within a restricted temporal window are perceptually bound. Previous research in the audiovisual field has investigated various features of the temporal binding window, revealing asymmetries in its size and plasticity depending on the leading input: auditory-visual (AV) or visual-auditory (VA). Here, we tested whether separate neuronal mechanisms underlie this AV-VA dichotomy in humans. We recorded high-density EEG while participants performed an audiovisual simultaneity judgment task including various AV-VA asynchronies and unisensory control conditions (visual-only, auditory-only) and tested whether AV and VA processing generate different patterns of brain activity. After isolating the multisensory components of AV-VA event-related potentials (ERPs) from the sum of their unisensory constituents, we ran a time-resolved topographical representational similarity analysis (tRSA) comparing the AV and VA ERP maps. Spatial cross-correlation matrices were built from real data to index the similarity between the AV and VA maps at each time point (500 ms window after stimulus) and then correlated with two alternative similarity model matrices: AV maps = VA maps versus AV maps ≠ VA maps The tRSA results favored the AV maps ≠ VA maps model across all time points, suggesting that audiovisual temporal binding (indexed by synchrony perception) engages different neural pathways depending on the leading sense. The existence of such dual route supports recent theoretical accounts proposing that multiple binding mechanisms are implemented in the brain to accommodate different information parsing strategies in auditory and visual sensory systems. SIGNIFICANCE STATEMENT Intersensory timing is a crucial aspect of multisensory integration, determining whether and how inputs in one modality enhance stimulus processing in another modality. Our research demonstrates that evaluating synchrony of auditory-leading (AV) versus visual-leading (VA) audiovisual stimulus pairs is characterized by two distinct patterns of brain activity. This suggests that audiovisual integration is not a unitary process and that different binding mechanisms are recruited in the brain based on the leading sense. These mechanisms may be relevant for supporting different classes of multisensory operations, for example, auditory enhancement of visual attention (AV) and visual enhancement of auditory speech (VA). Copyright © 2017 Cecere et al.

  12. Laboratory toxicity and benthic invertebrate field colonization of Upper Columbia River sediments: Finding adverse effects using multiple lines of evidence

    USGS Publications Warehouse

    Fairchild, J.F.; Kemble, N.E.; Allert, A.L.; Brumbaugh, W.G.; Ingersoll, C.G.; Dowling, B.; Gruenenfelder, C.; Roland, J.L.

    2012-01-01

    From 1930 to 1995, the Upper Columbia River (UCR) of northeast Washington State received approximately 12 million metric tons of smelter slag and associated effluents from a large smelter facility located in Trail, British Columbia, approximately 10 km north of the United States–Canadian border. Studies conducted during the past two decades have demonstrated the presence of toxic concentrations of heavy metals in slag-based sandy sediments, including cadmium, copper, zinc, and lead in the UCR area as well as the downstream reservoir portion of Lake Roosevelt. We conducted standardized whole-sediment toxicity tests with the amphipod Hyalella azteca (28-day) and the midge Chironomus dilutus (10-day) on 11 samples, including both UCR and study-specific reference sediments. Metal concentrations in sediments were modeled for potential toxicity using three approaches: (1) probable effects quotients (PEQs) based on total recoverable metals (TRMs) and simultaneously extracted metals (SEMs); (2) SEMs corrected for acid-volatile sulfides (AVS; i.e., ∑SEM − AVS); and (3) ∑SEM − AVS normalized to the fractional organic carbon (foc) (i.e., ∑SEM − AVS/foc). The most highly metal-contaminated sample (∑PEQTRM = 132; ∑PEQSEM = 54; ∑SEM − AVS = 323; and ∑SEM − AVS/foc = 64,600 umol/g) from the UCR was dominated by weathered slag sediment particles and resulted in 80% mortality and 94% decrease in biomass of amphipods; in addition, this sample significantly decreased growth of midge by 10%. The traditional ∑AVS – SEM, uncorrected for organic carbon, was the most accurate approach for estimating the effects of metals in the UCR. Treatment of the toxic slag sediment with 20% Resinex SIR-300 metal-chelating resin significantly decreased the toxicity of the sample. Samples ∑SEM − AVS > 244 was not toxic to amphipods or midge in laboratory testing, indicating that this value may be an approximate threshold for effects in the UCR. In situ benthic invertebrate colonization studies in an experimental pond (8-week duration) indicated that two of the most metal-contaminated UCR sediments (dominated by high levels of sand-sized slag particles) exhibited decreased invertebrate colonization compared with sand-based reference sediments. Field-exposed SIR-300 resin samples also exhibited decreased invertebrate colonization numbers compared with reference materials, which may indicate behavioral avoidance of this material under field conditions. Multiple lines of evidence (analytical chemistry, laboratory toxicity, and field colonization results), along with findings from previous studies, indicate that high metal concentrations associated with slag-enriched sediments in the UCR are likely to adversely impact the growth and survival of native benthic invertebrate communities. Additional laboratory toxicity testing, refinement of the applications of sediment benchmarks for metal toxicity, and in situ benthic invertebrate studies will assist in better defining the spatial extent, temporal variations, and ecological impacts of metal-contaminated sediments in the UCR system.

  13. A profile of fatal accidents involving alcohol

    DOT National Transportation Integrated Search

    1977-09-01

    Author's abstract: Accident investigation studies were conducted during 1971-75 in the cities of Boston, Baltimore, Oklahoma City and Albuquerque where Alcohol Safety Action Programs (ASAPs) were operating. Analysis of the four studies, plus newly av...

  14. Total Warrant Officer System (TWOS). Volume 1

    DTIC Science & Technology

    1985-08-30

    Compensation DiGirolamo, Nicholas A. CW4 OD ARNG Representative Dougherty, John R. CW4 AV Action Officer Hawk, Chuck CW4 AV Branch Chief Jinks, Dennis M. CW4...NCOIC Knight, Lewis D. SSG 81E Illustrator Cunningham, Linda L. SGT 71C Secretary/ Steno Grigsby, Steven A. SP4 64C Driver iv - ---- . "%o EXECUTIVE

  15. A microcosm approach to evaluate the degradation of tributyltin (TBT) by Aeromonas molluscorum Av27 in estuarine sediments.

    PubMed

    Cruz, Andreia; Henriques, Isabel; Sousa, Ana C A; Baptista, Inês; Almeida, Adelaide; Takahashi, Shin; Tanabe, Shinsuke; Correia, António; Suzuki, Satoru; Anselmo, Ana Maria; Mendo, Sónia

    2014-07-01

    Tributyltin (TBT) is a biocide extremely toxic to a wide range of organisms, which has been used for decades in antifouling paints. Despite its global ban in 2008, TBT is still a problem of great concern due to the high levels trapped in sediments. Aeromonas molluscorum Av27 is a TBT degrading bacterium that was isolated from an estuarine system. We investigated the ability and the role of this bacterium on TBT degradation in this estuarine system, using a microcosm approach in order to mimic environmental conditions. The experiment was established and followed for 150 days. Simultaneously, changes in the indigenous bacterial community structure were also investigated. The results revealed a maximum TBT degradation rate of 28% accompanied by the detection of the degradation products over time. Additionally, it was observed that TBT degradation was significantly enhanced by the presence of Av27. In addition a significantly higher TBT degradation occurred when the concentration of Av27 was higher. TBT degradation affected the bacterial community composition as revealed by the changes in the prevalence of Proteobacteria subdivisions, namely the increase of Deltaproteobacteria and the onset of Epsilonproteobacteria. However, the addition of Av27 strain did not affect the dominant phylotypes. Total bacterial number, bacterial biomass productivity, 16S rRNA gene and denaturing gradient gel electrophoresis (DGGE) analyses also indicated alterations on the bacterial community structure over time, with bacteria non-tolerant to pollutants increasing their representativeness, as, for instance, the increase of the number of Alphaproteobacteria clones from 6% in the beginning to 12% at the end of the experiment. The work herein presented confirms the potential of Av27 strain to be used in the decontamination of TBT-polluted environments. Copyright © 2014 Elsevier Inc. All rights reserved.

  16. A Simple Approach for Monitoring Business Service Time Variation

    PubMed Central

    2014-01-01

    Control charts are effective tools for signal detection in both manufacturing processes and service processes. Much of the data in service industries comes from processes having nonnormal or unknown distributions. The commonly used Shewhart variable control charts, which depend heavily on the normality assumption, are not appropriately used here. In this paper, we propose a new asymmetric EWMA variance chart (EWMA-AV chart) and an asymmetric EWMA mean chart (EWMA-AM chart) based on two simple statistics to monitor process variance and mean shifts simultaneously. Further, we explore the sampling properties of the new monitoring statistics and calculate the average run lengths when using both the EWMA-AV chart and the EWMA-AM chart. The performance of the EWMA-AV and EWMA-AM charts and that of some existing variance and mean charts are compared. A numerical example involving nonnormal service times from the service system of a bank branch in Taiwan is used to illustrate the applications of the EWMA-AV and EWMA-AM charts and to compare them with the existing variance (or standard deviation) and mean charts. The proposed EWMA-AV chart and EWMA-AM charts show superior detection performance compared to the existing variance and mean charts. The EWMA-AV chart and EWMA-AM chart are thus recommended. PMID:24895647

  17. A simple approach for monitoring business service time variation.

    PubMed

    Yang, Su-Fen; Arnold, Barry C

    2014-01-01

    Control charts are effective tools for signal detection in both manufacturing processes and service processes. Much of the data in service industries comes from processes having nonnormal or unknown distributions. The commonly used Shewhart variable control charts, which depend heavily on the normality assumption, are not appropriately used here. In this paper, we propose a new asymmetric EWMA variance chart (EWMA-AV chart) and an asymmetric EWMA mean chart (EWMA-AM chart) based on two simple statistics to monitor process variance and mean shifts simultaneously. Further, we explore the sampling properties of the new monitoring statistics and calculate the average run lengths when using both the EWMA-AV chart and the EWMA-AM chart. The performance of the EWMA-AV and EWMA-AM charts and that of some existing variance and mean charts are compared. A numerical example involving nonnormal service times from the service system of a bank branch in Taiwan is used to illustrate the applications of the EWMA-AV and EWMA-AM charts and to compare them with the existing variance (or standard deviation) and mean charts. The proposed EWMA-AV chart and EWMA-AM charts show superior detection performance compared to the existing variance and mean charts. The EWMA-AV chart and EWMA-AM chart are thus recommended.

  18. Identification of side- and shear-dependent microRNAs regulating porcine aortic valve pathogenesis

    NASA Astrophysics Data System (ADS)

    Rathan, Swetha; Ankeny, Casey J.; Arjunon, Sivakkumar; Ferdous, Zannatul; Kumar, Sandeep; Fernandez Esmerats, Joan; Heath, Jack M.; Nerem, Robert M.; Yoganathan, Ajit P.; Jo, Hanjoong

    2016-05-01

    Aortic valve (AV) calcification is an inflammation driven process that occurs preferentially in the fibrosa. To explore the underlying mechanisms, we investigated if key microRNAs (miRNA) in the AV are differentially expressed due to disturbed blood flow (oscillatory shear (OS)) experienced by the fibrosa compared to the ventricularis. To identify the miRNAs involved, endothelial-enriched RNA was isolated from either side of healthy porcine AVs for microarray analysis. Validation using qPCR confirmed significantly higher expression of 7 miRNAs (miR-100, -130a, -181a/b, -199a-3p, -199a-5p, and -214) in the fibrosa versus the ventricularis. Upon bioinformatics analysis, miR-214 was selected for further investigation using porcine AV leaflets in an ex vivo shear system. Fibrosa and ventricularis sides were exposed to either oscillatory or unidirectional pulsatile shear for 2 days and 3 & 7 days in regular and osteogenic media, respectively. Higher expression of miR-214, increased thickness of the fibrosa, and calcification was observed when the fibrosa was exposed to OS compared to the ventricularis. Silencing of miR-214 by anti-miR-214 in whole AV leaflets with the fibrosa exposed to OS significantly increased the protein expression of TGFβ1 and moderately increased collagen content but did not affect AV calcification. Thus, miR-214 is identified as a side- and shear-dependent miRNA that regulates key mechanosensitive gene in AV such as TGFβ1.

  19. Biomarkers of IgA vasculitis nephritis in children

    PubMed Central

    Pillebout, Evangeline; Jamin, Agnès; Ayari, Hamza; Housset, Pierre; Pierre, Melissa; Sauvaget, Virginia; Viglietti, Denis; Deschenes, Georges

    2017-01-01

    Henoch–Schönlein purpura is a systemic vasculitis characterized by IgA deposits, which target the skin, joints, and kidneys, among other organs. In children, prognosis is often good but little is known about biomarkers of pediatric nephritis. We hypothesized that biological markers, including cytokines, immunoglobulins, IgA-immune complexes, IgA glycosylation and neutrophil gelatinase-associated lipocalin (NGAL), may discriminate IgA vasculitis (IgAV) pediatric patients with renal involvement from those without renal involvement. Fifty children at the time of IgAV rash between 2010 and 2015 were prospectively enrolled and compared to 21 controls. All patients were assessed for clinical and biological parameters at the time of diagnosis, including the levels of cytokines, immunoglobulins, immune complexes, IgA glycosylation and NGAL in serum and urine. Among IgAV patients, 33 patients exhibited nephritis (IgAV-N) and 17 children were without nephritis (IgAV-woN). The serum level of galactose-deficient (Gd)-IgA1 (p<0.01) and the urinary concentrations of IgA, IgG, IgM, IL-6, IL-8, IL-10, IgA-IgG complexes and IgA-sCD89 complexes (p<0.001 for all) were higher in the IgAV-N patients than in the IgAV-woN patients. Among those markers, urinary IgA and IgM had the highest AUC (0.86 and 0.87 respectively, p<0.0001). This prospective cohort study furthers our understanding of the pathophysiology of IgAV. We identified biomarkers that are able to distinguish patients initially with or without nephritis. To conclude, serum Gd-IgA1 and urinary IgA, IgG, IgM, IL-6, IL-8, IL-10, and IgA-IgG and IgA-sCD89 complexes could identify IgAV pediatric patients with renal involvement at the time of diagnosis. PMID:29190714

  20. Application of variable structure system theory to aircraft flight control. [AV-8A and the Augmentor Wing Jet STOL Research Aircraft

    NASA Technical Reports Server (NTRS)

    Calise, A. J.; Kadushin, I.; Kramer, F.

    1981-01-01

    The current status of research on the application of variable structure system (VSS) theory to design aircraft flight control systems is summarized. Two aircraft types are currently being investigated: the Augmentor Wing Jet STOL Research Aircraft (AWJSRA), and AV-8A Harrier. The AWJSRA design considers automatic control of longitudinal dynamics during the landing phase. The main task for the AWJSRA is to design an automatic landing system that captures and tracks a localizer beam. The control task for the AV-8A is to track velocity commands in a hovering flight configuration. Much effort was devoted to developing computer programs that are needed to carry out VSS design in a multivariable frame work, and in becoming familiar with the dynamics and control problems associated with the aircraft types under investigation. Numerous VSS design schemes were explored, particularly for the AWJSRA. The approaches that appear best suited for these aircraft types are presented. Examples are given of the numerical results currently being generated.

  1. Artificial vision support system (AVS(2)) for improved prosthetic vision.

    PubMed

    Fink, Wolfgang; Tarbell, Mark A

    2014-11-01

    State-of-the-art and upcoming camera-driven, implanted artificial vision systems provide only tens to hundreds of electrodes, affording only limited visual perception for blind subjects. Therefore, real time image processing is crucial to enhance and optimize this limited perception. Since tens or hundreds of pixels/electrodes allow only for a very crude approximation of the typically megapixel optical resolution of the external camera image feed, the preservation and enhancement of contrast differences and transitions, such as edges, are especially important compared to picture details such as object texture. An Artificial Vision Support System (AVS(2)) is devised that displays the captured video stream in a pixelation conforming to the dimension of the epi-retinal implant electrode array. AVS(2), using efficient image processing modules, modifies the captured video stream in real time, enhancing 'present but hidden' objects to overcome inadequacies or extremes in the camera imagery. As a result, visual prosthesis carriers may now be able to discern such objects in their 'field-of-view', thus enabling mobility in environments that would otherwise be too hazardous to navigate. The image processing modules can be engaged repeatedly in a user-defined order, which is a unique capability. AVS(2) is directly applicable to any artificial vision system that is based on an imaging modality (video, infrared, sound, ultrasound, microwave, radar, etc.) as the first step in the stimulation/processing cascade, such as: retinal implants (i.e. epi-retinal, sub-retinal, suprachoroidal), optic nerve implants, cortical implants, electric tongue stimulators, or tactile stimulators.

  2. Successful catheter ablation of ventricular premature complexes from the right atrial side of the atrioventricular septum with good contact force.

    PubMed

    Arai, Marina; Fukamizu, Seiji; Kawamura, Iwanari; Miyazawa, Satoshi; Hojo, Rintaro; Sakurada, Harumizu; Hiraoka, Masayasu

    2018-04-01

    The acquisition of good contact force for radiofrequency catheter ablation of ventricular premature complexes (VPCs) originating from the basal septum of the left ventricle (LV) is often difficult. We describe a case of VPCs originating from the basal septum of the LV, which were successfully eliminated by applying radiofrequency at the right atrium (RA) side of the atrioventricular septum (AVS) without causing any significant impairment of atrioventricular conduction because the ablation catheter could obtain better contact force through the RA approach. Moreover, intracardiac echocardiography (ICE) and RA angiography effectively demonstrated the AVS.

  3. Tumor-specific detection of an optically targeted antibody combined with a quencher-conjugated neutravidin "quencher-chaser": a dual "quench and chase" strategy to improve target to nontarget ratios for molecular imaging of cancer.

    PubMed

    Ogawa, Mikako; Kosaka, Nobuyuki; Choyke, Peter L; Kobayashi, Hisataka

    2009-01-01

    In vivo molecular cancer imaging with monoclonal antibodies has great potential not only for cancer detection, but also for cancer characterization. However, the prolonged retention of intravenously injected antibody in the blood causes low target tumor-to-background ratio (TBR). Avidin has been used as a "chase" to clear the unbound, circulating biotinylated antibody and decrease the background signal. Here, we utilize a combined approach of a fluorescence resonance energy transfer (FRET) quenched antibody with an "avidin chase" to increase TBR. Trastuzumab, a humanized monoclonal antibody against human epidermal growth factor receptor type 2 (HER2), was biotinylated and conjugated with the near-infrared (NIR) fluorophore Alexa680 to synthesize Tra-Alexa680-biotin. Next, the FRET quencher, QSY-21, was conjugated to avidin, neutravidin (nAv), or streptavidin (sAv), thus creating Av-QSY21, nAv-QSY21, or sAv-QSY21 as "chasers". The fluorescence was quenched in vitro by binding Tra-Alexa680-biotin to Av-QSY21, nAv-QSY21, or sAv-QSY21. To evaluate if the injection of quencher-conjugated avidin derivatives can improve target TBR by using a dual "quench and chase" strategy, both target (3T3/HER2+) and nontarget (Balb3T3/ZsGreen) tumor-bearing mice were employed. The "FRET quench" effect induced by all the QSY21 avidin-based conjugates reduced but did not totally eliminate background signal from the blood pool. The addition of nAv-QSY21 administration increased target TBR mainly because of the "chase" effect where unbound conjugated antibody was preferentially cleared to the liver. The relatively slow clearance of unbound nAv-QSY21 leads to further reductions in background signal by leaking out of the vascular space and binding to unbound antibodies in the extravascular space of tumors, resulting in decreased nontarget tumor-to-background ratios but increased target TBR due to the "FRET quench" effect, because target-bound antibodies were internalized and could not bind to nAv-QSY21. In conclusion, the proposed "quench-and-chase" system combines two strategies, fluorescent quenching and avidin chasing, to improve target TBR and reduce nontarget TBR, which should result in both improved tumor sensitivity and improved specificity.

  4. Spatially divergent cardiac responses to nicotinic stimulation of ganglionated plexus neurons in the canine heart.

    PubMed

    Cardinal, René; Pagé, Pierre; Vermeulen, Michel; Ardell, Jeffrey L; Armour, J Andrew

    2009-01-28

    Ganglionated plexuses (GPs) are major constituents of the intrinsic cardiac nervous system, the final common integrator of regional cardiac control. We hypothesized that nicotinic stimulation of individual GPs exerts divergent regional influences, affecting atrial as well as ventricular functions. In 22 anesthetized canines, unipolar electrograms were recorded from 127 atrial and 127 ventricular epicardial loci during nicotine injection (100 mcg in 0.1 ml) into either the 1) right atrial (RA), 2) dorsal atrial, 3) left atrial, 4) inferior vena cava-inferior left atrial, 5) right ventricular, 6) ventral septal ventricular or 7) cranial medial ventricular (CMV) GP. In addition to sinus and AV nodal function, neural effects on atrial and ventricular repolarization were identified as changes in the area subtended by unipolar recordings under basal conditions and at maximum neurally-induced effects. Animals were studied with intact AV node or following ablation to achieve ventricular rate control. Atrial rate was affected in response to stimulation of all 7 GPs with an incidence of 50-95% of the animals among the different GPs. AV conduction was affected following stimulation of 6/7 GP with an incidence of 22-75% among GPs. Atrial and ventricular repolarization properties were affected by atrial as well as ventricular GP stimulation. Distinct regional patterns of repolarization changes were identified in response to stimulation of individual GPs. RAGP predominantly affected the RA and posterior right ventricular walls whereas CMVGP elicited biatrial and biventricular repolarization changes. Spatially divergent and overlapping cardiac regions are affected in response to nicotinic stimulation of neurons in individual GPs.

  5. DNA methylation of a PLPP3 MIR transposon-based enhancer promotes an osteogenic program in calcific aortic valve disease.

    PubMed

    Mkannez, Ghada; Gagné-Ouellet, Valérie; Nsaibia, Mohamed Jalloul; Boulanger, Marie-Chloé; Rosa, Mickael; Argaud, Deborah; Hadji, Fayez; Gaudreault, Nathalie; Rhéaume, Gabrielle; Bouchard, Luigi; Bossé, Yohan; Mathieu, Patrick

    2018-05-02

    Calcific aortic valve disease (CAVD) is characterized by the osteogenic transition of valve interstitial cells (VICs). In CAVD, lysophosphatidic acid (LysoPA), a lipid mediator with potent osteogenic activity, is produced in the aortic valve (AV) and is degraded by membrane-associated phospholipid phosphatases (PLPPs). We thus hypothesized that a dysregulation of PLPPs could participate to the osteogenic reprograming of VICs during CAVD. The expression of PLPPs was examined in human control and mineralized AVs and comprehensive analyses were performed to document the gene regulation and impact of PLPPs on the osteogenic transition of VICs. We found that PLPP3 gene and enzymatic activity were downregulated in mineralized AVs. Multidimensional gene profiling in 21 human AVs showed that expression of PLPP3 was inversely correlated with the level of 5-methylcytosine (5meC) located in an intronic mammalian interspersed repeat element (MIR). Bisulfite pyrosequencing in a larger series of 67 AVs confirmed that 5meC in intron 1 was increased by 2.2-fold in CAVD compared to control AVs. In isolated cells, epigenome editing with CRISPR-Cas9 system containing a deficient Cas9 fused with DNA methyltransferase (dCas9-DNMT) was used to increase 5meC in the intronic enhancer and showed that it reduced significantly the expression of PLPP3. Knockdown experiments showed that lower expression of PLPP3 in VICs promotes an osteogenic program. DNA methylation of a MIR-based enhancer downregulates the expression of PLPP3 and promotes the mineralization of the AV.

  6. sugE: A gene involved in tributyltin (TBT) resistance of Aeromonas molluscorum Av27.

    PubMed

    Cruz, Andreia; Micaelo, Nuno; Félix, Vitor; Song, Jun-Young; Kitamura, Shin-Ichi; Suzuki, Satoru; Mendo, Sónia

    2013-01-01

    The mechanism of bacterial resistance to tributyltin (TBT) is still unclear. The results herein presented contribute to clarify that mechanism in the TBT-resistant bacterium Aeromonas molluscorum Av27. We have identified and cloned a new gene that is involved in TBT resistance in this strain. The gene is highly homologous (84%) to the Aeromonas hydrophila-sugE gene belonging to the small multidrug resistance gene family (SMR), which includes genes involved in the transport of lipophilic drugs. In Av27, expression of the Av27-sugE was observed at the early logarithmic growth phase in the presence of a high TBT concentration (500 μM), thus suggesting the contribution of this gene for TBT resistance. E. coli cells transformed with Av27-sugE become resistant to ethidium bromide (EtBr), chloramphenicol (CP) and tetracycline (TE), besides TBT. According to the Moriguchi logP (miLogP) values, EtBr, CP and TE have similar properties and are substrates for the sugE-efflux system. Despite the different miLogP of TBT, E. coli cells transformed with Av27-sugE become resistant to this compound. So it seems that TBT is also a substrate for the SugE protein. The modelling studies performed also support this hypothesis. The data herein presented clearly indicate that sugE is involved in TBT resistance of this bacterium.

  7. First Aviation System Technology Advanced Research (AvSTAR) Workshop

    NASA Technical Reports Server (NTRS)

    Denery, Dallas G. (Editor); Weathers, Del W. (Editor); Rosen, Robert (Technical Monitor); Edwards, Tom (Technical Monitor)

    2001-01-01

    This Conference Proceedings documents the results of a two-day NASA/FAA/Industry workshop that was held at the NASA Ames Research Center, located at Moffett Field, CA, on September 21-22, 2000. The purpose of the workshop was to bring together a representative cross section of leaders in air traffic management, from industry. FAA, and academia, to assist in defining the requirements for a new research effort, referred to as AvSTAR Aviation Systems Technology Advanced Research). The Conference Proceedings includes the individual presentation, and summarizes the workshop discussions and recommendations.

  8. Effects of freshwater leaching on potential bioavailability of heavy metals in tidal flat soils.

    PubMed

    Li, Hui; Lu, Jun; Li, Qu-Sheng; He, Bao-Yan; Mei, Xiu-Qin; Yu, Dan-Ping; Xu, Zhi-Min; Guo, Shi-Hong; Chen, Hui-Jun

    2016-02-01

    Leaching experiments were conducted to investigate the effects of desalination levels and sediment depths on potential bioavailability of heavy metal (Cd, Cr, Cu, Fe, Mn, Ni, Pb, and Zn) in tidal flat soils. The data showed that both the desalination levels (p < 0.001) and soil depths (p < 0.001) had significant effects on the concentrations of acid-volatile sulfide (AVS). AVS concentrations generally exhibited increasing trends with an increase in depth and decreasing trends with enhanced desalination levels. The desalination levels had significant (p < 0.05) effects on the concentrations of simultaneously extracted metal (SEM; Cd, Cr, Cu, Fe, Mn, Pb, and Zn). Moreover, the concentrations of SEM (Cd, Cr, Cu, Fe, Mn, Pb, and Zn) generally tended to decrease with an increase in the desalination level. The desalination treatment significantly reduced the ratios of SEM/AVS compared with control. However, the ratios of SEM/AVS increased with enhanced desalination levels in treatments. Results reveal that low desalination treatment is better for reducing toxicity to benthic organisms than high desalination treatment. Since these reclaimed tidal flats with low desalinisation are suitable for saline water aquaculture, transforming the present land use of reclaimed tidal flats from fresh water aquaculture into saline water aquaculture may reduce health risk of heavy metals remained in sediments. These results will also contribute to our understanding of the dynamic behavior of heavy metals in the reclamation of tidal flats during leaching and the role of the ratio of SEM/AVS predictions on assessing the ecological risks of reclaimed tidal flats.

  9. Determination of the optimal atrioventricular interval in sick sinus syndrome during DDD pacing.

    PubMed

    Kato, Masaya; Dote, Keigo; Sasaki, Shota; Goto, Kenji; Takemoto, Hiroaki; Habara, Seiji; Hasegawa, Daiji; Matsuda, Osamu

    2005-09-01

    Although the AAI pacing mode has been shown to be electromechanically superior to the DDD pacing mode in sick sinus syndrome (SSS), there is evidence suggesting that during AAI pacing the presence of natural ventricular activation pattern is not enough for hemodynamic benefit to occur. Myocardial performance index (MPI) is a simply measurable Doppler-derived index of combined systolic and diastolic myocardial performance. The aim of this study was to investigate whether AAI pacing mode is electromechanically superior to the DDD mode in patients with SSS by using Doppler-derived MPI. Thirty-nine SSS patients with dual-chamber pacing devices were evaluated by using Doppler echocardiography in AAI mode and DDD mode. The optimal atrioventricular (AV) interval in DDD mode was determined and atrial stimulus-R interval was measured in AAI mode. The ratio of the atrial stimulus-R interval to the optimal AV interval was defined as relative AV interval (rAVI) and the ratio of MPI in AAI mode to that in DDD mode was defined as relative MPI (rMPI). The rMPI was significantly correlated with atrial stimulus-R interval and rAVI (r = 0.57, P = 0.0002, and r = 0.67, P < 0.0001, respectively). A cutoff point of 1.73 for rAVI provided optimum sensitivity and specificity for rMPI >1 based on the receiver operator curves. Even though the intrinsic AV conduction is moderately prolonged, some SSS patients with dual-chamber pacing devices benefit from the ventricular pacing with optimal AV interval. MPI is useful to determine the optimal pacing mode in acute experiment.

  10. Posterior reversible encephalopathy syndrome in IgA vasculitis: Neuroimaging of a 14-year-old child.

    PubMed

    Arslan, Harun; Yavuz, Alpaslan; Arslan, Ayşe; Aycan, Abdurrahman

    IgA vasculitis (IgAV) is a leukocytoclastic vasculitis and characterized by involvement of small vessels in skin, gastrointestinal system, joints, kidneys, and less frequently other organs. It is the commonest vasculitis in childhood and etiology is not completely known. Neurological manifestations of IgAV are very rare and usually seen in patients with severe hypertension or as an uncommon feature such as peripheral neuropathy. Posterior reversible encephalopathy syndrome (PRES) is a clinic-radiologic entity characterized with temporary vasogenic edema developing typically in posterior circulation of the brain and has been reported as a rare manifestation of IgAV. In this paper, a PRES case of 14-year-old male with IgAV is reported and etiopathogenesis was discussed with literature. Diagnosis was made by magnetic resonance imaging because of the existence of neurological symptoms (headache and visual loss) during the course of disease. His radiological findings have resolved with therapy. Although neurological involvement is a rare manifestation in IgAV, we recommend magnetic resonance imaging in such patients for diagnosis and evaluation of complications. Copyright © 2017. Published by Elsevier Urban & Partner Sp. z o.o.

  11. Regulation of Long-Chain N-Acyl-Homoserine Lactones in Agrobacterium vitis

    PubMed Central

    Hao, Guixia; Burr, Thomas J.

    2006-01-01

    Homologs of quorum-sensing luxR and luxI regulatory genes, avsR and avsI, were identified in Agrobacterium vitis strain F2/5. Compared to other LuxI proteins from related species, the deduced AvsI shows the greatest identity to SinI (71%) from Sinorhizobium meliloti Rm1021. AvsR possesses characteristic autoinducer binding and helix-turn-helix DNA binding domains and shares a high level of identity with SinR (38%) from Rm1021. Site-directed mutagenesis of avsR and avsI was performed, and both genes are essential for hypersensitive-like response (HR) and necrosis. Two hypothetical proteins (ORF1 and ORF2) that are positioned downstream of avsR-avsI are also essential for the phenotypes. Profiles of N-acyl-homoserine lactones (AHLs) isolated from the wild type and mutants revealed that disruption of avsI, ORF1, or ORF2 abolished the production of long-chain AHLs. Disruption of avsR reduces long-chain AHLs. Expression of a cloned avsI gene in A. tumefaciens strain NT1 resulted in synthesis of long-chain AHLs. The necrosis and HR phenotypes of the avsI and avsR mutants were fully complemented with cloned avsI. The addition of synthetic AHLs (C16:1 and 3-O-C16:1) complemented grape necrosis in the avsR, avsI, ORF1, and ORF2 mutants. It was determined by reverse transcriptase PCR that the expression level of avsI is regulated by avsR but not by aviR or avhR, two other luxR homologs which were previously shown to be associated with induction of a tobacco hypersensitive response and grape necrosis. We further verified that avsR regulates avsI by measuring the expression of an avsI::lacZ fusion construct. PMID:16513747

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

    Chen, Yuche; Young, Stanley; Gonder, Jeff

    This study estimates the range of fuel and emissions impact of an automated-vehicle (AV) based transit system that services campus-based developments, termed an automated mobility district (AMD). The study develops a framework to quantify the fuel consumption and greenhouse gas (GHG) emission impacts of a transit system comprised of AVs, taking into consideration average vehicle fleet composition, fuel consumption/GHG emission of vehicles within specific speed bins, and the average occupancy of passenger vehicles and transit vehicles. The framework is exercised using a previous mobility analysis of a personal rapid transit (PRT) system, a system which shares many attributes with envisionedmore » AV-based transit systems. Total fuel consumption and GHG emissions with and without an AMD are estimated, providing a range of potential system impacts on sustainability. The results of a previous case study based of a proposed implementation of PRT on the Kansas State University (KSU) campus in Manhattan, Kansas, serves as the basis to estimate personal miles traveled supplanted by an AMD at varying levels of service. The results show that an AMD has the potential to reduce total system fuel consumption and GHG emissions, but the amount is largely dependent on operating and ridership assumptions. The study points to the need to better understand ride-sharing scenarios and calls for future research on sustainability benefits of an AMD system at both vehicle and system levels.« less

  13. Geologic Mapping of the Av-11 Pinaria Quadrangle of Asteroid 4 Vesta

    NASA Astrophysics Data System (ADS)

    Schenk, P.; Hoogenboom, T.; Williams, D.; Yingst, R. A.; Jaumann, R.; Gaskell, R.; Preusker, F.; Nathues, A.; Roatsch, T.

    2012-04-01

    As part of the Dawn's orbital mapping investigation of Vesta, the Science Team is conducting geologic mapping of the surface in the form of 15 quadrangle maps, including quadrangle Av-11 (Pinaria). The base map is a monochrome Framing Camera (FC) mosaic at ~70 m/pixel, supplemented by Digital Terrain Models (DTM) and FC color ratio images, both at ~250 m/pixel, slope and contour maps, and Visible and Infrared (VIR) hyperspectral images. Av-11 straddles the 45-degree longitude in the South Polar Region, and is dominated by the rim of the ~505 km south polar topographic feature, Rheasilvia. Sparsely cratered (relatively), Av-11 is dominated by a 20 km high rim scarp (Matronalia Rupes) and by arcuate ridges and troughs forming a radial to spiral pattern across the basin floor. Primary geologic features of Av-11 include the following. Ridge-and-groove terrain radiating arcuately from the central mound unit, interpreted to be structural disruption of the basin floor associated with basin formation. The largest crater in Av-11 is Pinaria (37 km). Mass wasting deposits are observed on its floor. Secondary crater chains and fields are also evident. Mass wasting observed along Rheasilvia rim scarp and in the largest craters indicates scarp failure is a significant process. Parallel fault scarps mark this deposit of slumped debris at the base of 20 km high Matronalia Rupes, which may have formed during or shortly after basin excavation. We interpret most of these deposits as slump material emplaced as a result of the effects of basin formation and collapse. Lobate materials are characterized by lineations and lobate scarps and interpreted as Rheasilvia ejecta deposit outside Rheasilvia rim (the smoothest terrain on Vesta), and are consistent with formation by ejecta. Partial burial of older craters near the edge of these deposits are also observed.

  14. Approach for delineation of contributing areas and zones of transport to selected public-supply wells using a regional ground-water flow model, Palm Beach County, Florida

    USGS Publications Warehouse

    Renken, R.A.; Patterson, R.D.; Orzol, L.L.; Dixon, Joann

    2001-01-01

    Rapid urban development and population growth in Palm Beach County, Florida, have been accompanied with the need for additional freshwater withdrawals from the surficial aquifer system. To maintain water quality, County officials protect capture areas and determine zones of transport of municipal supply wells. A multistep process was used to help automate the delineation of wellhead protection areas. A modular ground-water flow model (MODFLOW) Telescopic Mesh Refinement program (MODTMR) was used to construct an embedded flow model and combined with particle tracking to delineate zones of transport to supply wells; model output was coupled with a geographic information system. An embedded flow MODFLOW model was constructed using input and output file data from a preexisting three-dimensional, calibrated model of the surficial aquifer system. Three graphical user interfaces for use with the geographic information software, ArcView, were developed to enhance the telescopic mesh refinement process. These interfaces include AvMODTMR for use with MODTMR; AvHDRD to build MODFLOW river and drain input files from dynamically segmented linear (canals) data sets; and AvWELL Refiner, an interface designed to examine and convert well coverage spatial data layers to a MODFLOW Well package input file. MODPATH (the U.S. Geological Survey particle-tracking postprocessing program) and MODTOOLS (the set of U.S. Geological Survey computer programs to translate MODFLOW and MODPATH output to a geographic information system) were used to map zones of transport. A steady-state, five-layer model of the Boca Raton area was created using the telescopic mesh refinement process and calibrated to average conditions during January 1989 to June 1990. A sensitivity analysis of various model parameters indicates that the model is most sensitive to changes in recharge rates, hydraulic conductivity for layer 1, and leakance for layers 3 and 4 (Biscayne aquifer). Recharge (58 percent); river (canal) leakance (29 percent); and inflow through the northern, western, and southern prescribed flux model boundaries (10 percent) represent the major inflow components. Principal outflow components in the Boca Raton well field area include well discharge (56 percent), river (canal) leakance (27 percent), and water that discharges along the coast (10 percent). A particle-tracking analysis using MODPATH was conducted to better understand well-field ground-water flow patterns and time of travel. MODTOOLS was used to construct zones-of-transport spatial data for municipal supply wells. Porosity estimates were uniformly increased to study the effect of porosity on zones of transport. Where porosity was increased, the size of the zones of transport were shown to decrease.

  15. Higher sympathetic nerve activity during ventricular (VVI) than during dual-chamber (DDD) pacing

    NASA Technical Reports Server (NTRS)

    Taylor, J. A.; Morillo, C. A.; Eckberg, D. L.; Ellenbogen, K. A.

    1996-01-01

    OBJECTIVES: We determined the short-term effects of single-chamber ventricular pacing and dual-chamber atrioventricular (AV) pacing on directly measured sympathetic nerve activity. BACKGROUND: Dual-chamber AV cardiac pacing results in greater cardiac output and lower systemic vascular resistance than does single-chamber ventricular pacing. However, it is unclear whether these hemodynamic advantages result in less sympathetic nervous system outflow. METHODS: In 13 patients with a dual-chamber pacemaker, we recorded the electrocardiogram, noninvasive arterial pressure (Finapres), respiration and muscle sympathetic nerve activity (microneurography) during 3 min of underlying basal heart rate and 3 min of ventricular and AV pacing at rates of 60 and 100 beats/min. RESULTS: Arterial pressure was lowest and muscle sympathetic nerve activity was highest at the underlying basal heart rate. Arterial pressure increased with cardiac pacing and was greater with AV than with ventricular pacing (change in mean blood pressure +/- SE: 10 +/- 3 vs. 2 +/- 2 mm Hg at 60 beats/min; 21 +/- 5 vs. 14 +/- 2 mm Hg at 100 beats/min; p < 0.05). Sympathetic nerve activity decreased with cardiac pacing and the decline was greater with AV than with ventricular pacing (60 beats/min -40 +/- 11% vs. -17 +/- 7%; 100 beats/min -60 +/- 9% vs. -48 +/- 10%; p < 0.05). Although most patients showed a strong inverse relation between arterial pressure and muscle sympathetic nerve activity, three patients with severe left ventricular dysfunction (ejection fraction < or = 30%) showed no relation between arterial pressure and sympathetic activity. CONCLUSIONS: Short-term AV pacing results in lower sympathetic nerve activity and higher arterial pressure than does ventricular pacing, indicating that cardiac pacing mode may influence sympathetic outflow simply through arterial baroreflex mechanisms. We speculate that the greater incidence of adverse outcomes in patients treated with single-chamber ventricular rather than dual-chamber pacing may be due in part to increased sympathetic nervous outflow.

  16. An improved radiosynthesis of [18F]AV-133: a PET imaging agent for vesicular monoamine transporter 2.

    PubMed

    Zhu, Lin; Liu, Yajing; Plössl, Karl; Lieberman, Brian; Liu, Jingying; Kung, Hank F

    2010-02-01

    Recently, a PET tracer, 9-[(18)F]fluoropropyl-(+)-dihydrotetrabenazine ([(18)F]AV-133), targeting vesicular monoamine transporter 2 (VMAT2) in the central nervous system has been reported. It is currently under Phase II clinical trials to establish its usefulness in the diagnosis of neurodegenerative diseases including dementia with Lewy bodies and Parkinson's disease. The radiolabeling of [(18)F]AV-133, nucleophilic fluorination reaction and potential effects of pseudo-carrier were evaluated by in vivo biodistribution. The preparation of [(18)F]AV-133 was evaluated under different conditions, specifically by employing different precursors (-OTs or -Br as the leaving group at the 9-propoxy position), reagents (K222/K(2)CO(3) vs. tributylammonium bicarbonate) and solvents (acetonitrile vs. DMSO), reaction temperature and reaction time. With optimized conditions from these experiments, radiosynthesis and purification with solid-phase extraction (SPE) of [(18)F]AV-133 were performed by an automated nucleophilic [(18)F]fluorination module. In vivo biodistribution in mice on [(18)F]AV-133 purified by either HPLC (no-carrier-added) or the SPE method (containing a pseudo-carrier) was performed and the results compared. Under a mild fluorination condition (heating at 115 degrees C for 5 min in dimethyl sulfoxide), [(18)F]AV-133 was obtained in a high yield using either -OTs or -Br as the leaving group. However, the -OTs precursor gave better radiochemical yields (>70%, thin layer chromatography analysis) compared to those of the -Br precursor. The optimized reaction conditions were successfully implemented to an automated nucleophilic fluorination module. Labeling and purification of [(18)F]AV133 were readily achieved via this automatic module in good radiochemical yield of 21-41% (n=10) in 40 min. The radiochemical purity was larger than 95%. Biodistribution of SPE-purified product (containing a pseudo-carrier) in mice showed a high striatum/cerebellum ratio (4.18+/-0.51), which was comparable to that of HPLC-purified [(18)F]AV-133 (4.51+/-0.10). The formation of [(18)F]AV-133 was evaluated under different labeling conditions. These improved labeling conditions and SPE purification were successfully implemented into an automated synthesis module. This offers a short preparation time (about 40 min), simplicity in operation and ready applicability for routine clinical operation. (c) 2010 Elsevier Inc. All rights reserved.

  17. Balloon launched decelerator test program: Post-flight test report, BLDT vehicle AV-2, Viking 1975 project

    NASA Technical Reports Server (NTRS)

    Dickinson, D.; Hicks, F.; Schlemmer, J.; Michel, F.; Moog, R. D.

    1972-01-01

    The pertinent events concerned with the launch, float, and flight of balloon launched decelerator test vehicle AV-2 are discussed. The performance of the decelerator system is analyzed. Data on the flight trajectory and decelerator test points at the time of decelerator deployment are provided. A description of the time history of vehicle events and anomalies encounters during the mission is included.

  18. Balloon launched decelerator test program: Post-flight test report, BLDT vehicle AV-3, Viking 1975 project

    NASA Technical Reports Server (NTRS)

    Dickinson, D.; Hicks, F.; Schlemmer, J.; Michel, F.; Moog, R. D.

    1973-01-01

    The pertinent events concerned with the launch, float, and flight of balloon launched decelerator test vehicle AV-3 are discussed. The performance of the decelerator system is analyzed. Data on the flight trajectory and decelerator test points at the time of decelerator deployment are provided. A description of the time history of vehicle events and anaomalies encounters during the mission is included.

  19. Distributed Trust Management and Rogue AV Software

    DTIC Science & Technology

    2010-06-10

    Integrate with QTM – Particularly important in federated systems (e.g., dynamically composable SOAs) • Investigate the use of reactive mechanisms – Global...of demonstrators surfaced on Capitol Hill in opposition to the Democrats’ health care legislation. MAGAZINE PREVIEW Making Health Care Better By...sale will be sent on saving green forests in Amazonia . Have more questions? You can contact us easy via Online Supoort. Green AV an award-winning

  20. Tumor Specific Detection of an Optically Targeted Antibody Combined with a Quencher-conjugated Neutravidin “Quencher-Chaser”: A Dual “Quench and Chase” Strategy to Improve Target to Non-target Ratios for Molecular Imaging of Cancer

    PubMed Central

    Ogawa, Mikako; Kosaka, Nobuyuki; Choyke, Peter L; Kobayashi, Hisataka

    2009-01-01

    In vivo molecular cancer imaging with monoclonal antibodies has great potential not only for cancer detection but also for cancer characterization. However, the prolonged retention of intravenously injected antibody in the blood causes low target tumor-to-background ratio (TBR). Avidin has been used as a “chase” to clear the unbound, circulating biotinylated antibody and decrease the background signal. Here, we utilize a combined approach of a Fluorescence Resonance Energy Transfer (FRET) quenched antibody with an “avidin chase” to increase TBR. Trastuzumab, a humanized monoclonal antibody against human epidermal growth factor receptor type 2 (HER2), was biotinylated and conjugated with the near-infrared (NIR) fluorophore Alexa680 to synthesize Tra-Alexa680-biotin. Next, the FRET quencher, QSY-21, was conjugated to avidin, neutravidin (nAv) or streptavidin (sAv), thus creating Av-QSY21, nAv-QSY21 or sAv-QSY21 as “chasers”. The fluorescence was quenched in vitro by binding Tra-Alexa680-biotin to Av-QSY21, nAv-QSY21 or sAv-QSY21. To evaluate if the injection of quencher-conjugated avidin-derivatives can improve target TBR by using a dual “quench and chase” strategy, both target (3T3/HER2+) and non-target (Balb3T3/ZsGreen) tumor bearing mice were employed. The “FRET quench” effect induced by all the QSY21 avidin-based conjugates reduced but did not totally eliminate background signal from the blood pool. The addition of nAv-QSY21 administration increased target TBR mainly due to the “chase” effect where unbound conjugated antibody was preferentially cleared to the liver. The relatively slow clearance of unbound nAv-QSY21 leads to further reductions in background signal by leaking out of the vascular space and binding to unbound antibodies in the extravascular space of tumors resulting in decreased non-target tumor-to-background ratios but increased target TBR due to the “FRET quench” effect because target-bound antibodies were internalized and could not bind to nAv-QSY21. In conclusion, the proposed “quench-and-chase” system combines two strategies, fluorescent quenching and avidin chasing to improve target TBR and reduce non target TBR which should result in both improved tumor sensitivity and specificity. PMID:19072537

  1. The Auditory-Visual Speech Benefit on Working Memory in Older Adults with Hearing Impairment

    PubMed Central

    Frtusova, Jana B.; Phillips, Natalie A.

    2016-01-01

    This study examined the effect of auditory-visual (AV) speech stimuli on working memory in older adults with poorer-hearing (PH) in comparison to age- and education-matched older adults with better hearing (BH). Participants completed a working memory n-back task (0- to 2-back) in which sequences of digits were presented in visual-only (i.e., speech-reading), auditory-only (A-only), and AV conditions. Auditory event-related potentials (ERP) were collected to assess the relationship between perceptual and working memory processing. The behavioral results showed that both groups were faster in the AV condition in comparison to the unisensory conditions. The ERP data showed perceptual facilitation in the AV condition, in the form of reduced amplitudes and latencies of the auditory N1 and/or P1 components, in the PH group. Furthermore, a working memory ERP component, the P3, peaked earlier for both groups in the AV condition compared to the A-only condition. In general, the PH group showed a more robust AV benefit; however, the BH group showed a dose-response relationship between perceptual facilitation and working memory improvement, especially for facilitation of processing speed. Two measures, reaction time and P3 amplitude, suggested that the presence of visual speech cues may have helped the PH group to counteract the demanding auditory processing, to the level that no group differences were evident during the AV modality despite lower performance during the A-only condition. Overall, this study provides support for the theory of an integrated perceptual-cognitive system. The practical significance of these findings is also discussed. PMID:27148106

  2. Adrenal vein sampling: substantial need for technical improvement at regional referral centres.

    PubMed

    Elliott, Panda; Holmes, Daniel T

    2013-10-01

    Adrenal vein sampling (AVS) is the gold standard for localization of aldosterone producing adenoma. The anatomy of the right adrenal vein makes this procedure technically demanding and it may yield no clinical information if the adrenal veins are not adequately cannulated. Having frequently observed the technical failure of AVS, we undertook a review of 220 procedures in British Columbia, Canada. Subjects were retrospectively identified through the laboratory information system. The following were collected: demographics, screening aldosterone concentration and renin activity/mass, results of dynamic function tests, AVS aldosterone and cortisol results. Standard calculations were performed on AVS data and site-specific success rates were compared. The effect of adrenocorticotropin hormone (ACTH) stimulation on the selectivity index (SI) and lateralization index (LI) were explored. The overall technical success-rate of AVS procedures was only 44% in procedures where no ACTH-stimulation was used (n=200) but this rose significantly (p<0.01) to 82% for those employing ACTH (n=139). ACTH-stimulation significantly increased the median SI (left: 5.8 vs 36.7, p<0.01; right: 7.0 vs 51.2, p<0.01), and salvaged 36 procedures from yielding no information, 21 of which demonstrated lateralization of aldosterone production. In 64 cases showing lateralization both pre and post-stimulation, ACTH significantly decreased the median LI from 5.4 to 2.2, p<0.01, creating substantial risk for spurious loss of lateralization. The technical success of AVS is lower than reported elsewhere. Provided that effects on the LI are considered, the use of ACTH-stimulation during AVS assists in the identification of unilateral forms of PA. Copyright © 2013 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  3. Effects of audiovisual distraction on children’s behaviour during dental treatment: a randomized controlled clinical trial

    PubMed Central

    Al-Khotani, Amal; Bello, Lanre A'aziz; Christidis, Nikolaos

    2016-01-01

    Abstract Aim: Dental anxiety leads to undesirable distresses such as avoidance of dental treatment and increase stress among caregivers that consequently affect the treatment quality. The aim of this study was therefore to evaluate the effectiveness of viewing videotaped cartoons using an eyeglass system (i-theatre™) as an audiovisual (AV) distraction technique on behaviour and anxiety in children receiving dental restorative treatment. Methods: Fifty-six consecutive children patients who presented for treatment and met inclusion criteria were included and randomly divided into two groups; a control group without distraction (CTR-group) and a distraction-group (AV-group). Three dental treatment visits were provided for each patient. Anxiety and cooperative behaviour were assessed with the Facial Image Scale (FIS) and the Modified Venham’s clinical ratings of anxiety and cooperative behaviour scale (MVARS). The vital signs, blood pressure and pulse were also taken. Results: The AV-group showed significantly lower MVARS scores than the CTR-group (p = 0.029), and the scores decreased significantly during treatment in the AV-group (p = 0.04). Further, the pulse rate was significantly increased in the CTR-group during injection with local anaesthesia (p = 0.02), but not in the AV-group. Conclusion: AV distraction seems to be an effective method in reducing fear and anxiety in children during dental treatment. Further, children who used eyeglass goggle display as a distraction tool during dental treatment reported not only less anxiety than control groups but also showed more positive responses after injection with local anaesthesia. Hence, AV-distraction seems to be a useful tool to decrease the distress and dental anxiety during dental treatment. PMID:27409593

  4. An automatic graph-based approach for artery/vein classification in retinal images.

    PubMed

    Dashtbozorg, Behdad; Mendonça, Ana Maria; Campilho, Aurélio

    2014-03-01

    The classification of retinal vessels into artery/vein (A/V) is an important phase for automating the detection of vascular changes, and for the calculation of characteristic signs associated with several systemic diseases such as diabetes, hypertension, and other cardiovascular conditions. This paper presents an automatic approach for A/V classification based on the analysis of a graph extracted from the retinal vasculature. The proposed method classifies the entire vascular tree deciding on the type of each intersection point (graph nodes) and assigning one of two labels to each vessel segment (graph links). Final classification of a vessel segment as A/V is performed through the combination of the graph-based labeling results with a set of intensity features. The results of this proposed method are compared with manual labeling for three public databases. Accuracy values of 88.3%, 87.4%, and 89.8% are obtained for the images of the INSPIRE-AVR, DRIVE, and VICAVR databases, respectively. These results demonstrate that our method outperforms recent approaches for A/V classification.

  5. Early Warning Systems of natural disasters in the frame of EUNADICS-AV

    NASA Astrophysics Data System (ADS)

    Brenot, Hugues; Theys, Nicolas; Clarisse, Lieven; Kopp, Anna; Graf, Kaspar; Mona, Lucia; Coltelli, Mauro; Peltonen, Tuomas; Hirtl, Marcus; Virtanen, Timo; Nína Petersen, Guðrún

    2017-04-01

    Aviation is one of the most critical infrastructures of the 21st century. In Europe, safe flight operations, air traffic management and air traffic control are shared responsibilities of EUROCONTROL, national authorities, airlines and pilots. All stakeholders have one common goal, namely to warrant and maintain the safety of flight crews and passengers. Currently, however, there is a significant gap in the availability of real-time hazard measurement and monitoring information for airborne hazards. The main objective of the new Horizon 2020 project EUNADICS-AV (European Natural Airborne Disaster Information and Coordination System for Aviation; http://www.eunadics.eu) is to close this gap in data and information availability, enabling all stakeholders in the aviation system to obtain fast, coherent, and consistent information. Here we report on WP5 of EUNADICS-AV, the objective of which is to develop a prototype multi-hazard monitoring and early warning system. This task includes the development of a service for improved near real-time analyses (delay of a few hours maximum) of observations from satellite and ground-based platforms in order to detect ash and SO2 plumes (at the global scale), as well as desert sand dusts, fire plumes, and radioactive plumes.

  6. SU-D-17A-04: The Impact of Audiovisual Biofeedback On Image Quality During 4D Functional and Anatomic Imaging: Results of a Prospective Clinical Trial

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

    Keall, P; Pollock, S; Yang, J

    2014-06-01

    Purpose: The ability of audiovisual (AV) biofeedback to improve breathing regularity has not previously been investigated for functional imaging studies. The purpose of this study was to investigate the impact of AV biofeedback on 4D-PET and 4D-CT image quality in a prospective clinical trial. We hypothesized that motion blurring in 4D-PET images and the number of artifacts in 4D-CT images are reduced using AV biofeedback. Methods: AV biofeedback is a real-time, interactive and personalized system designed to help a patient self-regulate his/her breathing using a patient-specific representative waveform and musical guides. In an IRB-approved prospective clinical trial, 4D-PET and 4D-CTmore » images of 10 lung cancer patients were acquired with AV biofeedback (AV) and free breathing (FB). The 4D-PET images in 6 respiratory bins were analyzed for motion blurring by: (1) decrease of GTVPET and (2) increase of SUVmax in 4-DPET compared to 3D-PET. The 4D-CT images were analyzed for artifacts by: (1) comparing normalized cross correlation-based scores (NCCS); and (2) quantifying a visual assessment score (VAS). A two-tailed paired t-test was used to test the hypotheses. Results: The impact of AV biofeedback on 4D-PET and 4D-CT images varied widely between patients, suggesting inconsistent patient comprehension and capability. Overall, the 4D-PET decrease of GTVPET was 2.0±3.0cm3 with AV and 2.3±3.9cm{sup 3} for FB (p=0.61). The 4D-PET increase of SUVmax was 1.6±1.0 with AV and 1.1±0.8 with FB (p=0.002). The 4D-CT NCCS were 0.65±0.27 with AV and 0.60±0.32 for FB (p=0.32). The 4D-CT VAS was 0.0±2.7 (p=ns). Conclusion: A 10-patient study demonstrated a statistically significant reduction of motion blurring of AV over FB for 1/2 functional 4D-PET imaging metrics. No difference between AV and FB was found for 2 anatomic 4D-CT imaging metrics. Future studies will focus on optimizing the human-computer interface and including patient training sessions for improved comprehension and capability. Supported by NIH/NCI R01 CA 093626, Stanford BioX Interdisciplinary Initiatives Program, NHMRC Australia Fellowship, and Kwanjeong Educational Foundation. GE Healthcare provided the Respiratory Gating Toolbox for 4D-PET image reconstruction. Stanford University owns US patent #E7955270 which is unlicensed to any commercial entity.« less

  7. Towards a personalized and dynamic CRT-D. A computational cardiovascular model dedicated to therapy optimization.

    PubMed

    Di Molfetta, A; Santini, L; Forleo, G B; Minni, V; Mafhouz, K; Della Rocca, D G; Fresiello, L; Romeo, F; Ferrari, G

    2012-01-01

    In spite of cardiac resynchronization therapy (CRT) benefits, 25-30% of patients are still non responders. One of the possible reasons could be the non optimal atrioventricular (AV) and interventricular (VV) intervals settings. Our aim was to exploit a numerical model of cardiovascular system for AV and VV intervals optimization in CRT. A numerical model of the cardiovascular system CRT-dedicated was previously developed. Echocardiographic parameters, Systemic aortic pressure and ECG were collected in 20 consecutive patients before and after CRT. Patient data were simulated by the model that was used to optimize and set into the device the intervals at the baseline and at the follow up. The optimal AV and VV intervals were chosen to optimize the simulated selected variable/s on the base of both echocardiographic and electrocardiographic parameters. Intervals were different for each patient and in most cases, they changed at follow up. The model can well reproduce clinical data as verified with Bland Altman analysis and T-test (p > 0.05). Left ventricular remodeling was 38.7% and left ventricular ejection fraction increasing was 11% against the 15% and 6% reported in literature, respectively. The developed numerical model could reproduce patients conditions at the baseline and at the follow up including the CRT effects. The model could be used to optimize AV and VV intervals at the baseline and at the follow up realizing a personalized and dynamic CRT. A patient tailored CRT could improve patients outcome in comparison to literature data.

  8. Future Air Transportation System Breakout Series Report

    NASA Technical Reports Server (NTRS)

    2001-01-01

    This presentation discusses: AvSTAR Future System Effort Critically important; Investment in the future; Need to follow a systems engineering process; and Efforts need to be worked in worldwide context

  9. Electronic structures and nonlinear optical properties of trinuclear transition metal clusters M-(mu-S)-M' (M = Mo, W; M' = Cu, Ag, Au).

    PubMed

    Chen, Xihua; Wu, Kechen; Snijders, Jaap G; Lin, Chensheng

    2003-01-27

    A series of trinuclear metal clusters MS4(M'PPh3)2(M'PPh3) (M = Mo, W; M' = Cu, Ag, Au) have been studied using the density functional theory (DFT) method. The static polarizabilities and hyperpolarizabilities of the model clusters have been calculated using the finite-field (F-F) method. The model clusters, divided into two groups, are alike in the structure of two fragments of rhombic units M-(mu-S)2-M' (M = Mo, W; M' = Cu, Ag, Au), perpendicular to each other, which are joined by sharing the bridge metal M. It is the charge transfer from one of these moieties to the other in these characteristic sulfido-transitional metal cores that is responsible for the polarizabilities and hyperpolarizabilities. This kind of electronic delocalization, different from that of the planar pi-system, is interesting and warrants further investigation. The structural effects on properties are important. In these models, considerable third-order nonlinearities are exhibited. The element substitution effect of Mo and W is weak, while that of Cu and Ag is relatively substantial. An overall order is gamma xxxx(Mo-Ag) > gamma xxxx(W-Ag) > gamma xxxx(Mo-Au) > gamma xxxx(W-Au) > gamma xxxx (Mo-Cu) > gamma xxxx(W-Cu) and gamma av(Mo-Ag) approximately gamma av(W-Ag) > gamma av(Mo-Au) approximately gamma av(W-Au) approximately gamma av (Mo-Cu) approximately gamma av(W-Cu).

  10. Avocado Consumption Increases Macular Pigment Density in Older Adults: A Randomized, Controlled Trial.

    PubMed

    Scott, Tammy M; Rasmussen, Helen M; Chen, Oliver; Johnson, Elizabeth J

    2017-08-23

    Lutein is selectively incorporated into the macula and brain. Lutein levels in the macula (macular pigment; MP) and the brain are related to better cognition. MP density (MPD) is a biomarker of brain lutein. Avocados are a bioavailable source of lutein. This study tests the effects of the intake of avocado on cognition. This was a six-month, randomized, controlled trial. Healthy subjects consumed one avocado ( n = 20, 0.5 mg/day lutein, AV) vs. one potato or one cup of chickpeas ( n = 20, 0 mg/day lutein, C). Serum lutein, MPD, and cognition were assessed at zero, three, and six months. Primary analyses were conducted according to intent-to-treat principles, with repeated-measures analysis. At six months, AV increased serum lutein levels by 25% from baseline ( p = 0.001). C increased by 15% ( p = 0.030). At six months, there was an increase in MPD from baseline in AV ( p = 0.001) and no increase in C. For both groups, there was an improvement in memory and spatial working memory ( p = 0.001; p = 0.032, respectively). For AV only there was improved sustained attention ( p = 0.033), and the MPD increase was related to improved working memory and efficiency in approaching a problem ( p = 0.036). Dietary recommendations including avocados may be an effective strategy for cognitive health.

  11. Hydraulic resistance of submerged flexible vegetation

    NASA Astrophysics Data System (ADS)

    Stephan, Ursula; Gutknecht, Dieter

    2002-12-01

    The main research objective consisted in analysing the influence of roughness caused by aquatic vegetation (av), in particular submerged macrophytes, on the overall flow field. These plants are highly flexible and behave differently depending on the flow situation. They also react substantially to the flow field and thus, the roughness becomes variable and dynamic. Conventional flow formulas, such as the Manning or the Strickler formula, are one-dimensional and based on integral flow parameters. They are not suitable for quantifying the roughness of av, because the flow is complex and more dimensional due to the variable behaviour of the plants. Therefore, the present investigation concentrates on the definition of a characteristic hydraulic roughness parameter to quantify the resistance of av. Within this investigation laboratory experiments were carried out with three different types of av, chosen with respect to varying plant structures as well as stem lengths. Velocity measurements above these plants were conducted to determine the relationship between the hydraulic roughness and the deflected plant height. The deflected plant height is used as the geometric roughness parameter, whereas the equivalent sand roughness based on the universal logarithmic law modified by Nikuradse was used as hydraulic roughness parameter. The influence of relative submergence on the hydraulic roughness was also analysed. The analysis of the velocity measurements illustrates that equivalent sand roughness and zero plane displacement of the logarithmic law are correlated to the deflected plant height and are equally to this height.

  12. Chronic manganism: A long-term follow-up study with a new dopamine terminal biomarker of 18F-FP-(+)-DTBZ (18F-AV-133) brain PET scan.

    PubMed

    Huang, Chu-Yun; Liu, Chi-Hung; Tsao, Eusden; Hsieh, Chia-Ju; Weng, Yi-Hsin; Hsiao, Ing-Tsung; Yen, Tzu-Chen; Lin, Kun-Ju; Huang, Chin-Chang

    2015-01-01

    Recent experimental studies revealed that dopamine neuron dysfunction in chronic manganism may be due to a reduced capacity of dopamine release in the striatum. The findings imposed further difficulty in the differential diagnosis between manganism and IPD. We conducted a long-term clinical follow-up study of 4 manganism patients, applying a new tracer (18)F-9-fluoropropyl-(+)-dihydrotetrabenazine ((18)F-AV-133) with positron emission tomography (PET). Twenty age-matched subjects including 4 manganism patients, 8 idiopathic Parkinson's disease (IPD) patients, and 8 healthy controls were enrolled for comparison. Volumes of interest of the bilateral putamen, caudate nuclei and occipital cortex as the reference region were delineated from individual magnetic resonance images. The clinical features of the manganism patients still progressed, with increased scores on the Unified Parkinson Disease Rating Scale. The (18)F-AV-133 uptake in the IPD patients decreased at the bilateral striatum, compared with the healthy controls. In the manganism patients, there was no decreased uptake of radioactivity involving the bilateral striatum, except Patient 4, who had a stroke with decreased uptake in the right posterior putamen. The (18)F-AV-133 PET finding reveals that nigrostriatum neurons are not degenerated in chronic manganism and can provide a useful neuroimage biomarker in the differential diagnosis. Copyright © 2015. Published by Elsevier B.V.

  13. An Overview-NASA LeRC Structures Program

    NASA Technical Reports Server (NTRS)

    Zaretsky, Erwin V.

    1997-01-01

    The Structures and Acoustics Division of the NASA Lewis Research Center has its genesis dating back to 1943. It has been an independent Division at Lewis since 1979. Its two primary capabilities are performance and life analysis of static and dynamic systems such as those found in aircraft and spacecraft propulsion systems and experimental verification of these analyses. Research is conducted in-house, through university grants and contracts, and through cooperative programs with industry. Our work directly supports NASA's Advanced Subsonic Technology (AST), Smart Green Engine, Fast Quiet Engine, High-Temperature Materials and Processing (HiTEMP), Hybrid Hyperspeed Propulsion, Rotorcraft, High-Speed Research (HSR), and Aviation Safety Program (AvSP). A general overview is given discussing these programs and other technologies that are being developed at NASA LeRC.

  14. The use of virtual reality and audiovisual eyeglass systems as adjunct analgesic techniques: a review of the literature.

    PubMed

    Wismeijer, Andreas A J; Vingerhoets, Ad J J M

    2005-12-01

    This review focuses on the application of technologically advanced methods of audiovisual distraction as adjunct analgesic techniques; more specifically, (a) virtual reality (VR) and (b) audiovisual (A/V) eyeglass systems (A/V distraction). It is assumed that distraction taxes the patient's limited attention capacity, resulting in the withdrawal of attention from the noxious stimulus with a subsequent reduction in pain. Twenty studies evaluating the analgesic potential of both methods in different patient groups and in healthy volunteers were identified in the scientific literature. Although the majority of these studies are hampered by serious methodological drawbacks, particularly a small number of participants, the results nevertheless strongly suggest that both VR and A/V distraction can be a very promising analgesic technique that may be used safely and effectively for the reduction of pain and discomfort during medical procedures. An additional important aspect is that few negative side effects have been reported. Directions for future research are presented.

  15. DDN Directory,

    DTIC Science & Technology

    1984-06-01

    Electronic Systems Division/TCG Washington, D.C. 20375 Hanscom Air Force Base ALMQUIST, Philip (202) 767-3249 (AV) 297-3249 Bedford, MA 01731 (Almquist...20375 CSC 4352 ANDREWS, Philip (202) 767-3623 (AV) 297-3623 College Park, MD 20742 (ANDREWSoNOSC-F4.ARPA) (301) 454-4526 Commander ANDERSON William J...619) 939-3661 New York, NrY 10027 (206) 543-9344 (212) 280-2736 BABEL, Philip S. BAER, Larry , (BABELPeWPAFB-JALCF.ARPA) BACON, James (baerRAND

  16. Brain uptake of a non-radioactive pseudo-carrier and its effect on the biodistribution of [(18)F]AV-133 in mouse brain.

    PubMed

    Wu, Xianying; Zhou, Xue; Zhang, Shuxian; Zhang, Yan; Deng, Aifang; Han, Jie; Zhu, Lin; Kung, Hank F; Qiao, Jinping

    2015-07-01

    9-[(18)F]Fluoropropyl-(+)-dihydrotetrabenazine ([(18)F]AV-133) is a new PET imaging agent targeting vesicular monoamine transporter type II (VMAT2). To shorten the preparation of [(18)F]AV-133 and to make it more widely available, a simple and rapid purification method using solid-phase extraction (SPE) instead of high-pressure liquid chromatography (HPLC) was developed. The SPE method produced doses containing the non-radioactive pseudo-carrier 9-hydroxypropyl-(+)-dihydrotetrabenazine (AV-149). The objectives of this study were to evaluate the brain uptake of AV-149 by UPLC-MS/MS and its effect on the biodistribution of [(18)F]AV-133 in the brains of mice. The mice were injected with a bolus including [(18)F]AV-133 and different doses of AV-149. Brain tissue and blood samples were harvested. The effect of different amounts of AV-149 on [(18)F]AV-133 was evaluated by quantifying the brain distribution of radiolabelled tracer [(18)F]AV-133. The concentrations of AV-149 in the brain and plasma were analyzed using a UPLC-MS/MS method. The concentrations of AV-149 in the brain and plasma exhibited a good linear relationship with the doses. The receptor occupancy curve was fit, and the calculated ED50 value was 8.165mg/kg. The brain biodistribution and regional selectivity of [(18)F]AV-133 had no obvious differences at AV-149 doses lower than 0.1mg/kg. With increasing doses of AV-149, the brain biodistribution of [(18)F]AV-133 changed significantly. The results are important to further support that the improved radiolabelling procedure of [(18)F]AV-133 using an SPE method may be suitable for routine clinical application. Copyright © 2015 Elsevier Inc. All rights reserved.

  17. High-dose nifuratel for simple and mixed aerobic vaginitis: A single-center prospective open-label cohort study.

    PubMed

    Liang, Qian; Li, Nan; Song, Shurong; Zhang, Aihua; Li, Ni; Duan, Ying

    2016-10-01

    The efficacy and safety of two nifuratel dosages for the treatment of aerobic vaginitis (AV) were compared. This was a prospective open-label cohort study of patients diagnosed and treated at the Tianjin Third Central Hospital between January 2012 and December 2013. The co-presence of bacterial vaginosis (BV), vulvovaginal candidiasis (VVC), or/and trichomonal vaginitis (TV; mixed AV) was determined. Patients were randomized to nifuratel-500 (500 mg nifuratel, intravaginal, 10 days) or nifuratel-250 (250 mg nifuratel, intravaginal, 10 days), and followed-up for three to seven days after treatment completion. Primary and secondary outcomes were recovery rate and adverse events, respectively. The study included 142 patients with AV. Age was not significantly different between the groups (n = 71 each), and disease distribution was identical: 29 (40.85%) simple AV and 42 (59.15%) mixed AV (AV + BV, 42.86 %; AV + VVC, 30.95%; AV + TV, 26.19%). In patients with simple AV, the recovery rate did not differ significantly between the nifuratel-500 (26/29, 89.66%) and nifuratel-250 (22/29, 75.86%) groups. In patients with mixed AV, recovery rates were significantly higher in the nifuratel-500 than in the nifuratel-250 group (AV + BV, 88.89% vs 50.00 %; AV + VVC, 76.92 % vs 30.77 %; AV + TV, 90.91 % vs 36.36%; all P < 0.05). Only one patient (nifuratel-500) reported an adverse event (mild anaphylactic reaction). Nifuratel 500 mg showed good clinical efficacy for the treatment of AV, particularly mixed AV, and is superior to the 250 mg dosage in the treatment of mixed AV. © 2016 Japan Society of Obstetrics and Gynecology.

  18. Estimate of Fuel Consumption and GHG Emission Impact from an Automated Mobility District

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

    Chen, Yuche; Young, Stanley; Qi, Xuewei

    2015-10-19

    This study estimates the range of fuel and emissions impact of an automated-vehicle (AV) based transit system that services campus-based developments, termed an automated mobility district (AMD). The study develops a framework to quantify the fuel consumption and greenhouse gas (GHG) emission impacts of a transit system comprised of AVs, taking into consideration average vehicle fleet composition, fuel consumption/GHG emission of vehicles within specific speed bins, and the average occupancy of passenger vehicles and transit vehicles. The framework is exercised using a previous mobility analysis of a personal rapid transit (PRT) system, a system which shares many attributes with envisionedmore » AV-based transit systems. Total fuel consumption and GHG emissions with and without an AMD are estimated, providing a range of potential system impacts on sustainability. The results of a previous case study based of a proposed implementation of PRT on the Kansas State University (KSU) campus in Manhattan, Kansas, serves as the basis to estimate personal miles traveled supplanted by an AMD at varying levels of service. The results show that an AMD has the potential to reduce total system fuel consumption and GHG emissions, but the amount is largely dependent on operating and ridership assumptions. The study points to the need to better understand ride-sharing scenarios and calls for future research on sustainability benefits of an AMD system at both vehicle and system levels.« less

  19. Inhibition of methyldigoxin-induced arrhythmias by pentadecapeptide BPC 157: a relation with NO-system.

    PubMed

    Balenovic, Dijana; Bencic, Martina Lovric; Udovicic, Mario; Simonji, Karol; Hanzevacki, Jadranka Separovic; Barisic, Ivan; Kranjcevic, Stjepan; Prkacin, Ingrid; Coric, Vedran; Brcic, Luka; Coric, Marijana; Brcic, Iva; Borovic, Suzana; Radic, Bozo; Drmic, Domagoj; Vrcic, Hrvoje; Seiwerth, Sven; Sikiric, Predrag

    2009-08-07

    Pentadecapeptide BPC 157 (GEPPPGKPADDAGLV, MW 1419) reversed congestive heart failure and various arrhythmias, influenced the NO-system and showed no proarrhythmic effect. In therapy analogy, we challenged rats with digitalis, to show attenuation by BPC 157 and the relation between the NO-system and digitalis toxicity. (i). BPC 157 prophylactic effect. Development of cumulative intravenous digitalis toxicity, BPC 157 (50 microg, 10 microg, 10 ng/kg applied intravenously immediately before a methyldigoxin increment regimen (2.0/1.5/1.5/1.0 mg/kg at 15 min-intervals, total dose 6.0 mg/kg/45 min)) reduced the number of ventricular premature beats, prolonged the time before onset of ventricular tachycardia, reduced ventricular tachycardia and AV-block duration (microg-regimes) or reduced mainly the AV-block duration (ng-regimen). (ii). BPC 157 therapy. Advanced methyldigoxin toxicity (6.0 mg/kg i.v. bolus). BPC 157 applied at the 20th second of the grade 3 AV-block shortened AV-blocks, mitigated a further digitalis toxicity course. Ventricular tachycardias were either avoided (50 microg), or markedly reduced (10 microg, 10 ng). Fatal outcome was either avoided (50 microg), reduced (10 microg), or only delayed (10 ng) (iii) BPC 157, L-NAME, l-arginine, L-NAME+l-arginine application. L-NAME-application (5 mg/kg i.p.) aggravated methyldigoxin-arrhythmias. l-arginine (200 mg/kg i.p.) alone had no effect but blunted L-NAME-exaggeration (L-NAME+l-arginine). In this respect, BPC 157 (50 microg/kg i.p.) was prophylactically and therapeutically more effective: the antagonism of L-NAME with BPC 157 produced an effect similar to BPC 157 alone. In conclusion, digitalis-induced arrhythmias in rats could be prevented and counteracted by pentadecapeptide BPC 157, mainly through an interaction with the NO-system.

  20. Risk assessment of heavy metals in Vembanad Lake sediments (south-west coast of India), based on acid-volatile sulfide (AVS)-simultaneously extracted metal (SEM) approach.

    PubMed

    Shyleshchandran, Mohanachandran Nair; Mohan, Mahesh; Ramasamy, Eswara Venkatesaperumal

    2018-03-01

    Contamination of estuarine system due to heavy metals is a severe issue in tropical countries, especially in India. For the evaluation of the risk due to heavy metals, the current study assessed spatial and temporal variation of acid-volatile sulfide (AVS), simultaneously extracted metal (SEM), and total metal concentration as toxicity indicator of aquatic sediments in Vembanad Lake System (VLS), India. Surface sediment samples collected from 12 locations from the northern portion of VLS for 4 years during different seasons. The results suggest, in post-monsoon season, 91% of the sampling locations possessed high bioavailability of metals and results in toxicity to aquatic biota. The average seasonal distribution of SEM during the period of observations was in the order post-monsoon > pre-monsoon > monsoon (1.76 ± 2.00 > 1.35 ± 0.60 > 0.80 ± 0.54 μmol/g). The concentration of individual metals on ∑SEM are in the order SEM Zn > SEM Cu> SEM Cd ≈ SEM Pb > SEM Hg. Considering annual ΣSEM/AVS ratio, 83% of the sites cross the critical value of 'One,' reveals that active sulfide phase of the sediment for fixing the metals is saturated. The molar ratio (differences between SEM and AVS) and its normalized organic carbon ratio reveals that in the post-monsoon season, about 42% of the sites are in the category of adverse effects are possible. The study suggests the toxicity and mobility of the metals largely depend on the available AVS, and the current situation may pose harm to benthic organisms.

  1. Reversing the established order: Should adrenal venous sampling precede cross-sectional imaging in the evaluation of primary aldosteronism?

    PubMed

    Asmar, Melissa; Wachtel, Heather; Yan, Yan; Fraker, Douglas L; Cohen, Debbie; Trerotola, Scott O

    2015-08-01

    Adrenal venous sampling (AVS) is the definitive evaluation for primary aldosteronism (PA). Pre-AVS cross-sectional imaging does not reduce the need for AVS. The goal of this study was to examine whether performing AVS prior to imaging could decrease the use of imaging in the evaluation of PA at a high volume, experienced center. We performed a retrospective analysis of all AVS procedures (n = 337) done for PA from 2001-2013. Patients whose cross-sectional imaging reports were unavailable (n = 90) or AVS was non-diagnostic (n = 12) were excluded. AVS was performed using modified Mayo technique. Univariate analysis utilized the χ² test and fisher's exact test. Of the 235 patients analyzed, 63% (n = 148) were male. The mean age was 55 ± 11 years. AVS was non-lateralizing in 43% (n = 101); these patients might have avoided imaging with an AVS-first approach. Imaging and AVS were concordant in 52% (n = 123). In patients ≤40yo (n = 23), 35% (n = 8) had no lateralization on AVS, and might have avoided imaging in an AVS-first approach. Imaging and AVS were concordant in 52% (n = 12) of patients ≤ 40yo, versus 52% (n = 111) of patients > 40 yo (P = 0.987). An AVS-first, imaging-second approach could have avoided CT/MRI in 43% of patients. At a high volume, experienced center, performing AVS first on patients with PA may reduce unnecessary cross-sectional imaging studies. © 2015 Wiley Periodicals, Inc.

  2. Elevated lipoprotein(a) and risk of aortic valve stenosis in the general population.

    PubMed

    Kamstrup, Pia R; Tybjærg-Hansen, Anne; Nordestgaard, Børge G

    2014-02-11

    The purpose of this study was to determine whether elevated lipoprotein(a) levels and corresponding LPA risk genotypes (rs10455872, rs3798220, kringle IV type 2 repeat polymorphism) prospectively associate with increased risk of aortic valve stenosis (AVS). The etiologic basis of AVS is unclear. Recent data implicate an LPA genetic variant (rs10455872), associated with Lp(a) levels, in calcific AVS. We combined data from 2 prospective general population studies, the Copenhagen City Heart Study (1991 to 2011; n = 10,803) and the Copenhagen General Population Study (2003 to 2011; n = 66,877), following up 77,680 Danish participants for as long as 20 years, during which time 454 were diagnosed with AVS. We conducted observational and genetic instrumental variable analyses in a Mendelian randomization study design. Elevated Lp(a) levels were associated with multivariable adjusted hazard ratios for AVS of 1.2 (95% confidence interval [CI]: 0.8 to 1.7) for 22nd to 66th percentile levels (5 to 19 mg/dl), 1.6 (95% CI: 1.1 to 2.4) for 67th to 89th percentile levels (20 to 64 mg/dl), 2.0 (95% CI: 1.2 to 3.4) for 90th to 95th percentile levels (65 to 90 mg/dl), and 2.9 (95% CI: 1.8 to 4.9) for levels greater than 95th percentile (>90 mg/dl), versus levels less than the 22nd percentile (<5 mg/dl; trend, p < 0.001). Lp(a) levels were elevated among carriers of rs10455872 and rs3798220 minor alleles, and of low number of KIV-2 repeats (trend, all p < 0.001). Combining all genotypes, instrumental variable analysis yielded a genetic relative risk for AVS of 1.6 (95% CI: 1.2 to 2.1) for a 10-fold Lp(a) increase, comparable to the observational hazard ratio of 1.4 (95% CI: 1.2 to 1.7) for a 10-fold increase in Lp(a) plasma levels. Elevated Lp(a) levels and corresponding genotypes were associated with increased risk of AVS in the general population, with levels >90 mg/dl predicting a threefold increased risk. Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  3. Patients' and procedural characteristics of AV-block during slow pathway modulation for AVNRT-single center 10year experience.

    PubMed

    Wasmer, Kristina; Dechering, Dirk G; Köbe, Julia; Leitz, Patrick; Frommeyer, Gerrit; Lange, Phillip S; Kochhäuser, Simon; Reinke, Florian; Pott, Christian; Mönnig, Gerold; Breithardt, Günter; Eckardt, Lars

    2017-10-01

    Permanent AV-block is a recognized and feared complication of slow pathway modulation for AVNRT. We aimed to assess incidence of transient and permanent AV-block as well as consequences of transient AV-block in a large contemporary AVNRT ablation cohort. We searched our single center prospective ablation database for occurrence of transient and permanent AV-block during slow pathway modulation between January 2004 and October 2015. We analyzed patients' and procedural characteristics as well as outcome of patients in whom transient or permanent AV-block occurred. Of 9170 patients who underwent a catheter ablation at our institution between January 2004 and October 2015, 2101 patients (64% women, mean age 50±18years) underwent slow pathway modulation. In three patients, permanent AV-block occurred during RF application. Additional two patients had transient AV-block that recovered (after a few minutes and 25min), but recurred within two days of the procedure. All five patients underwent dual chamber pacemaker implantation (0.2%). Transient AV-block related to RF delivery occurred in 44 patients (2%). Transient mechanical AV-block occurred in additional 17 patients (0.8%). In 12 patients, ablation was continued despite transient AV-block. One of these patients developed permanent AV-block. Permanent AV-block following slow pathway modulation is a rare event, occurring in 0.2% of patients in a large contemporary single center cohort. Transient AV-block is more frequent (2%). Copyright © 2017 Elsevier B.V. All rights reserved.

  4. After-visit summaries in primary care: mixed methods results from a literature review and stakeholder interviews.

    PubMed

    Lyles, Courtney R; Gupta, Reena; Tieu, Lina; Fernandez, Alicia

    2018-05-28

    After-visit summary (AVS) documents presenting key information from each medical encounter have become standard in the USA due to federal health care reform. Little is known about how they are used or whether they improve patient care. First, we completed a literature review and described the totality of the literature on AVS by article type and major outcome measures. Next, we used reputational sampling from large-scale US studies on primary care to identify and interview nine stakeholders on their perceptions of AVS across high-performing primary care practices. Interviews were transcribed and coded for AVS use in practice, perceptions of the best/worst features and recommendations for improving AVS utility in routine care. The literature review resulted in 17 studies; patients reported higher perceived value of AVS compared with providers, despite poor recall of specific AVS content and varied post-visit use. In key informant interviews, key informants expressed enthusiasm for the potential of using AVS to reinforce key information with patients, especially if AVS were customizable. Despite this potential, key informants found that AVS included incorrect information and did not feel that patients or their practices were using AVS to enhance care. There is a gap between the potential of AVS and how providers and patients are using it in routine care. Suggestions for improved use of AVS include increasing customization, establishing care team responsibilities and workflows and ensuring patients with communication barriers have dedicated support to review AVS during visits.

  5. Electrocardiographic characteristics of atrioventricular block induced by tilt testing.

    PubMed

    Zyśko, Dorota; Gajek, Jacek; Koźluk, Edward; Mazurek, Walentyna

    2009-02-01

    The electrocardiographic (ECG) characteristics of atrioventricular (AV) block during reflex syncope may be unique due to the presence of hypervagotonia. The aim of the present study was to define the ECG characteristics of the AV block induced by neurocardiogenic reflex provoked by tilt testing (TT). A series of 31 patients with presumed vasovagal syncope and AV block provoked by TT was studied. The duration of PP and PR interval, AV block grade and type, concomitant arrhythmias, and timing of the AV block occurrence were assessed. The AV block occurred at TT termination in 26 patients, in the recovery in 4 patients, and in both periods in 1 patient. Atrioventricular block was preceded by sinus slowing, and sinus rhythm during AV block was slow and instable. Mobitz I, 2:1 second-degree AV block, and advanced second-degree AV block were recognized in 35.5, 48.4, and 67.8% of patients, respectively. Third-degree AV block was diagnosed in 41.9% of patients. Twenty-one patients had at least two AV block forms. The most prevalent concomitant arrhythmia was junctional escape rhythm (61.3%). (i) The occurrence of the AV block during neurocardiogenic reaction induced by TT is always preceded by sinus rhythm slowing and usually by PR interval prolongation. (ii) The AV block provoked by TT usually occurs at TT termination, but may occur even in the recovery period in a supine position. Sometimes the AV block may be present both at TT termination and during the recovery period.

  6. Reversible second degree atrioventricular block after a severe sickle cell crisis.

    PubMed

    Jaeggi, E; Bolens, M; Friedli, B

    1998-01-01

    Despite the high prevalence of sickle cell disease and trait in the black population and its serious potential for microinfarction, there are only a few reports on acute myocardial damage during vasoocclusive crisis. We report a unique case of transient second degree atrioventricular (A-V) block of Mobitz I and II type during a severe sickle cell crisis. Localized high ventricular septum hypoperfusion demonstrated by a 99mTc-MIBI radionuclide study and reversible echocardiographic wall motion abnormalities in the same area were strong indicators for a local ischemic event in the A-V node and His bundle area, explaining the observed transient conduction abnormalities. The present report draws attention to a potentially lethal complication of sickle cell crisis.

  7. Probabilistic Causal Analysis for System Safety Risk Assessments in Commercial Air Transport

    NASA Technical Reports Server (NTRS)

    Luxhoj, James T.

    2003-01-01

    Aviation is one of the critical modes of our national transportation system. As such, it is essential that new technologies be continually developed to ensure that a safe mode of transportation becomes even safer in the future. The NASA Aviation Safety Program (AvSP) is managing the development of new technologies and interventions aimed at reducing the fatal aviation accident rate by a factor of 5 by year 2007 and by a factor of 10 by year 2022. A portfolio assessment is currently being conducted to determine the projected impact that the new technologies and/or interventions may have on reducing aviation safety system risk. This paper reports on advanced risk analytics that combine the use of a human error taxonomy, probabilistic Bayesian Belief Networks, and case-based scenarios to assess a relative risk intensity metric. A sample case is used for illustrative purposes.

  8. A variable structure approach to robust control of VTOL aircraft

    NASA Technical Reports Server (NTRS)

    Calise, A. J.; Kramer, F.

    1982-01-01

    This paper examines the application of variable structure control theory to the design of a flight control system for the AV-8A Harrier in a hover mode. The objective in variable structure design is to confine the motion to a subspace of the total state space. The motion in this subspace is insensitive to system parameter variations and external disturbances that lie in the range space of the control. A switching type of control law results from the design procedure. The control system was designed to track a vector velocity command defined in the body frame. For comparison purposes, a proportional controller was designed using optimal linear regulator theory. Both control designs were first evaluated for transient response performance using a linearized model, then a nonlinear simulation study of a hovering approach to landing was conducted. Wind turbulence was modeled using a 1052 destroyer class air wake model.

  9. Capstone: A Geometry-Centric Platform to Enable Physics-Based Simulation and Design of Systems

    DTIC Science & Technology

    2015-10-05

    foundation for the air-vehicle early design tool DaVinci being developed by CREATETM-AV project to enable development of associative models of air...CREATETM-AV solvers Kestrel [11] and Helios [16,17]. Furthermore, it is the foundation for the CREATETM-AV’s DaVinci [9] tool that provides a... Tools and Environments (CREATETM) program [6] aimed at developing a suite of high- performance physics-based computational tools addressing the needs

  10. Is there a role for segmental adrenal venous sampling and adrenal sparing surgery in patients with primary aldosteronism?

    PubMed

    Satoh, Fumitoshi; Morimoto, Ryo; Seiji, Kazumasa; Satani, Nozomi; Ota, Hideki; Iwakura, Yoshitsugu; Ono, Yoshikiyo; Kudo, Masataka; Nezu, Masahiro; Omata, Kei; Tezuka, Yuta; Kawasaki, Yoshihide; Ishidoya, Shigeto; Arai, Yoichi; Takase, Kei; Nakamura, Yasuhiro; McNamara, Keely; Sasano, Hironobu; Ito, Sadayoshi

    2015-10-01

    Adrenal venous sampling (AVS) is critical to determine the subtype of primary aldosteronism (PA). Central AVS (C-AVS)--that is, the collection of effluents from bilateral adrenal central veins (CV)--sometimes does not allow differentiation between bilateral aldosterone-producing adenomas (APA) and idiopathic hyperaldosteronism. To establish the best treatment course, we have developed segmental AVS (S-AVS); that is, we collect effluents from the tributaries of CV to determine the intra-adrenal sources of aldosterone overproduction. We then evaluated the clinical utility of this novel approach in the diagnosis and treatment of PA. We performed C-AVS and/or S-AVS in 297 PA patients and assessed the accuracy of diagnosis based on the results of C-AVS (n=138, 46.5%) and S-AVS (n=159, 53.5%) by comparison with those of clinicopathological evaluation of resected specimens. S-AVS demonstrated both elevated and attenuated secretion of aldosterone from APA and non-tumorous segments, respectively, in patients with bilateral APA and recurrent APA. These findings were completely confirmed by detailed histopathological examination after surgery. S-AVS, but not C-AVS, also served to identify APA located distal from the CV. Compared to C-AVS, S-AVS served to identify APA in some patients, and its use should expand the pool of patients eligible for adrenal sparing surgery through the identification of unaffected segments, despite the fact that S-AVS requires more expertise and time. Especially, this new technique could enormously benefit patients with bilateral or recurrent APA because of the preservation of non-tumorous glandular tissue. © 2015 European Society of Endocrinology.

  11. 76 FR 63824 - Research Area Within Gray's Reef National Marine Sanctuary

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-14

    ... sanctuary). A research area is a region specifically designed for conducting controlled scientific studies... research area as this boundary was designed based solely on scientific research considerations. Although.... 070726412-1300-02] RIN 0648-AV88 Research Area Within Gray's Reef National Marine Sanctuary AGENCY: Office...

  12. OIL SPILL BIOREMEDIATION ON COASTAL SHORELINES: A CRITIQUE

    EPA Science Inventory

    The purpose of this chapter is not to provide an extensive review of the literature on oil spill bioremediation. For that, the reader is referred to Swannell et al. (1996), who have conducted the most exhaustive review I have yet to come across. Other reviews are also av...

  13. Preliminary Results Obtained in Integrated Safety Analysis of NASA Aviation Safety Program Technologies

    NASA Technical Reports Server (NTRS)

    Reveley, Mary S.

    2003-01-01

    The goal of the NASA Aviation Safety Program (AvSP) is to develop and demonstrate technologies that contribute to a reduction in the aviation fatal accident rate by a factor of 5 by the year 2007 and by a factor of 10 by the year 2022. Integrated safety analysis of day-to-day operations and risks within those operations will provide an understanding of the Aviation Safety Program portfolio. Safety benefits analyses are currently being conducted. Preliminary results for the Synthetic Vision Systems (SVS) and Weather Accident Prevention (WxAP) projects of the AvSP have been completed by the Logistics Management Institute under a contract with the NASA Glenn Research Center. These analyses include both a reliability analysis and a computer simulation model. The integrated safety analysis method comprises two principal components: a reliability model and a simulation model. In the reliability model, the results indicate how different technologies and systems will perform in normal, degraded, and failed modes of operation. In the simulation, an operational scenario is modeled. The primary purpose of the SVS project is to improve safety by providing visual-flightlike situation awareness during instrument conditions. The current analyses are an estimate of the benefits of SVS in avoiding controlled flight into terrain. The scenario modeled has an aircraft flying directly toward a terrain feature. When the flight crew determines that the aircraft is headed toward an obstruction, the aircraft executes a level turn at speed. The simulation is ended when the aircraft completes the turn.

  14. Role of adrenal vein sampling in primary aldosteronism: the Monash Health experience.

    PubMed

    Teng, J; Hutchinson, M E; Doery, J C G; Choy, K W; Chong, W; Fuller, P J; Yang, J

    2015-11-01

    Adrenal vein sampling (AVS) is useful for distinguishing unilateral versus bilateral hypersecretion in primary aldosteronism (PA), but is technically challenging. Furthermore, the use of adrenocorticotropic hormone (ACTH)-stimulation in AVS is controversial. We implemented a Monash Health-specific AVS protocol in 2010. The audit aimed to: (i) examine the impact of a dedicated protocol on success rates of AVS at a tertiary referral centre; (ii) evaluate the impact of AVS on sub-typing of PA; and (iii) assess the utility of ACTH stimulation in AVS. AVS was performed on patients with PA confirmed by positive saline suppression testing (aldosterone level >140 pmol/L post-saline infusion), with sequential sampling of adrenal and peripheral veins, pre- and post-ACTH infusion. Patients with unilateral aldosterone-producing adenoma diagnosed on successful AVS were referred for adrenalectomy. Between 2010 and 2014 inclusive, a total of 28 AVS procedures was performed, with complete pre- and post-ACTH data for 19 procedures. Bilateral successful cannulation rates improved post-implementation of our protocol (61% vs 41%). Of the patients, 32% had discordant imaging and AVS results: four patients with unilateral adenomas did not lateralise on AVS and were managed medically; four patients with bilateral or no adenomas on imaging, lateralised on AVS and had surgery. Overall, use of ACTH did not increase successful cannulation and tended to mask lateralisation. AVS is crucial in subtype classification of PA and should be performed by a dedicated radiologist with a standardised protocol. AVS outcomes were not improved with the use of ACTH stimulation. © 2015 Royal Australasian College of Physicians.

  15. Structure-function analysis of Avian β-defensin-6 and β-defensin-12: role of charge and disulfide bridges.

    PubMed

    Yang, Ming; Zhang, Chunye; Zhang, Xuehan; Zhang, Michael Z; Rottinghaus, George E; Zhang, Shuping

    2016-09-09

    Avian beta-defensins (AvBD) are small, cationic, antimicrobial peptides. The potential application of AvBDs as alternatives to antibiotics has been the subject of interest. However, the mechanisms of action remain to be fully understood. The present study characterized the structure-function relationship of AvBD-6 and AvBD-12, two peptides with different net positive charges, similar hydrophobicity and distinct tissue expression profiles. AvBD-6 was more potent than AvBD-12 against E. coli, S. Typhimurium, and S. aureus as well as clinical isolates of extended spectrum beta lactamase (ESBL)-positive E. coli and K. pneumoniae. AvBD-6 was more effective than AvBD-12 in neutralizing LPS and interacting with bacterial genomic DNA. Increasing bacterial concentration from 10(5) CFU/ml to 10(9) CFU/ml abolished AvBDs' antimicrobial activity. Increasing NaCl concentration significantly inhibited AvBDs' antimicrobial activity, but not the LPS-neutralizing function. Both AvBDs were mildly chemotactic for chicken macrophages and strongly chemotactic for CHO-K1 cells expressing chicken chemokine receptor 2 (CCR2). AvBD-12 at higher concentrations also induced chemotactic migration of murine immature dendritic cells (DCs). Disruption of disulfide bridges abolished AvBDs' chemotactic activity. Neither AvBDs was toxic to CHO-K1, macrophages, or DCs. AvBDs are potent antimicrobial peptides under low-salt conditions, effective LPS-neutralizing agents, and broad-spectrum chemoattractant peptides. Their antimicrobial activity is positively correlated with the peptides' net positive charges, inversely correlated with NaCl concentration and bacterial concentration, and minimally dependent on intramolecular disulfide bridges. In contrast, their chemotactic property requires the presence of intramolecular disulfide bridges. Data from the present study provide a theoretical basis for the design of AvBD-based therapeutic and immunomodulatory agents.

  16. Attachment styles in patients with avoidant personality disorder compared with social phobia.

    PubMed

    Eikenaes, Ingeborg; Pedersen, Geir; Wilberg, Theresa

    2016-09-01

    Avoidant personality disorder (AvPD) and social phobia (SP) are common, closely related conditions. Little is known about the underlying processes related to the social discomfort of subjects with AvPD and SP. Both disorders are associated with interpersonal problems. An attachment perspective may shed light on similarities and differences in close relationships between the disorders. The aim of the study was to compare self-reported attachment styles in patients with AvPD and SP. We expected that patients with AvPD would have more attachment anxiety and avoidance and more often a Fearful attachment style, compared with SP. This is a cross-sectional multisite study of 90 adult patients with AvPD and SP. Patients with AvPD with and without SP (AvPD group) were compared with patients with SP without AvPD (SP group). Patients were assessed using structured diagnostic interviews and self-reporting questionnaires, including Experiences in Close Relationships (ECR). The ECR dimensions, Anxiety and Avoidance, and the new described five factors of the ECR were used. The AvPD group had higher levels of attachment anxiety than the SP group, especially for the sub-factors Anxiety for abandonment and Separation frustration. The diagnostic groups did not differ in levels of avoidance. Anxiety for abandonment was still associated with AvPD after controlling for symptom disorders and the criteria of other personality disorders. A Fearful attachment style was more frequent among patients with AvPD. The results indicate AvPD is associated with more attachment anxiety than SP. Fear of abandonment may play a significant role in the AvPD pathology. This is the first study to compare attachment styles in patients with avoidant personality disorder (AvPD) and social phobia (SP). The AvPD group had higher attachment-related anxiety than the SP group, and anxiety was most pronounced for the fear of abandonment. Fear of abandonment may play an important role in the AvPD pathology. © 2015 The British Psychological Society.

  17. AV-block and conduction slowing prevail over TdP arrhythmias in the methoxamine-sensitized pro-arrhythmic rabbit model.

    PubMed

    Varkevisser, Rosanne; Vos, Marc A; Beekman, Jet D; Tieland, Ralph G; Van Der Heyden, Marcel A

    2015-01-01

    The methoxamine-sensitized rabbit model is widely used to screen drugs for proarrhythmic properties, especially repolarization-dependent TdP arrhythmias. With the change of anesthesia and/or sensitizing agent, conduction disturbances have been reported as well. Therefore, we compared currently available in-house anesthetics in order to preserve arrhythmia sensitivity and preclude conduction disturbances. Rabbits were randomly assigned to 3 groups: (1) 35 mg/kg ketamine + 5 mg/kg xylazine; (2) 0.5 mL/kg hypnorm + 3 mg/kg midazolam; (3) 35 mg/kg ketamine + 20 mg/kg propofol. Anesthesia was maintained by 1.5% isoflurane. Concomitant infusion of methoxamine (17 μg/kg/min for 40 minutes) and dofetilide (10 μg/kg/min for 30 minutes) was used to induce arrhythmias. Sole methoxamine infusion exclusively decreased HR in groups 1 and 3. Dofetilide lengthened repolarization, followed in time by PQ/QRS prolongation, second-degree AV block, and subsequently TdP arrhythmias. TdP was seen in 80%, 0%, and 33% of the rabbits in groups 1, 2, and 3, respectively. Decreasing the dose of dofetilide to 5 μg/kg/min in ketamine/xylazine anesthetized rabbits resulted in a drop in TdP incidence (25%) while conduction disturbances persisted. Flunarizine (n = 6) suppressed all TdP arrhythmias while conduction disturbances remained present. TdP incidence in the methoxamine-sensitized rabbit could be dramatically influenced by anesthesia, drug dose, and flunarizine, while conduction slowing remained present. Thus, conduction slowing seems to be the integral outcome in this model. © 2014 Wiley Periodicals, Inc.

  18. AUDIO-VISUAL INSTRUCTION, AN ADMINISTRATIVE HANDBOOK.

    ERIC Educational Resources Information Center

    Missouri State Dept. of Education, Jefferson City.

    THIS HANDBOOK WAS DESIGNED FOR USE BY SCHOOL ADMINISTRATORS IN DEVELOPING A TOTAL AUDIOVISUAL (AV) PROGRAM. ATTENTION IS GIVEN TO THE IMPORTANCE OF AUDIOVISUAL MEDIA TO EFFECTIVE INSTRUCTION, ADMINISTRATIVE PERSONNEL REQUIREMENTS FOR AN AV PROGRAM, BUDGETING FOR AV INSTRUCTION, PROPER UTILIZATION OF AV MATERIALS, SELECTION OF AV EQUIPMENT AND…

  19. Pharmacokinetics of avenanthramides (AV) from AV-enriched malted oats in healthy older adults

    USDA-ARS?s Scientific Manuscript database

    Avenanthramides (AV) are a unique group of phytochemicals found in oat bran. In vitro studies show both purified AV and concentrated oat AV mixtures have anti-atherogenic and anti-inflammatory activity, suggesting they may have similar effects in vivo if they are sufficiently bioavailable. The bioav...

  20. AVS on satellite

    NASA Astrophysics Data System (ADS)

    Zhao, Haiwu; Wang, Guozhong; Hou, Gang

    2005-07-01

    AVS is a new digital audio-video coding standard established by China. AVS will be used in digital TV broadcasting and next general optical disk. AVS adopted many digital audio-video coding techniques developed by Chinese company and universities in recent years, it has very low complexity compared to H.264, and AVS will charge very low royalty fee through one-step license including all AVS tools. So AVS is a good and competitive candidate for Chinese DTV and next generation optical disk. In addition, Chinese government has published a plan for satellite TV signal directly to home(DTH) and a telecommunication satellite named as SINO 2 will be launched in 2006. AVS will be also one of the best hopeful candidates of audio-video coding standard on satellite signal transmission.

  1. Novel synthetic analogues of avian β-defensin-12: the role of charge, hydrophobicity, and disulfide bridges in biological functions.

    PubMed

    Yang, Ming; Zhang, Chunye; Zhang, Michael Z; Zhang, Shuping

    2017-02-23

    Avian β-defensins (AvBD) possess broad-spectrum antimicrobial, LPS neutralizing and chemotactic properties. AvBD-12 is a chemoattractant for avian immune cells and mammalian dendritic cells (JAWSII) - a unique feature that is relevant to the applications of AvBDs as chemotherapeutic agents in mammalian hosts. To identify the structural components essential to various biological functions, we have designed and evaluated seven AvBD analogues. In the first group of analogues, the three conserved disulfide bridges were eliminated by replacing cysteines with alanine and serine residues, peptide hydrophobicity and charge were increased by changing negatively charged amino acid residues to hydrophobic (AvBD-12A1) or positively charged residues (AvBD-12A2 and AvBD-12A3). All three analogues in this group showed improved antimicrobial activity, though AvBD-12A3, with a net positive charge of +9, hydrophobicity of 40% and a predicted CCR2 binding domain, was the most potent antimicrobial peptide. AvBD-12A3 also retained more than 50% of wild type chemotactic activity. In the second group of analogues (AvBD-12A4 to AvBD-12A6), one to three disulfide bridges were removed via substitution of cysteines with isosteric amino acids. Their antimicrobial activity was compromised and chemotactic activity abolished. The third type of analogue was a hybrid that had the backbone of AvBD-12 and positively charged amino acid residues AvBD-6. The antimicrobial and chemotactic activities of the hybrid resembled that of AvBD-6 and AvBD-12, respectively. While the net positive charge and charge distribution have a dominating effect on the antimicrobial potency of AvBDs, the three conserved disulfide bridges are essential to the chemotactic property and the maximum antimicrobial activity. Analogue AvBD-12A3 with a high net positive charge, a moderate degree of hydrophobicity and a CCR2-binding domain can serve as a template for the design of novel antimicrobial peptides with chemotactic property and salt resistance.

  2. Influence of the heart rate and atrioventricular delays on vortex evolution and blood transport inside the left ventricle

    NASA Astrophysics Data System (ADS)

    Hendabadi, Sahar; Martinez-Legazpi, Pablo; Benito, Yolanda; Bermejo, Javier; Del Alamo, Juan Carlos; Shadden, Shawn

    2013-11-01

    Cardiac resynchronization therapy (CRT) is used to help restore coordinated pumping of the ventricles by overcoming delays in electrical conduction due to cardiac disease. This is accomplished by a specialized cardiac pacemaker that is able to adjust the atrioventricular (AV) delay.A major clinical challenge is to adjust the pacing strategy to best coordinate the blood flow mechanics of ventricular filling and ejection. To this end, we have studied the difference in the vortex formation and its evolution inside the left ventricle (LV) for 4 different AV delays in a cohort of patients with implanted pacemakers. A reconstruction algorithm was used to obtain 2D velocity over the apical long-axis view of the LV from color Doppler and B-mode ultrasound data. To study blood transport, we have identified Lagrangian coherent structures to determine moving boundaries of the blood volumes injected to the LV in diastole and ejected to the aorta in systole. In all cases, we have analyzed the differences in filling and ejection patterns and the blood transport during the E-wave and A-wave formation.Finally we have assessed the influence of the AV delay on 2 indices of stasis, direct flow and residence time.The findings shed insight to the optimization of AV delays in patients undergoing CRT. NIH award 5R21HL108268 and grants PIS09/02603 and RD06/0010 from the Plan Nacional de Investigacion Cientifica, Spain.

  3. Evaluating the Relationships Between NTNU/SINTEF Drillability Indices with Index Properties and Petrographic Data of Hard Igneous Rocks

    NASA Astrophysics Data System (ADS)

    Aligholi, Saeed; Lashkaripour, Gholam Reza; Ghafoori, Mohammad; Azali, Sadegh Tarigh

    2017-11-01

    Thorough and realistic performance predictions are among the main requisites for estimating excavation costs and time of the tunneling projects. Also, NTNU/SINTEF rock drillability indices, including the Drilling Rate Index™ (DRI), Bit Wear Index™ (BWI), and Cutter Life Index™ (CLI), are among the most effective indices for determining rock drillability. In this study, brittleness value (S20), Sievers' J-Value (SJ), abrasion value (AV), and Abrasion Value Cutter Steel (AVS) tests are conducted to determine these indices for a wide range of Iranian hard igneous rocks. In addition, relationships between such drillability parameters with petrographic features and index properties of the tested rocks are investigated. The results from multiple regression analysis revealed that the multiple regression models prepared using petrographic features provide a better estimation of drillability compared to those prepared using index properties. Also, it was found that the semiautomatic petrography and multiple regression analyses provide a suitable complement to determine drillability properties of igneous rocks. Based on the results of this study, AV has higher correlations with studied mineralogical indices than AVS. The results imply that, in general, rock surface hardness of hard igneous rocks is very high, and the acidic igneous rocks have a lower strength and density and higher S20 than those of basic rocks. Moreover, DRI is higher, while BWI is lower in acidic igneous rocks, suggesting that drill and blast tunneling is more convenient in these rocks than basic rocks.

  4. [Automated detection and volumetric segmentation of the spleen in CT scans].

    PubMed

    Hammon, M; Dankerl, P; Kramer, M; Seifert, S; Tsymbal, A; Costa, M J; Janka, R; Uder, M; Cavallaro, A

    2012-08-01

    To introduce automated detection and volumetric segmentation of the spleen in spiral CT scans with the THESEUS-MEDICO software. The consistency between automated volumetry (aV), estimated volume determination (eV) and manual volume segmentation (mV) was evaluated. Retrospective evaluation of the CAD system based on methods like "marginal space learning" and "boosting algorithms". 3 consecutive spiral CT scans (thoraco-abdominal; portal-venous contrast agent phase; 1 or 5 mm slice thickness) of 15 consecutive lymphoma patients were included. The eV: 30 cm³ + 0.58 (width × length × thickness of the spleen) and the mV as the reference standard were determined by an experienced radiologist. The aV could be performed in all CT scans within 15.2 (± 2.4) seconds. The average splenic volume measured by aV was 268.21 ± 114.67 cm³ compared to 281.58 ± 130.21 cm³ in mV and 268.93 ± 104.60 cm³ in eV. The correlation coefficient was 0.99 (coefficient of determination (R²) = 0.98) for aV and mV, 0.91 (R² = 0.83) for mV and eV and 0.91 (R² = 0.82) for aV and eV. There was an almost perfect correlation of the changes in splenic volume measured with the new aV and mV (0.92; R² = 0.84), mV and eV (0.95; R² = 0.91) and aV and eV (0.83; R² = 0.69) between two time points. The automated detection and volumetric segmentation software rapidly provides an accurate measurement of the splenic volume in CT scans. Knowledge about splenic volume and its change between two examinations provides valuable clinical information without effort for the radiologist. © Georg Thieme Verlag KG Stuttgart · New York.

  5. Transitions in early embryonic atrioventricular valvular function correspond with changes in cushion biomechanics that are predictable by tissue composition.

    PubMed

    Butcher, Jonathan T; McQuinn, Tim C; Sedmera, David; Turner, Debi; Markwald, Roger R

    2007-05-25

    Endocardial cushions are critical to maintain unidirectional blood flow under constantly increasing hemodynamic forces, but the interrelationship between endocardial cushion structure and the mechanics of atrioventricular junction function is poorly understood. Atrioventricular (AV) canal motions and blood velocities of embryonic chicks at Hamburger and Hamilton (HH) stages 17, 21, and 25 were quantified using ultrasonography. Similar to the embryonic zebrafish heart, the HH17 AV segment functions like a suction pump, with the cushions expanding in a wave during peak myocardial contraction and becoming undetectable during the relaxation phase. By HH25, the AV canal contributes almost nothing to the piston-like propulsion of blood, but the cushions function as stoppers apposing blood flow with near constant thickness. Using a custom built mesomechanical testing system, we quantified the nonlinear pseudoelastic biomechanics of developing AV cushions, and found that both AV cushions increased in effective modulus between HH17 and HH25. Enzymatic digestion of major structural constituent collagens or glycosaminoglycans resulted in distinctly different stress-strain curves suggestive of their individual contributions. Mixture theory using histologically determined volume fractions of cells, collagen, and glycosaminoglycans showed good prediction of cushion material properties regardless of stage and cushion position. These results have important implications in valvular development, as biomechanics may play a larger role in stimulating valvulogenic events than previously thought.

  6. Genetics of immunoglobulin-A vasculitis (Henoch-Schönlein purpura): An updated review.

    PubMed

    López-Mejías, Raquel; Castañeda, Santos; Genre, Fernanda; Remuzgo-Martínez, Sara; Carmona, F David; Llorca, Javier; Blanco, Ricardo; Martín, Javier; González-Gay, Miguel A

    2018-03-01

    Immunoglobulin-A vasculitis (IgAV) is classically a childhood small-sized blood vessel vasculitis with predominant involvement of the skin. Gastrointestinal and joint manifestations are common in patients diagnosed with this condition. Nephritis, which is more severe in adults, constitutes the most feared complication of this vasculitis. The molecular bases underlying the origin of IgAV have not been completely elucidated. Nevertheless, several pieces of evidence support the claim that genes play a crucial role in the pathogenesis of this disease. The human leukocyte antigen (HLA) region is, until now, the main genetic factor associated with IgAV pathogenesis. Besides a strong association with HLA class II alleles, specifically HLA-DRB1 alleles, HLA class I alleles also seem to influence on the predisposition of this disease. Other gene polymorphisms located outside the HLA region, including those coding cytokines, chemokines, adhesion molecules as well as those related to T-cells, aberrant glycosylation of IgA1, nitric oxide production, neoangiogenesis, renin-angiotensin system and lipid, Pyrin and homocysteine metabolism, may be implicated not only in the predisposition to IgAV but also in its severity. An update of the current knowledge of the genetic component associated with the pathogenesis of IgAV is detailed in this review. Copyright © 2018 The Author(s). Published by Elsevier B.V. All rights reserved.

  7. Real-Time PCR with an Internal Control for Detection of All Known Human Adenovirus Serotypes▿

    PubMed Central

    Damen, Marjolein; Minnaar, René; Glasius, Patricia; van der Ham, Alwin; Koen, Gerrit; Wertheim, Pauline; Beld, Marcel

    2008-01-01

    The “gold standard” for the diagnosis of adenovirus (AV) infection is virus culture, which is rather time-consuming. Especially for immunocompromised patients, in whom severe infections with AV have been described, rapid diagnosis is important. Therefore, an internally controlled AV real-time PCR assay detecting all known human AV serotypes was developed. Primers were chosen from the hexon region, which is the most conserved region, and in order to cover all known serotypes, degenerate primers were used. The internal control (IC) DNA contained the same primer binding sites as the AV DNA control but had a shuffled probe region compared to the conserved 24-nucleotide consensus AV hexon probe region (the target). The IC DNA was added to the clinical sample in order to monitor extraction and PCR efficiency. The sensitivity and the linearity of the AV PCR were determined. For testing the specificity of this PCR assay for human AVs, a selection of 51 AV prototype strains and 66 patient samples positive for other DNA viruses were tested. Moreover, a comparison of the AV PCR method described herein with culture and antigen (Ag) detection was performed with a selection of 151 clinical samples. All 51 AV serotypes were detected in the selection of AV prototype strains. Concordant results from culture or Ag detection and PCR were found for 139 (92.1%) of 151 samples. In 12 cases (7.9%), PCR was positive while the culture was negative. In conclusion, a sensitive, internally controlled nonnested AV real-time PCR assay which is able to detect all known AV serotypes with higher sensitivity than a culture or Ag detection method was developed. PMID:18923006

  8. Predictors of nonfunctional arteriovenous access at hemodialysis initiation and timing of access creation: A registry-based study

    PubMed Central

    Metzger, Marie; Labeeuw, Michel; Ayav, Carole; Jacquelinet, Christian; Massy, Ziad A.; Stengel, Bénédicte

    2017-01-01

    Determinants of nonfunctional arteriovenous (AV) access, including timing of AV access creation, have not been sufficiently described. We studied 29 945 patients who had predialysis AV access placement and were included in the French REIN registry from 2005 through 2013. AV access was considered nonfunctional when dialysis began with a catheter. We estimated crude and adjusted odds ratio (OR) with 95% confidence intervals (CI) of nonfunctional versus functional AV access associated with case-mix, facility characteristics, and timing of AV access creation. Analyses were stratified by dialysis start condition (planned or as an emergency) and comorbidity profile. Overall, 18% patients had nonfunctional AV access at hemodialysis initiation. In the group with planned dialysis start, female gender (OR 1.43, 95% CI 1.32–1.56), diabetes (OR 1.28, 95% CI 1.15–1.44), and a higher number of cardiovascular comorbidities (OR 1.27, 95% CI 1.09–1.49, and 1.31, 1.05–1.64, for 3 and >3 cardiovascular comorbidities versus none, respectively) were independent predictors of nonfunctional AV access. A higher percentage of AV access creation at the region level was associated with a lower rate of nonfunctional AV access (OR 0.98, 95% CI 0.98–0.99 per 1% increase). The odds of nonfunctional AV access decreased as time from creation to hemodialysis initiation increased up to 3 months in nondiabetic patients with fewer than 2 cardiovascular comorbidities and 6 months in patients with diabetes or 2 or more such comorbidities. In conclusion, both patient characteristics and clinical practices may play a role in successful AV access use at hemodialysis initiation. Adjusting the timing of AV access creation to patients’ comorbidity profiles may improve functional AV access rates. PMID:28749967

  9. Predictors of nonfunctional arteriovenous access at hemodialysis initiation and timing of access creation: A registry-based study.

    PubMed

    Alencar de Pinho, Natalia; Coscas, Raphael; Metzger, Marie; Labeeuw, Michel; Ayav, Carole; Jacquelinet, Christian; Massy, Ziad A; Stengel, Bénédicte

    2017-01-01

    Determinants of nonfunctional arteriovenous (AV) access, including timing of AV access creation, have not been sufficiently described. We studied 29 945 patients who had predialysis AV access placement and were included in the French REIN registry from 2005 through 2013. AV access was considered nonfunctional when dialysis began with a catheter. We estimated crude and adjusted odds ratio (OR) with 95% confidence intervals (CI) of nonfunctional versus functional AV access associated with case-mix, facility characteristics, and timing of AV access creation. Analyses were stratified by dialysis start condition (planned or as an emergency) and comorbidity profile. Overall, 18% patients had nonfunctional AV access at hemodialysis initiation. In the group with planned dialysis start, female gender (OR 1.43, 95% CI 1.32-1.56), diabetes (OR 1.28, 95% CI 1.15-1.44), and a higher number of cardiovascular comorbidities (OR 1.27, 95% CI 1.09-1.49, and 1.31, 1.05-1.64, for 3 and >3 cardiovascular comorbidities versus none, respectively) were independent predictors of nonfunctional AV access. A higher percentage of AV access creation at the region level was associated with a lower rate of nonfunctional AV access (OR 0.98, 95% CI 0.98-0.99 per 1% increase). The odds of nonfunctional AV access decreased as time from creation to hemodialysis initiation increased up to 3 months in nondiabetic patients with fewer than 2 cardiovascular comorbidities and 6 months in patients with diabetes or 2 or more such comorbidities. In conclusion, both patient characteristics and clinical practices may play a role in successful AV access use at hemodialysis initiation. Adjusting the timing of AV access creation to patients' comorbidity profiles may improve functional AV access rates.

  10. Failure mode analysis in adrenal vein sampling: a single-center experience.

    PubMed

    Trerotola, Scott O; Asmar, Melissa; Yan, Yan; Fraker, Douglas L; Cohen, Debbie L

    2014-10-01

    To analyze failure modes in a high-volume adrenal vein sampling (AVS) practice in an effort to identify preventable causes of nondiagnostic sampling. A retrospective database was constructed containing 343 AVS procedures performed over a 10-year period. Each nondiagnostic AVS procedure was reviewed for failure mode and correlated with results of any repeat AVS. Data collected included selectivity index, lateralization index, adrenalectomy outcomes if performed, and details of AVS procedure. All AVS procedures were performed after cosyntropin stimulation, using sequential technique. AVS was nondiagnostic in 12 of 343 (3.5%) primary procedures and 2 secondary procedures. Failure was right-sided in 8 (57%) procedures, left-sided in 4 (29%) procedures, bilateral in 1 procedure, and neither in 1 procedure (laboratory error). Failure modes included diluted sample from correctly identified vein (n = 7 [50%]; 3 right and 4 left), vessel misidentified as adrenal vein (n = 3 [21%]; all right), failure to locate an adrenal vein (n = 2 [14%]; both right), cosyntropin stimulation failure (n = 1 [7%]; diagnostic by nonstimulated criteria), and laboratory error (n = 1 [7%]; specimen loss). A second AVS procedure was diagnostic in three of five cases (60%), and a third AVS procedure was diagnostic in one of one case (100%). Among the eight patients in whom AVS ultimately was not diagnostic, four underwent adrenalectomy based on diluted AVS samples, and one underwent adrenalectomy based on imaging; all five experienced improvement in aldosteronism. A substantial percentage of AVS failures occur on the left, all related to dilution. Even when technically nondiagnostic per strict criteria, some "failed" AVS procedures may be sufficient to guide therapy. Repeat AVS has a good yield. Copyright © 2014 SIR. Published by Elsevier Inc. All rights reserved.

  11. Diagnostic and therapeutic advancements for aerobic vaginitis.

    PubMed

    Han, Cha; Wu, Wenjuan; Fan, Aiping; Wang, Yingmei; Zhang, Huiying; Chu, Zanjun; Wang, Chen; Xue, Fengxia

    2015-02-01

    Aerobic vaginitis (AV) is a newly defined clinical entity that is distinct from candidiasis, trichomoniasis and bacterial vaginosis (BV). Because of the poor recognition of AV, this condition can lead to treatment failures and is associated with severe complications, such as pelvic inflammatory disease, infertility, preterm birth and foetal infections. This review describes the diagnosis and treatment of AV and the relationship between AV and pregnancy. The characteristics of AV include severely depressed levels of lactobacilli, increased levels of aerobic bacteria and an inflamed vagina. The diagnosis is made by microscopy on wet mounts of fresh vaginal fluid, and some distinct clinical features are recognized. Vaginal suppositories that contain kanamycin or clindamycin have shown curative effects in nonpregnant women. Additionally, the application of topical probiotics can restore the vaginal flora and reduce the recurrence of AV. Clindamycin vaginal suppositories and probiotics may be a better choice for gravida with AV than metronidazole. AV requires prompt attention, and the early diagnosis and treatment of AV during pregnancy significantly improves perinatal outcomes. Further research is needed to define the pathogenesis, diagnostic criteria and standard treatment guidelines for AV.

  12. Open-Loop Audio-Visual Stimulation (AVS): A Useful Tool for Management of Insomnia?

    PubMed

    Tang, Hsin-Yi Jean; Riegel, Barbara; McCurry, Susan M; Vitiello, Michael V

    2016-03-01

    Audio Visual Stimulation (AVS), a form of neurofeedback, is a non-pharmacological intervention that has been used for both performance enhancement and symptom management. We review the history of AVS, its two sub-types (close- and open-loop), and discuss its clinical implications. We also describe a promising new application of AVS to improve sleep, and potentially decrease pain. AVS research can be traced back to the late 1800s. AVS's efficacy has been demonstrated for both performance enhancement and symptom management. Although AVS is commonly used in clinical settings, there is limited literature evaluating clinical outcomes and mechanisms of action. One of the challenges to AVS research is the lack of standardized terms, which makes systematic review and literature consolidation difficult. Future studies using AVS as an intervention should; (1) use operational definitions that are consistent with the existing literature, such as AVS, Audio-visual Entrainment, or Light and Sound Stimulation, (2) provide a clear rationale for the chosen training frequency modality, (3) use a randomized controlled design, and (4) follow the Consolidated Standards of Reporting Trials and/or related guidelines when disseminating results.

  13. Development of a membrane of poly (L-co-D,L lactic acid-co-trimethylene carbonate) with aloe vera: An alternative biomaterial designed to improve skin healing.

    PubMed

    Komatsu, Daniel; Mistura, Daniel V; Motta, Adriana; Domingues, Juliana A; Hausen, Moema A; Duek, Eliana

    2017-09-01

    The search for new therapies and drugs that act as topical agents to relieve pain and control the infectious processes in burns always attracted interest in clinical trials. As an alternative to synthetic drugs, the use of natural extracts is useful in the development of new strategies and formulations for improving the life quality. The aim of this study was to develop a wound dressing using Poly(L-co-D,L lactic acid-co-TMC) (PLDLA-co-TMC) containing aloe vera (AV). This natural plant extract is known for its modulatory effects under healing process. The membrane of PLDLA-co-TMC+aloe vera was prepared at different concentrations of AV (5, 10, 15 and 50%). The FTIR showed no change in the PLDLA-co-TMC spectrum after AV addition, while the swelling test showed changes only in PLDLA-co-TMC+AV at 50%. The wettability measurements showed decrease in the contact angle in all samples after the AV addition in the polymer, while the AV release test showed that PLDLA-co-TMC+50%AV sample has higher AV release rate than the sample with other AV concentrations. The SEM analysis showed that AV was homogeneously distributed at 5% only. Tensile tests demonstrated an increase in the Young's modulus and a reduction in the elongation till rupture of the PLDLA-co-TMC after the addition of AV. Biocompatibility in vitro evaluation with fibroblast cells seeded in the membranes of PLDLA-co-TMC+AV showed that the cells were able to adhere, proliferate and maintain mitochondrial activity in all AV concentrations tested. Due to the known skin medicinal properties attributed to AV and the results here obtained, we suggest that after in vivo trials, the PLDLA-co-TMC+AV should be a promising biomaterial for application as a device for skin curative and healing agent.

  14. Discovery and characterization of Coturnix chinensis avian β-defensin 10, with broad antibacterial activity.

    PubMed

    Ma, Deying; Lin, Lijuan; Zhang, Kexin; Han, Zongxi; Shao, Yuhao; Wang, Ruiqin; Liu, Shengwang

    2012-04-01

    A novel avian β-defensin (AvBD), AvBD10, was discovered in the liver and bone marrow tissues from Chinese painted quail (Coturnix chinensis) in the present study. The complete nucleotide sequence of quail AvBD10 contains a 207-bp open reading frame that encodes 68 amino acids. The quail AvBD10 was expressed widely in all the tissues from quails except the tongue, crop, breast muscle, and thymus and was highly expressed in the bone marrow. In contrast to the expression pattern of AvBD10 in tissues from quail, the chicken AvBD10 was expressed in all 21 tissues from the layer hens investigated, with a high level of expression in the kidney, lung, liver, bone marrow, and Harderian glands. Recombinant glutathione S-transferase (GST)-tagged AvBD10s of both quail and chicken were produced and purified by expression of the two cDNAs in Escherichia coli, respectively. In addition, peptide according to the respective AvBD10s sequence was synthesized, named synthetic AvBD10s. As expected, both recombinant GST-tagged AvBD10s and synthetic AvBD10s of quail and chicken exhibited similar bactericidal properties against most bacteria, including Gram-positive and Gram-negative forms. However, no significant bactericidal activity was found for quail recombinant GST-tagged AvBD10 against Salmonella choleraesuis or for chicken recombinant GST-tagged AvBD10 against Proteus mirabilis. Copyright © 2012 European Peptide Society and John Wiley & Sons, Ltd.

  15. Auto-Versioning Systems Image Manager

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

    Pezzaglia, Larry

    2013-08-01

    The av_sys_image_mgr utility provides an interface for the creation, manipulation, and analysis of system boot images for computer systems. It is primarily intended to provide a convenient method for managing the introduction of changes to boot images for long-lived production HPC systems.

  16. Iowa in motion : aviation system plan : implementing Iowa's state transportation plan

    DOT National Transportation Integrated Search

    1999-09-14

    Iowa's system of airports provides a variety of services vital to the state's economy and is an integral part of Iowa's overall transportation system. This 1999 Iowa Aviation System Plan (IASP) addresses issues concerning the state's investment in av...

  17. Evidence-based, multidisciplinary approach to the development of a crotalidae polyvalent antivenin (CroFab) protocol at a university hospital.

    PubMed

    Weant, Kyle A; Johnson, Peter N; Bowers, Rebecca C; Armitstead, John A

    2010-03-01

    Several thousand people are bitten annually by venomous snakes in the US. While the development of ovine Crotalidae polyvalent immune Fab antivenin (FabAV) for Crotalinae snakebite envenomations has greatly changed the way this clinical presentation is treated, multiple issues complicate its use. From patient assessment and evaluation, to medication preparation and administration, to the management of adverse drug reactions, the use of this antidote carries with it multiple points of possible medication variances. The inappropriate use of this agent can result in adverse patient consequences and a significant financial burden for both the hospital and the patient. To describe an evidence-based, multidisciplinary approach that was taken to ensure optimal, safe, and cost-effective treatment of patients with FabAV. Following an analysis of the available literature, a multidisciplinary committee was formed to construct a protocol for use of FabAV. This group included clinical pharmacists, pharmacy administrators, emergency medicine physicians who specialized in wilderness medicine and pharmacy residents. A multidisciplinary FabAV usage protocol was constructed and implemented to ensure appropriate patient evaluation, FabAV use and preparation, monitoring, and follow-up. This protocol was based on the available literature and the expert opinion of the committee. Through the use of a 24-hour in-house pharmacy resident on-call system, clinical pharmacy services were provided to ensure a multidisciplinary approach to the care of these patients emergently. Although limited, initial data show that this approach is effective and may result in substantial cost savings. Initial results from implementation of a protocol for use of FabAV have limited inappropriate use, reduced medication wastage, and decreased costs.

  18. Moving domain computational fluid dynamics to interface with an embryonic model of cardiac morphogenesis.

    PubMed

    Lee, Juhyun; Moghadam, Mahdi Esmaily; Kung, Ethan; Cao, Hung; Beebe, Tyler; Miller, Yury; Roman, Beth L; Lien, Ching-Ling; Chi, Neil C; Marsden, Alison L; Hsiai, Tzung K

    2013-01-01

    Peristaltic contraction of the embryonic heart tube produces time- and spatial-varying wall shear stress (WSS) and pressure gradients (∇P) across the atrioventricular (AV) canal. Zebrafish (Danio rerio) are a genetically tractable system to investigate cardiac morphogenesis. The use of Tg(fli1a:EGFP) (y1) transgenic embryos allowed for delineation and two-dimensional reconstruction of the endocardium. This time-varying wall motion was then prescribed in a two-dimensional moving domain computational fluid dynamics (CFD) model, providing new insights into spatial and temporal variations in WSS and ∇P during cardiac development. The CFD simulations were validated with particle image velocimetry (PIV) across the atrioventricular (AV) canal, revealing an increase in both velocities and heart rates, but a decrease in the duration of atrial systole from early to later stages. At 20-30 hours post fertilization (hpf), simulation results revealed bidirectional WSS across the AV canal in the heart tube in response to peristaltic motion of the wall. At 40-50 hpf, the tube structure undergoes cardiac looping, accompanied by a nearly 3-fold increase in WSS magnitude. At 110-120 hpf, distinct AV valve, atrium, ventricle, and bulbus arteriosus form, accompanied by incremental increases in both WSS magnitude and ∇P, but a decrease in bi-directional flow. Laminar flow develops across the AV canal at 20-30 hpf, and persists at 110-120 hpf. Reynolds numbers at the AV canal increase from 0.07±0.03 at 20-30 hpf to 0.23±0.07 at 110-120 hpf (p< 0.05, n=6), whereas Womersley numbers remain relatively unchanged from 0.11 to 0.13. Our moving domain simulations highlights hemodynamic changes in relation to cardiac morphogenesis; thereby, providing a 2-D quantitative approach to complement imaging analysis.

  19. Transportation System After Next & Comments on AvSTAR Planning

    NASA Technical Reports Server (NTRS)

    Pearce, Robert

    2001-01-01

    The purpose of this presentation is to define and identify: the role of transportation in supporting future US needs, trends, system after next, supporting research and education, priority investments, and barriers.

  20. Social phobia and avoidant personality disorder: similar but different?

    PubMed

    Lampe, Lisa; Sunderland, Matthew

    2015-02-01

    Avoidant personality disorder (AvPD) is regarded as a severe variant of social phobia (SP), consistent with a dimensional model. However, these conclusions are largely drawn from studies based on individuals with SP, with or without comorbid AvPD. The present study hypothesized that there are qualitative differences between AvPD and SP that are undermined by limiting research to participants with SP. The authors sought to test this hypothesis by comparing three groups-SP only, AvPD only, and SP+AvPD-using data extracted from an epidemiological sample of 10,641 adults aged 18 years and over. Screening questions were used in the epidemiological survey to identify ICD-10 personality disorders; from this the author developed a proxy measure for DSM-IV AvPD. Axis I diagnoses, including DSM-IV SP, were identified using the Composite International Diagnostic Interview (CIDI). In this sample, the majority of those with AvPD did not also have SP: The authors found 116 persons with AvPD only, 196 with SP only, and 69 with SP+AvPD. There was little difference between any of the groups on sex, marital status, employment, education, or impairment variables. The SP+AvPD group reported more distress and comorbidity than the SP only and AvPD only groups, which did not differentiate from each other. More feared social situations were endorsed in the SP only group compared to the AvPD only group. Although the finding of few differences between SP only and AvPD only groups among the variables measured in this epidemiological survey fails to provide support for the hypothesis of qualitative differences, the finding that the AvPD only group appears more similar to the SP only group than to the SP+AvPD group also fails to provide support for the alternative continuity hypothesis. The greater distress and additional comorbidity with depression associated with SP+AvPD may be due to the additional symptom load of a second disorder rather than simply representing a more severe variant of social phobia. The use of a proxy for AvPD is a limitation of the study. Future studies should focus on broader clinical variables that have been proposed as qualitatively different between these disorders, and on the possible genetic and environmental factors that might help explain such differences.

  1. Are acid volatile sulfides (AVS) important trace metals sinks in semi-arid mangroves?

    PubMed

    Queiroz, Hermano Melo; Nóbrega, Gabriel Nuto; Otero, Xose L; Ferreira, Tiago Osório

    2018-01-01

    Acid-volatile sulfides (AVS) formation and its role on trace metals bioavailability were studied in semi-arid mangroves. The semi-arid climatic conditions at the studied sites, marked by low rainfall and high evapotranspiration rates, clearly limited the AVS formation (AVS contents varied from 0.10 to 2.34μmolg -1 ) by favoring oxic conditions (Eh>+350mV). The AVS contents were strongly correlated with reactive iron and organic carbon (r=0.84; r=0.83 respectively), evidencing their dominant role for AVS formation under semi-arid conditions. On the other hand, the recorded ΣSEM/AVS values remained >1 evidencing a little control of AVS over the bioavailability of trace metals and, thus, its minor role as a sink for toxic metals. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. Avoidant personality disorder versus social phobia: the significance of childhood neglect.

    PubMed

    Eikenaes, Ingeborg; Egeland, Jens; Hummelen, Benjamin; Wilberg, Theresa

    2015-01-01

    Avoidant personality disorder (AvPD) and social phobia (SP) are common disorders both in the community and in clinical settings. Whether the two disorders represent different severity levels of social anxiety disorder is currently in dispute. The relationship between AvPD and SP is probably more complex than previously assumed. Several environmental, temperamental, and constitutional factors may play a role in the etiology of AvPD and SP. Better knowledge about childhood experiences may shed light on similarities and differences between the two disorders. The aim of this study was to compare self-reported childhood experiences in AvPD and SP patients. This is a cross-sectional multi-site study of 91 adult patients with AvPD and/ or SP. We compared patients with AvPD with and without SP (AvPD group) to patients with SP without AvPD (SP group). The patients were examined using structured diagnostic interviews and self-report measures, including Child Trauma Questionnaire, Parental Bonding Instrument, and Adult Temperament Questionnaire. Both AvPD and SP were associated with negative childhood experiences. AvPD patients reported more severe childhood neglect than patients with SP, most pronounced for physical neglect. The difference between the disorders in neglect remained significant after controlling for temperamental factors and concurrent abuse. The study indicates that childhood neglect is a risk factor for AvPD and may be one contributing factor to phenomenological differences between AvPD and SP.

  3. The clinical spectrum of autoimmune congenital heart block

    PubMed Central

    Brito-Zerón, Pilar; Izmirly, Peter M.; Ramos-Casals, Manuel; Buyon, Jill P.; Khamashta, Munther A.

    2017-01-01

    Autoimmune congenital heart block (CHB) is an immune-mediated acquired disease that is associated with the placental transference of maternal antibodies specific for Ro and La autoantigens. The disease develops in a fetal heart without anatomical abnormalities that could otherwise explain the block, and which is usually diagnosed in utero, but also at birth or within the neonatal period. Autoantibody-mediated damage of fetal conduction tissues causes inflammation and fibrosis and leads to blockage of signal conduction at the atrioventricular (AV) node. Irreversible complete AV block is the principal cardiac manifestation of CHB, although some babies might develop other severe cardiac complications, such as endocardial fibroelastosis or valvular insufficiency, even in the absence of cardiac block. In this Review, we discuss the epidemiology, classification and management of women whose pregnancies are affected by autoimmune CHB, with a particular focus on the autoantibodies associated with autoimmune CHB and how we should test for these antibodies and diagnose this disease. Without confirmed effective preventive or therapeutic strategies and further research on the aetiopathogenic mechanisms, autoimmune CHB will remain a severe life-threatening disorder. PMID:25800217

  4. Audiovisual biofeedback improves the correlation between internal/external surrogate motion and lung tumor motion.

    PubMed

    Lee, Danny; Greer, Peter B; Paganelli, Chiara; Ludbrook, Joanna Jane; Kim, Taeho; Keall, Paul

    2018-03-01

    Breathing management can reduce breath-to-breath (intrafraction) and day-by-day (interfraction) variability in breathing motion while utilizing the respiratory motion of internal and external surrogates for respiratory guidance. Audiovisual (AV) biofeedback, an interactive personalized breathing motion management system, has been developed to improve reproducibility of intra- and interfraction breathing motion. However, the assumption of the correlation of respiratory motion between surrogates and tumors is not always verified during medical imaging and radiation treatment. Therefore, the aim of the study was to test the hypothesis that the correlation of respiratory motion between surrogates and tumors is the same under free breathing without guidance (FB) and with AV biofeedback guidance for voluntary motion management. For 13 lung cancer patients receiving radiotherapy, 2D coronal and sagittal cine-MR images were acquired across two MRI sessions (pre- and mid-treatment) with two breathing conditions: (a) FB and (b) AV biofeedback, totaling 88 patient measurements. Simultaneously, the external respiratory motion of the abdomen was measured. The internal respiratory motion of the diaphragm and lung tumor was retrospectively measured from 2D coronal and sagittal cine-MR images. The correlation of respiratory motion between surrogates and tumors was calculated using Pearson's correlation coefficient for: (a) abdomen to tumor (abdomen-tumor) and (b) diaphragm to tumor (diaphragm-tumor). The correlations were compared between FB and AV biofeedback using several metrics: abdomen-tumor and diaphragm-tumor correlations with/without ≥5 mm tumor motion range and with/without adjusting for phase shifts between the signals. Compared to FB, AV biofeedback improved abdomen-tumor correlation by 11% (p = 0.12) from 0.53 to 0.59 and diaphragm-tumor correlation by 13% (p = 0.02) from 0.55 to 0.62. Compared to FB, AV biofeedback improved abdomen-tumor correlation by 17% (p = 0.01) and diaphragm-tumor correlation by 15% (p < 0.01) while correcting 0.3 s (p = 0.54) and 0.2 s (p = 0.19) phase shifts, respectively. In addition, AV biofeedback with ≥5 mm tumor motion range, compared to FB improved abdomen-tumor correlation by 14% (p = 0.18) and diaphragm-tumor correlation by 17% (p = 0.01). The highest abdomen-tumor and diaphragm-tumor correlations were found using ≥5 mm tumor motion range and phase shifts, resulting in a 12% improvement in AV biofeedback. Our results demonstrated that AV biofeedback improves the correlation of respiratory motion between surrogates and the tumor. This suggests a need for AV biofeedback for respiratory guidance utilizing respiratory surrogates during image-guided and MRI-guided radiotherapy in thoracic regions. © 2018 American Association of Physicists in Medicine.

  5. Antigenic characterization of intermediate adenovirus 14-11 strains associated with upper respiratory illness in a military camp.

    PubMed Central

    Hierholzer, J C; Pumarola, A

    1976-01-01

    An unusual variant of adenovirus (AV) 11 was isolated from throat and rectal swabs from six persons with upper respiratory illness in a Spanish military camp in March 1969. The same strain was serologically related to the upper respiratory illness of seven other men among 25 sample cases studied in detail. After strain purification, the virus was grouped as an AV by standard biological tests; it possessed the usual titers of group-specific hexon antigen but only low hemagglutinin titers (1:4 to 1:8) with erythrocytes from selected rhesus monkeys. The virus gave little reaction in hemagglutination inhibition (HI) tests with antisera to AV 1 through 35, but was neutralized to homologous titers by AV 11 antiserum. Reciprocally, rabbit and guinea pig antisera to the isolates possessed high HI antibody titers to prototype AV 14 and high serum neutralization (SN) antibody titers to prototype AV 11. On this basis, the variants were classified as AV 14-11 intermediates. Sequential serum specimens from the patients with and without positive cultures showed diagnostic rises in HI and SN antibody levels to the AV 14-11 intermediate and to prototype AV 11, but little response to AV 14. PMID:177365

  6. Adrenal Vein Sampling for Conn's Syndrome: Diagnosis and Clinical Outcomes.

    PubMed

    Deipolyi, Amy R; Bailin, Alexander; Wicky, Stephan; Alansari, Shehab; Oklu, Rahmi

    2015-06-19

    Adrenal vein sampling (AVS) is the gold standard test to determine unilateral causes of primary aldosteronism (PA). We have retrospectively characterized our experience with AVS including concordance of AVS results and imaging, and describe the approach for the PA patient in whom bilateral AVS is unsuccessful. We reviewed the medical records of 85 patients with PA and compared patients who were treated medically and surgically on pre-procedure presentation and post-treatment outcomes, and evaluated how technically unsuccessful AVS results were used in further patient management. Out of the 92 AVS performed in 85 patients, AVS was technically successful bilaterally in 58 (63%) of cases. Either unsuccessful AVS prompted a repeat AVS, or results from the contralateral side and from CT imaging were used to guide further therapy. Patients who were managed surgically with adrenalectomy had higher initial blood pressure and lower potassium levels compared with patients who were managed medically. Adrenalectomy results in significantly decreased blood pressure and normalization of potassium levels. AVS can identify surgically curable causes of PA, but can be technically challenging. When one adrenal vein fails to be cannulated, results from the contralateral vein can be useful in conjunction with imaging and clinical findings to suggest further management.

  7. A randomized phase II trial comparing two different sequence combinations of autologous vaccine and human recombinant interferon gamma and human recombinant interferon alpha2B therapy in patients with metastatic renal cell carcinoma: clinical outcome and analysis of immunological parameters.

    PubMed

    Schwaab, T; Heaney, J A; Schned, A R; Harris, R D; Cole, B F; Noelle, R J; Phillips, D M; Stempkowski, L; Ernstoff, M S

    2000-04-01

    The clinical observation of spontaneous regression in patients with renal cell carcinoma (RCC) and the response to various immunotherapeutic therapies strongly suggest a role for the host immune system in this disease. Prior studies showed that sequential administration of interferon (IFN) gamma and IFN alpha to RCC patients was safe. Clinical responses as well as immune changes in the peripheral blood mononuclear cell compartment were observed. Autologous tumor cell vaccines (AV) have also demonstrated activity in renal cell carcinoma. We hypothesize that the addition of AV to sequential IFN gamma and a therapy might improve the tumor-specific immune response by providing an appropriate source of antigen in the appropriate cytokine environment. To our knowledge, this is the first trial using AV combined with IFN alpha and IFN gamma. The purpose of this study was to evaluate the feasibility of manufacturing and administering (AV) from resected tumor samples, and administration of AV with combination IFN gamma and IFN alpha therapy. Finally, the impact on immunological parameters of these treatment options was assessed. Patients with metastatic RCC were randomly assigned to receive AV plus bCG along with a sequential administration of IFN gamma and a either together or after initiation of vaccine. Toxicity and clinical responses were evaluated. Modulations of the immune system were investigated by analyzing phenotype, cytokine mRNA expression, T cell proliferation and cytotoxicity in the peripheral blood mononuclear cell compartment. Fourteen patients with metastatic renal cell carcinoma were enrolled in this study; 9 were available for response evaluation. In a 70 day period, 3 (33%) showed mixed responses, 5 (56%) stable disease and 1 (11%) progression of disease. Toxicities were consistent with previous clinical reports. In the flow-cytometry phenotype analysis, stimulation of distinct subsets of circulating T-lymphocytes and a decrease of CD8+ T cell subsets was demonstrated. T-cell proliferation to allogeneic tumor cell stimulation improved following treatment. IL-4 and IL-5 mRNA levels were reduced in all patients after treatment. Patients who responded to treatment did not produce any IL-4 mRNA at all, before or after treatment. AV with IFNgamma and IFNalpha therapy might induce a MHC class-mediated cytotoxic T lymphocyte (CTL) response. We suggest that adequate therapy might direct T cell response toward a Th1 type response. We hypothesize a state of improved immune readiness in patients who might eventually respond to immunotherapy.

  8. Effects of liquid cooling garments on recovery and performance time in individuals performing strenuous work wearing a firefighter ensemble.

    PubMed

    Kim, Jung-Hyun; Coca, Aitor; Williams, W Jon; Roberge, Raymond J

    2011-07-01

    This study investigated the effects of body cooling using liquid cooling garments (LCG) on performance time (PT) and recovery in individuals wearing a fully equipped prototype firefighter ensemble (PFE) incorporating a self-contained breathing apparatus (SCBA). Six healthy male participants (three firefighters and three non-firefighters) completed six experimental sessions in an environmental chamber (35°C, 50% relative humidity), consisting of three stages of 15 min exercise at 75% VO2max, and 10 min rest following each exercise stage. During each session, one of the following six conditions was administered in a randomized order: control (no cooling, CON); air ventilation of exhaust SCBA gases rerouted into the PFE (AV); top cooling garment (TCG); TCG combined with AV (TCG+AV); a shortened whole body cooling garment (SCG), and SCG combined with AV (SCG+AV). Results showed that total PT completed was longer under SCG and SCG+AV compared with CON, AV, TCG, and TCG+AV (p<0.01). Magnitude of core temperature (Tc) elevation was significantly decreased when SCG was utilized (p<0.01), and heart rate recovery rate (10 min) was enhanced under SCG, SCG+AV, TCG, and TCG+AV compared with CON (p<0.05). Estimated Esw rate (kg·h(-1)) was the greatest in CON, 1.62 (0.37), and the least in SCG+AV 0.98 (0.44): (descending order: CON>AV>TCG=TCG+AV>SCG>SCG+AV) without a statistical difference between the conditions (p<0.05). Results of the present study suggest that the application of LCG underneath the PFE significantly improves the recovery during a short period of rest and prolongs performance time in subsequent bouts of exercise. LCG also appears to be an effective method for body cooling that promotes heat dissipation during uncompensable heat stress.

  9. Bacterial vaginosis, aerobic vaginitis, vaginal inflammation and major Pap smear abnormalities.

    PubMed

    Vieira-Baptista, P; Lima-Silva, J; Pinto, C; Saldanha, C; Beires, J; Martinez-de-Oliveira, J; Donders, G

    2016-04-01

    The purpose of this investigation was to evaluate the impact of the vaginal milieu on the presence of abnormal Pap smears and a positive human papilloma virus (HPV) test. A cross-sectional study was conducted between June 2014 and May 2015, evaluating the vaginal discharge by fresh wet mount microscopy and comparing these data with Pap smear findings. Wet mount slides were scored for bacterial vaginosis (BV), aerobic vaginitis (AV), presence of Candida and Trichomonas vaginalis. Cytologic evaluation was done on all Pap smears according to the Bethesda criteria. The cobas© HPV Test (Roche) was performed for HPV detection. A total of 622 cases were evaluated. The mean age of the patients was 41.6 ± 10.65 years (range 21-75). Eighty-three women (13.3 %) had a cytology result worse than low-grade squamous intraepithelial lesion (LSIL). When comparing this group with the one with normal or minor [atypical squamous cells of undetermined significance (ASC-US) or LSIL] Pap smear abnormalities, there were no differences in the presence of Candida (32.5 % vs. 33.2 %, p = 1.0), absence of lactobacilli (38.6 % vs. 32.5 %, p = 0.32) or BV (20.5 % vs. 13.2 %, p = 0.09). On the other hand, moderate or severe inflammation (msI) (41.0 % vs. 28.8 %, p = 0,04), moderate or severe AV (msAV) (16.9 % vs. 7.2 %, p = 0.009) and msAV/BV (37.3 % vs. 20.0 %, p = 0.001) were more common in women with such major cervical abnormalities. No significant association was found between deviations of the vaginal milieu and high-risk HPV infection. The presence of msI or msAV, but not BV, is independently associated with an increased risk of major cervical cytological abnormalities, but not with HPV infection.

  10. Impact of early initiation of corticosteroid therapy on cardiac function and rhythm in patients with cardiac sarcoidosis.

    PubMed

    Padala, Santosh K; Peaslee, Samuel; Sidhu, Mandeep S; Steckman, David A; Judson, Marc A

    2017-01-15

    There is limited data on the effect of corticosteroid therapy in patients with cardiac sarcoidosis (CS). We sought to examine the impact of early initiation of corticosteroid therapy, within a month of CS diagnosis, on left ventricular ejection fraction (LVEF), ventricular arrhythmias (VAs), and atrioventricular (AV) block. We retrospectively identified 30 CS patients from a large university sarcoidosis clinic. The effect of early initiation of corticosteroid therapy on LVEF was assessed by serial echocardiography, and on VAs and AV block was assessed by Holter monitoring and/or device interrogations. The median time from diagnosis of extra-cardiac sarcoidosis to CS was 40months. 90% (27/30) of the CS patients received corticosteroid therapy and 85% percent (23/27) had early initiation of corticosteroid therapy. Fourteen patients (47%) had reduced EF<50%. 9/14 patients who had early initiation of corticosteroid therapy had improvement in mean EF (25% to 46%, P<0.001); 5/14 patients who had a delay in initiation or who did not receive corticosteroids had no improvement in mean EF (41% to 37%, P=0.47). Fourteen patients (47%) had VAs and 5 patients (17%) had advanced AV block. Early initiation of corticosteroid therapy resulted in no VA recurrences in 8/11 patients (72%), and complete recovery of AV conduction in 2/3 patients (67%). Patients with VAs (n=3) or advanced AV block (n=2) who failed to receive early corticosteroid therapy did not show improvement. There is often a delay in manifestation of cardiac sarcoidosis for several years from the diagnosis of extra-cardiac sarcoidosis. Prompt initiation of corticosteroid therapy in CS patients may improve outcomes whereas delayed initiation of corticosteroids or failure to use corticosteroids may be associated with worse outcomes. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  11. Association of In Vivo [18F]AV-1451 Tau PET Imaging Results With Cortical Atrophy and Symptoms in Typical and Atypical Alzheimer Disease.

    PubMed

    Xia, Chenjie; Makaretz, Sara J; Caso, Christina; McGinnis, Scott; Gomperts, Stephen N; Sepulcre, Jorge; Gomez-Isla, Teresa; Hyman, Bradley T; Schultz, Aaron; Vasdev, Neil; Johnson, Keith A; Dickerson, Bradford C

    2017-04-01

    Previous postmortem studies have long demonstrated that neurofibrillary tangles made of hyperphosphorylated tau proteins are closely associated with Alzheimer disease clinical phenotype and neurodegeneration pattern. Validating these associations in vivo will lead to new diagnostic tools for Alzheimer disease and better understanding of its neurobiology. To examine whether topographical distribution and severity of hyperphosphorylated tau pathologic findings measured by fluorine 18-labeled AV-1451 ([18F]AV-1451) positron emission tomographic (PET) imaging are linked with clinical phenotype and cortical atrophy in patients with Alzheimer disease. This observational case series, conducted from July 1, 2012, to July 30, 2015, in an outpatient referral center for patients with neurodegenerative diseases, included 6 patients: 3 with typical amnesic Alzheimer disease and 3 with atypical variants (posterior cortical atrophy, logopenic variant primary progressive aphasia, and corticobasal syndrome). Patients underwent [18F]AV-1451 PET imaging to measure tau burden, carbon 11-labeled Pittsburgh Compound B ([11C]PiB) PET imaging to measure amyloid burden, and structural magnetic resonance imaging to measure cortical thickness. Seventy-seven age-matched controls with normal cognitive function also underwent structural magnetic resonance imaging but not tau or amyloid PET imaging. Tau burden, amyloid burden, and cortical thickness. In all 6 patients (3 women and 3 men; mean age 61.8 years), the underlying clinical phenotype was associated with the regional distribution of the [18F]AV-1451 signal. Furthermore, within 68 cortical regions of interest measured from each patient, the magnitude of cortical atrophy was strongly correlated with the magnitude of [18F]AV-1451 binding (3 patients with amnesic Alzheimer disease, r = -0.82; P < .001; r = -0.70; P < .001; r = -0.58; P < .001; and 3 patients with nonamnesic Alzheimer disease, r = -0.51; P < .001; r = -0.63; P < .001; r = -0.70; P < .001), but not of [11C]PiB binding. These findings provide further in vivo evidence that distribution of the [18F]AV-1451 signal as seen on results of PET imaging is a valid marker of clinical symptoms and neurodegeneration. By localizing and quantifying hyperphosphorylated tau in vivo, results of tau PET imaging will likely serve as a key biomarker that links a specific type of molecular Alzheimer disease neuropathologic condition with clinically significant neurodegeneration, which will likely catalyze additional efforts to develop disease-modifying therapeutics.

  12. CD142+/CD61+, CD146+ and CD45+ microparticles predict cardiovascular events in high risk patients following a Mediterranean diet supplemented with nuts.

    PubMed

    Chiva-Blanch, Gemma; Crespo, Javier; Suades, Rosa; Arderiu, Gemma; Padro, Teresa; Vilahur, Gemma; Cubedo, Judith; Corella, Dolores; Salas-Salvadó, Jordi; Arós, Fernando; Martínez-González, Miguel-Angel; Ros, Emilio; Fitó, Montse; Estruch, Ramon; Badimon, Lina

    2016-07-04

    Circulating microparticles (cMPs) are small phospholipid-rich microvesicles shed by activated cells that play a pivotal role in cell signalling related to the pathogenesis of atherothrombosis. We aimed to investigate the prognostic value of cMPs released from different vascular cells for cardiovascular event (CVE) presentation in asymptomatic patients at high cardiovascular risk factors under nutritional and pharmacologic treatment. This is a nested case-control study of 50 patients from the five-year follow-up prospective PREDIMED trial enrolled in the nuts arm of the Mediterranean diet (MedDiet-nuts). We randomly selected 25 patients who had suffered a CVE during follow-up and pair-matched them for sex, age, and classical CV risk factors to 25 patients who remained asymptomatic (no-CVE). Total Annexin V-(AV)+ cMPs and cMPs from cells of the vascular compartment were quantified by flow cytometry at baseline and after one year follow-up. MedDiet-nuts and pharmacological treatment neither modified levels nor source of MP shedding in CVE patients. However, no-CVE patients showed 40-86 % decreased total AV+, PAC-1+/AV+, CD61+/AV+, CD142+/CD61+/AV+, CD62P+/AV+, CD146+/AV+, CD63+/AV+ and CD11a+/AV+ cMPs at one year follow-up (p≤0.046, all). CD142+/CD61+/AV+, CD146+/AV+ and CD45+/AV+ cMPs were decreased in no-CVE patients compared to CVE patients. A ROC-curve clustered model for CD142+/CD61+/AV+, CD45+/AV+ and CD146+/AV+ cMPs predicted a future CVE [p<0.0001, AUC=0.805 (0.672 to 0.938)]. In patients at high CV risk profile treated with a controlled MedDiet supplemented with nuts and receiving up-to-date CV drug treatment, reduced cMPs derived from activated platelets, leukocytes and endothelial cells are predictive of protection against CVE within the next four years.

  13. The Unusual Resistance of Avian Defensin AvBD7 to Proteolytic Enzymes Preserves Its Antibacterial Activity

    PubMed Central

    Bailleul, Geoffrey; Kravtzoff, Amanda; Joulin-Giet, Alix; Lecaille, Fabien; Labas, Valérie; Meudal, Hervé; Loth, Karine; Teixeira-Gomes, Ana-Paula; Gilbert, Florence B.; Coquet, Laurent; Jouenne, Thierry; Brömme, Dieter; Schouler, Catherine; Landon, Céline; Lalmanach, Gilles; Lalmanach, Anne-Christine

    2016-01-01

    Defensins are frontline peptides of mucosal immunity in the animal kingdom, including birds. Their resistance to proteolysis and their ensuing ability to maintain antimicrobial potential remains questionable and was therefore investigated. We have shown by bottom-up mass spectrometry analysis of protein extracts that both avian beta-defensins AvBD2 and AvBD7 were ubiquitously distributed along the chicken gut. Cathepsin B was found by immunoblotting in jejunum, ileum, caecum, and caecal tonsils, while cathepsins K, L, and S were merely identified in caecal tonsils. Hydrolysis product of AvBD2 and AvBD7 incubated with a panel of proteases was analysed by RP-HPLC, mass spectrometry and antimicrobial assays. AvBD2 and AvBD7 were resistant to serine proteases and to cathepsins D and H. Conversely cysteine cathepsins B, K, L, and S degraded AvBD2 and abolished its antibacterial activity. Only cathepsin K cleaved AvBD7 and released Ile4-AvBD7, a N-terminal truncated natural peptidoform of AvBD7 that displayed antibacterial activity. Besides the 3-stranded antiparallel beta-sheet typical of beta-defensins, structural analysis of AvBD7 by two-dimensional NMR spectroscopy highlighted the restricted accessibility of the C-terminus embedded by the N-terminal region and gave a formal evidence of a salt bridge (Asp9-Arg12) that could account for proteolysis resistance. The differential susceptibility of avian defensins to proteolysis opens intriguing questions about a distinctive role in the mucosal immunity against pathogen invasion. PMID:27561012

  14. Bioinspired Development of P(St-MAA)-Avermectin Nanoparticles with High Affinity for Foliage To Enhance Folia Retention.

    PubMed

    Liang, Jie; Yu, Manli; Guo, Liya; Cui, Bo; Zhao, Xiang; Sun, Changjiao; Wang, Yan; Liu, Guoqiang; Cui, Haixin; Zeng, Zhanghua

    2017-08-01

    Pesticides are chemical or biological substances to control pests and protect the crop yield. Most pesticides suffering from large amounts of losses in the environment lead to damage of ecological systems and food pollution. To reduce their losses and increase the utilization rate, we have developed bioinspired mussel avermectin nanoparticles [P(St-MAA)-Av-Cat] with strong adhesion to crop foliage by the emulsion-solvent evaporation method and chemical modification. They were near spheres with a diameter of around 120 nm. They displayed remarkable high avermectin content of more than 50% (w/w) and presented excellent storage stability as well as continuous sustained release. The photosensitive avermectins loaded were highly improved against ultraviolet light. Meanwhile, the retention rate of P(St-MAA)-Av-Cat on the crop foliage surfaces was significantly increased. As a result, the indoor toxicity of P(St-MAA)-Av-Cat was highly enhanced. The adhesive property strongly depended upon the functional groups on the nanoparticle surface. The multimodal binding mode of P(St-MAA)-Av-Cat to the crop foliage surface resulted in stronger adhesion and a longer retention time.

  15. AVS-1357 inhibits melanogenesis via prolonged ERK activation.

    PubMed

    Kim, Dong-Seok; Lee, Hyun-Kyung; Park, Seo-Hyoung; Chae, Chong Hak; Park, Kyoung-Chan

    2009-08-01

    In this study, we demonstrated that a derivative of imidazole, AVS-1357, is a novel skin-whitening compound. AVS-1357 was found to significantly inhibit melanin production in a dose-dependent manner; however, it did not directly inhibit tyrosinase. Furthermore, we found that AVS-1357 induced prolonged activation of extracellular signal-regulated kinase (ERK) and Akt, while it downregulated microphthalmia-associated transcription factor (MITF) and tyrosinase. It has been reported that the activation of ERK and/or Akt is involved in melanogenesis. Therefore, we examined the effects of AVS-1357 on melanogenesis in the absence or presence of PD98059 (a specific inhibitor of the ERK pathway) and/or LY294002 (a specific inhibitor of the Akt pathway). PD98059 dramatically increased melanogenesis, whereas LY294002 had no effect. Furthermore, PD98059 attenuated AVS-1357 induced ERK activation, as well as the downregulation of MITF and tyrosinase. These findings suggest that the effects of AVS-1357 occur via downregulation of MITF and tyrosinase, which is caused by AVS-1357-induced prolonged ERK activation. Taken together, our results indicate that AVS-1357 has the potential as a new skin whitening agent.

  16. Analysis of Aviation Safety Reporting System Incident Data Associated with the Technical Challenges of the System-Wide Safety and Assurance Technologies Project

    NASA Technical Reports Server (NTRS)

    Withrow, Colleen A.; Reveley, Mary S.

    2015-01-01

    The Aviation Safety Program (AvSP) System-Wide Safety and Assurance Technologies (SSAT) Project asked the AvSP Systems and Portfolio Analysis Team to identify SSAT-related trends. SSAT had four technical challenges: advance safety assurance to enable deployment of NextGen systems; automated discovery of precursors to aviation safety incidents; increasing safety of human-automation interaction by incorporating human performance, and prognostic algorithm design for safety assurance. This report reviews incident data from the NASA Aviation Safety Reporting System (ASRS) for system-component-failure- or-malfunction- (SCFM-) related and human-factor-related incidents for commercial or cargo air carriers (Part 121), commuter airlines (Part 135), and general aviation (Part 91). The data was analyzed by Federal Aviation Regulations (FAR) part, phase of flight, SCFM category, human factor category, and a variety of anomalies and results. There were 38 894 SCFM-related incidents and 83 478 human-factorrelated incidents analyzed between January 1993 and April 2011.

  17. Complications of pacemaker therapy in adults with congenital heart disease: a multicenter study.

    PubMed

    Opić, Petra; van Kranenburg, Matthijs; Yap, Sing-Chien; van Dijk, Arie P; Budts, Werner; Vliegen, Hubert W; van Erven, Lieselot; Can, Anil; Sahin, Gulhan; Theuns, Dominic A M J; Witsenburg, Maarten; Roos-Hesselink, Jolien W

    2013-10-09

    This study aims to investigate indications and complications of permanent cardiac pacing in adults with congenital heart disease (CHD). Two-hundred and seventy-four CHD patients were identified who underwent permanent pacemaker implantation between 1972 and 2009. The indication for pacing was acquired sinus node or AV node conduction disease (63%), sinus node or AV node conduction disease after cardiac surgery (28%), and drug/arrhythmia-related indications (9%). Patients with complex CHD received a pacemaker at younger age (23 versus 31 years, p<0.0001) and more often received an epicardial pacing system (51% versus 23%, p<0.0001) compared to those with simple or moderate CHD. Twenty-nine patients (10.6%) had a periprocedural complication during the primary pacemaker implantation (general population: 5.2%). The most common acute complications were lead dysfunction (4.0%), bleeding (2.6%), pocket infection (1.5%) and pneumothorax (1.5%). During a median follow-up of 12 years, pacemaker-related complications requiring intervention occurred in 95 patients (34.6%). The most common late pacemaker-related complications included lead failure (24.8%), pacemaker dysfunction/early battery depletion (5.1%), pacemaker migration (4.7%) and erosion (4.7%). Pacemaker implantation at younger age (<18 years) was an independent predictor of late pacemaker-related complication (adjusted hazard ratio 1.68, 95% confidence interval 1.07 to 2.63, p=0.023). The risk of periprocedural complications seems higher in the CHD population compared to the general population and more than one-third of CHD patients encountered a pacemaker-related complication during long-term follow-up. This risk increases for those who receive a pacemaker at younger age. Crown Copyright © 2013. Published by Elsevier Ireland Ltd. All rights reserved.

  18. Efficient lowering of triglyceride levels in mice by human apoAV protein variants associated with hypertriglyceridemia.

    PubMed

    Vaessen, Stefan F C; Sierts, Jeroen A; Kuivenhoven, Jan Albert; Schaap, Frank G

    2009-02-06

    Variation in the apolipoprotein A5 (APOA5) gene has consistently been associated with increased plasma triglyceride (TG) levels in epidemiological studies. In vivo functionality of these variations, however, has thus far not been tested. Using adenoviral over-expression, we evaluated plasma expression levels and TG-lowering efficacies of wild-type human apoAV, two human apoAV variants associated with increased TG (S19W, G185C) and one variant (Q341H) that is predicted to have altered protein function. Injection of mice with adenovirus encoding wild-type or mutant apoAV resulted in an identical dose-dependent elevation of human apoAV levels in plasma. The increase in apoAV levels resulted in pronounced lowering of plasma TG levels at two viral dosages. Unexpectedly, the TG-lowering efficacy of all three apoAV variants was similar to wild-type apoAV. In addition, no effect on TG-hydrolysis-related plasma parameters (free fatty acids, glycerol and post-heparin lipoprotein lipase activity) was apparent upon expression of all apoAV variants. In conclusion, our data indicate that despite their association with hypertriglyceridemia and/or predicted protein dysfunction, the 19W, 185C and 341H apoAV variants are equally effective in reducing plasma TG levels in mice.

  19. Adrenal Vein Sampling for Conn’s Syndrome: Diagnosis and Clinical Outcomes

    PubMed Central

    Deipolyi, Amy R.; Bailin, Alexander; Wicky, Stephan; Alansari, Shehab; Oklu, Rahmi

    2015-01-01

    Adrenal vein sampling (AVS) is the gold standard test to determine unilateral causes of primary aldosteronism (PA). We have retrospectively characterized our experience with AVS including concordance of AVS results and imaging, and describe the approach for the PA patient in whom bilateral AVS is unsuccessful. We reviewed the medical records of 85 patients with PA and compared patients who were treated medically and surgically on pre-procedure presentation and post-treatment outcomes, and evaluated how technically unsuccessful AVS results were used in further patient management. Out of the 92 AVS performed in 85 patients, AVS was technically successful bilaterally in 58 (63%) of cases. Either unsuccessful AVS prompted a repeat AVS, or results from the contralateral side and from CT imaging were used to guide further therapy. Patients who were managed surgically with adrenalectomy had higher initial blood pressure and lower potassium levels compared with patients who were managed medically. Adrenalectomy results in significantly decreased blood pressure and normalization of potassium levels. AVS can identify surgically curable causes of PA, but can be technically challenging. When one adrenal vein fails to be cannulated, results from the contralateral vein can be useful in conjunction with imaging and clinical findings to suggest further management. PMID:26854152

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

    Brown, A.; Repac, B.; Gonder, J.

    This poster presents initial estimates of the net energy impacts of automated vehicles (AVs). Automated vehicle technologies are increasingly recognized as having potential to decrease carbon dioxide emissions and petroleum consumption through mechanisms such as improved efficiency, better routing, lower traffic congestion, and by enabling advanced technologies. However, some effects of AVs could conceivably increase fuel consumption through possible effects such as longer distances traveled, increased use of transportation by underserved groups, and increased travel speeds. The net effect on petroleum use and climate change is still uncertain. To make an aggregate system estimate, we first collect best estimates formore » the energy impacts of approximately ten effects of AVs. We then use a modified Kaya Identity approach to estimate the range of aggregate effects and avoid double counting. We find that depending on numerous factors, there is a wide range of potential energy impacts. Adoption of automated personal or shared vehicles can lead to significant fuel savings but has potential for backfire.« less

  1. Acute hypersensitivity reactions associated with administration of crotalidae polyvalent immune Fab antivenom.

    PubMed

    Cannon, Robert; Ruha, Anne-Michelle; Kashani, John

    2008-04-01

    Acute hypersensitivity reactions are well known to occur with the administration of the Antivenin (Crotalidae) Polyvalent (Wyeth Laboratories, Marietta, PA). Crotalidae polyvalent immune Fab (ovine) (CroFab; FabAV, Protherics, Inc., Brentwood, TN) was introduced in 2001, and early studies reported a hypersensitivity reaction rate up to 19%. We describe the incidence of acute hypersensitivity reactions to FabAV in patients bitten by rattlesnakes. This was a nonconcurrent observational cohort study, with data obtained by chart review of all patients admitted to our service for rattlesnake bites from July 2000 to June 2004. The study was conducted at an urban Level I trauma center and urban children's hospital. All patients treated with FabAV were included. Those who received no antivenom or who were treated with Antivenin (Crotalidae) Polyvalent were excluded. The main outcome variable was whether an acute hypersensitivity reaction developed. Ninety-three patients were included in the review (72 male and 21 female patients). The mean age was 34.5 years (range 16 months to 91 years), and the mean dose of antivenom was 12 vials (range 4 to 32 vials). The incidence of acute hypersensitivity reactions was 5 of 93, or 5.4%. Four patients developed a mild reaction that was easily treated and were able to finish the full course of antivenom. Only 1 patient developed a reaction that prevented further antivenom administration. FabAV appears to be associated with a lower incidence of acute hypersensitivity than initially reported. Most reactions are mild and easily treated and do not preclude further dosing of antivenom.

  2. Importance of equilibration time in the partitioning and toxicity of zinc in spiked sediment bioassays

    USGS Publications Warehouse

    Lee, J.-S.; Lee, B.-G.; Luoma, S.N.; Yoo, H.

    2004-01-01

    The influences of spiked Zn concentrations (1-40 ??mol/g) and equilibration time (???95 d) on the partitioning of Zn between pore water (PW) and sediment were evaluated with estuarine sediments containing two levels (5 and 15 ??mol/g) of acid volatile sulfides (AVS). Their influence on Zn bioavailability was also evaluated by a parallel, 10-d amphipod (Leptocheirus plumulosus) mortality test at 5, 20, and 85 d of equilibration. During the equilibration, AVS increased (up to twofold) with spiked Zn concentration ([Zn]), whereas Zn-simultaneously extracted metals ([SEM]; Zn with AVS) remained relatively constant. Concentrations of Zn in PW decreased most rapidly during the initial 30 d and by 11- to 23-fold during the whole 95-d equilibration period. The apparent partitioning coefficient (Kpw, ratio of [Zn] in SEM to PW) increased by 10- to 20-fold with time and decreased with spiked [Zn] in sediments. The decrease of PW [Zn] could be explained by a combination of changes in AVS and redistribution of Zn into more insoluble phases as the sediment aged. Amphipod mortality decreased significantly with the equilibration time, consistent with decrease in dissolved [Zn]. The median lethal concentration (LC50) value (33 ??M) in the second bioassay, conducted after 20 d of equilibration, was twofold the LC50 in the initial bioassay at 5 d of equilibration, probably because of the change of dissolved Zn speciation. Sediment bioassay protocols employing a short equilibration time and high spiked metal concentrations could accentuate partitioning of metals to the dissolved phase and shift the pathway for metal exposure toward the dissolved phase.

  3. Using EEG and stimulus context to probe the modelling of auditory-visual speech.

    PubMed

    Paris, Tim; Kim, Jeesun; Davis, Chris

    2016-02-01

    We investigated whether internal models of the relationship between lip movements and corresponding speech sounds [Auditory-Visual (AV) speech] could be updated via experience. AV associations were indexed by early and late event related potentials (ERPs) and by oscillatory power and phase locking. Different AV experience was produced via a context manipulation. Participants were presented with valid (the conventional pairing) and invalid AV speech items in either a 'reliable' context (80% AVvalid items) or an 'unreliable' context (80% AVinvalid items). The results showed that for the reliable context, there was N1 facilitation for AV compared to auditory only speech. This N1 facilitation was not affected by AV validity. Later ERPs showed a difference in amplitude between valid and invalid AV speech and there was significant enhancement of power for valid versus invalid AV speech. These response patterns did not change over the context manipulation, suggesting that the internal models of AV speech were not updated by experience. The results also showed that the facilitation of N1 responses did not vary as a function of the salience of visual speech (as previously reported); in post-hoc analyses, it appeared instead that N1 facilitation varied according to the relative time of the acoustic onset, suggesting for AV events N1 may be more sensitive to the relationship of AV timing than form. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.

  4. Do gender differences in audio-visual benefit and visual influence in audio-visual speech perception emerge with age?

    PubMed Central

    Alm, Magnus; Behne, Dawn

    2015-01-01

    Gender and age have been found to affect adults’ audio-visual (AV) speech perception. However, research on adult aging focuses on adults over 60 years, who have an increasing likelihood for cognitive and sensory decline, which may confound positive effects of age-related AV-experience and its interaction with gender. Observed age and gender differences in AV speech perception may also depend on measurement sensitivity and AV task difficulty. Consequently both AV benefit and visual influence were used to measure visual contribution for gender-balanced groups of young (20–30 years) and middle-aged adults (50–60 years) with task difficulty varied using AV syllables from different talkers in alternative auditory backgrounds. Females had better speech-reading performance than males. Whereas no gender differences in AV benefit or visual influence were observed for young adults, visually influenced responses were significantly greater for middle-aged females than middle-aged males. That speech-reading performance did not influence AV benefit may be explained by visual speech extraction and AV integration constituting independent abilities. Contrastingly, the gender difference in visually influenced responses in middle adulthood may reflect an experience-related shift in females’ general AV perceptual strategy. Although young females’ speech-reading proficiency may not readily contribute to greater visual influence, between young and middle-adulthood recurrent confirmation of the contribution of visual cues induced by speech-reading proficiency may gradually shift females AV perceptual strategy toward more visually dominated responses. PMID:26236274

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

    Schmelter, Christopher, E-mail: christopher.schmelter@klinikum-ingolstadt.de; Raab, Udo, E-mail: udo.raab@klinikum-ingolstadt.de; Lazarus, Friedrich, E-mail: friedrich.lazarus@klinikum-ingolstadt.de

    PurposeThe study was designed to assess outcomes of arteriovenous (AV) accesses after interventional stent-graft deployment in haemodialysis patients.Materials and Methods63 haemodialysis patients with 66 AV fistulas and AV grafts were treated by interventional stent-graft deployment from 2006 to 2012 at our hospital. Data of these patients were retrospectively analysed for location of deployed stent-grafts, occurrence and location of (re-)stenosis and (re-)thrombosis. Complex stenosis was the most frequent indication for stent-graft deployment (45.5 %), followed by complications of angioplasty with vessel rupture or dissection (31.8 %).ResultsA high rate of procedural success was achieved (98.5 %). The most frequent location of the deployed stent-graft wasmore » the draining vein (66.7 %). Stent-graft deployment was more frequent in AV grafts than in AV fistulas. Primary patency was 45.5 % at 6 month, 31.3 % at 12 month and 19.2 % at 24 month. Primary patency was significantly better for AV fistulas than for AV grafts with deployed stent-grafts. Patency of the deployed stent-graft was much better than overall AV access primary patency with deployed stent-graft. Re-stenosis with thrombosis was the most frequent indication for re-intervention. Most frequent location of re-stenosis was the draining vein (37.1 %), followed by stenosis at the AV access (29.5 %) and the deployed stent-graft (23.5 %).ConclusionRe-stenosis and re-thrombosis remain frequent in AV fistulas and AV grafts in haemodialysis patients despite stent-graft deployment. Re-stenosis of the deployed stent-graft is, only in the minority of the cases, responsible for AV access dysfunction.« less

  6. Differential gene expression profiles of β-defensins in the crop, intestine, and spleen using a necrotic enteritis model in 2 commercial broiler chicken lines.

    PubMed

    Hong, Y H; Song, W; Lee, S H; Lillehoj, H S

    2012-05-01

    Changes in the expression levels of avian β-defensin (AvBD) mRNA were evaluated in necrotic enteritis (NE) disease model in 2 genetically disparate commercial broiler chicken lines: Ross and Cobb. The NE was initiated in the gut by a previously established co-infection model using oral Eimeria maxima infection followed by a Clostridium perfringens challenge. Among the 14 AvBD types examined, there was a tissue-specific expression of AvBD transcripts: AvBD1, AvBD7, and AvBD9 in the crop; AvBD8, AvBD10, and AvBD13; in the intestine and AvBD1 and AvBD7 in the spleen. The 2 different commercial broiler chicken lines showed differential gene expression patterns of AvBD transcripts following co-infection with E. maxima and C. perfringens, with R-line chickens generally showing higher expression levels than the C strain. Both chicken strains showed enhanced gene expression levels of proinflammatory cytokines, such as IL-1β, IL-6, IL-17F, and TNFSF15 in spleen, and TNFSF15 in intestine, whereas IL-17F was significantly increased only in the intestine of R-line chickens following NE infection. Although the exact nature of interactions between defensins and cytokines in determining the outcome of host innate immune responses to the pathogens of NE remains to be investigated, the differences in gene expression levels of β-defensins and proinflammatory cytokines in the intestine, crop, and spleen could explain the predisposed disease resistance and susceptibility to NE in the 2 commercial broiler chicken lines.

  7. Adrenal vein sampling in primary aldosteronism: concordance of simultaneous vs sequential sampling.

    PubMed

    Almarzooqi, Mohamed-Karji; Chagnon, Miguel; Soulez, Gilles; Giroux, Marie-France; Gilbert, Patrick; Oliva, Vincent L; Perreault, Pierre; Bouchard, Louis; Bourdeau, Isabelle; Lacroix, André; Therasse, Eric

    2017-02-01

    Many investigators believe that basal adrenal venous sampling (AVS) should be done simultaneously, whereas others opt for sequential AVS for simplicity and reduced cost. This study aimed to evaluate the concordance of sequential and simultaneous AVS methods. Between 1989 and 2015, bilateral simultaneous sets of basal AVS were obtained twice within 5 min, in 188 consecutive patients (59 women and 129 men; mean age: 53.4 years). Selectivity was defined by adrenal-to-peripheral cortisol ratio ≥2, and lateralization was defined as an adrenal aldosterone-to-cortisol ratio ≥2, the contralateral side. Sequential AVS was simulated using right sampling at -5 min (t = -5) and left sampling at 0 min (t = 0). There was no significant difference in mean selectivity ratio (P = 0.12 and P = 0.42 for the right and left sides respectively) and in mean lateralization ratio (P = 0.93) between t = -5 and t = 0. Kappa for selectivity between 2 simultaneous AVS was 0.71 (95% CI: 0.60-0.82), whereas it was 0.84 (95% CI: 0.76-0.92) and 0.85 (95% CI: 0.77-0.93) between sequential and simultaneous AVS at respectively -5 min and at 0 min. Kappa for lateralization between 2 simultaneous AVS was 0.84 (95% CI: 0.75-0.93), whereas it was 0.86 (95% CI: 0.78-0.94) and 0.80 (95% CI: 0.71-0.90) between sequential AVS and simultaneous AVS at respectively -5 min at 0 min. Concordance between simultaneous and sequential AVS was not different than that between 2 repeated simultaneous AVS in the same patient. Therefore, a better diagnostic performance is not a good argument to select the AVS method. © 2017 European Society of Endocrinology.

  8. Audiovisual Vowel Monitoring and the Word Superiority Effect in Children

    ERIC Educational Resources Information Center

    Fort, Mathilde; Spinelli, Elsa; Savariaux, Christophe; Kandel, Sonia

    2012-01-01

    The goal of this study was to explore whether viewing the speaker's articulatory gestures contributes to lexical access in children (ages 5-10) and in adults. We conducted a vowel monitoring task with words and pseudo-words in audio-only (AO) and audiovisual (AV) contexts with white noise masking the acoustic signal. The results indicated that…

  9. Evolving Practice Trends of Aortic Root Surgery in North America.

    PubMed

    Caceres, Manuel; Ma, Yicheng; Rankin, J Scott; Saha-Chaudhuri, Paramita; Gammie, James S; Suri, Rakesh M; Thourani, Vinod H; Englum, Brian R; Esmailian, Fardad; Czer, Lawrence S; Puskas, John D; Svensson, Lars G

    2014-08-19

    Aortic-valve sparing (AVS) techniques have emerged as alternatives to composite graft-valve replacement (CVR) for treatment of aortic root aneurysm. This study analyzed recent practice trends of aortic root surgery using the Society of Thoracic Surgeons database. From January 2000 through June 2011, 31,747, Overall patients received AVS (n=3,585/31,747; 11.3%) or CVR (n=28,162/31,747; 88.7%). A High-Risk Subgroup was defined as: age >75 years, endocarditis, aortic stenosis, dialysis, multi-valve surgery, valve reoperation, or emergency/salvage status, and high-risk patients were less likely to receive AVS (n=20,356/31,747 [64.1%]; 6% AVS; unadjusted operative mortality 10.5% AVS and 11.7% CVR). The remaining patients comprised a Low-Risk Subgroup, in which AVS was more common (n=11,388/31,747 [35.9%]; 21% AVS; unadjusted operative mortality 1.4% AVS and 3.1% CVR). Procedural changes over 3 equal time periods (P1-P2-P3) were evaluated by Cochran-Armitage trends analysis. Compared to AVS, Overall CVR patients had worse baseline risk profiles and higher unadjusted operative mortality. In High-Risk patients, AVS mortality was comparable to CVR (10.5% vs 11.7%, p=0.19), but AVS mortality was lower in the Low-Risk group (1.4% vs 3%, p<0.0001). For P1/P2/P3, AVS percentages and trend p-values were: High-Risk (6%/6%/7%, p=0.26) and Low-Risk (12%/21%/25%, p<0.0001). CVR prosthesis type (mechanical/bioprosthesis/homograft) also changed: P1 (63%/22%/15%), P2 (58%/38%/4%), and P3 (53%/44%/3%) (all p<0.0001, except mechanical valves in High-Risk patients p=0.18). Patients receiving CVR tended to have higher risk profiles. AVS increased over time in Low-Risk patients while bioprostheses increased in CVR. Favorable outcomes support the trend toward further expansion of AVS. Copyright © 2014 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  10. Graduate Student Researchers Program (GSRP)

    NASA Technical Reports Server (NTRS)

    Westerhoff, John

    2004-01-01

    An advanced concept in in-space transportation currently being studied is the Momentum-Exchange/Electrodynamic Reboost Tether System (MXER). The MXER system is a permanently orbiting platform designed to boost payloads from low earth orbit (LEO). Unlike conventional rockets that use propellants, MXER acts as a large momentum wheel, imparting a Av to a payload at the expense of its own orbital energy. After throwing a payload, the system reboosts itself using an electrodynamic tether to push against Earth s magnetic field and brings itself back up to an operational orbit to prepare for the next payload. The ability to reboost itself allows for continued reuse of the system without the expenditure of propellants. Considering the cost of lifting propellant from the ground to LEO to do the same Av boost at $10000 per pound, the system cuts the launch cost of the payload dramatically, and subsequently, the MXER system pays for itself after a small number of missions. As such, this technology is a valuable addition to NASA s mission for in-space transportation.

  11. The Efficacy of Crotalidae Polyvalent Immune Fab (Ovine) Antivenom Versus Placebo Plus Optional Rescue Therapy on Recovery From Copperhead Snake Envenomation: A Randomized, Double-Blind, Placebo-Controlled, Clinical Trial.

    PubMed

    Gerardo, Charles J; Quackenbush, Eugenia; Lewis, Brandon; Rose, S Rutherfoord; Greene, Spencer; Toschlog, Eric A; Charlton, Nathan P; Mullins, Michael E; Schwartz, Richard; Denning, David; Sharma, Kapil; Kleinschmidt, Kurt; Bush, Sean P; Ryan, Samantha; Gasior, Maria; Anderson, Victoria E; Lavonas, Eric J

    2017-08-01

    Copperhead snake (Agkistrodon contortrix) envenomation causes limb injury resulting in pain and disability. It is not known whether antivenom administration improves limb function. We determine whether administration of antivenom improves recovery from limb injury in patients envenomated by copperhead snakes. From August 2013 through November 2015, we performed a multicenter, randomized, double-blind, placebo-controlled, clinical trial to evaluate the effect of ovine Crotalidae polyvalent immune Fab (ovine) (CroFab; FabAV) antivenom therapy on recovery of limb function in patients with copperhead snake envenomation at 14 days postenvenomation. The study setting was 18 emergency departments in regions of the United States where copperhead snakes are endemic. Consecutive patients aged 12 years or older with mild- to moderate-severity envenomation received either FabAV or placebo. The primary outcome was limb function 14 days after envenomation, measured by the Patient-Specific Functional Scale. Additional outcomes included the Patient-Specific Functional Scale at other points; the Disorders of the Arm, Shoulder, and Hand, Lower Extremity Functional Scale, and Patient's Global Impression of Change instruments; grip strength; walking speed; quality of life (Patient-Reported Outcomes Measurement Information System Physical Fucntion-10); pain; and analgesic use. Seventy-four patients received study drug (45 FabAV, 29 placebo). Mean age was 43 years (range 12 to 86 years). Fifty-three percent were men, 62% had lower extremity envenomation, and 88% had mild initial severity. The primary outcome, the least square mean Patient-Specific Functional Scale score at 14 days postenvenomation, was 8.6 for FabAV-treated subjects and 7.4 for placebo recipients (difference 1.2; 95% confidence interval 0.1 to 2.3; P=.04). Additional outcome assessments generally favored FabAV. More FabAV-treated subjects experienced treatment-emergent adverse events (56% versus 28%), but few were serious (1 in each group). Treatment with FabAV reduces limb disability measured by the Patient-Specific Functional Scale 14 days after copperhead envenomation. Copyright © 2017 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

  12. SU-E-J-235: Audiovisual Biofeedback Improves the Correlation Between Internal and External Respiratory Motion

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

    Lee, D; Pollock, S; Keall, P

    Purpose: External respiratory surrogates are often used to predict internal lung tumor motion for beam gating but the assumption of correlation between external and internal surrogates is not always verified resulting in amplitude mismatch and time shift. To test the hypothesis that audiovisual (AV) biofeedback improves the correlation between internal and external respiratory motion, in order to improve the accuracy of respiratory-gated treatments for lung cancer radiotherapy. Methods: In nine lung cancer patients, 2D coronal and sagittal cine-MR images were acquired across two MRI sessions (pre- and mid-treatment) with (1) free breathing (FB) and (2) AV biofeedback. External anterior-posterior (AP)more » respiratory motions of (a) chest and (b) abdomen were simultaneously acquired with physiological measurement unit (PMU, 3T Skyra, Siemens Healthcare Erlangen, Germany) and real-time position management (RPM) system (Varian, Palo Alto, USA), respectively. Internal superior-inferior (SI) respiratory motions of (c) lung tumor (i.e. centroid of auto-segmented lung tumor) and (d) diaphragm (i.e. upper liver dome) were measured from individual cine-MR images across 32 dataset. The four respiratory motions were then synchronized with the cine-MR image acquisition time. Correlation coefficients were calculated in the time variation of two nominated respiratory motions: (1) chest-abdomen, (2) abdomen-diaphragm and (3) diaphragm-lung tumor. The three combinations were compared between FB and AV biofeedback. Results: Compared to FB, AV biofeedback improved chest-abdomen correlation by 17% (p=0.005) from 0.75±0.23 to 0.90±0.05 and abdomen-diaphragm correlation by 4% (p=0.058) from 0.91±0.11 to 0.95±0.05. Compared to FB, AV biofeedback improved diaphragm-lung tumor correlation by 12% (p=0.023) from 0.65±0.21 to 0.74±0.16. Conclusions: Our results demonstrated that AV biofeedback significantly improved the correlation of internal and external respiratory motion, thus suggesting the need of AV biofeedback in respiratory-gated treatments.« less

  13. Genomic sequence of Heliothis virescens ascovirus 3g isolated from Spodoptera exigua.

    PubMed

    Huang, Guo-Hua; Wang, Yun-Sheng; Wang, Xing; Garretson, Tyler A; Dai, Liang-Ying; Zhang, Chuan-Xi; Cheng, Xiao-Wen

    2012-11-01

    Heliothis virescens ascovirus 3a (HvAV-3a), a member of the family Ascoviridae, has the highest diversity among ascovirus species that have been reported in Australia, Indonesia, China, and the United States. To understand the diversity and origin of this important ascovirus, the complete genome of the HvAV Indonesia strain (HvAV-3g), isolated from Spodoptera exigua, was determined to be 199,721 bp, with a G+C content of 45.9%. Therefore, HvAV-3g has the largest genome among the reported ascovirus genomes to date. There are 194 predicted open reading frames (ORFs) encoding proteins of 50 or more amino acid residues. In comparison to HvAV-3e reported from Australia, HvAV-3g has all the ORFs in HvAV-3e with 6 additional ORFs unique to HvAV-3g, including 1 peptidase C26 gene with the highest identity to Drosophila spp. and 2 gas vesicle protein U (GvpU) genes with identities to Bacillus megaterium. The five unique homologous regions (hrs) and 25 baculovirus repeat ORFs (bro) of HvAV-3g are highly variable.

  14. 8D.04: CLINICAL BENEFITS OF ADMINISTERING SUPER-SELECTIVE SEGMENTAL ADRENAL VENOUS SAMPLING AND PERFORMING ADRENAL SPARING SURGERY IN THE PATIENTS WITH PRIMARY ALDOSTERONISM.

    PubMed

    Satoh, F; Morimoto, R; Ono, Y; Iwakura, Y; Omata, K; Kudo, M; Satani, N; Ota, H; Seiji, K; Takase, K; Nakamura, Y; Sasano, H; Ito, S

    2015-06-01

    Adrenal venous sampling (AVS) has been well known to play pivotal roles in clinical differential diagnosis of unilateral aldosterone producing adenoma (APA) from bilateral idiopathic hyperaldosteronism (IHA). However, it is also true that a central vein AVS or c-AVS which collects the blood from right and left central adrenal veins can by no means discriminate bilateral APA from BHA. There have been no published studies reporting the reliable clinical differential diagnosis between bilateral APA and IHA, especially IHA cases with bilateral non-functioning adenomas (NFA), which has been considered practically impossible in clinical differential diagnosis. As an attempt to this clinical dilemma, segmental AVS (S-AVS), which could evaluate segmental effluents from adrenal tributary veins, has been recently developed. We have performed S-AVS in these patients above following C-AVS, via the insertion of a microcatheter in up to three intra-adrenal first-degree tributary veins on bilateral adrenals. S-AVS did enable us to evaluate the intra-adrenal localization of corticosteroidogenesis. These data did indicate that S-AVS should be performed in the PA patients who had increased aldosterone levels in bilateral central vein and demonstrated space occupying lesions in the bilateral adrenals in order to avoid bilateral adrenalectomy or long lasting medical treatment toward persistent PA. In addition to the situations above, we have administere S-AVS to the following patients; those who had clinically suspected APA but not sufficiently high lateralization indexes according to the results of C-AVS, very young ones with higher clinical probability of recurrence and those who could benefit from partial adrenalectomy by demonstrating the sites of specific steroidogenesis. However, it is also entirely true that S-AVS is more expensive, time-consuming and labor-intensive compared to C-AVS.(Figure is included in full-text article.)The angiography during S-AVS (A, B), the coronal CT image (C), and the data in external iliac vein (EIV), each central vein (1, 4) and each tributary vein (2, 3, 5, 6) of 66 year-old male patient with bilateral APAs. We should carefully select the candidate patients who should undergo S-AVS, which will give a benefit to themselves by demonstrating intra-adrenal steroidogenesis for a safer preserving adrenalectomy.

  15. Differential games in economic systems with delays

    NASA Astrophysics Data System (ADS)

    Kim, A. V.; Kormyshev, V. M.; Novikov, M. Yu.; Nikonov, M. A.

    2017-11-01

    In the paper, we consider application of i-smooth analysis (A.V. Kim, 2015) to differential games with delays in economics (Dockner E.J., et all, 2000; R. Isaacs, 1999). The approach is developed in the framework of the theory of positional differential games (N.N. Krasovskii, A.I. Subbotin, 1988; A.V. Kryazhimskii, Yu.S. Osipov, 1973; Yu.S. Osipov, J. Appl. Math. Mech. Vol. 35, № 1, № 6, 1971) and is based on application of the extremal shift strategy. We consider basic notions and constructions of the approach-evasion problem for linear systems with delays. The necessary and sufficient conditions of solvability the approach-evasion problem in terms of special u-stable sets are presented in another paper.

  16. On control of systems delays in economics

    NASA Astrophysics Data System (ADS)

    Kim, A. V.; Kormyshev, V. M.; Novikov, M. Yu.; Nikonov, M. A.

    2017-11-01

    The paper continues presentation of the differential game theory for systems with delays and is devoted to the solution of an approach problem in application to economic problems (Dockner E.J., et all, 2000; R. Isaacs, 1999). The results are obtained in the framework of the positional differential game theory (N.N. Krasovskii, A.I. Subbotin, 1988; A.V. Kryazhimskii, Yu.S. Osipov, 1973; Yu.S. Osipov, J. Appl. Math. Mech. Vol. 35, № 1, № 6, 1971) with application of the i-smooth analysis methodology (A.V. Kim, 2015). Effective construction of extremal positional control is based on the utilization of the so called u-stable sets The necessary and sufficient conditions of high u-stability are presented in the paper.

  17. An Improved Azimuth Angle Estimation Method with a Single Acoustic Vector Sensor Based on an Active Sonar Detection System.

    PubMed

    Zhao, Anbang; Ma, Lin; Ma, Xuefei; Hui, Juan

    2017-02-20

    In this paper, an improved azimuth angle estimation method with a single acoustic vector sensor (AVS) is proposed based on matched filtering theory. The proposed method is mainly applied in an active sonar detection system. According to the conventional passive method based on complex acoustic intensity measurement, the mathematical and physical model of this proposed method is described in detail. The computer simulation and lake experiments results indicate that this method can realize the azimuth angle estimation with high precision by using only a single AVS. Compared with the conventional method, the proposed method achieves better estimation performance. Moreover, the proposed method does not require complex operations in frequencydomain and achieves computational complexity reduction.

  18. Prevention of DVT after orthopaedic surgery: the A-V Impulse System.

    PubMed

    Turnbull, Betty

    Deep vein thrombosis (DVT) is a major health problem, which affects 1 in 1000 people in the general population each year. It may be asymptomatic or cause swelling and pain, and can lead to potentially fatal complications. Immobilisation following bone surgery significantly increases the risk of DVT, and prevention is a salient goal for nursing. This article reviews the pathogenesis of DVT, and therapeutic venous thromboembolic prophylaxis in the prevention of DVT following orthopaedic surgery. Best nursing practice is outlined from management of the Arteriovenous (A-V) Impulse System(R), the advent of which has had a positive impact on the incidence of DVT following orthopaedic surgery but requires further research to substantiate its effectiveness and determine patient acceptability.

  19. Diagnosis of aerobic vaginitis by quantitative real-time PCR.

    PubMed

    Rumyantseva, T A; Bellen, G; Savochkina, Y A; Guschin, A E; Donders, G G G

    2016-07-01

    To evaluate a real-time PCR-based technique to quantify bacteria associated with aerobic vaginitis (AV) as a potential test. Vaginal samples from 100 women were tested by wet-mount microscopy, gram stain and quantitative real-time PCR targeting Enterobacteriacea, Staphylococcus spp., Streptococcus spp., Enterococcus spp., Escherichia coli, Streptococcus agalactiae, S. aureus; Lactobacillus spp. AV diagnosis obtained by wet-mount microscopy was used as reference. Some level of AV was diagnosed in 23 (23.7 %) cases. Various concentrations of Enterobacteriacea, Staphylococcus spp., Streptococcus spp. were detected an all patients. Enterococcus spp. were detected in 76 (78.3 %) cases. Summarized concentrations of aerobes were tenfold higher in AV-positive compared to AV-negative cases [7.30lg vs 6.06lg (p = 0.02)]. Concentrations of aerobes in severe, moderate and light AV cases did not vary significantly (p = 0.14). Concentration of lactobacilli was 1000-fold lower in AV-positive cases compared to normal cases (5.3lg vs 8.3lg, p < 0.0001). Streptococcus spp. dominated in the majority of AV-positive cases [19/22 (86.4 %) samples]. The relation of high loads of aerobes to the low numbers of Lactobacilli are a reliable marker for the presence of AV and could substitute microscopy as a test. PCR may be a good standardized substitution for AV diagnosis in settings where well-trained microscopists are lacking.

  20. Is it useful to repeat an adrenal venous sampling in patients with primary hyperaldosteronism?

    PubMed

    Bouhanick, B; Delchier, M-C; Fauvel, J; Rousseau, H; Amar, J; Chamontin, B

    2014-02-01

    Adrenal venous sampling (AVS) is a challenging technical procedure and few patients had AVS procedure twice. To evaluate the reproducibility of the AVS, why AVS were repeated and the conclusions drawn from them. From 1997-2012, 12 patients underwent two AVS. A cortisol level in the adrenal vein greater than or equal to 1.1 to inferior vena cava defined a successful catheterization and a lateralization of secretion corresponded to an aldosterone-to-cortisol vein ratio greater than or equal to 2 between the one side to another. The same side of lateralization of secretion was found in 75% of them. The second AVS were due to technical failure (n=4), unproven lateralization (n=2), a lateralization opposite to the main nodule and ipsilateral to hyperplasia (n=4) on first AVS. For two patients, as the CT was normal, AVS was required again. The second AVS was successful in all patients, including those with an initial technical failure but only patient with technical failure underwent surgery, as BP and kaliemia were controlled. Lateralization on the side of hyperplasia or opposite to the biggest nodule was confirmed in two of four cases. When AVS is unsuccessful for technical reasons, it is worth doing it again but after being sure that surgery is still possibly indicated. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  1. Neural networks supporting audiovisual integration for speech: A large-scale lesion study.

    PubMed

    Hickok, Gregory; Rogalsky, Corianne; Matchin, William; Basilakos, Alexandra; Cai, Julia; Pillay, Sara; Ferrill, Michelle; Mickelsen, Soren; Anderson, Steven W; Love, Tracy; Binder, Jeffrey; Fridriksson, Julius

    2018-06-01

    Auditory and visual speech information are often strongly integrated resulting in perceptual enhancements for audiovisual (AV) speech over audio alone and sometimes yielding compelling illusory fusion percepts when AV cues are mismatched, the McGurk-MacDonald effect. Previous research has identified three candidate regions thought to be critical for AV speech integration: the posterior superior temporal sulcus (STS), early auditory cortex, and the posterior inferior frontal gyrus. We assess the causal involvement of these regions (and others) in the first large-scale (N = 100) lesion-based study of AV speech integration. Two primary findings emerged. First, behavioral performance and lesion maps for AV enhancement and illusory fusion measures indicate that classic metrics of AV speech integration are not necessarily measuring the same process. Second, lesions involving superior temporal auditory, lateral occipital visual, and multisensory zones in the STS are the most disruptive to AV speech integration. Further, when AV speech integration fails, the nature of the failure-auditory vs visual capture-can be predicted from the location of the lesions. These findings show that AV speech processing is supported by unimodal auditory and visual cortices as well as multimodal regions such as the STS at their boundary. Motor related frontal regions do not appear to play a role in AV speech integration. Copyright © 2018 Elsevier Ltd. All rights reserved.

  2. The analysis of forms of sulfur in ancient sediments and sedimentary rocks: comments and cautions

    USGS Publications Warehouse

    Rice, C.A.; Tuttle, M.L.; Reynolds, R.L.

    1993-01-01

    Assumptions commonly made during analysis of the amount of monosulfides [acid-volatile sulfides (AVS)] and disulfides in modern sediments, may not be valid for ancient sedimentary rocks. It is known that ferric iron can oxidize H2S during AVS analysis unless a reducing agent such as stannous chloride is added to the treatment. In addition, some monosulfides such as greigite and pyrrhotite require heat during the AVS analysis in order to dissolve completely. However, the use of heat and/or stannous chloride in the AVS treatment may partially dissolve disulfides and it is generally recommended that stannous chloride not be used in the AVS treatment for modern sediments. Most of the monosulfides are assumed to be recovered as AVS without the addition of stannous chloride. This study investigates the recovery of monosulfides during sulfur speciation analysis with application to ancient sedimentary rocks. Sulfur in samples containing naturally occurring greigite and mackinawite or pyrite was measured using variations of a common sulfur-speciation scheme. The sulfur-speciation scheme analyzes for monosulfide sulfur, disulfide sulfur, elemental sulfur, inorganic sulfate and organically bound sulfur. The effects of heat, stannous chloride and ferric iron on the amounts of acid-volatile sulfide and disulfide recovered during treatment for AVS were investigated. Isotopic compositions of the recovered sulfur species along with yields from an extended sulfur-speciation scheme were used to quantify the effects. Hot 6 N HCl AVS treatment recovers > 60% of the monosulfides as AVS in samples containing pure greigite and mackinawite. The remaining monosulfide sulfur is recovered in a subsequent elemental sulfur extraction. Hot 6 N HCl plus stannous chloride recovers 100% of the monosulfides as AVS. The addition of ferric iron to pure greigite and mackinawite samples during AVS treatment without stannous chloride decreased the amount of monosulfides recovered as AVS and, if present in great enough concentration, oxidized some of the AVS to a form not recovered in later treatments. The hot stannous chloride AVS treatments dissolve <5% of well-crystallized pyrite in this study. The amount of pyrite dissolved depends on grain size and crystallinity. Greigite in ancient sedimentary rocks was quantitatively recovered as AVS only with hot 6 N HCl plus stannous chloride. Hot 6 N HCl AVS treatment of these rocks did not detect any monosulfides in most samples. A subsequent elemental sulfur extraction did not completely recover the oxidized monosulfides. Therefore, the use of stannous chloride plus heat is recommended in the AVS treatment of ancient sedimentary rocks if monosulfides are present and of interest. All assumptions about the amount of monosulfides and disulfides recovered with the sulfur-speciation scheme used should be verified by extended sulfur-speciation and/or isotopic analysis of the species recovered. ?? 1993.

  3. The social dilemma of autonomous vehicles.

    PubMed

    Bonnefon, Jean-François; Shariff, Azim; Rahwan, Iyad

    2016-06-24

    Autonomous vehicles (AVs) should reduce traffic accidents, but they will sometimes have to choose between two evils, such as running over pedestrians or sacrificing themselves and their passenger to save the pedestrians. Defining the algorithms that will help AVs make these moral decisions is a formidable challenge. We found that participants in six Amazon Mechanical Turk studies approved of utilitarian AVs (that is, AVs that sacrifice their passengers for the greater good) and would like others to buy them, but they would themselves prefer to ride in AVs that protect their passengers at all costs. The study participants disapprove of enforcing utilitarian regulations for AVs and would be less willing to buy such an AV. Accordingly, regulating for utilitarian algorithms may paradoxically increase casualties by postponing the adoption of a safer technology. Copyright © 2016, American Association for the Advancement of Science.

  4. Slow Pathway Radiofrequency Ablation Using Magnetic Navigation: A Description of Technique and Retrospective Case Analysis.

    PubMed

    Bhaskaran, Abhishek; Albarri, Maha; Ross, Neil; Al Raisi, Sara; Samanta, Rahul; Roode, Leonette; Nadri, Fazlur; Ng, Jeanette; Thomas, Stuart; Thiagalingam, Aravinda; Kovoor, Pramesh

    2017-12-01

    The Magnetic Navigation System (MNS) catheter was shown to be stable in the presence of significant cardiac wall motion and delivered more effective lesions compared to manual control. This stability could potentially make AV junctional re-entrant tachycardia (AVNRT) ablation safer. The aim of this study is to describe the method of mapping and ablation of AVNRT with MNS and 3-D electro-anatomical mapping system (CARTO, Biosense Webster, Diamond bar, CA, USA) anatomical mapping, with a view to improve the safety of ablation. The method of precise mapping and ablation with MNS is described. Consecutive AVNRT cases (n=30) from 2012 January to 2015 November, in which magnetic navigation was used, are analysed. Ablation was successful in 27 (90%) out of 30 patients. In three cases, ablation was abandoned due to the proximity of the three-dimensional His image to the potential ablation site. No complications, including AV nodal injury, occurred. The distance from the nearest His position to successful ablation site in both LAO and RAO projections of CARTO images was 26.4±8.8 and 27±7.7mm respectively. Only in two (9%) patients, ablation needed to be extended superior to the plane of coronary sinus ostium, towards the His bundle region, to achieve slow pathway modification. AVNRT ablation with MNS allows for accurate mapping of the AV node and stable ablation at a safe distance, which could help avoid AV nodal injury. We recommend this modality for younger patients with AVNRT. Copyright © 2017. Published by Elsevier B.V.

  5. Using the application visualization system to view HALOE three-dimensional satellite data

    NASA Technical Reports Server (NTRS)

    Luo, Mingzhao; Schiano, Allen V. R.; Russell, James M., III; Gordley, Larry L.; Stone, Kenneth A.; Cicerone, Ralph J.

    1995-01-01

    The Application Visualization System (AVS) is used to view a three-dimensional data field containing the volume mixing ratios of a chemical species in the middle atmosphere obtained by the Halogen Occultation Experiment (HALOE) aboard the Upper Atmosphere Research Satellite (UARS). Since launch in September 1991, HALOE has been collecting data on approximately 30 sunrise/sunset events in two narrow latitude bands each day. The vertical volume mixing ratio profiles are retrieved for eight species for each event. The accumulated data for approximately 30 days cover most of the globe (limited by sunlit latitudes), and this monthly data block can be described as the volume mixing ratio of a specific species in the atmosphere as a function of latitude, longitude, and height. The data were remapped using linear interpolation for pressure levels and Gaussian weighted binning from sampling locations to a three-dimensional grid. An AVS network is constructed that allows for viewing the three-dimensional field with rendered slices at constant latitudes, longitudes or pressure levels. Discussions are given on the advantages and some disadvantages learned about from experiences applying AVS to visualize HALOE three dimensional data.

  6. Feasibility and safety of adenosine cardiovascular magnetic resonance in patients with MR conditional pacemaker systems at 1.5 Tesla.

    PubMed

    Klein-Wiele, Oliver; Garmer, Marietta; Urbien, Rhyan; Busch, Martin; Kara, Kaffer; Mateiescu, Serban; Grönemeyer, Dietrich; Schulte-Hermes, Michael; Garbrecht, Marc; Hailer, Birgit

    2015-12-22

    Cardiovascular Magnetic Resonance (CMR) with adenosine stress is a valuable diagnostic tool in coronary artery disease (CAD). However, despite the development of MR conditional pacemakers CMR is not yet established in clinical routine for pacemaker patients with known or suspected CAD. A possible reason is that adenosine stress perfusion for ischemia detection in CMR has not been studied in patients with cardiac conduction disease requiring pacemaker therapy. Other than under resting conditions it is unclear whether MR safe pacing modes (paused pacing or asynchronous mode) can be applied safely because the effect of adenosine on heart rate is not precisely known in this entity of patients. We investigate for the first time feasibility and safety of adenosine stress CMR in pacemaker patients in clinical routine and evaluate a pacing protocol that considers heart rate changes under adenosine. We retrospectively analyzed CMR scans of 24 consecutive patients with MR conditional pacemakers (mean age 72.1 ± 11.0 years) who underwent CMR in clinical routine for the evaluation of known or suspected CAD. MR protocol included cine imaging, adenosine stress perfusion and late gadolinium enhancement. Pacemaker indications were sinus node dysfunction (n = 18) and second or third degree AV block (n = 6). Under a pacing protocol intended to avoid competitive pacing on the one hand and bradycardia due to AV block on the other no arrhythmia occurred. Pacemaker stimulation was paused to prevent competitive pacing in sinus node dysfunction with resting heart rate >45 bpm. Sympatho-excitatory effect of adenosine led to a significant acceleration of heart rate by 12.3 ± 8.3 bpm (p < 0.001), no bradycardia occurred. On the contrary in AV block heart rate remained constant; asynchronous pacing above resting heart rate did not interfere with intrinsic rhythm. Adenosine stress CMR appears to be feasible and safe in patients with MR conditional pacemakers. Heart rate response to adenosine has to be considered for the choice of pacing modes during CMR.

  7. Trajectory Optimization of a Bimodal Nuclear Powered Spacecraft to Mars

    DTIC Science & Technology

    1990-05-29

    velocity M = initial mass of spacecraft o m= ion fuel expulsion rate (constant) 0 = thrust direction angle = gravitational constant of Sun AVto t...total velocity change possible for the impulsive engines AV1 = velocity change for Earth escape AV2 = velocity change for Mars capture AVto t = AV + AV

  8. Improving sediment-quality guidelines for nickel: development and application of predictive bioavailability models to assess chronic toxicity of nickel in freshwater sediments

    USGS Publications Warehouse

    Vangheluwe, Marnix L. U.; Verdonck, Frederik A. M.; Besser, John M.; Brumbaugh, William G.; Ingersoll, Christopher G.; Schlekat, Christan E.; Rogevich Garman, Emily

    2013-01-01

    Within the framework of European Union chemical legislations an extensive data set on the chronic toxicity of sediment nickel has been generated. In the initial phase of testing, tests were conducted with 8 taxa of benthic invertebrates in 2 nickel-spiked sediments, including 1 reasonable worst-case sediment with low concentrations of acid-volatile sulfide (AVS) and total organic carbon. The following species were tested: amphipods (Hyalella azteca, Gammarus pseudolimnaeus), mayflies (Hexagenia sp.), oligochaetes (Tubifex tubifex, Lumbriculus variegatus), mussels (Lampsilis siliquoidea), and midges (Chironomus dilutus, Chironomus riparius). In the second phase, tests were conducted with the most sensitive species in 6 additional spiked sediments, thus generating chronic toxicity data for a total of 8 nickel-spiked sediments. A species sensitivity distribution was elaborated based on 10% effective concentrations yielding a threshold value of 94 mg Ni/kg dry weight under reasonable worst-case conditions. Data from all sediments were used to model predictive bioavailability relationships between chronic toxicity thresholds (20% effective concentrations) and AVS and Fe, and these models were used to derive site-specific sediment-quality criteria. Normalization of toxicity values reduced the intersediment variability in toxicity values significantly for the amphipod species Hyalella azteca and G. pseudolimnaeus, but these relationships were less clearly defined for the mayfly Hexagenia sp. Application of the models to prevailing local conditions resulted in threshold values ranging from 126 mg to 281 mg Ni/kg dry weight, based on the AVS model, and 143 mg to 265 mg Ni/kg dry weight, based on the Fe model

  9. Modeling the influence of the VV delay for CRT on the electrical activation patterns in absence of conduction through the AV node

    NASA Astrophysics Data System (ADS)

    Romero, D. A.; Sebastián, Rafael; Plank, Gernot; Vigmond, Edward J.; Frangi, Alejandro F.

    2008-03-01

    From epidemiological studies, it has been shown that 0.2% of men and 0.1% of women suffer from a degree of atrioventricular (AV) block. In recent years, the palliative treatment for third degree AV block has included Cardiac Resynchronization Therapy (CRT). It was found that patients show more clinical improvement in the long term with CRT compared with single chamber devices. Still, an important group of patients does not improve their hemodynamic function as much as could be expected. A better understanding of the basis for optimizing the devices settings (among which the VV delay) will help to increase the number of responders. In this work, a finite element model of the left and right ventricles was generated using an atlas-based approach for their segmentation, which includes fiber orientation. The electrical activity was simulated with the electrophysiological solver CARP, using the Ten Tusscher et al. ionic model for the myocardium, and the DiFrancesco-Noble for Purkinje fibers. The model is representative of a patient without dilated or ischemic cardiomyopathy. The simulation results were analyzed for total activation times and latest activated regions at different VV delays and pre-activations (RV pre-activated, LV pre-activated). To optimize the solution, simulations are compared against the His-Purkinje network activation (normal physiological conduction), and interventricular septum activation (as collision point for the two wave fronts). The results were analyzed using Pearson's coefficient of correlation for point to point comparisons between simulation cases. The results of this study contribute to gain insight on the VV delay and how its adjustment might influence response to CRT and how it can be used to optimize the treatment.

  10. An Examination of Commercial Aviation Accidents and Incidents Related to Integrated Vehicle Health Management

    NASA Technical Reports Server (NTRS)

    Reveley, Mary S.; Briggs, Jeffrey L.; Thomas, Megan A.; Evans, Joni K.; Jones, Sharon M.

    2011-01-01

    The Integrated Vehicle Health Management (IVHM) Project is one of the four projects within the National Aeronautics and Space Administration's (NASA) Aviation Safety Program (AvSafe). The IVHM Project conducts research to develop validated tools and technologies for automated detection, diagnosis, and prognosis that enable mitigation of adverse events during flight. Adverse events include those that arise from system, subsystem, or component failure, faults, and malfunctions due to damage, degradation, or environmental hazards that occur during flight. Determining the causal factors and adverse events related to IVHM technologies will help in the formulation of research requirements and establish a list of example adverse conditions against which IVHM technologies can be evaluated. This paper documents the results of an examination of the most recent statistical/prognostic accident and incident data that is available from the Aviation Safety Information Analysis and Sharing (ASIAS) System to determine the causal factors of system/component failures and/or malfunctions in U.S. commercial aviation accidents and incidents.

  11. Environmental assessment of three egg production systems--Part II. Ammonia, greenhouse gas, and particulate matter emissions.

    PubMed

    Shepherd, T A; Zhao, Y; Li, H; Stinn, J P; Hayes, M D; Xin, H

    2015-03-01

    As an integral part of the Coalition for Sustainable Egg Supply (CSES) Project, this study simultaneously monitored air emissions of 3 commercially operated egg production systems at the house level and associated manure storage over 2 single-cycle flocks (18 to 78 wk of age). The 3 housing systems were 1) a conventional cage house (CC) with a 200,000-hen capacity (6 hens in a cage at a stocking density of 516 cm2/hen), 2) an enriched colony house (EC) with a 50,000-hen capacity (60 hens per colony at a stocking density of 752 cm2/hen), and 3) an aviary house (AV) with a 50,000-hen capacity (at a stocking density of 1253 to 1257 cm2/hen). The 3 hen houses were located on the same farm and were populated with Lohmann white hens of the same age. Indoor environment and house-level gaseous (ammonia [NH3] and greenhouse gasses [GHG], including carbon dioxide [CO2], methane [CH4], and nitrous oxide [N2O]) and particulate matter (PM10, PM2.5) emissions were monitored continually. Gaseous emissions from the respective manure storage of each housing system were also monitored. Emission rates (ERs) are expressed as emission quantities per hen, per animal unit (AU, 500 kg live BW), and per kilogram of egg output. House-level NH3 ER (g/hen/d) of EC (0.054) was significantly lower than that of CC (0.082) or AV (0.112) (P<0.05). The house-level CO2 ER (g/hen/d) was lower for CC (68.3) than for EC and AV (74.4 and 74.0, respectively), and the CH4 ER (g/hen/d) was similar for all 3 houses (0.07 to 0.08). The house-level PM ER (mg/hen/d), essentially representing the farm-level PM ER, was significantly higher for AV (PM10 100.3 and PM2.5 8.8) than for CC (PM10 15.7 and PM2.5 0.9) or EC (PM10 15.6 and PM2.5 1.7) (P<0.05). The farm-level (house plus manure storage) NH3 ER (g/hen/d) was significantly lower for EC (0.16) than for CC (0.29) or AV (0.30) (P<0.05). As expected, the magnitudes of GHG emissions were rather small for all 3 production systems. Data from this study enable comparative assessment of conventional vs. alternative hen housing systems regarding air emissions and enhance the U.S. national air emissions inventory for farm animal operations. © The Author 2015. Published by Oxford University Press on behalf of Poultry Science Association.

  12. Environmental assessment of three egg production systems — Part II. Ammonia, greenhouse gas, and particulate matter emissions

    PubMed Central

    Shepherd, T. A.; Zhao, Y.; Li, H.; Stinn, J. P.; Hayes, M. D.; Xin, H.

    2015-01-01

    As an integral part of the Coalition for Sustainable Egg Supply (CSES) Project, this study simultaneously monitored air emissions of 3 commercially operated egg production systems at the house level and associated manure storage over 2 single-cycle flocks (18 to 78 wk of age). The 3 housing systems were 1) a conventional cage house (CC) with a 200,000-hen capacity (6 hens in a cage at a stocking density of 516 cm2/hen), 2) an enriched colony house (EC) with a 50,000-hen capacity (60 hens per colony at a stocking density of 752 cm2/hen), and 3) an aviary house (AV) with a 50,000-hen capacity (at a stocking density of 1253 to 1257 cm2/hen). The 3 hen houses were located on the same farm and were populated with Lohmann white hens of the same age. Indoor environment and house-level gaseous (ammonia [NH3] and greenhouse gasses [GHG], including carbon dioxide [CO2], methane [CH4], and nitrous oxide [N2O]) and particulate matter (PM10, PM2.5) emissions were monitored continually. Gaseous emissions from the respective manure storage of each housing system were also monitored. Emission rates (ERs) are expressed as emission quantities per hen, per animal unit (AU, 500 kg live BW), and per kilogram of egg output. House-level NH3 ER (g/hen/d) of EC (0.054) was significantly lower than that of CC (0.082) or AV (0.112) (P < 0.05). The house-level CO2 ER (g/hen/d) was lower for CC (68.3) than for EC and AV (74.4 and 74.0, respectively), and the CH4 ER (g/hen/d) was similar for all 3 houses (0.07 to 0.08). The house-level PM ER (mg/hen/d), essentially representing the farm-level PM ER, was significantly higher for AV (PM10 100.3 and PM2.5 8.8) than for CC (PM10 15.7 and PM2.5 0.9) or EC (PM10 15.6 and PM2.5 1.7) (P < 0.05). The farm-level (house plus manure storage) NH3 ER (g/hen/d) was significantly lower for EC (0.16) than for CC (0.29) or AV (0.30) (P < 0.05). As expected, the magnitudes of GHG emissions were rather small for all 3 production systems. Data from this study enable comparative assessment of conventional vs. alternative hen housing systems regarding air emissions and enhance the U.S. national air emissions inventory for farm animal operations. PMID:25737568

  13. Equation of state of asymmetric nuclear matter using re-projected nucleon–nucleon potentials

    NASA Astrophysics Data System (ADS)

    Asadi Aghbolaghi, Z.; Bigdeli, M.

    2018-06-01

    In this paper, we have calculated the equation of state of asymmetric nuclear matter using the lowest order constrained variational approach and Argonne family potentials with and without three-nucleon interaction (TNI) contribution. In particular, we have used the AV18 potential and the re-projected potentials, AV8‧, and AV6‧. We have also calculated the saturation properties of symmetric nuclear matter, and the nuclear symmetry energy using AV18+TNI, AV8‧+TNI and AV6‧+TNI potentials. The inclusion of TNI has modified the agreement with experiment. We have also made a comparison between our results and those of other many-body calculations.

  14. Replication of Heliothis virescens ascovirus in insect cell lines.

    PubMed

    Asgari, S

    2006-09-01

    Ascoviruses (AVs) infect larvae of various insect pests belonging to the family Noctuidae. The result of AV infection in the hosts is cleavage of infected cells into vesicles, a unique feature of AV infection. Since insect cell lines facilitate the study of virus life cycles, attempts were made to analyze Heliothis virescens AV (HvAV3e) infection in several cell lines and compare cell pathology to larval infection. In this study, replication and cytopathological effects of HvAV3e on four different cell lines were investigated. HvAV3e replication was confirmed in three noctuid cell lines from Spodoptera frugiperda (Sf9) and Helicoverpa zea (BCIRL-Hz-AM1 and FB33). However, the virus did not replicate in the non-noctuid insect cell line from Pieris rapae (Pieridae). Despite replication of the virus in the three permissive cell lines, the cytopathological effects of the virus were significantly different from that of larval infection.

  15. Sampling method, storage and pretreatment of sediment affect AVS concentrations with consequences for bioassay responses.

    PubMed

    De Lange, H J; Van Griethuysen, C; Koelmans, A A

    2008-01-01

    Sediment treatment and sediment storage may alter sediment toxicity, and consequently biotic response. Purpose of our study was to combine these three aspects (treatment-toxicity-biotic response) in one integrated approach. We used Acid Volatile Sulfide (AVS) concentrations as a proxy of the disturbance of the sediment. AVS and Simultaneously Extracted Metal (SEM) concentrations were compared to bioassay responses with the freshwater benthic macroinvertebrate Asellus aquaticus. Storage conditions and sediment treatment affected AVS but not SEM levels. AVS can be used as a proxy for sediment disturbance. The best way to pretreat the sediment for use in a bioassay in order to maintain initial AVS conditions was to sample the sediment with an Ekman grab, immediately store it in a jar without headspace, and freeze it as soon as possible. In a survey using seven different sediments, bioassay responses of A. aquaticus were correlated with SEM and AVS characteristics.

  16. The Pattern of Brain Amyloid Load in Posterior Cortical Atrophy Using 18F-AV45: Is Amyloid the Principal Actor in the Disease?

    PubMed Central

    Beaufils, Emilie; Ribeiro, Maria Joao; Vierron, Emilie; Vercouillie, Johnny; Dufour-Rainfray, Diane; Cottier, Jean-Philippe; Camus, Vincent; Mondon, Karl; Guilloteau, Denis; Hommet, Caroline

    2014-01-01

    Background Posterior cortical atrophy (PCA) is characterized by progressive higher-order visuoperceptual dysfunction and praxis declines. This syndrome is related to a number of underlying diseases, including, in most cases, Alzheimer's disease (AD). The aim of this study was to compare the amyloid load with 18F-AV45 positron emission tomography (PET) between PCA and AD subjects. Methods We performed 18F-AV45 PET, cerebrospinal fluid (CSF) biomarker analysis and a neuropsychological assessment in 11 PCA patients and 12 AD patients. Results The global and regional 18F-AV45 uptake was similar in the PCA and AD groups. No significant correlation was observed between global 18F-AV45 uptake and CSF biomarkers or between regional 18F-AV45 uptake and cognitive and affective symptoms. Conclusion This 18F-AV45 PET amyloid imaging study showed no specific regional pattern of cortical 18F-AV45 binding in PCA patients. These results confirm that a distinct clinical phenotype in amnestic AD and PCA is not related to amyloid distribution. PMID:25538727

  17. Proteolysis in isolated autophagic vacuoles from the rat pancreas. Effects of chloroquine administration.

    PubMed

    Yucel-Lindberg, T; Jansson, H; Glaumann, H

    1991-01-01

    Administration of the antimalaria drug chloroquine increased the number of autophagic vacuoles (AVs) in the rat pancreas. Ultrastructural analysis showed that AVs contained segregated organelles such as mitochondria, zymogen granules, peroxisomes and small portions of cytoplasm. The maximum number of AVs was observed after 3 h of chloroquine treatment. The effect lasted for 12 h and almost disappeared after 16 h. The increase in AVs caused by chloroquine made it possible to isolate them in a discontinuous Metrizamide gradient with high purity. The proteolytic capacity of the AVs isolated after different chloroquine exposure times was measured after prelabeling pancreatic proteins with an injection of L-(1-14C)leucine 16 h before sacrifice. Protein degradation in isolated AVs increased during the first 6 h of chloroquine exposure and then returned to control values 16 h after the administration. In addition, the activities of two lysosomal enzymes, acid phosphatase and cathepsin B, increased in the AV-fractions following chloroquine treatment. It is concluded that the augmented proteolysis in the isolated AVs is due to a combination of increased substrate content and increased proteolytic lysosomal enzyme activities.

  18. Prevalence and treatment of aerobic vaginitis among non-pregnant women: evaluation of the evidence for an underestimated clinical entity.

    PubMed

    Tansarli, G S; Kostaras, E K; Athanasiou, S; Falagas, M E

    2013-08-01

    We sought to evaluate the evidence on the prevalence of aerobic vaginitis (AV) among symptomatic non-pregnant women, as well as the treatment administered for this clinical entity. The PubMed and Scopus databases were systematically searched. Sixteen studies met the inclusion criteria, 11 of which reported on the prevalence of possible AV, two on the prevalence of diagnosed AV, and three on the treatment and outcomes of women with diagnosed AV. The prevalence of diagnosed AV varied from 5 to 10.5 %. Streptococcus spp., Staphylococcus aureus, and coagulase-negative staphylococci were the most commonly identified Gram-positive pathogens among women with possible AV, with prevalences of up to 58.7, 41.7, and 37.4 %, respectively, while Escherichia coli was the most common Gram-negative pathogen identified, with a prevalence of up to 23 % among symptomatic women. Regarding antibiotic treatment for AV, the antibiotic schemes administered, which mainly consisted of suppositories of aminoglycosides, showed good effectiveness without serious adverse events provided by any of the included studies. The currently available data suggest that the prevalence of AV is not negligible, while the prevalence of possible AV is considerable. Well-designed studies comparing the prevalence of aerobic pathogens between symptomatic and asymptomatic women are warranted.

  19. [Clinical characteristics of aerobic vaginitis and its mixed infections].

    PubMed

    Fan, Ai-Ping; Xue, Feng-Xia

    2010-12-01

    To investigate clinical characteristics of aerobic vaginitis (AV) and its mixed infections for diagnosis efficiently. From April 2008 to December 2008, 516 patients with vaginitis treated in Tianjin Medical University General Hospital were enrolled in this study. AV, bacterial vaginosis (BV), vulvovaginal candidiasis (VVC), trichomonal vaginitis (TV), and cytolytic vaginosis (CV) were diagnosed based on symptoms, sign and vaginal discharge examination. Among 516 cases, AV cases were found in 14.7% (76/516), and AV was common vaginal infection. AV mixed infections was diagnosed in 58% (44/76), including mixed with BV (45%, 20/44), mixed with VVC (30%, 13/44), and mixed with TV (25%, 11/44). Those common symptom of AV were yellow vaginal discharge (63%, 20/32), more vaginal discharge (44%, 14/32). Vaginal pH value was usually more than 4.5 (84%, 27/32). Vaginal cleanliness mainly was grade III - IV (88%, 28/32). Six cases with enterococcus faecium and 4 cases with streptococci were frequently isolated. The symptom and sign of mixed AV infection was atypical. Aerobic vaginitis is a common lower vaginal infection and easily mixed with other pathogens, especially with BV, VVC or TV. When patients were diagnosed with AV or other vaginal infection, it should be mentioned whether those patients have mixed vaginal infection or AV.

  20. Expression and mutagenesis of the sea anemone toxin Av2 reveals key amino acid residues important for activity on voltage-gated sodium channels.

    PubMed

    Moran, Yehu; Cohen, Lior; Kahn, Roy; Karbat, Izhar; Gordon, Dalia; Gurevitz, Michael

    2006-07-25

    Type I sea anemone toxins are highly potent modulators of voltage-gated Na-channels (Na(v)s) and compete with the structurally dissimilar scorpion alpha-toxins on binding to receptor site-3. Although these features provide two structurally different probes for studying receptor site-3 and channel fast inactivation, the bioactive surface of sea anemone toxins has not been fully resolved. We established an efficient expression system for Av2 (known as ATX II), a highly insecticidal sea anemone toxin from Anemonia viridis (previously named A. sulcata), and mutagenized it throughout. Each toxin mutant was analyzed in toxicity and binding assays as well as by circular dichroism spectroscopy to discern the effects derived from structural perturbation from those related to bioactivity. Six residues were found to constitute the anti-insect bioactive surface of Av2 (Val-2, Leu-5, Asn-16, Leu-18, and Ile-41). Further analysis of nine Av2 mutants on the human heart channel Na(v)1.5 expressed in Xenopus oocytes indicated that the bioactive surfaces toward insects and mammals practically coincide but differ from the bioactive surface of a structurally similar sea anemone toxin, Anthopleurin B, from Anthopleura xanthogrammica. Hence, our results not only demonstrate clear differences in the bioactive surfaces of Av2 and scorpion alpha-toxins but also indicate that despite the general conservation in structure and importance of the Arg-14 loop and its flanking residues Gly-10 and Gly-20 for function, the surface of interaction between different sea anemone toxins and Na(v)s varies.

  1. An arterio-venous bridge for gradual weaning from adult veno-arterial extracorporeal life support.

    PubMed

    Babar, Z U D; Sharma, A S; Ganushchak, Y M; Delnoij, T S R; Donker, D W; Maessen, J G; Weerwind, P W

    2015-11-01

    Weaning from extracorporeal life support (ELS) is particularly challenging when cardiac recovery is slow, largely incomplete and hard to predict. Therefore, we describe an individualized gradual weaning strategy using an arterio-venous (AV) bridge incorporated into the circuit to facilitate weaning. Thirty adult patients weaned from veno-arterial ELS using an AV bridge were retrospectively analyzed. Serial echocardiography and hemodynamic monitoring were used to assess cardiac recovery and load responsiveness. Upon early signs of myocardial recovery, an AV bridge with an Hoffman clamp was added to the circuit and weaning was initiated. Support flow was reduced stepwise by 10-15% every 2 to 8 hours while the circuit flow was maintained at 3.5-4.5 L/min. The AV bridge facilitated gradual weaning in all 30 patients (median age: 66 [53-71] years; 21 males) over a median period of 25 [8-32] hours, with a median support duration of 96 [31-181] hours. During weaning, the median left ventricular ejection fraction was 25% [15-32] and the median velocity time integral of the aortic valve was 16 cm [10-23]. Through the weaning period, the mean arterial blood pressure was maintained at 70 mmHg and the activated partial thromboplastin time was 60 ± 10 seconds without additional systemic heparinization. Neither macroscopic thrombus formation in the ELS circuit during and after weaning nor clinically relevant thromboembolism was observed. Incorporation of an AV bridge for weaning from veno-arterial ELS is safe and feasible to gradually wean patients with functional cardiac recovery without compromising the circuit integrity. © The Author(s) 2015.

  2. Clinical feasibility of exercise-based A-V interval optimization for cardiac resynchronization: a pilot study.

    PubMed

    Choudhuri, Indrajit; MacCarter, Dean; Shaw, Rachael; Anderson, Steve; St Cyr, John; Niazi, Imran

    2014-11-01

    One-third of eligible patients fail to respond to cardiac resynchronization therapy (CRT). Current methods to "optimize" the atrio-ventricular (A-V) interval are performed at rest, which may limit its efficacy during daily activities. We hypothesized that low-intensity cardiopulmonary exercise testing (CPX) could identify the most favorable physiologic combination of specific gas exchange parameters reflecting pulmonary blood flow or cardiac output, stroke volume, and left atrial pressure to guide determination of the optimal A-V interval. We assessed relative feasibility of determining the optimal A-V interval by three methods in 17 patients who underwent optimization of CRT: (1) resting echocardiographic optimization (the Ritter method), (2) resting electrical optimization (intrinsic A-V interval and QRS duration), and (3) during low-intensity, steady-state CPX. Five sequential, incremental A-V intervals were programmed in each method. Assessment of cardiopulmonary stability and potential influence on the CPX-based method were assessed. CPX and determination of a physiological optimal A-V interval was successfully completed in 94.1% of patients, slightly higher than the resting echo-based approach (88.2%). There was a wide variation in the optimal A-V delay determined by each method. There was no observed cardiopulmonary instability or impact of the implant procedure that affected determination of the CPX-based optimized A-V interval. Determining optimized A-V intervals by CPX is feasible. Proposed mechanisms explaining this finding and long-term impact require further study. ©2014 Wiley Periodicals, Inc.

  3. Utilisation of Crotalidae polyvalent immune fab (ovine) for Viperidae envenomations in children.

    PubMed

    Johnson, P N; McGoodwin, L; Banner, W

    2008-12-01

    Snakebite envenomations occur in 45,000 patients in the USA annually and are associated with morbidity especially in children and the elderly. Crotalidae polyvalent immune fab (ovine; FabAV) is a polyvalent antivenom derived from sheep for crotalid envenomations. Limited clinical trials are available in paediatric patients. A literature search using MEDLINE (1950-February 2008), International Pharmaceutical Abstracts (1970-February 2008), EMBASE (1988-February 2008) and Cochrane Library (1996-June 2008) was conducted using key words including: antivenom OR snakebites OR children OR Crotalid OR envenomations. All English-language articles were identified from data sources. Pertinent studies pertaining to FabAV in children and adolescents with crotalid envenomations were included for analysis. Ten papers were included for review, representing 47 children. Initial doses ranging from 2 to 18 g were administered and initial control was achieved in most children. Maintenance dosing was continued in 63.8% (30/47) of patients; 4.3% (2/47) of patients had episodes of venom recurrence. Adverse events were noted in 8.5% of children (4/47) when pooled for data analysis. FabAV appears to be a safe and effective agent for children with crotalid envenomations. Clinicians should adapt dosing recommendations used for adults until future large, well-designed trials can confirm the efficacy and safety from observation studies and case reports.

  4. [AVS concentrations in Xinan Creek and the influencing factors].

    PubMed

    Liu, Xiao-Bing; Wen, Yan-Mao; Li, Feng; Wu, Chang-Hua; Duan, Zhi-Peng

    2012-07-01

    Sediment and overlying water samples were collected at 10 sampling stations at Xinan Creek, a tidal river in Pearl River Delta, and analyzed for physical and chemical characteristics as well as microbial incicators, in order to reveal the main factors dominating the spatial distribution of acid volatile sulfide (AVS). The effects of Eh, SRB OC and TS on the spatial distribution of AVS were investigated and the impact of AVS on the toxicity of heavy metals in the studied area was evaluated. The results showed that the range of AVS was 0.207-41.453 micromol x g(-1), with an average of 6.684 micromol x g(-1), which is relatively high compared to the results in other studies. The AVS value of the surface layer was higher than the bottom layer in 5 stations. The AVS values in both the surface layer and the bottom layer were highly variable, the coefficients of variation being 93.61% and 153.09% , respectively. The analytical results revealed that TS was the factor with the greatest impact on the spatial distribution of AVS, and the order was TS > OC > Eh > SRB. Potential ecological risk of heavy metals existed in 60% of the smpling stations based on the value of Sigma (SEM5-AVS), however, with the criterion of [Sigma(SEM5-AVS)]/foc, none of them had inacceptable ecological risk. Furthermore, in terms of single species of heavy metals, there was certain risk of toxic effect for all the five heavy metals (Cd, Ni, Cu, Zn and Pb). The above mentioned results will provide valuable data for the in-depth study of the formation mechanism of AVS and helpful reference for environmental impact assessment and scientific rehabilitation of heavy metals in polluted rivers.

  5. C-Arm Computed Tomography-Assisted Adrenal Venous Sampling Improved Right Adrenal Vein Cannulation and Sampling Quality in Primary Aldosteronism.

    PubMed

    Park, Chung Hyun; Hong, Namki; Han, Kichang; Kang, Sang Wook; Lee, Cho Rok; Park, Sungha; Rhee, Yumie

    2018-05-04

    Adrenal venous sampling (AVS) is a gold standard for subtype classification of primary aldosteronism (PA). However, this procedure has a high failure rate because of the anatomical difficulties in accessing the right adrenal vein. We investigated whether C-arm computed tomography-assisted AVS (C-AVS) could improve the success rate of adrenal sampling. A total of 156 patients, diagnosed with PA who underwent AVS from May 2004 through April 2017, were included. Based on the medical records, we retrospectively compared the overall, left, and right catheterization success rates of adrenal veins during the periods without C-AVS (2004 to 2010, n=32) and with C-AVS (2011 to 2016, n=134). The primary outcome was adequate bilateral sampling defined as a selectivity index (SI) >5. With C-AVS, the rates of adequate bilateral AVS increased from 40.6% to 88.7% (P<0.001), with substantial decreases in failure rates (43.7% to 0.8%, P<0.001). There were significant increases in adequate sampling rates from right (43.7% to 91.9%, P<0.001) and left adrenal veins (53.1% to 95.9%, P<0.001) as well as decreases in catheterization failure from right adrenal vein (9.3% to 0.0%, P<0.001). Net improvement of SI on right side remained significant after adjustment for left side (adjusted SI, 1.1 to 9.0; P=0.038). C-AVS was an independent predictor of adequate bilateral sampling in the multivariate model (odds ratio, 9.01; P<0.001). C-AVS improved the overall success rate of AVS, possibly as a result of better catheterization of right adrenal vein. Copyright © 2018 Korean Endocrine Society.

  6. Prevalence of E/A wave fusion and A wave truncation in DDD pacemaker patients with complete AV block under nominal AV intervals.

    PubMed

    Poller, Wolfram C; Dreger, Henryk; Schwerg, Marius; Melzer, Christoph

    2015-01-01

    Optimization of the AV-interval (AVI) in DDD pacemakers improves cardiac hemodynamics and reduces pacemaker syndromes. Manual optimization is typically not performed in clinical routine. In the present study we analyze the prevalence of E/A wave fusion and A wave truncation under resting conditions in 160 patients with complete AV block (AVB) under the pre-programmed AVI. We manually optimized sub-optimal AVI. We analyzed 160 pacemaker patients with complete AVB, both in sinus rhythm (AV-sense; n = 129) and under atrial pacing (AV-pace; n = 31). Using Doppler analyses of the transmitral inflow we classified the nominal AVI as: a) normal, b) too long (E/A wave fusion) or c) too short (A wave truncation). In patients with a sub-optimal AVI, we performed manual optimization according to the recommendations of the American Society of Echocardiography. All AVB patients with atrial pacing exhibited a normal transmitral inflow under the nominal AV-pace intervals (100%). In contrast, 25 AVB patients in sinus rhythm showed E/A wave fusion under the pre-programmed AV-sense intervals (19.4%; 95% confidence interval (CI): 12.6-26.2%). A wave truncations were not observed in any patient. All patients with a complete E/A wave fusion achieved a normal transmitral inflow after AV-sense interval reduction (mean optimized AVI: 79.4 ± 13.6 ms). Given the rate of 19.4% (CI 12.6-26.2%) of patients with a too long nominal AV-sense interval, automatic algorithms may prove useful in improving cardiac hemodynamics, especially in the subgroup of atrially triggered pacemaker patients with AV node diseases.

  7. A Novel Agonist of the TRIF Pathway Induces a Cellular State Refractory to Replication of Zika, Chikungunya, and Dengue Viruses

    PubMed Central

    Pryke, Kara M.; Abraham, Jinu; Sali, Tina M.; Gall, Bryan J.; Archer, Iris; Liu, Andrew; Bambina, Shelly; Baird, Jason; Gough, Michael; Chakhtoura, Marita; Haddad, Elias K.; Kirby, Ilsa T.; Nilsen, Aaron; Streblow, Daniel N.; Hirsch, Alec J.; Smith, Jessica L.

    2017-01-01

    ABSTRACT The ongoing concurrent outbreaks of Zika, Chikungunya, and dengue viruses in Latin America and the Caribbean highlight the need for development of broad-spectrum antiviral treatments. The type I interferon (IFN) system has evolved in vertebrates to generate tissue responses that actively block replication of multiple known and potentially zoonotic viruses. As such, its control and activation through pharmacological agents may represent a novel therapeutic strategy for simultaneously impairing growth of multiple virus types and rendering host populations resistant to virus spread. In light of this strategy’s potential, we undertook a screen to identify novel interferon-activating small molecules. Here, we describe 1-(2-fluorophenyl)-2-(5-isopropyl-1,3,4-thiadiazol-2-yl)-1,2-dihydrochromeno[2,3-c]pyrrole-3,9-dione, which we termed AV-C. Treatment of human cells with AV-C activates innate and interferon-associated responses that strongly inhibit replication of Zika, Chikungunya, and dengue viruses. By utilizing genome editing, we investigated the host proteins essential to AV-C-induced cellular states. This showed that the compound requires a TRIF-dependent signaling cascade that culminates in IFN regulatory factor 3 (IRF3)-dependent expression and secretion of type I interferon to elicit antiviral responses. The other canonical IRF3-terminal adaptor proteins STING and IPS-1/MAVS were dispensable for AV-C-induced phenotypes. However, our work revealed an important inhibitory role for IPS-1/MAVS, but not TRIF, in flavivirus replication, implying that TRIF-directed viral evasion may not occur. Additionally, we show that in response to AV-C, primary human peripheral blood mononuclear cells secrete proinflammatory cytokines that are linked with establishment of adaptive immunity to viral pathogens. Ultimately, synthetic innate immune activators such as AV-C may serve multiple therapeutic purposes, including direct antimicrobial responses and facilitation of pathogen-directed adaptive immunity. PMID:28465426

  8. Moving Domain Computational Fluid Dynamics to Interface with an Embryonic Model of Cardiac Morphogenesis

    PubMed Central

    Lee, Juhyun; Moghadam, Mahdi Esmaily; Kung, Ethan; Cao, Hung; Beebe, Tyler; Miller, Yury; Roman, Beth L.; Lien, Ching-Ling; Chi, Neil C.; Marsden, Alison L.; Hsiai, Tzung K.

    2013-01-01

    Peristaltic contraction of the embryonic heart tube produces time- and spatial-varying wall shear stress (WSS) and pressure gradients (∇P) across the atrioventricular (AV) canal. Zebrafish (Danio rerio) are a genetically tractable system to investigate cardiac morphogenesis. The use of Tg(fli1a:EGFP)y1 transgenic embryos allowed for delineation and two-dimensional reconstruction of the endocardium. This time-varying wall motion was then prescribed in a two-dimensional moving domain computational fluid dynamics (CFD) model, providing new insights into spatial and temporal variations in WSS and ∇P during cardiac development. The CFD simulations were validated with particle image velocimetry (PIV) across the atrioventricular (AV) canal, revealing an increase in both velocities and heart rates, but a decrease in the duration of atrial systole from early to later stages. At 20-30 hours post fertilization (hpf), simulation results revealed bidirectional WSS across the AV canal in the heart tube in response to peristaltic motion of the wall. At 40-50 hpf, the tube structure undergoes cardiac looping, accompanied by a nearly 3-fold increase in WSS magnitude. At 110-120 hpf, distinct AV valve, atrium, ventricle, and bulbus arteriosus form, accompanied by incremental increases in both WSS magnitude and ∇P, but a decrease in bi-directional flow. Laminar flow develops across the AV canal at 20-30 hpf, and persists at 110-120 hpf. Reynolds numbers at the AV canal increase from 0.07±0.03 at 20-30 hpf to 0.23±0.07 at 110-120 hpf (p< 0.05, n=6), whereas Womersley numbers remain relatively unchanged from 0.11 to 0.13. Our moving domain simulations highlights hemodynamic changes in relation to cardiac morphogenesis; thereby, providing a 2-D quantitative approach to complement imaging analysis. PMID:24009714

  9. Aerobic vaginitis and mixed infections: comparison of clinical and laboratory findings.

    PubMed

    Fan, Aiping; Yue, Yingli; Geng, Nv; Zhang, Huiying; Wang, Yingmei; Xue, Fengxia

    2013-02-01

    To investigate the clinical features of aerobic vaginitis (AV) and mixed infections with AV to achieve efficient diagnosis. From April 2008 to August 2009, 657 consecutive outpatients with vaginal symptoms in gynecology clinic in the General Hospital of Tianjin Medical University were investigated. Samples were taken for examination of vaginal discharge and fresh wet mount microscopy. AV, bacterial vaginosis (BV), vulvovaginal candidiasis (VVC), and trichomonal vaginitis (TV) were diagnosed according to standardized definitions. Sixty patients with single AV were randomly selected over the same period. Each patient accepted moxifloxacin therapy. Two kinds of treatment course (400 mg qd, 6 days or 400 mg qd, 12 days) were given. Clinical features and laboratory test results in the first visit and follow-ups were recorded and statistically analyzed. Among the 657 cases, AV was found in 23.74 % of the cases (156/657). AV mixed infections were diagnosed in 53.85 % (84/156): the mixed infections included VVC (32/84, 38.10 %), BV (31/84, 36.90 %), and TV (21/84, 25.00 %). Common symptoms of AV were a change in the characteristics of the discharge (44/72, 61.11 %) and increased discharge (30/72, 41.67 %). Vaginal pH was usually higher than 4.5 (63/72, 87.50 %). Enterococcus faecalis, Streptococcus viridans, Escherichia coli, and Staphylococcus epidermidis were frequently isolated. There is no statistically significant difference between two moxifloxacin treatment groups (p > 0.05). Cure rate was 89.7 % in 6-day group, and 71.4 % in 12-day group. AV is a common vaginal infection, and it is often mixed with other infections, especially VVC, BV and TV. The symptoms and signs of AV mixed infections are atypical. If a patient has vaginal complaints, it is necessary to determine whether AV or mixed infections are present. Oral moxifloxacin is effective in treating AV, and an appropriate course should be selected taking the severity of AV into consideration.

  10. Elimination of both E1 and E2 from adenovirus vectors further improves prospects for in vivo human gene therapy.

    PubMed Central

    Gorziglia, M I; Kadan, M J; Yei, S; Lim, J; Lee, G M; Luthra, R; Trapnell, B C

    1996-01-01

    A novel recombinant adenovirus vector, Av3nBg, was constructed with deletions in adenovirus E1, E2a, and E3 regions and expressing a beta-galactosidase reporter gene. Av3nBg can be propagated at a high titer in a corresponding A549-derived cell line, AE1-2a, which contains the adenovirus E1 and E2a region genes inducibly expressed from separate glucocorticoid-responsive promoters. Av3nBg demonstrated gene transfer and expression comparable to that of Av1nBg, a first-generation adenovirus vector with deletions in E1 and E3. Several lines of evidence suggest that this vector is significantly more attenuated than E1 and E3 deletion vectors. Metabolic DNA labeling studies showed no detectable de novo vector DNA synthesis or accumulation, and metabolic protein labeling demonstrated no detectable de novo hexon protein synthesis for Av3nBg in naive A549 cells even at a multiplicity of infection of up to 3,000 PFU per cell. Additionally, naive A549 cells infected by Av3nBg did not accumulate infectious virions. In contrast, both Av1nBg and Av2Lu vectors showed DNA replication and hexon protein synthesis at multiplicities of infection of 500 PFU per cell. Av2Lu has a deletion in E1 and also carries a temperature-sensitive mutation in E2a. Thus, molecular characterization has demonstrated that the Av3nBg vector is improved with respect to the potential for vector DNA replication and hexon protein expression compared with both first-generation (Av1nBg) and second-generation (Av2Lu) adenoviral vectors. These observations may have important implications for potential use of adenovirus vectors in human gene therapy. PMID:8648763

  11. Audiovisual spoken word training can promote or impede auditory-only perceptual learning: prelingually deafened adults with late-acquired cochlear implants versus normal hearing adults

    PubMed Central

    Bernstein, Lynne E.; Eberhardt, Silvio P.; Auer, Edward T.

    2014-01-01

    Training with audiovisual (AV) speech has been shown to promote auditory perceptual learning of vocoded acoustic speech by adults with normal hearing. In Experiment 1, we investigated whether AV speech promotes auditory-only (AO) perceptual learning in prelingually deafened adults with late-acquired cochlear implants. Participants were assigned to learn associations between spoken disyllabic C(=consonant)V(=vowel)CVC non-sense words and non-sense pictures (fribbles), under AV and then AO (AV-AO; or counter-balanced AO then AV, AO-AV, during Periods 1 then 2) training conditions. After training on each list of paired-associates (PA), testing was carried out AO. Across all training, AO PA test scores improved (7.2 percentage points) as did identification of consonants in new untrained CVCVC stimuli (3.5 percentage points). However, there was evidence that AV training impeded immediate AO perceptual learning: During Period-1, training scores across AV and AO conditions were not different, but AO test scores were dramatically lower in the AV-trained participants. During Period-2 AO training, the AV-AO participants obtained significantly higher AO test scores, demonstrating their ability to learn the auditory speech. Across both orders of training, whenever training was AV, AO test scores were significantly lower than training scores. Experiment 2 repeated the procedures with vocoded speech and 43 normal-hearing adults. Following AV training, their AO test scores were as high as or higher than following AO training. Also, their CVCVC identification scores patterned differently than those of the cochlear implant users. In Experiment 1, initial consonants were most accurate, and in Experiment 2, medial consonants were most accurate. We suggest that our results are consistent with a multisensory reverse hierarchy theory, which predicts that, whenever possible, perceivers carry out perceptual tasks immediately based on the experience and biases they bring to the task. We point out that while AV training could be an impediment to immediate unisensory perceptual learning in cochlear implant patients, it was also associated with higher scores during training. PMID:25206344

  12. Audiovisual spoken word training can promote or impede auditory-only perceptual learning: prelingually deafened adults with late-acquired cochlear implants versus normal hearing adults.

    PubMed

    Bernstein, Lynne E; Eberhardt, Silvio P; Auer, Edward T

    2014-01-01

    Training with audiovisual (AV) speech has been shown to promote auditory perceptual learning of vocoded acoustic speech by adults with normal hearing. In Experiment 1, we investigated whether AV speech promotes auditory-only (AO) perceptual learning in prelingually deafened adults with late-acquired cochlear implants. Participants were assigned to learn associations between spoken disyllabic C(=consonant)V(=vowel)CVC non-sense words and non-sense pictures (fribbles), under AV and then AO (AV-AO; or counter-balanced AO then AV, AO-AV, during Periods 1 then 2) training conditions. After training on each list of paired-associates (PA), testing was carried out AO. Across all training, AO PA test scores improved (7.2 percentage points) as did identification of consonants in new untrained CVCVC stimuli (3.5 percentage points). However, there was evidence that AV training impeded immediate AO perceptual learning: During Period-1, training scores across AV and AO conditions were not different, but AO test scores were dramatically lower in the AV-trained participants. During Period-2 AO training, the AV-AO participants obtained significantly higher AO test scores, demonstrating their ability to learn the auditory speech. Across both orders of training, whenever training was AV, AO test scores were significantly lower than training scores. Experiment 2 repeated the procedures with vocoded speech and 43 normal-hearing adults. Following AV training, their AO test scores were as high as or higher than following AO training. Also, their CVCVC identification scores patterned differently than those of the cochlear implant users. In Experiment 1, initial consonants were most accurate, and in Experiment 2, medial consonants were most accurate. We suggest that our results are consistent with a multisensory reverse hierarchy theory, which predicts that, whenever possible, perceivers carry out perceptual tasks immediately based on the experience and biases they bring to the task. We point out that while AV training could be an impediment to immediate unisensory perceptual learning in cochlear implant patients, it was also associated with higher scores during training.

  13. Group B Streptococcus serotypes III and V induce apoptosis and necrosis of human epithelial A549 cells.

    PubMed

    Da Costa, Andréia Ferreira Eduardo; Pereira, Camila Serva; Santos, Gabriela Da Silva; Carvalho, Técia Maria Ulisses; Hirata, Raphael; De Mattos-Guaraldi, Ana Luiza; Rosa, Ana Cláudia De Paula; Nagao, Prescilla Emy

    2011-05-01

    Although group B Streptococcus (GBS) has been classically described as an exclusively extracellular pathogen, growing evidence suggests that it may be internalized by epithelial cells. However, the fates of intracellular GBS and of infected respiratory epithelial cells remain unclear. Little is known about the bacterial components involved in these processes. The present study investigated the bacterial internalization by A549 cells and the apoptosis/necrosis of the infected human epithelial cells. The morphological changes in A549 cells observed from 2 h post-infection with GBS included vacuolization and the formation of apoptotic bodies. Flow cytometry revealed that 81.2% of apoptotic A549 cells were infected with GBS serotype III 90356-liquor. Moreover, a double-staining assay using propidium iodide (PI)/Annexin V (AV) gave information about the numbers of viable (PI-/AV-) (18.27%) vs. early apoptotic (PI-/AV+) (73.83%) and late apoptotic cells (PI+/AV+) (7.37%) during infection of A549 cells with GBS III 90356-liquor. In addition, 37% necrotic cells were observed in A549 cells infected with GBS serotype V 90186-blood. In conclusion, GBS serotypes III and V induce apoptosis of epithelial cells in the early stages of GBS infection, resulting in tissue destruction, bacterial spreading and, in consequence, invasive disease or systemic infection.

  14. Chemical constituents and antioxidant activity of the essential oil from leaves of Annona vepretorum Mart. (Annonaceae).

    PubMed

    Araújo, Camila de Souza; de Oliveira, Ana Paula; Lima, Rafaely Nascimento; Alves, Péricles Barreto; Diniz, Tâmara Coimbra; da Silva Almeida, Jackson Roberto Guedes

    2015-01-01

    Annona vepretorum (AV) is a native tree from Caatinga biome (semiarid region of Brazil) popularly known as "araticum" and "pinha da Caatinga." This study was carried out to evaluate the chemical constituents and antioxidant activity (AA) of the essential oil from the leaves from AV (EO-Av) collected in Petrolina, Pernambuco, Brazil. Fresh leaves of AV were cut into pieces, and subjected to distillation for 2 h in a clevenger-type apparatus. Gas chromatograph (GC) analyses were performed using a mass spectrometry/flame ionization detector. The identification of the constituents was assigned on the basis of comparison of their relative retention indices. The antioxidant ability of the EO was investigated through two in vitro models such as radical scavenging activity using 2,2-diphenyl-1-picrylhydrazyl method and β-carotene-linoleate-model system. The positive controls (ascorbic acid, butylated hydroxyanisole and butylated hydroxytoluene) were those using the standard solutions. Assays were carried out in triplicate. The oil showed a total of 21 components, and 17 were identified, representing 93.9% of the crude EO. Spathulenol (43.7%), limonene (20.5%), caryophyllene oxide (8.1%) and α-pinene (5.5%) were found to be the major individual constituents. Spathulenol and caryophyllene oxide could be considered chemotaxonomic markers of these genera. The EO demonstrated weak AA.

  15. Influence of acid volatile sulfides and metal concentrations on metal partitioning in contaminated sediments

    USGS Publications Warehouse

    Lee, J.-S.; Lee, B.-G.; Luoma, S.N.; Choi, H.J.; Koh, C.-H.; Brown, C.L.

    2000-01-01

    The influence of acid volatile sulfide (AVS) on the partitioning of Cd, Ni, and Zn in porewater (PW) and sediment as reactive metals (SEM, simultaneously extracted metals) was investigated in laboratory microcosms. Two spiking procedures were compared, and the effects of vertical geochemical gradients and infaunal activity were evaluated. Sediments were spiked with a Cd-Ni-Zn mixture (0.06, 3, 7.5 ??mol/g, respectively) containing four levels of AVS (0.5, 7.5, 15, 35 ??mol/g). The results were compared to sediments spiked with four levels of Cd-Ni-Zn mixtures at one AVS concentration (7.5 ??mol/g). A vertical redox gradient was generated in each treatment by an 18-d incubation with an oxidized water column. [AVS] in the surface sediments decreased by 65-95% due to oxidation during incubation; initial [AVS] was maintained at 0.5-7.5 cm depth. PW metal concentrations were correlated with [SEM - AVS] among all data. But PW metal concentrations were variable, causing the distribution coefficient, Kd(pw) (the ratio of [SEM] to PW metal concentrations) to vary by 2-3 orders of magnitude at a given [SEM - AVS]. One reason for the variability was that vertical profiles in PW metal concentrations appeared to be influenced by diffusion as well as [SEM - AVS]. The presence of animals appeared to enhance the diffusion of at least Zn. The generalization that PW metal concentrations are controlled by [SEM - AVS] is subject to some important qualifications if vertical gradients are complicated, metal concentrations vary, or equilibration times differ.The influence of acid volatile sulfide (AVS) on the partitioning of Cd, Ni, and Zn in porewater (PW) and sediment as reactive metals (SEM, simultaneously extracted metals) was investigated in laboratory microcosms. Two spiking procedures were compared, and the effects of vertical geochemical gradients and infaunal activity were evaluated. Sediments were spiked with a Cd-Ni-Zn mixture (0.06, 3, 7.5 ??mol/g, respectively) containing four levels of AVS (0.5, 7.5, 15, 35 ??mol/g). The results were compared to sediments spiked with four levels of Cd-Ni-Zn mixtures at one AVS concentration (7.5 ??mol/g). A vertical redox gradient was generated in each treatment by an 18-d incubation with an oxidized water column. [AVS] in the surface sediments decreased by 65-95% due to oxidation during incubation; initial [AVS] was maintained at 0.5-7.5 cm depth. PW metal concentrations were correlated with [SEM - AVS] among all data. But PW metal concentrations were variable, causing the distribution coefficient, Kdpw (the ratio of [SEM] to PW metal concentrations) to vary by 2-3 orders of magnitude at a given [SEM - AVS]. One reason for the variability was that vertical profiles in PW metal concentrations appeared to be influenced by diffusion as well as [SEM - AVS]. The presence of animals appeared to enhance the diffusion of at least Zn. The generalization that PW metal concentrations are controlled by [SEM - AVS] is subject to some important qualifications if vertical gradients are complicated, metal concentrations vary, or equilibration times differ.

  16. Characterization of a nose-only inhalation exposure system for hydrocarbon mixtures and jet fuels.

    PubMed

    Martin, Sheppard A; Tremblay, Raphael T; Brunson, Kristyn F; Kendrick, Christine; Fisher, Jeffrey W

    2010-04-01

    A directed-flow nose-only inhalation exposure system was constructed to support development of physiologically based pharmacokinetic (PBPK) models for complex hydrocarbon mixtures, such as jet fuels. Due to the complex nature of the aerosol and vapor-phase hydrocarbon exposures, care was taken to investigate the chamber hydrocarbon stability, vapor and aerosol droplet compositions, and droplet size distribution. Two-generation systems for aerosolizing fuel and hydrocarbons were compared and characterized for use with either jet fuels or a simple mixture of eight hydrocarbons. Total hydrocarbon concentration was monitored via online gas chromatography (GC). Aerosol/vapor (A/V) ratios, and total and individual hydrocarbon concentrations, were determined using adsorbent tubes analyzed by thermal desorption-gas chromatography-mass spectrometry (TDS-GC-MS). Droplet size distribution was assessed via seven-stage cascade impactor. Droplet mass median aerodynamic diameter (MMAD) was between 1 and 3 mum, depending on the generator and mixture utilized. A/V hydrocarbon concentrations ranged from approximately 200 to 1300 mg/m(3), with between 20% and 80% aerosol content, depending on the mixture. The aerosolized hydrocarbon mixtures remained stable during the 4-h exposure periods, with coefficients of variation (CV) of less than 10% for the total hydrocarbon concentrations. There was greater variability in the measurement of individual hydrocarbons in the A-V phase. In conclusion, modern analytical chemistry instruments allow for improved descriptions of inhalation exposures of rodents to aerosolized fuel.

  17. Large Capacity Missile Carrier (CMX)

    DTIC Science & Technology

    1993-12-01

    FSU) is emerging from a turbulent period that lasted from about 1990-2005. Some of the great hopes for the emergence of democracy and open markets ...34* AN/ UGC -I43A(V) NST "• OK-455(V) LJHF DAMA "* AN/UYQ-62 C2P VER I Link Processor "* ANIWSC-3(V)3 UHF SAT Transmitter/Receiver "* AN/USC-38 EHF...Graphics System Command, Control & NAVMACS II Communications (C’) AN/ UGC -143A(V) NST OKg455(V) UHF DAMA AN/UYQ-62 C2P VER I Link Processor AN/WSC-3(V

  18. Parachute-deployment-parameter identification based on an analytical simulation of Viking BLDT AV-4

    NASA Technical Reports Server (NTRS)

    Talay, T. A.

    1974-01-01

    A six-degree-of-freedom analytical simulation of parachute deployment dynamics developed at the Langley Research Center is presented. A comparison study was made using flight results from the Viking Balloon Launched Decelerator Test (BLDT) AV-4. Since there are significant voids in the knowledge of vehicle and decelerator aerodynamics and suspension system physical properties, a set of deployment-parameter input has been defined which may be used as a basis for future studies of parachute deployment dynamics. The study indicates the analytical model is sufficiently sophisticated to investigate parachute deployment dynamics with reasonable accuracy.

  19. KRASH Parametric Sensitivity Study - Transport Category Airplanes

    DTIC Science & Technology

    1987-12-01

    8217_ COPILOT PELVIS w Uj 0 •-’-AV - 24.8 -10 .Y +10 VERTICAL ACCELERATION, -i 0 COPILOT PELVIS uUoAV 4 4 -10 2891 "+15 VERTICAL ACCELERATION...j 0 " -- PILOT PELVIS Uw - - AV =47,9 • ----- 4 -15 AV INCREMENTAL VELOCITY CHANGE, FT/SEC Figure 3-65. DC-7 Test, Measured Acceleration, Eight

  20. Algorithm Visualization: The State of the Field

    ERIC Educational Resources Information Center

    Shaffer, Clifford A.; Cooper, Matthew L.; Alon, Alexander Joel D.; Akbar, Monika; Stewart, Michael; Ponce, Sean; Edwards, Stephen H.

    2010-01-01

    We present findings regarding the state of the field of Algorithm Visualization (AV) based on our analysis of a collection of over 500 AVs. We examine how AVs are distributed among topics, who created them and when, their overall quality, and how they are disseminated. There does exist a cadre of good AVs and active developers. Unfortunately, we…

  1. Association of In Vivo [18F]AV-1451 Tau PET Imaging Results With Cortical Atrophy and Symptoms in Typical and Atypical Alzheimer Disease

    PubMed Central

    Xia, Chenjie; Makaretz, Sara J.; Caso, Christina; McGinnis, Scott; Gomperts, Stephen N.; Sepulcre, Jorge; Gomez-Isla, Teresa; Hyman, Bradley T.; Schultz, Aaron; Vasdev, Neil; Johnson, Keith A.

    2017-01-01

    Importance Previous postmortem studies have long demonstrated that neurofibrillary tangles made of hyperphosphorylated tau proteins are closely associated with Alzheimer disease clinical phenotype and neurodegeneration pattern. Validating these associations in vivo will lead to new diagnostic tools for Alzheimer disease and better understanding of its neurobiology. Objective To examine whether topographical distribution and severity of hyperphosphorylated tau pathologic findings measured by fluorine 18–labeled AV-1451 ([18F]AV-1451) positron emission tomographic (PET) imaging are linked with clinical phenotype and cortical atrophy in patients with Alzheimer disease. Design, Setting, and Participants This observational case series, conducted from July 1, 2012, to July 30, 2015, in an outpatient referral center for patients with neurodegenerative diseases, included 6 patients: 3 with typical amnesic Alzheimer disease and 3 with atypical variants (posterior cortical atrophy, logopenic variant primary progressive aphasia, and corticobasal syndrome). Patients underwent [18F]AV-1451 PET imaging to measure tau burden, carbon 11–labeled Pittsburgh Compound B ([11C]PiB) PET imaging to measure amyloid burden, and structural magnetic resonance imaging to measure cortical thickness. Seventy-seven age-matched controls with normal cognitive function also underwent structural magnetic resonance imaging but not tau or amyloid PET imaging. Main Outcomes and Measures Tau burden, amyloid burden, and cortical thickness. Results In all 6 patients (3 women and 3 men; mean age 61.8 years), the underlying clinical phenotype was associated with the regional distribution of the [18F]AV-1451 signal. Furthermore, within 68 cortical regions of interest measured from each patient, the magnitude of cortical atrophy was strongly correlated with the magnitude of [18F]AV-1451 binding (3 patients with amnesic Alzheimer disease, r = –0.82; P < .001; r = –0.70; P < .001; r = –0.58; P < .001; and 3 patients with nonamnesic Alzheimer disease, r = –0.51; P < .001; r = –0.63; P < .001; r = –0.70; P < .001), but not of [11C]PiB binding. Conclusions and Relevance These findings provide further in vivo evidence that distribution of the [18F]AV-1451 signal as seen on results of PET imaging is a valid marker of clinical symptoms and neurodegeneration. By localizing and quantifying hyperphosphorylated tau in vivo, results of tau PET imaging will likely serve as a key biomarker that links a specific type of molecular Alzheimer disease neuropathologic condition with clinically significant neurodegeneration, which will likely catalyze additional efforts to develop disease-modifying therapeutics. PMID:28241163

  2. Noninvasive, automatic optimization strategy in cardiac resynchronization therapy.

    PubMed

    Reumann, Matthias; Osswald, Brigitte; Doessel, Olaf

    2007-07-01

    Optimization of cardiac resynchronization therapy (CRT) is still unsolved. It has been shown that optimal electrode position,atrioventricular (AV) and interventricular (VV) delays improve the success of CRT and reduce the number of non-responders. However, no automatic, noninvasive optimization strategy exists to date. Cardiac resynchronization therapy was simulated on the Visible Man and a patient data-set including fiber orientation and ventricular heterogeneity. A cellular automaton was used for fast computation of ventricular excitation. An AV block and a left bundle branch block were simulated with 100%, 80% and 60% interventricular conduction velocity. A right apical and 12 left ventricular lead positions were set. Sequential optimization and optimization with the downhill simplex algorithm (DSA) were carried out. The minimal error between isochrones of the physiologic excitation and the therapy was computed automatically and leads to an optimal lead position and timing. Up to 1512 simulations were carried out per pathology per patient. One simulation took 4 minutes on an Apple Macintosh 2 GHz PowerPC G5. For each electrode pair an optimal pacemaker delay was found. The DSA reduced the number of simulations by an order of magnitude and the AV-delay and VV - delay were determined with a much higher resolution. The findings are well comparable with clinical studies. The presented computer model of CRT automatically evaluates an optimal lead position and AV-delay and VV-delay, which can be used to noninvasively plan an optimal therapy for an individual patient. The application of the DSA reduces the simulation time so that the strategy is suitable for pre-operative planning in clinical routine. Future work will focus on clinical evaluation of the computer models and integration of patient data for individualized therapy planning and optimization.

  3. Sulfur K-edge XANES and acid volatile sulfide analyses of changes in chemical speciation of S and Fe during sequential extraction of trace metals in anoxic sludge from biogas reactors.

    PubMed

    Shakeri Yekta, Sepehr; Gustavsson, Jenny; Svensson, Bo H; Skyllberg, Ulf

    2012-01-30

    The effect of sequential extraction of trace metals on sulfur (S) speciation in anoxic sludge samples from two lab-scale biogas reactors augmented with Fe was investigated. Analyses of sulfur K-edge X-ray absorption near edge structure (S XANES) spectroscopy and acid volatile sulfide (AVS) were conducted on the residues from each step of the sequential extraction. The S speciation in sludge samples after AVS analysis was also determined by S XANES. Sulfur was mainly present as FeS (≈ 60% of total S) and reduced organic S (≈ 30% of total S), such as organic sulfide and thiol groups, in the anoxic solid phase. Sulfur XANES and AVS analyses showed that during first step of the extraction procedure (the removal of exchangeable cations), a part of the FeS fraction corresponding to 20% of total S was transformed to zero-valent S, whereas Fe was not released into the solution during this transformation. After the last extraction step (organic/sulfide fraction) a secondary Fe phase was formed. The change in chemical speciation of S and Fe occurring during sequential extraction procedure suggests indirect effects on trace metals associated to the FeS fraction that may lead to incorrect results. Furthermore, by S XANES it was verified that the AVS analysis effectively removed the FeS fraction. The present results identified critical limitations for the application of sequential extraction for trace metal speciation analysis outside the framework for which the methods were developed. Copyright © 2011 Elsevier B.V. All rights reserved.

  4. Factors associated with difficulty achieving initial control with crotalidae polyvalent immune fab antivenom in snakebite patients.

    PubMed

    Yin, Shan; Kokko, Jamie; Lavonas, Eric; Mlynarchek, Sara; Bogdan, Greg; Schaeffer, Tammi

    2011-01-01

    The prescribing information for Crotalidae Fab antivenom (FabAV) instructs clinicians to administer FabAV until initial control of the envenomation syndrome is achieved. Risk factors for difficulty achieving initial control are not known. The study aim was to identify factors present before administration of antivenom associated with difficulty achieving initial control. The authors conducted a retrospective study of all patients presenting to any one of 17 centers and receiving FabAV from 2002 to 2004. Demographic and historical information, as well as data about nine specific venom effects, were collected prior to the administration of antivenom. An expert panel used standard criteria to determine if initial control was achieved. The patient group that had difficulty achieving initial control was compared to the group that achieved initial control, and adjusted odds ratios were calculated using stepwise logistic regression. A total of 247 patients were included in the final analysis. The majority of patients were envenomated on the upper extremity and were young males. A total of 203 patients (82.2%) achieved initial control. In univariate analysis, thrombocytopenia, bleeding, neurologic effects, and a severe bite were significantly associated with difficulty achieving initial control. After logistic regression, the presence of neurologic effects and thrombocytopenia remained significantly associated with difficulty achieving initial control. When both factors were present, the patient was 13.8 times more likely to have difficulty achieving initial control. A number of factors were present before the administration of FabAV that were independently associated with difficulty achieving initial control of the envenomation syndrome. Predicting which patients will have difficulty achieving initial control has important ramifications for patient disposition and may provide insight into the mechanisms for lack of antivenom efficacy. © 2010 by the Society for Academic Emergency Medicine.

  5. Nonpharmacologic control of postoperative supraventricular arrhythmias using AV nodal fat pad stimulation in a young animal open heart surgical model.

    PubMed

    Moak, Jeffrey P; Mercader, Marco A; He, Dingchao; Trachiotis, Gregory; Langert, Joshua; Blicharz, Andy; Montaque, Erin; Li, Xiyan; Cheng, Yao I; McCarter, Robert; Bornzin, Gene A; Martin, Gerard R; Jonas, Richard A

    2013-06-01

    Supraventricular arrhythmias (junctional ectopic tachycardia [JET] and atrial tachyarrhythmias) frequently complicate recovery from open heart surgery in children and can be difficult to manage. Medical treatment of JET can result in significant morbidity. Our goal was to develop a nonpharmacological approach using autonomic stimulation of selective fat pad (FP) regions of the heart in a young canine model of open heart surgery to control 2 common postoperative supraventricular arrhythmias. Eight mongrel dogs, varying in age from 5 to 8 months and weighting 22±4 kg, underwent open heart surgery replicating a nontransannular approach to tetralogy of Fallot repair. Neural stimulation of the right inferior FP was used to control the ventricular response to supraventricular arrhythmias. Right inferior FP stimulation decreased baseline AV nodal conduction without altering sinus cycle length. AV node Wenckebach cycle length prolonged from 270±33 to 352±89 ms, P=0.02. Atrial fibrillation occurred in 7 animals, simulating a rapid atrial tachyarrhythmias. FP stimulation slowed the ventricular response rate from 166±58 to 63±29 beats per minute, P<0.001. Postoperative JET occurred in 7 dogs. FP stimulation slowed the ventricular rate during postoperative JET from 148±31 to 106±32 beats per minute, P<0.001, and restored sinus rhythm in 7/7 dogs. Right inferior FP stimulation had a selective effect on the AV node, and slowed the ventricular rate during postoperative JET and atrial tachyarrhythmias in our young canine open heart surgery model. FP stimulation may be a useful new technique for managing children with JET and atrial tachyarrhythmias.

  6. The innate immune response may be important for surviving plague in wild Gunnison's prairie dogs.

    PubMed

    Busch, Joseph D; Van Andel, Roger; Stone, Nathan E; Cobble, Kacy R; Nottingham, Roxanne; Lee, Judy; VerSteeg, Michael; Corcoran, Jeff; Cordova, Jennifer; Van Pelt, William; Shuey, Megan M; Foster, Jeffrey T; Schupp, James M; Beckstrom-Sternberg, Stephen; Beckstrom-Sternberg, James; Keim, Paul; Smith, Susan; Rodriguez-Ramos, Julia; Williamson, Judy L; Rocke, Tonie E; Wagner, David M

    2013-10-01

    Prairie dogs (Cynomys spp.) are highly susceptible to Yersinia pestis, with ≥99% mortality reported from multiple studies of plague epizootics. A colony of Gunnison's prairie dogs (Cynomys gunnisoni) in the Aubrey Valley (AV) of northern Arizona appears to have survived several regional epizootics of plague, whereas nearby colonies have been severely affected by Y. pestis. To examine potential mechanisms accounting for survival in the AV colony, we conducted a laboratory Y. pestis challenge experiment on 60 wild-caught prairie dogs from AV and from a nearby, large colony with frequent past outbreaks of plague, Espee (n = 30 per colony). Test animals were challenged subcutaneously with the fully virulent Y. pestis strain CO92 at three doses: 50, 5,000, and 50,000 colony-forming units (cfu); this range is lethal in black-tailed prairie dogs (Cynomys ludovicianus). Contrary to our expectations, only 40% of the animals died. Although mortality trended higher in the Espee colony (50%) compared with AV (30%), the differences among infectious doses were not statistically significant. Only 39% of the survivors developed moderate to high antibody levels to Y. pestis, indicating that mechanisms other than humoral immunity are important in resistance to plague. The ratio of neutrophils to lymphocytes was not correlated with plague survival in this study. However, several immune proteins with roles in innate immunity (VCAM-1, CXCL-1, and vWF) were upregulated during plague infection and warrant further inquiry into their role for protection against this disease. These results suggest plague resistance exists in wild populations of the Gunnison's prairie dog and provide important directions for future studies.

  7. The innate immune response may be important for surviving plague in wild Gunnison's prairie dogs

    USGS Publications Warehouse

    Busch, Joseph D.; Van Andel, Roger; Stone, Nathan E.; Cobble, Kacy R.; Nottingham, Roxanne; Lee, Judy; VerSteeg, Michael; Corcoran, Jeff; Cordova, Jennifer; Van Pelt, William E.; Shuey, Megan M.; Foster, Jeffrey T.; Schupp, James M.; Beckstrom-Sternberg, Stephen; Beckstrom-Sternberg, James; Keim, Paul; Smith, Susan; Rodriguez-Ramos, Julia; Williamson, Judy L.; Rocke, Tonie E.; Wagner, David M.

    2013-01-01

    Prairie dogs (Cynomys spp.) are highly susceptible to Yersinia pestis, with ≥99% mortality reported from multiple studies of plague epizootics. A colony of Gunnison's prairie dogs (Cynomys gunnisoni) in the Aubrey Valley (AV) of northern Arizona appears to have survived several regional epizootics of plague, whereas nearby colonies have been severely affected by Y. pestis. To examine potential mechanisms accounting for survival in the AV colony, we conducted a laboratory Y. pestis challenge experiment on 60 wild-caught prairie dogs from AV and from a nearby, large colony with frequent past outbreaks of plague, Espee (n = 30 per colony). Test animals were challenged subcutaneously with the fully virulent Y. pestis strain CO92 at three doses: 50, 5,000, and 50,000 colony-forming units (cfu); this range is lethal in black-tailed prairie dogs (Cynomys ludovicianus). Contrary to our expectations, only 40% of the animals died. Although mortality trended higher in the Espee colony (50%) compared with AV (30%), the differences among infectious doses were not statistically significant. Only 39% of the survivors developed moderate to high antibody levels to Y. pestis, indicating that mechanisms other than humoral immunity are important in resistance to plague. The ratio of neutrophils to lymphocytes was not correlated with plague survival in this study. However, several immune proteins with roles in innate immunity (VCAM-1, CXCL-1, and vWF) were upregulated during plague infection and warrant further inquiry into their role for protection against this disease. These results suggest plague resistance exists in wild populations of the Gunnison's prairie dog and provide important directions for future studies.

  8. Geothermal Energy Potential in Western United States

    ERIC Educational Resources Information Center

    Pryde, Philip R.

    1977-01-01

    Reviews types of geothermal energy sources in the western states, including hot brine systems and dry steam systems. Conversion to electrical energy is a major potential use of geothermal energy, although it creates environmental disruptions such as noise, corrosion, and scaling of equipment. (AV)

  9. An Improved Azimuth Angle Estimation Method with a Single Acoustic Vector Sensor Based on an Active Sonar Detection System

    PubMed Central

    Zhao, Anbang; Ma, Lin; Ma, Xuefei; Hui, Juan

    2017-01-01

    In this paper, an improved azimuth angle estimation method with a single acoustic vector sensor (AVS) is proposed based on matched filtering theory. The proposed method is mainly applied in an active sonar detection system. According to the conventional passive method based on complex acoustic intensity measurement, the mathematical and physical model of this proposed method is described in detail. The computer simulation and lake experiments results indicate that this method can realize the azimuth angle estimation with high precision by using only a single AVS. Compared with the conventional method, the proposed method achieves better estimation performance. Moreover, the proposed method does not require complex operations in frequency-domain and achieves computational complexity reduction. PMID:28230763

  10. Manifestations of Lyme carditis.

    PubMed

    Kostić, Tomislav; Momčilović, Stefan; Perišić, Zoran D; Apostolović, Svetlana R; Cvetković, Jovana; Jovanović, Andriana; Barać, Aleksandra; Šalinger-Martinović, Sonja; Tasić-Otašević, Suzana

    2017-04-01

    The first data of Lyme carditis, a relatively rare manifestation of Lyme disease, were published in eighties of the last century. Clinical manifestations include syncope, light-headedness, fainting, shortness of breath, palpitations, and/or chest pain. Atrioventricular (AV) electrical block of varying severity presents the most common conduction disorder in Lyme carditis. Although is usually mild, AV block can fluctuates rapidly and progress from a prolonged P-R interval to a His-Purkinje block within minutes to hours and days. Rarely, Lyme disease may be the cause of endocarditis, while some studies and reports, based on serological and/or molecular investigations, have suggested possible influence of Borrelia burgdorferi on degenerative cardiac valvular disease. Myocarditis, pericarditis, pancarditis, dilated cardiomyopathy, and heart failure have also been described as possible manifestations of Lyme carditis. The clinical course of Lyme carditis is generally mild, short term, and in most cases, completely reversible after adequate antibiotic treatment. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  11. Toxicity of stormwater treatment pond sediments to Hyallela azteca (Amphipoda)

    USGS Publications Warehouse

    Karouna-Renier, N.K.; Sparling, D.W.

    1997-01-01

    Stormwater wetlands are created to contain runoff from human developments and are designed to retain contaminants such as heavy metals, petroleum hydrocarbons, silt, pesticides, and nutrients before the runoff enter natural waterways. Because of this design, stormwater wetlands have a potential of becoming toxic sinks to organisms utilizing the wetlands for habitat. We conducted a 10-day sediment bioassay on Hyallela azteca as part of a larger study on the possible hazards of stormwater wetlands to aquatic invertebrates. Water and sediments from 10 wetlands separated into reference, residential, commercial, and highway land uses were used. No differences in survival were observed among land use categories, possibly because the ratio of acid volatile sulfides/simultaneously extractable metals (AVS/SEM) was > 1.0 for all of the ponds tested; values > 1 in this ratio are indications that toxic metals may not be bioavailable. Survival and growth rates correlated positively with AVS.

  12. Deletion of Rbpj from postnatal endothelium leads to abnormal arteriovenous shunting in mice

    PubMed Central

    Nielsen, Corinne M.; Cuervo, Henar; Ding, Vivianne W.; Kong, Yupeng; Huang, Eric J.; Wang, Rong A.

    2014-01-01

    Arteriovenous malformations (AVMs) are tortuous vessels characterized by arteriovenous (AV) shunts, which displace capillaries and shunt blood directly from artery to vein. Notch signaling regulates embryonic AV specification by promoting arterial, as opposed to venous, endothelial cell (EC) fate. To understand the essential role of endothelial Notch signaling in postnatal AV organization, we used inducible Cre-loxP recombination to delete Rbpj, a mediator of canonical Notch signaling, from postnatal ECs in mice. Deletion of endothelial Rbpj from birth resulted in features of AVMs by P14, including abnormal AV shunting and tortuous vessels in the brain, intestine and heart. We further analyzed brain AVMs, as they pose particular health risks. Consistent with AVM pathology, we found cerebral hemorrhage, hypoxia and necrosis, and neurological deficits. AV shunts originated from capillaries (and possibly venules), with the earliest detectable morphological abnormalities in AV connections by P8. Prior to AV shunt formation, alterations in EC gene expression were detected, including decreased Efnb2 and increased Pai1, which encodes a downstream effector of TGFβ signaling. After AV shunts had formed, whole-mount immunostaining showed decreased Efnb2 and increased Ephb4 expression within AV shunts, suggesting that ECs were reprogrammed from arterial to venous identity. Deletion of Rbpj from adult ECs led to tortuosities in gastrointestinal, uterine and skin vascular beds, but had mild effects in the brain. Our results demonstrate a temporal requirement for Rbpj in postnatal ECs to maintain proper artery, capillary and vein organization and to prevent abnormal AV shunting and AVM pathogenesis. PMID:25209249

  13. Multimodal correlation of dynamic [18F]-AV-1451 perfusion PET and neuronal hypometabolism in [18F]-FDG PET.

    PubMed

    Hammes, Jochen; Leuwer, Isabel; Bischof, Gérard N; Drzezga, Alexander; van Eimeren, Thilo

    2017-12-01

    Cerebral glucose metabolism measured with [18F]-FDG PET is a well established marker of neuronal dysfunction in neurodegeneration. The tau-protein tracer [18F]-AV-1451 PET is currently under evaluation and shows promising results. Here, we assess the feasibility of early perfusion imaging with AV-1451 as a substite for FDG PET in assessing neuronal injury. Twenty patients with suspected neurodegeneration underwent FDG and early phase AV-1451 PET imaging. Ten one-minute timeframes were acquired after application of 200 MBq AV-1451. FDG images were acquired on a different date according to clinical protocol. Early AV-1451 timeframes were coregistered to individual FDG-scans and spatially normalized. Voxel-wise intermodal correlations were calculated on within-subject level for every possible time window. The window with highest pooled correlation was considered optimal. Z-transformed deviation maps (ZMs) were created from both FDG and early AV-1451 images, comparing against FDG images of healthy controls. Regional patterns and extent of perfusion deficits were highly comparable to metabolic deficits. Best results were observed in a time window from 60 to 360 s (r = 0.86). Correlation strength ranged from r = 0.96 (subcortical gray matter) to 0.83 (frontal lobe) in regional analysis. ZMs of early AV-1451 and FDG images were highly similar. Perfusion imaging with AV-1451 is a valid biomarker for assessment of neuronal dysfunction in neurodegenerative diseases. Radiation exposure and complexity of the diagnostic workup could be reduced significantly by routine acquisition of early AV-1451 images, sparing additional FDG PET.

  14. Atorvastatin and fenofibrate increase apolipoprotein AV and decrease triglycerides by up-regulating peroxisome proliferator-activated receptor-α

    PubMed Central

    Huang, Xian-sheng; Zhao, Shui-ping; Bai, Lin; Hu, Min; Zhao, Wang; Zhang, Qian

    2009-01-01

    Background and purpose: Combining statin and fibrate in clinical practice provides a greater reduction of triglycerides than either drug given alone, but the mechanism for this effect is poorly understood. Apolipoprotein AV (apoAV) has been implicated in triglyceride metabolism. This study was designed to investigate the effect of the combination of statin and fibrate on apoAV and the underlying mechanism(s). Experimental approach: Hypertriglyceridaemia was induced in rats by giving them 10% fructose in drinking water for 2 weeks. They were then treated with atorvastatin, fenofibrate or the two agents combined for 4 weeks, and plasma triglyceride and apoAV measured. We also tested the effects of these two agents on triglycerides and apoAV in HepG2 cells in culture. Western blot and reverse transcription polymerase chain reaction was used to measure apoAV and peroxisome proliferator-activated receptor-α (PPARα) expression. Key results: The combination of atorvastatin and fenofibrate resulted in a greater decrease in plasma triglycerides and a greater increase in plasma and hepatic apoAV than either agent given alone. Hepatic expression of the PPARα was also more extensively up-regulated in rats treated with the combination. A similar, greater increase in apoAV and a greater decrease in triglycerides were observed following treatment of HepG2 cells pre-exposed to fructose), with the combination. Adding an inhibitor of PPARα (MK886) abolished the effects of atorvastatin on HepG2 cells. Conclusions and implications: A combination of atorvastatin and fenofibrate increased apoAV and decreased triglycerides through up-regulation of PPARα. PMID:19694729

  15. Impact of New Quick Gold Nanoparticle-Based Cortisol Assay During Adrenal Vein Sampling for Primary Aldosteronism.

    PubMed

    Yoneda, Takashi; Karashima, Shigehiro; Kometani, Mitsuhiro; Usukura, Mikiya; Demura, Masashi; Sanada, Junichirou; Minami, Tetsuya; Koda, Wataru; Gabata, Toshifumi; Matsui, Osamu; Idegami, Koutarou; Takamura, Yuzuru; Tamiya, Eiichi; Oe, Masashi; Nakai, Masuo; Mori, Shunsuke; Terayama, Noboru; Matsuda, Yuichi; Kamemura, Kouhei; Fujii, Sumie; Seta, Takashi; Sawamura, Toshitaka; Okuda, Rika; Takeda, Yoshimichi; Hayashi, Kenshi; Yamagishi, Masakazu; Takeda, Yoshiyu

    2016-06-01

    Adrenal vein sampling (AVS) is essential for identifying a surgically curable form of primary aldosteronism (PA), but accurate placement of the sampling catheter is technically challenging. Intraprocedural cortisol measurement can confirm the catheter's position, thereby increasing the AVS success rate. We developed a quick cortisol assay (QCA) that uses immunochromatography and gold nanoparticles and can be performed either semiquantitatively or quantitatively. The assay was evaluated in two studies. In a single-center study, PA patients were assigned to undergo AVS incorporating the semiquantitative QCA (n = 30), the quantitative QCA (n = 30), or without the QCA (n = 30), and the rates of successful AVS were determined. In a prospective multicenter randomized, controlled study, the success rates of AVS performed with (n = 148) or without (n = 145) the semiquantitative QCA were determined. Cortisol concentrations were measured during AVS in 6 minutes or less in the radiology suite, without additional technical assistance, and significantly correlated with a conventional reference assay (R(2) = 0.994; P < .001). In the single-center study, the differences in the AVS success rates associated with semiquantitative and quantitative QCAs were not significant (both 93%); however, the success rates were significantly higher than the rate of successful AVS performed without using the QCA (63%; P < .001). The success rate of AVS performed in the multicenter study was 94% for the semiquantitative QCA, which was significantly higher than the rate for the patients without QCA (60%; P < .001). Our novel QCA was rapidly and easily performed at the point of care and improved the rate of successful AVS.

  16. Adrenal venous sampling: the learning curve of a single interventionalist with 282 consecutive procedures.

    PubMed

    Jakobsson, Hugo; Farmaki, Katerina; Sakinis, Augustinas; Ehn, Olof; Johannsson, Gudmundur; Ragnarsson, Oskar

    2018-01-01

    Primary aldosteronism (PA) is a common cause of secondary hypertension. Adrenal venous sampling (AVS) is the gold standard for assessing laterality of PA, which is of paramount importance to decide adequate treatment. AVS is a technically complicated procedure with success rates ranging between 30% and 96%. The aim of this study was to investigate the success rate of AVS over time, performed by a single interventionalist. This was a retrospective study based on consecutive AVS procedures performed by a single operator between September 2005 and June 2016. Data on serum concentrations of aldosterone and cortisol from right and left adrenal vein, inferior vena cava, and peripheral vein were collected and selectivity index (SI) calculated. Successful AVS was defined as SI > 5. In total, 282 AVS procedures were performed on 269 patients, 168 men (62%) and 101 women (38%), with a mean age of 55±11 years (range, 26-78 years). Out of 282 AVS procedures, 259 were successful, giving an overall success rate of 92%. The most common reason for failure was inability to localize the right adrenal vein (n=16; 76%). The success rates were 63%, 82%, and 94% during the first, second, and third years, respectively. During the last 8 years the success rate was 95%, and on average 27 procedures were performed annually. Satisfactory AVS success rate was achieved after approximately 36 procedures and satisfactory success rate was maintained by performing approximately 27 procedures annually. AVS should be limited to few operators that perform sufficiently large number of procedures to achieve, and maintain, satisfactory AVS success rate.

  17. Diagnostic performance of multidetector computed tomography in distinguishing unilateral from bilateral abnormalities in primary hyperaldosteronism: comparison of multidetector computed tomography with adrenal vein sampling.

    PubMed

    Raman, Siva P; Lessne, Mark; Kawamoto, Satomi; Chen, Yifei; Salvatori, Roberto; Prescott, Jason D; Fishman, Elliot K

    2015-01-01

    The management of patients with primary hyperaldosteronism (PH) varies depending on whether the unregulated aldosterone secretion localizes to a single unilateral adrenal gland, traditionally determined using adrenal vein sampling (AVS). This study seeks to determine if the performance of multidetector computed tomography (MDCT) examinations performed using the latest scanner technology can reasonably match the results of AVS, and potentially avoid AVS in some patients. Computed tomographic scans in 56 patients with PH were independently reviewed by 2 radiologists for the presence of adrenal nodules and qualitative adrenal thickening. Results were correlated with AVS results. Of 35 patients with MDCT evidence of unilateral nodules, the imaging findings correctly predicted AVS localization in only 23 (65.7%) cases. When stratified by size, MDCT was accurate in only 71.4% of cases for nodules measuring 10 mm or less, and only 55.0% of cases for nodules measuring 11 to 20 mm. Of the 12 cases where MDCT did not correctly localize, AVS localized to the contralateral adrenal gland in 4 cases, whereas AVS suggested no lateralization in 8 cases. In patients with normal bilateral adrenal glands on MDCT, 2/7 (28.6%) of cases demonstrated unilateral localization on AVS, and in patients with bilateral adrenal nodules, only 3/14 (21.4%) did not demonstrate lateralization on AVS. Multidetector computed tomography, even when performed with the latest generation of MDCT scanners, does not offer sufficient diagnostic accuracy to replace AVS in patients with PH.

  18. Alternating versus synchronous ventilation of left and right lungs in piglets.

    PubMed

    Versprille, A; Hrachovina, V; Jansen, J R

    1995-12-01

    We tested whether alternating ventilation (AV) of each lung (i.e. with a phase difference of half a ventilatory cycle) would decrease central venous pressure and so increase cardiac output when compared with simultaneous ventilation (SV) of both lungs. If, during AV, the inflated lung expands partly via compression of the opposite lung, mean lung volume will be smaller during AV than SV. As a consequence, mean intrathoracic pressure (as cited in the literature), and therefore, central venous pressure will be smaller. The experiments were performed in seven anaesthetized and paralyzed piglets using a double-piston ventilator. Minute ventilation was the same during AV and SV. Starting at SV, we alternated three times between AV and SV for periods of 10 min. During AV, central venous pressure was decreased by 0.7 mmHg and cardiac output was increased by 10 +/- 4.4% (mean, +/-SD) compared with SV. AV also resulted in increased arterial pressure. During one-sided inflation with closed outlet of the opposite lung, a pressure rise occurred in the opposite lung, indicating compression. The higher cardiac output during AV than SV can be explained by the fact that central venous pressure is lower during AV. This lower central venous pressure is very probably due to the lower mean intrathoracic pressure caused by compression of the opposite lung during unilateral inflation.

  19. Diagnosis and microecological characteristics of aerobic vaginitis in outpatients based on preformed enzymes.

    PubMed

    Wang, Zhi-Liang; Fu, Lan-Yong; Xiong, Zheng-Ai; Qin, Qin; Yu, Teng-Hua; Wu, Yu-Tong; Hua, Yuan-Yuan; Zhang, Yong-Hong

    2016-02-01

    Aerobic vaginitis (AV) is a recently proposed term for genital tract infection in women. The diagnosis of AV is mainly based on descriptive diagnostic criteria proposed by Donders and co-workers. The objective of this study is to report AV prevalence in southwest China using an objective assay kit based on preformed enzymes and also to determine its characteristics. A total of 1948 outpatients were enrolled and tested by a commercial diagnostic kit to investigate the AV prevalence and characteristics in southwestern China. The study mainly examined the vaginal ecosystem, age distribution, Lactobacillus amount, and changes in pH. Differences within groups were analyzed by Wilcoxon two-sample test. The AV detection rate is 15.40%. The AV patients were usually seen in the sexually active age group of 20-30 years, followed by those in the age group of 30-40 years. The vaginal ecosystems of all the patients studied were absolutely abnormal, and diagnosed to have a combined infection [aerobic vaginitis (AV) + bacterial vaginitis (BV) 61.33%; 184/300]. Aerobic bacteria, especially Staphylococcus aureus and Escherichia coli, were predominantly found in the vaginal samples of these women. AV is a common type of genital infection in southwestern China and is characterized by sexually active age and combined infection predominated by the AV and BV type. Copyright © 2016. Published by Elsevier B.V.

  20. Audio-visual speech perception in infants and toddlers with Down syndrome, fragile X syndrome, and Williams syndrome.

    PubMed

    D'Souza, Dean; D'Souza, Hana; Johnson, Mark H; Karmiloff-Smith, Annette

    2016-08-01

    Typically-developing (TD) infants can construct unified cross-modal percepts, such as a speaking face, by integrating auditory-visual (AV) information. This skill is a key building block upon which higher-level skills, such as word learning, are built. Because word learning is seriously delayed in most children with neurodevelopmental disorders, we assessed the hypothesis that this delay partly results from a deficit in integrating AV speech cues. AV speech integration has rarely been investigated in neurodevelopmental disorders, and never previously in infants. We probed for the McGurk effect, which occurs when the auditory component of one sound (/ba/) is paired with the visual component of another sound (/ga/), leading to the perception of an illusory third sound (/da/ or /tha/). We measured AV integration in 95 infants/toddlers with Down, fragile X, or Williams syndrome, whom we matched on Chronological and Mental Age to 25 TD infants. We also assessed a more basic AV perceptual ability: sensitivity to matching vs. mismatching AV speech stimuli. Infants with Williams syndrome failed to demonstrate a McGurk effect, indicating poor AV speech integration. Moreover, while the TD children discriminated between matching and mismatching AV stimuli, none of the other groups did, hinting at a basic deficit or delay in AV speech processing, which is likely to constrain subsequent language development. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Pilot Implementation and Preliminary Evaluation of START:AV Assessments in Secure Juvenile Correctional Facilities

    PubMed Central

    Sellers, Brian G; Viljoen, Jodi L.; Cruise, Keith R.; Nicholls, Tonia L.; Dvoskin, Joel A.

    2012-01-01

    The Short-Term Assessment of Risk and Treatability: Adolescent Version (START:AV) is a new structured professional judgment guide for assessing short-term risks in adolescents. The scheme may be distinguished from other youth risk assessment and treatment planning instruments by its inclusion of 23 dynamic factors that are each rated for both vulnerability and strength. In addition, START:AV is also unique in that it focuses on multiple adverse outcomes—namely, violence, self-harm, suicide, unauthorized leave, substance abuse, self-neglect, victimization, and general offending—over the short-term (i.e., weeks to months) rather than long-term (i.e., years). This paper describes a pilot implementation and preliminary evaluation of START:AV in three secure juvenile correctional facilities in the southern United States. Specifically, we examined the descriptive characteristics and psychometric properties of START:AV assessments completed by 21 case managers on 291 adolescent offenders (250 boys and 41 girls) at the time of admission. Results provide preliminary support for the feasibility of completing START:AV assessments as part of routine practice. Findings also highlight differences in the characteristics of START:AV assessments for boys and girls and differential associations between the eight START:AV risk domains. Though results are promising, further research is needed to establish the reliability and validity of START:AV assessments completed in the field. PMID:23316116

  2. Temporal changes in the expression of avian β-defensins in the chicken vagina during sexual maturation and Salmonella infection.

    PubMed

    Anastasiadou, Maria; Avdi, Melpomeni; Theodoridis, Alexandros; Michailidis, Georgios

    2013-06-01

    Avian β-defensins (AvβDs) constitute a family of antimicrobial peptides that are critical to innate immunity in chickens, providing protection against microbial pathogens including Salmonella Enteritidis (SE). As apart from the digestive tract another main route of SE colonization in birds is via infection of the oviduct and specifically of the vagina, the aim of this study was to investigate the expression of the complete family of AvβDs, in the chicken vagina in vivo, to determine whether sexual maturation affects their mRNA abundance and to investigate whether SE infection alters the vaginal AvβDs expression. Expression analysis revealed that 11 members of the AvβD family were expressed in the chicken vagina. Quantitative real-time PCR analysis revealed that the mRNA abundance of five AvβDs was up regulated and of one AvβD was down regulated with respect to sexual maturation. In addition SE infection resulted in a significant induction of AvβD5, 7, 10, 11, 12 and 14 in the vagina of sexually mature birds, and in a significant induction of AvβD5 and 11 in the vagina of aged birds. These findings provide strong evidence to suggest that an AvβD-mediated immune response mechanism exists in the chicken vagina providing protection against bacterial pathogens including Salmonella species.

  3. Modification of atrioventricular nodal electrophysiology by selective radiofrequency delivery on the anterior or posterior approaches.

    PubMed

    Chorro, F J; Sanchis, J; Such, L; Artal, L; Llavador, J J; Llavador, E; Monmeneu, J V; López-Merino, V

    1997-05-01

    An analysis was made in 14 isolated and perfused rabbit hearts of the electrophysiological effects of selective radiofrequency (RF) delivery in the anterior (group I, n = 7) or posterior zone (group II, n = 7) of the Koch triangle, with the aim of modifying atrioventricular nodal (AVN) conduction without suppressing 1:1 transmission. After opening the right atrium, RF was delivered (0.5 W) with a 1-mm diameter unipolar electrode positioned in the selected zone until a prolongation of no less than 15% was obtained in the Wenckebach cycle length (WCL). Before and after (30 min) RF, anterograde and retrograde AVN refractoriness and conduction were evaluated, stimulating from the crista terminalis (CT), the interatrial septum (IAS), and from the RV epicardium. After RF, the following percentage increments were observed in group I: AH(CT) = 36% +/- 9%, AH(IAS) = 38% +/- 11%, WCL(CT) = 28% +/- 8%, WCL(IAS) = 22% +/- 6%, functional refractory period (FRP) of the AVN(CT) = 13% +/- 11%, FRP-AVN(IAS) = 13% +/- 8%, retrograde WCL = 20% +/- 19%, and retrograde FRPVA = 13% +/- 16%. The increments observed in group II and the significances of the differences with respect to group I were: AH(CT) = 11% +/- 14% (P < 0.01), AH(IAS) = 19% +/- 32% (NS), WCL(CT) = 42% +/- 14% (P < 0.05), WCL(IAS) = 42% +/- 16% (P < 0.01), FRP-AVN(CT) = 28% +/- 28% (NS), FRP-AVN(LAS) = 21% +/- 19% (NS), retrograde WCL = 35% +/- 24% (NS), and retrograde FRP = 16% +/- 13% (NS). In both groups, the AH interval variations were not correlated with those of the rest of the parameters analyzed. Truncated nodal function curves suggestive of a dual AV nodal pathway were obtained in three experiments, though in only one of them was this observed under basal conditions. In the other two experiments, with dual AV nodal physiology only after RF (one from each group), AV nodal reentrant tachycardias were triggered with atrial extrastimulus at coupling intervals equal to or shorter than at those that cause a sudden lengthening of the AH interval, RF delivered in the anterior and posterior zones of the Koch triangle produced effects of different magnitude on the AH interval and Wenckebach cycle length. In the anterior zone the AH interval was prolonged to a greater extent, while in the posterior zone the effects were greater on the Wenckebach cycle length. No correlation existed between the variations in AH interval and Wenckebach cycle length, regardless of where RF was delivered. The evaluation of anterograde AV nodal refractoriness was similar when stimulating from the crista terminalis or from the interatrial septum. By delivering RF, it was possible to induce dual AV nodal physiology and reentrant tachycardias.

  4. The magnetic navigation system allows safety and high efficacy for ablation of arrhythmias.

    PubMed

    Bauernfeind, Tamas; Akca, Ferdi; Schwagten, Bruno; de Groot, Natasja; Van Belle, Yves; Valk, Suzanne; Ujvari, Barbara; Jordaens, Luc; Szili-Torok, Tamas

    2011-07-01

    We aimed to evaluate the safety and long-term efficacy of the magnetic navigation system (MNS) in a large number of patients. The MNS has the potential for improving safety and efficacy based on atraumatic catheter design and superior navigation capabilities. In this study, 610 consecutive patients underwent ablation. Patients were divided into two age- and sex-matched groups. Ablations were performed either using MNS (group MNS, 292) or conventional manual ablation [group manual navigation (MAN), 318]. The following parameters were analysed: acute success rate, fluoroscopy time, procedure time, complications [major: pericardial tamponade, permanent atrioventricular (AV) block, major bleeding, and death; minor: minor bleeding and temporary AV block]. Recurrence rate was assessed during follow-up (15±9.5 months). Subgroup analysis was performed for the following groups: atrial fibrillation, isthmus dependent and atypical atrial flutter, atrial tachycardia, AV nodal re-entrant tachycardia, circus movement tachycardia, and ventricular tachycardia (VT). Magnetic navigation system was associated with less major complications (0.34 vs. 3.2%, P=0.01). The total numbers of complications were lower in group MNS (4.5 vs. 10%, P=0.005). Magnetic navigation system was equally effective as MAN in acute success rate for overall groups (92 vs. 94%, P=ns). Magnetic navigation system was more successful for VTs (93 vs. 72%, P<0.05). Less fluoroscopy was used in group MNS (30±20 vs. 35±25 min, P<0.01). There were no differences in procedure times and recurrence rates for the overall groups (168±67 vs. 159±75 min, P=ns; 14 vs. 11%, P=ns; respectively). Our data suggest that the use of MNS improves safety without compromising efficiency of ablations. Magnetic navigation system is more effective than manual ablation for VTs.

  5. Vibration-Rotation Bands of HF and DF

    DTIC Science & Technology

    1977-09-23

    98 IZa. Comparison of Observed and Calculated Line Positions of HF, Av = I Sequence ........................... 99 f2b. Comparison of Observed and...Calculated Line Positions of HF, Av = 2 Sequence ........................... 102 12c. Comparison of Observed and Calculated Line Positions of HF, Av = 3...Sequence ........................... 107 i2d. Comparison of Observed and Calculated Line Positions ofHF, Av = 4 Sequence ........................... fi

  6. 30 CFR 773.26 - How to challenge an ownership or control listing or finding.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... authority with jurisdiction over the violation and the AVS Office to obtain additional information. (d) A... investigation by the AVS Office. (e) At any time, you, a person listed in AVS as an owner or controller of a surface coal mining operation, may request an informal explanation from the AVS Office as to the reason...

  7. Preschoolers Benefit From Visually Salient Speech Cues

    PubMed Central

    Holt, Rachael Frush

    2015-01-01

    Purpose This study explored visual speech influence in preschoolers using 3 developmentally appropriate tasks that vary in perceptual difficulty and task demands. They also examined developmental differences in the ability to use visually salient speech cues and visual phonological knowledge. Method Twelve adults and 27 typically developing 3- and 4-year-old children completed 3 audiovisual (AV) speech integration tasks: matching, discrimination, and recognition. The authors compared AV benefit for visually salient and less visually salient speech discrimination contrasts and assessed the visual saliency of consonant confusions in auditory-only and AV word recognition. Results Four-year-olds and adults demonstrated visual influence on all measures. Three-year-olds demonstrated visual influence on speech discrimination and recognition measures. All groups demonstrated greater AV benefit for the visually salient discrimination contrasts. AV recognition benefit in 4-year-olds and adults depended on the visual saliency of speech sounds. Conclusions Preschoolers can demonstrate AV speech integration. Their AV benefit results from efficient use of visually salient speech cues. Four-year-olds, but not 3-year-olds, used visual phonological knowledge to take advantage of visually salient speech cues, suggesting possible developmental differences in the mechanisms of AV benefit. PMID:25322336

  8. A complete characterization of all-versus-nothing arguments for stabilizer states.

    PubMed

    Abramsky, Samson; Barbosa, Rui Soares; Carù, Giovanni; Perdrix, Simon

    2017-11-13

    An important class of contextuality arguments in quantum foundations are the all-versus-nothing (AvN) proofs, generalizing a construction originally due to Mermin. We present a general formulation of AvN arguments and a complete characterization of all such arguments that arise from stabilizer states. We show that every AvN argument for an n -qubit stabilizer state can be reduced to an AvN proof for a three-qubit state that is local Clifford-equivalent to the tripartite Greenberger-Horne-Zeilinger state. This is achieved through a combinatorial characterization of AvN arguments, the AvN triple theorem, whose proof makes use of the theory of graph states. This result enables the development of a computational method to generate all the AvN arguments in [Formula: see text] on n -qubit stabilizer states. We also present new insights into the stabilizer formalism and its connections with logic.This article is part of the themed issue 'Second quantum revolution: foundational questions'. © 2017 The Author(s).

  9. TIME VARIATION OF AV AND RV FOR TYPE Ia SUPERNOVAE BEHIND INTERSTELLAR DUST

    NASA Astrophysics Data System (ADS)

    Huang, Xiaosheng; Biederman, M.; Herger, B.; Aldering, G. S.

    2014-01-01

    TIME VARIATION OF AV AND RV FOR TYPE Ia SUPERNOVAE BEHIND NON-UNIFORM INTERSTELLAR DUST ABSTRACT We investigate the time variation of the visual extinction, AV, and the total-to-selective extinction ratio, RV, resulting from interstellar dust in front of an expanding photospheric disk of a type Ia supernova (SN Ia). We simulate interstellar dust clouds according to a power law power spectrum and produce extinction maps that either follow a pseudo-Gaussian distribution or a lognormal distribution. The RV maps are produced through a correlation between AV and RV. With maps of AV and RV generated in each case (pseudo-Gaussian and lognormal), we then compute the effective AV and RV for a SN as its photospheric disk expands behind the dust screen. We find for a small percentage of SNe the AV and RV values can vary by a large factor from day to day in the first 40 days after explosion.

  10. Axonal autophagosomes recruit dynein for retrograde transport through fusion with late endosomes

    PubMed Central

    Cheng, Xiu-Tang; Zhou, Bing; Lin, Mei-Yao; Cai, Qian

    2015-01-01

    Efficient degradation of autophagic vacuoles (AVs) via lysosomes is an important cellular homeostatic process. This is particularly challenging for neurons because mature acidic lysosomes are relatively enriched in the soma. Although dynein-driven retrograde transport of AVs was suggested, a fundamental question remains how autophagosomes generated at distal axons acquire dynein motors for retrograde transport toward the soma. In this paper, we demonstrate that late endosome (LE)–loaded dynein–snapin complexes drive AV retrograde transport in axons upon fusion of autophagosomes with LEs into amphisomes. Blocking the fusion with syntaxin17 knockdown reduced recruitment of dynein motors to AVs, thus immobilizing them in axons. Deficiency in dynein–snapin coupling impaired AV transport, resulting in AV accumulation in neurites and synaptic terminals. Altogether, our study provides the first evidence that autophagosomes recruit dynein through fusion with LEs and reveals a new motor–adaptor sharing mechanism by which neurons may remove distal AVs engulfing aggregated proteins and dysfunctional organelles for efficient degradation in the soma. PMID:25940348

  11. Starch nanoparticle as a vitamin E-TPGS carrier loaded in silk fibroin-poly(vinyl alcohol)-Aloe vera nanofibrous dressing.

    PubMed

    Kheradvar, Shadi Alsadat; Nourmohammadi, Jhamak; Tabesh, Hadi; Bagheri, Behnam

    2018-06-01

    Core-sheath nanofibrous mat as a new vitamin E (VE) delivery system based on silk fibroin (SF)/poly(vinyl alcohol) (PVA)/aloe vera (AV) was successfully prepared by the electrospinning method. Initially, VE-loaded starch nanoparticles were produced and then incorporated into the best beadless SF-PVA-AV nanofibers. The successful loading of VE in starch nanoparticles was proved by Fourier-transform infrared spectroscopy. The scanning electron microscopy and transmission electron microscopy indicated that spherical nanoparticles were successfully embedded within the nanofibers. In vitro release studies demonstrated that the release of VE was controlled by Fickian diffusion and was faster in samples containing more nanoparticles. Fibroblast attachment, proliferation, and collagen secretion were enhanced after adding AV and VE to the SF-PVA nanomatrix. Moreover, the incorporation of VE into the nanocomposite dressing enhanced antioxidant activity, which can have a positive effect on wound healing process by protecting the cells from toxic oxidation products. Copyright © 2018 Elsevier B.V. All rights reserved.

  12. The Time Is Up: Compression of Visual Time Interval Estimations of Bimodal Aperiodic Patterns

    PubMed Central

    Duarte, Fabiola; Lemus, Luis

    2017-01-01

    The ability to estimate time intervals subserves many of our behaviors and perceptual experiences. However, it is not clear how aperiodic (AP) stimuli affect our perception of time intervals across sensory modalities. To address this question, we evaluated the human capacity to discriminate between two acoustic (A), visual (V) or audiovisual (AV) time intervals of trains of scattered pulses. We first measured the periodicity of those stimuli and then sought for correlations with the accuracy and reaction times (RTs) of the subjects. We found that, for all time intervals tested in our experiment, the visual system consistently perceived AP stimuli as being shorter than the periodic (P) ones. In contrast, such a compression phenomenon was not apparent during auditory trials. Our conclusions are: first, the subjects exposed to P stimuli are more likely to measure their durations accurately. Second, perceptual time compression occurs for AP visual stimuli. Lastly, AV discriminations are determined by A dominance rather than by AV enhancement. PMID:28848406

  13. Natural history of aortic valve disease following intervention for rheumatic mitral valve disease.

    PubMed

    Namboodiri, Narayanan; Remash, Krishnan; Tharakan, Jaganmohan A; Shajeem, Othayoth; Nair, Krishnakumar; Titus, Thomas; Ajitkumar, Valaparambil K; Sivasankaran, Sivasubramonian; Krishnamoorthy, Kavassery M; Harikrishnan, Sivadasan P; Harikrishnan, Madhavankutty S; Bijulal, Sasidharan

    2009-01-01

    A significant proportion of patients who require interventions for rheumatic mitral valve (MV) disease have coexisting aortic valve (AV) disease. To date, little is known of the natural history of AV disease in these patients. The details of a cohort of 200 patients (146 females, 54 males; mean age at MV intervention 30.3 +/- 9.9 years) with rheumatic heart disease were retrospectively reviewed. The patients had undergone an index MV intervention (either closed or balloon mitral valvotomy) or MV replacement between 1994 and 1996, and received long-term regular follow up examinations. The clinical and echocardiographic data at entry and at follow up were noted. Patients were allocated to two groups, based on whether the AV disease was absent (group I, n=98) or present (group II, n=102) at baseline. The AV disease was categorized as thickening only (group IIA), isolated aortic regurgitation (AR) (group IIB), or combined aortic stenosis (AS) and AR (group IIC). No patient had isolated AS at baseline. The mean follow up period was 9.3 +/- 1.07 years; during which 10 patients in group I developed new AV disease, which included AV thickening only (n=2), trivial-mild AR (n=7) and mild AS with trivial AR (n=1). Of 16 patients in group IIA, 11 developed isolated AR, and one patient progressed to have mild AS and AR. Among 69 patients in group IIB, 22 (31.9%) developed AS, and all had either mild (n=8) or moderate (n=14) AR with mild AS. Group IIC included 17 patients with mild combined AV disease at baseline, except for moderate AS and moderate AR in one patient each. Among 16 patients with mild AS in group IIC, six progressed to moderate AS and two to severe AS. AR became moderate in 10 patients and severe in one patient. The two patients who progressed to severe AS requiring AV replacement had mild AS at baseline. No patient who developed new combined AV disease had lesions with severity more than mild AS or moderate AR. On logistic regression analysis of the variables predisposing to progression of AV disease, such as age, gender, history of rheumatic fever (RF) and recurrence, and interval from RF episode to symptom onset, only the initial AV gradient was identified as being statistically significant (beta coefficient 0.528, SE = 0.17, p < 0.0001). Patients with no or mild AV disease at the time of MV intervention rarely develop severe AV disease, and seldom require AV surgery over the long-term follow up. The presence of mild AS at baseline is predictive in the minority of cases where AV disease will progress relatively more rapidly.

  14. CFD- and Bernoulli-based pressure drop estimates: A comparison using patient anatomies from heart and aortic valve segmentation of CT images.

    PubMed

    Weese, Jürgen; Lungu, Angela; Peters, Jochen; Weber, Frank M; Waechter-Stehle, Irina; Hose, D Rodney

    2017-06-01

    An aortic valve stenosis is an abnormal narrowing of the aortic valve (AV). It impedes blood flow and is often quantified by the geometric orifice area of the AV (AVA) and the pressure drop (PD). Using the Bernoulli equation, a relation between the PD and the effective orifice area (EOA) represented by the area of the vena contracta (VC) downstream of the AV can be derived. We investigate the relation between the AVA and the EOA using patient anatomies derived from cardiac computed tomography (CT) angiography images and computational fluid dynamic (CFD) simulations. We developed a shape-constrained deformable model for segmenting the AV, the ascending aorta (AA), and the left ventricle (LV) in cardiac CT images. In particular, we designed a structured AV mesh model, trained the model on CT scans, and integrated it with an available model for heart segmentation. The planimetric AVA was determined from the cross-sectional slice with minimum AV opening area. In addition, the AVA was determined as the nonobstructed area along the AV axis by projecting the AV leaflet rims on a plane perpendicular to the AV axis. The flow rate was derived from the LV volume change. Steady-state CFD simulations were performed on the patient anatomies resulting from segmentation. Heart and valve segmentation was used to retrospectively analyze 22 cardiac CT angiography image sequences of patients with noncalcified and (partially) severely calcified tricuspid AVs. Resulting AVAs were in the range of 1-4.5 cm 2 and ejection fractions (EFs) between 20 and 75%. AVA values computed by projection were smaller than those computed by planimetry, and both were strongly correlated (R 2 = 0.995). EOA values computed via the Bernoulli equation from CFD-based PD results were strongly correlated with both AVA values (R 2 = 0.97). EOA values were ∼10% smaller than planimetric AVA values. For EOA values < 2.0 cm 2 , the EOA was up to ∼15% larger than the projected AVA. The presented segmentation algorithm allowed to construct detailed AV models for 22 patient cases. Because of the crown-like 3D structure of the AV, the planimetric AVA is larger than the projected AVA formed by the free edges of the AV leaflets. The AVA formed by the free edges of the AV leaflets was smaller than the EOA for EOA values <2.0cm2. This contradiction with respect to previous studies that reported the EOA to be always smaller or equal to the geometric AVA is explained by the more detailed AV models used within this study. © 2017 American Association of Physicists in Medicine.

  15. Quality control considerations for the determination of acid-volatile sulfide and simultaneously extracted metals in sediments

    USGS Publications Warehouse

    Brumbaugh, William G.; Arms, Jesse W.

    1996-01-01

    The determination of acid-volatile sulfide (AVS) and simultaneously extracted metals (SEMs) in sediment by treatment with dilute HCl shows promise as a tool for predicting the potential for metal toxicity to sediment-dwelling organisms. Effective quality control measures must be developed if this method is to become a reliable procedure and to ensure comparability of data. However, establishing quality control measures that assess procedural errors for an operationally defined method can be problematic. For example, preextraction spikes added for assessing the accuracy of AVS and SEMs may be poorly recovered due to adsorption or reaction with sediment constituents. For a variety of sediment types, we found preextraction spikes of sulfide, mercury, and copper to be prone to variable recoveries for the AVS/SEM procedure; recoveries averaged 76.3% (SD, 20.9) for sulfide, 61.9% (39.6) for Hg, and 90.1% (12.7) for Cu. The average recovery was near 100% for preextraction spikes of sediments for Cd, Ni, Pb, and Zn, and the recoveries of preextraction blank spikes for all analytes were consistently 95 to 105%. Binding of Cu or Hg with sulfides is sufficiently strong that 1 N hydrochloric acid will not necessarily keep the spiked metal in the dissolved state. This does not mean that the SEM procedure is invalid for these metals, only that the quality control of procedural error is difficult to assess. However, Hg will generally not be detected when measured as an SEM because of its tendency to adsorb onto sulfide minerals even at extremely low pH. Some reference sediments may be useful for assessing consistency of AVS determinations; we measured 5.97 ± 0.65 μmol/g in National Institute of Standards and Technology (NIST) 1645 and 1.34 ± 0.14 μmol/g in NIST 2704 for repeated determinations conducted over the past 3 years. Apparently, some sediments may contain an oxidation-resistant sulfide component that can release low to moderate AVS when treated with dilute HCl.

  16. Flavodoxin 1 of Azotobacter vinelandii: characterization and role in electron donation to purified assimilatory nitrate reductase.

    PubMed Central

    Gangeswaran, R; Eady, R R

    1996-01-01

    Flavodoxins synthesized by Azotobacter vinelandii strain UW 36 during growth on nitrate as nitrogen source were separated by FPLC on a Mono Q column into two species, flavodoxin 1 (AvFld 1) and flavodoxin 2 (AvFld 2). Both proteins migrated as single bands on SDS/PAGE. AvFld 1 was approx. 5-fold more abundant than AvFld 2 in the unresolved flavodoxin mixture. N-terminal amino acid analysis showed the sequence of AvFld 2 to correspond to the nif F gene product, an electron donor to nitrogenase. The sequences also show that these species corresponded to the flavodoxins Fld A and Fld B isolated from N2-grown cultures of the closely related organism Azotobacter throococcum [Bagby, Barker, Hill, Eady and Thorneley (1991) Biochem.J.277, 313-319]. Electrospray mass spectrometry gave M, values for the polypeptides of 19430 +/- 3 and 19533 +/- 5 respectively. 31P-NMR measurements showed that in addition to the phosphate associated with the FMN (delta = -136.3 p.p.m. and -135.48 p.p.m.), AvFld 1 had a signal at delta = -142.1 p.p.m. and AvFld 2 at delta = -138.59 p.p.m. present in substoichiometric amounts with FMN. These appeared to arise from unstable species since they were readily lost on further manipulation of the proteins. The mid-point potentials of the semiquinone hydroquinone redox couples were -330 mV and -493 mV for AvFld 1 and AvFld 2 respectively, but only AvFld 1 was competent in donating electrons to the purified assimilatory nitrate reductase of A. vinelandii to catalyse the reduction of nitrate to nitrite. Flavodoxin isolated from NH4(+)-grown cells (Fld 3) also functioned as electron donor at half the rate of AvFld 1, but ferredoxin 1 from A. chroococcum did not. PMID:8694750

  17. Initial experience with Crotalidae polyvalent immune Fab (ovine) antivenom in the treatment of copperhead snakebite.

    PubMed

    Lavonas, Eric J; Gerardo, Charles J; O'Malley, Gerald; Arnold, Thomas C; Bush, Sean P; Banner, William; Steffens, Mark; Kerns, William P

    2004-02-01

    Crotalidae polyvalent immune Fab (ovine) (CroFab; FabAV) effectively treats patients bitten by rattlesnakes. The copperhead snake (Agkistrodon contortrix) caused 37% of venomous snakebites reported to US poison centers in 2001 and is the major envenomating reptile in the southeastern United States. FabAV has not been tested in human beings envenomated by copperhead snakes. In this preliminary study, we performed a retrospective chart review of all copperhead snake envenomations reported to the Carolinas Poison Center that were treated with FabAV. Progression of limb swelling, coagulopathy, and hemodynamic status before and after FabAV administration, adverse effects of FabAV therapy, and recurrence phenomena were recorded. Of approximately 400 copperhead envenomation cases reported to the poison center during the study period, 32 received FabAV and were included. Most patients had moderate envenomation. The median time to FabAV administration was 4.0 hours. The median time to achieve initial control was 1.0 hour, with a median dose of 4 vials of FabAV. A rapid initial response, defined as cessation of the progression of local tissue injury within 4 hours of FabAV administration, occurred in 28 cases (88%; 95% confidence interval [CI] 76% to 99%). Four cases (13%; 95% CI 1% to 24%) were considered treatment failures. Recurrent swelling occurred in 6 cases (19%; 95% CI 5% to 32%). The incidence of recurrent swelling was not reduced by administration of repeated doses of antivenom on a planned schedule. One patient developed late-onset coagulopathy. One minor allergic reaction was observed. In this select group of patients bitten by copperhead snakes, local tissue effects of envenomation halted promptly after FabAV treatment in most cases. Treatment failures occurred, and recurrence of swelling and defibrination syndrome was sometimes problematic. Time to return to work and long-term limb function were not assessed. A controlled trial with long-term follow-up is needed to define the role of FabAV treatment for copperhead envenomation.

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

    Le Blanche, Alain F.; Pautas, Eric; Gouin, Isabelle

    Purpose. To evaluate routine use of access sites in the arm for percutaneous caval filter placement (PCFP) in elderly patients. Neck arthritis, patient anxiety, access site thrombosis or fecal/urinary incontinence complicating jugular or femoral access may require alternative access sites in this population. Methods. Access via the right arm was chosen for PCFP (VenaTech LP). The indication for PCFP was deep vein thrombosis, a history of pulmonary embolism, and a contraindication to anticoagulant therapy. Ultrasound-guided puncture was performed after diameter measurement of the arm veins (O{sub AV}). The filter was inserted with standard imaging procedures. Procedural difficulty was graded andmore » compared with O{sub AV} and the angle from the arm vein to the superior vena cava ({alpha}{sub AV/SVC}). Results. Over 2 years, 16 patients (14 women, 2 men) with an average age of 90 years (range 79-97 years) were included in the study. The average O{sub AV} value of the basilic or brachial veins was 4.2 mm (range 3.0-5.1 mm). The minimal O{sub AV} for successful access was determined after the first 15 patients. No hematoma occurred at the puncture sites. The average {alpha}{sub AV/SVC} value was 62 deg. (range 29 deg. - 90 deg.). Arm access was possible in 12 of 16 patients (75%) with O{sub AV} {>=} 3.5 mm and {alpha}{sub AV/SVC} {>=} 29 deg. Every procedure via the arm was graded 'easy' by the operator, regardless of angulation values. Femoral access was used in one case due to the impossibility of traversing the heart (patient no. 2), and jugular access was used in 3 of 16 (19%) patients due to puncture failure (patient no. 4), small O{sub AV} (3 mm) (patient no. 6), and stenosis of the distal right subclavian vein (patient no.16), respectively. Conclusion. PCFP via the arm can be routinely accomplished in patients older than 75 years, provided O{sub AV} {>=} 3.5 mm, and {alpha}{sub AV/SVC} {>=} 200119 d.« less

  19. Temporal dissociation between muscle and pulmonary oxygen uptake kinetics: influences of perfusion dynamics and arteriovenous oxygen concentration differences in muscles and lungs.

    PubMed

    Drescher, U; Koschate, J; Thieschäfer, L; Schneider, S; Hoffmann, U

    2018-06-22

    The aim of the study was to test whether or not the arteriovenous oxygen concentration difference (avDO 2 ) kinetics at the pulmonary (avDO 2 pulm) and muscle (avDO 2 musc) levels is significantly different during dynamic exercise. A re-analysis involving six publications dealing with kinetic analysis was utilized with an overall sample size of 69 participants. All studies comprised an identical pseudorandom binary sequence work rate (WR) protocol-WR changes between 30 and 80 W-to analyze the kinetic responses of pulmonary ([Formula: see text]) and muscle ([Formula: see text]) oxygen uptake kinetics as well as those of avDO 2 pulm and avDO 2 musc. A significant difference between [Formula: see text] (0.395 ± 0.079) and [Formula: see text] kinetics (0.330 ± 0.078) was observed (p < 0.001), where the variables showed a significant relationship (r SP  = 0.744, p < 0.001). There were no significant differences between avDO 2 musc (0.446 ± 0.077) and avDO 2 pulm kinetics (0.451 ± 0.075), which are highly correlated (r = 0.929, p < 0.001). It is suggested that neither avDO 2 pulm nor avDO 2 musc kinetic responses seem to be responsible for the differences between estimated [Formula: see text] and measured [Formula: see text] kinetics. Obviously, the conflation of avDO 2 and perfusion ([Formula: see text] ) at different points in time and at different physiological levels drive potential differences in [Formula: see text] and [Formula: see text] kinetics. Therefore, [Formula: see text] should, in general, be considered whenever oxygen uptake kinetics are analyzed or discussed.

  20. Diastolic mitral and tricuspid regurgitation by Doppler echocardiography in patients with atrioventricular block: new insight into the mechanism of atrioventricular valve closure.

    PubMed

    Schnittger, I; Appleton, C P; Hatle, L K; Popp, R L

    1988-01-01

    The purpose of this study was to prospectively determine the incidence of diastolic mitral and tricuspid regurgitation in atrioventricular (AV) block using Doppler echocardiography. The temporal relation between mitral and tricuspid diastolic insufficiency and the diastolic murmur recorded in patients with complete heart block was also investigated. Twenty-two consecutive patients with AV block (referred to the Echo-Doppler laboratory for routine clinical studies), aged 18 to 87 years, were enrolled in the study. Eleven patients had third degree AV block and a ventricular-inhibited (VVI) pacemaker, two patients had second degree AV block, seven patients had first degree AV block, one patient had blocked premature atrial complexes and one patient had atrial flutter with 4:1 AV block. Diastolic mitral regurgitation was detected in 20 patients, and diastolic tricuspid regurgitation in 21. A mid-diastolic murmur was detected in all patients except in the three youngest. The murmur occurred before diastolic regurgitation and coincided with peak forward flow through the AV valve after atrial contraction. M-mode mitral valve echocardiograms obtained in nine patients demonstrated near closure of some portions of the mitral valve after atrial contraction. Effective closure of the valve, however, did not occur unless ventricular systole supervened. In conclusion, diastolic mitral and tricuspid regurgitation are almost universally present in patients with AV block and are associated with a diastolic murmur. The murmur coincides with forward AV valve flow. Diastolic regurgitation is silent. Effective AV valve closure is not established until ventricular systole occurs, as demonstrated by M-mode echocardiographic recording of the mitral valve.

  1. Chronic effect of cadmium in sediments on colonization by benthic marine organisms: An evaluation of the role of interstitial cadmium and acid-volatile sulfide in biological availability

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

    Hansen, D.J.; Berry, W.J.; Benyi, S.J.

    1996-12-01

    The role of interstitial cadmium and acid-volatile sulfide (AVS) in controlling the bioavailability of sediment-associated metal was examined using the chronic saltwater benthic colonization test. Sediments were spiked to achieve nominal cadmium/AVS molar ratios of 0.0 (control), 0.1, 0.8, and 3.0 in this 118-d test. Oxidation of AVS in the surficial 2.4 cm within 2 to 4 weeks resulted in sulfide profiles similar to those occurring naturally in local sediments. In the nominal 0.1 cadmium/AVS treatment measured simultaneously extracted metal (SEM{sub Cd}) was always less than AVS. Interstitial cadmium concentrations were less than those likely to cause biological effects. Nomore » significant biological effects were detected. In the nominal 0.8 cadmium/AVS treatment, measured SEM{sub Cd} commonly exceeded AVS in the surficial 2.4 cm of sediment. Interstitial cadmium concentrations were of likely toxicological significance to highly sensitive species. Shifts in the presence or absence over all taxa, and fewer macrobenthic polychaetes (Mediomastus ambiseta, Streblospio benedicti, and Podarke obscurea) and unidentified meiofaunal nematodes, were observed. In the nominal 3.0 cadmium/AVS treatment, concentrations of SEM{sub Cd} were always greater than AVS throughout the sediment column. Interstitial cadmium ranged from 28,000 to 174,000 {micro}g/L. In addition to the effects above, the sediments were colonized by fewer macrobenthic species, polychaete species, and harpacticoids; had lower densities of diatoms; lacked bivalve molluscs; and exhibited other impacts. Over all treatments, the observed biological responses were consistent with SEM{sub Cd}/AVS ratios in surficial sediments and interstitial water cadmium concentrations.« less

  2. Effect of cadmium in sediments on colonization by benthic marine organisms: Role of interstitial cadmium and acid volatile sulfide in bioavailability

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

    Hansen, D.; Berry, W.; Benyi, S.

    1995-12-31

    The role of interstitial cadmium and acid volatile sulfide (AVS) in controlling the bioavailability of sediment-associated metal was examined using the chronic saltwater benthic colonization test. Sediments were spiked with cadmium to achieve simultaneously extracted metal (SEM)/AVS molar ratios of 0. 0 (control), 0.1, 0.8 and 3.0 in this 118-day test. Oxidation of AVS in the surficial 2.4 cm within two to four weeks resulted in sulfide profiles similar to those occurring naturally in local sediments. In the nominal 0.1 SEM/AVS treatment, measured SEM was always less than AVS. Interstitial cadmium concentrations (< 3--10 {micro}g/L) were below those likely tomore » cause biological effects. No significant biological effects were detected. In the nominal 0.8 SEM/AVS treatment, measured SEM commonly exceeded AVS in the surficial 2.4 cm of sediment. Interstitial cadmium concentrations (24--157 {micro}g/L) were likely of toxicological significance to sensitive species. Shifts were observed in presence/absence of species, and there were fewer macrobenthic polychaetes (Mediomastus ambiseta, Strebloapio benedicti and Podarke obscura) and unidentified meiofaunal nematodes. In the nominal 3.0 SEM/AVS treatment, concentrations of SEM were always greater than AVS throughout the sediment column. Interstitial cadmium ranged from 28,000 to 174,000 {micro}g/L. In addition to the effects above, these sediments were colonized by fewer macrobenthic species, polychaete species and harpacticoids; had lower densities of diatoms; lacked bivalve molluscs and exhibited other impacts. The observed biological responses were consistent with measured SEM/AVS ratios in surficial sediments and interstitial water cadmium concentrations, further supporting their utility in predicting metals bioavailability.« less

  3. Vitamin D(2) supplementation induces the development of aortic stenosis in rabbits: interactions with endothelial function and thioredoxin-interacting protein.

    PubMed

    Ngo, Doan T M; Stafford, Irene; Kelly, Darren J; Sverdlov, Aaron L; Wuttke, Ronald D; Weedon, Helen; Nightingale, Angus K; Rosenkranz, Anke C; Smith, Malcolm D; Chirkov, Yuliy Y; Kennedy, Jennifer A; Horowitz, John D

    2008-08-20

    Understanding of the pathophysiology of aortic valve stenosis (AVS) and finding potentially effective treatments are impeded by the lack of suitable AVS animal models. A previous study demonstrated the development of AVS in rabbits with vitamin D(2) and cholesterol supplementation without any hemodynamic changes in the cholesterol supplemented group alone. The current study aimed to determine whether AVS develops in an animal model with vitamin D(2) supplementation alone, and to explore pathophysiological mechanisms underlying this process. The effects of 8 weeks' treatment with vitamin D(2) alone (n=8) at 25,000 IU/4 days weekly on aortic valve structure and function were examined in male New Zealand white rabbits. Echocardiographic aortic valve backscatter (AV(BS)), transvalvular velocity, and transvalvular pressure gradient were utilized to quantitate changes in valve structure and function. Valvular histology/immunochemistry and function were examined after 8 weeks. Changes in valves were compared with those in endothelial function and in valvular measurement of thioredoxin-interacting protein (TXNIP), a marker/mediator of reactive oxygen species-induced oxidative stress. Vitamin D(2) treated rabbits developed AVS with increased AV(BS) (17.6+/-1.4 dB vs 6.7+/-0.8 dB, P<0.0001), increased transvalvular velocity and transvalvular pressure gradient (both P<0.01 via 2-way ANOVA) compared to the control group. There was associated valve calcification, lipid deposition and macrophage infiltration. Endothelial function was markedly impaired, and intravalvular TXNIP concentration increased. In this model, vitamin D(2) induces the development of AVS with histological features similar to those of early AVS in humans and associated endothelial dysfunction/redox stress. AVS development may result from the loss of nitric oxide suppression of TXNIP expression.

  4. The human apolipoprotein AV gene is regulated by peroxisome proliferator-activated receptor-alpha and contains a novel farnesoid X-activated receptor response element.

    PubMed

    Prieur, Xavier; Coste, Herve; Rodriguez, Joan C

    2003-07-11

    The newly identified apolipoprotein AV (apoAV) gene is a key player in determining plasma triglyceride concentrations. Because hypertriglyceridemia is a major independent risk factor in coronary artery disease, the understanding of the regulation of the expression of this gene is of considerable importance. We presently characterize the structure, the transcription start site, and the promoter of the human apoAV gene. Since the peroxisome proliferator-activated receptor-alpha (PPARalpha) and the farnesoid X-activated receptor (FXR) have been shown to modulate the expression of genes involved in triglyceride metabolism, we evaluated the potential role of these nuclear receptors in the regulation of apoAV transcription. Bile acids and FXR induced the apoAV gene promoter activity. 5'-Deletion, mutagenesis, and gel shift analysis identified a heretofore unknown element at positions -103/-84 consisting of an inverted repeat of two consensus receptor-binding hexads separated by 8 nucleotides (IR8), which was required for the response to bile acid-activated FXR. The isolated IR8 element conferred FXR responsiveness on a heterologous promoter. On the other hand, in apoAV-expressing human hepatic Hep3B cells, transfection of PPARalpha specifically enhanced apoAV promoter activity. By deletion, site-directed mutagenesis, and binding analysis, a PPARalpha response element located 271 bp upstream of the transcription start site was identified. Finally, treatment with a specific PPARalpha activator led to a significant induction of apoAV mRNA expression in hepatocytes. The identification of apoAV as a PPARalpha target gene has major implications with respect to mechanisms whereby pharmacological PPARalpha agonists may exert their beneficial hypotriglyceridemic actions.

  5. Adrenal venous sampling: the learning curve of a single interventionalist with 282 consecutive procedures

    PubMed Central

    Jakobsson, Hugo; Farmaki, Katerina; Sakinis, Augustinas; Ehn, Olof; Johannsson, Gudmundur; Ragnarsson, Oskar

    2018-01-01

    PURPOSE Primary aldosteronism (PA) is a common cause of secondary hypertension. Adrenal venous sampling (AVS) is the gold standard for assessing laterality of PA, which is of paramount importance to decide adequate treatment. AVS is a technically complicated procedure with success rates ranging between 30% and 96%. The aim of this study was to investigate the success rate of AVS over time, performed by a single interventionalist. METHODS This was a retrospective study based on consecutive AVS procedures performed by a single operator between September 2005 and June 2016. Data on serum concentrations of aldosterone and cortisol from right and left adrenal vein, inferior vena cava, and peripheral vein were collected and selectivity index (SI) calculated. Successful AVS was defined as SI >5. RESULTS In total, 282 AVS procedures were performed on 269 patients, 168 men (62%) and 101 women (38%), with a mean age of 55±11 years (range, 26–78 years). Out of 282 AVS procedures, 259 were successful, giving an overall success rate of 92%. The most common reason for failure was inability to localize the right adrenal vein (n=16; 76%). The success rates were 63%, 82%, and 94% during the first, second, and third years, respectively. During the last 8 years the success rate was 95%, and on average 27 procedures were performed annually. CONCLUSION Satisfactory AVS success rate was achieved after approximately 36 procedures and satisfactory success rate was maintained by performing approximately 27 procedures annually. AVS should be limited to few operators that perform sufficiently large number of procedures to achieve, and maintain, satisfactory AVS success rate. PMID:29467114

  6. FTO Is Associated with Aortic Valve Stenosis in a Gender Specific Manner of Heterozygote Advantage: A Population-Based Case-Control Study.

    PubMed

    Thron, Cindy; Akhyari, Payam; Godehardt, Erhard; Lichtenberg, Artur; Rüther, Ulrich; Seehaus, Stefanie

    2015-01-01

    Single nucleotide polymorphisms (SNPs) within the Fat mass and obesity associated (FTO) gene have been linked with increased body weight. However, the data on an association of FTO with cardiovascular diseases remains conflicting. Therefore, we ascertained whether FTO is associated with aortic valve stenosis (AVS), one of the most frequent cardiovascular diseases in the Western world. In this population-based case-control study the FTO SNP rs9939609 was analyzed in 300 German patients with AVS and 429 German controls of the KORA survey S4, representing a random population. Blood samples were collected prior to aortic valve replacement in AVS cases and FTO rs9939609 was genotyped via ARMS-PCR. Genotype frequencies differed significantly between AVS cases and KORA controls (p = 0.004). Separate gender-analyses uncovered an association of FTO with AVS exclusively in males; homozygote carriers for the risk-allele (A) had a higher risk to develop AVS (p = 0.017, odds ratio (OR) 1.727; 95% confidence interval (CI) 1.087-2.747, recessive model), whereas heterozygote carriers for the risk-allele showed a lower risk (p = 0.002, OR 0.565, 95% CI 0.384-0.828, overdominant model). After adjustment for multiple co-variables, the odds ratios of heterozygotes remained significant for an association with AVS (p = 0.008, OR 0.565, 95% CI 0.369-0.861). This study revealed an association of FTO rs9939609 with AVS. Furthermore, this association was restricted to men, with heterozygotes having a significantly lower chance to develop AVS. Lastly, the association between FTO and AVS was independent of BMI and other variables such as diabetes mellitus.

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

    Lee, Danny; Greer, Peter B.; Department of Radiation Oncology, Calvary Mater Newcastle, Newcastle, NSW

    Purpose: To assess the impact of an audiovisual (AV) biofeedback on intra- and interfraction tumor motion for lung cancer patients. Methods and Materials: Lung tumor motion was investigated in 9 lung cancer patients who underwent a breathing training session with AV biofeedback before 2 3T magnetic resonance imaging (MRI) sessions. The breathing training session was performed to allow patients to become familiar with AV biofeedback, which uses a guiding wave customized for each patient according to a reference breathing pattern. In the first MRI session (pretreatment), 2-dimensional cine-MR images with (1) free breathing (FB) and (2) AV biofeedback were obtained, andmore » the second MRI session was repeated within 3-6 weeks (mid-treatment). Lung tumors were directly measured from cine-MR images using an auto-segmentation technique; the centroid and outlier motions of the lung tumors were measured from the segmented tumors. Free breathing and AV biofeedback were compared using several metrics: intra- and interfraction tumor motion consistency in displacement and period, and the outlier motion ratio. Results: Compared with FB, AV biofeedback improved intrafraction tumor motion consistency by 34% in displacement (P=.019) and by 73% in period (P<.001). Compared with FB, AV biofeedback improved interfraction tumor motion consistency by 42% in displacement (P<.046) and by 74% in period (P=.005). Compared with FB, AV biofeedback reduced the outlier motion ratio by 21% (P<.001). Conclusions: These results demonstrated that AV biofeedback significantly improved intra- and interfraction lung tumor motion consistency for lung cancer patients. These results demonstrate that AV biofeedback can facilitate consistent tumor motion, which is advantageous toward achieving more accurate medical imaging and radiation therapy procedures.« less

  8. The tau positron-emission tomography tracer AV-1451 binds with similar affinities to tau fibrils and monoamine oxidases.

    PubMed

    Vermeiren, Céline; Motte, Philippe; Viot, Delphine; Mairet-Coello, Georges; Courade, Jean-Philippe; Citron, Martin; Mercier, Joël; Hannestad, Jonas; Gillard, Michel

    2018-02-01

    Lilly/Avid's AV-1451 is one of the most advanced tau PET tracers in the clinic. Although results obtained in Alzheimer's disease patients are compelling, discrimination of tracer uptake in healthy individuals and patients with supranuclear palsy (PSP) is less clear as there is substantial overlap of signal in multiple brain regions. Moreover, accurate quantification of [ 18 F]AV-1451 uptake in Alzheimer's disease may not be possible. The aim of the present study was to characterize the in vitro binding of AV-1451 to understand and identify potential off-target binding that could explain the poor discrimination observed in PSP patients. [ 3 H]AV-1451 and AV-1451 were characterized in in vitro binding assays using recombinant and native proteins/tissues from postmortem samples of controls and Alzheimer's disease and PSP patients. [ 3 H]AV-1451 binds to multiple sites with nanomolar affinities in brain homogenates and to tau fibrils isolated from Alzheimer's disease or PSP patients. [ 3 H]AV-1451 also binds with similarly high affinities in brain homogenates devoid of tau pathology. This unexpected binding was demonstrated to be because of nanomolar affinities of [ 3 H]AV-1451 for monoamine oxidase A and B enzymes. High affinity of AV-1451 for monoamine oxidase proteins may limit its utility as a tau PET tracer in PSP and Alzheimer's disease because of high levels of monoamine oxidase expression in brain regions also affected by tau deposition, especially if monoamine oxidase levels change over time or with a treatment intervention. © 2017 International Parkinson and Movement Disorder Society. © 2017 International Parkinson and Movement Disorder Society.

  9. FTO Is Associated with Aortic Valve Stenosis in a Gender Specific Manner of Heterozygote Advantage: A Population-Based Case-Control Study

    PubMed Central

    Thron, Cindy; Akhyari, Payam; Godehardt, Erhard; Lichtenberg, Artur; Rüther, Ulrich; Seehaus, Stefanie

    2015-01-01

    Background Single nucleotide polymorphisms (SNPs) within the Fat mass and obesity associated (FTO) gene have been linked with increased body weight. However, the data on an association of FTO with cardiovascular diseases remains conflicting. Therefore, we ascertained whether FTO is associated with aortic valve stenosis (AVS), one of the most frequent cardiovascular diseases in the Western world. Methods and Findings In this population-based case-control study the FTO SNP rs9939609 was analyzed in 300 German patients with AVS and 429 German controls of the KORA survey S4, representing a random population. Blood samples were collected prior to aortic valve replacement in AVS cases and FTO rs9939609 was genotyped via ARMS-PCR. Genotype frequencies differed significantly between AVS cases and KORA controls (p = 0.004). Separate gender-analyses uncovered an association of FTO with AVS exclusively in males; homozygote carriers for the risk-allele (A) had a higher risk to develop AVS (p = 0.017, odds ratio (OR) 1.727; 95% confidence interval (CI) 1.087–2.747, recessive model), whereas heterozygote carriers for the risk-allele showed a lower risk (p = 0.002, OR 0.565, 95% CI 0.384–0.828, overdominant model). After adjustment for multiple co-variables, the odds ratios of heterozygotes remained significant for an association with AVS (p = 0.008, OR 0.565, 95% CI 0.369–0.861). Conclusions This study revealed an association of FTO rs9939609 with AVS. Furthermore, this association was restricted to men, with heterozygotes having a significantly lower chance to develop AVS. Lastly, the association between FTO and AVS was independent of BMI and other variables such as diabetes mellitus. PMID:26431034

  10. A Multi-institutional Comparison of Adrenal Venous Sampling in Patients with Primary Aldosteronism: Caution Advised if Successful Bilateral Adrenal Vein Sampling is Not Achieved.

    PubMed

    Wang, Tracy S; Kline, Greg; Yen, Tina W; Yin, Ziyan; Liu, Ying; Rilling, William; So, Benny; Findling, James W; Evans, Douglas B; Pasieka, Janice L

    2018-02-01

    In patients with primary aldosteronism (PA), adrenal venous sampling (AVS) is recommended to differentiate between unilateral (UNI) or bilateral (BIL) adrenal disease. A recent study suggested that lateralization could be predicted, based on the ratio of aldosterone/cortisol levels (A/C) between the left adrenal vein (LAV) and inferior vena cava (IVC), with a 100% positive predictive value (PPV). This study aimed to validate those findings utilizing a larger, multi-institutional cohort. A retrospective review was performed of patients with PA who underwent AVS from 2 tertiary-care institutions. Laterality was predicted by an A/C ratio of >3:1 between the dominant and non-dominant adrenal. AVS results were compared to LAV/IVC ratios utilizing the published criteria (Lt ≥ 5.5; Rt ≤ 0.5). Of 222 patients, 124 (57%) had UNI and 98 (43%) had BIL disease based on AVS. AVS and LAV/IVC findings were concordant for laterality in 141 (64%) patients (69 UNI, 72 BIL). Using only the LAV/IVC ratio, 54 (24%) patients with UNI disease on AVS who underwent successful surgery would have been assumed to have BAH unless AVS was repeated, and 24 (11%) patients with BIL disease on AVS may have been incorrectly offered surgery (PPV 70%). Based on median LAV/IVC ratios (left 5.26; right 0.31; BIL 2.84), no LAV/IVC ratio accurately predicted laterality. This multi-institutional study of patients with both UNI and BIL PA failed to validate the previously reported PPV of LAV/IVC ratio for lateralization. Caution should be used in interpreting incomplete AVS data to differentiate between UNI versus BIL disease and strong consideration given to repeat AVS prior to adrenalectomy.

  11. Application of strict criteria in adrenal venous sampling increases the proportion of missed patients with unilateral disease who benefit from surgery for primary aldosteronism.

    PubMed

    Kline, Gregory; Leung, Alexander; So, Benny; Chin, Alex; Harvey, Adrian; Pasieka, Janice L

    2018-06-01

    Adrenal vein sampling (AVS) is intended to confirm unilateral forms of primary aldosteronism, which are amenable to surgical cure. Excessively strict AVS criteria to define lateralization may result in many patients incorrectly categorized as bilateral primary aldosteronism and opportunity for surgical cure missed. Retrospective review of an AVS-primary aldosteronism database in which surgical cases are verified by standardized outcomes. Having used 'less strict' AVS criteria for lateralization, we examined the distribution of AVS lateralization indices in our confirmed unilateral primary aldosteronism cases both with and without cosyntropin stimulation. The proportion of proven unilateral cases that would have been missed with stricter AVS interpretation criteria was calculated. Particular focus was given to the proportion of missed cases according to use of international guidelines. False-positive lateralization with 'less strict' interpretation was also calculated. Of 80 surgical primary aldosteronism cases, 10-23% would have been missed with AVS lateralization indices of 3 : 1 to 5 : 1, with or without cosyntropin. If strict selectivity indices (for confirmation of catheterization) were combined with strict lateralization indices, up to 70% of unilateral primary aldosteronism cases could have been missed. Use of Endocrine Society AVS guidelines would have missed 21-43% of proven unilateral cases. 'Less strict' AVS interpretation yielded one case (1.2%) of false lateralization. Excessively strict AVS interpretation criteria will result in a high rate of missed unilateral primary aldosteronism with subsequent loss of opportunity for intervention. Use of more lenient lateralization criteria will improve the detection rate of unilateral primary aldosteronism with very low false-positive rate.

  12. Early and 1-year outcomes of aortic root surgery in patients with Marfan syndrome: a prospective, multicenter, comparative study.

    PubMed

    Coselli, Joseph S; Volguina, Irina V; LeMaire, Scott A; Sundt, Thoralf M; Connolly, Heidi M; Stephens, Elizabeth H; Schaff, Hartzell V; Milewicz, Dianna M; Vricella, Luca A; Dietz, Harry C; Minard, Charles G; Miller, D Craig

    2014-06-01

    To compare the 1-year results after aortic valve-sparing (AVS) or valve-replacing (AVR) aortic root replacement from a prospective, international registry of 316 patients with Marfan syndrome (MFS). Patients underwent AVS (n = 239, 76%) or AVR (n = 77, 24%) aortic root replacement at 19 participating centers from 2005 to 2010. One-year follow-up data were complete for 312 patients (99%), with imaging findings available for 293 (94%). The time-to-events were compared between groups using Kaplan-Meier curves and Cox proportional hazards models. Two patients (0.6%)--1 in each group--died within 30 days. No significant differences were found in early major adverse valve-related events (MAVRE; P = .6). Two AVS patients required early reoperation for coronary artery complications. The 1-year survival rates were similar in the AVR (97%) and AVS (98%) groups; the procedure type was not significantly associated with any valve-related events. At 1 year and beyond, aortic regurgitation of at least moderate severity (≥2+) was present in 16 patients in the AVS group (7%) but in no patients in the AVR group (P = .02). One AVS patient required late AVR. AVS aortic root replacement was not associated with greater 30-day mortality or morbidity rates than AVR root replacement. At 1 year, no differences were found in survival, valve-related morbidity, or MAVRE between the AVS and AVR groups. Of concern, 7% of AVS patients developed grade ≥2+ aortic regurgitation, emphasizing the importance of 5 to 10 years of follow-up to learn the long-term durability of AVS versus AVR root replacement in patients with MFS. Copyright © 2014 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

  13. Modeling Increased Complexity and the Reliance on Automation: FLightdeck Automation Problems (FLAP) Model

    NASA Technical Reports Server (NTRS)

    Ancel, Ersin; Shih, Ann T.

    2014-01-01

    This paper highlights the development of a model that is focused on the safety issue of increasing complexity and reliance on automation systems in transport category aircraft. Recent statistics show an increase in mishaps related to manual handling and automation errors due to pilot complacency and over-reliance on automation, loss of situational awareness, automation system failures and/or pilot deficiencies. Consequently, the aircraft can enter a state outside the flight envelope and/or air traffic safety margins which potentially can lead to loss-of-control (LOC), controlled-flight-into-terrain (CFIT), or runway excursion/confusion accidents, etc. The goal of this modeling effort is to provide NASA's Aviation Safety Program (AvSP) with a platform capable of assessing the impacts of AvSP technologies and products towards reducing the relative risk of automation related accidents and incidents. In order to do so, a generic framework, capable of mapping both latent and active causal factors leading to automation errors, is developed. Next, the framework is converted into a Bayesian Belief Network model and populated with data gathered from Subject Matter Experts (SMEs). With the insertion of technologies and products, the model provides individual and collective risk reduction acquired by technologies and methodologies developed within AvSP.

  14. Anteroventral Third Ventricle Lesions Attenuate Pressor Responses to Serotonin in Anesthetized Rats

    NASA Technical Reports Server (NTRS)

    Muntzel, Martin S.; Lewis, Stephen J.; Johnson, Alan Kim

    1996-01-01

    When administered intravenously, serotonin (5-hydroxytryptamine; 5-HT) evokes a triphasic blood pressure response, consisting of the Bezold-Jarisch-associated depressor response, a pressor action, and long-lasting depressor response. Because the pressor response may, in part, be caused by central nervous system (CNS) activation by 5-HT, we predicted that destruction of the anteroventral third ventricle (AV3V) region, an area rich in 5-HT receptors, would attenuate increases in blood pressure to intravenous 5-HT. In anesthetized sham-lesioned and AV3V-lesioned Sprague-Dawley rats. we measured mean arterial pressure (MAP), heart rate (HR), and lumbar sympathetic nerve activity (SNA) to increasing bolus doses of intravenous 5-HT (1, 2.5, 5, 10, 25 microg/kg), before and after blockade of bradycardia using methylatropine (200 microg/kg). In all rats, bolus injections of 5-HT elicited bradycardia accompanied by a fall in lumbar SNA and an initial hypotension followed by a pressor response and a longer lasting hypotensive response. The bradycardia, reduction in lumbar SNA, and both depressor responses were equivalent in sham-lesioned and AV3V-lesioned groups. Importantly, AV3V lesions attenuated pressor responses to increasing doses of 5-HT (3 +/- 1, 6 +/- 4, 6 +/- 4, 17 +/- 4, 35 +/- 3 mmHg) compared to sham-lesioned controls (6 +/- 3, 16 +/- 7, 33 +/- 5, 54 +/- 4, 51 +/- 6 mmHg; P < 0.0001). This attenuation was conserved following blockade of bradycardia with methylatropine (P < 0.01). In summary, pressor responses to intravenous 5-HT are diminished by AV3V lesions. These data indicate that the pressor component of the blood pressure response to intravenous 5-HT is partly dependent upon interaction with the CNS.

  15. The effect of pharmacological inactivation of the mammillary body and anterior thalamic nuclei on hippocampal theta rhythm in urethane-anesthetized rats.

    PubMed

    Żakowski, Witold; Zawistowski, Piotr; Braszka, Łukasz; Jurkowlaniec, Edyta

    2017-10-24

    The mammillary body (MB) and the anterior thalamic nuclei (ATN) are closely related structures, which take part in learning and memory processes. However, the exact role of these structures has remained unclear. In both structures neurons firing according to hippocampal theta rhythm have been found, mainly in the medial mammillary nucleus (MM) and anteroventral thalamic nucleus (AV). These neurons are driven by descending projections from the hippocampal formation and are thought to convey theta rhythm back to the hippocampus (HP). We argue that the MB-ATN axis not only relays theta signal, but may also modulate it. To examine it, we performed a pharmacological inactivation of the MM and AV by local infusion of procaine, and measured changes in theta activity in selected structures of the extended hippocampal system in urethane-anesthetized rats. The inactivation of the MM resulted in decrease in EEG power in the HP and AV, the most evidently in the lower theta frequency bands, i.e. 3-5Hz in the HP (down to 9.2% in 3- to 4-Hz band and 37.6% in 4- to 5-Hz band, in comparison to the power in the control conditions) and 3-4Hz in the AV (down to 24.9%). After the AV inactivation, hippocampal EEG power decreased in theta frequency bands of 3-8Hz (down to 61.6% in 6- to 7-Hz band and 69.4% in 7- to 8-Hz band). Our results suggest that the role of the MB-ATN axis in regulating theta rhythm signaling may be much more important than has been speculated so far. Copyright © 2017 IBRO. Published by Elsevier Ltd. All rights reserved.

  16. Cruise-Efficient Short Takeoff and Landing (CESTOL): Potential Impact on Air Traffic Operations

    NASA Technical Reports Server (NTRS)

    Couluris, G. J.; Signor, D.; Phillips, J.

    2010-01-01

    The National Aeronautics and Space Administration (NASA) is investigating technological and operational concepts for introducing Cruise-Efficient Short Takeoff and Landing (CESTOL) aircraft into a future US National Airspace System (NAS) civil aviation environment. CESTOL is an aircraft design concept for future use to increase capacity and reduce emissions. CESTOL provides very flexible takeoff, climb, descent and landing performance capabilities and a high-speed cruise capability. In support of NASA, this study is a preliminary examination of the potential operational impact of CESTOL on airport and airspace capacity and delay. The study examines operational impacts at a subject site, Newark Liberty Intemational Airport (KEWR), New Jersey. The study extends these KEWR results to estimate potential impacts on NAS-wide network traffic operations due to the introduction of CESTOL at selected major airports. These are the 34 domestic airports identified in the Federal Aviation Administration's Operational Evolution Plan (OEP). The analysis process uses two fast-time simulation tools to separately model local and NAS-wide air traffic operations using predicted flight schedules for a 24-hour study period in 2016. These tools are the Sen sis AvTerminal model and NASA's Airspace Concept Evaluation System (ACES). We use both to simulate conventional-aircraft-only and CESTOL-mixed-with-conventional-aircraft operations. Both tools apply 4-dimension trajectory modeling to simulate individual flight movement. The study applies AvTerminal to model traffic operations and procedures for en route and terminal arrival and departures to and from KEWR. These AvTerminal applications model existing arrival and departure routes and profiles and runway use configurations, with the assumption jet-powered, large-sized civil CESTOL aircraft use a short runway and standard turboprop arrival and departure procedures. With these rules, the conventional jet and CESTOL aircraft are procedurally separated from each other geographically and in altitude during tenninal airspace approach and departure operations, and each use a different arrival runway. AvTeminal implements its unique Focal-point Scheduling Process to sequence, space and delay aircraft to resolve spacing and overtake conflicts among flights in the airspace and airport system serving KEWR. This Process effectively models integrated arrival and departure operations. AvTerminal assesses acceptance rates and delay magnitude and causality at selected locations, including en route outer boundary fixes, tenninal airspace arrival and departure boundary fixes, terminal airspace arrival merge and departure diverge fixes, and runway landing and takeoff runways. The analysis compares the resulting capacity impacts, flight delays and delay sources between CESTOL and conventional KEWR operations. AvTerminal quantitative results showed that CESTOL has significant capability to increase airport arrival acceptance rates (35-40% at KEWR) by taking advantage of otherwise underused airspace and runways where available. The study extrapolates the AvTerminal-derived KEWR peak arrival and departure acceptance rates to estimate capacity parameter values for each of the OEP airports in the ACES modeling of traffic through the entire NAS network. The extrapolations of acceptance rates allow full, partial or no achievement of CESTOL capacity gains at an OEP airport as determined by assessments of the degree to which local procedures allow leveraging of CESTOL capabilities. These assessments consider each OEP airport's runway geometries, runway system configurations, airport and airspace operations, and potential CESTOL traffic loadings. The ACES modeling, simulates airport and airspace spacing constraints imposed by airport runway system, terminal and en route air traffic control and traffic flow management operations using airport acceptance rates representing conventional-aircraft-only and CESTOL-mixed operations. CEOL aircraft are assumed to have Mach 0.8, and alternatively Mach 0.7, cruise speeds to examine compatibility with conventional aircraft operations in common airspace. The ACES results provides estimates of CESTOL delay impact NAS-wide and at OEP airports due to changes in OEP airport acceptance rates and changes in en route airspace potential conflict rates. Preliminary results show meaningful nationwide delay reductions (20%) due to CESTOL operations at 34 major domestic airports.

  17. Evaluating the Effort Expended to Understand Speech in Noise Using a Dual-Task Paradigm: The Effects of Providing Visual Speech Cues

    ERIC Educational Resources Information Center

    Fraser, Sarah; Gagne, Jean-Pierre; Alepins, Majolaine; Dubois, Pascale

    2010-01-01

    Purpose: Using a dual-task paradigm, 2 experiments (Experiments 1 and 2) were conducted to assess differences in the amount of listening effort expended to understand speech in noise in audiovisual (AV) and audio-only (A-only) modalities. Experiment 1 had equivalent noise levels in both modalities, and Experiment 2 equated speech recognition…

  18. A dual mechanism involved in membrane and nucleic acid disruption of AvBD103b, a new avian defensin from the king penguin, against Salmonella enteritidis CVCC3377.

    PubMed

    Teng, Da; Wang, Xiumin; Xi, Di; Mao, Ruoyu; Zhang, Yong; Guan, Qingfeng; Zhang, Jun; Wang, Jianhua

    2014-10-01

    The food-borne bacterial gastrointestinal infection is a serious public health threat. Defensins are evolutionarily conserved innate immune components with broad-spectrum antibacterial activity that do not easily induce resistance. AvBD103b, an avian defensin with potent activity against Salmonella enteritidis, was isolated from the stomach contents of the king penguin (Aptenodytes patagonicus). To elucidate further the antibacterial mechanism of AvBD103b, its effect on the S. enteritidis CVCC3377 cell membrane and intracellular DNA was researched. The cell surface hydrophobicity and a N-phenyl-1-naphthylamine uptake assay demonstrated that AvBD103b treatment increased the cell surface hydrophobicity and outer membrane permeability. Atomic absorption spectrometry, ultraviolet spectrophotometry, flow cytometry, and transmission electron microscopy (TEM) indicated that AvBD103b treatment can lead to the release of the cellular contents and cell death through damage of the membrane. DNA gel retardation and circular dichroism analysis demonstrated that AvBD103b interacted with DNA and intercalated into the DNA base pairs. A cell cycle assay demonstrated that AvBD103b affected cellular functions, such as DNA synthesis. Our results confirmed that AvBD103b exerts its antibacterial activity by damaging the cell membrane and interfering with intracellular DNA, ultimately causing cell death, and suggested that AvBD103b may be a promising candidate as an alternative to antibiotics against S. enteritidis.

  19. IgA Vasculitis: Genetics and Clinical and Therapeutic Management.

    PubMed

    González-Gay, Miguel A; López-Mejías, Raquel; Pina, Trinitario; Blanco, Ricardo; Castañeda, Santos

    2018-04-02

    The purpose of the study is to perform an update on the current knowledge on genetics, clinical manifestations, and therapy in immunoglobulin A vasculitis (IgAV) (Henoch-Schönlein purpura). A strong genetic predisposition in individuals with IgAV was confirmed. It was due to the association with the HLA class II region that in people of European background is mainly related to HLA-DRB1*01 allele. Recent reports support the claim that kidney disease is more common in adults than in children with IgAV. The clinical spectrum and outcome of adults with IgAV depends on the age of onset. Relapses are not uncommon in IgAV. The presence of renal impairment or proteinuria excretion exceeding 1 g/24 h at the time of disease diagnosis and the degree of renal damage on the kidney biopsy are the best predictors of end-stage renal failure in adults with IgAV. The levels of urinary IgA at the onset of the disease may predict a poor renal outcome. The use of prednisone does not seem to prevent persistent kidney disease in children with IgAV. No additional benefit of adding cyclophosphamide to glucocorticoids in adults with IgAV was found. Rituximab seems to be a promising therapy in the management of adults with IgAV. In this overview, we focus on the genetics, clinical manifestations, and therapy of IgA vasculitis, emphasizing the main differences in the clinical expression of the disease between children and adults.

  20. Effects of spatial and temporal variation of acid-volatile sulfide on the bioavailability of copper and zinc in freshwater sediments

    USGS Publications Warehouse

    Besser, John M.; Ingersoll, Christopher G.; Giesty, John P.

    1996-01-01

    Variation in concentrations of acid-volatile sulfide (AVS) in sediments from the upper Clark Fork River of Montana, USA, was associated with differences in bioaccumulation of Cu and Zn and growth of larvae of the midge, Chironomus tentans. Growth of midge larvae was significantly greater and bioaccumulation of Cu was significantly less in surface sections (0–3 cm depth) of sediment cores, which had greater concentrations of AVS and lesser ratios of simultaneously extracted metals to AVS (SEM:AVS ratios) than in subsurface sediments (6–9 cm). Concentrations of AVS were significantly less in sediments incubated with oxic overlying water for 9 weeks than in the same sediments incubated under anoxic conditions. Bioaccumulation of Cu differed significantly between incubation treatments, corresponding to differences in concentrations of AVS and SEM:AVS ratios, although midge growth did not. Bioaccumulation of Zn did not differ significantly between depth strata of sediment cores or between incubation treatments. When results from the two sets of bioassays were combined, bioaccumulation of Cu and Zn, but not growth, was significantly correlated with SEM:AVS ratios and other estimates of bioavailable metal fractions in sediments. Growth of midge larvae was significantly correlated with bioaccumulation of Zn, but not Cu, suggesting that Zn was the greater contributor to the toxicity of these sediments. Assessments of the toxicity of metal-contaminated freshwater sediments should consider the effects of spatial and temporal variation in AVS concentrations on metal bioavailability.

  1. Influence of diagnostic criteria on the interpretation of adrenal vein sampling.

    PubMed

    Lethielleux, Gaëlle; Amar, Laurence; Raynaud, Alain; Plouin, Pierre-François; Steichen, Olivier

    2015-04-01

    Guidelines promote the use of adrenal vein sampling (AVS) to document lateralized aldosterone hypersecretion in primary aldosteronism. However, there are large discrepancies between institutions in the criteria used to interpret its results. This study evaluates the consequences of these differences on the classification and management of patients. The results of all 537 AVS procedures performed between January 2001 and July 2010 in our institution were interpreted with 4 diagnostic criteria used in experienced institutions where AVS is performed without cosyntropin (Brisbane, Padua, Paris, and Turin) and with criteria proposed by a recent consensus statement. AVS procedures were classified as unsuccessful, lateralized, or not lateralized according to each set of criteria. Almost 5× more AVS procedures were classified as unsuccessful with the strictest criteria than with the least strict criteria (18% versus 4%, respectively). Similarly, over 2× more AVS procedures were classified as lateralized with the least stringent criteria than with the most stringent criteria (60% versus 26%, respectively). Multiple samples were available from ≥1 side for 155 AVS procedures. These procedures were classified differently by ≥2 right-left sample pairs in 12% to 20% of cases. Thus, different sets of criteria used to interpret AVS in experienced institutions translate into heterogeneous classifications and hence management decisions, for patients with primary aldosteronism. Defining the most appropriate procedures and diagnostic criteria is needed for AVS to achieve optimal performance and fully justify its status as a gold standard. © 2015 American Heart Association, Inc.

  2. A SAR Observation and Numerical Study on Ocean Surface Imprints of Atmospheric Vortex Streets.

    PubMed

    Li, Xiaofeng; Zheng, Weizhong; Zou, Cheng-Zhi; Pichel, William G

    2008-05-21

    The sea surface imprints of Atmospheric Vortex Street (AVS) off Aleutian Volcanic Islands, Alaska were observed in two RADARSAT-1 Synthetic Aperture Radar (SAR) images separated by about 11 hours. In both images, three pairs of distinctive vortices shedding in the lee side of two volcanic mountains can be clearly seen. The length and width of the vortex street are about 60-70 km and 20 km, respectively. Although the AVS's in the two SAR images have similar shapes, the structure of vortices within the AVS is highly asymmetrical. The sea surface wind speed is estimated from the SAR images with wind direction input from Navy NOGAPS model. In this paper we present a complete MM5 model simulation of the observed AVS. The surface wind simulated from the MM5 model is in good agreement with SAR-derived wind. The vortex shedding rate calculated from the model run is about 1 hour and 50 minutes. Other basic characteristics of the AVS including propagation speed of the vortex, Strouhal and Reynolds numbers favorable for AVS generation are also derived. The wind associated with AVS modifies the cloud structure in the marine atmospheric boundary layer. The AVS cloud pattern is also observed on a MODIS visible band image taken between the two RADARSAT SAR images. An ENVISAT advance SAR image taken 4 hours after the second RADARSAT SAR image shows that the AVS has almost vanished.

  3. Role of adrenal vein sampling in primary aldosteronism: Impact of imaging, localization, and age.

    PubMed

    Wachtel, Heather; Zaheer, Salman; Shah, Parth K; Trerotola, Scott O; Karakousis, Giorgos C; Roses, Robert E; Cohen, Debbie L; Fraker, Douglas L

    2016-04-01

    The role of adrenal vein sampling (AVS) has been debated, with some authorities advocating selective use in younger patients (≤40 years), and those localized by preoperative imaging. We examined our experience to determine the impact of AVS in patients who routinely underwent AVS with a high success rate. A retrospective cohort study was performed using a prospectively maintained database of patients referred for evaluation of PA (1997-2013). Patients were classified as localized (L) if a unilateral mass was identified on imaging, and non-localized (NL) otherwise. Of 367 patients, 94% (n = 345) underwent successful AVS. Seventy-two percent (n = 265) were L; AVS was lateralizing 58% (n = 214). AVS changed management in 43% of patients (n = 158). In patients ≤40 years, AVS changed management in 30% (n = 15). In patients ≤40 years with a ≥1 cm adrenal mass, 12% (n = 3) would have undergone unnecessary surgery based on imaging results alone; in patients >40 years with a ≥1 cm adrenal mass, 3% (n = 5) would have undergone wrong-side surgery, and 30% (n = 50) would have undergone unnecessary surgery based on imaging. AVS changed management in a significant minority of patients regardless of age and imaging findings. AVS should be routinely recommended in all patients with PA, to direct operative therapy. J. Surg. Oncol. 2016;113:532-537. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  4. Beneficial Effects of Galectin-3 Blockade in Vascular and Aortic Valve Alterations in an Experimental Pressure Overload Model

    PubMed Central

    Ibarrola, Jaime; Martínez-Martínez, Ernesto; Sádaba, J. Rafael; Arrieta, Vanessa; García-Peña, Amaia; Álvarez, Virginia; Fernández-Celis, Amaya; Gainza, Alicia; Rossignol, Patrick; Cachofeiro Ramos, Victoria; López-Andrés, Natalia

    2017-01-01

    Galectin-3 (Gal-3) is involved in cardiovascular fibrosis and aortic valve (AV) calcification. We hypothesized that Gal-3 pharmacological inhibition with modified citrus pectin (MCP) could reduce aortic and AV remodeling in normotensive rats with pressure overload (PO). Six weeks after aortic constriction, vascular Gal-3 expression was up-regulated in male Wistar rats. Gal-3 overexpression was accompanied by an increase in the aortic media layer thickness, enhanced total collagen, and augmented expression of fibrotic mediators. Further, vascular inflammatory markers as well as inflammatory cells content were greater in aorta from PO rats. MCP treatment (100 mg/kg/day) prevented the increase in Gal-3, media thickness, fibrosis, and inflammation in the aorta of PO rats. Gal-3 levels were higher in AVs from PO rats. This paralleled enhanced AV fibrosis, inflammation, as well as greater expression of calcification markers. MCP treatment prevented the increase in Gal-3 as well as fibrosis, inflammation, and calcification in AVs. Overall, Gal-3 is overexpressed in aorta and AVs from PO rats. Gal-3 pharmacological inhibition blocks aortic and AV remodeling in experimental PO. Gal-3 could be a new therapeutic approach to delay the progression and the development of aortic remodeling and AV calcification in PO. PMID:28758988

  5. Patented natural avocado sugar modulates the HBD-2 and HBD-3 expression in human keratinocytes through toll-like receptor-2 and ERK/MAPK activation.

    PubMed

    Paoletti, Iole; Buommino, Elisabetta; Fusco, Alessandra; Baudouin, Caroline; Msika, Philippe; Tufano, Maria Antonietta; Baroni, Adone; Donnarumma, Giovanna

    2012-10-01

    Keratinocytes stimulated by microbial organisms secrete not only a variety of cytokines, chemokines and growth factors, but also antimicrobial peptides such as beta-defensins (HBDs) such as HBD-2 and HBD-3. AV119, a patented blend of avocado sugar, triggers the up-regulation of HBD-2 in skin epithelia upon contact with AV119, but the signalling mechanisms involved are not completely understood. The purpose of this study was to determine if AV119 was able to induce also the expression of HBD-3 in human keratinocytes. In addition, the receptor and intracellular pathways involved in the AV119 up-regulation of HBD-2 and HBD-3 were investigated. Our results demonstrated that AV119 induces a significantly increase of the expression of HBD-3. In addition, the HBD-2 and HBD-3 AV119-induced gene expression and release are TLR-2 dependent. Finally, we demonstrated that AV119 induced ERK/MAPK phosphorylation in human keratinocytes, thus providing evidence that HBD-2 and HBD-3 secretion is through the same transductional pathway. The ability of AV119 to induce also HBD-3 may amplify its therapeutic potential against a broader spectrum of bacterial and yeast strains responsible for human skin disorders.

  6. Innate Immune Mechanisms in Transplant Allograft Vasculopathy

    PubMed Central

    Jane-wit, D; Fang, C; Goldstein, DR

    2016-01-01

    Purpose of Review Allograft vasculopathy (AV) is the leading cause of late allograft loss following solid organ transplantation. Ischemia reperfusion injury (IRI) and donor specific antibody (DSA)-induced complement activation confer heightened risk for AV via numerous innate immune mechanisms including MyD88, HMGB1, and complement induced non-canonical NF-kB signaling. Recent Findings The role of MyD88, a signal adaptor downstream of the toll-like receptors (TLR), has been defined in an experimental heart transplant model, which demonstrated that recipient MyD88 enhanced AV. Importantly, triggering receptor on myeloid receptor 1(Trem1), a MyD88 amplifying signal, was present in rejecting human cardiac transplant biopsies and enhanced the development of AV in mice. HMGB1, a nuclear protein that activates TLRs, also enhanced the development of AV. Complement activation elicits assembly of membrane attack complexes (MAC) on endothelial cells which activate non-canonical NF-kB signaling, a novel complement effector pathway that induces pro-inflammatory genes and potentiates endothelial cell mediated alloimmune T cell activation, processes which enhance AV. Summary Innate immune mediators including HMGB1, MyD88, and non-canonical NFκB signaling via complement activation contribute to AV. These pathways represent potential therapeutic targets to reduce AV after solid organ transplantation. PMID:27077602

  7. Ammonia Volatilization Losses from Paddy Fields under Controlled Irrigation with Different Drainage Treatments

    PubMed Central

    He, Yupu; Yang, Shihong; Wang, Yijiang

    2014-01-01

    The effect of controlled drainage (CD) on ammonia volatilization (AV) losses from paddy fields under controlled irrigation (CI) was investigated by managing water table control levels using a lysimeter. Three drainage treatments were implemented, namely, controlled water table depth 1 (CWT1), controlled water table depth 2 (CWT2), and controlled water table depth 3 (CWT3). As the water table control levels increased, irrigation water volumes in the CI paddy fields decreased. AV losses from paddy fields reduced due to the increases in water table control levels. Seasonal AV losses from CWT1, CWT2, and CWT3 were 59.8, 56.7, and 53.0 kg N ha−1, respectively. AV losses from CWT3 were 13.1% and 8.4% lower than those from CWT1 and CWT2, respectively. A significant difference in the seasonal AV losses was confirmed between CWT1 and CWT3. Less weekly AV losses followed by TF and PF were also observed as the water table control levels increased. The application of CD by increasing water table control levels to a suitable level could effectively reduce irrigation water volumes and AV losses from CI paddy fields. The combination of CI and CD may be a feasible water management method of reducing AV losses from paddy fields. PMID:24741349

  8. Ammonia volatilization losses from paddy fields under controlled irrigation with different drainage treatments.

    PubMed

    He, Yupu; Yang, Shihong; Xu, Junzeng; Wang, Yijiang; Peng, Shizhang

    2014-01-01

    The effect of controlled drainage (CD) on ammonia volatilization (AV) losses from paddy fields under controlled irrigation (CI) was investigated by managing water table control levels using a lysimeter. Three drainage treatments were implemented, namely, controlled water table depth 1 (CWT1), controlled water table depth 2 (CWT2), and controlled water table depth 3 (CWT3). As the water table control levels increased, irrigation water volumes in the CI paddy fields decreased. AV losses from paddy fields reduced due to the increases in water table control levels. Seasonal AV losses from CWT1, CWT2, and CWT3 were 59.8, 56.7, and 53.0 kg N ha(-1), respectively. AV losses from CWT3 were 13.1% and 8.4% lower than those from CWT1 and CWT2, respectively. A significant difference in the seasonal AV losses was confirmed between CWT1 and CWT3. Less weekly AV losses followed by TF and PF were also observed as the water table control levels increased. The application of CD by increasing water table control levels to a suitable level could effectively reduce irrigation water volumes and AV losses from CI paddy fields. The combination of CI and CD may be a feasible water management method of reducing AV losses from paddy fields.

  9. The ocean quasi-homogeneous layer model and global cycle of carbon dioxide in system of atmosphere-ocean

    NASA Astrophysics Data System (ADS)

    Glushkov, Alexander; Glushkov, Alexander; Loboda, Nataliya; Khokhlov, Valery; Serbov, Nikoly; Svinarenko, Andrey

    The purpose of this paper is carrying out the detailed model of the CO2 global turnover in system of "atmosphere-ocean" with using the ocean quasi-homogeneous layer model. Practically all carried out models are functioning in the average annual regime and accounting for the carbon distribution in bio-sphere in most general form (Glushkov et al, 2003). We construct a modified model for cycle of the carbon dioxide, which allows to reproduce a season dynamics of carbon turnover in ocean with account of zone ocean structure (up quasi-homogeneous layer, thermocline and deepest layer). It is taken into account dependence of the CO2 transfer through the bounder between atmosphere and ocean upon temperature of water and air, wind velocity, buffer mechanism of the CO2 dissolution. The same program is realized for atmosphere part of whole system. It is obtained a tempo-ral and space distribution for concentration of non-organic carbon in ocean, partial press of dissolute CO2 and value of exchange on the border between atmosphere and ocean. It is estimated a role of the wind intermixing of the up ocean layer. The increasing of this effect leads to increasing the plankton mass and further particles, which are transferred by wind, contribute to more quick immersion of microscopic shells and organic material. It is fulfilled investigation of sen-sibility of the master differential equations system solutions from the model parameters. The master differential equa-tions system, describing a dynamics of the CO2 cycle, is numerically integrated by the four order Runge-Cutt method under given initial values of valuables till output of solution on periodic regime. At first it is indicated on possible real-zation of the chaos scenario in system. On our data, the difference of the average annual values for the non-organic car-bon concentration in the up quasi-homogeneous layer between equator and extreme southern zone is 0.15 mol/m3, be-tween the equator and extreme northern zone is 0.12 mol/m3. the maximum amplitude of season oscillations (40° -50° n.l.) is 0.07 mol/m3. A link between global cycle of carbon dioxide and global climate change is investigated. Refrences: Glushkov A.V., Khokhlov V.N., Prepelitsa G.P., Tsenenko I.A., Optics of atmosphere and ocean.-2004.-Vol.14,N7.-p.219-223; Glushkov A.V., Loboda N.S., Khokhlov V.N., Atmospheric Research (Elseiver).-2005.-Vol.77.-P.100-113;Glushkov A.V., Loboda N.S., Khokhlov V.N., Lovett L. Journal of Hydrology (Elseiver).-2006.-Vol. 322. N1-4.-P.14-24; Glushkov A.V., Khokhlov V.N., Loboda N.S., Quart.J.Royal Meteorol. Soc.-2006.-Vol.132.- pp.447-465; Glushkov A.V., Khokhlov V.N., Loboda N.S., Ponomarenko E.L., Environm. Inf. Arch.-2003.-Vol.1.-P.125-130.

  10. [Complete atrioventricular block in Duchenne muscular dystrophy].

    PubMed

    Kuru, Satoshi; Tanahashi, Tamotsu; Matsumoto, Shinjirou; Kitamura, Tetsuya; Konagaya, Masaaki

    2012-01-01

    We report a case of complete atrioventricular (AV) block in a 40-year-old patient with Duchenne muscular dystrophy (DMD). While he was bed-ridden and required mechanical ventilation, his cardiac involvement was mild. He had the deletion of exon 45-52 in the dystrophin gene. He underwent transient complete AV block and came to require pacemaker implantation due to recurrence of complete AV block ten days after the first attack. Electrophysiological study revealed mild prolonged AH and HV interval. Although DMD patients with AV block have been rarely reported so far, attention should be paid to AV block for patients who prolonged their lives.

  11. Synthesis of Automated Vehicle Legislation

    DOT National Transportation Integrated Search

    2017-10-01

    This report provides a synthesis of issues addressed by state legislation regarding automated vehicles (AV); AV technologies are rapidly evolving and many states have developed legislation to govern AV testing and deployment and to assure safety on p...

  12. A complete characterization of all-versus-nothing arguments for stabilizer states

    NASA Astrophysics Data System (ADS)

    Abramsky, Samson; Barbosa, Rui Soares; Carù, Giovanni; Perdrix, Simon

    2017-10-01

    An important class of contextuality arguments in quantum foundations are the all-versus-nothing (AvN) proofs, generalizing a construction originally due to Mermin. We present a general formulation of AvN arguments and a complete characterization of all such arguments that arise from stabilizer states. We show that every AvN argument for an n-qubit stabilizer state can be reduced to an AvN proof for a three-qubit state that is local Clifford-equivalent to the tripartite Greenberger-Horne-Zeilinger state. This is achieved through a combinatorial characterization of AvN arguments, the AvN triple theorem, whose proof makes use of the theory of graph states. This result enables the development of a computational method to generate all the AvN arguments in on n-qubit stabilizer states. We also present new insights into the stabilizer formalism and its connections with logic. This article is part of the themed issue `Second quantum revolution: foundational questions'.

  13. Autonomous vehicles are cost-effective when used as taxis.

    PubMed

    Freedman, Isaac G; Kim, Ellen; Muennig, Peter A

    2018-06-04

    Autonomous vehicles (AVs) will radically re-shape the health and well-being of people in the United States in good ways and bad. We set out to estimate a reasonable time-to-adoption using cost-effectivenessmodels to estimate the point at which AVs become reasonably safe and affordable for widespread adoption. We used Waymo data (previously, Google Self-Driving Car Project) and a microsimulation model to explore projected costs and safety issues today and five years from today to get a sense of the speed of consumer adoption were AVs brought to the market. The adoption of AVs for private use was associated with an ICER of 1,396,110/QALY gained today, a figure that would decline to 173,890/QALY gained 5-years in the future. However, AV taxis are both less expensive and potentially already safer than human-piloted taxis. While AVs are not unlikely to be used a family vehicles any time soon, it would make economic sense to adopt them as taxis today. Legislation enhancing the benefits while mitigating the potential harmful health impacts of AV taxis is needed with some urgency.

  14. Enhanced mobility for aging populations using automated vehicles.

    DOT National Transportation Integrated Search

    2015-12-01

    Automated vehicles (AV) offer a unique opportunity to improve the safety and efficiency of the transportation : system and enhance the mobility of aging and transportation disadvantaged populations simultaneously. : However, before this potential can...

  15. Aerobic vaginitis in pregnancy.

    PubMed

    Donders, Ggg; Bellen, G; Rezeberga, D

    2011-09-01

    Aerobic vaginitis (AV) is an alteration in vaginal bacterial flora that differs from bacterial vaginosis (BV). AV is characterised by an abnormal vaginal microflora accompanied by an increased localised inflammatory reaction and immune response, as opposed to the suppressed immune response that is characteristic of BV. Given the increased local production of interleukin (IL)-1, IL-6 and IL-8 associated with AV during pregnancy, not surprisingly AV is associated with an increased risk of preterm delivery, chorioamnionitis and funisitis of the fetus. There is no consensus on the optimal treatment for AV in pregnant or non-pregnant women, but a broader spectrum drug such as clindamycin is preferred above metronidazole to prevent infection-related preterm birth. The exact role of AV in pregnancy, the potential benefit of screening, and the use of newer local antibiotics, disinfectants, probiotics and immune modulators need further study. © 2011 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2011 RCOG.

  16. Mass movement on Vesta at steep scarps and crater rims

    NASA Astrophysics Data System (ADS)

    Krohn, K.; Jaumann, R.; Otto, K.; Hoogenboom, T.; Wagner, R.; Buczkowski, D. L.; Garry, B.; Williams, D. A.; Yingst, R. A.; Scully, J.; De Sanctis, M. C.; Kneissl, T.; Schmedemann, N.; Kersten, E.; Stephan, K.; Matz, K.-D.; Pieters, C. M.; Preusker, F.; Roatsch, T.; Schenk, P.; Russell, C. T.; Raymond, C. A.

    2014-12-01

    The Quadrangles Av-11 and Av-12 on Vesta are located at the northern rim of the giant Rheasilvia south polar impact basin. The primary geologic units in Av-11 and Av-12 include material from the Rheasilvia impact basin formation, smooth material and different types of impact crater structures (such as bimodal craters, dark and bright crater ray material and dark ejecta material). Av-11 and Av-12 exhibit almost the full range of mass wasting features observed on Vesta, such as slump blocks, spur-and-gully morphologies and landslides within craters. Processes of collapse, slope instability and seismically triggered events force material to slump down crater walls or scarps and produce landslides or rotational slump blocks. The spur-and-gully morphology that is known to form on Mars is also observed on Vesta; however, on Vesta this morphology formed under dry conditions.

  17. Mass Movement on Vesta at Steep Scarps and Crater Rims

    NASA Technical Reports Server (NTRS)

    Krohn, K.; Jaumann, R.; Otto, K.; Hoogenboom, T.; Wagner, R.; Buczkowski, D. L.; Garry, B.; Williams, D. A.; Yingst, R. A.; Scully, J.; hide

    2014-01-01

    The Quadrangles Av-11 and Av-12 on Vesta are located at the northern rim of the giant Rheasilvia south polar impact basin. The primary geologic units in Av-11 and Av-12 include material from the Rheasilvia impact basin formation, smooth material and different types of impact crater structures (such as bimodal craters, dark and bright crater ray material and dark ejecta material). Av-11 and Av-12 exhibit almost the full range of mass wasting features observed on Vesta, such as slump blocks, spur-and-gully morphologies and landslides within craters. Processes of collapse, slope instability and seismically triggered events force material to slump down crater walls or scarps and produce landslides or rotational slump blocks. The spur-and-gully morphology that is known to form on Mars is also observed on Vesta; however, on Vesta this morphology formed under dry conditions.

  18. Examination of office visit patient preferences for the after-visit summary (AVS).

    PubMed

    Neuberger, Marolee; Dontje, Katherine; Holzman, Greg; Corser, Bill; Keskimaki, Abigail; Chant, Ericka

    2014-01-01

    The federal government advocates the practice of routinely providing an after-visit summary (AVS) to patients after each office-based visit as an element of stage 1 meaningful use. A significant potential benefit of the AVS is improved patient engagement achieved by enabling patients and family members to better understand and retain key health information. The methodology for this study was a mixed-methods pilot study to examine, through the perspectives of adult primary care patients, how relevant and actionable data can be better formatted in the AVS. Results of this study suggest that the goal of the AVS to serve as a communication tool to engage and support patients is frequently not being met. Further study is needed to understand, from the viewpoints of patients and providers, what barriers are keeping them from optimally providing and using the information on the AVS.

  19. Examination of Office Visit Patient Preferences for the After-Visit Summary (AVS)

    PubMed Central

    Neuberger, Marolee; Dontje, Katherine; Holzman, Greg; Corser, Bill; Keskimaki, Abigail; Chant, Ericka

    2014-01-01

    The federal government advocates the practice of routinely providing an after-visit summary (AVS) to patients after each office-based visit as an element of stage 1 meaningful use. A significant potential benefit of the AVS is improved patient engagement achieved by enabling patients and family members to better understand and retain key health information. The methodology for this study was a mixed-methods pilot study to examine, through the perspectives of adult primary care patients, how relevant and actionable data can be better formatted in the AVS. Results of this study suggest that the goal of the AVS to serve as a communication tool to engage and support patients is frequently not being met. Further study is needed to understand, from the viewpoints of patients and providers, what barriers are keeping them from optimally providing and using the information on the AVS. PMID:25593570

  20. [Preclinical study of AV0012 early stage inhibitor of hepatitis C virus infection: I. In vitro ADME and pharmacokinetics].

    PubMed

    Ivashchenko, A V; Iamanushkin, P M; Mit'kin, O D; Ezhova, E V; Korzinov, O M; Shevkun, N A; Koriakova, A G; Karapetian, R N; Bychko, V V; Ivashchenko, A A; Agrba, V Z; Lapin, B A; Orlov, S V

    2014-01-01

    In vitro immunohistochemical investigations on the human hepatoma cell line (Huh7) infected with hepatitis C virus (HCV) strain JFH-1 showed that AV0012 compound blocks the early stages of viral infection. AV0012 also blocked viral infection spread in tissue culture through the secreted virus and through tight cell-to-cell contact. AV0012 is a specific inhibitor of HCV but not of related pestivirus, flaviviruses and other RNA-containing viruses such as bovine diarrhea (BVDV), Venezuelan equine encephalitis (strain TC-83), dengue type 2 (New Guinea), yellow fever (strain 17D), west Nile fever, parainfluenza (type 3) virus, RSV (strain A2), and Rhinovirus (type 2 strain HGP). It is established that human serum does not significantly affect the antiviral activity of AV0012 in vitro. The drug combination studies with AV0012 and interferon alpha 2a in vitro showed that the two inhibitors act additively, which makes possible the use of this combination in clinical tests. AV0012 is highly soluble and stable in aqueous solutions and murine blood plasma, has limited metabolic stability, low binding to human plasma proteins, high permeability through biological membranes, and only interacts with isoenzymes 2D6 and 3A4 of human cytochrome P450. In animal pharmacokinetic studies, AV0012 was rapidly absorbed into the blood stream upon oral administration, showed sufficiently long half-elimination times, and had high oral bioavailability that reached 92% in monkeys. Further preclinical development of AV0012 is in progress.

  1. Electrophysiologic and histologic observations of chronic atrioventricular block induced by closed-chest catheter desiccation with radiofrequency energy.

    PubMed

    Huang, S K; Bharati, S; Lev, M; Marcus, F I

    1987-07-01

    Direct-current or laser energy has been used to induce atrioventricular (AV) block, but certain complications associated with this type of energy have been reported. We have previously documented that radiofrequency (RF) energy can effectively and safely induce acute AV block in closed-chest dogs during the 4-7 days of follow-up. This study was undertaken to determine if the ablation was permanent and to define the chronic pathology and site of AV block. Complete AV block was successfully achieved in four dogs immediately after ablation with a bipolar "standard" RF output (750 kHz) delivered between the tip electrode of a standard 7F USCI catheter and an external patch electrode on the left lateral chest wall. During 2 months of follow-up, three dogs had persistent complete AV block with a stable escape rhythm; the other had persistent 2:1 AV block. Repeat His bundle recordings were performed at 2 months prior to sacrifice of the dogs. Supra-His AV block was noted in two dogs; His bundle potential could not be recorded in another two. Histologically, the damaged area was well delineated. In all animals, the AV node and, in some dogs, part of the His bundle were completely replaced by granulation tissue and/or cartilage. There was fatty infiltration and also chronic inflammatory cells around the lesions. Neither perforation, hemorrhage nor vacuolation was seen in the adjacent area. Thrombus was not present. It is concluded that RF energy can effectively achieve chronic AV block and produce well-circumscribed pathological lesions.

  2. Discordance between imaging and immunohistochemistry in unilateral primary aldosteronism.

    PubMed

    Nanba, Aya T; Nanba, Kazutaka; Byrd, James B; Shields, James J; Giordano, Thomas J; Miller, Barbara S; Rainey, William E; Auchus, Richard J; Turcu, Adina F

    2017-12-01

    Correct subtyping of primary aldosteronism (PA) is essential for good surgical outcomes. Adrenal vein sampling (AVS) and/or computed tomography (CT) are used for PA subclassification. Clinical and/or biochemical improvement after surgery, however, is not always achieved in patients with presumed unilateral PA. We aimed to identify the pitfalls in PA subclassification leading to surgical treatment failures. We retrospectively studied 208 patients who underwent adrenal vein sampling (AVS) for PA subclassification in a tertiary referral centre, between January 2009 and August 2016. Simultaneous bilateral AVS was performed before and after cosyntropin administration. We implemented immunohistochemistry for aldosterone synthase (CYP11B2) and 17α-hydroxylase/17,20 lyase (CYP17A1) in adrenal glands resected from patients without improvement of PA after surgical treatment and from those with limitations in AVS interpretation. Of 55 patients who underwent adrenalectomy, three (5.5%) had no improvement of PA. All three patients underwent partial adrenalectomy to remove a CT-detected nodule present on the same side with AVS lateralization. Immunohistochemistry revealed a CYP11B2-negative nodule in both cases available. All patients who underwent total adrenalectomy based on AVS lateralization benefitted from surgery, including three patients with unilateral unsuccessful AVS and aldosterone suppression in the catheterized side vs inferior vena cava. Radiographically identified adrenal nodules are not always a source of PA, even when ipsilateral with AVS lateralization. These data caution against reliance on imaging findings, either alone or in conjunction with AVS, to guide surgery for PA. © 2017 John Wiley & Sons Ltd.

  3. 76 FR 24957 - Nineteenth Meeting: RTCA Special Committee 203: Unmanned Aircraft Systems

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-03

    ..., Washington, DC, 20036, telephone (202) 833-9339, fax (202) 833-9434, Web site http://www.rtca.org... Session Closing Plenary Session Plenary Adjourns RTCA Workspace Web Tool Mid-Morning/Afternoon--Workgroup Breakout Sessions Systems Engineering Workgroup Requirements Status and Overview AV2 Overview Control and...

  4. High Resolution Multispectral and Hyperspectral Data Fusion for Advanced Geospatial Information Products

    DTIC Science & Technology

    2005-09-30

    Barbara, Newport, and San Diego Harbor. The MSI instrumentation was provided under a cooperative agreement with the Applanix Systems Integration Group...part of the Applanix Position and Orientation System (POS AV; http://www.applanix.com/products/posav_index.php), which was being evaluated as a

  5. Cost-Effectiveness of Antivenoms for Snakebite Envenoming in 16 Countries in West Africa.

    PubMed

    Hamza, Muhammad; Idris, Maryam A; Maiyaki, Musa B; Lamorde, Mohammed; Chippaux, Jean-Philippe; Warrell, David A; Kuznik, Andreas; Habib, Abdulrazaq G

    2016-03-01

    Snakebite poisoning is a significant medical problem in agricultural societies in Sub Saharan Africa. Antivenom (AV) is the standard treatment, and we assessed the cost-effectiveness of making it available in 16 countries in West Africa. We determined the cost-effectiveness of AV based on a decision-tree model from a public payer perspective. Specific AVs included in the model were Antivipmyn, FAV Afrique, EchiTab-G and EchiTab-Plus. We derived inputs from the literature which included: type of snakes causing bites (carpet viper (Echis species)/non-carpet viper), AV effectiveness against death, mortality without AV, probability of Early Adverse Reactions (EAR), likelihood of death from EAR, average age at envenomation in years, anticipated remaining life span and likelihood of amputation. Costs incurred by the victims include: costs of confirming and evaluating envenomation, AV acquisition, routine care, AV transportation logistics, hospital admission and related transportation costs, management of AV EAR compared to the alternative of free snakebite care with ineffective or no AV. Incremental Cost Effectiveness Ratios (ICERs) were assessed as the cost per death averted and the cost per Disability-Adjusted-Life-Years (DALY) averted. Probabilistic Sensitivity Analyses (PSA) using Monte Carlo simulations were used to obtain 95% Confidence Intervals of ICERs. The cost/death averted for the 16 countries of interest ranged from $1,997 in Guinea Bissau to $6,205 for Liberia and Sierra Leone. The cost/DALY averted ranged from $83 (95% Confidence Interval: $36-$240) for Benin Republic to $281 ($159-457) for Sierra-Leone. In all cases, the base-case cost/DALY averted estimate fell below the commonly accepted threshold of one time per capita GDP, suggesting that AV is highly cost-effective for the treatment of snakebite in all 16 WA countries. The findings were consistent even with variations of inputs in 1-way sensitivity analyses. In addition, the PSA showed that in the majority of iterations ranging from 97.3% in Liberia to 100% in Cameroun, Guinea Bissau, Mali, Nigeria and Senegal, our model results yielded an ICER that fell below the threshold of one time per capita GDP, thus, indicating a high degree of confidence in our results. Therapy for SBE with AV in countries of WA is highly cost-effective at commonly accepted thresholds. Broadening access to effective AVs in rural communities in West Africa is a priority.

  6. Effect of calcium level and phytase addition on ileal phytate degradation and amino acid digestibility of broilers fed corn-based diets.

    PubMed

    Amerah, A M; Plumstead, P W; Barnard, L P; Kumar, A

    2014-04-01

    This study investigated the effect of dietary Ca to available P (AvP) ratio and phytase supplementation on bone ash, ileal phytate degradation, and nutrient digestibility in broilers fed corn-based diets. The experimental design was a 4 × 2 factorial arrangement of treatments evaluating 4 Ca:AvP ratios (1.43, 2.14, 2.86, and 3.57) and 2 levels of phytase (0 and 1,000 phytase units/kg of feed). The 4 Ca:AvP ratios were achieved by formulating all diets to a constant AvP level of 0.28% and varying Ca levels (0.4, 0.6, 0.8, and 1.0%). Each treatment was fed to 6 cages of 8 male Ross 308 broilers from 5 to 21 d. At 21 d, digesta from the terminal ileum was collected and analyzed for energy, phytate, P, Ca, and amino acids (AA) to determine digestibility. Digesta pH was measured in each segment (crop, gizzard, duodenum, and ileum) of the digestive tract. Data were analyzed by 2-way analysis of covariance. There was a significant interaction between dietary Ca:AvP ratio and phytase supplementation for weight gain (WG), feed intake (FI), and feed conversion ratio (FCR). In diets with no phytase, Ca:AvP ratio had a greater effect on WG, FI, and FCR compared with those fed diets without phytase. The orthogonal polynomial contrasts showed that the increase in dietary Ca:AvP ratio significantly decreased WG and FI in a quadratic manner, whereas FCR increased (P < 0.05) linearly with higher dietary Ca:AvP ratio. Increasing dietary Ca:AvP ratio led to a significant quadratic decrease in phytate degradation and significant linear decreases in P digestibility and bone ash. Phytase addition increased (P < 0.05) phytate degradation and improved (P < 0.05) energy, AA, and P digestibility at all levels of Ca:AvP with no interaction (P > 0.05) between the main factors. Digestibility of AA was positively correlated (P < 0.05) with the degree of phytate degradation. Increasing dietary Ca:AvP ratio significantly increased gizzard pH in a linear manner. In conclusion, phytase (1,000 phytase units/kg of feed) improved phytate, and P and AA digestibility at all Ca:AvP ratios evaluated in this study.

  7. Crotalidae polyvalent immune Fab (ovine) antivenom is effective in the neutralization of South American viperidae venoms in a murine model.

    PubMed

    Richardson, William H; Tanen, David A; Tong, Tri C; Betten, David P; Carstairs, Shaun D; Williams, Saralyn R; Cantrell, Frank L; Clark, Richard F

    2005-06-01

    Crotalidae polyvalent immune Fab (ovine) (CroFab; FabAV) is used in the treatment of symptomatic crotaline envenomations in North America. Unlike Antivenin (Crotalidae) Polyvalent, which is approved for treatment of crotaline envenomation in North and South America, FabAV is manufactured using only venoms from crotaline snakes native to the United States. This study was designed to evaluate the efficacy of FabAV in the neutralization of venom from 2 South American crotaline snakes: Crotalus durissus terrificus (tropical rattlesnake) and Bothrops atrox (fer-de-lance). A randomized, blinded, placebo-controlled murine model of intraperitoneal venom injection was used. Venom potency was determined in preliminary median lethal dose (LD 50) dosing studies. Study animals were then divided into 7 groups: (1) C durissus terrificus venom (Sigma-Aldrich Co.)+FabAV, (2) C durissus terrificus venom (Sigma-Aldrich Co.)+0.9% normal saline solution, (3) C durissus terrificus venom (Biotoxins Inc.)+FabAV, (4) C durissus terrificus venom (Biotoxins Inc.)+normal saline solution, (5) B atrox venom+FabAV, (6) B atrox venom+normal saline solution, and (7) FabAV+normal saline solution. Twice the estimated LD 50 was the chosen venom dose, and the amount of FabAV injected was 10 times the amount needed for venom neutralization. Statistical analysis included Fisher's exact test and log-rank testing to compare survival rates and times. The venom LD 50 was found in preliminary studies to be 0.9 mg/kg and 1.35 mg/kg for the C durissus terrificus venom obtained from Sigma-Aldrich Co. and Biotoxins Inc., respectively. The LD 50 for B atrox venom was 5.0 mg/kg. All animals receiving venom only and saline solution died. Animals receiving FabAV together with either venom survived to the end of the 24-hour observation period ( P <.001). Comparison of survival times between groups demonstrated a significant difference in time to death between venom-only control groups and the FabAV+venom groups (P <.001). All animals in the FabAV+normal saline solution group survived to the conclusion of the study. FabAV, when premixed with venom, decreases lethality in a murine model of intraperitoneal venom injection of the South American pit vipers, C durissus terrificus and B atrox .

  8. Flight Simulator Evaluation of Display Media Devices for Synthetic Vision Concepts

    NASA Technical Reports Server (NTRS)

    Arthur, J. J., III; Williams, Steven P.; Prinzel, Lawrence J., III; Kramer, Lynda J.; Bailey, Randall E.

    2004-01-01

    The Synthetic Vision Systems (SVS) Project of the National Aeronautics and Space Administration's (NASA) Aviation Safety Program (AvSP) is striving to eliminate poor visibility as a causal factor in aircraft accidents as well as enhance operational capabilities of all aircraft. To accomplish these safety and capacity improvements, the SVS concept is designed to provide a clear view of the world around the aircraft through the display of computer-generated imagery derived from an onboard database of terrain, obstacle, and airport information. Display media devices with which to implement SVS technology that have been evaluated so far within the Project include fixed field of view head up displays and head down Primary Flight Displays with pilot-selectable field of view. A simulation experiment was conducted comparing these display devices to a fixed field of view, unlimited field of regard, full color Helmet-Mounted Display system. Subject pilots flew a visual circling maneuver in IMC at a terrain-challenged airport. The data collected for this experiment is compared to past SVS research studies.

  9. Avian coronavirus isolated from a pigeon sample induced clinical disease, tracheal ciliostasis, and a high humoral response in day-old chicks.

    PubMed

    Martini, Matheus C; Caserta, Leonardo C; Dos Santos, Marcia M A B; Barnabé, Ana C S; Durães-Carvalho, Ricardo; Padilla, Marina A; Simão, Raphael M; Rizotto, Laís S; Simas, Paulo V M; Bastos, Juliana C S; Cardoso, Tereza C; Felippe, Paulo A N; Ferreira, Helena L; Arns, Clarice W

    2018-06-01

    The detection of avian coronaviruses (AvCoV) in wild birds and the emergence of new AvCoV have increased in the past few years. In the present study, the pathogenicity of three AvCoV isolates was investigated in day-old chicks. One AvCoV isolated from a pigeon, which clustered with the Massachusetts vaccine serotype, and two AvCoV isolated from chickens, which grouped with a Brazilian genotype lineage, were used. Clinical signs, gross lesions, histopathological changes, ciliary activity, viral RNA detection, and serology were evaluated during 42 days post infection. All AvCoV isolates induced clinical signs, gross lesions in the trachea, moderate histopathological changes in the respiratory tract, and mild changes in other tissues. AvCoV isolated from the pigeon sample caused complete tracheal ciliostasis over a longer time span. Specific viral RNA was detected in all tissues, but the highest RNA loads were detected in the digestive tract (cloacal swabs and ileum). The highest antibody levels were also detected in the group infected with an isolate from the pigeon. These results confirm the pathogenicity of Brazilian variants, which can cause disease and induce gross lesions and histopathological changes in chickens. Our results suggest that non-Galliformes birds can also play a role in the ecology of AvCoV.

  10. [EPIDEMIOLOGICAL, CLINICAL AND MICROBIOLOGICAL FINDINGS IN WOMEN WITH AEROBIC VAGINITIS].

    PubMed

    Dermendjiev, T; Pehlivanov, B; Hadjieva, K; Stanev, S

    2015-01-01

    Aerobic vaginitis (AV) is an alterarion of the normal lactobacillic flora accompanied by signs of inflammation, presence of mainly aerobic microorganisms from intestinal commensals or other aerobic pathogens. Clinical symptoms may vary by type and intensity and are marked by a high tendency for recurrence and chronification. Inflammation and ulcerations in AV could increase the risk of contracting HIV or other sexually transmitted infections. The aim is to study some epidemiological, clinical and microbiological features of the aerobic vaginitis in patients of the specialized Obstetric and Gynecological Clinic in Plovdiv, Bulgaria. In a retrospective research 4687 vaginal smears have been gathered in Microbiological laboratory at "St. George" Hospital - Plovdiv. We used clinical, microbiological and statistical methods. Information processing is performed by variation, alternative, correlation and graphical analysis using specialized package SPSS v13.0. The overall prevalence rate of AV in the studied population is 11.77%. The levels of prevalence of AV in pregnant and non-pregnant women are respectively 13.08% and 4.34%. The highest frequency of AV is in the age group 21-30 years (32.3%). The results show a marked association between Escherichia coli and the cases of AV (p < 0.001). AV is a common cause of vaginal symptoms in patients of specialized ambulatory outpatient. One in ten women with vaginal complaints suffers from AV Streptococcus agalactiae and Escherichia coli are most often isolated aerobic microorganisms.

  11. Ramipril retards development of aortic valve stenosis in a rabbit model: mechanistic considerations.

    PubMed

    Ngo, Doan Tm; Stafford, Irene; Sverdlov, Aaron L; Qi, Weier; Wuttke, Ronald D; Zhang, Yuan; Kelly, Darren J; Weedon, Helen; Smith, Malcolm D; Kennedy, Jennifer A; Horowitz, John D

    2011-02-01

    Aortic valve stenosis (AVS) is associated with significant cardiovascular morbidity and mortality. To date, no therapeutic modality has been shown to be effective in retarding AVS progression. We evaluated the effect of angiotensin-converting enzyme inhibition with ramipril on disease progression in a recently developed rabbit model of AVS. The effects of 8 weeks of treatment with either vitamin D₂ at 25,000 IU for 4 days a week alone or in combination with ramipril (0.5 mg·kg⁻¹) on aortic valve structure and function were examined in New Zealand white rabbits. Echocardiographic aortic valve backscatter (AV(BS)) and aortic valve:outflow tract flow velocity ratio were utilized to quantify changes in valve structure and function. Treatment with ramipril significantly reduced AV(BS) and improved aortic valve :outflow tract flow velocity ratio. The intravalvular content of the pro-oxidant thioredoxin-interacting protein was decreased significantly with ramipril treatment. Endothelial function, as measured by asymmetric dimethylarginine concentrations and vascular responses to ACh, was improved significantly with ramipril treatment. Ramipril retards the development of AVS, reduces valvular thioredoxin-interacting protein accumulation and limits endothelial dysfunction in this animal model. These findings provide important insights into the mechanisms of AVS development and an impetus for future human studies of AVS retardation using an angiotensin-converting enzyme inhibitor. © 2011 The Authors. British Journal of Pharmacology © 2011 The British Pharmacological Society.

  12. Temporal characteristics of audiovisual information processing.

    PubMed

    Fuhrmann Alpert, Galit; Hein, Grit; Tsai, Nancy; Naumer, Marcus J; Knight, Robert T

    2008-05-14

    In complex natural environments, auditory and visual information often have to be processed simultaneously. Previous functional magnetic resonance imaging (fMRI) studies focused on the spatial localization of brain areas involved in audiovisual (AV) information processing, but the temporal characteristics of AV information flow in these regions remained unclear. In this study, we used fMRI and a novel information-theoretic approach to study the flow of AV sensory information. Subjects passively perceived sounds and images of objects presented either alone or simultaneously. Applying the measure of mutual information, we computed for each voxel the latency in which the blood oxygenation level-dependent signal had the highest information content about the preceding stimulus. The results indicate that, after AV stimulation, the earliest informative activity occurs in right Heschl's gyrus, left primary visual cortex, and the posterior portion of the superior temporal gyrus, which is known as a region involved in object-related AV integration. Informative activity in the anterior portion of superior temporal gyrus, middle temporal gyrus, right occipital cortex, and inferior frontal cortex was found at a later latency. Moreover, AV presentation resulted in shorter latencies in multiple cortical areas compared with isolated auditory or visual presentation. The results provide evidence for bottom-up processing from primary sensory areas into higher association areas during AV integration in humans and suggest that AV presentation shortens processing time in early sensory cortices.

  13. A marked proportional rise in IVC aldosterone following cosyntropin administration during AVS is a signal to the presence of adrenal hyperplasia in primary aldosteronism.

    PubMed

    Kline, G A; Pasieka, J L; Harvey, A; So, B; Dias, V C

    2014-05-01

    We hypothesized aldosteronoma responsiveness to cosyntropin may be a characterizing feature that could be determined in addition to standard adrenal vein sampling (AVS) data. We reviewed an AVS database from June 2005 to October 2011 including 65 patients with confirmed primary aldosteronism (PA) who underwent AVS and, if applicable, unilateral adrenalectomy. Patients were divided into confirmed lateralized and non-lateralized groups and subgrouped by histology. Plasma aldosterone in inferior vena cava (IVC) pre- and post-cosyntropin infusion during AVS was measured. Peak aldosterone and proportional change was compared between groups. Baseline and peak IVC aldosterone was higher in lateralized patients but incremental aldosterone rise was much greater in subjects with bilateral hyperplasia. From receiver operator characteristics (ROC) analysis, the optimized diagnostic cut point of peak IVC aldosterone of >649 pmol l(-1) would have a sensitivity of 94% for surgical disease although specificity of just 59%. A 250% increase in IVC aldosterone following cosyntropin would be specific enough to exclude 87% of surgical/lateralized disease. These diagnostic capabilities are similar to other results with non-AVS tests performed for diagnosis of lateralization. Although not specific enough to replace standard AVS interpretation, a marked IVC aldosterone increase after cosyntropin during AVS is a useful additional test to diagnose non-lateralizing forms of PA. Such a calculation requires no additional expense or tests.

  14. Evaluating the Effects of Metals on Microorganisms in Flooded Paddy Soils Using the SEM/AVS-Based Approach and Measurements of Exchangeable Metal Concentrations.

    PubMed

    Kunito, Takashi; Toya, Hitomi; Sumi, Hirotaka; Ishikawa, Yuichi; Toda, Hideshige; Nagaoka, Kazunari; Saeki, Kazutoshi; Aikawa, Yoshio; Matsumoto, Satoshi

    2017-04-01

    We examined possible adverse effects of heavy metals on microbial activity, biomass, and community composition using the simultaneously extracted metals (SEM)/acid-volatile sulfide (AVS)-based approach and measurements of exchangeable metal concentrations in three paddy soils (wastewater-contaminated soil, mine-contaminated soil, and noncontaminated soil) incubated for 60 days under flooded conditions. Incubation under flooding increased pH and decreased Eh in all samples. AVS increased when Eh decreased to approximately -200 mV for the mine-contaminated and noncontaminated soils, while the wastewater-contaminated soil originally had a high concentration of AVS despite its air-dried condition. Addition of rice straw or alkaline material containing calcium carbonate and gypsum increased AVS levels under flooded conditions. We observed no apparent relationship between soil enzyme activity (β-D-glucosidase and acid phosphatase) and concentrations of SEM, [∑SEM - AVS], and exchangeable metals. Bacterial and fungal community composition, assessed using polymerase chain reaction-denaturing gradient gel electrophoresis (DGGE) analysis targeting rRNA genes, was largely influenced by site of collection and incubation time, but metal contamination did not influence community composition. We observed significant negative correlations between biomass C and [∑SEM - AVS] and between biomass C and ∑SEM, suggesting that [∑SEM - AVS] and ∑SEM might reflect the bioavailability of organic matter to microorganisms in these soils.

  15. Divisible Auditoriums: A Challenge to AV Systems. Part II

    ERIC Educational Resources Information Center

    Wadsworth, Raymond H.

    1975-01-01

    The second of two articles, describing how auditoriums could be divided with different types of operable walls, covers the rotating turntable technique of dividing auditoriums and the conflicting acoustical requirements for different uses. (MLF)

  16. Enhanced mobility for aging populations using automated vehicles : [summary].

    DOT National Transportation Integrated Search

    2016-01-01

    Studies show that aging adults have travel needs that can be inadequately addressed by todays : transportation system. Automated vehicles (AVs), ranging from assistive technologies to full : automation, may offer a safe and efficient transportatio...

  17. 21st International Seapower Symposium

    DTIC Science & Technology

    2015-02-01

    frequency ] radio on channel ten. • AV17-8 T2000: I intend to conduct vertical replenishment operations at 2000. • X Corpen Port 000: I intend to alter...welcome you to Newport, Rhode Island, for the 21st International Seapower Symposium (ISS-21). The International Naval Community is well-represented...Italy .......................... 173 Chapter 11 Closing Remarks Rear Admiral P. Gardener Howe III and Admiral Jonathan W. Greenert, U.S. Navy

  18. MAS Bulletin. Microtherm Thermal Insulation

    DTIC Science & Technology

    1989-03-03

    EUROPEAN OFFICE Box 39, FPO New York 0951P .0700 Phone (AV)235.ൕjLomm) 409-4131 MASB 16-89 11 1 E, March 1989 MICROTHERM THERMAL INSULAT 00T...Background. Microtherm insulation is being marketed by Figure 1 illustrates the relative differenbeibetween Microtherm Micropore Insulation, Ltd., of Wirral...tivity properties. Figure 2 displays thermal conductivity compari- facturer has introduced a new product - Microtherm MPS, a sons between Microtherm MPS

  19. Mortality characteristics of aortic root surgery in North America†

    PubMed Central

    Caceres, Manuel; Ma, Yicheng; Rankin, J. Scott; Saha-Chaudhuri, Paramita; Englum, Brian R.; Gammie, James S.; Suri, Rakesh M.; Thourani, Vinod H.; Esmailian, Fardad; Czer, Lawrence S.; Puskas, John D.; Svensson, Lars G.

    2014-01-01

    OBJECTIVES Aortic root surgery is transitioning to aortic valve sparing (AVS), but little is known about the relative early outcomes of AVS versus composite graft-valve replacement (CVR). This study assessed mortality differences for AVS versus CVR to guide future practice decisions. METHODS From January 2000 to June 2011, 31 747 patients had aortic root replacement with AVS (n = 3585; 11%) or CVR (n = 28 162; 89%). The cohort of Overall patients was divided into two subgroups: high-risk patients (n = 20 356; 6% AVS) having age >75 years, endocarditis, aortic stenosis, dialysis, multiple valves, reoperation or emergency/salvage status, and the remaining low-risk patients (n = 11 388; 21% AVS). Using logistic regression analysis, outcomes were presented as unadjusted operative mortality (UOM), risk-adjusted operative mortality (AOM) and adjusted odds ratio (AOR) for mortality. RESULTS Baseline characteristics for the Overall group (AVS versus CVR) were: mean age (52 vs 57 years), endocarditis (1 vs 11%), aortic stenosis (4 vs 36%), dialysis (1 vs 2%), multiple valves (7 vs 10%), reoperation (6 vs 17%) and emergency status (14 vs 12%) (all P < 0.0001). In high- and low-risk groups, baseline differences narrowed, and lower mortality was generally observed with AVS: (AVS versus CVR) UOM group Overall (4.5 vs 8.9%)*, group High-risk (10.5 vs 11.7%), group Low-risk (1.4 vs 3.1%)*; AOM group Overall (6.2 vs 8.6%), group High-risk (10.1 vs 11.7%), group Low-risk (2.2 vs 2.8%); AOR group Overall (0.59)*, group High-risk (0.62)*, group Low-risk (0.69). *P < 0.05. CONCLUSIONS Relative risk-adjusted mortality seemed comparable with AVS versus CVR in low- and high-risk subgroups. These data support judicious expansion of aortic valve repair in patients having aortic root replacement. PMID:24639452

  20. Mortality characteristics of aortic root surgery in North America.

    PubMed

    Caceres, Manuel; Ma, Yicheng; Rankin, J Scott; Saha-Chaudhuri, Paramita; Englum, Brian R; Gammie, James S; Suri, Rakesh M; Thourani, Vinod H; Esmailian, Fardad; Czer, Lawrence S; Puskas, John D; Svensson, Lars G

    2014-11-01

    Aortic root surgery is transitioning to aortic valve sparing (AVS), but little is known about the relative early outcomes of AVS versus composite graft-valve replacement (CVR). This study assessed mortality differences for AVS versus CVR to guide future practice decisions. From January 2000 to June 2011, 31 747 patients had aortic root replacement with AVS (n = 3585; 11%) or CVR (n = 28 162; 89%). The cohort of Overall patients was divided into two subgroups: high-risk patients (n = 20 356; 6% AVS) having age >75 years, endocarditis, aortic stenosis, dialysis, multiple valves, reoperation or emergency/salvage status, and the remaining low-risk patients (n = 11 388; 21% AVS). Using logistic regression analysis, outcomes were presented as unadjusted operative mortality (UOM), risk-adjusted operative mortality (AOM) and adjusted odds ratio (AOR) for mortality. Baseline characteristics for the Overall group (AVS versus CVR) were: mean age (52 vs 57 years), endocarditis (1 vs 11%), aortic stenosis (4 vs 36%), dialysis (1 vs 2%), multiple valves (7 vs 10%), reoperation (6 vs 17%) and emergency status (14 vs 12%) (all P < 0.0001). In high- and low-risk groups, baseline differences narrowed, and lower mortality was generally observed with AVS: (AVS versus CVR) UOM group Overall (4.5 vs 8.9%)*, group High-risk (10.5 vs 11.7%), group Low-risk (1.4 vs 3.1%)*; AOM group Overall (6.2 vs 8.6%), group High-risk (10.1 vs 11.7%), group Low-risk (2.2 vs 2.8%); AOR group Overall (0.59)*, group High-risk (0.62)*, group Low-risk (0.69). *P < 0.05. Relative risk-adjusted mortality seemed comparable with AVS versus CVR in low- and high-risk subgroups. These data support judicious expansion of aortic valve repair in patients having aortic root replacement. © The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  1. Lipoprotein(a) levels, genotype, and incident aortic valve stenosis: a prospective Mendelian randomization study and replication in a case-control cohort.

    PubMed

    Arsenault, Benoit J; Boekholdt, S Matthijs; Dubé, Marie-Pierre; Rhéaume, Eric; Wareham, Nicholas J; Khaw, Kay-Tee; Sandhu, Manjinder S; Tardif, Jean-Claude

    2014-06-01

    Although a previous study has suggested that a genetic variant in the LPA region was associated with the presence of aortic valve stenosis (AVS), no prospective study has suggested a role for lipoprotein(a) levels in the pathophysiology of AVS. Our objective was to determine whether lipoprotein(a) levels and a common genetic variant that is strongly associated with lipoprotein(a) levels are associated with an increased risk of developing AVS. Serum lipoprotein(a) levels were measured in 17 553 participants of the European Prospective Investigation into Cancer (EPIC)-Norfolk study. Among these study participants, 118 developed AVS during a mean follow-up of 11.7 years. The rs10455872 genetic variant in LPA was genotyped in 14 735 study participants, who simultaneously had lipoprotein(a) level measurements, and in a replication study of 379 patients with echocardiography-confirmed AVS and 404 controls. In EPIC-Norfolk, compared with participants in the bottom lipoprotein(a) tertile, those in the top lipoprotein(a) tertile had a higher risk of AVS (hazard ratio, 1.57; 95% confidence interval, 1.02-2.42) after adjusting for age, sex, and smoking. Compared with rs10455872 AA homozygotes, carriers of 1 or 2 G alleles were at increased risk of AVS (hazard ratio, 1.78; 95% confidence interval, 1.11-2.87, versus hazard ratio, 4.83; 95% confidence interval, 1.77-13.20, respectively). In the replication study, the genetic variant rs10455872 also showed a positive association with AVS (odds ratio, 1.57; 95% confidence interval, 1.10-2.26). Patients with high lipoprotein(a) levels are at increased risk for AVS. The rs10455872 variant, which is associated with higher lipoprotein(a) levels, is also associated with increased risk of AVS, suggesting that this association may be causal. © 2014 American Heart Association, Inc.

  2. Valve-sparing aortic root replacement in patients with Marfan syndrome enrolled in the National Registry of Genetically Triggered Thoracic Aortic Aneurysms and Cardiovascular Conditions.

    PubMed

    Song, Howard K; Preiss, Liliana R; Maslen, Cheryl L; Kroner, Barbara; Devereux, Richard B; Roman, Mary J; Holmes, Kathryn W; Tolunay, H Eser; Desvigne-Nickens, Patrice; Asch, Federico M; Milewski, Rita K; Bavaria, Joseph; LeMaire, Scott A

    2014-05-01

    The long-term outcomes of aortic valve-sparing (AVS) root replacement in Marfan syndrome (MFS) patients remain uncertain. The study aim was to determine the utilization and outcomes of AVS root replacement in MFS patients enrolled in the Registry of Genetically Triggered Thoracic Aortic Aneurysms and Cardiovascular Conditions (GenTAC). At the time of this analysis, 788 patients with MFS were enrolled in the GenTAC Registry, of whom 288 had undergone aortic root replacement. Patients who had undergone AVS procedures were compared to those who had undergone aortic valve replacement (AVR). AVS root replacement was performed in 43.5% of MFS patients, and the frequency of AVS was increased over the past five years. AVS patients were younger at the time of surgery (31.0 versus 36.3 years, p = 0.006) and more likely to have had elective rather than emergency surgery compared to AVR patients, in whom aortic valve dysfunction and aortic dissection was the more likely primary indication for surgery. After a mean follow up of 6.2 +/- 3.6 years, none of the 87 AVS patients had required reoperation; in contrast, after a mean follow up of 10.5 +/- 7.6 years, 11.5% of AVR patients required aortic root reoperation. Aortic valve function has been durable, with 95.8% of AVS patients having aortic insufficiency that was graded as mild or less. AVS root replacement is performed commonly among the MFS population, and the durability of the aortic repair and aortic valve function have been excellent to date. These results justify a continued use of the procedure in an elective setting. The GenTAC Registry will be a useful resource to assess the long-term durability of AVS root replacement in the future.

  3. The internal-external respiratory motion correlation is unaffected by audiovisual biofeedback.

    PubMed

    Steel, Harry; Pollock, Sean; Lee, Danny; Keall, Paul; Kim, Taeho

    2014-03-01

    This study evaluated if an audiovisual (AV) biofeedback causes variation in the level of external and internal correlation due to its interactive intervention in natural breathing. The internal (diaphragm) and external (abdominal wall) respiratory motion signals of 15 healthy human subjects under AV biofeedback and free breathing (FB) were analyzed and measures of correlation and regularity taken. Regularity metrics (root mean square error and spectral power dispersion metric) were obtained and the correlation between these metrics and the internal and external correlation was investigated. For FB and AV biofeedback assisted breathing the mean correlations found between internal and external respiratory motion were 0.96±0.02 and 0.96±0.03, respectively. This means there is no evidence to suggest (p-value=0.88) any difference in the correlation between internal and external respiratory motion with the use of AV biofeedback. Our results confirmed the hypothesis that the internal-external correlation with AV biofeedback is the same as for free breathing. Should this correlation be maintained for patients, AV biofeedback can be implemented in the clinic with confidence as regularity improvements using AV biofeedback with an external signal will be reflected in increased internal motion regularity.

  4. Isolation and chemical characterization of agelaiatoxin8 (AvTx8) from Agelaia vicina wasp venom and its biological effects on GABA neurotransmission.

    PubMed

    Pizzo, Andrea B; Beleboni, Renê O; Gomes Carolino, Ruither O; de Oliveira, Luciana; Miranda, Antonio; Coutinho-Netto, Joaquim; Fontana, Andréia C K; Dos Santos, Wagner Ferreira

    2017-10-01

    Arthropod venoms are sources of molecules that may be useful tools to investigate molecular mechanisms of putative new medicines and laboratory drugs. Here we show the effects of the compound agelaiatoxin-8 (AVTx8), isolated from Agelaia vicina venom, on γ-aminobutyric acid (GABA) neurotransmission in rat brain synaptosomes. Analysis reveals that AvTx8 is composed by 14 amino acid residues with a molecular weight (MW) of 1567 Da. AvTx8 increased GABA release and inhibited GABA uptake in synaptosomes from rat cerebral cortex. AvTx8 inhibited GABA uptake and increased GABA release in the presence of Ca + , Na + , and K + channel blockers, suggesting that it acts directly on GABA transporters. In addition, AvTx8 significantly decreases GABA binding in synaptic membranes from rat brain cortex, suggesting that it also modulates the activity of GABA receptors. Moreover, AvTx8 decreased GAT-1- and GAT-3-mediated GABA uptake in transfected COS-7 cells. Accordingly, we suggest that AvTx8 modulates GABA neurotransmission and might provide a novel entry point for identifying a new class of GABA-modulating neuroprotective drugs. © 2017 Wiley Periodicals, Inc.

  5. [Comparison of echocardiographic findings in AVS patients with and without high IgG, IgM, IgA titers against Chlamydia pneumoniae during 12 months' observation of AVS natural course].

    PubMed

    Swierszcz, Jolanta; Dubiel, Jacek S; Krzysiek, Józef; Sztefko, Krystyna; Galicka-Latała, Danuta; Roman, Pfitzner; Podolec, Piotr; Wodniecki, Jan

    2011-01-01

    Comparison of echocardiographic findings in AVS patients with and without high IgG, IgM, IgA titers against Chlamydia pneumoniae during 12 months' observation of AVS natural course. 60 AVS patients who did not agree for operational treatment were divided into group A (30 patients with high IgG titer) group B (30 patients with low IgG titer), group C (22 patients with high IgA titer) group D (38 patients with low IgA titer), group E (7 patients with high IgM titer), group F (53 patients with low IgA titer) Antibodies titers and echocardiographic scans were carried out every 12 months. There were more (p < 0.02) patients with AVS deterioration in group A compared to group B. Group A patients had lower left ventricle posteriori wall systolic diameter compared to group B. There were no differences in echocardiographic parameters between group C and D. Mean ejection fraction was lower and mean right atrium diameter was higher in group E compared to group F. The results may suggest link between Chlamydia pneumoniae and deterioration of AVS.

  6. Spinal arteriovenous shunts: accuracy of shunt detection, localization, and subtype discrimination using spinal magnetic resonance angiography and manual contrast injection using a syringe.

    PubMed

    Unsrisong, Kittisak; Taphey, Siriporn; Oranratanachai, Kanokporn

    2016-04-01

    The object of this study was to evaluate the accuracy of fast 3D contrast-enhanced spinal MR angiography (MRA) using a manual syringe contrast injection technique for detecting and evaluating spinal arteriovenous shunts (AVSs). This was a retrospective study of 15 patients and 20 spinal MRA and catheter angiography studies. The accuracy of using spinal MRA to detect spinal AVS, localize shunts, and discriminate the subtype and dominant arterial feeder of the AVS were studied. There were 14 pretherapeutic and 6 posttherapeutic follow-up spinal MRA and catheter spinal angiography studies. The spinal AVS was demonstrated in 17 of 20 studies. Spinal MRA demonstrated 100% sensitivity for detecting spinal AVS with no false-negative results. A 97% accuracy rate for AVS subtype discrimination and shunt level localization was achieved using this study's diagnostic criteria. The detection of the dominant arterial feeder was limited to 9 of these 17 cases (53%). The fast 3D contrast-enhanced MRA technique performed using manual syringe contrast injection can detect the presence of a spinal AVS, locate the shunt level, and discriminate AVS subtype in most cases, but is limited when detecting small arterial feeders.

  7. What are the keys to successful adrenal venous sampling (AVS) in patients with primary aldosteronism?

    PubMed

    Young, William F; Stanson, Anthony W

    2009-01-01

    Adrenal venous sampling (AVS) is the criterion standard to distinguish between unilateral and bilateral adrenal disease in patients with primary aldosteronism. The keys to successful AVS include appropriate patient selection, careful patient preparation, focused technical expertise, defined protocol, and accurate data interpretation. The use of AVS should be based on patient preferences, patient age, clinical comorbidities, and the clinical probability of finding an aldosterone-producing adenoma. AVS is optimally performed in the fasting state in the morning. AVS is an intricate procedure because the right adrenal vein is small and may be difficult to locate - the success rate depends on the proficiency of the angiographer. The key factors that determine the successful catheterization of both adrenal veins are experience, dedication and repetition. With experience, and focusing the expertise to 1 or 2 radiologists at a referral centre, the AVS success rate can be as high as 96%. A centre-specific, written protocol is mandatory. The protocol should be developed by an interested group of endocrinologists, radiologists and laboratory personnel. Safeguards should be in place to prevent mislabelling of the blood tubes in the radiology suite and to prevent sample mix-up in the laboratory.

  8. Development of an Automatic Testing Platform for Aviator's Night Vision Goggle Honeycomb Defect Inspection.

    PubMed

    Jian, Bo-Lin; Peng, Chao-Chung

    2017-06-15

    Due to the direct influence of night vision equipment availability on the safety of night-time aerial reconnaissance, maintenance needs to be carried out regularly. Unfortunately, some defects are not easy to observe or are not even detectable by human eyes. As a consequence, this study proposed a novel automatic defect detection system for aviator's night vision imaging systems AN/AVS-6(V)1 and AN/AVS-6(V)2. An auto-focusing process consisting of a sharpness calculation and a gradient-based variable step search method is applied to achieve an automatic detection system for honeycomb defects. This work also developed a test platform for sharpness measurement. It demonstrates that the honeycomb defects can be precisely recognized and the number of the defects can also be determined automatically during the inspection. Most importantly, the proposed approach significantly reduces the time consumption, as well as human assessment error during the night vision goggle inspection procedures.

  9. Developing a Methodology for Eliciting Subjective Probability Estimates During Expert Evaluations of Safety Interventions: Application for Bayesian Belief Networks

    NASA Technical Reports Server (NTRS)

    Wiegmann, Douglas A.a

    2005-01-01

    The NASA Aviation Safety Program (AvSP) has defined several products that will potentially modify airline and/or ATC operations, enhance aircraft systems, and improve the identification of potential hazardous situations within the National Airspace System (NAS). Consequently, there is a need to develop methods for evaluating the potential safety benefit of each of these intervention products so that resources can be effectively invested to produce the judgments to develop Bayesian Belief Networks (BBN's) that model the potential impact that specific interventions may have. Specifically, the present report summarizes methodologies for improving the elicitation of probability estimates during expert evaluations of AvSP products for use in BBN's. The work involved joint efforts between Professor James Luxhoj from Rutgers University and researchers at the University of Illinois. The Rutgers' project to develop BBN's received funding by NASA entitled "Probabilistic Decision Support for Evaluating Technology Insertion and Assessing Aviation Safety System Risk." The proposed project was funded separately but supported the existing Rutgers' program.

  10. Perinatal outcome in fetuses with heterotaxy syndrome and atrioventricular block or bradycardia.

    PubMed

    Escobar-Diaz, Maria C; Tworetzky, Wayne; Friedman, Kevin; Lafranchi, Terra; Fynn-Thompson, Francis; Alexander, Mark E; Mah, Douglas Y

    2014-08-01

    Congenital atrioventricular (AV) block is commonly associated with heterotaxy syndrome; together they have reportedly low survival rates (10-25%). However, information about perinatal outcome and predictors of non-survival after prenatal diagnosis of this association is scarce. Therefore, we studied fetuses with heterotaxy syndrome and bradycardia or AV-block diagnosed between 1995 and 2011, and analyzed pre and post-natal variables. The primary outcome was death and the secondary outcome was pacemaker placement. Of the 154 fetuses with heterotaxy syndrome, 91 had polysplenia syndrome, 22/91(24%) with bradycardia or AV-block. Thirteen (59%) patients had sinus bradycardia at diagnosis, 8 (36%) complete AV block, and 1 (5%) second-degree AV-block. Three patients elected for termination of pregnancy (3/22, 14%), 4 had spontaneous fetal demise (4/22, 18%), and 15 (15/22, 68%) were live-born. Of the fetuses with bradycardia/AV-block, 30% presented with hydrops, 20% had ventricular rates <55 beats/min, and 10% had cardiac dysfunction. Excluding termination of pregnancy, 15/19 fetuses (79%) survived to birth. Among the 15 live-born patients, 4 had bradycardia and 11 had AV-block. A further 3 patients died in infancy, all with AV-block who required pacemakers in the neonatal period. Thus, the 1-year survival rate, excluding termination of pregnancy, was 63% (12/19). Of the remaining 12 patients, 9 required pacemaker. Predictors of perinatal death included hydrops (p < 0.0001), ventricular dysfunction (p = 0.002), prematurity (p = 0.04), and low ventricular rates (p = 0.04). In conclusion, we found a higher survival rate (63%) than previously published in patients with heterotaxy syndrome and AV block or bradycardia diagnosed prenatally. Hydrops, cardiac dysfunction, prematurity and low ventricular rates were predictors of death.

  11. Perinatal Outcome in Fetuses with Heterotaxy Syndrome and Atrioventricular Block or Bradycardia

    PubMed Central

    Tworetzky, Wayne; Friedman, Kevin; Lafranchi, Terra; Fynn-Thompson, Francis; Alexander, Mark E.; Mah, Douglas Y.

    2015-01-01

    Congenital atrioventricular (AV) block is commonly associated with heterotaxy syndrome; together they have reportedly low survival rates (10–25 %). However, information about perinatal outcome and predictors of nonsurvival after prenatal diagnosis of this association is scarce. Therefore, we studied fetuses with heterotaxy syndrome and bradycardia or AV-block diagnosed between 1995 and 2011, and analyzed pre and post-natal variables. The primary outcome was death and the secondary outcome was pacemaker placement. Of the 154 fetuses with heterotaxy syndrome, 91 had polysplenia syndrome, 22/91(24 %) with bradycardia or AV-block. Thirteen (59 %) patients had sinus bradycardia at diagnosis, 8 (36 %) complete AV block, and 1 (5 %) second-degree AV-block. Three patients elected for termination of pregnancy (3/22, 14 %), 4 had spontaneous fetal demise (4/22, 18 %), and 15 (15/22, 68 %) were live-born. Of the fetuses with bradycardia/AV-block, 30 % presented with hydrops, 20 % had ventricular rates <55 beats/min, and 10 % had cardiac dysfunction. Excluding termination of pregnancy, 15/19 fetuses (79 %) survived to birth. Among the 15 live-born patients, 4 had bradycardia and 11 had AV-block. A further 3 patients died in infancy, all with AV-block who required pacemakers in the neonatal period. Thus, the 1-year survival rate, excluding termination of pregnancy, was 63 % (12/19). Of the remaining 12 patients, 9 required pacemaker. Predictors of perinatal death included hydrops (p < 0.0001), ventricular dysfunction (p = 0.002), prematurity (p = 0.04), and low ventricular rates (p = 0.04). In conclusion, we found a higher survival rate (63 %) than previously published in patients with heterotaxy syndrome and AV block or bradycardia diagnosed prenatally. Hydrops, cardiac dysfunction, prematurity and low ventricular rates were predictors of death. PMID:24509635

  12. AV-95 Sun Devil: High-Speed Military Rotorcraft

    NASA Technical Reports Server (NTRS)

    1996-01-01

    The AV-95 Sun Devil must combine helicopter capabilities, such as vertical takeoff and landings (VTOL) and rotor-powered flight, along with long-duration cruise and high-speed dash capabilities unobtainable by conventional helicopters. To be able to perform both tasks, and perform them well, the AV-95 Sun Devil design incorporates several unconventional devices; the AV-95 uses two convertible turbofan engines, able to provide both shaft power for the main rotor and tall fan as well as jet thrust either separately or simultaneously. Other devices used for the AV-95 include a variable diameter main rotor and a blown flap. In helicopter mode, the AV-95 Sun Devil performs like a winged helicopter. The addition of wings to an attack helicopter results in two significant advantages. First, the addition of wings makes a helicopter more maneuverable than a wingless, but otherwise similar helicopter. Second, since the wings produce lift, rotor stall and compressibility effects can be significantly delayed at high tip velocities. In fixed-wing mode, the main rotor is completely off-loaded but slightly powered, and the rotor diameter has been minimized. The AV-95 Sun Devil has many advantages over other VTOL aircraft. The conversion process is simple and fast; conversion does not make the AV-95 vulnerable to enemy attack during conversion such as a tilt-wing or a tilt-rotor. Stop-rotor aircraft and a stowed rotor aircraft require heavy breaking of the rotor for conversion; this adds time for conversion and weight to the aircraft. Because the AV-95 never stops the rotor in flight, much weight is spared, and conversion is much simpler and faster.

  13. A Helminth Protease Inhibitor Modulates the Lipopolysaccharide-Induced Proinflammatory Phenotype of Microglia in vitro.

    PubMed

    Behrendt, Peter; Arnold, Philipp; Brueck, Max; Rickert, Uta; Lucius, Richard; Hartmann, Susanne; Klotz, Christian; Lucius, Ralph

    2016-01-01

    The aim of this study was to examine whether the natural protease inhibitor Av-cystatin (rAv17) of the parasitic nematode Acanthocheilonema viteae exerts anti-inflammatory effects in an in vitro model of lipopolysaccharide (LPS)-activated microglia. Primary microglia were harvested from the brains of 2-day-old Wistar rats and cultured with or without rAv17 (250 nM). After 6 and 24 h the release of nitric oxide (Griess reagent) and TNF-α (ELISA) was measured in the supernatant. Real-time PCR was performed after 2, 6 and 24 h of culture to measure the mRNA expression of IL-1β, IL-6, TNF-α, COX-2, iNOS and IL-10. To address the involved signaling pathways, nuclear NF-x0138;B translocation was visualized by immunocytochemistry. Morphological changes of microglia were analyzed by Coomassie blue staining. Differences between groups were calculated using one-way ANOVA with Bonferroni's post hoc test. Morphological analysis indicated that LPS-induced microglial transformation towards an amoeboid morphology is inhibited by rAv17. Av-cystatin caused a time-dependent downregulation of proinflammatory cytokines, iNOS and COX-2 mRNA expression, respectively. This was paralleled by an upregulated expression of IL-10 in resting as well as in LPS-stimulated microglia. Av-cystatin reduced the release of NO and TNF-α in the culture supernatant. Immunocytochemical staining demonstrated an attenuated translocation of NF-x0138;B by Av-cystatin in response to LPS. In addition, Western blot analysis revealed a rAv17-dependent reduction of the LPS-induced ERK1/2-pathway activation. The parasite-derived secretion product Av-cystatin inhibits proinflammatory mechanisms of LPS-induced microglia with IL-10, a potential key mediator. © 2016 S. Karger AG, Basel.

  14. Auditory Perceptual Learning for Speech Perception Can be Enhanced by Audiovisual Training.

    PubMed

    Bernstein, Lynne E; Auer, Edward T; Eberhardt, Silvio P; Jiang, Jintao

    2013-01-01

    Speech perception under audiovisual (AV) conditions is well known to confer benefits to perception such as increased speed and accuracy. Here, we investigated how AV training might benefit or impede auditory perceptual learning of speech degraded by vocoding. In Experiments 1 and 3, participants learned paired associations between vocoded spoken nonsense words and nonsense pictures. In Experiment 1, paired-associates (PA) AV training of one group of participants was compared with audio-only (AO) training of another group. When tested under AO conditions, the AV-trained group was significantly more accurate than the AO-trained group. In addition, pre- and post-training AO forced-choice consonant identification with untrained nonsense words showed that AV-trained participants had learned significantly more than AO participants. The pattern of results pointed to their having learned at the level of the auditory phonetic features of the vocoded stimuli. Experiment 2, a no-training control with testing and re-testing on the AO consonant identification, showed that the controls were as accurate as the AO-trained participants in Experiment 1 but less accurate than the AV-trained participants. In Experiment 3, PA training alternated AV and AO conditions on a list-by-list basis within participants, and training was to criterion (92% correct). PA training with AO stimuli was reliably more effective than training with AV stimuli. We explain these discrepant results in terms of the so-called "reverse hierarchy theory" of perceptual learning and in terms of the diverse multisensory and unisensory processing resources available to speech perception. We propose that early AV speech integration can potentially impede auditory perceptual learning; but visual top-down access to relevant auditory features can promote auditory perceptual learning.

  15. Auditory Perceptual Learning for Speech Perception Can be Enhanced by Audiovisual Training

    PubMed Central

    Bernstein, Lynne E.; Auer, Edward T.; Eberhardt, Silvio P.; Jiang, Jintao

    2013-01-01

    Speech perception under audiovisual (AV) conditions is well known to confer benefits to perception such as increased speed and accuracy. Here, we investigated how AV training might benefit or impede auditory perceptual learning of speech degraded by vocoding. In Experiments 1 and 3, participants learned paired associations between vocoded spoken nonsense words and nonsense pictures. In Experiment 1, paired-associates (PA) AV training of one group of participants was compared with audio-only (AO) training of another group. When tested under AO conditions, the AV-trained group was significantly more accurate than the AO-trained group. In addition, pre- and post-training AO forced-choice consonant identification with untrained nonsense words showed that AV-trained participants had learned significantly more than AO participants. The pattern of results pointed to their having learned at the level of the auditory phonetic features of the vocoded stimuli. Experiment 2, a no-training control with testing and re-testing on the AO consonant identification, showed that the controls were as accurate as the AO-trained participants in Experiment 1 but less accurate than the AV-trained participants. In Experiment 3, PA training alternated AV and AO conditions on a list-by-list basis within participants, and training was to criterion (92% correct). PA training with AO stimuli was reliably more effective than training with AV stimuli. We explain these discrepant results in terms of the so-called “reverse hierarchy theory” of perceptual learning and in terms of the diverse multisensory and unisensory processing resources available to speech perception. We propose that early AV speech integration can potentially impede auditory perceptual learning; but visual top-down access to relevant auditory features can promote auditory perceptual learning. PMID:23515520

  16. Audio-visual onset differences are used to determine syllable identity for ambiguous audio-visual stimulus pairs

    PubMed Central

    ten Oever, Sanne; Sack, Alexander T.; Wheat, Katherine L.; Bien, Nina; van Atteveldt, Nienke

    2013-01-01

    Content and temporal cues have been shown to interact during audio-visual (AV) speech identification. Typically, the most reliable unimodal cue is used more strongly to identify specific speech features; however, visual cues are only used if the AV stimuli are presented within a certain temporal window of integration (TWI). This suggests that temporal cues denote whether unimodal stimuli belong together, that is, whether they should be integrated. It is not known whether temporal cues also provide information about the identity of a syllable. Since spoken syllables have naturally varying AV onset asynchronies, we hypothesize that for suboptimal AV cues presented within the TWI, information about the natural AV onset differences can aid in speech identification. To test this, we presented low-intensity auditory syllables concurrently with visual speech signals, and varied the stimulus onset asynchronies (SOA) of the AV pair, while participants were instructed to identify the auditory syllables. We revealed that specific speech features (e.g., voicing) were identified by relying primarily on one modality (e.g., auditory). Additionally, we showed a wide window in which visual information influenced auditory perception, that seemed even wider for congruent stimulus pairs. Finally, we found a specific response pattern across the SOA range for syllables that were not reliably identified by the unimodal cues, which we explained as the result of the use of natural onset differences between AV speech signals. This indicates that temporal cues not only provide information about the temporal integration of AV stimuli, but additionally convey information about the identity of AV pairs. These results provide a detailed behavioral basis for further neuro-imaging and stimulation studies to unravel the neurofunctional mechanisms of the audio-visual-temporal interplay within speech perception. PMID:23805110

  17. Low molecular-weight gel fraction of Aloe vera exhibits gastroprotection by inducing matrix metalloproteinase-9 inhibitory activity in alcohol-induced acute gastric lesion tissues.

    PubMed

    Park, Chul-Hong; Son, Hyeong-U; Yoo, Chi-Yeol; Lee, Sang-Han

    2017-12-01

    Aloe has been used for the prevention and cure of various diseases and symptoms including burns, injuries, oedema and pain. This study determines the specific inhibitory activity of matrix metalloproteinase (MMP)-9 induced by the low molecular-weight gel fraction of Aloe vera (L.) Burm.f. (lgfAv) on alcohol-induced acute gastric lesions. We examined the protective effects of oral (p.o.) administration of lgfAv (molecular weight cutoff <50.0 kDa, 150.0 mg/kg body weight) in a Balb/c mouse model of alcohol-induced acute gastritis for 1 h exposure. By measuring ulcer index, we compared the antiulcerative activity of the fraction. mRNA expression and immunohistochemical analysis of various biomarkers were performed. The lgfAv-treated mice exhibited drastically fewer ulcer lesions than the untreated control mice did. It featured that lgfAv lessened the ulcer lesions than their relevant controls. Moreover, the transcriptional level of MMP-9 was completely alleviated by lgfAv treatment in alcohol-treated gastritis-induced mice. The transcriptional level of MMP-9 was significantly alleviated by lgfAv treatment of the model. However, reverse transcription-polymerase chain reaction (RT-PCR) and immunohistochemistry experiments revealed that lgfAv treatment in mucosal tissues had the potential to inhibit the mRNA and protein expression levels of MMP-9, respectively. The protein expression of MMP-9 was closely associated with lgfAv-induced gastroprotection against alcohol-induced gastric lesions. The present findings suggest that lgfAv has the potential to alleviate alcohol-induced acute gastric lesions, which is mediated in part, mainly by the suppression of the mRNA expression of MMP-9.

  18. Alcohol consumption, cigarette smoking and incidence of aortic valve stenosis.

    PubMed

    Larsson, S C; Wolk, A; Bäck, M

    2017-10-01

    Alcohol consumption and cigarette smoking are modifiable lifestyle factors with important impact on public health. It is unclear whether these factors influence the risk of aortic valve stenosis (AVS). To investigate the associations of alcohol consumption and smoking, including smoking intensity and time since cessation, with AVS incidence in two prospective cohorts. This analysis was based on data from the Swedish Mammography Cohort and the Cohort of Swedish Men, comprising 69 365 adults without cardiovascular disease at baseline. Participants were followed for AVS incidence and death by linkage to the Swedish National Patient and Causes of Death Registers. Hazard ratios (HR) with 95% confidence intervals (CI) were estimated by Cox proportional hazards regression. Over a mean follow-up of 15.3 years, 1249 cases of AVS (494 in women and 755 in men) were recorded. Compared with never drinkers of alcohol (lifelong abstainers), the risk of AVS was significantly lower in current light drinkers (1-6 drinks per week [1 drink = 12 g alcohol]; multivariable HR 0.82; 95% CI: 0.68-0.99). The risk of AVS increased with increasing smoking intensity. Compared with never smokers, the HR was 1.46 (95% CI: 1.16-1.85) in current smokers of ≥30 pack-years. Former smokers who had quit smoking 10 or more years previously had similar risk for AVS as never smokers. This study suggests that current light alcohol consumption is associated with a lower risk of AVS, and indicates that the association between smoking and AVS risk is reversible. © 2017 The Authors. Journal of Internal Medicine published by John Wiley & Sons Ltd on behalf of Association for Publication of The Journal of Internal Medicine.

  19. Could circulating fetuin A be a biomarker of aortic valve stenosis?

    PubMed

    Di Minno, Alessandro; Zanobini, Marco; Myasoedova, Veronika A; Valerio, Vincenza; Songia, Paola; Saccocci, Matteo; Di Minno, Matteo Nicola Dario; Tremoli, Elena; Poggio, Paolo

    2017-12-15

    Aortic valve stenosis (AVS) is a multifactorial-progressive pathological process. In the past decades, many studies have focus their attention on circulating biomarkers able to identify AVS and/or to predict its progression. One of the many biomarkers studied is the fetuin A. The aim of the present meta-analysis was to evaluate the correlation between fetuin A levels and end-stage AVS. A systematic search was performed in three electronic databases (PubMed, Web of Science and Scopus), looking for studies that compared control subjects with AVS patients and that have measured fetuin A circulating levels in both groups. The main outcome was to evaluate the difference in circulating fetuin A concentration in the two groups. Seven studies, enrolling 2283 AVS patients and 1549 controls, were included. Differences between control subjects and AVS patients were expressed as standardized mean difference (SMD) with pertinent 95% confidence intervals (95%CI) and standard deviation (SD), analysing the data using a random effect model. We found significantly lower circulating levels of fetuin A in AVS patients compared to healthy subjects (SMD: -0.96μg/mL, 95% CI: -1.62, -0.30; p=0.004). In addition, meta-regression analyses showed that several cardiovascular risk factors were significantly associated with circulating levels of fetuin A between patients affected by AVS and healthy controls. In conclusion, our meta-analysis shows that AVS patients have significant lower circulating levels of fetuin A compared to control subjects. However, dedicated studies with large and matched cohorts are needed to validate these findings, evaluating if there is a real link or just a mere association. Copyright © 2017 Elsevier B.V. All rights reserved.

  20. Audio-visual onset differences are used to determine syllable identity for ambiguous audio-visual stimulus pairs.

    PubMed

    Ten Oever, Sanne; Sack, Alexander T; Wheat, Katherine L; Bien, Nina; van Atteveldt, Nienke

    2013-01-01

    Content and temporal cues have been shown to interact during audio-visual (AV) speech identification. Typically, the most reliable unimodal cue is used more strongly to identify specific speech features; however, visual cues are only used if the AV stimuli are presented within a certain temporal window of integration (TWI). This suggests that temporal cues denote whether unimodal stimuli belong together, that is, whether they should be integrated. It is not known whether temporal cues also provide information about the identity of a syllable. Since spoken syllables have naturally varying AV onset asynchronies, we hypothesize that for suboptimal AV cues presented within the TWI, information about the natural AV onset differences can aid in speech identification. To test this, we presented low-intensity auditory syllables concurrently with visual speech signals, and varied the stimulus onset asynchronies (SOA) of the AV pair, while participants were instructed to identify the auditory syllables. We revealed that specific speech features (e.g., voicing) were identified by relying primarily on one modality (e.g., auditory). Additionally, we showed a wide window in which visual information influenced auditory perception, that seemed even wider for congruent stimulus pairs. Finally, we found a specific response pattern across the SOA range for syllables that were not reliably identified by the unimodal cues, which we explained as the result of the use of natural onset differences between AV speech signals. This indicates that temporal cues not only provide information about the temporal integration of AV stimuli, but additionally convey information about the identity of AV pairs. These results provide a detailed behavioral basis for further neuro-imaging and stimulation studies to unravel the neurofunctional mechanisms of the audio-visual-temporal interplay within speech perception.

  1. AGATE: Adversarial Game Analysis for Tactical Evaluation

    NASA Technical Reports Server (NTRS)

    Huntsberger, Terrance L.

    2013-01-01

    AGATE generates a set of ranked strategies that enables an autonomous vehicle to track/trail another vehicle that is trying to break the contact using evasive tactics. The software is efficient (can be run on a laptop), scales well with environmental complexity, and is suitable for use onboard an autonomous vehicle. The software will run in near-real-time (2 Hz) on most commercial laptops. Existing software is usually run offline in a planning mode, and is not used to control an unmanned vehicle actively. JPL has developed a system for AGATE that uses adversarial game theory (AGT) methods (in particular, leader-follower and pursuit-evasion) to enable an autonomous vehicle (AV) to maintain tracking/ trailing operations on a target that is employing evasive tactics. The AV trailing, tracking, and reacquisition operations are characterized by imperfect information, and are an example of a non-zero sum game (a positive payoff for the AV is not necessarily an equal loss for the target being tracked and, potentially, additional adversarial boats). Previously, JPL successfully applied the Nash equilibrium method for onboard control of an autonomous ground vehicle (AGV) travelling over hazardous terrain.

  2. Effects of isradipine and other calcium antagonists on arteriovenous-shunt flow in anesthetized rabbits and cats

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

    Hof, R.P.

    The effects of vasodilators on arteriovenous (AV)-shunt flow was investigated in anesthetized cats and rabbits, using the tracer microsphere method. In cats, the calcium antagonist isradipine reduced AV-shunt flow; verapamil showed a similar tendency and nicardipine was without effect. Dihydralazine strongly increased, but nitroglycerin and dipyridamole decreased AV-shunt flow. In rabbits, the effects of isradipine and verapamil were similar to those seen in cats. Sodium nitroprusside had no effect, whereas prazosin, minoxidil, and the potassium-channel activator cromakalim increased AV-shunt flow. The contrasting effects of drugs sharing the same mechanism of action suggest that target-tissue selectivity is more important than themore » mechanism of action. An increase of AV-shunt flow is unlikely to be beneficial but could be associated with a number of undesirable side effects. It might negatively affect migraine sufferers and, if AV-shunt dilatation shows no tolerance development, it represents an unnecessary hemodynamic burden for the heart.« less

  3. Airborne hygrometer calibration inter-comparison against a metrological water vapour standard

    NASA Astrophysics Data System (ADS)

    Smorgon, Denis; Boese, Norbert; Ebert, Volker

    2014-05-01

    Water vapour is the most important atmospheric greenhouse gas, which causes a major feedback to warming and other changes in the climate system. Knowledge of the distribution of water vapour and its climate induced changes is especially important in the upper troposphere and lower stratosphere (UT/LS) where vapour plays a critical role in atmospheric radiative balance, cirrus cloud formation, and photochemistry. But, our understanding of water in the UT/LS is limited by significant uncertainties in current UT/LS water measurements. One of the most comprehensive inter-comparison campaigns for airborne hygrometers, termed AQUAVIT (AV1) [1], took place in 2007 at the AIDA chamber at the Karlsruhe Institute of Technology (KIT) in Germany. AV1 was a well-defined, referred, blind inter-comparison of 22 airborne field instruments from 17 international research groups. One major metrological deficit of AV1, however, was, that no traceable reference instrument participated in the inter-comparison experiments and that the calibration procedures of the participating instruments were not monitored or interrogated. Consequently a follow-up inter-comparison was organized in April 2013, which for the first time also provides a traceable link to the international humidity scale. This AQUAVIT2 (AV2) campaign (details see: http://www.imk-aaf.kit.edu/aquavit/index.php/Main_Page) was again located at KIT/AIDA and organised by an international organizing committee including KIT, PTB, FZJ and others. Generally AV2 is divided in two parallel comparisons: 1) AV2-A uses the AIDA chamber for a simultaneous comparison of all instruments (incl. sampling and in-situ instruments) over a broad range of conditions characteristic for the UT/LS; 2) AV2-B, about which this paper is reporting, is a sequential comparison of selected hygrometers and (when possible) their reference calibration infrastructures by means of a chilled mirror hygrometer traced back to the primary National humidity standard of PTB and a validated, two-pressure generator acting as a highly stable and reproducible source of water vapour. The aim of AV2-B was to perform an absolute, metrological comparison of the field instruments/calibration infrastructures to the metrological humidity scale, and to collect essential information about methods and procedures used by the atmospheric community for instrument calibration and validation, in order to investigate e.g. the necessity and possible comparability advantage by a standardized calibration procedure. The work will give an overview over the concept of the AV2-B inter-comparison, the various general measurement and calibration principles, and discuss the outcome and consequences of the comparison effort. The AQUAVIT effort is linked to the EMRP project METEOMET (ENV07) and partially supported by the EMRP and ENV07. The EMRP is jointly funded by the EMRP participating countries within EURAMET and the European Union. [1] H. Saathoff, C. Schiller, V. Ebert, D. W. Fahey, R.-S. Gao, O. Möhler, and the aquavit team, The AQUAVIT formal intercomparison of atmospheric water measurement methods, 5th General Assembly of the European Geosciences Union, 13-18 April 2008, Vienna, Austria Keywords: humidity, water vapour, inter-comparison, airborne instruments.

  4. Aerobic vaginitis: no longer a stranger.

    PubMed

    Donders, Gilbert G G; Bellen, Gert; Grinceviciene, Svitrigaile; Ruban, Kateryna; Vieira-Baptista, Pedro

    Aerobic vaginitis (AV) is the name given in 2002 to a vaginal infectious entity which was not recognized as such before. It is characterized by abnormal (dysbiotic) vaginal microflora containing aerobic, enteric bacteria, variable levels of vaginal inflammation and deficient epithelial maturation. Although AV and bacterial vaginosis (BV) share some characteristics, such as a diminished number or absence of lactobacilli, increased discharge (fishy smelling in BV, while in severe forms of AV, a foul, rather rotten smell may be present) and increased pH (often more pronounced in AV), there are also striking differences between the two. There is no inflammation in women with BV, whereas the vagina of women with AV often appears red and edematous, and may even display small erosions or ulcerations. The color of the discharge in BV is usually whitish or gray and of a watery consistency, whereas in AV it is yellow to green and rather thick and mucoid. Women with BV do not have dyspareunia, while some women with severe AV do. Finally, the microscopic appearance differs in various aspects, such as the presence of leucocytes and parabasal or immature epithelial cells in AV and the absence of the granular aspect of the microflora, typical of BV. Despite all these differences, the distinction between AV and BV was not recognized in many former studies, leading to incomplete and imprecise diagnostic workouts and erroneous management of patients in both clinical and research settings. The prevalence of AV ranges between 7 and 12%, and is therefore less prevalent than BV. Although still largely undiagnosed, many researchers and clinicians increasingly take it into account as a cause of symptomatic vaginitis. AV can co-occur with other entities, such as BV and candidiasis. It can be associated with dyspareunia, sexually transmitted infections (such as human papilloma virus, human immunodeficiency virus, Trichomonas vaginalis and Chlamydia trachomatis), chorioamnionitis, fetal infection, preterm birth and cervical dysplasia. Many other possible pathological associations are currently under investigation. The diagnosis of AV is made using wet mount microscopy, ideally using phase contrast. An AV score is calculated, according to: lactobacillary grade, presence of inflammation, proportion of toxic leucocytes, characteristics of the microflora and presence of immature epithelial cells. To circumvent the hurdle of microscopic investigation, some groups have begun to develop nucleic-acid-based and enzymatic diagnostic tests, but the detailed information obtained with phase contrast microscopy is irreplaceable. The best treatment is not yet fully determined, but it must be tailored according to the microscopic findings and the patient's needs. There is a role for local estrogen therapy, corticosteroids, antimicrobials and probiotics. Further research will reveal more precise data on diagnosis, pathogenesis, management and prevention. Copyright © 2017 Institut Pasteur. Published by Elsevier Masson SAS. All rights reserved.

  5. Analysis to feature-based video stabilization/registration techniques within application of traffic data collection

    NASA Astrophysics Data System (ADS)

    Sadat, Mojtaba T.; Viti, Francesco

    2015-02-01

    Machine vision is rapidly gaining popularity in the field of Intelligent Transportation Systems. In particular, advantages are foreseen by the exploitation of Aerial Vehicles (AV) in delivering a superior view on traffic phenomena. However, vibration on AVs makes it difficult to extract moving objects on the ground. To partly overcome this issue, image stabilization/registration procedures are adopted to correct and stitch multiple frames taken of the same scene but from different positions, angles, or sensors. In this study, we examine the impact of multiple feature-based techniques for stabilization, and we show that SURF detector outperforms the others in terms of time efficiency and output similarity.

  6. Sialidase activity in aerobic vaginitis is equal to levels during bacterial vaginosis.

    PubMed

    Marconi, C; Donders, G G G; Bellen, G; Brown, D R; Parada, C M G L; Silva, M G

    2013-04-01

    To evaluate levels of proinflammatory cytokines and sialidase activity in aerobic vaginitis (AV) in relation to normal vaginal flora and bacterial vaginosis (BV). In this cross-sectional study, a total of 682 consecutive non-pregnant women attending the gynecology service were assessed and 408 women were included. Vaginal rinsing samples were collected from 223 women with microscopic finding of BV (n=98), aerobic vaginitis (n=25) and normal flora (n=100). Samples were tested for interleukin (IL)-1β, IL-6, IL-8, tumor necrosis factor (TNF)-α, and sialidase activity. Compared to women with normal flora, vaginal levels of IL-1β were highly increased in both BV and AV (p<0.0001). Significantly higher vaginal IL-6 was detected in AV (p<0.0001) but not in BV, in relation to normal flora. Women with AV also presented increased IL-8 levels (p<0.001), while those with BV presented levels similar to normal flora. Sialidase was increased in BV and AV compared with the normal group (p<0.0001) but no difference in sialidase activity was observed between BV and AV. A more intense inflammatory host response occurs for AV than for BV when compared with normal flora. Furthermore, the increased sialidase activity in AV and BV indicates that both abnormal vaginal flora types can be harmful to the maintenance of a healthy vaginal environment. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  7. Recurrent coagulopathy and thrombocytopenia in children treated with crotalidae polyvalent immune fab: a case series.

    PubMed

    Miller, Alexander D; Young, Michael C; DeMott, Megan C; Ly, Binh T; Clark, Richard F

    2010-08-01

    Recurrent signs and symptoms after initial treatment and control of coagulopathy and thrombocytopenia after American pit viper (crotaline) envenomations have been previously described in patients treated with Crotalidae polyvalent immune Fab antivenom (FabAV). The significance and necessity of treatment of these recurrent abnormalities are uncertain. Our goal was to further characterize recurrent coagulopathy or thrombocytopenia in pediatric patients. All cases presenting to our Toxicology Consult Service, which covers 6 hospitals in a metropolitan area, from May 2007 to April 2008 with recurrent coagulopathy after initial control with FabAV were included and retrospectively reviewed. Four cases of pediatric patients are presented who presented with recurrent coagulopathy and/or thrombocytopenia after initial control with FabAV. The patients were all treated with delayed administration of FabAV with variable results. Blood products administered without concurrent FabAV were of limited use. The laboratory abnormalities took up to 18 days to resolve in one case. One patient developed hemodynamically significant spontaneous bleeding. The cases presented here suggest administration of FabAV may correct delayed coagulopathy associated with crotaline envenomations. The first 3 cases illustrate that in the face of severe derangements in laboratory values, most envenomated patients treated with FabAV do not develop significant bleeding. These cases may respond to additional antivenom alone. However, case 4 illustrates that hemodynamically significant spontaneous bleeding can occur. Until more data are available, readministration of FabAV is a reasonable first-line therapy for delayed coagulopathy associated with crotaline envenomations.

  8. The role of attainment value, academic self-efficacy, and message frame in the appraisal of value-promoting messages.

    PubMed

    Symes, Wendy; Putwain, David W

    2016-09-01

    Prior to high-stakes examinations, teachers may use value-promoting messages (VPMs) to communicate to students the value and importance of their forthcoming examinations in the hope that they will adopt adaptive learning and study behaviours. These messages can focus on achieving success (gain-framed) or avoiding failure (loss-framed). This study examined how secondary school students appraised hypothetical gain- and loss-framed VPMs, and how these appraisals differed according to self-reported levels of attainment value (AV) and academic self-efficacy (ASE). In total, 539 secondary school students (284 male, 255 female, mean age 14.8 years) were participated in this study. Participants completed self-report measures of AV and ASE and appraised hypothetical VPMs as challenging, threatening, or irrelevant (disregard). Participants were randomly assigned to a gain- or loss-framed condition. A challenge appraisal was greater in students with higher AV and ASE. A threat appraisal was greater in students with higher AV and lower ASE. A disregard appraisal was higher in students with lower AV. Message frame did not interact with AV or ASE in the appraisal of VPMs as challenging, threatening, or irrelevant. Educational practitioners should consider the characteristics of their students before using VPMs. In particular, they may not be effective for students high in AV and low in ASE. They are likely to be ineffective for students low in AV. © 2016 The British Psychological Society.

  9. Identification of Two Novel Amalgaviruses in the Common Eelgrass (Zostera marina) and in Silico Analysis of the Amalgavirus +1 Programmed Ribosomal Frameshifting Sites.

    PubMed

    Park, Dongbin; Goh, Chul Jun; Kim, Hyein; Hahn, Yoonsoo

    2018-04-01

    The genome sequences of two novel monopartite RNA viruses were identified in a common eelgrass ( Zostera marina ) transcriptome dataset. Sequence comparison and phylogenetic analyses revealed that these two novel viruses belong to the genus Amalgavirus in the family Amalgaviridae . They were named Zostera marina amalgavirus 1 (ZmAV1) and Zostera marina amalgavirus 2 (ZmAV2). Genomes of both ZmAV1 and ZmAV2 contain two overlapping open reading frames (ORFs). ORF1 encodes a putative replication factory matrix-like protein, while ORF2 encodes a RNA-dependent RNA polymerase (RdRp) domain. The fusion protein (ORF1+2) of ORF1 and ORF2, which mediates RNA replication, was produced using the +1 programmed ribosomal frameshifting (PRF) mechanism. The +1 PRF motif sequence, UUU_CGN, which is highly conserved among known amalgaviruses, was also found in ZmAV1 and ZmAV2. Multiple sequence alignment of the ORF1+2 fusion proteins from 24 amalgaviruses revealed that +1 PRF occurred only at three different positions within the 13-amino acid-long segment, which was surrounded by highly conserved regions on both sides. This suggested that the +1 PRF may be constrained by the structure of fusion proteins. Genome sequences of ZmAV1 and ZmAV2, which are the first viruses to be identified in common eelgrass, will serve as useful resources for studying evolution and diversity of amalgaviruses.

  10. Identification of Two Novel Amalgaviruses in the Common Eelgrass (Zostera marina) and in Silico Analysis of the Amalgavirus +1 Programmed Ribosomal Frameshifting Sites

    PubMed Central

    Park, Dongbin; Goh, Chul Jun; Kim, Hyein; Hahn, Yoonsoo

    2018-01-01

    The genome sequences of two novel monopartite RNA viruses were identified in a common eelgrass (Zostera marina) transcriptome dataset. Sequence comparison and phylogenetic analyses revealed that these two novel viruses belong to the genus Amalgavirus in the family Amalgaviridae. They were named Zostera marina amalgavirus 1 (ZmAV1) and Zostera marina amalgavirus 2 (ZmAV2). Genomes of both ZmAV1 and ZmAV2 contain two overlapping open reading frames (ORFs). ORF1 encodes a putative replication factory matrix-like protein, while ORF2 encodes a RNA-dependent RNA polymerase (RdRp) domain. The fusion protein (ORF1+2) of ORF1 and ORF2, which mediates RNA replication, was produced using the +1 programmed ribosomal frameshifting (PRF) mechanism. The +1 PRF motif sequence, UUU_CGN, which is highly conserved among known amalgaviruses, was also found in ZmAV1 and ZmAV2. Multiple sequence alignment of the ORF1+2 fusion proteins from 24 amalgaviruses revealed that +1 PRF occurred only at three different positions within the 13-amino acid-long segment, which was surrounded by highly conserved regions on both sides. This suggested that the +1 PRF may be constrained by the structure of fusion proteins. Genome sequences of ZmAV1 and ZmAV2, which are the first viruses to be identified in common eelgrass, will serve as useful resources for studying evolution and diversity of amalgaviruses. PMID:29628822

  11. Neural correlates of admiration and compassion

    PubMed Central

    Immordino-Yang, Mary Helen; McColl, Andrea; Damasio, Hanna; Damasio, Antonio

    2009-01-01

    In an fMRI experiment, participants were exposed to narratives based on true stories designed to evoke admiration and compassion in 4 distinct categories: admiration for virtue (AV), admiration for skill (AS), compassion for social/psychological pain (CSP), and compassion for physical pain (CPP). The goal was to test hypotheses about recruitment of homeostatic, somatosensory, and consciousness-related neural systems during the processing of pain-related (compassion) and non-pain-related (admiration) social emotions along 2 dimensions: emotions about other peoples' social/psychological conditions (AV, CSP) and emotions about others' physical conditions (AS, CPP). Consistent with theoretical accounts, the experience of all 4 emotions engaged brain regions involved in interoceptive representation and homeostatic regulation, including anterior insula, anterior cingulate, hypothalamus, and mesencephalon. However, the study also revealed a previously undescribed pattern within the posteromedial cortices (the ensemble of precuneus, posterior cingulate cortex, and retrosplenial region), an intriguing territory currently known for its involvement in the default mode of brain operation and in self-related/consciousness processes: emotions pertaining to social/psychological and physical situations engaged different networks aligned, respectively, with interoceptive and exteroceptive neural systems. Finally, within the anterior insula, activity correlated with AV and CSP peaked later and was more sustained than that associated with CPP. Our findings contribute insights on the functions of the posteromedial cortices and on the recruitment of the anterior insula in social emotions concerned with physical versus psychological pain. PMID:19414310

  12. Neural correlates of admiration and compassion.

    PubMed

    Immordino-Yang, Mary Helen; McColl, Andrea; Damasio, Hanna; Damasio, Antonio

    2009-05-12

    In an fMRI experiment, participants were exposed to narratives based on true stories designed to evoke admiration and compassion in 4 distinct categories: admiration for virtue (AV), admiration for skill (AS), compassion for social/psychological pain (CSP), and compassion for physical pain (CPP). The goal was to test hypotheses about recruitment of homeostatic, somatosensory, and consciousness-related neural systems during the processing of pain-related (compassion) and non-pain-related (admiration) social emotions along 2 dimensions: emotions about other peoples' social/psychological conditions (AV, CSP) and emotions about others' physical conditions (AS, CPP). Consistent with theoretical accounts, the experience of all 4 emotions engaged brain regions involved in interoceptive representation and homeostatic regulation, including anterior insula, anterior cingulate, hypothalamus, and mesencephalon. However, the study also revealed a previously undescribed pattern within the posteromedial cortices (the ensemble of precuneus, posterior cingulate cortex, and retrosplenial region), an intriguing territory currently known for its involvement in the default mode of brain operation and in self-related/consciousness processes: emotions pertaining to social/psychological and physical situations engaged different networks aligned, respectively, with interoceptive and exteroceptive neural systems. Finally, within the anterior insula, activity correlated with AV and CSP peaked later and was more sustained than that associated with CPP. Our findings contribute insights on the functions of the posteromedial cortices and on the recruitment of the anterior insula in social emotions concerned with physical versus psychological pain.

  13. Environmental assessment of three egg production systems - Part III: Airborne bacteria concentrations and emissions.

    PubMed

    Zhao, Y; Zhao, D; Ma, H; Liu, K; Atilgan, A; Xin, H

    2016-07-01

    Airborne microorganism level is an important indoor air quality indicator, yet it has not been well documented for laying-hen houses in the United States. As a part of the Coalition for Sustainable Egg Supply (CSES) environmental monitoring project, this study comparatively monitored the concentrations and emissions of airborne total and Gram-negative (Gram(-)) bacteria in three types of commercial laying-hen houses, i.e., conventional cage (CC), aviary (AV), and enriched colony (EC) houses, over a period of eight months covering the mid and late stages of the flock cycle. It also delineated the relationship between airborne total bacteria and particulate matter smaller than 10 μm in aerodynamic diameter (PM10). The results showed airborne total bacteria concentrations (log CFU/m(3)) of 4.7 ± 0.3 in CC, 6.0 ± 0.8 in AV, and 4.8 ± 0.3 in EC, all being higher than the level recommended for human environment (3.0 log CFU/m(3)). The much higher concentrations in AV arose from the presence of floor litter and hen activities on it, as evidenced by the higher concentrations in the afternoon (with litter access) than in the morning (without litter access). The overall means and standard deviation of airborne total bacteria emission rates, in log CFU/[h-hen] (or log CFU/[h-AU], AU = animal unit or 500 kg live weight) were 4.8 ± 0.4 (or 7.3 ± 0.4) for CC, 6.1 ± 0.7 (or 8.6 ± 0.7) for AV, and 4.8 ± 0.5 (or 7.3 ± 0.5) for EC. Both concentration and emission rate of airborne total bacteria were positively related to PM10 Gram(-) bacteria were present at low concentrations in all houses; and only 2 samples (6%) in CC, 7 (22%) samples in AV, and 2 (6%) samples in EC out of 32 air samples collected in each house were found positive with Gram(-) bacteria. The concentration of airborne Gram(-) bacteria was estimated to be <2% of the total bacteria. Total bacteria counts in manure on belt (in all houses) and floor litter (only in AV) were similar; however, the manure had much more Gram(-) bacteria than the litter. The results point out the need to mitigate airborne total bacteria in laying-hen houses, especially in AV houses. © 2016 Poultry Science Association Inc.

  14. Organizational Effectiveness Information System (OEIS) User’s Manual

    DTIC Science & Technology

    1986-09-01

    SUBJECT CODES B-l C. LISTING OF VALID RESOURCE SYSTEM CODES C-l »TflerÄ*w»fi*%f*fc**v.nft; ^’.A/.V. A y.A/.AAA«•.*-A/. AAV ...the valid codes used la the Implementation and Design System. MACOM 01 COE 02 DARCOM 03 EUSA 04 FORSCOM 05 HSC 06 HQDA 07 INSCOM 08 MDW 09

  15. Aviation System Technology Advanced Research Program - AvSTAR

    NASA Technical Reports Server (NTRS)

    Denery, Dallas G.

    2001-01-01

    The objectives of this presentation is to provide the research and development by 2007 necessary to: complete the development of technology for tomorrow (Free-Flight); provide the foundations for setting the direction for the future (Beyond Free-Flight). The goals are to establish tomorrow's as well as the future's Air transportation system.

  16. 15 CFR 740.15 - Aircraft and vessels (AVS).

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... Automated Export System (AES) record is filed in accordance with the requirements of the Foreign Trade Statistics Regulations (15 CFR part 30), except that an SED or AES record is not required when any of the...'s Export Declaration (SED) or Automated Export System (AES) record is filed in accordance with the...

  17. 15 CFR 740.15 - Aircraft and vessels (AVS).

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... Automated Export System (AES) record is filed in accordance with the requirements of the Foreign Trade Statistics Regulations (15 CFR part 30), except that an SED or AES record is not required when any of the...'s Export Declaration (SED) or Automated Export System (AES) record is filed in accordance with the...

  18. 15 CFR 740.15 - Aircraft and vessels (AVS).

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... Automated Export System (AES) record is filed in accordance with the requirements of the Foreign Trade Statistics Regulations (15 CFR part 30), except that an SED or AES record is not required when any of the...'s Export Declaration (SED) or Automated Export System (AES) record is filed in accordance with the...

  19. Cost-Effectiveness of Antivenoms for Snakebite Envenoming in 16 Countries in West Africa

    PubMed Central

    Hamza, Muhammad; Idris, Maryam A.; Maiyaki, Musa B.; Lamorde, Mohammed; Chippaux, Jean-Philippe; Warrell, David A.; Kuznik, Andreas; Habib, Abdulrazaq G.

    2016-01-01

    Background Snakebite poisoning is a significant medical problem in agricultural societies in Sub Saharan Africa. Antivenom (AV) is the standard treatment, and we assessed the cost-effectiveness of making it available in 16 countries in West Africa. Methods We determined the cost-effectiveness of AV based on a decision-tree model from a public payer perspective. Specific AVs included in the model were Antivipmyn, FAV Afrique, EchiTab-G and EchiTab-Plus. We derived inputs from the literature which included: type of snakes causing bites (carpet viper (Echis species)/non-carpet viper), AV effectiveness against death, mortality without AV, probability of Early Adverse Reactions (EAR), likelihood of death from EAR, average age at envenomation in years, anticipated remaining life span and likelihood of amputation. Costs incurred by the victims include: costs of confirming and evaluating envenomation, AV acquisition, routine care, AV transportation logistics, hospital admission and related transportation costs, management of AV EAR compared to the alternative of free snakebite care with ineffective or no AV. Incremental Cost Effectiveness Ratios (ICERs) were assessed as the cost per death averted and the cost per Disability-Adjusted-Life-Years (DALY) averted. Probabilistic Sensitivity Analyses (PSA) using Monte Carlo simulations were used to obtain 95% Confidence Intervals of ICERs. Results The cost/death averted for the 16 countries of interest ranged from $1,997 in Guinea Bissau to $6,205 for Liberia and Sierra Leone. The cost/DALY averted ranged from $83 (95% Confidence Interval: $36-$240) for Benin Republic to $281 ($159–457) for Sierra-Leone. In all cases, the base-case cost/DALY averted estimate fell below the commonly accepted threshold of one time per capita GDP, suggesting that AV is highly cost-effective for the treatment of snakebite in all 16 WA countries. The findings were consistent even with variations of inputs in 1—way sensitivity analyses. In addition, the PSA showed that in the majority of iterations ranging from 97.3% in Liberia to 100% in Cameroun, Guinea Bissau, Mali, Nigeria and Senegal, our model results yielded an ICER that fell below the threshold of one time per capita GDP, thus, indicating a high degree of confidence in our results. Conclusions Therapy for SBE with AV in countries of WA is highly cost-effective at commonly accepted thresholds. Broadening access to effective AVs in rural communities in West Africa is a priority. PMID:27027633

  20. Repetitive nonreentrant ventriculoatrial synchrony: An underrecognized cause of pacemaker-related arrhythmia.

    PubMed

    Sharma, Parikshit S; Kaszala, Karoly; Tan, Alex Y; Koneru, Jayanthi N; Shepard, Richard; Ellenbogen, Kenneth A; Huizar, Jose F

    2016-08-01

    Similar to endless loop tachycardia (ELT), repetitive nonreentrant ventriculoatrial synchrony (RNRVAS) is a ventriculoatrial (VA) synchrony pacemaker-mediated arrhythmia. RNRVAS was first described in 1990 and can only occur in the presence of retrograde VA conduction and dual-chamber or cardiac resynchronization devices with tracking (P-synchronous ventricular pacing such as DDD, DDDR) or nontracking pacing modes that allow AV-sequential pacing (DDI, DDIR). RNRVAS is promoted by (1) high lower rate limit or any feature that allows rapid pacing, (2) long AV intervals, or (3) long postventricular atrial refractory period (PVARP). In contrast to ELT, RNRVAS is a less well-recognized form of pacemaker-mediated arrhythmia; thus, unlike ELT, there are no specific device algorithms to prevent, recognize, and terminate RNRVAS. However, RNRVAS has been recently shown to occur frequently. We present a series of cases, some of which were found fortuitously. Owing to its clinical implications, we propose that algorithms should be developed to prevent, identify, and terminate RNRVAS. Published by Elsevier Inc.

  1. Enhanced pain and autonomic responses to ambiguous visual stimuli in chronic Complex Regional Pain Syndrome (CRPS) type I.

    PubMed

    Cohen, H E; Hall, J; Harris, N; McCabe, C S; Blake, D R; Jänig, W

    2012-02-01

    Cortical reorganisation of sensory, motor and autonomic systems can lead to dysfunctional central integrative control. This may contribute to signs and symptoms of Complex Regional Pain Syndrome (CRPS), including pain. It has been hypothesised that central neuroplastic changes may cause afferent sensory feedback conflicts and produce pain. We investigated autonomic responses produced by ambiguous visual stimuli (AVS) in CRPS, and their relationship to pain. Thirty CRPS patients with upper limb involvement and 30 age and sex matched healthy controls had sympathetic autonomic function assessed using laser Doppler flowmetry of the finger pulp at baseline and while viewing a control figure or AVS. Compared to controls, there were diminished vasoconstrictor responses and a significant difference in the ratio of response between affected and unaffected limbs (symmetry ratio) to a deep breath and viewing AVS. While viewing visual stimuli, 33.5% of patients had asymmetric vasomotor responses and all healthy controls had a homologous symmetric pattern of response. Nineteen (61%) CRPS patients had enhanced pain within seconds of viewing the AVS. All the asymmetric vasomotor responses were in this group, and were not predictable from baseline autonomic function. Ten patients had accompanying dystonic reactions in their affected limb: 50% were in the asymmetric sub-group. In conclusion, there is a group of CRPS patients that demonstrate abnormal pain networks interacting with central somatomotor and autonomic integrational pathways. © 2011 European Federation of International Association for the Study of Pain Chapters.

  2. Sedimentology, CSFe relationships and stable isotopic compositions in Devonian black mudrocks, Mackenzie Mountains, Northwest Territories, Canada

    NASA Astrophysics Data System (ADS)

    Al-Aasm, I. S.; Morad, S.; Durocher, S.; Muir, I.

    1996-11-01

    An integrated approach combining CSFe relationships, stable isotopic compositions, and lithofacies characterization was utilized to constrain the palaeoenvironmental and early diagenetic conditions of Middle-Upper Devonian (Eifelian-Frasnian) mudrocks from the Mackenzie Mountains, Northwest Territories, Canada. These rocks include the Hare Indian Formation (informally subdivided into the lower Bluefish Member and the Hare Indian Upper Member), Carcajou Marker and Canol Formation. The Bluefish Member is dominated by black, laminated, organic-rich shales (TOC = 0.35-10.34 wt.%; av. 5.83 wt.) with moderate degrees of pyritization (DOP) of 0.34-0.67 (av. 0.55). These mudrocks were deposited in dysoxic marine bottom-waters that became progressively more oxygenated with time. Variations in TOC, DOP and organic matter δ 13C PDB values (-29.7% to -19.9%; av. -27.2%) are attributed to repeated clastic dilution and increased input of terrestrial organic matter in association with shallowing-upward ramp-clinothem cycles. Pyrite δ 34S CDT values (-32.7% to -18.8%; av. -24.9%) indicate an open system, bacteriogenic seawater-sulphate reduction. Conversely, the overlying Hare Indian Upper Member, characterized by clinothem facies, is composed of grey to green mudstone with minor argillaceous limestones and considerably less organic matter contents (TOC = 0.28-2.99 wt.%; δ 13C = -29.5% to -22.5%). Deposition occurred in oxic to slightly dysoxic waters (DOP = 0.20-0.54; δ 34S = -23.0% to -20.9%), depending on the palaeotopographic location along the depositional slope. A rapid rise in sea level drowned the carbonate 'ramp' member of the Ramparts Formation and produced the thin, organic-rich Carcajou Marker. Bottom-water stagnation that resulted from subdued ramp palaeotopography produced anoxic sea bottom. Black, laminated, organic-rich shales from the Canol Formation (TOC = 1.37-6.68 wt.%) are very similar to those of the Bluefish Member, and are likewise basinal sediments. However, TOC, DOP and organic-matter δ 13C PDB values (-29.1% to -20.8%; av. -26.2%) do not show pronounced variations and indicate that low-energy, quietwater conditions persisted over relatively long, uninterrupted periods of time. High DOP values (0.72-0.93) throughout the Canol Formation suggest that deposition occurred in anoxic bottom-waters, but as basin-fill conditions continued there was a shift to a dysoxic environment (DOP = 0.55-0.65), which grades into nearshore and offshore sequences of the overlying Imperial Formation. In contrast with the Hare Indian Formation, much heavier δ 34S CDT values of pyrite in Canol mudrocks (-11.1% to +5.3%; av. -3.1%) point to bacterial sulphate reduction in a closed to semi-closed system with respect to seawater sulphate.

  3. Algorithm Visualization in Teaching Practice

    ERIC Educational Resources Information Center

    Törley, Gábor

    2014-01-01

    This paper presents the history of algorithm visualization (AV), highlighting teaching-methodology aspects. A combined, two-group pedagogical experiment will be presented as well, which measured the efficiency and the impact on the abstract thinking of AV. According to the results, students, who learned with AV, performed better in the experiment.

  4. Activatable Optical Imaging with a Silica-Rhodamine Based Near Infrared (SiR700) Fluorophore: A comparison with cyanine based dyes

    PubMed Central

    McCann, Thomas E.; Kosaka, Nobuyuki; Koide, Yuichiro; Mitsunaga, Makoto; Choyke, Peter L.; Nagano, Tetsuo; Urano, Yasuteru; Kobayashi, Hisataka

    2011-01-01

    Optical imaging is emerging as an important tool to visualize tumors. However, there are many potential choices among the available fluorophores. Optical imaging probes that emit in the visible range can image superficial tumors with high quantum yields, however, if deeper imaging is needed then near infrared (NIR) fluorophores are necessary. Most commercially available NIR fluorophores are cyanine based and are prone to non-specific binding and relatively limited photostability. Silica-containing rhodamine (SiR) fluorophores represent a new class of NIR fluorophores, which permit photoactivation via H-dimer formation as well as demonstrate improved photostability. This permits higher tumor-to-background ratios (TBRs) to be achieved over longer periods of time. Here, we compared an avidin conjugated with SiR700 (Av-SiR700) to similar compounds based on cyanine dyes (Av-Cy5.5 and Av-Alexa Fluor 680) in a mouse tumor model of ovarian cancer metastasis. We found that the Av-SiR700 probe demonstrated superior quenching enabling activation after binding-internalization to the target cell. As a result, Av-SiR700 had higher TBRs compared to Av-Cy5.5, and better biostability compared to Av-Alexa Fluor 680. PMID:22034863

  5. Assessment of sedimentary Cu availability: A comparison of biomimetic and AVS approaches

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

    Chen, Z.; Mayer, L.M.

    1999-02-15

    Sedimentary Cu bioavailability during deposit feeding is determined by both the digestive physiology of the organisms and the geochemistry of the sediments. The authors assessed the contribution of these two factors by using a biomimetic approach involving extraction of Cu with digestive fluids of two deposit feeders and one suspension feeder and a geochemical approach measuring Cu associated with acid-volatile sulfide (AVS) in sediments. Cu bioavailability determined by the biomimetic method varied among species with varying digestive physiology but all showed a marked increase when SEM{sub Cu}-AVS {ge} 0, corroborating the premise underlying the AVS method in determining sedimentary Cumore » bioavailability. The existence of a positive SEM{sub Cu}-AVS threshold suggests the existence of additional Cu-binding phases or mixed Cu(I)--Cu(II) sulfides in sediments. In addition, Cu bioavailable to digestive fluids was much less than that measured as SEM{sub Cu}-AVS, indicating that the AVS method overestimates Cu bioavailability to digestive fluid of deposit feeders. Incubation of digestive fluids with two Cu-bound model phases, goethite and sulfide, corroborated the relative unavailability of sulfide-bound Cu. Subsurface deposit feeders feeding on anoxic sediments may be exposed to less Cu than their surface-feeding counterparts in Cu-contaminated environments.« less

  6. Non-stimulated adrenal venous sampling using Dyna computed tomography in patients with primary aldosteronism

    PubMed Central

    Chang, Chin-Chen; Lee, Bo-Ching; Liu, Kao-Lang; Chang, Yeun-Chung; Wu, Vin-Cent; Huang, Kuo-How

    2016-01-01

    In this retrospective study, we aimed to examine the effect of applying Dyna computed tomography (CT) on the success rate of adrenal venous sampling (AVS) without adrenocorticotropic hormone stimulation. A total of 100 consecutive patients with primary aldosteronism who underwent AVS between May 2012 and July 2015 were enrolled. In all the cases, Dyna CT was used in AVS to validate catheter position in the right adrenal vein. A selectivity index (cortisoladrenal vein /cortisolinferior vena cava) of ≥2.0 of both adrenal veins were required for successful AVS. Dyna CT indicated misplaced catheters in 16 patients; of these patients, 75% (12/16) eventually had successful right AVS after catheter repositioning. The success rate of initial sampling at the right adrenal vein was 76% (76/100), which increased to 88% (88/100) after Dyna CT was applied (p < 0.001). The most common inadvertently catheterised vessels detected using Dyna CT were the accessory hepatic veins (56.3%, 9/16), followed by the renal capsular veins (37.5%, 6/16). The overall success rate of non-stimulated AVS using Dyna CT was 87% (87/100). Thus, the application of Dyna CT further increased the success rate of non-stimulated AVS. PMID:27876824

  7. Continuous IV Crotalidae Polyvalent Immune Fab (Ovine) (FabAV) for selected North American rattlesnake bite patients.

    PubMed

    Bush, Sean P; Seifert, Steven A; Oakes, Jennifer; Smith, Susan D; Phan, Tammy H; Pearl, Sarah R; Reibling, Ellen T

    2013-07-01

    In patients bitten by North American rattlesnakes and treated with Crotalidae Polyvalent Immune Fab (Ovine) (FabAV), late hematologic abnormalities-persistent, recurrent, or late, new onset of hypofibrinogenemia, prolonged PT/INR, prolonged PTT, and/or thrombocytopenia beyond 48 h post-envenomation-are common, difficult to manage, and may result in morbidity and mortality are common, difficult to manage, and may result in morbidity and mortality. The optimal management of late hematologic abnormalities, particularly the use of further treatment with antivenom, has not been well defined. The current FabAV treatment regimen is to give antivenom as a bolus dose over a one-hour period. We describe our experience using a continuous intravenous infusion of FabAV for late hematologic effects and/or associated bleeding complications in rattlesnake envenomation. This is a retrospective, observational case series of patients envenomated by North American rattlesnakes at three medical centers managed with a continuous intravenous infusion of FabAV for late hematologic abnormalities and/or associated bleeding complications. Indications, dilution and infusion protocols, and duration of therapy were individualized. Five cases were identified between July 2010 and September 2011. All patients had profound late hematologic abnormalities and/or were associated with bleeding complications. Several patients had received repeat bolus infusions of FabAV, with or without human blood products, with either inadequate or only transient beneficial response. All patients were then managed with a continuous intravenous infusion of FabAV and all appeared to respond to the continuous intravenous infusion of FabAV, titrated to effect, with cessation of progression and, in most cases, improvement in hematologic abnormalities. Rates of infusion varied from 2 to 4 vials per 24 h (mean = 3.1 ± 0.4 vials/day). The termination of FabAV infusion was between day 6 and day 14 from the time of envenomation (mean = 10 ± 3 days), after which hematologic values were normalized or were normalizing in all patients and continued to do so. The use of FabAV as a continuous intravenous infusion, particularly after the acute phase of envenomation has passed, provides a continuous source of circulating antibodies to neutralize venom components reaching circulation from tissue stores and allows natural replenishment of hematologic factors such as platelets and/or fibrinogen. This method is an efficient use of FabAV, avoiding the wasteful excess of a bolus dose, may be more effective, eliminating the potential for destruction of hematologic factors when protective antivenom levels are lost between bolus FabAV doses, and appears to be safe. Further assessments of the stability and sterility of the product during infusion are needed. The need to continue hospitalization is the major drawback, but continued observation and inpatient care may be needed for other indications (e.g. bleeding) in this subset of patients. A continuous intravenous infusion of FabAV between 2 and 4 vials per day, titrated to effect, and continued for 6-14 days post-envenomation appeared to be associated with reversal of late hematologic effects of rattlesnake envenomation and, when combined with indicated human blood products, control of significant bleeding. Continuous intravenous infusion of FabAV may be safer, more efficacious, and more cost-effective than observation without FabAV treatment or as-needed bolus dosing in selected patients with late hematologic abnormalities. Copyright © 2013 Elsevier Ltd. All rights reserved.

  8. Right bundle branch block without overt heart disease predicts higher risk of pacemaker implantation: the study of atomic-bomb survivors.

    PubMed

    Kusumoto, Saburo; Kawano, Hiroaki; Makita, Naomasa; Ichimaru, Shinichiro; Kaku, Takashi; Haruta, Daisuke; Hida, Ayumi; Sera, Nobuko; Imaizumi, Misa; Nakashima, Eiji; Maemura, Koji; Akahoshi, Masazumi

    2014-06-01

    We investigated the clinical course of complete right bundle branch block (RBBB) or RBBB with axis deviation (AD) in terms of subsequent pacemaker implantation for high-degree atrioventricular (AV) block or sick sinus syndrome (SSS). Among the 16,170 atomic-bomb survivors in our biennial health examination between July 1967 and December 2010, we detected 520 newly-acquired RBBB subjects with no organic heart disease, and selected 1038 age- (at RBBB diagnosis) and sex-matched subjects without RBBB to serve as comparison subjects. Multivariate Cox regression analysis was used to estimate the hazard ratios (HRs) for the risk of pacemaker implantation due to all causes, AV block or SSS between RBBB and comparison subjects and between RBBB subjects with and without AD. The risk of pacemaker implantation for RBBB was 4.79 (95% confidence interval [CI] 1.89-12.58; P=0.001), 3.77 (95% CI, 1.09-13.07; P=0.036), and 6.28 (95% CI, 1.24-31.73, P=0.026) when implantation was for all causes, AV block and SSS, respectively. RBBB subjects with AD had a higher risk for all-cause pacemaker implantation than subjects without AD (HR, 3.03; 95% CI, 1.00-9.13, P=0.049). RBBB subjects with AD were younger than subjects without AD at the time of RBBB diagnosis (59.4±7.6 vs 74.4±3.1 years old, P=0.019), and their progression from diagnosis to pacemaker implantation took longer (15.1±6.6 vs 6.4±3.0 years, P=0.032). RBBB, especially with AD, progresses to AV block and SSS that requires pacemaker implantation; the mechanisms by which the conduction defect progresses differ among patients with and without AD. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  9. The magnetic navigation system allows safety and high efficacy for ablation of arrhythmias

    PubMed Central

    Bauernfeind, Tamas; Akca, Ferdi; Schwagten, Bruno; de Groot, Natasja; Van Belle, Yves; Valk, Suzanne; Ujvari, Barbara; Jordaens, Luc; Szili-Torok, Tamas

    2011-01-01

    Aims We aimed to evaluate the safety and long-term efficacy of the magnetic navigation system (MNS) in a large number of patients. The MNS has the potential for improving safety and efficacy based on atraumatic catheter design and superior navigation capabilities. Methods and results In this study, 610 consecutive patients underwent ablation. Patients were divided into two age- and sex-matched groups. Ablations were performed either using MNS (group MNS, 292) or conventional manual ablation [group manual navigation (MAN), 318]. The following parameters were analysed: acute success rate, fluoroscopy time, procedure time, complications [major: pericardial tamponade, permanent atrioventricular (AV) block, major bleeding, and death; minor: minor bleeding and temporary AV block]. Recurrence rate was assessed during follow-up (15 ± 9.5 months). Subgroup analysis was performed for the following groups: atrial fibrillation, isthmus dependent and atypical atrial flutter, atrial tachycardia, AV nodal re-entrant tachycardia, circus movement tachycardia, and ventricular tachycardia (VT). Magnetic navigation system was associated with less major complications (0.34 vs. 3.2%, P = 0.01). The total numbers of complications were lower in group MNS (4.5 vs. 10%, P = 0.005). Magnetic navigation system was equally effective as MAN in acute success rate for overall groups (92 vs. 94%, P = ns). Magnetic navigation system was more successful for VTs (93 vs. 72%, P < 0.05). Less fluoroscopy was used in group MNS (30 ± 20 vs. 35 ± 25 min, P < 0.01). There were no differences in procedure times and recurrence rates for the overall groups (168 ± 67 vs. 159 ± 75 min, P = ns; 14 vs. 11%, P = ns; respectively). Conclusions Our data suggest that the use of MNS improves safety without compromising efficiency of ablations. Magnetic navigation system is more effective than manual ablation for VTs. PMID:21508006

  10. Fluidized reduction of oxides on fine metal powders without sintering

    NASA Technical Reports Server (NTRS)

    Hayashi, T.

    1985-01-01

    In the process of reducing extremely fine metal particles (av. particle size or = 1000 angstroms) covered with an oxide layer, the metal particles are fluidized by a gas flow contg. H, heated, and reduced. The method uniformly and easily reduces surface oxide layers of the extremely fine metal particles without causing sintering. The metal particles are useful for magnetic recording materials, conductive paste, powder metallurgy materials, chem. reagents, and catalysts.

  11. 18F-AV-1451 positron emission tomography in Alzheimer's disease and progressive supranuclear palsy.

    PubMed

    Passamonti, Luca; Vázquez Rodríguez, Patricia; Hong, Young T; Allinson, Kieren S J; Williamson, David; Borchert, Robin J; Sami, Saber; Cope, Thomas E; Bevan-Jones, W Richard; Jones, P Simon; Arnold, Robert; Surendranathan, Ajenthan; Mak, Elijah; Su, Li; Fryer, Tim D; Aigbirhio, Franklin I; O'Brien, John T; Rowe, James B

    2017-03-01

    The ability to assess the distribution and extent of tau pathology in Alzheimer's disease and progressive supranuclear palsy in vivo would help to develop biomarkers for these tauopathies and clinical trials of disease-modifying therapies. New radioligands for positron emission tomography have generated considerable interest, and controversy, in their potential as tau biomarkers. We assessed the radiotracer 18F-AV-1451 with positron emission tomography imaging to compare the distribution and intensity of tau pathology in 15 patients with Alzheimer's pathology (including amyloid-positive mild cognitive impairment), 19 patients with progressive supranuclear palsy, and 13 age- and sex-matched controls. Regional analysis of variance and a support vector machine were used to compare and discriminate the clinical groups, respectively. We also examined the 18F-AV-1451 autoradiographic binding in post-mortem tissue from patients with Alzheimer's disease, progressive supranuclear palsy, and a control case to assess the 18F-AV-1451 binding specificity to Alzheimer's and non-Alzheimer's tau pathology. There was increased 18F-AV-1451 binding in multiple regions in living patients with Alzheimer's disease and progressive supranuclear palsy relative to controls [main effect of group, F(2,41) = 17.5, P < 0.0001; region of interest × group interaction, F(2,68) = 7.5, P < 0.00001]. More specifically, 18F-AV-1451 binding was significantly increased in patients with Alzheimer's disease, relative to patients with progressive supranuclear palsy and with control subjects, in the hippocampus and in occipital, parietal, temporal, and frontal cortices (t's > 2.2, P's < 0.04). Conversely, in patients with progressive supranuclear palsy, relative to patients with Alzheimer's disease, 18F-AV-1451 binding was elevated in the midbrain (t = 2.1, P < 0.04); while patients with progressive supranuclear palsy showed, relative to controls, increased 18F-AV-1451 uptake in the putamen, pallidum, thalamus, midbrain, and in the dentate nucleus of the cerebellum (t's > 2.7, P's < 0.02). The support vector machine assigned patients' diagnoses with 94% accuracy. The post-mortem autoradiographic data showed that 18F-AV-1451 strongly bound to Alzheimer-related tau pathology, but less specifically in progressive supranuclear palsy. 18F-AV-1451 binding to the basal ganglia was strong in all groups in vivo. Postmortem histochemical staining showed absence of neuromelanin-containing cells in the basal ganglia, indicating that off-target binding to neuromelanin is an insufficient explanation of 18F-AV-1451 positron emission tomography data in vivo, at least in the basal ganglia. Overall, we confirm the potential of 18F-AV-1451 as a heuristic biomarker, but caution is indicated in the neuropathological interpretation of its binding. Off-target binding may contribute to disease profiles of 18F-AV-1451 positron emission tomography, especially in primary tauopathies such as progressive supranuclear palsy. We suggest that 18F-AV-1451 positron emission tomography is a useful biomarker to assess tau pathology in Alzheimer's disease and to distinguish it from other tauopathies with distinct clinical and pathological characteristics such as progressive supranuclear palsy. © The Author (2017). Published by Oxford University Press on behalf of the Guarantors of Brain.

  12. Diffusive oxygen shunting between vessels in the preglomerular renal vasculature: anatomic observations and computational modeling.

    PubMed

    Gardiner, Bruce S; Thompson, Sarah L; Ngo, Jennifer P; Smith, David W; Abdelkader, Amany; Broughton, Brad R S; Bertram, John F; Evans, Roger G

    2012-09-01

    To understand how geometric factors affect arterial-to-venous (AV) oxygen shunting, a mathematical model of diffusive oxygen transport in the renal cortex was developed. Preglomerular vascular geometry was investigated using light microscopy (providing vein shape, AV separation, and capillary density near arteries) and published micro-computed tomography (CT) data (providing vessel size and AV separation; Nordsletten DA, Blackett S, Bentley MD, Ritman EL, Smith NP. IUPS Physiome Project. http://www.physiome.org.nz/publications/nordsletten_blackett_ritman_bentley_smith_2005/folder_contents). A "U-shaped" relationship was observed between the arterial radius and the distance between the arterial and venous lumens. Veins were found to partially wrap around the artery more consistently for larger rather than smaller arteries. Intrarenal arteries were surrounded by an area of fibrous tissue, lacking capillaries, the thickness of which increased from ∼5 μm for the smallest arteries (<16-μm diameter) to ∼20 μm for the largest arteries (>200-μm diameter). Capillary density was greater near smaller arteries than larger arteries. No capillaries were observed between wrapped AV vessel pairs. The computational model comprised a single AV pair in cross section. Geometric parameters critical in renal oxygen transport were altered according to variations observed by CT and light microscopy. Lumen separation and wrapping of the vein around the artery were found to be the critical geometric factors determining the amount of oxygen shunted between AV pairs. AV oxygen shunting increases both as lumen separation decreases and as the degree of wrapping increases. The model also predicts that capillaries not only deliver oxygen, but can also remove oxygen from the cortical parenchyma close to an AV pair. Thus the presence of oxygen sinks (capillaries or tubules) near arteries would reduce the effectiveness of AV oxygen shunting. Collectively, these data suggest that AV oxygen shunting would be favored in larger vessels common to the cortical and medullary circulations (i.e., arcuate and proximal interlobular arteries) rather than the smaller vessels specific to the cortical circulation (distal interlobular arteries and afferent arterioles).

  13. Mid-term variation of vertical distribution of acid volatile sulphide and simultaneously extracted metals in sediment cores from Lake Albufera (Valencia, Spain).

    PubMed

    Hernández-Crespo, Carmen; Martín, Miguel

    2013-11-01

    Lake Albufera is one of the most eutrophic bodies of water in Spain due to point and diffuse pollution over past decades, and its sediments are likely to be anoxic because of high organic matter flux. Hence, sulphides can play an important role in limiting the mobility of heavy metals. This study aimed to study the vertical variation of acid volatile sulphide (AVS) and simultaneously extracted metals (SEM) in sediment cores collected from Lake Albufera; other sediment characteristics, such as organic matter, biochemical oxygen, demand or total metals, were also studied. Three sites were selected, and four sampling campaigns were performed to study spatial and temporal variation as well as to obtain information regarding historical variation in the composition of sediments. AVS and SEM were analysed by the purge-and-trap method. The vertical distribution of AVS and SEM varied depending on the sampling site-concentrations of AVS and SEM were higher at sites close to mouths of inflowing channels. A decreasing trend of AVS has been found at these sites over time: In the two first samplings, AVS increased with depth reaching maximum concentrations of 40 and 21 μmol g(-1), but from then on AVS were lower and decreased with depth. SEM decreased with depth from 3 μmol g(-1) in surface layers to approximately 1 μmol g(-1) at deeper segments at these sites. However, the central site was more uniform with respect to depth as well as with time; it presented lower values of SEM and AVS (mean 0.9 and 2.0 μmol g(-1) respectively), and the maximum value of AVS (7 μmol g(-1)) was found at the top layer (0-3 cm). According to the (SEM-AVS)/fOC approach, every site, and throughout the cores, can be classified as containing nontoxic metals because the values were <130 μmol g(-1).

  14. Beneficial Effects of High-Density Lipoproteins on Acquired von Willebrand Syndrome in Aortic Valve Stenosis.

    PubMed

    Gebhard, C; Maafi, F; Stähli, B E; Bonnefoy, A; Gebhard, C E; Nachar, W; de Oliveira Moraes, A Benjamim; Mecteau, M; Mihalache-Avram, T; Lavoie, V; Kernaleguen, A E; Shi, Y; Busseuil, D; Chabot-Blanchet, M; Perrault, L P; Rhainds, D; Rhéaume, E; Tardif, J C

    2018-02-01

     Infusions of apolipoprotein A-I (apoA-I), the major protein component of high-density lipoproteins (HDL), result in aortic valve stenosis (AVS) regression in experimental models. Severe AVS can be complicated by acquired von Willebrand syndrome, a haemorrhagic disorder associated with loss of high-molecular-weight von Willebrand factor (vWF) multimers (HMWM), the latter being a consequence of increased shear stress and enhanced vWF-cleaving protease (ADAMTS-13) activity. Although antithrombotic actions of HDL have been described, its effects on ADAMTS-13 and vWF in AVS are unknown.  We assessed ADAMTS-13 activity in plasma derived from a rabbit model of AVS ( n  = 29) as well as in plasma collected from 64 patients with severe AVS (age 65.0 ± 10.4 years, 44 males) undergoing aortic valve replacement (AVR). In both human and rabbit AVS plasma, ADAMTS-13 activity was higher than that in controls ( p  < 0.05). Accordingly, AVS patients had less HMWM than controls (66.3 ± 27.2% vs. 97.2 ± 24.1%, p  < 0.0001). Both ADAMTS-13 activity and HMWM correlated significantly with aortic transvalvular gradients, thereby showing opposing correlations ( r  = 0.3, p  = 0.018 and r  = -0.4, p  = 0.003, respectively). Administration of an apoA-I mimetic peptide reduced ADAMTS-13 activity in AVS rabbits as compared with the placebo group (2.0 ± 0.5 RFU/sec vs. 3.8 ± 0.4 RFU/sec, p  < 0.05). Similarly, a negative correlation was found between ADAMTS-13 activity and HDL cholesterol levels in patients with AVS ( r  = -0.3, p  = 0.045).  Our data indicate that HDL levels are associated with reduced ADAMTS-13 activity and increased HMWM. HDL-based therapies may reduce the haematologic abnormalities of the acquired von Willebrand syndrome in AVS. Schattauer GmbH Stuttgart.

  15. Growth prior to thermogenesis for a quick fledging of Adélie penguin chicks (Pygoscelis adeliae).

    PubMed

    Dégletagne, Cyril; Roussel, Damien; Rouanet, Jean Louis; Baudimont, Fanny; Moureaux, Elodie-Marie; Harvey, Steve; Duchamp, Claude; Le Maho, Yvon; Raccurt, Mireille

    2013-01-01

    The evolutionary trade-off between tissue growth and mature function restricts the post natal development of polar birds. The present study uses an original integrative approach as it includes gene expression, plus biochemical and physiological analysis to investigate how Adélie penguin chicks achieve a rapid growth despite the energetic constraints linked to the cold and the very short breeding season in Antarctica. In pectoralis muscle, the main thermogenic tissue in birds, our data show that the transition from ectothermy to endothermy on Day 15 post- hatching is associated with substantial and coordinated changes in the transcription of key genes. While the early activation of genes controlling cell growth and differentiation (avGHR, avIGF-1R, T3Rβ) is rapidly down-regulated after hatching, the global increase in the relative expression of genes involved in thermoregulation (avUCP, avANT, avLPL) and transcriptional regulation (avPGC1α, avT3Rβ) underlie the muscular acquisition of oxidative metabolism. Adélie chicks only become real endotherms at 15 days of age with the development of an oxidative muscle phenotype and the ability to shiver efficiently. The persistent muscular expression of IGF-1 throughout growth probably acts as a local mediator to adjust muscle size and its oxidative capacity to anticipate the new physiological demands of future Dives in cold water. The up-regulation of T3Rβ mRNA levels suggests that circulating T3 may play an important role in the late maturation of skeletal muscle by reinforcing, at least in part, the paracrine action of IGF-1. From day 30, the metabolic shift from mixed substrate to lipid metabolism, with the markedly increased mRNA levels of muscle avLPL, avANT and avUCP, suggests the late development of a fatty acid-enhanced muscle non-shivering thermogenesis mechanism. This molecular control is the key to this finely-tuned strategy by which the Adélie penguin chick successfully heads for the sea on schedule.

  16. Growth Prior to Thermogenesis for a Quick Fledging of Adélie Penguin Chicks (Pygoscelis adeliae)

    PubMed Central

    Dégletagne, Cyril; Roussel, Damien; Rouanet, Jean Louis; Baudimont, Fanny; Moureaux, Elodie-Marie; Harvey, Steve; Duchamp, Claude; Le Maho, Yvon; Raccurt, Mireille

    2013-01-01

    The evolutionary trade-off between tissue growth and mature function restricts the post natal development of polar birds. The present study uses an original integrative approach as it includes gene expression, plus biochemical and physiological analysis to investigate how Adélie penguin chicks achieve a rapid growth despite the energetic constraints linked to the cold and the very short breeding season in Antarctica. In pectoralis muscle, the main thermogenic tissue in birds, our data show that the transition from ectothermy to endothermy on Day 15 post- hatching is associated with substantial and coordinated changes in the transcription of key genes. While the early activation of genes controlling cell growth and differentiation (avGHR, avIGF-1R, T3Rβ) is rapidly down-regulated after hatching, the global increase in the relative expression of genes involved in thermoregulation (avUCP, avANT, avLPL) and transcriptional regulation (avPGC1α, avT3Rβ) underlie the muscular acquisition of oxidative metabolism. Adélie chicks only become real endotherms at 15 days of age with the development of an oxidative muscle phenotype and the ability to shiver efficiently. The persistent muscular expression of IGF-1 throughout growth probably acts as a local mediator to adjust muscle size and its oxidative capacity to anticipate the new physiological demands of future Dives in cold water. The up-regulation of T3Rβ mRNA levels suggests that circulating T3 may play an important role in the late maturation of skeletal muscle by reinforcing, at least in part, the paracrine action of IGF-1. From day 30, the metabolic shift from mixed substrate to lipid metabolism, with the markedly increased mRNA levels of muscle avLPL, avANT and avUCP, suggests the late development of a fatty acid-enhanced muscle non-shivering thermogenesis mechanism. This molecular control is the key to this finely-tuned strategy by which the Adélie penguin chick successfully heads for the sea on schedule. PMID:24040194

  17. Nitric Oxide Synthase-3 Promotes Embryonic Development of Atrioventricular Valves

    PubMed Central

    Liu, Yin; Lu, Xiangru; Xiang, Fu-Li; Lu, Man; Feng, Qingping

    2013-01-01

    Nitric oxide synthase-3 (NOS3) has recently been shown to promote endothelial-to-mesenchymal transition (EndMT) in the developing atrioventricular (AV) canal. The present study was aimed to investigate the role of NOS3 in embryonic development of AV valves. We hypothesized that NOS3 promotes embryonic development of AV valves via EndMT. To test this hypothesis, morphological and functional analysis of AV valves were performed in wild-type (WT) and NOS3−/− mice at postnatal day 0. Our data show that the overall size and length of mitral and tricuspid valves were decreased in NOS3−/− compared with WT mice. Echocardiographic assessment showed significant regurgitation of mitral and tricuspid valves during systole in NOS3−/− mice. These phenotypes were all rescued by cardiac specific NOS3 overexpression. To assess EndMT, immunostaining of Snail1 was performed in the embryonic heart. Both total mesenchymal and Snail1+ cells in the AV cushion were decreased in NOS3−/− compared with WT mice at E10.5 and E12.5, which was completely restored by cardiac specific NOS3 overexpression. In cultured embryonic hearts, NOS3 promoted transforming growth factor (TGFβ), bone morphogenetic protein (BMP2) and Snail1expression through cGMP. Furthermore, mesenchymal cell formation and migration from cultured AV cushion explants were decreased in the NOS3−/− compared with WT mice. We conclude that NOS3 promotes AV valve formation during embryonic heart development and deficiency in NOS3 results in AV valve insufficiency. PMID:24204893

  18. AV3V lesions reduce the pressor response to L-glutamate into the RVLM.

    PubMed

    Vieira, Alexandre Antonio; Colombari, Eduardo; De Luca, Laurival A; Colombari, Débora Simões de Almeida; Menani, José V

    2006-05-01

    Neurons from the rostral ventrolateral medulla (RVLM) directly activate sympathetic pre-ganglionic neurons in the spinal cord. Hypertensive responses and sympathetic activation produced by different stimuli are strongly affected by lesions of the preoptic periventricular tissue surrounding the anteroventral third ventricle (AV3V region). Therefore, in the present study, we investigated the effects of acute (1 day) and chronic (15 days) electrolytic lesions of the AV3V region on the pressor responses produced by injections of the excitatory amino acid L-glutamate into the RVLM of unanesthetized rats. Male Holtzman rats with sham or electrolytic AV3V lesions and a stainless steel cannula implanted into the RVLM were used. The pressor responses produced by injections of L-glutamate (1, 5 and 10 nmol/100 nl) into the RVLM were reduced 1 day (9 +/- 4, 39 +/- 6 and 37 +/- 4 mm Hg, respectively) and 15 days after AV3V lesions (13 +/- 6, 39 +/- 4 and 43 +/- 4 mm Hg, respectively, vs. sham lesions: 29 +/- 3, 50 +/- 2 and 58 +/- 3 mm Hg, respectively). Injections of L-glutamate into the RVLM in sham or AV3V-lesioned rats produced no significant change in the heart rate (HR). Baroreflex bradycardia and tachycardia produced by iv phenylephrine or sodium nitroprusside, respectively, and the pressor and bradycardic responses to chemoreflex activation with iv potassium cyanide were not modified by AV3V lesions. The results suggest that signals from the AV3V region are important for sympathetic activation induced by L-glutamate into the RVLM.

  19. Recurrent hemorrhage after western diamondback rattlesnake envenomation treated with crotalidae polyvalent immune fab (ovine).

    PubMed

    Fazelat, Joyia; Teperman, Sheldon H; Touger, Michael

    2008-11-01

    Recurrent coagulopathy has been observed in patients after rattlesnake envenomation treated with Crotalidae Polyvalent Immune Fab (ovine) [FabAV]. While recurrent coagulopathy is well documented in the literature, clinically significant sequelae have not been reported. We present a case of recurrent thrombocytopenia after western diamondback envenomation treated with FabAV, resulting in an extensive recurrent local hemorrhage. A 24-year-old male presented to our emergency department several hours after western diamondback envenomation. He sustained bites to both hands and the right flank by leaning over his pet "snake enclosure." On presentation, the patient was hypotensive, tachycardic, and thrombocytopenic with a platelet count of 17/nl. Antivenom therapy was initiated according to the standard FabAV protocol. However, sixteen hours after completion of the recommended FabAV infusion, the patient experienced a recurrent thrombocytopenia with a dramatic seventeen point drop in hematocrit. The source of bleeding was clinically attributed to an expanding hematoma at the site of envenomation. FabAV has become the standard treatment for symptomatic crotalid envenomation. However, the pharmacokinetics of this drug predispose it to recurrent coagulopathies. While studies have shown persistent and recurrent coagulopathic derangements after FabAV therapy, no clinically significant sequelae have been reported. This report highlights the potential for recurrent local hemorrhagic complications following rattlesnake envenomation, even after treatment guided by the current FabAV protocol. Recurrent coagulopathy following FabAV therapy can result in clinically significant hemorrhage, supporting the observation that extended repeat dosing may be necessary to adequately treat subjects of rattlesnake envenomation.

  20. Adrenal venous sampling for stratifying patients for surgery of adrenal nodules detected using dynamic contrast enhanced CT

    PubMed Central

    Kim, Jin Young; Kim, See Hyung; Lee, Hee Jung; Kim, Young Hwan; Kim, Mi Jeong; Cho, Seung Hyun

    2014-01-01

    PURPOSE We aimed to assess the value of adrenal venous sampling (AVS) for diagnosing primary aldosteronism (PA) subtypes in patients with a unilateral nodule detected on adrenal computed tomography (CT) and scheduled for adrenalectomy. MATERIALS AND METHODS This retrospective study included 80 consecutive patients with PA undergoing CT and AVS. Different lateralization indices were assessed, and a cutoff established using receiver operating characteristic curve analysis. The value of CT alone versus CT with AVS for differentiating PA subtypes was compared. The adrenalectomy outcome was assessed, and predictors of cure were determined using univariate analysis. RESULTS AVS was successful in 68 patients. A cortisol-corrected aldosterone affected-to-unaffected ratio cutoff of 2.0 and affected-to-inferior vena cava ratio cutoff of 1.4 were the best lateralization indices, with accuracies of 82.5% and 80.4%, respectively. CT and AVS diagnosed 38 patients with aldosterone-producing adenomas, five patients with unilateral adrenal hyperplasia, and 25 patients with bilateral adrenal hyperplasia. Of the 52 patients with a nodule detected on CT, subsequent AVS diagnosed bilateral adrenal hyperplasia in 14 patients (27%). Compared to the results of combining CT with AVS, the accuracy of CT alone for diagnosing aldosterone-producing adenomas was 71.1% (P < 0.001). The cure rate for hypertension after adrenalectomy was 39.2%, with improvement in 53.5% of patients. On univariate analysis, predictors of persistent hypertension were male gender and preoperative systolic blood pressure. CONCLUSION To avoid inappropriate surgery, AVS is necessary for diagnosing unilateral nodules with aldosterone hypersecretion detected by CT. PMID:24047720

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