Endoscopic techniques and management of foreign body ingestion and food bolus impaction in the upper gastrointestinal tract: a retrospective analysis of 139 cases.

PubMed

Katsinelos, Panagiotis; Kountouras, Jannis; Paroutoglou, George; Zavos, Christos; Mimidis, Kostas; Chatzimavroudis, Grigoris

2006-10-01

Ingested foreign bodies and food bolus impaction are frequently seen in endoscopic practice. Successful foreign body and food bolus removal may depend on the method used, the choice of device, and the experience level of the endoscopist, although few papers report experience and outcome of tertiary centers. To investigate the effectiveness of our protocol designed for removal of ingested foreign bodies and food boluses. We retrospectively reviewed all patients with a diagnosis of foreign body ingestion and food bolus impaction from 1994 to 2005 identified by computer search. Patients were excluded if medical record was incomplete. The analysis included 171 patients. Foreign bodies and impacted food boluses were found in 77 and 62 patients, respectively. In 32 cases (23%), the foreign bodies passed spontaneously through the gastrointestinal tract. The overall success rate for endoscopic management was obtained in 137 patients (98.6%). Surgical removal of a foreign body was required in only 2 cases (1.4%). According to the type and location of the foreign object and food bolus we used Dormia baskets, retrieval forceps, polypectomy snares, and all sizes of Roth net. No complications relating to the endoscopic procedure were observed; 50 patients (35.2%) had an underlying esophageal disease. Endoscopic removal of upper gastrointestinal tract foreign bodies and food bolus impaction is efficacious and safe. Especially the Roth net is the best device for safe retrieval of food boluses and button disc batteries.

TU-H-CAMPUS-TeP1-05: Fast Processed 3D Printing-Aided Urethane Resin (PUR) Bolus in Radiation Therapy

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

Zhao, B; Chiu, T; Gu, X

Purpose: 3D printed custom bolus is regularly used in radiation therapy clinic as a compensator. However, usual method of bolus printing with 100% filling is very time-consuming. The purpose of this study is to evaluate the feasibility and benefit of 3D printed bolus filled with UR. Methods: Two boluses were designed on nose (9e electrons) and ear (6× photons) for a head phantom in treatment planning system (TPS) to achieve dose coverage to the skin. The bolus structures (56–167cc) were converted to STereoLithographic (STL) model using an in-house developed algorithm and sent to a commercial fused deposition modeling (FDM) printer.more » Only shells were printed with polylactic acid (PLA) material. Liquid UR was then placed in a vacuum pump and slowly poured into the hollow bolus from its top opening. Liquid UR hardened in around half an hour. The phantom was rescanned with custom boluses attached and the dosimetry was compared with original design in TPS. Basic CT and dose properties were investigated. GaF films were irradiated to measure dose profile and output of several open photon and electron beams under solid water and UR slabs of same thicknesses. Results: CT number was 11.2±7.3 and 65.4±7.8, respectively for solid water(∼1.04g/cc) and UR(∼1.08g/cc). The output measurement at dmax for 6× was within 2% for the two materials. The relative dose profiles of the two materials above dmax show 94–99% Gamma analysis passing rates for both photons and electrons. Dose distributions with 3D PUR boluses maintained great coverage on the intended skin regions and resembled that with computer generated boluses. Manufacturing 3D PUR boluses was 3–4 times faster than 100% printed boluses. The efficiency significantly improves for larger boluses. Conclusion: The study suggests UR has similar dose responses as solid water. Making custom bolus with UR greatly increases clinical workflow efficiency.« less

Broadening Participation Not Border Protection: How Universities Can Support Women in Computer Science

ERIC Educational Resources Information Center

Michell, Dee; Szorenyi, Anna; Falkner, Katrina; Szabo, Claudia

2017-01-01

Computer science, like technology in general, is seen as a masculine field and the under-representation of women an intransigent problem. In this paper, we argue that the cultural belief in Australia that computer science is a domain for men results in many girls and women being chased away from that field as part of a border protection campaign…

Chasing as a model of psychogenic stress: characterization of physiological and behavioral responses.

PubMed

Lee, Ji-Hye; Kimm, Sunwhi; Han, Jung-Soo; Choi, June-Seek

2018-03-25

Being chased by a predator or a dominant conspecific can induce significant stress. However, only a limited number of laboratory studies have employed chasing by itself as a stressor. In this study, we developed a novel stress paradigm in which rats were chased by a fast-moving object in an inescapable maze. In Experiment 1, defensive behaviors and stress hormone changes induced by chasing stress were measured. During the chasing stress, the chasing-stress group (n = 9) froze and emitted 22-kHz ultrasonic vocalizations (USVs), but the no-chasing control group (n = 10) did not. Plasma corticosterone levels significantly increased following the chasing and were comparable to those of the restraint-stress group (n = 6). In Experiment 2, the long-lasting memory of the chasing event was tested after three weeks. The chasing-stress group (n = 15) showed higher levels of freezing and USV than the no-chasing group (n = 14) when they were presented with the tone associated with the object's chasing action. Subsequently, the rats were subjected to Pavlovian threat conditioning with a tone as a conditioned stimulus and footshock as an unconditioned stimulus. The chasing-stress group showed higher levels of freezing and USV during the conditioning session than the no-chasing group, indicating sensitized defensive reactions in a different threat situation. Taken together, the current results suggest that chasing stress can induce long-lasting memory and sensitization of defensive responses to a new aversive event as well as immediate, significant stress responses.

Commentary on “Performance of a Glucose Meter with a Built-In Automated Bolus Calculator versus Manual Bolus Calculation in Insulin-Using Subjects”

PubMed Central

Rossetti, Paolo; Vehí, Josep; Revert, Ana; Calm, Remei; Bondia, Jorge

2012-01-01

Since the early 2000s, there has been an exponentially increasing development of new diabetes-applied technology, such as continuous glucose monitoring, bolus calculators, and “smart” pumps, with the expectation of partially overcoming clinical inertia and low patient compliance. However, its long-term efficacy in glucose control has not been unequivocally proven. In this issue of Journal of Diabetes Science and Technology, Sussman and colleagues evaluated a tool for the calculation of the prandial insulin dose. A total of 205 insulin-treated patients were asked to compute a bolus dose in two simulated conditions either manually or with the bolus calculator built into the FreeStyle InsuLinx meter, revealing the high frequency of wrong calculations when performed manually. Although the clinical impact of this study is limited, it highlights the potential implications of low diabetes-related numeracy in poor glycemic control. Educational programs aiming to increase patients’ empowerment and caregivers’ knowledge are needed in order to get full benefit of the technology. PMID:22538145

75 FR 51849 - Investigations Regarding Certifications of Eligibility To Apply for Worker Adjustment Assistance

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-23

... Kimble Chase Life Science Vineland, NJ 08/04/10 07/14/10 and Research Products, LLC (Company). 74464.../10 74488 Computer Sciences Newark, DE 08/06/10 07/30/10 Corporation (CSC) (State/ One-Stop). 74489...

Chasing a Fault across Ship and Shore

ERIC Educational Resources Information Center

Evans, Michael A.; Schwen, Thomas M.

2006-01-01

Knowledge management (KM) in the U.S. Navy is championed as a strategic initiative to improve shipboard maintenance and troubleshooting at a distance. The approach requires capturing, coordinating, and distributing domain expertise in electronics and computer engineering via advanced information and communication technologies. Coordination must be…

Discriminating movements of liquid and gas in the rabbit colon with impedance manometry.

PubMed

Mohd Rosli, R; Leibbrandt, R E; Wiklendt, L; Costa, M; Wattchow, D A; Spencer, N J; Brookes, S J; Omari, T I; Dinning, P G

2018-05-01

High-resolution impedance manometry is a technique that is well established in esophageal motility studies for relating motor patterns to bolus flow. The use of this technique in the colon has not been established. In isolated segments of rabbit proximal colon, we recorded motor patterns and the movement of liquid or gas boluses with a high-resolution impedance manometry catheter. These detected movements were compared to video recorded changes in gut diameter. Using the characteristic shapes of the admittance (inverse of impedance) and pressure signals associated with gas or liquid flow we developed a computational algorithm for the automated detection of these events. Propagating contractions detected by video were also recorded by manometry and impedance. Neither pressure nor admittance signals alone could distinguish between liquid and gas transit, however the precise relationship between admittance and pressure signals during bolus flow could. Training our computational algorithm upon these characteristic shapes yielded a detection accuracy of 87.7% when compared to gas or liquid bolus events detected by manual analysis. Characterizing the relationship between both admittance and pressure recorded with high-resolution impedance manometry can not only help in detecting luminal transit in real time, but also distinguishes between liquid and gaseous content. This technique holds promise for determining the propulsive nature of human colonic motor patterns. © 2017 John Wiley & Sons Ltd.

Current clinical use of reteplase for thrombolysis. A pharmacokinetic-pharmacodynamic perspective.

PubMed

Martin, U; Kaufmann, B; Neugebauer, G

1999-04-01

Clinical evaluation of a new thrombolytic agent should start with a dose that provides adequate efficacy and has an acceptably low bleeding risk; this results in a narrow therapeutic window at the upper end of the dose-response curve. Angiographic patency of the infarct-related artery is still the clinical surrogate end-point for mortality in phase II dose-ranging studies. There is experimental and clinical evidence that the area under the concentration-time curve (AUC) for plasminogenolytic activity of a thrombolytic agent is positively correlated with patency of the infarct-related artery. Dose-ranging studies of the novel recombinant plasminogen activator reteplase in healthy volunteers enabled computation of a linear regression curve by which a clinical starting dose could be calculated for an adapted target AUC that would be clinically effective. Pharmacokinetic analysis also revealed that the half-life of reteplase is 4 times longer than that of the reference thrombolytic alteplase, thus allowing bolus injection. The suggested single bolus starting dose of 10U was supported by results from studies in a canine model of coronary thrombolysis. The feedback of insufficiently high patency rates compared with the increased efficacy of front-loaded and accelerated alteplase demanded optimisation strategies for reteplase. Animal experiments suggested that a double bolus regimen of reteplase would be preferable to doubling the single bolus dose. Pharmacokinetic modelling suggested a time interval of 30 min between the 2 bolus injections. Selection of the tested double bolus regimens was conservative and empirical. First, the previously tested single bolus of 15U was divided to 10 + 5U; secondly, the second bolus dose was increased to 10U. This strategy proved to be successful. The current dosage recommendation for reteplase is a double bolus intravenous injection of 10 + 10U, each over 2 min, 30 min apart. This produces a reduction in mortality in patients with acute myocardial infarction that is equivalent to that produced by front-loaded and accelerated infusion of alteplase.

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

Sommer, Karsten, E-mail: sommerk@uni-mainz.de, E-mail: Schreiber-L@ukw.de; Bernat, Dominik; Schmidt, Regine

Purpose: The extent to which atherosclerotic plaques affect contrast agent (CA) transport in the coronary arteries and, hence, quantification of myocardial blood flow (MBF) using magnetic resonance imaging (MRI) is unclear. The purpose of this work was to evaluate the influence of plaque induced stenosis both on CA transport and on the accuracy of MBF quantification. Methods: Computational fluid dynamics simulations in a high-detailed realistic vascular model were employed to investigate CA bolus transport in the coronary arteries. The impact of atherosclerosis was analyzed by inserting various medium- to high-grade stenoses in the vascular model. The influence of stenosis morphologymore » was examined by varying the stenosis shapes but keeping the area reduction constant. Errors due to CA bolus transport were analyzed using the tracer-kinetic model MMID4. Results: Dispersion of the CA bolus was found in all models and for all outlets, but with a varying magnitude. The impact of stenosis was complex: while high-grade stenoses amplified dispersion, mild stenoses reduced the effect. Morphology was found to have a marked influence on dispersion for a small number of outlets in the post-stenotic region. Despite this marked influence on the concentration–time curves, MBF errors were less affected by stenosis. In total, MBF was underestimated by −7.9% to −44.9%. Conclusions: The presented results reveal that local hemodynamics in the coronary vasculature appears to have a direct impact on CA bolus dispersion. Inclusion of atherosclerotic plaques resulted in a complex alteration of this effect, with both degree of area reduction and stenosis morphology affecting the amount of dispersion. This strong influence of vascular transport effects impairs the accuracy of MRI-based MBF quantification techniques and, potentially, other bolus-based perfusion measurement techniques like computed tomography perfusion imaging.« less

The illusion of handy wins: Problem gambling, chasing, and affective decision-making.

PubMed

Nigro, Giovanna; Ciccarelli, Maria; Cosenza, Marina

2018-01-01

Chasing losses is a behavioral marker and a diagnostic criterion for gambling disorder. It consists in continuing gambling to recoup previous losses. Although chasing has been recognized playing a central role in gambling disorder, research on this topic is relatively scarce, and it remains unclear whether chasing affects decision-making in behavioral tasks in which participants gain or loss some money. Even if several studies found that the more the gambling involvement, the poorer the decision-making, to date no research investigated the role of chasing in decision-making. The study aimed to first investigate the relation between chasing and decision-making in adult gamblers. One hundred and four VLT players were administered the South Oaks Gambling Screen (SOGS), a computerized task measuring chasing, and the Iowa Gambling Task (IGT). Correlation analysis showed that the higher the SOGS scores, the higher the propensity to chase, and the poorer the decision-making performance. Regression analysis revealed that chasing propensity and gambling severity predicted IGT performance. Mediation analysis indicated that the association between gambling severity and poor decision-making is mediated by chasing. Gambling severity was assessed by means of a self-report measure. The generalizability of findings is limited, since the study focused only on VLT players. This study provides the first evidence that chasing, along with gambling severity, affects decision-making, at least in behavioral tasks involving money. Since chasers and non-chasers could be two different sub-types of gamblers, treatment protocols should take into account the additive role of chasing in gambling disorder. Copyright © 2017 Elsevier B.V. All rights reserved.

Enhancing automatic closed-loop glucose control in type 1 diabetes with an adaptive meal bolus calculator - in silico evaluation under intra-day variability.

PubMed

Herrero, Pau; Bondia, Jorge; Adewuyi, Oloruntoba; Pesl, Peter; El-Sharkawy, Mohamed; Reddy, Monika; Toumazou, Chris; Oliver, Nick; Georgiou, Pantelis

2017-07-01

Current prototypes of closed-loop systems for glucose control in type 1 diabetes mellitus, also referred to as artificial pancreas systems, require a pre-meal insulin bolus to compensate for delays in subcutaneous insulin absorption in order to avoid initial post-prandial hyperglycemia. Computing such a meal bolus is a challenging task due to the high intra-subject variability of insulin requirements. Most closed-loop systems compute this pre-meal insulin dose by a standard bolus calculation, as is commonly found in insulin pumps. However, the performance of these calculators is limited due to a lack of adaptiveness in front of dynamic changes in insulin requirements. Despite some initial attempts to include adaptation within these calculators, challenges remain. In this paper we present a new technique to automatically adapt the meal-priming bolus within an artificial pancreas. The technique consists of using a novel adaptive bolus calculator based on Case-Based Reasoning and Run-To-Run control, within a closed-loop controller. Coordination between the adaptive bolus calculator and the controller was required to achieve the desired performance. For testing purposes, the clinically validated Imperial College Artificial Pancreas controller was employed. The proposed system was evaluated against itself but without bolus adaptation. The UVa-Padova T1DM v3.2 system was used to carry out a three-month in silico study on 11 adult and 11 adolescent virtual subjects taking into account inter-and intra-subject variability of insulin requirements and uncertainty on carbohydrate intake. Overall, the closed-loop controller enhanced by an adaptive bolus calculator improves glycemic control when compared to its non-adaptive counterpart. In particular, the following statistically significant improvements were found (non-adaptive vs. adaptive). Adults: mean glucose 142.2 ± 9.4vs. 131.8 ± 4.2mg/dl; percentage time in target [70, 180]mg/dl, 82.0 ± 7.0vs. 89.5 ± 4.2; percentage time above target 17.7 ± 7.0vs. 10.2 ± 4.1. Adolescents: mean glucose 158.2 ± 21.4vs. 140.5 ± 13.0mg/dl; percentage time in target, 65.9 ± 12.9vs. 77.5 ± 12.2; percentage time above target, 31.7 ± 13.1vs. 19.8 ± 10.2. Note that no increase in percentage time in hypoglycemia was observed. Using an adaptive meal bolus calculator within a closed-loop control system has the potential to improve glycemic control in type 1 diabetes when compared to its non-adaptive counterpart. Copyright © 2017 Elsevier B.V. All rights reserved.

Coffee pulp koji of Aspergillus sojae as stable immobilized catalyst of chlorogenate hydrolase.

PubMed

Adachi, Osao; Ano, Yoshitaka; Akakabe, Yoshihiko; Shinagawa, Emiko; Matsushita, Kazunobu

2008-11-01

Chlorogenate hydrolase (EC 3.1.1.42, CHase) was highly induced in mycelia of Aspergillus sojae AKU 3312 grown in Czapek medium containing either instant coffee powder or coffee pulp as inducer. No CHase formation was observed in the mycelia when cultivated without the inducer. CHase was purified readily from CHase-induced mycelia to high homogeneity, and the purified CHase revealed the molecular weight of 180,000 consisting of two identical subunits of 88 kDa. Equimolar quinate (QA) and caffeate (CA) were confirmed on hydrolysis of chlorogenate (CGA). The purified CHase was only useful for a laboratory scale hydrolysis of CGA. For practical QA and CA production using scaled up hydrolysis of vegetable extracts of natural CGA resources, the enzyme activity of purified CHase decreased and denatured irreversibly. Preparation of coffee pulp koji and its application to QA and CA production were proposed instead of purified CHase. When coffee pulp koji was heated at 60 degrees C for 30 min, CHase survived without any appreciable loss of enzyme activity while vegetative mycelial growth and spore germination were terminated. The heated coffee pulp koji thus prepared was effective itself as stable immobilized catalyst of CHase for QA and CA production from vegetable CGA resources such as coffee powders, coffee pulp, and others.

A Research Program in Computer Technology

DTIC Science & Technology

1975-09-01

Dale M. Chase Neil M. Goldman Jeannette Christen~sen Norton R. Green feld Kathie Cole grove John F. Heafner Nancy Dechter James Koda Oralio E. Garza...Thomas L. Boynton Stephen L. Casner E. Randolph Cole James Koda Robert Parker Paul Raveling Dono Van-Mierop Research Assistant: John K. Kastner

Gambling goals predict chasing behavior during slot machine play.

PubMed

Lister, Jamey J; Nower, Lia; Wohl, Michael J A

2016-11-01

The purpose of this study was to test the effect of gambling goals (i.e., gambling achievement-orientation) on chasing behavior (i.e., decision to chase, chasing spins) over and above known antecedents (e.g., problem gambling severity, winning money motivations, approach/avoidance motivation). Young adult gamblers (N=121) were provided $20 and invited to use those funds on a slot machine situated in an immersive virtual reality casino. Unbeknownst to participants, outcomes were manipulated such that a nominal amount of money was either won or lost (depending on experimental condition) after 30 spins. Before the 31st spin, participants were asked if they wished to continue play. If they agreed, all successive spin outcomes were a loss. This permitted an assessment of what factors influence a player's: (1) decision to chase and (2) the number of chasing spins played in the face of loss. Almost all participants (n=95, 78.5%) screened positive for problem gambling symptoms. The majority of gamblers decided to chase (n=67, 55.4%). In bivariate analyses, higher gambling goal and problem gambling severity scores (but not approach/avoidance nor 'loss/win' condition) were positively related to both forms of chasing. Gamblers 'motivated to win money' were more likely to decide to chase. In multivariate analyses, higher gambling goals best accounted for both forms of chasing independent of known antecedents. This study provides the first evidence that gambling goals can influence chasing. Implications for shaping responsible gambling approaches to be more consistent with motivations for play are discussed. Copyright © 2016 Elsevier Ltd. All rights reserved.

A predictive software tool for optimal timing in contrast enhanced carotid MR angiography

NASA Astrophysics Data System (ADS)

Moghaddam, Abbas N.; Balawi, Tariq; Habibi, Reza; Panknin, Christoph; Laub, Gerhard; Ruehm, Stefan; Finn, J. Paul

2008-03-01

A clear understanding of the first pass dynamics of contrast agents in the vascular system is crucial in synchronizing data acquisition of 3D MR angiography (MRA) with arrival of the contrast bolus in the vessels of interest. We implemented a computational model to simulate contrast dynamics in the vessels using the theory of linear time-invariant systems. The algorithm calculates a patient-specific impulse response for the contrast concentration from time-resolved images following a small test bolus injection. This is performed for a specific region of interest and through deconvolution of the intensity curve using the long division method. Since high spatial resolution 3D MRA is not time-resolved, the method was validated on time-resolved arterial contrast enhancement in Multi Slice CT angiography. For 20 patients, the timing of the contrast enhancement of the main bolus was predicted by our algorithm from the response to the test bolus, and then for each case the predicted time of maximum intensity was compared to the corresponding time in the actual scan which resulted in an acceptable agreement. Furthermore, as a qualitative validation, the algorithm's predictions of the timing of the carotid MRA in 20 patients with high quality MRA were correlated with the actual timing of those studies. We conclude that the above algorithm can be used as a practical clinical tool to eliminate guesswork and to replace empiric formulae by a priori computation of patient-specific timing of data acquisition for MR angiography.

Tornado chasing: an introduction to risk tourism opportunities

Treesearch

Heather Cantillon; Robert S. Bristow

2001-01-01

Tours devoted to tornado storm chasing have become popular in recent years, especially with the emergence of many profit and non-profit storm chasing organizations. While most literature in risk recreation has been directed toward rock climbing or other high-risk outdoor recreation activities, tours devoted to storm chasing are quite unlike these traditional activities...

An application of importance-performance analysis to recreational storm chasing

Treesearch

Jiawen Chen; Sonja Wilhelm Stanis; Carla Barbieri; Shuangyu Xu

2012-01-01

Since the release of the movie "Twister" in 1996, storm chasing has become an increasingly popular form of recreation. Storm chasing tour agencies have emerged to provide technical assistance and guidance to individuals wishing to participate in this activity. However, little is known about the participants' perceptions of their storm chasing tours....

75 FR 31510 - Fox Chase Bancorp, Inc., Hatboro, PA; Approval of Conversion

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-03

... DEPARTMENT OF THE TREASURY Office of Thrift Supervision [AC-43: OTS No. H-4707] Fox Chase Bancorp, Inc., Hatboro, PA; Approval of Conversion Application Notice is hereby given that on May 14, 2010, the Office of Thrift Supervision approved the application of Fox Chase MHC and Fox Chase Bank, Hatboro...

[Observing the density increase curve after intravenous contrast medium administration using a bolus triggering system: a method for detection cardiovascular disorders?].

PubMed

Stückle, C A; Kickuth, R; Kirchner, E M; Liermann, D; Kirchner, J

2002-06-01

Recently bolus tracking systems were developed to improve the timing of intravenous contrast media application in helical computed tomography. We investigated the benefit of this new method as a parameter of the cardiac function. Retrospective analysis of 64 patients which incidentally underwent bolus triggered contrast enhanced helical CT and invasive investigation of the heart within one week. All examinations were performed on the CT scanner Somatom Plus 4 Volume Zoom (Siemens Corp., Forchheim, Germany) using the C.A.R.E. Bolus software. This performs repetitive low-dose test scans (e.g. for the abdomen: 140 kV, 20 mA, Tl 0.5 s) and measures the Hounsfield attenuation (increase over the baseline) in a preselected region of interest. The displayed increase of vascular density over the time after peripheral contrast media injection (75 ml lopromid (300 mg/ml), 2 ml/s) was categorised to three types: (a) rapid increase, (b) deceleration before a 100 HE threshold was reached and (c) one or more peaks. The findings of the invasive investigation of the heart were correlated to the findings of the bolus-tracking measurements. The examinations were categorized as follows: 19 type A, 34 type B, 11 type C. We found a high significant correlation between the type of the Hounsfield attenuation and systolic pressure in the left ventricle. There was no correlation between the type of the Hounsfield attenuation and the diastolic pressure in the left ventricle, the pressures related to the right ventricle or the ejection fraction. The bolus-tacking system showed a sensitivity of 53, a specificity of 82, an accuracy of 70%, a positive predictive value of 70% and a negative predictive value of 70% in detection of left heart failure. The bolus tracking system C.A.R.E.-bolus often shows atypical Hounsfield attenuation in cases of cardiac failure but is not suitable as a screening method of the cardiopulmonary function.

A mathematical model for the movement of food bolus of varying viscosities through the esophagus

NASA Astrophysics Data System (ADS)

Tripathi, Dharmendra

2011-09-01

This mathematical model is designed to study the influence of viscosity on swallowing of food bolus through the esophagus. Food bolus is considered as viscous fluid with variable viscosity. Geometry of esophagus is assumed as finite length channel and flow is induced by peristaltic wave along the length of channel walls. The expressions for axial velocity, transverse velocity, pressure gradient, volume flow rate and stream function are obtained under the assumptions of long wavelength and low Reynolds number. The impacts of viscosity parameter on pressure distribution, local wall shear stress, mechanical efficiency and trapping are numerically discussed with the help of computational results. On the basis of presented study, it is revealed that swallowing of low viscous fluids through esophagus requires less effort in comparison to fluids of higher viscosity. This result is similar to the experimental result obtained by Raut et al. [1], Dodds [2] and Ren et al. [3]. It is further concluded that the pumping efficiency increases while size of trapped bolus reduces when viscosity of fluid is high.

Chunks in expert memory: evidence for the magical number four ... or is it two?

PubMed

Gobet, Fernand; Clarkson, Gary

2004-11-01

This study aims to test the divergent predictions of the chunking theory (Chase & Simon, 1973) and template theory (Gobet & Simon, 1996a, 2000) with respect to the number of chunks held in visual short-term memory and the size of chunks used by experts. We presented game and random chessboards in both a copy and a recall task. In a within-subject design, the stimuli were displayed using two presentation media: (a) physical board and pieces, as in Chase and Simon's (1973) study; and (b) a computer display, as in Gobet and Simon's (1998) study. Results show that, in most cases, no more than three chunks were replaced in the recall task, as predicted by template theory. In addition, with game positions in the computer condition, chess Masters replaced very large chunks (up to 15 pieces), again in line with template theory. Overall, the results suggest that the original chunking theory overestimated short-term memory capacity and underestimated the size of chunks used, in particular with Masters. They also suggest that Cowan's (2001) proposal that STM holds four chunks may be an overestimate.

[Characteristics of autonomic status in employees working with computers].

PubMed

Vlasova, E M; Zaĭtseva, N V; Maliutina, N N

2011-01-01

Human evolution is accompanied by "sensible thoughts" spread to all spheres of occupational activities. One can hardly find an industrial enterprise without computers. In contemporary industry, health care in conditions of humans and computers interaction and evaluation of harm in computer users remain topical. Social and occupational environment is not always comfortable for human body. Changes is occupational conditions, with wide use of computer technologies, decrease role of manual labour and increase role of intellectual work from the one hand, but from the other hand, chasing economic profit alters individual "comfort zone" due to constant psychoemotional stress and causes "burnout". Being healthy in constant stress is impossible.

Simulation studies of circular muscle contraction, longitudinal muscle shortening, and their coordination in esophageal transport.

PubMed

Kou, Wenjun; Pandolfino, John E; Kahrilas, Peter J; Patankar, Neelesh A

2015-08-15

On the basis of a fully coupled active musculomechanical model for esophageal transport, we aimed to find the roles of circular muscle (CM) contraction and longitudinal muscle (LM) shortening in esophageal transport, and the influence of their coordination. Two groups of studies were conducted using a computational model. In the first group, bolus transport with only CM contraction, only LM shortening, or both was simulated. Overall features and detailed information on pressure and the cross-sectional area (CSA) of mucosal and the two muscle layers were analyzed. In the second group, bolus transport with varying delay in CM contraction or LM shortening was simulated. The effect of delay on esophageal transport was studied. For cases showing abnormal transport, pressure and CSA were further analyzed. CM contraction by itself was sufficient to transport bolus, but LM shortening by itself was not. CM contraction decreased the CSA and the radius of the muscle layer locally, but LM shortening increased the CSA. Synchronized CM contraction and LM shortening led to overlapping of muscle CSA and pressure peaks. Advancing LM shortening adversely influenced bolus transport, whereas lagging LM shortening was irrelevant to bolus transport. In conclusion, CM contraction generates high squeezing pressure, which plays a primary role in esophageal transport. LM shortening increases muscle CSA, which helps to strengthen CM contraction. Advancing LM shortening decreases esophageal distensibility in the bolus region. Lagging LM shortening no longer helps esophageal transport. Synchronized CM contraction and LM shortening seems to be most effective for esophageal transport. Copyright © 2015 the American Physiological Society.

Child and adolescent service experience (ChASE): measuring service quality and therapeutic process.

PubMed

Day, Crispin; Michelson, Daniel; Hassan, Imren

2011-11-01

OBJECTIVES. Dissatisfaction with services has been associated with poorer child mental health outcomes, early treatment termination as well as disagreements over the nature of mental health difficulties, reasons for referral and therapy goals. The development of straightforward, reliable, and accurate methods of eliciting service users' views is essential within child and adolescent mental health care. This paper describes the development of the child and adolescent service experience (ChASE), a tool to measure children and young people's service experience DESIGN. The study comprises a non-experimental, cross-sectional design. METHODS. Participants were 132 mental health service users aged 8-18 years. Participants and their main carer completed the ChASE, Parent Satisfaction Questionnaire (PSQ) (Stallard, 1996) and Strengths and Difficulties (SDQ) Impact Supplement. Clinicians completed the SDQ Impact Supplement and provided clinical activity data. A sub-sample of participants completed the ChASE on a second occasion, 6 weeks after the completion of the first questionnaire. RESULTS. Scrutiny of ChASE data indicated high levels of completion. Principal axis factoring identified three factors within the ChASE: Relationship, Privacy, and Session Activity. The ChASE has good internal consistency and test-retest reliability. Significant correlations were found between the ChASE and carer satisfaction, service use, and youth clinical outcomes. CONCLUSIONS. The ChASE is a short, psychometrically robust tool for routine measurement of children, and young people's experience of mental health services, which users can complete easily. The results underline the importance of alliance factors to children and young people and their association with clinical improvement as well as the potential for the ChASE to be used a measure of children's therapeutic progress and alliance. ©2011 The British Psychological Society.

Alterations in functional brain networks associated with loss-chasing in gambling disorder and cocaine-use disorder.

PubMed

Worhunsky, Patrick D; Potenza, Marc N; Rogers, Robert D

2017-09-01

Continued, persistent gambling to recover accumulating losses, or 'loss-chasing', is a behavioral pattern linked particularly closely to gambling disorder (GD) but may reflect impaired decision-making processes relevant to drug addictions like cocaine-use disorder (CUD). However, little is known regarding the neurocognitive mechanisms of this complex, maladaptive behavior, particularly in individuals with addictive disorders. Seventy participants (25 GD, 18 CUD, and 27 healthy comparison (HC)) completed a loss-chase task during fMRI. Engagement of functional brain networks in response to losing outcomes and during decision-making periods preceding choices to loss-chase or to quit chasing losses were investigated using independent component analysis (ICA). An exploratory factor analysis was performed to examine patterns of coordinated engagement across identified networks. In GD relative to HC and CUD participants, choices to quit chasing were associated with greater engagement of a medial frontal executive-processing network. By comparison, CUD participants exhibited altered engagement of a striato-amygdala motivational network in response to losing outcomes as compared to HC, and during decision-making as compared to GD. Several other networks were differentially engaged during loss-chase relative to quit-chasing choices, but did not differ across participant groups. Exploratory factor analysis identified a system of coordinated activity across prefrontal executive-control networks that was greater in GD and CUD relative to HC participants and was associated with increased chasing persistence across all participants. Results provide evidence of shared and distinct neurobiological mechanisms in substance and behavioral addictions, and lend insight into potential cognitive interventions targeting loss-chasing behavior in GD. Copyright © 2017 Elsevier B.V. All rights reserved.

[Multispiral computed tomographic semiotics of laryngeal cancer].

PubMed

Vasil'ev, P V; Iudin, A L; Sdvizhkov, A M; Kozhanov, L G

2007-01-01

Multispiral computed tomography (MSCT) with intravenous bolus contrasting is a currently available method for radiodiagnosis of laryngeal cancer. MSCT is of much higher informative value in estimating the extent of a tumorous lesion than the traditional radiodiagnostic techniques: linear tomography, lateral X-ray study, roentgenoscopy and roentgenography of the laryngopharynx and esophagus with barium meal.

Alexithymia predicts loss chasing for people at risk for problem gambling.

PubMed

Bibby, Peter A; Ross, Katherine E

2017-12-01

Background and aims The aim of this research was to investigate the relationship between alexithymia and loss-chasing behavior in people at risk and not at risk for problem gambling. Methods An opportunity sample of 58 (50 males and 8 females) participants completed the Problem Gambling Severity Index and the Toronto Alexithymia Scale (TAS-20). They then completed the Cambridge Gambling Task from which a measure of loss-chasing behavior was derived. Results Alexithymia and problem gambling risk were significantly positively correlated. Subgroups of non-alexithymic and at or near caseness for alexithymia by low risk and at risk for problem gambling were identified. The results show a clear difference for loss-chasing behavior for the two alexithymia conditions, but there was no evidence that low and at-risk problem gamblers were more likely to loss chase. The emotion-processing components of the TAS-20 were shown to correlate with loss chasing. Discussion and conclusion These findings suggest that loss-chasing behavior may be particularly prevalent in a subgroup of problem gamblers those who are high in alexithymia.

Computational and Experimental Evaluation of a Complex Inlet Swirl Pattern Generation System (POSTPRINT)

DTIC Science & Technology

2016-08-01

Sanders, Chase A. Nessler, William W. Copenhaver, Michael G. List, and Timothy J. Janczewski Turbomachinery Branch Turbine Engine Division AUGUST...Branch Turbine Engine Division Turbine Engine Division Aerospace Systems Directorate //Signature// ROBERT D. HANCOCK Principal Scientist Turbine ...ORGANIZATION Turbomachinery Branch Turbine Engine Division Air Force Research Laboratory, Aerospace Systems Directorate Wright-Patterson Air Force

Open-loop glucose control: Automatic IOB-based super-bolus feature for commercial insulin pumps.

PubMed

Rosales, Nicolás; De Battista, Hernán; Vehí, Josep; Garelli, Fabricio

2018-06-01

Although there has been significant progress towards closed-loop type 1 diabetes mellitus (T1DM) treatments, most diabetic patients still treat this metabolic disorder in an open-loop manner, based on insulin pump therapy (basal and bolus insulin infusion). This paper presents a method for automatic insulin bolus shaping based on insulin-on-board (IOB) as an alternative to conventional bolus dosing. The methodology presented allows the pump to generate the so-called super-bolus (SB) employing a two-compartment IOB dynamic model. The extra amount of insulin to boost the bolus and the basal cutoff time are computed using the duration of insulin action (DIA). In this way, the pump automatically re-establishes basal insulin when IOB reaches its basal level. Thus, detrimental transients caused by manual or a-priori computations are avoided. The potential of this method is illustrated via in-silico trials over a 30 patients cohort in single meal and single day scenarios. In the first ones, improvements were found (standard treatment vs. automatic SB) both in percentage time in euglycemia (75g meal: 81.9 ± 15.59 vs. 89.51 ± 11.95, ρ ≃ 0; 100g meal: 75.12 ± 18.23 vs. 85.46 ± 14.96, ρ ≃ 0) and time in hypoglecymia (75g meal: 5.92 ± 14.48 vs. 0.97 ± 4.15, ρ=0.008; 100g meal: 9.5 ± 17.02 vs. 1.85 ± 7.05, ρ=0.014). In a single day scenario, considering intra-patient variability, the time in hypoglycemia was reduced (9.57 ± 14.48 vs. 4.21 ± 6.18, ρ=0.028) and improved the time in euglycemia (79.46 ± 17.46 vs. 86.29 ± 11.73, ρ=0.007). The automatic IOB-based SB has the potential of a better performance in comparison with the standard treatment, particularly for high glycemic index meals with high carbohydrate content. Both glucose excursion and time spent in hypoglycemia were reduced. Copyright © 2018 Elsevier B.V. All rights reserved.

Correlates of frequent gambling and gambling-related chasing behaviors in individuals with schizophrenia-spectrum disorders.

PubMed

Yakovenko, Igor; Fortgang, Rebecca; Prentice, Jennifer; Hoff, Rani A; Potenza, Marc N

2018-05-23

Background and aims Published research on the relationship between disordered gambling and schizophrenia is limited. However, existing data suggest that individuals with schizophrenia/schizoaffective disorder may have a high prevalence of co-occurring disordered gambling. As such, effective strategies for screening and assessing gambling-related problems in individuals with psychosis are needed. The goal of this study was to explore the correlates of increased gambling frequency and chasing behavior, a hallmark feature of gambling disorder, in a sample of individuals with schizophrenia and schizoaffective disorders. Methods Data from 336 participants who met DSM-IV criteria for schizophrenia or schizoaffective disorder were used to examine differences between non-gamblers, infrequent gamblers, frequent gamblers who do not report chasing, and frequent gamblers who report chasing on a variety of associated features and symptoms of schizophrenia and disordered gambling. Results and discussion The results of the study support the conclusion that chasing behavior in individuals with schizophrenia/schizoaffective disorder lies on a continuum of severity, with more frequent gamblers endorsing greater chasing. Chasing was also associated with indicators of lower functioning across co-occurring disorders, such as greater problems with alcohol and drugs, greater gambling involvement, and a family history of gambling problems. The findings from the study suggest the utility of screening for chasing behavior as a brief and efficient strategy for assessing risk of gambling problems in individuals with psychotic-spectrum disorders.

Optimization of coronary attenuation in coronary computed tomography angiography using diluted contrast material.

PubMed

Kawaguchi, Naoto; Kurata, Akira; Kido, Teruhito; Nishiyama, Yoshiko; Kido, Tomoyuki; Miyagawa, Masao; Ogimoto, Akiyoshi; Mochizuki, Teruhito

2014-01-01

The purpose of this study was to evaluate a personalized protocol with diluted contrast material (CM) for coronary computed tomography angiography (CTA). One hundred patients with suspected coronary artery disease underwent retrospective electrocardiogram-gated coronary CTA on a 256-slice multidetector-row CT scanner. In the diluted CM protocol (n=50), the optimal scan timing and CM dilution rate were determined by the timing bolus scan, with 20% CM dilution (5ml/s during 10s) being considered suitable to achieve the target arterial attenuation of 350 Hounsfield units (HU). In the body weight (BW)-adjusted protocol (n=50, 222mg iodine/kg), only the optimal scan timing was determined by the timing bolus scan. The injection rate and volume in the timing bolus scan and real scan were identical between the 2 protocols. We compared the means and variations in coronary attenuation between the 2 protocols. Coronary attenuation (mean±SD) in the diluted CM and BW-adjusted protocols was 346.1±23.9 HU and 298.8±45.2 HU, respectively. The diluted CM protocol provided significantly higher coronary attenuation and lower variance than did the BW-adjusted protocol (P<0.05, in each). The diluted CM protocol facilitates more uniform attenuation on coronary CTA in comparison with the BW-adjusted protocol.  

Systemic administration of 8-OH-DPAT and eticlopride, but not SCH23390, alters loss-chasing behavior in the rat.

PubMed

Rogers, Robert D; Wong, Adeline; McKinnon, Chris; Winstanley, Catharine A

2013-05-01

Gambling to recover losses is a common gaming behavior. In a clinical context, however, this phenomenon mediates the relationship between diminished control over gambling and the adverse socioeconomic consequences of gambling problems. Modeling loss-chasing through analogous behaviors in rats could facilitate its pharmacological investigation as a potential therapeutic target. Here, rats were trained to make operant responses that produced both food rewards, and unpredictably, imminent time-out periods in which rewards would be unavailable. At these decision points, rats were offered choices between waiting for these time-out periods to elapse before resuming responding for rewards ('quit' responses), or selecting risky options with a 0.5 probability of avoiding the time-outs altogether and a 0.5 probability of time-out periods twice as long as signaled originally ('chase' responses). Chasing behavior, and the latencies to chase or quit, during sequences of unfavorable outcomes were tested following systemic administration of the 5-HT1A receptor agonist, 8-OH-DPAT, the D2 receptor antagonist, eticlopride, and the D1 receptor antagonist, SCH23390. 8-OH-DPAT and eticlopride significantly reduced the proportion of chase responses, and the mean number of consecutive chase responses, in a dose-dependent manner. 8-OH-DPAT also increased latencies to chase. Increasing doses of eticlopride first speeded, then slowed, latencies to quit while SCH23390 had no significant effects on any measure. Research is needed to identify the precise cognitive mechanisms mediating these kinds of risky choices in rats. However, our data provide the first experimental demonstration that 5-HT1A and D2, but not D1, receptor activity influence a behavioral analog of loss-chasing in rats.

Systemic Administration of 8-OH-DPAT and Eticlopride, but not SCH23390, Alters Loss-Chasing Behavior in the Rat

PubMed Central

Rogers, Robert D; Wong, Adeline; McKinnon, Chris; Winstanley, Catharine A

2013-01-01

Gambling to recover losses is a common gaming behavior. In a clinical context, however, this phenomenon mediates the relationship between diminished control over gambling and the adverse socioeconomic consequences of gambling problems. Modeling loss-chasing through analogous behaviors in rats could facilitate its pharmacological investigation as a potential therapeutic target. Here, rats were trained to make operant responses that produced both food rewards, and unpredictably, imminent time-out periods in which rewards would be unavailable. At these decision points, rats were offered choices between waiting for these time-out periods to elapse before resuming responding for rewards (‘quit' responses), or selecting risky options with a 0.5 probability of avoiding the time-outs altogether and a 0.5 probability of time-out periods twice as long as signaled originally (‘chase' responses). Chasing behavior, and the latencies to chase or quit, during sequences of unfavorable outcomes were tested following systemic administration of the 5-HT1A receptor agonist, 8-OH-DPAT, the D2 receptor antagonist, eticlopride, and the D1 receptor antagonist, SCH23390. 8-OH-DPAT and eticlopride significantly reduced the proportion of chase responses, and the mean number of consecutive chase responses, in a dose-dependent manner. 8-OH-DPAT also increased latencies to chase. Increasing doses of eticlopride first speeded, then slowed, latencies to quit while SCH23390 had no significant effects on any measure. Research is needed to identify the precise cognitive mechanisms mediating these kinds of risky choices in rats. However, our data provide the first experimental demonstration that 5-HT1A and D2, but not D1, receptor activity influence a behavioral analog of loss-chasing in rats. PMID:23303072

Aerosol bolus dispersion in acinar airways—influence of gravity and airway asymmetry

PubMed Central

Ma, Baoshun

2012-01-01

The aerosol bolus technique can be used to estimate the degree of convective mixing in the lung; however, contributions of different lung compartments to measured dispersion cannot be differentiated unambiguously. To estimate dispersion in the distal lung, we studied the effect of gravity and airway asymmetry on the dispersion of 1 μm-diameter particle boluses in three-dimensional computational models of the lung periphery, ranging from a single alveolar sac to four-generation (g4) structures of bifurcating airways that deformed homogeneously during breathing. Boluses were introduced at the beginning of a 2-s inhalation, immediately followed by a 3-s exhalation. Dispersion was estimated by the half-width of the exhaled bolus. Dispersion was significantly affected by the spatial orientation of the models in normal gravity and was less in zero gravity than in normal gravity. Dispersion was strongly correlated with model volume in both normal and zero gravity. Predicted pulmonary dispersion based on a symmetric g4 acinar model was 391 ml and 238 ml under normal and zero gravity, respectively. These results accounted for a significant amount of dispersion measured experimentally. In zero gravity, predicted dispersion in a highly asymmetric model accounted for ∼20% of that obtained in a symmetric model with comparable volume and number of alveolated branches, whereas normal gravity dispersions were comparable in both models. These results suggest that gravitational sedimentation and not geometrical asymmetry is the dominant factor in aerosol dispersion in the lung periphery. PMID:22678957

Aerosol bolus dispersion in acinar airways--influence of gravity and airway asymmetry.

PubMed

Ma, Baoshun; Darquenne, Chantal

2012-08-01

The aerosol bolus technique can be used to estimate the degree of convective mixing in the lung; however, contributions of different lung compartments to measured dispersion cannot be differentiated unambiguously. To estimate dispersion in the distal lung, we studied the effect of gravity and airway asymmetry on the dispersion of 1 μm-diameter particle boluses in three-dimensional computational models of the lung periphery, ranging from a single alveolar sac to four-generation (g4) structures of bifurcating airways that deformed homogeneously during breathing. Boluses were introduced at the beginning of a 2-s inhalation, immediately followed by a 3-s exhalation. Dispersion was estimated by the half-width of the exhaled bolus. Dispersion was significantly affected by the spatial orientation of the models in normal gravity and was less in zero gravity than in normal gravity. Dispersion was strongly correlated with model volume in both normal and zero gravity. Predicted pulmonary dispersion based on a symmetric g4 acinar model was 391 ml and 238 ml under normal and zero gravity, respectively. These results accounted for a significant amount of dispersion measured experimentally. In zero gravity, predicted dispersion in a highly asymmetric model accounted for ∼20% of that obtained in a symmetric model with comparable volume and number of alveolated branches, whereas normal gravity dispersions were comparable in both models. These results suggest that gravitational sedimentation and not geometrical asymmetry is the dominant factor in aerosol dispersion in the lung periphery.

Lidocaine bolus may facilitate computed tomographic coronary angiography in patients with frequent premature ventricular contractions

PubMed Central

Jastrzębski, Jan; Kępka, Cezary; Kruk, Mariusz; Demkow, Marcin; Kalińczuk, Łukasz; Wolny, Rafał; Ciszewski, Michał; Michałowska, Ilona; Witkowski, Adam

2013-01-01

Introduction Heart rate irregularities are the major limitations of computed tomographic coronary angiography (CTCA) due to severe motion artifacts. Aim To evaluate the safety and efficacy of a lidocaine intravenous bolus in preserving good image quality by the transient suppression of premature ventricular contractions (PVC) during the CTCA scan. Material and methods The study group comprised 67 consecutive patients with sinus rhythm and numerous PVC scheduled for CTCA. Intravenous boluses of 25–50 mg lidocaine were given after calcium score assessment and immediately before CTCA. The control group comprised 67 patients with sinus rhythm without PVC matched according to the body mass index (BMI), age, sex, and calcium score. All coronary vessel segments were assessed for image quality and presence of significant stenosis. Results As compared with calcium score assessment, after administration of lidocaine and during the CTCA scan PVC were completely suppressed in 22 (40%), reduced in 10 (18%), unchanged in 18 (32%), and intensified in 5 (10%) patients. Overall, there were 32 (58%) patients with sinus rhythm during CTCA as compared with only 11 (20%) patients free from PVC during calcium score assessment (p < 0.001). Image quality in 871 coronary segments including both the study group and control patients was worse in patients with PVC (p < 0.0001). However, there was no statistically significant difference in the number of patients with at least one segment of non-diagnostic quality (6% vs. 12%, p = 0.36; respectively). Conclusions Single lidocaine bolus given prior to CTCA is safe, may temporarily eliminate or reduce the intensity of arrhythmia, and hence results in improved quality of CTCA in patients with numerous PVC. PMID:24570719

Predator pursuit strategies: how do falcons and hawks chase prey?

NASA Astrophysics Data System (ADS)

Kane, Suzanne Amador; Zamani, Marjon; Fulton, Andrew; Rosenthal, Lee

2014-03-01

This study reports on experiments on falcons, goshawks and red-tailed hawks wearing miniature videocameras mounted on their backs or heads while pursuing flying or ground-based prey. Videos of hunts recorded by the raptors were analyzed to determine apparent prey positions on their visual fields during pursuits. These video data then were interpreted using computer simulations of pursuit steering laws observed in insects and mammals. A comparison of the empirical and modeling data indicates that falcons use cues due to the apparent motion of prey on the falcon's visual field to track and capture flying prey via a form of motion camouflage. The falcons also were found to maintain their prey's image at visual angles consistent with using their shallow fovea. Results for goshawks and red-tailed hawks were analyzed for a comparative study of how pursuits of ground-based prey by accipeters and buteos differ from those used by falcons chasing flying prey. These results should prove relevant for understanding the coevolution of pursuit and evasion, as well as the development of computer models of predation on flocks,and the integration of sensory and locomotion systems in biomimetic robots.

What are the underlying units of perceived animacy? Chasing detection is intrinsically object-based.

PubMed

van Buren, Benjamin; Gao, Tao; Scholl, Brian J

2017-10-01

One of the most foundational questions that can be asked about any visual process is the nature of the underlying 'units' over which it operates (e.g., features, objects, or spatial regions). Here we address this question-for the first time, to our knowledge-in the context of the perception of animacy. Even simple geometric shapes appear animate when they move in certain ways. Do such percepts arise whenever any visual feature moves appropriately, or do they require that the relevant features first be individuated as discrete objects? Observers viewed displays in which one disc (the "wolf") chased another (the "sheep") among several moving distractor discs. Critically, two pairs of discs were also connected by visible lines. In the Unconnected condition, both lines connected pairs of distractors; but in the Connected condition, one connected the wolf to a distractor, and the other connected the sheep to a different distractor. Observers in the Connected condition were much less likely to describe such displays using mental state terms. Furthermore, signal detection analyses were used to explore the objective ability to discriminate chasing displays from inanimate control displays in which the wolf moved toward the sheep's mirror-image. Chasing detection was severely impaired on Connected trials: observers could readily detect an object chasing another object, but not a line-end chasing another line-end, a line-end chasing an object, or an object chasing a line-end. We conclude that the underlying units of perceived animacy are discrete visual objects.

Chasing losses in online poker and casino games: characteristics and game play of Internet gamblers at risk of disordered gambling.

PubMed

Gainsbury, Sally M; Suhonen, Niko; Saastamoinen, Jani

2014-07-30

Disordered Internet gambling is a psychological disorder that represents an important public health issue due to the increase in highly available and conveniently accessible Internet gambling sites. Chasing losses is one of the few observable markers of at-risk and problem gambling that may be used to detect early signs of disordered Internet gambling. This study examined loss chasing behaviour in a sample of Internet casino and poker players and the socio-demographic variables, irrational beliefs, and gambling behaviours associated with chasing losses. An online survey was completed by 10,838 Internet gamblers (58% male) from 96 countries. The results showed that Internet casino players had a greater tendency to report chasing losses than poker players and gamblers who reported chasing losses were more likely to hold irrational beliefs about gambling and spend more time and money gambling than those who reported that they were unaffected by previous losses. Gamblers who played for excitement and to win money were more likely to report chasing losses. This study is one of the largest ever studies of Internet gamblers and the results are highly significant as they provide insight into the characteristics and behaviours of gamblers using this mode of access. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Efficacy of patient-specific bolus created using three-dimensional printing technique in photon radiotherapy.

PubMed

Fujimoto, Koya; Shiinoki, Takehiro; Yuasa, Yuki; Hanazawa, Hideki; Shibuya, Keiko

2017-06-01

A commercially available bolus ("commercial-bolus") does not make complete contact with the irregularly shaped patient skin. This study aims to customise a patient-specific three-dimensional (3D) bolus using a 3D printing technique ("3D-bolus") and to evaluate its clinical feasibility for photon radiotherapy. The 3D-bolus was designed using a treatment planning system (TPS) in Digital Imaging and Communications in Medicine-Radiotherapy (DICOM-RT) format, and converted to stereolithographic format for printing. To evaluate its physical characteristics, treatment plans were created for water-equivalent phantoms that were bolus-free, or had a flat-form printed 3D-bolus, a TPS-designed bolus ("virtual-bolus"), or a commercial-bolus. These plans were compared based on the percentage depth dose (PDD) and target-volume dose volume histogram (DVH) measurements. To evaluate the clinical feasibility, treatment plans were created for head phantoms that were bolus-free or had a 3D-bolus, a virtual-bolus, or a commercial-bolus. These plans were compared based on the target volume DVH. In the physical evaluation, the 3D-bolus provided effective dose coverage in the build-up region, which was equivalent to the commercial-bolus. With regard to the clinical feasibility, the air gaps were lesser with the 3D-bolus when compared to the commercial-bolus. Furthermore, the prescription dose could be delivered appropriately to the target volume. The 3D-bolus has potential use for air-gap reduction compared to the commercial-bolus and facilitates target-volume dose coverage and homogeneity improvement. A 3D-bolus produced using a 3D printing technique is comparable to a commercial-bolus applied to an irregular-shaped skin surface. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

Contrast-enhanced peripheral MRA: technique and contrast agents.

PubMed

Nielsen, Yousef W; Thomsen, Henrik S

2012-09-01

In the last decade contrast-enhanced magnetic resonance angiography (CE-MRA) has gained wide acceptance as a valuable tool in the diagnostic work-up of patients with peripheral arterial disease. This review presents current concepts in peripheral CE-MRA with emphasis on MRI technique and contrast agents. Peripheral CE-MRA is defined as an MR angiogram of the arteries from the aortic bifurcation to the feet. Advantages of CE-MRA include minimal invasiveness and lack of ionizing radiation. The basic technique employed for peripheral CE-MRA is the bolus-chase method. With this method a paramagnetic MRI contrast agent is injected intravenously and T1-weighted images are acquired in the subsequent arterial first-pass phase. In order to achieve high quality MR angiograms without interfering venous contamination or artifacts, a number of factors need to be taken into account. This includes magnetic field strength of the MRI system, receiver coil configuration, use of parallel imaging, contrast bolus timing technique, and k-space filling strategies. Furthermore, it is possible to optimize peripheral CE-MRA using venous compression techniques, hybrid scan protocols, time-resolved imaging, and steady-state MRA. Gadolinium(Gd)-based contrast agents are used for CE-MRA of the peripheral arteries. Extracellular Gd agents have a pharmacokinetic profile similar to iodinated contrast media. Accordingly, these agents are employed for first-pass MRA. Blood-pool Gd-based agents are characterized by prolonged intravascular stay, due to macromolecular structure or protein binding. These agents can be used for first-pass, as well as steady-state MRA. Some Gd-based contrast agents with low thermodynamic stability have been linked to development of nephrogenic systemic fibrosis in patients with severe renal insufficiency. Using optimized technique and a stable MRI contrast agent, peripheral CE-MRA is a safe procedure with diagnostic accuracy close to that of conventional catheter X-ray angiography.

A minimal model of predator–swarm interactions

PubMed Central

Chen, Yuxin; Kolokolnikov, Theodore

2014-01-01

We propose a minimal model of predator–swarm interactions which captures many of the essential dynamics observed in nature. Different outcomes are observed depending on the predator strength. For a ‘weak’ predator, the swarm is able to escape the predator completely. As the strength is increased, the predator is able to catch up with the swarm as a whole, but the individual prey is able to escape by ‘confusing’ the predator: the prey forms a ring with the predator at the centre. For higher predator strength, complex chasing dynamics are observed which can become chaotic. For even higher strength, the predator is able to successfully capture the prey. Our model is simple enough to be amenable to a full mathematical analysis, which is used to predict the shape of the swarm as well as the resulting predator–prey dynamics as a function of model parameters. We show that, as the predator strength is increased, there is a transition (owing to a Hopf bifurcation) from confusion state to chasing dynamics, and we compute the threshold analytically. Our analysis indicates that the swarming behaviour is not helpful in avoiding the predator, suggesting that there are other reasons why the species may swarm. The complex shape of the swarm in our model during the chasing dynamics is similar to the shape of a flock of sheep avoiding a shepherd. PMID:24598204

A minimal model of predator-swarm interactions.

PubMed

Chen, Yuxin; Kolokolnikov, Theodore

2014-05-06

We propose a minimal model of predator-swarm interactions which captures many of the essential dynamics observed in nature. Different outcomes are observed depending on the predator strength. For a 'weak' predator, the swarm is able to escape the predator completely. As the strength is increased, the predator is able to catch up with the swarm as a whole, but the individual prey is able to escape by 'confusing' the predator: the prey forms a ring with the predator at the centre. For higher predator strength, complex chasing dynamics are observed which can become chaotic. For even higher strength, the predator is able to successfully capture the prey. Our model is simple enough to be amenable to a full mathematical analysis, which is used to predict the shape of the swarm as well as the resulting predator-prey dynamics as a function of model parameters. We show that, as the predator strength is increased, there is a transition (owing to a Hopf bifurcation) from confusion state to chasing dynamics, and we compute the threshold analytically. Our analysis indicates that the swarming behaviour is not helpful in avoiding the predator, suggesting that there are other reasons why the species may swarm. The complex shape of the swarm in our model during the chasing dynamics is similar to the shape of a flock of sheep avoiding a shepherd.

Development of a bolus injection system for regional deposition studies of nanoparticles in the human respiratory system

NASA Astrophysics Data System (ADS)

Koujalagi, V.; Ramesh, S. L.; Gunarathne, G. P. P.; Semple, S.; Ayres, J. G.

2009-02-01

This study presents the work carried out in developing a precision bolus injection system in order to understand the regional deposition of nanoparticles (NP) in human lung. A real-time control system has been developed that is capable of storing graphite NP, assessing human breathing pattern and delivering a bolus of the stored NP at a pre-determined instance of the inhalation phase of breathing. This will form the basis for further development of a system to deliver radioactive nanoparticles to enable 3-dimensional lung imaging using techniques such as positron emission tomography (PET). The system may then be used to better understand the actual regional deposition in human lung, which could validate or challenge the current computational lung models such as that published by the International Commission for Radiation Protection (ICRP-1994). A dose related response to inhaled PM can possibly be shown, which can be used to review the current workplace exposure limits (WELs).

Paper Chase and the Socratic Method of Teaching Law.

ERIC Educational Resources Information Center

Dillon, J. T.

1980-01-01

It is argued that the Socratic method of teaching law as depicted in the book, movie, and TV series "Paper Chase" is not really the Socratic method at all. The genuine Socratic method and the questioning technique used in "Paper Chase" are examined and their appropriateness and effectiveness as methods for teaching contract law…

Thermal Characteristics of ThermoBrachytherapy Surface Applicators (TBSA) for Treating Chestwall Recurrence

PubMed Central

Arunachalam, K.; Maccarini, P. F.; Craciunescu, O. I.; Schlorff, J. L.; Stauffer, P. R.

2010-01-01

Purpose To study temperature and thermal dose distributions of ThermoBrachytherapy Surface Applicators (TBSA) developed for concurrent or sequential high dose rate (HDR) brachytherapy and microwave hyperthermia treatment of chest wall recurrence and other superficial disease. Methods A steady state thermodynamics model coupled with the fluid dynamics of water bolus and electromagnetic radiation of hyperthermia applicator is used to characterize the temperature distributions achievable with TBSA applicators in an elliptical phantom model of the human torso. Power deposited by 915 MHz conformal microwave array (CMA) applicators is used to assess the specific absorption rate (SAR) distributions of rectangular (500 cm2) and L-shaped (875 cm2) TBSA. The SAR distribution in tissue and fluid flow distribution inside the Dual-Input Dual-Output (DIDO) water bolus are coupled to solve the steady state temperature and thermal dose distributions of rectangular TBSA (R-TBSA) for superficial tumor targets extending 10–15 mm beneath the skin surface. Thermal simulations are carried out for a range of bolus inlet temperature (Tb=38–43°C), water flow rate (Qb=2–4 L/min) and tumor blood perfusion (ωb=2–5 kg/m3/s) to characterize their influence on thermal dosimetry. Results Steady state SAR patterns of R- and L-TBSA demonstrate the ability to produce conformal and localized power deposition inside tumor target sparing surrounding normal tissues and nearby critical organs. Acceptably low variation in tissue surface cooling and surface temperature homogeneity was observed for the new DIDO bolus at 2 L/min water flow rate. Temperature depth profiles and thermal dose volume histograms indicate bolus inlet temperature (Tb) to be the most influential factor on thermal dosimetry. A 42 °C water bolus was observed to be the optimal choice for superficial tumors extending 10–15 mm from the surface even under significant blood perfusion. Lower bolus temperature may be chosen to reduce thermal enhancement ratio (TER) in the most sensitive skin where maximum radiation dose is delivered and to extend thermal enhancement of radiation dose deeper. Conclusion This computational study indicates that well-localized elevation of tumor target temperature to 40–44 °C can be accomplished by large surface-conforming TBSA applicators using appropriate selection of coupling bolus temperature. PMID:20224154

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

Zhao, Yizhou, E-mail: yizhou.zhao@dal.ca; Moran, Kathryn; Yewondwossen, Mammo

Three-dimensional (3D) printing is suitable for the fabrication of complex radiotherapy bolus. Although investigated from dosimetric and feasibility standpoints, there are few reports to date of its use for actual patient treatment. This study illustrates the versatile applications of 3D printing in clinical radiation oncology through a selection of patient cases, namely, to create bolus for photon and modulated electron radiotherapy (MERT), as well as applicators for surface high-dose rate (HDR) brachytherapy. Photon boluses were 3D-printed to treat a recurrent squamous cell carcinoma (SCC) of the nasal septum and a basal cell carcinoma (BCC) of the posterior pinna. For amore » patient with a mycosis fungoides involving the upper face, a 3D-printed MERT bolus was used. To treat an SCC of the nose, a 3D-printed applicator for surface brachytherapy was made. The structures' fit to the anatomy and the radiotherapy treatment plans were assessed. Based on the treatment planning computed tomography (CT), the size of the largest air gap at the interface of the 3D-printed structure was 3 mm for the SCC of the nasal septum, 3 mm for the BCC of the pinna, 2 mm for the mycosis fungoides of the face, and 2 mm for the SCC of the nose. Acceptable treatment plans were obtained for the SCC of the nasal septum (95% isodose to 99.8% of planning target volume [PTV]), the BCC of the pinna (95% isodose to 97.7% of PTV), and the mycosis fungoides of the face (90% isodose to 92.5% of PTV). For the latter, compared with a plan with a uniform thickness bolus, the one featuring the MERT bolus achieved relative sparing of all the organs at risk (OARs) distal to the target volume, while maintaining similar target volume coverage. The surface brachytherapy plan for the SCC of the nose had adequate coverage (95% isodose to 95.6% of clinical target volume [CTV]), but a relatively high dose to the left eye, owing to its proximity to the tumor. 3D printing can be implemented effectively in the clinical setting to create highly conformal bolus for photon and MERT, as well as applicators for surface brachytherapy.« less

78 FR 69663 - Jonathan and Jayne Chase Troy Mills Hydroelectric Inc.; Notice of Transfer of Exemption

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-20

... Jayne Chase Troy Mills Hydroelectric Inc.; Notice of Transfer of Exemption 1. By letter filed October 15, 2013, Jonathan Chase informed the Commission that the exemption from licensing for the Troy Hydroelectric Project, FERC No. 13381, originally issued December 2, 2011,\\1\\ has been transferred to Troy Mills...

Noninvasive determination of respiratory ozone absorption: development of a fast-responding ozone analyzer.

PubMed

Ultman, J S; Ben-Jebria, A

1991-03-01

We developed a chemiluminescent ozone analyzer and constructed an ozone bolus generator with the eventual goal of using a bolus-response method to measure noninvasively the longitudinal distribution of ozone absorption in human lungs. Because the analyzer will be used to sample gases within a single breath, it must have a sufficiently rapid response to monitor changes in ozone concentration during a four-second breathing period, yet its sampling flow must be small enough that it does not interfere with quiet respiratory flows of 300 mL/sec. Our analyzer, which is based on the chemiluminescent reaction between 2-methyl-2-butene and ozone, has favorable performance characteristics: a 90 percent step-response time of 110 msec; a linear calibration from 0.03 to 10 parts per million (ppm)2 with a sensitivity of 2.3 nA/ppm; a signal-to-noise ratio of 30 evaluated at 0.5 ppm; and a minimum detection limit of 0.017 ppm. At an airflow corresponding to quiet breathing, the ozone generator is capable of producing single boluses with a peak ozone fraction as high as 4 ppm, but containing only 0.35 micrograms of ozone dispersed over a small volume of 19 mL. To test the combination of ozone analyzer and bolus generator, we performed bolus-response experiments at steady airflows of 50 to 200 mL/sec in excised pig and sheep tracheas. In spite of the small surface area available for radial diffusion, we found that 25 to 50 percent of the ozone introduced into the trachea was absorbed. By comparing the mathematical moments of the bolus input and the response curves to the predictions of a diffusion theory, we computed an absorption coefficient (K). The values of K increased with increasing airflow, implying that ozone absorption is limited by diffusion processes in the airway lumen as well as in the surrounding tissue.

Contrast Media Delivery in the Assessment of Anomalous Left Coronary Artery From the Pulmonary Artery.

PubMed

Saade, Charbel; Al-Hamra, Salam; Al-Mohiy, Hussain; El-Merhi, Fadi

2016-05-01

A patient with a history of mitral valve prolapse and regurgitation that was corrected with a mitral ring repair 15 years earlier received a diagnosis of anomalous left coronary artery arising from the pulmonary artery and underwent repair. Coronary computed tomography angiography (CTA) was employed to image the patient before surgical intervention. Synchronizing contrast media administration to opacify the right coronary artery in the arterial phase and the left coronary artery in the venous phase required a test-bolus approach. Matching compromised cardiovascular dynamics with patient-specific contrast media administration protocols was improved considerably with the use of a test-bolus technique during electrocardiography-gated coronary CTA.

Individual Differences in Planning-Related Activities for Simple Digital Circuit Design

DTIC Science & Technology

1994-01-01

Learning Technology Center Vanderbilt University 94-1 Box 45, Peabody Nashville, TN 37203 g. SPONSORING/ MONITORING AGENCY NAME(S) AND ADDRESS(ES) 10...they learned in class, rather than first constructing a deeper understanding of what role each component played in the problem-solving process. One of...Pezdek, & W. P. Banks (Eds.), Application of cognitive psychology: Problen, suiving, education and computing (pp. 123-137). Hillsdale, NJ: Erlbaum. Chase

SU-C-213-06: Dosimetric Verification of 3D Printed Electron Bolus

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

Rasmussen, K; Corbett, M; Pelletier, C

2015-06-15

Purpose: To determine the dosimetric effect of 3D printed bolus in an anthropomorphic phantom. Methods: Conformable bolus material was generated for an anthropomorphic phantom from a DICOM volume. The bolus generated was a uniform expansion of 5mm applied to the nose region of the phantom, as this is a difficult area to uniformly apply bolus clinically. A Printrbot metal 3D Printer using PLA plastic generated the bolus. A 9MeV anterior beam with a 5cm cone was used to deliver dose to the nose of the phantom. TLD measurements were compared to predicted values at the phantom surface. Film planes weremore » analyzed for the printed bolus, a standard 5mm bolus sheet placed on the phantom, and the phantom with no bolus applied to determine depth and dose distributions. Results: TLDs measured within 2.5% of predicted value for the 3D bolus. Film demonstrated a more uniform dose distribution in the nostril region for the 3d printed bolus than the standard bolus. This difference is caused by the air gap created around the nostrils by the standard bolus, creating a secondary build-up region. Both demonstrated a 50% central axis dose shift of 5mm relative to the no bolus film. HU for the bolus calculated the PLA electron density to be ∼1.1g/cc. Physical density was measured to be 1.3g/cc overall. Conclusion: 3D printed PLA bolus demonstrates improved dosimetric performance to standard bolus for electron beams with complex phantom geometry.« less

Lockheed L-1011 TriStar to support Adaptive Performance Optimization study with NASA F-18 chase plan

NASA Technical Reports Server (NTRS)

1995-01-01

This Lockheed L-1011 Tristar, seen here June 1995, is currently the subject of a new flight research experiment developed by NASA's Dryden Flight Research Center, Edwards, California, to improve the effiecency of large transport aircraft. Shown with a NASA F-18 chase plane over California's Sierra Nevada mountains during an earlier baseline flight, the jetliner operated by Oribtal Sciences Corp., recently flew its first data-gathering mission in the Adaptive Performance Optimization project. The experiment seeks to reduce fuel comsumption of large jetliners by improving the aerodynamic efficiency of their wings at cruise conditions. A research computer employing a sophisticated software program adapts to changing flight conditions by commanding small movements of the L-1011's outboard ailerons to give its wings the most efficient - or optimal - airfoil. Up to a dozen research flights will be flown in the current and follow-on phases of the project over the next couple years.

Optimal insulin pump dosing and postprandial glycemia following a pizza meal using the continuous glucose monitoring system.

PubMed

Jones, Susan M; Quarry, Jill L; Caldwell-McMillan, Molly; Mauger, David T; Gabbay, Robert A

2005-04-01

We attempted to identify an optimal insulin pump meal bolus by comparing postprandial sensor glucose values following three methods of insulin pump meal bolusing for a consistent pizza meal. Twenty-four patients with type 1 diabetes participated in a study to compare postprandial glucose values following three meal bolus regimens for a consistent evening pizza meal. Each participant utilized the following insulin lispro regimens on consecutive evenings, and glucose values were tracked by the Continuous Glucose Monitoring System (CGMS, Medtronic MiniMed, Northridge, CA): (a) single-wave bolus (100% of insulin given immediately); (b) 4-h dual-wave bolus (50% of insulin given immediately and 50% given over a 4-h period); and (c) 8-h dual-wave bolus (50% of insulin given immediately and 50% given over a 8-h period). Total insulin bolus amount was kept constant for each pizza meal. Divergence in blood glucose among the regimens was greatest at 8-12 h. The 8-h dual-wave bolus provided the best glycemic control and lowest mean glucose values (singlewave bolus, 133 mg/dL; 4-h dual-wave bolus, 145 mg/dL; 8-h dual-wave bolus, 104 mg/dL), leading to a difference in mean glucose of 29 mg/dL for the single-wave bolus versus the 8-h dual-wave bolus and 42 mg/dL for the 4-h dual-wave bolus versus the 8-h dual-wave bolus. The lower mean glucose in the 8-h dual-wave bolus was not associated with any increased incidence of hypoglycemia. Use of a dual-wave bolus extended over an 8-h period following a pizza meal provided significantly less postprandial hyperglycemia in the late postprandial period (8-12 h) with no increased risk of hypoglycemia.

SU-F-T-500: The Effectiveness of a Patient Specific Bolus Made by Using Three-Dimensional Printing Technique in Photon Radiotherapy

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

Fujimoto, K; Yuasa, Y; Shiinoki, T

Purpose: A commercially available bolus (commercial-bolus) would not completely contact with the irregular shape of a patient’s skin. The purposes of this study were to customize a patient specific three-dimensional (3D) bolus using a 3D printer (3D-bolus) and to evaluate its clinical feasibility for photon radiotherapy. Methods: The 3D-bolus was designed using a treatment planning system (TPS) in DICOM-RT format. To print the 3D bolus, the file was converted into stereolithography format. To evaluate its physical characteristics, plans were created for water equivalent phantoms without the bolus, with the 3D-bolus printed in a flat form, and with the virtual bolusmore » which supposed a commercial-bolus. These plans were compared with the percent depth dose (PDD) measured from the TPS. Furthermore, to evaluate its clinical feasibility, the treatment plans were created for RANDO phantoms without the bolus and with the 3D-bolus which was customized for contacting with the surface of the phantom. Both plans were compared with the dose volume histogram (DVH) of the target volume. Results: In the physical evaluation, dmax of the plan without the bolus, with the 3D-bolus, and with the virtual bolus were 2.2 cm, 1.6 cm, and 1.7 cm, respectively. In the evaluation of clinical feasibility, for the plan without the bolus, Dmax, Dmin, Dmean, D90%, and V90% of the target volume were 102.6 %, 1.6 %, 88.8 %, 57.2 %, and 69.3 %, respectively. By using the 3D-bolus, the prescription dose could be delivered to at least 90 % of the target volume, Dmax, Dmin, Dmean, D90%, and V90% of the target volume were 104.3 %, 91.6 %, 92.1 %, 91.7 %, and 98.0 %, respectively. The 3D-bolus has the potential to be useful for providing effective dose coverage in the buildup region. Conclusion: A 3D-bolus produced using 3D printing technique is comparable to a commercially available bolus.« less

CT Angiography of Peripheral Arterial Disease by 256-Slice Scanner: Accuracy, Advantages and Disadvantages Compared to Digital Subtraction Angiography.

PubMed

Mishra, Atul; Jain, Narendra; Bhagwat, Anand

2017-07-01

Peripheral arterial occlusive disease (PAOD) may cause disabling claudication or critical limb ischemia. Multidetector computed tomography (CT) technology has evolved to the level of 256-slice CT scanners which has significantly improved the spatial and temporal resolution of the images. This has provided the capability of chasing the contrast bolus at a fast speed enabling angiographic imaging of long segments of the body. These images can be reconstructed in various planes and various modes for detailed analysis of the peripheral vascular diseases which helps in making treatment decision. The aim of this retrospective study was to compare the CT angiograms (CTAs) of all cases of PAOD done by 256-slice CT scanner at a tertiary care vascular center and comparing these images with the digital subtraction angiograms (DSAs) of these patients. The retrospective study included 53 patients who underwent both CTA and DSA at our center over a period of 3 years from March 2013 to March 2016. The CTA showed high sensitivity (93%) and specificity (92.7%) for overall assessment of degree of stenosis in a vascular segment in cases of aortic and lower limb occlusive disease. The assessment of lesions of infrapopliteal segment was comparatively inferior (sensitivity 91.6%, accuracy 73.3%, and positive predictive value 78.5%), more so in the presence of significant calcification. The advantages of CTA were its noninvasive nature, ability to image large area of body, almost no adverse effects to the patients, and better assessment of vessel wall disease. However, the CTA assessment of collaterals was inferior with a sensitivity of only 62.7% as compared to DSA. Overall, 256-slice CTA provides fast and accurate imaging of vascular tree which can restrict DSA only in few selected cases as a problem-solving tool where clinico-radiological mismatch is present.

Esophageal Transit, Contraction and Perception of Transit After Swallows of Two Viscous Boluses

PubMed Central

Dalmazo, Jucileia; Aprile, Lilian Rose Otoboni; Dantas, Roberto Oliveira

2015-01-01

Background There have been results showing the influence of bolus viscosities and consistency on esophageal motility and transit. However, there is no description about the influence of two different viscous boluses on esophageal contractions, bolus transit and perception of transit. Our objective in this investigation was to evaluate the esophageal transit and contraction after swallows of two viscous boluses. Methods By impedance and manometric methods, we measured the esophageal transit and contraction after swallows of two viscous boluses of 5 mL volume, 100% barium sulfate and yogurt, swallowed in duplicate in the supine and upright positions. The bolus transit, esophageal contractions and the perception of bolus transit through the esophagus were evaluated in both positions. Impedance and contraction were measured at 5, 10, 15 and 20 cm from the lower esophageal sphincter. After each swallow, the volunteers were asked about the sensation of bolus transit through the esophagus. Results In supine position, the yogurt had a less frequent complete bolus transit than barium. Also in the supine position, the esophageal transit was longer with yogurt than with barium. Esophageal contractions after swallows were similar between barium and yogurt boluses. There was no difference in perception of transit between the two boluses. Conclusion Although both 100% barium sulfate and yogurt are viscous boluses and have similar viscosities, the transit through the esophagus is slower with yogurt bolus than with barium bolus, which suggests that viscosity may be not the sole factor to determine transit. PMID:27785308

Attributing intentions to random motion engages the posterior superior temporal sulcus.

PubMed

Lee, Su Mei; Gao, Tao; McCarthy, Gregory

2014-01-01

The right posterior superior temporal sulcus (pSTS) is a neural region involved in assessing the goals and intentions underlying the motion of social agents. Recent research has identified visual cues, such as chasing, that trigger animacy detection and intention attribution. When readily available in a visual display, these cues reliably activate the pSTS. Here, using functional magnetic resonance imaging, we examined if attributing intentions to random motion would likewise engage the pSTS. Participants viewed displays of four moving circles and were instructed to search for chasing or mirror-correlated motion. On chasing trials, one circle chased another circle, invoking the percept of an intentional agent; while on correlated motion trials, one circle's motion was mirror reflected by another. On the remaining trials, all circles moved randomly. As expected, pSTS activation was greater when participants searched for chasing vs correlated motion when these cues were present in the displays. Of critical importance, pSTS activation was also greater when participants searched for chasing compared to mirror-correlated motion when the displays in both search conditions were statistically identical random motion. We conclude that pSTS activity associated with intention attribution can be invoked by top-down processes in the absence of reliable visual cues for intentionality.

SU-F-T-387: A Novel Optimization Technique for Field in Field (FIF) Chestwall Radiation Therapy Using a Single Plan to Improve Delivery Safety and Treatment Planning Efficiency

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

Tabibian, A; Kim, A; Rose, J

Purpose: A novel optimization technique was developed for field-in-field (FIF) chestwall radiotherapy using bolus every other day. The dosimetry was compared to currently used optimization. Methods: The prior five patients treated at our clinic to the chestwall and supraclavicular nodes with a mono-isocentric four-field arrangement were selected for this study. The prescription was 5040 cGy in 28 fractions, 5 mm bolus every other day on the tangent fields, 6 and/or 10 MV x-rays, and multileaf collimation.Novelly, tangents FIF segments were forward planned optimized based on the composite bolus and non-bolus dose distribution simultaneously. The prescription was spilt into 14 fractionsmore » for both bolus and non-bolus tangents. The same segments and monitor units were used for the bolus and non-bolus treatment. The plan was optimized until the desired coverage was achieved, minimized 105% hotspots, and a maximum dose of less than 108%. Each tangential field had less than 5 segments.Comparison plans were generated using FIF optimization with the same dosimetric goals, but using only the non-bolus calculation for FIF optimization. The non-bolus fields were then copied and bolus was applied. The same segments and monitor units were used for the bolus and non-bolus segments. Results: The prescription coverage of the chestwall, as defined by RTOG guidelines, was on average 51.8% for the plans that optimized bolus and non-bolus treatments simultaneous (SB) and 43.8% for the plans optimized to the non-bolus treatments (NB). Chestwall coverage of 90% prescription averaged to 80.4% for SB and 79.6% for NB plans. The volume receiving 105% of the prescription was 1.9% for SB and 0.8% for NB plans on average. Conclusion: Simultaneously optimizing for bolus and non-bolus treatments noticeably improves prescription coverage of the chestwall while maintaining similar hotspots and 90% prescription coverage in comparison to optimizing only to non-bolus treatments.« less

Role of physical bolus properties as sensory inputs in the trigger of swallowing.

PubMed

Peyron, Marie-Agnès; Gierczynski, Isabelle; Hartmann, Christoph; Loret, Chrystel; Dardevet, Dominique; Martin, Nathalie; Woda, Alain

2011-01-01

Swallowing is triggered when a food bolus being prepared by mastication has reached a defined state. However, although this view is consensual and well supported, the physical properties of the swallowable bolus have been under-researched. We tested the hypothesis that measuring bolus physical changes during the masticatory sequence to deglutition would reveal the bolus properties potentially involved in swallowing initiation. Twenty normo-dentate young adults were instructed to chew portions of cereal and spit out the boluses at different times in the masticatory sequence. The mechanical properties of the collected boluses were measured by a texture profile analysis test currently used in food science. The median particle size of the boluses was evaluated by sieving. In a simultaneous sensory study, twenty-five other subjects expressed their perception of bolus texture dominating at any mastication time. Several physical changes appeared in the food bolus as it was formed during mastication: (1) in rheological terms, bolus hardness rapidly decreased as the masticatory sequence progressed, (2) by contrast, adhesiveness, springiness and cohesiveness regularly increased until the time of swallowing, (3) median particle size, indicating the bolus particle size distribution, decreased mostly during the first third of the masticatory sequence, (4) except for hardness, the rheological changes still appeared in the boluses collected just before swallowing, and (5) physical changes occurred, with sensory stickiness being described by the subjects as a dominant perception of the bolus at the end of mastication. Although these physical and sensory changes progressed in the course of mastication, those observed just before swallowing seem to be involved in swallowing initiation. They can be considered as strong candidates for sensory inputs from the bolus that are probably crucially involved in the triggering of swallowing, since they appeared in boluses prepared in various mastication strategies by different subjects.

Clinical applications of 3-dimensional printing in radiation therapy.

PubMed

Zhao, Yizhou; Moran, Kathryn; Yewondwossen, Mammo; Allan, James; Clarke, Scott; Rajaraman, Murali; Wilke, Derek; Joseph, Paul; Robar, James L

2017-01-01

Three-dimensional (3D) printing is suitable for the fabrication of complex radiotherapy bolus. Although investigated from dosimetric and feasibility standpoints, there are few reports to date of its use for actual patient treatment. This study illustrates the versatile applications of 3D printing in clinical radiation oncology through a selection of patient cases, namely, to create bolus for photon and modulated electron radiotherapy (MERT), as well as applicators for surface high-dose rate (HDR) brachytherapy. Photon boluses were 3D-printed to treat a recurrent squamous cell carcinoma (SCC) of the nasal septum and a basal cell carcinoma (BCC) of the posterior pinna. For a patient with a mycosis fungoides involving the upper face, a 3D-printed MERT bolus was used. To treat an SCC of the nose, a 3D-printed applicator for surface brachytherapy was made. The structures' fit to the anatomy and the radiotherapy treatment plans were assessed. Based on the treatment planning computed tomography (CT), the size of the largest air gap at the interface of the 3D-printed structure was 3 mm for the SCC of the nasal septum, 3 mm for the BCC of the pinna, 2 mm for the mycosis fungoides of the face, and 2 mm for the SCC of the nose. Acceptable treatment plans were obtained for the SCC of the nasal septum (95% isodose to 99.8% of planning target volume [PTV]), the BCC of the pinna (95% isodose to 97.7% of PTV), and the mycosis fungoides of the face (90% isodose to 92.5% of PTV). For the latter, compared with a plan with a uniform thickness bolus, the one featuring the MERT bolus achieved relative sparing of all the organs at risk (OARs) distal to the target volume, while maintaining similar target volume coverage. The surface brachytherapy plan for the SCC of the nose had adequate coverage (95% isodose to 95.6% of clinical target volume [CTV]), but a relatively high dose to the left eye, owing to its proximity to the tumor. 3D printing can be implemented effectively in the clinical setting to create highly conformal bolus for photon and MERT, as well as applicators for surface brachytherapy. Copyright © 2017 American Association of Medical Dosimetrists. Published by Elsevier Inc. All rights reserved.

Optimizing the combination insulin bolus split for a high-fat, high-protein meal in children and adolescents using insulin pump therapy.

PubMed

Lopez, P E; Smart, C E; McElduff, P; Foskett, D C; Price, D A; Paterson, M A; King, B R

2017-10-01

To determine the optimum combination bolus split to maintain postprandial glycaemia with a high-fat and high-protein meal in young people with Type 1 diabetes. A total of 19 young people (mean age 12.9 ± 6.7 years) participated in a randomized, repeated-measures trial comparing postprandial glycaemic control across six study conditions after a high-fat and high-protein meal. A standard bolus and five different combination boluses were delivered over 2 h in the following splits: 70/30 = 70% standard /30% extended bolus; 60/40=60% standard/40% extended bolus; 50/50=50% standard/50% extended bolus; 40/60=40% standard/60% extended bolus; and 30/70=30% standard/70% extended bolus. Insulin dose was determined using the participant's optimized insulin:carbohydrate ratio. Continuous glucose monitoring was used to assess glucose excursions for 6 h after the test meal. Standard bolus and combination boluses 70/30 and 60/40 controlled the glucose excursion up to 120 min. From 240 to 300 min after the meal, the glucose area under the curve was significantly lower for combination bolus 30/70 compared with standard bolus (P=0.004). High-fat and high-protein meals require a ≥60% insulin:carbohydrate ratio as a standard bolus to control the initial postprandial rise. Additional insulin at an insulin:carbohydrate ratio of up to 70% is needed in the extended bolus for a high fat and protein meal to prevent delayed hyperglycaemia. © 2017 Diabetes UK.

MO-H-19A-03: Patient Specific Bolus with 3D Printing Technology for Electron Radiotherapy

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

Zou, W; Swann, B; Siderits, R

2014-06-15

Purpose: Bolus is widely used in electron radiotherapy to achieve desired dose distribution. 3D printing technologies provide clinicians with easy access to fabricate patient specific bolus accommodating patient body surface irregularities and tissue inhomogeneity. This study presents the design and the clinical workflow of 3D printed bolus for patient electron therapy in our clinic. Methods: Patient simulation CT images free of bolus were exported from treatment planning system (TPS) to an in-house developed software package. Bolus with known material properties was designed in the software package and then exported back to the TPS as a structure. Dose calculation was carriedmore » out to examine the coverage of the target. After satisfying dose distribution was achieved, the bolus structure was transferred in Standard Tessellation Language (STL) file format for the 3D printer to generate the machine codes for printing. Upon receiving printed bolus, a quick quality assurance was performed with patient resimulated with bolus in place to verify the bolus dosimetric property before treatment started. Results: A patient specific bolus for electron radiotherapy was designed and fabricated in Form 1 3D printer with methacrylate photopolymer resin. Satisfying dose distribution was achieved in patient with bolus setup. Treatment was successfully finished for one patient with the 3D printed bolus. Conclusion: The electron bolus fabrication with 3D printing technology was successfully implemented in clinic practice.« less

Fabrication and characterization of bolus material using polydimethyl-siloxane

NASA Astrophysics Data System (ADS)

Wiratma Jaya, Gede; Sutanto, Heri

2018-01-01

Bolus has been used in radiotherapy to reduce tissue harm and to increase the superficial dose for skin cancer treatment. Commonly, a bolus is made of melamine in several hospitals. In this research, polydimethyl-siloxane (PDMS) material was used for bolus fabrication. The aims of the study are to investigate bolus density, percentage surface dose and its structural strength for each various composition. In bolus preparation, bolus material used composition variation between PDMS volume and catalyst volume. Composition variation were 20:1, 22:1, 24:1, 26:1, 28:1, 30:1 and 32:1. PDMS and catalyst were mixed by chemical solution deposition method. Bolus was molded by using glass cast with the size of 10 × 10 × 0.5 cm3. Bolus density was analyzed by mass per volume equation, for bolus radiation was examined by the linear accelerator using two electron energy (5 and 7 MeV) and bolus strain and tensile strength were examined by Brookfield CT 3 machine. The results of bolus density were similar with soft tissue density, while the lowest and highest density each variation are 22:1 and 28:1. In general, the use of bolus has increased the surface dose. Percentage of surface dose at 5 MeV energy is higher than 7 MeV energy. The highest percentage of surface dose at 5 MeV energy with 0.5 and 1.0 cm bolus thickness was achieved at composition of 32:1. For strain and tensile strength result, the lowest and highest strain each variation are 22:1 and 28:1, then the lowest and highest tensile strength each variation are 32:1 and 28:1. These results is important to select composition material for bolus fabrication in radiotherapy treatment.

SU-F-T-517: Determining the Tissue Equivalence of a Brass Mesh Bolus in a Reconstructed Chest Wall Irradiation

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

Shekel, E; Epstein, D; Levin, D

2016-06-15

Purpose: To determine the tissue equivalence of a brass mesh bolus (RPD) in the setting of a reconstructed chest wall irradiation Methods: We measured breast skin dose delivered by a tangential field plan on an anthropomorphic phantom using Mosfet and nanoDot (Landauer) dosimeters in five different locations on the breast. We also measured skin dose using no bolus, 5mm and 10 mm superflab bolus. In the Eclipse treatment planning system (Varian, Palo Alto, CA) we calculated skin dose for different bolus thicknesses, ranging from 0 to 10 mm, in order to evaluate which calculation best matches the brass mesh measurements,more » as the brass mesh cannot be simulated due to artefacts.Finally, we measured depth dose behavior with the brass mesh bolus to verify that the bolus does not affect the dose to the breast itself beyond the build-up region. Results: Mosfet and nanoDot measurements were consistent with each other.As expected, skin dose measurements with no bolus had the least agreement with Eclipse calculation, while measurements for 5 and 10 mm agreed well with the calculation despite the difficulty in conforming superflab bolus to the breast contour. For the brass mesh the best agreement was for 3 mm bolus Eclipse calculation. For Mosfets, the average measurement was 90.8% of the expected dose, and for nanoDots 88.33% compared to 83.34%, 88.64% and 93.94% (2,3 and 5 mm bolus calculation respectively).The brass mesh bolus increased skin dose by approximately 25% but there was no dose increase beyond the build-up region. Conclusion: Brass mesh bolus is most equivalent to a 3 mm bolus, and does not affect the dose beyond the build-up region. The brass mesh cannot be directly calculated in Eclipse, hence a 3mm bolus calculation is a good reflection of the dose response to the brass mesh bolus.« less

Role of Physical Bolus Properties as Sensory Inputs in the Trigger of Swallowing

PubMed Central

Peyron, Marie-Agnès; Gierczynski, Isabelle; Hartmann, Christoph; Loret, Chrystel; Dardevet, Dominique; Martin, Nathalie; Woda, Alain

2011-01-01

Background Swallowing is triggered when a food bolus being prepared by mastication has reached a defined state. However, although this view is consensual and well supported, the physical properties of the swallowable bolus have been under-researched. We tested the hypothesis that measuring bolus physical changes during the masticatory sequence to deglutition would reveal the bolus properties potentially involved in swallowing initiation. Methods Twenty normo-dentate young adults were instructed to chew portions of cereal and spit out the boluses at different times in the masticatory sequence. The mechanical properties of the collected boluses were measured by a texture profile analysis test currently used in food science. The median particle size of the boluses was evaluated by sieving. In a simultaneous sensory study, twenty-five other subjects expressed their perception of bolus texture dominating at any mastication time. Findings Several physical changes appeared in the food bolus as it was formed during mastication: (1) in rheological terms, bolus hardness rapidly decreased as the masticatory sequence progressed, (2) by contrast, adhesiveness, springiness and cohesiveness regularly increased until the time of swallowing, (3) median particle size, indicating the bolus particle size distribution, decreased mostly during the first third of the masticatory sequence, (4) except for hardness, the rheological changes still appeared in the boluses collected just before swallowing, and (5) physical changes occurred, with sensory stickiness being described by the subjects as a dominant perception of the bolus at the end of mastication. Conclusions Although these physical and sensory changes progressed in the course of mastication, those observed just before swallowing seem to be involved in swallowing initiation. They can be considered as strong candidates for sensory inputs from the bolus that are probably crucially involved in the triggering of swallowing, since they appeared in boluses prepared in various mastication strategies by different subjects. PMID:21738616

Gaze maintenance and autism spectrum disorder.

PubMed

Kaye, Leah; Kurtz, Marie; Tierney, Cheryl; Soni, Ajay; Augustyn, Marilyn

2014-01-01

Chase is a 5½-year-old boy whom you have followed in your primary care practice since age 26 months. He was born full-term vaginal delivery weighing 6 pounds 15 ounces. His biological mother used heroin, tobacco, and cocaine during pregnancy. From 8 weeks to 18 months, he spent time in a foster home where he was provided limited attention and nurturing. At age 18 months, he entered a loving foster home; at 26 months, he was adopted. There is maternal history of attention-deficit hyperactivity disorder, learning disability, depression, bipolar disorder, and substance abuse but no history of autism or cognitive disability. Chase received early intervention before adoption. Specific concerns are unknown. At the time of his adoption, he had delays in gross motor and fine motor skills, nonverbal communication, and speech production. Familiar listeners find Chase to be 100% intelligible but unfamiliar listeners understand about 70% of what Chase says. He enjoys being with his adopted mother and imitating her. He has demonstrated significant anxiety during his play therapy. He has difficulty in paying attention to multistep directions. Chase can point and wave but has difficulty following someone's eyes to see where another person is looking. Chase enjoys a variety of interests but has a special fixation on Toy Story characters. Chase does initiate social interactions but can be aggressive toward his siblings and oppositional toward his parents. He is not aggressive at school. Teachers note hyperactivity and impulsivity. Chase is bothered by bright lights and by others making loud noises but has no difficulty with crowds. Chase is reported to have difficulty in transitioning between activities. At his 5-year-old visit, you as well as his mother and therapists note that he has trouble following with his eyes so he is referred to a neuro-ophthalmologist. Evaluation showed Chase was able to fix on and follow objects and light, his peripheral vision was normal, his pupils were equal and reactive without afferent pupillary defect, and normal visual tracking as assessed through pursuit and saccades. There were some head jerking motions observed which were not thought to be part of Chase's attempts to view objects. Gaze impersistence was noted, although it was not clear if this was due to a lack of attention or a true inability to maintain a gaze in the direction instructed. On review of the school's speech and language report, they state that he is >90% intelligible. He has occasional lip trills. Testing with the Clinical Evaluation of Language Fundamentals shows mild delays in receptive language, especially those that require visual attention. Verbal Motor Production Assessment for Children reveals focal oromotor control and sequencing skills that are below average, with groping when asked to imitate single oromotor nonspeech movements and sequenced double oromotor nonspeech movements. At 5½ years, he returns for follow-up, and he is outgoing and imaginative, eager to play and socialize. He makes eye contact but does not always maintain it. He asks and responds to questions appropriately, and he is able to follow verbal directions and verbal redirection. He is very interested in Toy Story characters but willing to share them and plays with other toys. Chase's speech has predictable, easy to decode sound substitutions. On interview with him, you feel that he has borderline cognitive abilities. He also demonstrates good eye contact but lack of visual gaze maintenance; this is the opposite of the pattern you are accustomed to in patients with autism spectrum disorder. What do you do next?

Pre-pharyngeal swallow effects of recurrent laryngeal nerve lesion on bolus shape and airway protection in an infant pig model

PubMed Central

Gould, Francois D. H.; Yglesias, B.; Ohlemacher, J.; German, R. Z.

2016-01-01

Recurrent laryngeal nerve (RLN) damage in infants leads to increased dysphagia and aspiration pneumonia. Recent work has shown that intra oral transport and swallow kinematics change following RLN lesion, suggesting potential changes in bolus formation prior to the swallow. In this study we used geometric morphometrics to understand the effect of bolus shape on penetration and aspiration in infants with and without RLN lesion. We hypothesized 1) that geometric bolus properties are related to airway protection outcomes and 2) that in infants with RLN lesion, the relationship between geometric bolus properties and dysphagia is changed. In five infant pigs, dysphagia in 188 swallows was assessed using the Infant Mammalian Penetration Aspiration Score (IMPAS). Using images from high-speed VFSS, bolus shape, bolus area, and tongue outline were quantified digitally. Bolus shape was analyzed using elliptical Fourier analysis, and tongue outline using polynomial curve fitting. Despite large inter-individual differences, significant within individual effects of bolus shape and bolus area on airway protection exist. The relationship between penetration-aspiration score and both bolus area and shape changed post lesion. Tongue shape differed between pre and post lesion swallows, and between swallows with different IMPAS scores. Bolus shape and area affect airway protection outcomes. RLN lesion changes that relationship, indicating that proper bolus formation and control by the tongue requires intact laryngeal sensation. The impact of RLN lesion on dysphagia is pervasive. PMID:27873091

Pre-pharyngeal Swallow Effects of Recurrent Laryngeal Nerve Lesion on Bolus Shape and Airway Protection in an Infant Pig Model.

PubMed

Gould, Francois D H; Yglesias, B; Ohlemacher, J; German, R Z

2017-06-01

Recurrent laryngeal nerve (RLN) damage in infants leads to increased dysphagia and aspiration pneumonia. Recent work has shown that intraoral transport and swallow kinematics change following RLN lesion, suggesting potential changes in bolus formation prior to the swallow. In this study, we used geometric morphometrics to understand the effect of bolus shape on penetration and aspiration in infants with and without RLN lesion. We hypothesized (1) that geometric bolus properties are related to airway protection outcomes and (2) that in infants with RLN lesion, the relationship between geometric bolus properties and dysphagia is changed. In five infant pigs, dysphagia in 188 swallows was assessed using the Infant Mammalian Penetration-Aspiration Scale (IMPAS). Using images from high-speed VFSS, bolus shape, bolus area, and tongue outline were quantified digitally. Bolus shape was analyzed using elliptical Fourier analysis, and tongue outline using polynomial curve fitting. Despite large inter-individual differences, significant within individual effects of bolus shape and bolus area on airway protection exist. The relationship between penetration-aspiration score and both bolus area and shape changed post lesion. Tongue shape differed between pre- and post-lesion swallows, and between swallows with different IMPAS scores. Bolus shape and area affect airway protection outcomes. RLN lesion changes that relationship, indicating that proper bolus formation and control by the tongue require intact laryngeal sensation. The impact of RLN lesion on dysphagia is pervasive.

Use of an Automated Bolus Calculator Reduces Fear of Hypoglycemia and Improves Confidence in Dosage Accuracy in Patients with Type 1 Diabetes Mellitus Treated with Multiple Daily Insulin Injections

PubMed Central

Barnard, Katharine; Parkin, Christopher; Young, Amanda; Ashraf, Mansoor

2012-01-01

Background Many patients do not intensify their insulin regimens. It is believed that lack of adherence may be largely due to fear of hypoglycemia. We hypothesized that utilization of an automated bolus calculator (bolus advisor) might reduce fear of hypoglycemia and encourage patients to achieve improved glycemic control. Method We surveyed 1,412 type 1 diabetes mellitus (T1DM) patients treated with multiple daily insulin injection therapy at 270 hospitals in the United Kingdom and Republic of Ireland to assess their attitudes and behaviors regarding insulin therapy after use of a bolus advisor (Accu-Chek® Aviva Expert blood glucose meter and bolus advisor system, Roche Diagnostics). The device automatically calculates bolus dosages based on current blood glucose values, anticipated meal intake, and other parameters. Results Five hundred eighty-eight T1DM patients responded to the survey. Respondents were predominantly female, age <1 to 70 years, with diabetes duration of <1 to >15 years. Respondents had 4–12 weeks prior experience using the bolus advisor. 76.7% of respondents indicated current bolus advisor use to calculate insulin boluses for meals/snacks always or quite often. 52.0% of respondents indicated that fear of hypoglycemia was reduced (39.0%) or significantly reduced (13.0%). 78.8% indicated that confidence in the insulin dose calculation improved (50.8%) or significantly improved (28.0%). 89.3% indicated that the bolus advisor made bolus calculation easy or very easy compared with manual calculation. Conclusions Most patients felt that using the bolus advisor was easier than manual bolus calculation, improved their confidence in the accuracy of their bolus dosage, and reduced their fear of hypoglycemia. Randomized trials are needed to confirm these perceptions and determine whether bolus advisor use improves clinical outcomes. PMID:22401332

Modeling the retention of rumen boluses for the electronic identification of goats.

PubMed

Carné, S; Caja, G; Ghirardi, J J; Salama, A A K

2011-02-01

We constructed a regression model to estimate the retention of electronic boluses in goats. With this aim, 2,482 boluses were administered to goats from dairy (Murciano-Granadina, n=1,326; French Alpine, n=381) and meat (Blanca de Rasquera, n=532) breeds. A total of 19 bolus types made of materials (ceramic, plastic tubes filled with concrete or silicone, and ballasts) differing in their specific gravity (SG) were used, thereby obtaining a wide variation in bolus features: diameter (9 to 22 mm), length (37 to 84 mm), weight (5 to 111 g), volume (2.6 to 26 mL), and SG (1.0 to 5.5). Each bolus contained a half-duplex glass encapsulated transponder (32 × 3.8mm) and was administered using adapted balling guns. Murciano-Granadina and Blanca de Rasquera goats also wore 2 visual plastic ear tags: V1 (double flag, 5.1g) and V2 (flag-button, 4.2g). No data on ear tags in French Alpine goats was available. Bolus and ear tag retention [(retained/monitored) × 100] was recorded for at least 1 yr. Dynamic reading efficiency [(dynamic reading/static reading) × 100] was also evaluated from 1,496 bolus readings. No administration incidences or apparent negative behavior or performance effects were observed for any bolus type. Static reading efficiency of retained boluses was 100%, except for the prototypes with metal ballasts, which yielded a 93.3% reading efficiency. Retention of metal-ballasted boluses was confirmed using x-ray equipment. Excluding ballasted boluses, a 99.5% dynamic reading efficiency was obtained. Ear tag losses were 6.5% for V1 and 3.7% for V2, ranging from 3.2 to 7.8% depending on ear tag type and goat breed. Bolus retention varied (0 to 100%) according to their physical features. Obtained data allowed the fitting of a logistic model of bolus retention rate according to bolus volume and weight (R(2) = 0.98); the SG was implicitly considered. Estimated weight and SG to produce medium- (15 mL) and standard-sized (22 mL) boluses for 99.95% retention rate in goats were 73.0 and 94.1g, and 4.87 and 4.28, respectively. Mini-boluses are not recommended, as none of the available radio translucent materials reach the required SG. In conclusion, increase of SG was fundamental to optimize bolus retention. Medium-sized boluses (10 to 15 mL; SG 5.8 to 4.9) for early administration and efficient retention in adult goats could be produced, thereby addressing the problem of using proper boluses for goat identification. Copyright © 2011 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Can Radiation Dose Be Reduced and Image Quality Improved With 80-kV and Dual-Phase Scanning of the Lower Extremities With 64-Slice Computed Tomography Angiography?

PubMed

Zhou, Yunfeng; Wang, Juan; Dassarath, Meera; Wang, Minhong; Zhang, Qiang; Xiong, Yuwei; Yuan, Quan

2015-01-01

To prospectively compare the new computed tomographic angiography (CTA) protocol (NCP) using 80-kV and dual-phase scanning with the routine CTA protocol (RCP) using 120-kV and single-phase scanning in patients with peripheral arterial disease. A total of 60 patients were randomized to undergo the NCP (30 patients) or RCP (30 patients) scan. We compared the arterial attenuation values, overriding of the contrast bolus, signal-to-noise ratio, and radiation dose between 2 groups. The occurrence rate of contrast bolus overriding was not statistically significant (P = 0.69). The average arterial attenuation value in the NCP group was significantly higher (P < 0.05) than that in the RCP group. The radiation dose in the RCP group was significantly higher (P < 0.001) than that in the NCP group. The mean signal-to-noise ratio in the NCP group was significantly lower (P < 0.001). Sixty-four-slice CTA with the NCP can significantly reduce the radiation dose and improve the arterial enhancement and calf arteries imaging.

SU-C-213-05: Evaluation of a Composite Copper-Plastic Material for a 3D Printed Radiation Therapy Bolus

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

Vitzthum, L; Ehler, E; Sterling, D

2015-06-15

Purpose: To evaluate a novel 3D printed bolus fabricated from a copper-plastic composite as a thin flexible, custom fitting device that can replicate doses achieved with conventional bolus techniques. Methods: Two models of bolus were created on a 3D printer using a composite copper-PLA/PHA. Firstly, boluses were constructed at thicknesses of 0.4, 0.6 and 0.8 mm. Relative dose measurements were performed under the bolus with an Attix Chamber as well as with radiochromic film. Results were compared to superficial Attix Chamber measurements in a water equivalent material to determine the dosimetric water equivalence of the copper-PLA/PHA plastic. Secondly, CT imagesmore » of a RANDO phantom were used to create a custom fitting bolus across the anterolateral scalp. Surface dose with the bolus placed on the RANDO phantom was measured with radiochromic film at tangential angles with 6, 10, 10 flattening filter free (FFF) and 18 MV photon beams. Results: Mean surface doses for 6, 10, 10FFF and 18 MV were measured as a percent of Dmax for the flat bolus devices of each thickness. The 0.4 mm thickness bolus was determined to be near equivalent to 2.5 mm depth in water for all four energies. Surface doses ranged from 59–63% without bolus and 85–90% with the custom 0.4 mm copper-plastic bolus relative to the prescribed dose for an oblique tangential beam arrangement on the RANDO phantom. Conclusion: Sub-millimeter thickness, 3D printed composite copper-PLA/PHA bolus can provide a build-up effect equivalent to conventional bolus. At this thickness, the 3D printed bolus allows a level of flexure that may provide more patient comfort than current 3D printing materials used in bolus fabrication while still retaining the CT based custom patient shape. Funding provided by an intra-department grant of the University of Minnesota Department of Radiation Oncology.« less

Evaluation of Impinging Stream Vortex Chamber Concepts for Liquid Rocket Engine Applications

NASA Technical Reports Server (NTRS)

Trinh, Huu; Kopicz, Charles; Bullard, Brad; Michaels, Scott

2003-01-01

NASA Marshall Space Flight Center (MSFC) and the U. S. Army are jointly investigating vortex chamber concepts for cryogenic oxygen/hydrocarbon fuel rocket engine applications. One concept, the Impinging Stream Vortex Chamber Concept (ISVC), has been tested with gel propellants at AMCOM at Redstone Arsenal, Alabama. A version of this concept for the liquid oxygen (LOX)/hydrocarbon fuel (RP-1) propellant system is derived from the one for the gel propellant. An unlike impinging injector is employed to deliver the propellants to the chamber. MSFC has also designed two alternative injection schemes, called the chasing injectors, associated with this vortex chamber concept. In these injection techniques, both propellant jets and their impingement point are in the same chamber cross-sectional plane. One injector has a similar orifice size with the original unlike impinging injector. The second chasing injector has small injection orifices. The team has achieved their objectives of demonstrating the self-cooled chamber wall benefits of ISVC and of providing the test data for validating computational fluids dynamics (CFD) models. These models, in turn, will be used to design the optimum vortex chambers in the future.

Energy cost and return for hunting in African wild dogs and cheetahs.

PubMed

Hubel, Tatjana Y; Myatt, Julia P; Jordan, Neil R; Dewhirst, Oliver P; McNutt, J Weldon; Wilson, Alan M

2016-03-29

African wild dogs (Lycaon pictus) are reported to hunt with energetically costly long chase distances. We used high-resolution GPS and inertial technology to record 1,119 high-speed chases of all members of a pack of six adult African wild dogs in northern Botswana. Dogs performed multiple short, high-speed, mostly unsuccessful chases to capture prey, while cheetahs (Acinonyx jubatus) undertook even shorter, higher-speed hunts. We used an energy balance model to show that the energy return from group hunting and feeding substantially outweighs the cost of multiple short chases, which indicates that African wild dogs are more energetically robust than previously believed. Comparison with cheetah illustrates the trade-off between sheer athleticism and high individual kill rate characteristic of cheetahs, and the energetic robustness of frequent opportunistic group hunting and feeding by African wild dogs.

The CHASE laboratory search for chameleon dark energy

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

Steffen, Jason H.; /Fermilab

2010-11-01

A scalar field is a favorite candidate for the particle responsible for dark energy. However, few theoretical means exist that can simultaneously explain the observed acceleration of the Universe and evade tests of gravity. The chameleon mechanism, whereby the properties of a particle depend upon the local environment, is one possible avenue. We present the results of the Chameleon Afterglow Search (CHASE) experiment, a laboratory probe for chameleon dark energy. CHASE marks a significant improvement other searches for chameleons both in terms of its sensitivity to the photon/chameleon coupling as well as its sensitivity to the classes of chameleon darkmore » energy models and standard power-law models. Since chameleon dark energy is virtually indistinguishable from a cosmological constant, CHASE tests dark energy models in a manner not accessible to astronomical surveys.« less

21 CFR 520.1158 - Iodochlorhydroxyquin boluses.

Code of Federal Regulations, 2011 CFR

2011-04-01

... Iodochlorhydroxyquin boluses. (a) Specifications. Each bolus contains 10 grams of iodochlorhydroxyquin. (b) Sponsor. See No. 053501 in § 510.600(c) of this chapter. (c) Conditions of use—(1) Amount. 1 bolus (10 grams...

21 CFR 520.1158 - Iodochlorhydroxyquin boluses.

Code of Federal Regulations, 2014 CFR

2014-04-01

... Iodochlorhydroxyquin boluses. (a) Specifications. Each bolus contains 10 grams of iodochlorhydroxyquin. (b) Sponsor. See No. 053501 in § 510.600(c) of this chapter. (c) Conditions of use—(1) Amount. 1 bolus (10 grams...

21 CFR 520.1158 - Iodochlorhydroxyquin boluses.

Code of Federal Regulations, 2010 CFR

2010-04-01

... Iodochlorhydroxyquin boluses. (a) Specifications. Each bolus contains 10 grams of iodochlorhydroxyquin. (b) Sponsor. See No. 053501 in § 510.600(c) of this chapter. (c) Conditions of use—(1) Amount. 1 bolus (10 grams...

21 CFR 520.1158 - Iodochlorhydroxyquin boluses.

Code of Federal Regulations, 2012 CFR

2012-04-01

... Iodochlorhydroxyquin boluses. (a) Specifications. Each bolus contains 10 grams of iodochlorhydroxyquin. (b) Sponsor. See No. 053501 in § 510.600(c) of this chapter. (c) Conditions of use—(1) Amount. 1 bolus (10 grams...

Optimizing the Entrainment Geometry of a Dry Powder Inhaler: Methodology and Preliminary Results.

PubMed

Kopsch, Thomas; Murnane, Darragh; Symons, Digby

2016-11-01

For passive dry powder inhalers (DPIs) entrainment and emission of the aerosolized drug dose depends strongly on device geometry and the patient's inhalation manoeuvre. We propose a computational method for optimizing the entrainment part of a DPI. The approach assumes that the pulmonary delivery location of aerosol can be determined by the timing of dose emission into the tidal airstream. An optimization algorithm was used to iteratively perform computational fluid dynamic (CFD) simulations of the drug emission of a DPI. The algorithm seeks to improve performance by changing the device geometry. Objectives were to achieve drug emission that was: A) independent of inhalation manoeuvre; B) similar to a target profile. The simulations used complete inhalation flow-rate profiles generated dependent on the device resistance. The CFD solver was OpenFOAM with drug/air flow simulated by the Eulerian-Eulerian method. To demonstrate the method, a 2D geometry was optimized for inhalation independence (comparing two breath profiles) and an early-bolus delivery. Entrainment was both shear-driven and gas-assisted. Optimization for a delay in the bolus delivery was not possible with the chosen geometry. Computational optimization of a DPI geometry for most similar drug delivery has been accomplished for an example entrainment geometry.

Bobcat attack on a cottontail rabbit

USGS Publications Warehouse

Biggins, D.E.; Biggins, D.M.

2006-01-01

We observed an attack by a bobcat (Lynx rufus) on a cottontail rabbit (Sylvilagus) that involved stealthy approach by the cat for >1 h, followed by a 12.3-s chase covering 116.0 m for the cat and 128.4 m for the rabbit. During the chase, the route of the cat from starting point to kill site was more direct than the semi-circular route of the rabbit. Stride lengths for the cat and total distance covered by the chase were longer than those previously reported for bobcats.

Ultrasound-guided continuous interscalene block: the influence of local anesthetic background delivery method on postoperative analgesia after shoulder surgery: a randomized trial.

PubMed

Hamdani, Mehdi; Chassot, Olivier; Fournier, Roxane

2014-01-01

Automated bolus delivery has recently been shown to reduce local anesthetic consumption and improve analgesia, compared with continuous infusion, in continuous sciatic and epidural block. However, there are few data on the influence of local anesthetic delivery method on local anesthetic consumption following interscalene blockade. This randomized, double-blind trial was designed to determine whether hourly automated perineural boluses (4 mL) of local anesthesia delivered with patient-controlled pro re nata (PRN, on demand) boluses would result in a reduction in total local anesthesia consumption during continuous interscalene blockade after shoulder surgery compared with continuous perineural infusion (4 mL/h) plus patient-controlled PRN boluses. One hundred one patients undergoing major shoulder surgery under general anesthesia with ultrasound-guided continuous interscalene block were randomly assigned to receive 0.2% ropivacaine via interscalene end-hole catheter either by continuous infusion 4 mL/h (n = 50) or as automated bolus 4 mL/h (n = 51). Both delivery methods were combined with 5 mL PRN boluses of 0.2% ropivacaine with a lockout time of 30 minutes. Postoperative number of PRN boluses, 24- and 48-hour local anesthetic consumption, pain scores, rescue analgesia (morphine), and adverse events were recorded. There were no significant differences in either the number of PRN ropivacaine boluses or total 48 hour local anesthetic consumption between the groups (18.5 [11-25.2] PRN boluses in the continuous infusion group vs 17 [8.5-29] PRN boluses in the automated bolus group). Postoperative pain was similar in both groups; on day 2, the median average pain score was 4 (2-6) in the continuous infusion group versus 3 (2-5) in the automated bolus group (P = 0.54). Nor were any statistically significant intergroup differences observed with respect to morphine rescue, incidence of adverse events, or patient satisfaction. In continuous interscalene blockade under ultrasound guidance after shoulder surgery, automated boluses of local anesthetic combined with PRN boluses did not provide any reduction in local anesthetic consumption or rescue analgesia, compared with continuous infusion combined with PRN boluses.

SU-E-T-489: Incorporating Skin Flash Into VMAT WBI: Impacts On Surface Dosimetry

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

Buele, A Bejarano; Tanny, S; Warrell, G

Purpose: Increased use of inverse planning limits the amount of skin flash in whole breast irradiation (WBI). Strategies to incorporate flash into inverse-planned treatments involve overriding air to the density of water or tissue. This introduces uncertainties to the superficial dose distribution, potentially degrading the coverage at the skin-bolus interface. We investigate the accuracy of various commonly used bolus materials to incorporate flash in VMAT WBI plans while minimizing the perturbation near the skin. Methods: We obtained a CT-simulation of an anthropomorphic phantom with a breast attachment. Three VMAT plans were created with different boluses: 1 cm of 1 g/cm{supmore » 3} bolus (Superflab), 1 cm of 0.65 g/cm{sup 3} bolus (wet towels), and 1 cm of g/cm{sup 3} bolus with 2 dose levels accounting for the difference between bolus and tissue density. The PTV was extended into the bolus, outside the patient body contour to incorporate flash. OSLDs were used to obtain surface doses at the medial, lateral and tip sites of the breast. Each plan was irradiated four times using CBCT for positioning and dosimeter localization. Results: The average thickness of the wet-towel bolus on delivery was 8 mm with a CBCT-measured density of 0.6 g/cm{sup 3}. OSLD measurements demonstrated good agreement with predicted doses from Pinnacle. Average deviations were −5.7%, −2.5%, and −2.6% for plans 1, 2, and 3, respectively. OSLDs placed at the medial and lateral portions of the breast showed the largest average deviations. The maximum recorded deviation from planned values was −8.6%. The largest dose fluctuations occurred near areas where the bolus failed to properly conform to the breast contour. Conclusion: Use of wet-towel bolus improved dose delivery accuracy compared to standard Superflab bolus. Areas of poor bolus conformity adversely affected dose delivery. We recommend the use of wet-towel bolus over Superflab bolus for VMAT WBI.« less

Adherence to Insulin Pump Behaviors in Young Children With Type 1 Diabetes Mellitus.

PubMed

Patton, Susana R; Driscoll, Kimberly A; Clements, Mark A

2017-01-01

Parents of young children are responsible for daily type 1 diabetes (T1DM) cares including insulin bolusing. For optimal insulin pump management, parents should enter a blood glucose result (SMBG) and a carbohydrate estimate (if food will be consumed) into the bolus advisor in their child's pump to assist in delivering the recommended insulin bolus. Previously, pump adherence behaviors were described in adolescents; we describe these behaviors in a sample of young children. Pump data covering between 14-30 consecutive days were obtained for 116 children. Assessed adherence to essential pump adherence behaviors (eg, SMBG, carbohydrate entry, and insulin use) and adherence to 3 Wizard/Bolus Advisor steps: SMBG-carbohydrate entry-insulin bolus delivered. Parents completed SMBG ≥4 times on 99% of days, bolused insulin ≥3 times on 95% of days, and entered carbohydrates ≥3 times on 93% of days, but they corrected for hyperglycemia (≥250 mg/dl or 13.9 mmol/l) only 63% of the time. Parents completed Wizard/Bolus Advisor steps (SMBG, carbohydrate entry, insulin bolus) within 30 minutes for 43% of boluses. Inverse correlations were found between children's mean daily glucose and the percentage of days with ≥4 SMBG and ≥3 carbohydrate entries as well as the percentage of boluses where all Wizard/Bolus Advisor steps were completed. Parents of young children adhered to individual pump behaviors, but showed some variability in their adherence to Wizard/Bolus Advisor steps. Parents showed low adherence to recommendations to correct for hyperglycemia. Like adolescents, targeting pump behaviors in young children may have the potential to optimize glycemic control.

78 FR 42777 - Formations of, Acquisitions by, and Mergers of Bank Holding Companies

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-17

... President) 100 North 6th Street, Philadelphia, Pennsylvania 19105-1521: 1. Fox Chase Bancorp Inc., Hatboro, Pennsylvania; to become a bank holding company upon the conversion of Fox Chase Bank, Hatboro, Pennsylvania...

Energy cost and return for hunting in African wild dogs and cheetahs

PubMed Central

Hubel, Tatjana Y.; Myatt, Julia P.; Jordan, Neil R.; Dewhirst, Oliver P.; McNutt, J. Weldon; Wilson, Alan M.

2016-01-01

African wild dogs (Lycaon pictus) are reported to hunt with energetically costly long chase distances. We used high-resolution GPS and inertial technology to record 1,119 high-speed chases of all members of a pack of six adult African wild dogs in northern Botswana. Dogs performed multiple short, high-speed, mostly unsuccessful chases to capture prey, while cheetahs (Acinonyx jubatus) undertook even shorter, higher-speed hunts. We used an energy balance model to show that the energy return from group hunting and feeding substantially outweighs the cost of multiple short chases, which indicates that African wild dogs are more energetically robust than previously believed. Comparison with cheetah illustrates the trade-off between sheer athleticism and high individual kill rate characteristic of cheetahs, and the energetic robustness of frequent opportunistic group hunting and feeding by African wild dogs. PMID:27023457

T-34C back seat instrument panel

NASA Image and Video Library

1997-05-15

The back seat instrument panel on the NASA T-34C chase plane. In its role as a military trainer, the instructor pilot would ride in the back seat, while the student would be in the front seat. As a chase plane, the back seat would be occupied by a photographer. The aircraft was previously used at the Lewis Research Center in propulsion experiments involving turboprop engines, and was used as a chase aircraft at Dryden for smaller and slower research projects. Chase aircraft accompany research flights for photography and video purposes, and also as support for safety and research. At Dryden, the T-34 is used mainly for smaller remotely piloted vehicles which fly slower than NASA's F-18's, used for larger scale projects. This aircraft was returned to the U.S. Navy in May of 2002. The T-34C, built by Beech, carries a crew of 2 and is nicknamed the Mentor.

In Silico Assessment of Literature Insulin Bolus Calculation Methods Accounting for Glucose Rate of Change.

PubMed

Cappon, Giacomo; Marturano, Francesca; Vettoretti, Martina; Facchinetti, Andrea; Sparacino, Giovanni

2018-05-01

The standard formula (SF) used in bolus calculators (BCs) determines meal insulin bolus using "static" measurement of blood glucose concentration (BG) obtained by self-monitoring of blood glucose (SMBG) fingerprick device. Some methods have been proposed to improve efficacy of SF using "dynamic" information provided by continuous glucose monitoring (CGM), and, in particular, glucose rate of change (ROC). This article compares, in silico and in an ideal framework limiting the exposition to possibly confounding factors (such as CGM noise), the performance of three popular techniques devised for such a scope, that is, the methods of Buckingham et al (BU), Scheiner (SC), and Pettus and Edelman (PE). Using the UVa/Padova Type 1 diabetes simulator we generated data of 100 virtual subjects in noise-free, single-meal scenarios having different preprandial BG and ROC values. Meal insulin bolus was computed using SF, BU, SC, and PE. Performance was assessed with the blood glucose risk index (BGRI) on the 9 hours after meal. On average, BU, SC, and PE improve BGRI compared to SF. When BG is rapidly decreasing, PE obtains the best performance. In the other ROC scenarios, none of the considered methods prevails in all the preprandial BG conditions tested. Our study showed that, at least in the considered ideal framework, none of the methods to correct SF according to ROC is globally better than the others. Critical analysis of the results also suggests that further investigations are needed to develop more effective formulas to account for ROC information in BCs.

Clinical implementation of 3D printing in the construction of patient specific bolus for electron beam radiotherapy for non-melanoma skin cancer.

PubMed

Canters, Richard A; Lips, Irene M; Wendling, Markus; Kusters, Martijn; van Zeeland, Marianne; Gerritsen, Rianne M; Poortmans, Philip; Verhoef, Cornelia G

2016-10-01

Creating an individualized tissue equivalent material build-up (i.e. bolus) for electron beam radiation therapy is complex and highly labour-intensive. We implemented a new clinical workflow in which 3D printing technology is used to create the bolus. A patient-specific bolus is designed in the treatment planning system (TPS) and a shell around it is created in the TPS. The shell is printed and subsequently filled with silicone rubber to make the bolus. Before clinical implementation we performed a planning study with 11 patients to evaluate the difference in tumour coverage between the designed 3D-print bolus and the clinically delivered plan with manually created bolus. For the first 15 clinical patients a second CT scan with the 3D-print bolus was performed to verify the geometrical accuracy. The planning study showed that the V85% of the CTV was on average 97% (3D-print) vs 88% (conventional). Geometric comparison of the 3D-print bolus to the originally contoured bolus showed a high similarity (DSC=0.89). The dose distributions on the second CT scan with the 3D print bolus in position showed only small differences in comparison to the original planning CT scan. The implemented workflow is feasible, patient friendly, safe, and results in high quality dose distributions. This new technique increases time efficiency. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Tornado Chasing.

ERIC Educational Resources Information Center

Faidley, Warren

1991-01-01

Presents the rationale and purposes behind the phenomenon known as storm chasing, as well as the contributions that tornado chasers have made to both scientific knowledge and public safety. Provides statistical information on tornado frequencies and locations and contact addresses for storm chasers. (JJK)

The use of a high resolution model in a private environment.

NASA Astrophysics Data System (ADS)

van Dijke, D.; Malda, D.

2009-09-01

The commercial organisation MeteoGroup uses high resolution modelling for multiple purposes. MeteoGroup uses the Weather Research and Forecasting Model (WRF®1). WRF is used in the operational environment of several MeteoGroup companies across Europe. It is also used in hindcast studies, for example hurricane tracking, wind climate computation and deriving boundary conditions for air quality models. A special operational service was set up for our tornado chasing team that uses high resolution flexible WRF data to chase for super cells and tornados in the USA during spring. Much effort is put into the development and improvement of the pre- and post-processing of the model. At MeteoGroup the static land-use data has been extended and adjusted to improve temperature and wind forecasts. The system has been modified such that sigma level input data from the global ECMWF model can be used for initialisation. By default only pressure level data could be used. During the spin-up of the model synoptical observations are nudged. A program to adjust possible initialisation errors of several surface parameters in coastal areas has been implemented. We developed an algorithm that computes cloud fractions using multiple direct model output variables. Forecasters prefer to use weather codes for their daily forecasts to detect severe weather. For this usage we developed model weather codes using a variety of direct model output and our own derived variables. 1 WRF® is a registered trademark of the University Corporation for Atmospheric Research (UCAR)

Probabilistic Reward- and Punishment-based Learning in Opioid Addiction: Experimental and Computational Data

PubMed Central

Myers, Catherine E.; Sheynin, Jony; Baldson, Tarryn; Luzardo, Andre; Beck, Kevin D.; Hogarth, Lee; Haber, Paul; Moustafa, Ahmed A.

2016-01-01

Addiction is the continuation of a habit in spite of negative consequences. A vast literature gives evidence that this poor decision-making behavior in individuals addicted to drugs also generalizes to laboratory decision making tasks, suggesting that the impairment in decision-making is not limited to decisions about taking drugs. In the current experiment, opioid-addicted individuals and matched controls with no history of illicit drug use were administered a probabilistic classification task that embeds both reward-based and punishment-based learning trials, and a computational model of decision making was applied to understand the mechanisms describing individuals’ performance on the task. Although behavioral results showed thatopioid-addicted individuals performed as well as controls on both reward- and punishment-based learning, the modeling results suggested subtle differences in how decisions were made between the two groups. Specifically, the opioid-addicted group showed decreased tendency to repeat prior responses, meaning that they were more likely to “chase reward” when expectancies were violated, whereas controls were more likely to stick with a previously-successful response rule, despite occasional expectancy violations. This tendency to chase short-term reward, potentially at the expense of developing rules that maximize reward over the long term, may be a contributing factor to opioid addiction. Further work is indicated to better understand whether this tendency arises as a result of brain changes in the wake of continued opioid use/abuse, or might be a pre-existing factor that may contribute to risk for addiction. PMID:26381438

Measurement of myocardial blood flow by cardiovascular magnetic resonance perfusion: comparison of distributed parameter and Fermi models with single and dual bolus.

PubMed

Papanastasiou, Giorgos; Williams, Michelle C; Kershaw, Lucy E; Dweck, Marc R; Alam, Shirjel; Mirsadraee, Saeed; Connell, Martin; Gray, Calum; MacGillivray, Tom; Newby, David E; Semple, Scott Ik

2015-02-17

Mathematical modeling of cardiovascular magnetic resonance perfusion data allows absolute quantification of myocardial blood flow. Saturation of left ventricle signal during standard contrast administration can compromise the input function used when applying these models. This saturation effect is evident during application of standard Fermi models in single bolus perfusion data. Dual bolus injection protocols have been suggested to eliminate saturation but are much less practical in the clinical setting. The distributed parameter model can also be used for absolute quantification but has not been applied in patients with coronary artery disease. We assessed whether distributed parameter modeling might be less dependent on arterial input function saturation than Fermi modeling in healthy volunteers. We validated the accuracy of each model in detecting reduced myocardial blood flow in stenotic vessels versus gold-standard invasive methods. Eight healthy subjects were scanned using a dual bolus cardiac perfusion protocol at 3T. We performed both single and dual bolus analysis of these data using the distributed parameter and Fermi models. For the dual bolus analysis, a scaled pre-bolus arterial input function was used. In single bolus analysis, the arterial input function was extracted from the main bolus. We also performed analysis using both models of single bolus data obtained from five patients with coronary artery disease and findings were compared against independent invasive coronary angiography and fractional flow reserve. Statistical significance was defined as two-sided P value < 0.05. Fermi models overestimated myocardial blood flow in healthy volunteers due to arterial input function saturation in single bolus analysis compared to dual bolus analysis (P < 0.05). No difference was observed in these volunteers when applying distributed parameter-myocardial blood flow between single and dual bolus analysis. In patients, distributed parameter modeling was able to detect reduced myocardial blood flow at stress (<2.5 mL/min/mL of tissue) in all 12 stenotic vessels compared to only 9 for Fermi modeling. Comparison of single bolus versus dual bolus values suggests that distributed parameter modeling is less dependent on arterial input function saturation than Fermi modeling. Distributed parameter modeling showed excellent accuracy in detecting reduced myocardial blood flow in all stenotic vessels.

Safety of Landiolol Hydrochloride as a Premedication for Producing an Appropriate Heart Rate for Multidetector-Row Computed Tomography Coronary Angiography.

PubMed

Koyoshi, Rie; Shiga, Yuhei; Idemoto, Yoshiaki; Ueda, Yoko; Tashiro, Kohei; Kuwano, Takashi; Kitajima, Ken; Fujimi, Kanta; Kawamura, Akira; Ogawa, Masahiro; Miura, Shin-Ichiro

2018-01-01

We evaluated the safety of a bolus injection of landiolol hydrochloride, an ultrashort-acting β1-selective antagonist, as a premedication prior to multidetector-row computed tomography coronary angiography (CTA). The subjects consisted of 176 patients (M/F = 64:112, 67 ± 11 years) who had heart rate (HR) at rest ≥ 70 beats/min (bpm) and underwent CTA. Systolic/diastolic blood pressure (SBP/DBP) and HR were measured before and after the administration of landiolol. SBP/DBP and HR upon entry to the CT room were 136 ± 17/80 ± 11 mm Hg and 83 ± 10 bpm, respectively. HR was significantly reduced at the time of CTA scan (62 ± 7 bpm). Next, we divided the patients into three groups according to HR upon entry to the CT room: 70 - 79 bpm (n = 76), 80 - 89 bpm (n = 60) and ≥ 90 bpm (n = 40). HR at the time of CTA scan was significantly lower than that upon entry to the CT room in all three groups: 70 - 79 bpm (74 ± 3 bpm upon entry to the CT room to 61 ± 6 bpm at the time of CAT scan), 80 - 89 bpm (84 ± 3 to 63 ± 7 bpm) and ≥ 90 bpm (98 ± 6 to 65 ± 7 bpm). Although SBP/DBP was significantly decreased after the CTA scan (123 ± 18/72 ± 12 mm Hg), landiolol had no severe adverse events throughout CTA. In conclusion, a bolus injection of landiolol reduced HR by about 20 bpm without any severe adverse effects. Thus, a bolus injection of landiolol hydrochloride may be a suitable pretreatment for controlling HR in CTA.

Comparison of respiratory-gated and respiratory-ungated planning in scattered carbon ion beam treatment of the pancreas using four-dimensional computed tomography.

PubMed

Mori, Shinichiro; Yanagi, Takeshi; Hara, Ryusuke; Sharp, Gregory C; Asakura, Hiroshi; Kumagai, Motoki; Kishimoto, Riwa; Yamada, Shigeru; Kato, Hirotoshi; Kandatsu, Susumu; Kamada, Tadashi

2010-01-01

We compared respiratory-gated and respiratory-ungated treatment strategies using four-dimensional (4D) scattered carbon ion beam distribution in pancreatic 4D computed tomography (CT) datasets. Seven inpatients with pancreatic tumors underwent 4DCT scanning under free-breathing conditions using a rapidly rotating cone-beam CT, which was integrated with a 256-slice detector, in cine mode. Two types of bolus for gated and ungated treatment were designed to cover the planning target volume (PTV) using 4DCT datasets in a 30% duty cycle around exhalation and a single respiratory cycle, respectively. Carbon ion beam distribution for each strategy was calculated as a function of respiratory phase by applying the compensating bolus to 4DCT at the respective phases. Smearing was not applied to the bolus, but consideration was given to drill diameter. The accumulated dose distributions were calculated by applying deformable registration and calculating the dose-volume histogram. Doses to normal tissues in gated treatment were minimized mainly on the inferior aspect, which thereby minimized excessive doses to normal tissues. Over 95% of the dose, however, was delivered to the clinical target volume at all phases for both treatment strategies. Maximum doses to the duodenum and pancreas averaged across all patients were 43.1/43.1 GyE (ungated/gated) and 43.2/43.2 GyE (ungated/gated), respectively. Although gated treatment minimized excessive dosing to normal tissue, the difference between treatment strategies was small. Respiratory gating may not always be required in pancreatic treatment as long as dose distribution is assessed. Any application of our results to clinical use should be undertaken only after discussion with oncologists, particularly with regard to radiotherapy combined with chemotherapy.

21 CFR 520.1660c - Oxytetracycline hydrochloride tablets/boluses.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Oxytetracycline hydrochloride tablets/boluses. 520....1660c Oxytetracycline hydrochloride tablets/boluses. (a) Specifications. Each tablet or bolus contains 250, 500, or 1,000 milligrams of oxytetracycline hydrochloride. (b) Sponsors. For sponsors in § 510...

21 CFR 520.2170 - Sulfabromomethazine sodium boluses.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 6 2012-04-01 2012-04-01 false Sulfabromomethazine sodium boluses. 520.2170 Section 520.2170 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... Sulfabromomethazine sodium boluses. (a) Specifications. Each bolus contains 15 grams of sulfabromomethazine sodium. (b...

Effects of Age, Gender, Bolus Volume, Bolus Viscosity, and Gustation on Swallowing Apnea Onset Relative to Lingual Bolus Propulsion Onset in Normal Adults

ERIC Educational Resources Information Center

Hiss, Susan G.; Strauss, Monica; Treole, Kathleen; Stuart, Andrew; Boutilier, Susan

2004-01-01

The purpose of this study was to ascertain the normal relation of swallowing apnea (SA) onset relative to lingual bolus propulsion along with factors that may alter this relation. Forty adults, composed of 10 men and 10 women in each of 2 age groups (i.e., 20-30 and 63-79 years) participated. SA onset was assessed during 5- and 20-ml bolus volumes…

[Usefulness of Bolus Administration Using the FLEX Mode(Bolus Infusion Mode)for Baclofen Tolerance].

PubMed

Tanaka, Kazunori

2017-02-01

Intrathecal baclofen(ITB)is used to treat intractable spasticity of various etiologies and can provide better control of spasticity through the adjustment of the dose administered through the pump. However, in patients who develop tolerance to baclofen with the standard simple continuous mode, a sharp increase in dose becomes necessary, and spasticity can become harder to control. We investigated whether switching from the simple continuous mode to the bolus infusion mode was effective in controlling spasticity in patients with baclofen tolerance. We reported four patients undergoing ITB therapy at our facility who were considered to have developed baclofen tolerance. We observed the number of bolus infusions and total dose suitable for maintaining spasticity control after switching from the simple continuous mode to the bolus infusion mode. After switching to the bolus infusion mode, the total dose could be reduced in the short term; however, in the long term, the frequency of bolus infusions had to be increased to maintain spasticity control. Two years after changing to bolus infusion six times a day, the total dose was higher than that in the simple continuous mode for two of the four patients, and was the same level in the other two patients. Our four cases suggest that bolus infusion is effective in patients with baclofen tolerance during ITB therapy. Therefore, the conditions of bolus infusion should be further investigated.

The influence of a slow-release multi-trace element ruminal bolus on trace element status, number of ovarian follicles and pregnancy outcomes in synchronized Afshari ewes

PubMed Central

Abdollahi, E.; Kohram, H.; Shahir, M. H.; Nemati, M. H.

2015-01-01

Published data on the effects of ruminal bolus on the number of ovulatory follicles in ewes does not exist. The present study determined the effects of a ruminal bolus on trace element status, follicular dynamics and reproductive performance in ewes. Eighty Afshari cycling ewes were synchronized during breeding season using CIDR for 14 days and assigned to 4 groups (n=20); group 1 received a single Ferrobloc bolus four weeks prior to CIDR insertion following 400 IU eCG on CIDR removal, group 2 received two boluses four weeks prior to CIDR insertion following 400 IU eCG on CIDR removal, group 3 received only 400 IU eCG on CIDR removal and group 4 (control) received no bolus and no eCG. Transrectal ultrasonography was done to monitor the ovarian follicles on the day of CIDR removal and a day later. Results showed that boluses increased the status of copper, selenium and iodine on mating day and days 90 to 100 of gestation. Ruminal bolus did not significantly increase the number of different classes of ovarian follicles in ewes fed a diet meeting all trace mineral requirements. All ewes eventually became pregnant with 1 or 2 boluses but the multiple births rate (80%) was higher (P<0.05) after 2 boluses compared to the other groups. PMID:27175153

Characterization of esophageal pressure-flow abnormalities in patients with non-obstructive dysphagia and normal manometry findings.

PubMed

Chen, Chien-Lin; Yi, Chih-Hsun; Liu, Tso-Tsai; Hsu, Ching-Sheng; Omari, Taher I

2013-06-01

Patients with non-obstructive dysphagia (NOD) report symptoms of impaired esophageal bolus transit without evidence of bolus stasis. In such patients, manometric investigation may diagnose esophageal motility disorders; however, many have normal motor patterns. We hypothesized that patients with NOD would demonstrate evidence of high flow-resistance during bolus passage which in turn would relate to the reporting of bolus hold up perception. Esophageal pressure-impedance recordings of 5 mL liquid and viscous swallows from 18 NOD patients (11 male; 19-71 years) and 17 control subjects (9 male; 25-60 years) were analyzed. The relationship between intrabolus pressure and bolus flow timing in the esophagus was assessed using the pressure flow index (PFI). Bolus perception was assessed swallow by swallow using standardized descriptors. NOD patients were characterized by a higher PFI than controls. The PFI defined a pressure-flow abnormality in all patients who appeared normal based on the assessment esophageal motor patterns and bolus clearance. The PFI was higher for individual swallows during which subjects reported perception of bolus passage. Bolus flow-resistance is higher in NOD patients compared with controls as well as higher in relation to perception of bolus transit, suggesting the presence of an esophageal motility disorder despite normal findings on conventional analysis. © 2013 Journal of Gastroenterology and Hepatology Foundation and Wiley Publishing Asia Pty Ltd.

Lung volume is a determinant of aerosol bolus dispersion.

PubMed

Schulz, Holger; Eder, Gunter; Heyder, Joachim

2003-01-01

The technique of inhaling a small volume element labeled with particles ("aerosol bolus") can be used to assess convective gas mixing in the lung. While a bolus undergoes mixing in the lung, particles are dispersed in an increasing volume of the respired air. However, determining factors of bolus dispersion are not yet completely understood. The present study tested the hypothesis that bolus dispersion is related, among others, to the total volume in which the bolus is allowed to mix--i.e., to the individual lung size. Bolus dispersion was measured in 32 anesthetized, mechanically ventilated dogs with total lung capacities (TLCs) of 1.1-2.5 L. Six-milliliter aerosol boluses were introduced at various preselected time-points during inspiration to probe different volumetric lung depths. Dispersion (SD) was determined by moment analysis of particle concentrations in the expired air. We found linear correlations between SD at a given lung depth and the individual end-inspiratory lung volume (V(L)). The relationship was tightest for boluses inhaled deepest into the lungs: SD(40) = 0.068 V(L) - 1.77, r(2) = 0.59. Normalizing SD to V(L) abolished this dependency and resulted in a considerable reduction of inter-individual variability as compared to the uncorrected measurements. These data indicate that lung size influences measurements of bolus dispersion. It therefore appears reasonable to apply a normalization procedure before interpreting the data. Apart from a reduction in measurement variability, this should help to separate the effects on bolus dispersion of altered lung volumes and altered mixing processes in diseased lungs.

76 FR 24912 - Sunshine Act Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-03

... DEPARTMENT OF JUSTICE Parole Commission Sunshine Act Meeting TIME AND DATE: 11 a.m., Tuesday, May 10, 2011. PLACE: U.S. Parole Commission, 5550 Friendship Boulevard, Chevy Chase, Maryland. STATUS... the Chairman, U.S. Parole Commission, 5550 Friendship Boulevard, Chevy Chase, Maryland 20815, (301...

Validity of chase car data used in developing emissions cycles

DOT National Transportation Integrated Search

2000-09-01

Air quality policies, driving cycles and profiles of average driving behavior have been constructed to characterize the driving behavior of the overall fleet in an effort to ensure vehicle compliance. Chase car data and speed-time profiles of in-use ...

Social object play among young Japanese macaques (Macaca fuscata) in Arashiyama, Japan.

PubMed

Shimada, Masaki

2006-10-01

Social object play (SOP), i.e., social play using portable object(s), among young Japanese macaques (Macaca fuscata; 0-4 years old) in the Arashiyama E troop was studied using a modified sequence sampling method from July to October 2000. SOP was a relatively common activity for most of the young macaques and often continued for long periods. Participants used many kinds of object, including edible natural objects and artificial objects, such as plastic bottles, but they never used provisioned food or wild fruit in SOP bouts. An analysis of long bouts (>/=0.5 min) revealed the following interactive SOP features: (1) at any given time, participants used only one object, and only one participant held the object; (2) during SOP play-chasing, the object holder was likely to be chased by others; (3) during long bouts, the object changed hands frequently; and (4) agonistic competition for an object among young macaques was rare. Combinations of sexes, ages, relative ranks, or matrilines of the object holder and non-holder did not affect the tendency that the holder was chased by non-holder(s) during play-chasing. Even when there was a change in object holders, the repetitiveness of this interactive pattern, i.e., that the holder would be chased during SOP bouts, distinguished the SOP structure from that of other types of social play without object(s). General proximate social play mechanisms, such as self-handicapping or role taking, were associated with SOP. Other mechanisms that affected SOP included the following: (1) young macaques treated an object as a target in play competition, and (2) 'being the holder of a target object' was associated with the 'role of the chasee.'

Effects of viscosity, taste, and bolus volume on swallowing apnea duration of normal adults.

PubMed

Butler, Susan G; Postma, Gregory N; Fischer, Eileen

2004-12-01

The effects of viscosity, taste, and nectar-thick liquid bolus volume on swallowing apnea duration (SAD) were examined. Twenty-two adults, comprised of 10 males and 12 females, participated. SAD was assessed via nasal airflow during swallow conditions of viscosity (thin liquid, thick liquid, and puree), taste (water, apple juice, lemon concentrate), and nectar-thick liquid bolus volumes (5, 10, 15, and 20 mL) across three trials. A significant main effect of nectar-thick liquid bolus volume was found (P < 0.05). Viscosity and taste were not significant. SAD increased with increases in bolus volume; however, neither changes in bolus viscosity nor changes in taste affected SAD. These findings indicate that since viscosity was not significant, the normative data previously published (by this PI) with 60 healthy adults stratified by age and gender can be utilized for comparison to disordered swallowing without regard to the bolus viscosity being used. D.

21 CFR 520.1802b - Piperazine-carbon disulfide complex boluses.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Piperazine-carbon disulfide complex boluses. 520....1802b Piperazine-carbon disulfide complex boluses. (a) Specifications. Each bolus contains 20 grams of piperazine-carbon disulfide complex. (b) Sponsor. See 000009 in § 510.600(c) of this chapter. (c) Conditions...

Effects of a sour bolus on the intramuscular electromyographic (EMG) activity of muscles in the submental region.

PubMed

Palmer, Phyllis M; McCulloch, Timothy M; Jaffe, Debra; Neel, Amy T

2005-01-01

A sour bolus has been used as a modality in the treatment of oropharyngeal dysphagia based on the hypothesis that this stimulus provides an effective preswallow sensory input that lowers the threshold required to trigger a pharyngeal swallow. The result is a more immediate swallow onset time. Additionally, the sour bolus may invigorate the oral muscles resulting in stronger contractions during the swallow. The purpose of this investigation was to compare the intramuscular electromyographic activity of the mylohyoid, geniohyoid, and anterior belly of the digastric muscles during sour and water boluses with regard to duration, strength, and timing of muscle activation. Muscle duration, swallow onset time, and pattern of muscle activation did not differ for the two bolus types. Muscle activation time was more tightly approximated across the onsets of the three muscles when a sour bolus was used. A sour bolus also resulted in a stronger muscle contraction as evidenced by greater electromyographic activity. These data support the use of a sour bolus as part of a treatment paradigm.

The use of Coca-Cola in the management of bolus obstruction in benign oesophageal stricture.

PubMed Central

Karanjia, N. D.; Rees, M.

1993-01-01

Oesophageal stricture is a complication of oesophageal reflux and may itself be complicated by bolus obstruction. We reviewed the records of patients presenting with dysphagia and who were found to have benign oesophageal strictures. We studied the outcome of bolus obstruction in 13 episodes affecting eight patients. In six episodes Coca-Cola was administered on the day before endoscopy, and in all these patients the bolus had cleared. In seven episodes nothing was administered before endoscopy, and in all seven a bolus was evident at endoscopy. In five of these seven the bolus was removed piecemeal and in each of these instances the endoscope had to be passed between two and five times. In the remaining two instances the procedure was abandoned and the patients returned to the ward for the administration of Coca-Cola. At subsequent endoscopy these patients were found to be clear of any bolus. These results suggest that the administration of Coca-Cola (or other aerated drinks) may clear a bolus in the acutely obstructed oesophagus. PMID:8476194

6. CONSTRUCTION PROGRESS VIEW (EXTERIOR) OF TANK, CABLE CHASE, AND ...

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

6. CONSTRUCTION PROGRESS VIEW (EXTERIOR) OF TANK, CABLE CHASE, AND MOUNDED BUNKER. CONSTRUCTION WAS 99 PERCENT COMPLETE. CAMERA IS FACING WEST. INEL PHOTO NUMBER 65-5435, TAKEN OCTOBER 20, 1965. - Idaho National Engineering Laboratory, Advanced Reentry Vehicle Fusing System, Scoville, Butte County, ID

A compilation of chase work characterizes this image, looking south, ...

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

A compilation of chase work characterizes this image, looking south, in the niche which slightly separates E Building form R Building, on the north side - Department of Energy, Mound Facility, Electronics Laboratory Building (E Building), One Mound Road, Miamisburg, Montgomery County, OH

Stare and chase of space debris targets using real-time derived pointing data

NASA Astrophysics Data System (ADS)

Steindorfer, Michael A.; Kirchner, Georg; Koidl, Franz; Wang, Peiyuan; Antón, Alfredo; Fernández Sánchez, Jaime; Merz, Klaus

2017-09-01

We successfully demonstrate Stare & Chase: Space debris laser ranging to uncooperative targets has been achieved without a priori knowledge of any orbital information. An analog astronomy CCD with a standard objective, piggyback mounted on our 50 cm Graz SLR receive telescope, 'stares' into the sky in a fixed direction. The CCD records the stellar background within a field of view of approx. 7°. From the stellar X/Y positions on the sensor a plate solving algorithm determines the pointing data of the image center with an accuracy of approx. 15 arc seconds. If a sunlit target passes through this field of view, its equatorial coordinates are calculated, stored and a Consolidated Prediction Format (CPF) file is created in near real time. The derived CPF data is used to start laser ranging ('chase' the object) within the same pass to retrieve highly accurate distance information. A comparison of Stare & Chase CPFs with standard TLE predictions shows the possibilities and limits of this method.

Clinical application of 3D-printed-step-bolus in post-total-mastectomy electron conformal therapy.

PubMed

Park, Kwangwoo; Park, Sungjin; Jeon, Mi-Jin; Choi, Jinhyun; Kim, Jun Won; Cho, Yoon Jin; Jang, Won-Seok; Keum, Yo Sup; Lee, Ik Jae

2017-04-11

The 3D-printed boluses were used during the radiation therapy of the chest wall in six patients with breast cancer after modified radical mastectomy (MRM). We measured the in-vivo skin doses while both conventional and 3D-printed boluses were placed on the chest wall and compared the mean doses delivered to the ipsilateral lung and the heart. The homogeneity and conformity of the dose distribution in the chest wall for both types of boluses were also evaluated. The uniformity index on the chest skin was improved when the 3D-printed boluses were used, with the overall average skin dose being closer to the prescribed one in the former case (-0.47% versus -4.43%). On comparing the dose-volume histogram (DVH), it was found that the 3D-printed boluses resulted in a reduction in the mean dose to the ipsilateral lung by up to 20%. The precision of dose delivery was improved by 3% with the 3D-printed boluses; in contrast, the conventional step bolus resulted in a precision level of 5%. In conclusion, the use of the 3D-printed boluses resulted in better dose homogeneity and conformity to the chest wall as well as the sparing of the normal organs, especially the lung. This suggested that their routine use on the chest wall as a therapeutic approach during post-mastectomy radiation therapy offers numerous advantages over conventional step boluses.

Clinical application of 3D-printed-step-bolus in post-total-mastectomy electron conformal therapy

PubMed Central

Park, Kwangwoo; Park, Sungjin; Jeon, Mi-Jin; Choi, Jinhyun; Kim, Jun Won; Cho, Yoon Jin; Jang, Won-Seok; Keum, Yo Sup; Lee, Ik Jae

2017-01-01

The 3D-printed boluses were used during the radiation therapy of the chest wall in six patients with breast cancer after modified radical mastectomy (MRM). We measured the in-vivo skin doses while both conventional and 3D-printed boluses were placed on the chest wall and compared the mean doses delivered to the ipsilateral lung and the heart. The homogeneity and conformity of the dose distribution in the chest wall for both types of boluses were also evaluated. The uniformity index on the chest skin was improved when the 3D-printed boluses were used, with the overall average skin dose being closer to the prescribed one in the former case (-0.47% versus -4.43%). On comparing the dose-volume histogram (DVH), it was found that the 3D-printed boluses resulted in a reduction in the mean dose to the ipsilateral lung by up to 20%. The precision of dose delivery was improved by 3% with the 3D-printed boluses; in contrast, the conventional step bolus resulted in a precision level of 5%. In conclusion, the use of the 3D-printed boluses resulted in better dose homogeneity and conformity to the chest wall as well as the sparing of the normal organs, especially the lung. This suggested that their routine use on the chest wall as a therapeutic approach during post-mastectomy radiation therapy offers numerous advantages over conventional step boluses. PMID:27784001

Bolus-dependent dosimetric effect of positioning errors for tangential scalp radiotherapy with helical tomotherapy

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

Lobb, Eric, E-mail: eclobb2@gmail.com

2014-04-01

The dosimetric effect of errors in patient position is studied on-phantom as a function of simulated bolus thickness to assess the need for bolus utilization in scalp radiotherapy with tomotherapy. A treatment plan is generated on a cylindrical phantom, mimicking a radiotherapy technique for the scalp utilizing primarily tangential beamlets. A planning target volume with embedded scalplike clinical target volumes (CTVs) is planned to a uniform dose of 200 cGy. Translational errors in phantom position are introduced in 1-mm increments and dose is recomputed from the original sinogram. For each error the maximum dose, minimum dose, clinical target dose homogeneitymore » index (HI), and dose-volume histogram (DVH) are presented for simulated bolus thicknesses from 0 to 10 mm. Baseline HI values for all bolus thicknesses were in the 5.5 to 7.0 range, increasing to a maximum of 18.0 to 30.5 for the largest positioning errors when 0 to 2 mm of bolus is used. Utilizing 5 mm of bolus resulted in a maximum HI value of 9.5 for the largest positioning errors. Using 0 to 2 mm of bolus resulted in minimum and maximum dose values of 85% to 94% and 118% to 125% of the prescription dose, respectively. When using 5 mm of bolus these values were 98.5% and 109.5%. DVHs showed minimal changes in CTV dose coverage when using 5 mm of bolus, even for the largest positioning errors. CTV dose homogeneity becomes increasingly sensitive to errors in patient position as bolus thickness decreases when treating the scalp with primarily tangential beamlets. Performing a radial expansion of the scalp CTV into 5 mm of bolus material minimizes dosimetric sensitivity to errors in patient position as large as 5 mm and is therefore recommended.« less

SU-E-T-09: A Dosimetric Analysis of Various Clinically Used Bolus Materials

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

Stowe, M; Yeager, C; Zhou, F

Purpose: To evaluate the dosimetric effect of various clinically used bolus materials. Methods: Materials investigated include solid water, superflab, wet gauze, wet sheets, Play-Doh{sup ™}, and gauze embedded with petroleum jelly. Each bolusing material was scanned in a Philips CT to determine the Hounsfield unit (HU) and to verify uniformity throughout the material. Using the corresponding HU, boluses of 0.5 cm and 1.0 cm thicknesses were created in the Eclipse treatment planning system (TPS) on a solid water phantom. Dose was calculated at various depths for beam energies 6 MV, 6 MeV, 9 MeV, and 12 MeV to determine themore » effects of each material on deposition of dose. In addition, linac-based measurements at these energies were made using a farmer chamber in solid water. Wet sheets and wet gauze were measured with various water content to quantify the effects on dose. Results: Preliminary CT scans find a range in HU of bolus materials from −120 to almost 300. There is a trend in the dose at depth based on the HU of the material; however inconsistencies are found when the bolus materials have a negative HU value. The measured data indicates that there is a linear relationship between the mass of water in a material and the dose reading, the slope of which is material dependent. Conclusion: Due to the variation in HU of the bolus materials studied, it is recommended that any new bolus be evaluated before clinical use to determine physical and dosimetric properties. If possible, patients should have bolus included in their CT scans; or if the bolus is created in the TPS, the HU should correspond to the material used. For water-soaked materials, once the bolus material is selected (gauze or sheet), the bolusing effect is only dependent on the amount of water applied to the material.« less

Early diagnosis of Budd-Chiari syndrome by computed tomography and ultrasonography: report of five cases

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

Baert, A.L.; Fevery, J.; Marchal, G.

1983-03-01

In 5 patients with Budd-Chiari syndrome, computed tomography after intravenous bolus injection of iodinated contrast agents demonstrated images not previously seen in other diseases. The images are compatible with stagnation of contrast material at the periphery of the liver. In 3 of the 5 cases, grey-scale ultrasonography failed to document the normal hepatic veins draining into the inferior caval vein, but showed an intrahepatic network of comma-shaped venous structures. It is proposed that these two noninvasive approaches can help in establishing an early diagnosis.

Computed tomography of infantile hepatic hemangioendothelioma

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

Lucaya, J.; Enriquez, G.; Amat, L.

1985-04-01

Computed tomography (CT) was performed on five infants with hepatic hemangioendothelioma. Precontrast scans showed solitary or multiple, homogeneous, circumscribed areas with reduced attenuation values. Tiny tumoral calcifications were identified in two patients. Serial scans, after injection of a bolus of contrast material, showed early massive enhancement, which was either diffuse or peripheral. On delayed scans, multinocular tumors became isodense with surrounding liver, while all solitary ones showed varied degrees of centripetal enhancement and persistent central cleftlike unenhanced areas. The authors believe that these CT features are characteristic and obviate arteriographic confirmation.

SU-F-T-442: Dose Distribution Comparison for Post-Laryngectomy Stoma Area Between Conventional AP and VMAT Plans with Or Without Bolus

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

Lee, B; Zhang, J; Cho-Lim, J

Purpose: To compare dose distributions of conventional AP vs. VMAT treatment plans with or without bolus around post-laryngectomy stoma. Methods: Radiation dose coverage for post-laryngectomy stoma was analyzed using a set of real-case CT-simulation images. After meticulous contouring of the catheter cuff, stoma lumen, peri-stoma skin and subclinical tumor bed at the larynx, the resulting dosimetry plans were analyzed with or without a 5 mm bolus placement. Wet gauze was used to minimize the effect of any air gap. Four plans were generated: AP superclavicular (SCV) plan with or without bolus, and VMAT plan with or without bolus. A dosemore » of 60Gy in 30 fractions was prescribed at 3 cm depth for AP SCV plan, and to 95% of the PTV volume for VMAT plan. Results: For the conventional AP SCV plan, the peri-stoma skin dose is sensitive to bolus placement as well as air gap compensation by wetted gauze (V95% of 20.7%, 33.0% and 94.8% for no bolus, bolus without and with air gap compensation, respectively). For stoma lumen, the dose drops off rapidly in depth. The catheter cuff may have certain dose-buildup effect, but air gap around it and under the bolus placed can pose a more serious problem. The dose distributions of the two VMAT plans are moderately different for peri-stoma skin (V95% of 95.0% with bolus and air gap compensation, and 82.3% without bolus), but nearly identical for stoma lumen (V95% of 91.5% and 92.0%, respectively). VMAT allows beamlets with different angles of incidence that helped achieve such dose distribution around the stoma even without bolus placement. Conclusion: Overall, the dose coverage around the stoma in the VMAT plan is better than the conventional AP SCV plan. To achieve optimal dose distribution, it is still recommended to place physical bolus and reduce the air gaps.« less

Mortality after fluid bolus in African children with severe infection.

PubMed

Maitland, Kathryn; Kiguli, Sarah; Opoka, Robert O; Engoru, Charles; Olupot-Olupot, Peter; Akech, Samuel O; Nyeko, Richard; Mtove, George; Reyburn, Hugh; Lang, Trudie; Brent, Bernadette; Evans, Jennifer A; Tibenderana, James K; Crawley, Jane; Russell, Elizabeth C; Levin, Michael; Babiker, Abdel G; Gibb, Diana M

2011-06-30

The role of fluid resuscitation in the treatment of children with shock and life-threatening infections who live in resource-limited settings is not established. We randomly assigned children with severe febrile illness and impaired perfusion to receive boluses of 20 to 40 ml of 5% albumin solution (albumin-bolus group) or 0.9% saline solution (saline-bolus group) per kilogram of body weight or no bolus (control group) at the time of admission to a hospital in Uganda, Kenya, or Tanzania (stratum A); children with severe hypotension were randomly assigned to one of the bolus groups only (stratum B). All children received appropriate antimicrobial treatment, intravenous maintenance fluids, and supportive care, according to guidelines. Children with malnutrition or gastroenteritis were excluded. The primary end point was 48-hour mortality; secondary end points included pulmonary edema, increased intracranial pressure, and mortality or neurologic sequelae at 4 weeks. The data and safety monitoring committee recommended halting recruitment after 3141 of the projected 3600 children in stratum A were enrolled. Malaria status (57% overall) and clinical severity were similar across groups. The 48-hour mortality was 10.6% (111 of 1050 children), 10.5% (110 of 1047 children), and 7.3% (76 of 1044 children) in the albumin-bolus, saline-bolus, and control groups, respectively (relative risk for saline bolus vs. control, 1.44; 95% confidence interval [CI], 1.09 to 1.90; P=0.01; relative risk for albumin bolus vs. saline bolus, 1.01; 95% CI, 0.78 to 1.29; P=0.96; and relative risk for any bolus vs. control, 1.45; 95% CI, 1.13 to 1.86; P=0.003). The 4-week mortality was 12.2%, 12.0%, and 8.7% in the three groups, respectively (P=0.004 for the comparison of bolus with control). Neurologic sequelae occurred in 2.2%, 1.9%, and 2.0% of the children in the respective groups (P=0.92), and pulmonary edema or increased intracranial pressure occurred in 2.6%, 2.2%, and 1.7% (P=0.17), respectively. In stratum B, 69% of the children (9 of 13) in the albumin-bolus group and 56% (9 of 16) in the saline-bolus group died (P=0.45). The results were consistent across centers and across subgroups according to the severity of shock and status with respect to malaria, coma, sepsis, acidosis, and severe anemia. Fluid boluses significantly increased 48-hour mortality in critically ill children with impaired perfusion in these resource-limited settings in Africa. (Funded by the Medical Research Council, United Kingdom; FEAST Current Controlled Trials number, ISRCTN69856593.).

Effects of therapy on masseter activity and chewing kinematics in patients with unilateral posterior crossbite.

PubMed

Piancino, Maria Grazia; Falla, Deborah; Merlo, Andrea; Vallelonga, Teresa; de Biase, Corrado; Dalessandri, Domenico; Debernardi, Cesare

2016-07-01

To describe the effects of therapy on masseter activity and chewing kinematic in patients with unilateral posterior crossbite (UPC). Fifty children (age: mean ± SD: 9.1 ± 2.3 years) with UPC (34 on the right side, 16 on the left side) and twenty children (age: 9.5 ± 2.6 years) with normal occlusion were selected for the study. The mandibular motion and the muscular activity during chewing soft and hard boli were simultaneously recorded, before and after correction with function generating bite, after a mean treatment time of 7.3 ± 2.4 months plus the retention time of 5-6 months. The percentage of reverse cycles and the percent difference between ipsilateral and contralateral peaks of the masseter electromyography envelopes were computed. Before therapy, the percentage of reverse cycles during chewing on the crossbite side was greater in patients than in controls (P<0.001) and significantly reduced after therapy (P<0.001) towards the reference normal value (soft bolus; pre: 57 ± 30%, post:12 ± 17%; hard bolus; pre: 65 ± 34%, post: 12 ± 13%; reference value: soft bolus 4 ± 2%, hard bolus 5 ± 3%). Before therapy the percent difference between electromyography envelope peaks in patients was lower than in controls (P<0.01) and significantly increased after therapy (P<0.05) becoming similar to the reference normal value. The correction induced a normal-like coordination of masseter muscles activity together with a significant reduction of the reverse chewing patterns. The previous altered muscular activation corresponded to the altered kinematics of reverse chewing cycles that might be considered a useful indicator of the severity of the masticatory function involvement. Copyright © 2016 Elsevier Ltd. All rights reserved.

A pilot study of contralateral homonymous muscle activity simulated electrical stimulation in chronic hemiplegia.

PubMed

Osu, Rieko; Otaka, Yohei; Ushiba, Junichi; Sakata, Sachiko; Yamaguchi, Tomofumi; Fujiwara, Toshiyuki; Kondo, Kunitsugu; Liu, Meigen

2012-01-01

For the recovery of hemiparetic hand function, a therapy was developed called contralateral homonymous muscle activity stimulated electrical stimulation (CHASE), which combines electrical stimulation and bilateral movements, and its feasibility was studied in three chronic stroke patients with severe hand hemiparesis. Patients with a subcortical lesion were asked to extend their wrist and fingers bilaterally while an electromyogram (EMG) was recorded from the extensor carpi radialis (ECR) muscle in the unaffected hand. Electric stimulation was applied to the homonymous wrist and finger extensors of the affected side. The intensity of the electrical stimulation was computed based on the EMG and scaled so that the movements of the paretic hand looked similar to those of the unaffected side. The patients received 30-minutes of therapy per day for 2 weeks. Improvement in the active range of motion of wrist extension was observed for all patients. There was a decrease in the scores of modified Ashworth scale in the flexors. Fugl-Meyer assessment scores of motor function of the upper extremities improved in two of the patients. The results suggest a positive outcome can be obtained using the CHASE system for upper extremity rehabilitation of patients with severe hemiplegia.

21 CFR 520.1720a - Phenylbutazone tablets and boluses.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Phenylbutazone tablets and boluses. 520.1720a... Phenylbutazone tablets and boluses. (a) Specifications. Each tablet contains 100, 200, or 400 milligrams (mg), or...-mg or 1-g tablets, or 2- or 4-g boluses, in dogs and horses. (2) Nos. 000010 and 059130 for use of...

Dynamic dual-isotope molecular imaging elucidates principles for optimizing intrathecal drug delivery

PubMed Central

Wolf, Daniel A.; Hesterman, Jacob Y.; Sullivan, Jenna M.; Orcutt, Kelly D.; Silva, Matthew D.; Lobo, Merryl; Wellman, Tyler; Hoppin, Jack

2016-01-01

The intrathecal (IT) dosing route offers a seemingly obvious solution for delivering drugs directly to the central nervous system. However, gaps in understanding drug molecule behavior within the anatomically and kinetically unique environment of the mammalian IT space have impeded the establishment of pharmacokinetic principles for optimizing regional drug exposure along the neuraxis. Here, we have utilized high-resolution single-photon emission tomography with X-ray computed tomography to study the behavior of multiple molecular imaging tracers following an IT bolus injection, with supporting histology, autoradiography, block-face tomography, and MRI. Using simultaneous dual-isotope imaging, we demonstrate that the regional CNS tissue exposure of molecules with varying chemical properties is affected by IT space anatomy, cerebrospinal fluid (CSF) dynamics, CSF clearance routes, and the location and volume of the injected bolus. These imaging approaches can be used across species to optimize the safety and efficacy of IT drug therapy for neurological disorders. PMID:27699254

Solution or suspension - Does it matter for lipid based systems? In vivo studies of chase dosing lipid vehicles with aqueous suspensions of a poorly soluble drug.

PubMed

Larsen, A T; Holm, R; Müllertz, A

2017-08-01

In this study, the potential of co-administering an aqueous suspension with a placebo lipid vehicle, i.e. chase dosing, was investigated in rats relative to the aqueous suspension alone or a solution of the drug in the lipid vehicle. The lipid investigated in the present study was Labrafil M2125CS and three evaluated poorly soluble model compounds, danazol, cinnarizine and halofantrine. For cinnarizine and danazol the oral bioavailability in rats after chase dosing or dosing the compound dissolved in Labrafil M21515CS was similar and significantly higher than for the aqueous suspension. For halofantrine the chase dosed group had a tendency towards a low bioavailability relative to the Labrafil M2125CS solution, but still a significant higher bioavailability relative to the aqueous suspension. This could be due to factors such as a slower dissolution rate in the intestinal phase of halofantrine or a lower solubility in the colloidal structures formed during digestion, but other mechanisms may also be involved. The study thereby supported the potential of chase dosing as a potential dosing regimen in situations where it is beneficial to have a drug in the solid state, e.g. due to chemical stability issues in the lipid vehicle. Copyright © 2017 Elsevier B.V. All rights reserved.

Effect of bolus volume and viscosity on pharyngeal automated impedance manometry variables derived for broad Dysphagia patients.

PubMed

Omari, Taher I; Dejaeger, Eddy; Tack, Jan; Van Beckevoort, Dirk; Rommel, Nathalie

2013-06-01

Automated impedance manometry (AIM) analysis measures swallow variables defining bolus timing, pressure, contractile vigour, and bolus presence, which are combined to derive a swallow risk index (SRI) correlating with aspiration. In a heterogeneous cohort of dysphagia patients, we assessed the impact of bolus volume and viscosity on AIM variables. We studied 40 patients (average age = 46 years). Swallowing of boluses was recorded with manometry, impedance, and videofluoroscopy. AIMplot software was used to derive functional variables: peak pressure (PeakP), pressure at nadir impedance (PNadImp), time from nadir impedance to peak pressure (TNadImp-PeakP), the interval of impedance drop in the distal pharynx (flow interval, FI), upper oesophageal sphincter (UES) relaxation interval (UES RI), nadir UES pressure (Nad UESP), UES intrabolus pressure (UES IBP), and UES resistance. The SRI was derived using the formula SRI = (FI * PNadImp)/(PeakP * (TNadImp-PeakP + 1)) * 100. A total of 173 liquid, 44 semisolid, and 33 solid boluses were analysed. The SRI was elevated in relation to aspiration. PeakP increased with volume. SRI was not significantly altered by bolus volume. PNadImp, UES IBP, and UES resistance increased with viscosity. SRI was lower with increased viscosity. In patients with dysphagia, the SRI is elevated in relation to aspiration, reduced by bolus viscosity, and not affected by bolus volume. These data provide evidence that pharyngeal AIM analysis may have clinical utility for assessing deglutitive aspiration risk to liquid boluses.

The comparison of the diuretic and natriuretic efficacy of continuous and bolus intravenous furosemide in patients with chronic kidney disease.

PubMed

Sanjay, Srinivas; Annigeri, Rajeev A; Seshadri, Rajagopalan; Rao, Budithi Subba; Prakash, Kowdle C; Mani, Muthu Krishna

2008-06-01

To compare natriuretic, kaliuretic, diuretic and free water clearance efficacy of continuous versus bolus intravenous furosemide administration in patients with chronic renal insufficiency. In a prospective randomized cross-over trial, 42 patients of chronic renal insufficiency were randomized to receive the same dose of intravenous furosemide as bolus and continuous infusion. The effects of bolus and intravenous administration of furosemide on the volume of urine, sodium and potassium excretion were assessed. Mean age was 53.6 +/- 14 years and 23 (55%) were male. The mean modification of diet in renal disease glomerular filtration rate was 20.5 +/- 17 mL/min per 1.73 m(2). The urinary excretion of sodium in intravenous bolus and infusion was 98.1 +/- 78 and 114.4 +/- 100 mmol, respectively (P = 0.001). Total urinary volume following bolus and infusion of furosemide was 1064 +/- 627 and 1170 +/- 764 mL, respectively (0.001). The excretion of potassium was similar in bolus (15.8 +/- 16.6) and infusion (14.3 +/- 9) administration (P = 0.11). The fractional excretion of sodium was higher following infusion (16.63 +/- 16.1) than bolus administration (12.87 +/- 9) of furosemide (P = 0.016). Continuous intravenous infusion of furosemide has significantly better natriuretic and diuretic effect than bolus administration of the same dose of the drug in patients with advanced chronic renal insufficiency.

Chinese Learning Journeys: Chasing the Dream

ERIC Educational Resources Information Center

Su, Feng, Ed.

2011-01-01

Eight students from mainland China chart their learning journeys across national and continental boundaries and socio-cultural contexts. The five women and three men structure their experiences of studying in China and the West around the turning points and life changing choices they made in chasing their dreams. They embody its emergent…

What Do Tag Games Teach?

ERIC Educational Resources Information Center

Belka, David

2006-01-01

Tag games have been described as "Chasing, fleeing, and dodging" type activities. Most "fleeing" activities involve dramatic play, use of movement concepts (such as quick and light), or movement changes without a partner, while many of the chasing and dodging activities utilize dodging concepts between partners or within small groups and are…

78 FR 18801 - Establishment of Class E Airspace; Beeville, TX

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-28

... Instrument Approach Procedures at Chase Field Industrial Airport. The FAA is taking this action to enhance the safety and management of Instrument Flight Rule (IFR) operations at the airport. DATES: Effective... Federal Register a notice of proposed rulemaking (NPRM) to establish Class E airspace at Chase Industrial...

Suitability of electronic mini-boluses for the early identification of goat kids and effects on growth performance and development of the reticulorumen.

PubMed

Castro, N; Martín, D; Castro-Alonso, A; Argüello, A; Capote, J; Caja, G

2010-10-01

A total of 60 twin-goat kids (30 male and 30 female) of the Canary Island Majorera dairy breed were used in 2 experiments to evaluate 2 types of electronic identification mini-boluses and their effects on rearing performances and reticulorumen development. Electronic identification mini-boluses were cylindrical and made of ceramic materials (B1, 9.0 g and 38.5 × 9.5 mm; B2, 16.3 g and 42.2 × 12.2 mm), contained a 32-mm half-duplex passive transponder, and were administered to kids at different BW. In Exp. 1, treatments were 1) control, without bolus (n = 15) and 2) identified with B1 at 4.8 kg of BW (n = 15). In Exp. 2, treatments were 1) control, without bolus (n = 15) and 2) identified with B2 at 5.6 kg of BW (n = 15). Kids were penned separately, according to mini-bolus treatments, fed a milk replacer daily, and slaughtered at 10 kg of BW. Milk replacer intake was recorded individually twice weekly and boluses read weekly until slaughter. The full and empty stomach complex was measured immediately after slaughter, and mini-bolus location was recorded. Samples of the reticulum and rumen wall were taken to measure the number and length of the papillae and crest. Despite the light BW of kids at time of mini-bolus treatment, no negative effects (P > 0.05) of B1 and B2 mini-boluses were observed on milk intake, growth rate, or G:F in either experiment. No kid mortality or mini-bolus losses were observed during either experiment. All mini-boluses were retained until slaughter, and all were found in the rumen upon dissection, except one B2, which was found in the reticulum. Mini-bolus treatment did not affect (P > 0.05) the weight of full and empty reticulorumen or the number of papillae and crest size of the reticulum epithelium. Moreover, the B1-treated kids showed a greater number of papillae in the rumen wall than the control kids (22.4 +/- 1.0 vs. 18.9 +/- 0.9 papillae/cm, respectively; P < 0.05) in Exp. 1. In conclusion, the use of mini-boluses was suitable for the electronic identification of growing kids from early ages (wk 2 to 5 of age and 5 to 6 kg of BW) and did not produce negative effects on their growth performances or on reticulorumen development. These results support the use of properly designed boluses as a unique identification device for the entire lifespan of goats.

Effects of a long-acting, trace mineral, reticulorumen bolus on range cow productivity and trace mineral profiles.

PubMed

Sprinkle, J E; Cuneo, S P; Frederick, H M; Enns, R M; Schafer, D W; Carstens, G E; Daugherty, S B; Noon, T H; Rickert, B M; Reggiardo, C

2006-06-01

The objectives were to determine if strategic supplementation of range cows with a long-acting (6 mo), trace mineral, reticulorumen bolus containing Cu, Se, and Co would: (1) increase cow BCS and BW, and calf birth, weaning, and postweaning weights, or weight per day of age (WDA); (2) increase liver concentrations of Cu or Zn in cows, or blood Se, Cu, or Zn concentrations in cows and calves; and (3) vary by cow breed for any of these response variables. There were 192 control and 144 bolused Composite cows (C; 25% Hereford, Angus, Gelbevieh, and Senepol or Barzona); 236 control and 158 bolused Hereford (H) cows; and 208 control and 149 bolused Brahman cross (B) cows used in a 3-yr experiment. Cows were weighed and scored for body condition in January, May, and September, and all bolused cows received boluses in January. Each year, from among the 3 breed groups a subset of 15 control and 15 bolused cows (n = 90) had samples obtained in January and May for liver Cu and Zn, blood Se, and serum Cu and Zn. As for cows, blood and serum from the calves of these cows were sampled each year in May and September for Cu, Se, and Zn. There was a significant breed x year x treatment interaction (P = 0.001) for cow weight loss from January to May. Calf WDA, weaning, and postweaning weights did not differ (P > 0.40) between bolused and control cows, but there was a significant (P = 0.022) breed x year x treatment interaction for birth weight. Liver Cu was deficient (< 75 ppm; P < 0.001) in control cows and adequate (< 75 to 90 ppm) for bolused cows. Liver Cu differed by year (P < 0.001). Blood Se was adequate (< 0.1 ppm) for all cows except in January 2001 and 2002. There was no difference (P > 0.50) in blood Se between treatment groups in January, but bolused cows had greater (P < 0.01) blood Se in May. Breed differences for blood Se concentrations existed for bolused cows, with B having greater (P < 0.05) blood Se than either C or H cows. Breed differences also existed for control cows, with H having less blood Se (P < 0.04) than B or C cows. Calves from bolused cows had greater blood Se than calves from control cows (P = 0.01). Supplementation via a long-acting trace mineral bolus was successful in increasing liver Cu in cows and blood Se in cows and calves, but the responses varied by year. Bolus administration had variable effects on BW change in early lactation, depending on breed and year, which may indicate the need for breed- and year-specific supplementation programs.

On the anomalous afterglow seen in a chameleon afterglow search

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

Steffen, Jason H.; Baumbaugh, Alan; Chou, Aaron S.

2012-05-01

We present data from our investigation of the anomalous orange-colored afterglow that was seen in the GammeV Chameleon Afterglow Search (CHASE). These data include information about the broadband color of the observed glow, the relationship between the glow and the temperature of the apparatus, and other data taken prior to, and during the science operations of CHASE. While differing in several details, the generic properties of the afterglow from CHASE are similar to luminescence seen in some vacuum compounds. Contamination from this, or similar, luminescent signatures will likely impact the design of implementation of future experiments involving single photon detectorsmore » and high intensity light sources in a cryogenic environment.« less

Aggregation increases prey survival time in group chase and escape

NASA Astrophysics Data System (ADS)

Yang, Sicong; Jiang, Shijie; Jiang, Li; Li, Geng; Han, Zhangang

2014-08-01

Recently developed chase-and-escape models have addressed a fascinating pursuit-and-evasion problem that may have both theoretical significance and potential applications. We introduce three aggregation strategies for the prey in a group chase model on a lattice. Simulation results show that aggregation dramatically increases the group survival time, even allowing immortal prey. The average survival time τ and the aggregation probability P have a power-law dependence of \\tau \\sim {{(1-P)}^{-1}} for P\\in [0.9,0.997]. With increasing numbers of predators, there is still a phase transition. When the number of predators is less than the critical point value, the prey group survival time increases significantly.

Surface dose measurements from air gaps under a bolus by using a MOSFET dosimeter in clinical oblique photon beams

NASA Astrophysics Data System (ADS)

Chung, Jin-Beom; Kim, Jae-Sung; Kim, In-Ah; Lee, Jeong-Woo

2012-10-01

This study is intended to investigate the effects of surface dose from air gaps under the bolus in clinically used oblique photon beams by using a Markus parallel-plate chamber and a metal-oxide semiconductor field-effect transistor (MOSFET) dosimeter. To evaluate the performances of the two detectors, the percentage surface doses of the MOSFET dosimeters in without an air gap under the bolus material were measured and compared with those of the Markus parallel-plate chamber. MOSFET dosimeters at the surface provided results mostly in good agreement with the parallelplate chamber. The MOSFET dosimeters seemed suitable for surface dose measurements having excellent accuracy for clinical used photon beams. The relative surface doses were measured with air gaps (2, 5, 10 mm) and without an air gap under 3 different bolus setups: (1) unbolused (no bolus), (2) 5-mm bolus, and (3) 10-mm bolus. The reductions in the surface dose substantially increased with small field size, thick bolus, and large air gap. The absolute difference in the reductions of the surface dose between the MOSFET dosimeter and the Markus parallel-plate chamber was less than 1.1%. Results at oblique angles of incidence showed larger reductions in surface dose with increasing angle of incidence. The largest reduction in surface dose was recorded for a 6 × 6 cm2 field at a 60° angle of incidence with an 10-mm air gap under a 10-mm bolus. When a 10-mm bolus was used, a reduction in the surface dose with an air gap of up to 10.5% could be achieved by varying the field size and the incident angle. Therefore, air gaps under the bolus should be avoided in radiotherapy treatment, especially for photon beam with highly oblique angles of incidence.

SU-E-T-176: Clinical Experience of Brass Mesh Bolus: Patient-Specific Parameters as Predictors of Measured Dosimetric Effect

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

Yock, A; Manger, R; Einck, J

2015-06-15

Purpose: Increasingly, brass mesh bolus is used to insure dosimetric coverage of the skin for patients treated post-mastectomy for breast cancer. Contribution of photoelectrons from interactions between the bolus and the primary beam increases dose superficially without affecting dose at greater depths. We present our experience using brass mesh bolus – including patients for whom the bolus was dosimetrically inadequate – along with analysis of relevant patient-specific parameters. Methods: Optically-stimulated luminescent dosimeters (OSLDs) were used to determine the effect of the bolus for 15 patients. They were positioned beneath the bolus within the tangent fields at three positions: 1.5–3cm insidemore » the medial and lateral field edges, and midway between the two. All OSLDs were midfield in the cranial-caudal direction. The measurements were compared with patient-specific parameters including separation, chest wall/breast tissue thickness, beam angle incidence, and planned surface dose. Results: The average OSLD measurement at the medial field edge, midfield, and lateral field edge position was 86.8%, 101.8%, and 92.8% of the prescription dose, respectively. A measurement for one patient was low enough (77.0%) to warrant a switch to an alternative type of bolus. Anatomic parameters were analyzed to investigate the low dose in this case, not observed in the planning system. The patient was observed to have a thin chest wall and very oblique beam angles. A second patient was also switched to an alternative type of bolus due to her being high risk and treated with an electron patch that extended onto the breast. Conclusion: Brass mesh bolus increases dose superficially while leaving dose at greater depths unaffected. However, our results suggest that this effect may be insufficient in patients with a thin chest wall or very oblique beam angles. More data and analysis is necessary to proactively identify patients for whom brass mesh bolus is effective.« less

Lowering postprandial glycemia in children with type 1 diabetes after Italian pizza "margherita" (TyBoDi2 Study).

PubMed

De Palma, Alessandra; Giani, Elisa; Iafusco, Dario; Bosetti, Alessandra; Macedoni, Maddalena; Gazzarri, Alessandra; Spiri, Daniele; Scaramuzza, Andrea E; Zuccotti, Gian Vincenzo

2011-04-01

Continuous subcutaneous insulin infusion is considered a safe and effective way to administer insulin in pediatric patients with type 1 diabetes, but achieving satisfactory and stable glycemic control is difficult. Several factors contribute to control, including fine-tuning the basal infusion rate and bolus type and timing. We evaluated the most effective type and timing of a pump-delivered, preprandial bolus in children with type 1 diabetes for a pizza "margherita" meal. We assessed the response of 38 children with type 1 diabetes to a meal based on pizza "margherita" (with mozzarella cheese and tomato sauce) after different types and timings of a bolus dose. The glucose levels for 6 h after the meal were lower (i.e., closer to the therapeutic target of <140 mg/dL) when the bolus doses were administered as a simple bolus 15 min before the meal (area under the curve [AUC] 0-6 h, 6.9 ± 14.9 mg/dL/min) versus a simple bolus administered immediately before the meal (AUC 0-6 h, 4.2 ± 25.9 mg/dL/min) (P = not significant) versus a double-wave bolus 30/70 extended over a 6-h period administered 15 min before the meal (AUC 0-6 h, 1.9 ± 21.3 mg/dL/min) (P = not significant) versus a double-wave bolus 30/70 extended over a 6-h period administered immediately before the meal (AUC 0-6 h, 13.3 ± 15.6 mg/dL/min) (P = 0.01). In the case of a pizza "margherita," our data support the injection of the simple bolus 15 min before a meal, rather than immediately before or delivered as a double-wave bolus, to control the glycemic rise usually observed.

Probabilistic reward- and punishment-based learning in opioid addiction: Experimental and computational data.

PubMed

Myers, Catherine E; Sheynin, Jony; Balsdon, Tarryn; Luzardo, Andre; Beck, Kevin D; Hogarth, Lee; Haber, Paul; Moustafa, Ahmed A

2016-01-01

Addiction is the continuation of a habit in spite of negative consequences. A vast literature gives evidence that this poor decision-making behavior in individuals addicted to drugs also generalizes to laboratory decision making tasks, suggesting that the impairment in decision-making is not limited to decisions about taking drugs. In the current experiment, opioid-addicted individuals and matched controls with no history of illicit drug use were administered a probabilistic classification task that embeds both reward-based and punishment-based learning trials, and a computational model of decision making was applied to understand the mechanisms describing individuals' performance on the task. Although behavioral results showed that opioid-addicted individuals performed as well as controls on both reward- and punishment-based learning, the modeling results suggested subtle differences in how decisions were made between the two groups. Specifically, the opioid-addicted group showed decreased tendency to repeat prior responses, meaning that they were more likely to "chase reward" when expectancies were violated, whereas controls were more likely to stick with a previously-successful response rule, despite occasional expectancy violations. This tendency to chase short-term reward, potentially at the expense of developing rules that maximize reward over the long term, may be a contributing factor to opioid addiction. Further work is indicated to better understand whether this tendency arises as a result of brain changes in the wake of continued opioid use/abuse, or might be a pre-existing factor that may contribute to risk for addiction. Copyright © 2015 Elsevier B.V. All rights reserved.

Unknown Safety and Efficacy of Smartphone Bolus Calculator Apps Puts Patients at Risk for Severe Adverse Outcomes.

PubMed

Hirsch, Irl B; Parkin, Christopher G

2016-07-01

Manual calculation of bolus insulin dosages can be challenging for individuals treated with multiple daily insulin injections (MDI) therapy. Automated bolus calculator capability has recently been made available via enhanced blood glucose meters and smartphone apps. Use of this technology has been shown to improve glycemic control and reduce glycemic variability without changing hypoglycemia; however, the clinical utility of app-based bolus calculators has not been demonstrated. Moreover, recent evidence challenges the safety and efficacy of these smartphone apps. Although the ability to automatically calculate bolus insulin dosages addresses a critical need of MDI-treated individuals, this technology raises concerns about efficacy of treatment and the protection of patient safety. This article discusses key issues and considerations associated with automated bolus calculator use. © 2016 Diabetes Technology Society.

The Interactive Effect of Diabetes Family Conflict and Depression on Insulin Bolusing Behaviors for Youth.

PubMed

Maliszewski, Genevieve; Patton, Susana R; Midyett, L Kurt; Clements, Mark A

2017-05-01

Adherence to type 1 diabetes management declines as children enter adolescence. For youth, psychosocial variables including mood and interpersonal relationships play a large role in diabetes maintenance. The current study assessed the unique and interactive roles diabetes family conflict and depression have on insulin bolusing behaviors for youth ages 10-16 years. Ninety-one youth-parent dyads completed a survey assessing family conflict and depression. Mean daily blood glucose levels, mealtime insulin bolus scores ( BOLUS), and glycated hemoglobin (HbA1c) were collected from the medical record as outcome variables. Parent-reported diabetes-related family conflict and youths' endorsed depression both significantly predicted insulin bolusing behavior, R 2 = .13, F(2, 88) = 6.66, P < .05. The interaction of diabetes family conflict and youth depression played a significant role in youths' bolusing behaviors, above and beyond that which was predicted by conflict and depression separately, R 2 = .18, F change (1, 87) = 4.63, P < .05. BOLUS was negatively related to youths' hemoglobin A1c, r = -.556, P < .001 and mean daily blood glucose levels, r = -.428, P < .001. Among depressed youth, mealtime insulin BOLUS scores declined with greater diabetes-related family conflict, while there was no change in BOLUS scores among depressed youth living in families reporting less conflict. Findings underscore the importance of screening for depression and family conflict in youth experiencing or at risk for poor adherence to mealtime insulin and higher HbA1c levels.

Chase and NYANA: A Partnership To Remove Barriers to Job Performance 1993-94. Final Report.

ERIC Educational Resources Information Center

Auerbach, Charles

A workplace literacy program implemented cooperatively by the New York Association for New Americans, Inc. (NYANA) and Chase Manhattan Bank is reported. The federally-funded project provided individualized communication workplace behavior and skills training in English as a Second Language for 30 limited-English-proficient bank employees working…

Motivations and sensation seeking characteristics of recreational storm chasers

Treesearch

Shuangyu Xu; Sonja Wilhelm Stanis; Carla Barbieri; Jiawen Chen

2012-01-01

Little is known about recreational storm chasing, a type of risk recreation that has increased in popularity since the 1990s. This study was conducted to understand factors associated with participation in recreational storm chasing in the United States. Particularly, this study assessed the motivations and sensation seeking attributes of recreational storm chasers, as...

Maternal programming of offspring hypothalamic-pituitary-interrenal axis in wild sockeye salmon (Oncorhynchus nerka).

PubMed

Sopinka, N M; Jeffrey, J D; Burnett, N J; Patterson, D A; Gilmour, K M; Hinch, S G

2017-02-01

In fishes, maternal exposure to a stressor can influence offspring size and behavior. However, less is known about how maternal stress influences physiological processes in offspring, such as function of the hypothalamic-pituitary-interrenal (HPI) axis. We examined the impact of chronic maternal exposure to an acute chase stressor on the stress response/HPI activity of progeny in wild sockeye salmon (Oncorhynchus nerka). Resting plasma cortisol and brain preoptic area (POA) corticotropin-releasing factor (CRF) mRNA levels did not vary between offspring reared from undisturbed, control females and offspring reared from females exposed to the stressor. However, resting levels of POA glucocorticoid receptors (GR1 and GR2), and head kidney melanocortin 2 receptor (MC2R), steroidogenic acute regulatory protein (StAR), and cytochrome P450 side chain cleavage enzyme (P450scc) were elevated in offspring reared from stressor-exposed females. Offspring reared from stressor-exposed females had lower plasma cortisol levels 1-h after an acute chase stressor compared to cortisol levels in offspring reared from control females. In offspring reared from chased females, mRNA levels of genes associated with cortisol biosynthesis were reduced in the head kidney post-chase. In offspring reared from control females, mRNA levels in the head kidney did not vary pre- to post-chase. Together, the results of the present study suggest maternal programming of progeny with respect to baseline and stressor-induced mediators of HPI axis activity. Copyright © 2015 Elsevier Inc. All rights reserved.

Predator evasion by white-tailed deer fawns

USGS Publications Warehouse

Grovenburg, Troy W.; Monteith, Kevin L.; Klaver, Robert W.; Jenks, Jonathan A.

2012-01-01

Despite their importance for understanding predator–prey interactions, factors that affect predator evasion behaviours of offspring of large ungulates are poorly understood. Our objective was to characterize the influence of selection and availability of escape cover and maternal presence on predator evasion by white-tailed deer, Odocoileus virginianus, fawns in the northern Great Plains, U.S.A. We observed 45 coyote, Canis latrans, chases of fawns, and we participated in 83 human chases of fawns during 2007–2009, of which, 19 and 42 chases, respectively, ended with capture of the fawn. Evasive techniques used by fawns were similar for human and coyote chases. Likelihood of a white-tailed deer fawn escaping capture, however, was influenced by deer group size and a number of antipredator behaviours, including aggressive defence by females, initial habitat and selection of escape cover, all of which were modified by the presence of parturient females. At the initiation of a chase, fawns in grasslands were more likely to escape, whereas fawns in forested cover, cultivated land or wheat were more likely to be captured by a coyote or human. Fawns fleeing to wetlands and grasslands also were less likely to be captured compared with those choosing forested cover, wheat and cultivated land. Increased probability of capture was associated with greater distance to wetland and grassland habitats and decreased distance to wheat. Use of wetland habitat as a successful antipredator strategy highlights the need for a greater understanding of the importance of habitat complexity in predator avoidance.

Sexually dimorphic aggression indicates male gray wolves specialize in pack defense against conspecific groups

USGS Publications Warehouse

Cassidy, Kira A.; Mech, L. David; MacNulty, Daniel R; Stahler, Daniel R.; Smith, Douglas W.

2017-01-01

Aggression directed at conspecific groups is common among gregarious, territorial species, and for some species such as gray wolves (Canis lupus) intraspecific strife is the leading cause of natural mortality. Each individual in a group likely has different measures of the costs and benefits associated with a group task, such as an aggressive attack on another group, which can alter motivation and behavior. We observed 292 inter-pack aggressive interactions in Yellowstone National Park between 1 April 1995 and 1 April 2011 (>5300 days of observation) in order to determine the role of both sexes, and the influence of pack, age, and other traits on aggression. We recorded the behaviors and characteristics of all individuals present during the interactions (n = 534 individuals) and which individuals participated in each step (i.e. chase, attack, kill, flight) of the interaction. Overall, all wolves were more likely to chase rivals if they outnumbered their opponent, suggesting packs accurately assess their opponent’s size during encounters and individuals adjust their behavior based on relative pack size. Males were more likely than females to chase rival packs and gray-colored wolves were more aggressive than black-colored wolves. Male wolves and gray-colored wolves also recorded higher cortisol levels than females and black-colored wolves, indicating hormonal support for more intense aggressive behavior. Further, we found a positive correlation between male age and probability of chasing, while age-specific participation for females remained constant. Chasing behavior was influenced by the sex of lone intruders, with males more likely to chase male intruders. This difference in behavior suggests male and female wolves may have different strategies and motivations during inter-pack aggressive interactions related to gray wolf mating systems. A division of labor between pack members concerning resource and territory defense suggests selection for specific traits related to aggression is an adaptive response to intense competition between groups of conspecifics.

Sexually dimorphic aggression indicates male gray wolves specialize in pack defense against conspecific groups.

PubMed

Cassidy, Kira A; Mech, L David; MacNulty, Daniel R; Stahler, Daniel R; Smith, Douglas W

2017-03-01

Aggression directed at conspecific groups is common among gregarious, territorial species, and for some species such as gray wolves (Canis lupus) intraspecific strife is the leading cause of natural mortality. Each individual in a group likely has different measures of the costs and benefits associated with a group task, such as an aggressive attack on another group, which can alter motivation and behavior. We observed 292 inter-pack aggressive interactions in Yellowstone National Park between 1 April 1995 and 1 April 2011 (>5300days of observation) in order to determine the role of both sexes, and the influence of pack, age, and other traits on aggression. We recorded the behaviors and characteristics of all individuals present during the interactions (n=534 individuals) and which individuals participated in each step (i.e. chase, attack, kill, flight) of the interaction. Overall, all wolves were more likely to chase rivals if they outnumbered their opponent, suggesting packs accurately assess their opponent's size during encounters and individuals adjust their behavior based on relative pack size. Males were more likely than females to chase rival packs and gray-colored wolves were more aggressive than black-colored wolves. Male wolves and gray-colored wolves also recorded higher cortisol levels than females and black-colored wolves, indicating hormonal support for more intense aggressive behavior. Further, we found a positive correlation between male age and probability of chasing, while age-specific participation for females remained constant. Chasing behavior was influenced by the sex of lone intruders, with males more likely to chase male intruders. This difference in behavior suggests male and female wolves may have different strategies and motivations during inter-pack aggressive interactions related to gray wolf mating systems. A division of labor between pack members concerning resource and territory defense suggests selection for specific traits related to aggression is an adaptive response to intense competition between groups of conspecifics. Copyright © 2017 Elsevier B.V. All rights reserved.

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.

Exploring mechanisms of excess mortality with early fluid resuscitation: insights from the FEAST trial

PubMed Central

2013-01-01

Background Early rapid fluid resuscitation (boluses) in African children with severe febrile illnesses increases the 48-hour mortality by 3.3% compared with controls (no bolus). We explored the effect of boluses on 48-hour all-cause mortality by clinical presentation at enrolment, hemodynamic changes over the first hour, and on different modes of death, according to terminal clinical events. We hypothesize that boluses may cause excess deaths from neurological or respiratory events relating to fluid overload. Methods Pre-defined presentation syndromes (PS; severe acidosis or severe shock, respiratory, neurological) and predominant terminal clinical events (cardiovascular collapse, respiratory, neurological) were described by randomized arm (bolus versus control) in 3,141 severely ill febrile children with shock enrolled in the Fluid Expansion as Supportive Therapy (FEAST) trial. Landmark analyses were used to compare early mortality in treatment groups, conditional on changes in shock and hypoxia parameters. Competing risks methods were used to estimate cumulative incidence curves and sub-hazard ratios to compare treatment groups in terms of terminal clinical events. Results Of 2,396 out of 3,141 (76%) classifiable participants, 1,647 (69%) had a severe metabolic acidosis or severe shock PS, 625 (26%) had a respiratory PS and 976 (41%) had a neurological PS, either alone or in combination. Mortality was greatest among children fulfilling criteria for all three PS (28% bolus, 21% control) and lowest for lone respiratory (2% bolus, 5% control) or neurological (3% bolus, 0% control) presentations. Excess mortality in bolus arms versus control was apparent for all three PS, including all their component features. By one hour, shock had resolved (responders) more frequently in bolus versus control groups (43% versus 32%, P <0.001), but excess mortality with boluses was evident in responders (relative risk 1.98, 95% confidence interval 0.94 to 4.17, P = 0.06) and 'non-responders' (relative risk 1.67, 95% confidence interval 1.23 to 2.28, P = 0.001), with no evidence of heterogeneity (P = 0.68). The major difference between bolus and control arms was the higher proportion of cardiogenic or shock terminal clinical events in bolus arms (n = 123; 4.6% versus 2.6%, P = 0.008) rather than respiratory (n = 61; 2.2% versus 1.3%, P = 0.09) or neurological (n = 63, 2.1% versus 1.8%, P = 0.6) terminal clinical events. Conclusions Excess mortality from boluses occurred in all subgroups of children. Contrary to expectation, cardiovascular collapse rather than fluid overload appeared to contribute most to excess deaths with rapid fluid resuscitation. These results should prompt a re-evaluation of evidence on fluid resuscitation for shock and a re-appraisal of the rate, composition and volume of resuscitation fluids. Trial registration ISRCTN69856593 PMID:23496872

Exploring mechanisms of excess mortality with early fluid resuscitation: insights from the FEAST trial.

PubMed

Maitland, Kathryn; George, Elizabeth C; Evans, Jennifer A; Kiguli, Sarah; Olupot-Olupot, Peter; Akech, Samuel O; Opoka, Robert O; Engoru, Charles; Nyeko, Richard; Mtove, George; Reyburn, Hugh; Brent, Bernadette; Nteziyaremye, Julius; Mpoya, Ayub; Prevatt, Natalie; Dambisya, Cornelius M; Semakula, Daniel; Ddungu, Ahmed; Okuuny, Vicent; Wokulira, Ronald; Timbwa, Molline; Otii, Benedict; Levin, Michael; Crawley, Jane; Babiker, Abdel G; Gibb, Diana M

2013-03-14

Early rapid fluid resuscitation (boluses) in African children with severe febrile illnesses increases the 48-hour mortality by 3.3% compared with controls (no bolus). We explored the effect of boluses on 48-hour all-cause mortality by clinical presentation at enrolment, hemodynamic changes over the first hour, and on different modes of death, according to terminal clinical events. We hypothesize that boluses may cause excess deaths from neurological or respiratory events relating to fluid overload. Pre-defined presentation syndromes (PS; severe acidosis or severe shock, respiratory, neurological) and predominant terminal clinical events (cardiovascular collapse, respiratory, neurological) were described by randomized arm (bolus versus control) in 3,141 severely ill febrile children with shock enrolled in the Fluid Expansion as Supportive Therapy (FEAST) trial. Landmark analyses were used to compare early mortality in treatment groups, conditional on changes in shock and hypoxia parameters. Competing risks methods were used to estimate cumulative incidence curves and sub-hazard ratios to compare treatment groups in terms of terminal clinical events. Of 2,396 out of 3,141 (76%) classifiable participants, 1,647 (69%) had a severe metabolic acidosis or severe shock PS, 625 (26%) had a respiratory PS and 976 (41%) had a neurological PS, either alone or in combination. Mortality was greatest among children fulfilling criteria for all three PS (28% bolus, 21% control) and lowest for lone respiratory (2% bolus, 5% control) or neurological (3% bolus, 0% control) presentations. Excess mortality in bolus arms versus control was apparent for all three PS, including all their component features. By one hour, shock had resolved (responders) more frequently in bolus versus control groups (43% versus 32%, P <0.001), but excess mortality with boluses was evident in responders (relative risk 1.98, 95% confidence interval 0.94 to 4.17, P = 0.06) and 'non-responders' (relative risk 1.67, 95% confidence interval 1.23 to 2.28, P = 0.001), with no evidence of heterogeneity (P = 0.68). The major difference between bolus and control arms was the higher proportion of cardiogenic or shock terminal clinical events in bolus arms (n = 123; 4.6% versus 2.6%, P = 0.008) rather than respiratory (n = 61; 2.2% versus 1.3%, P = 0.09) or neurological (n = 63, 2.1% versus 1.8%, P = 0.6) terminal clinical events. Excess mortality from boluses occurred in all subgroups of children. Contrary to expectation, cardiovascular collapse rather than fluid overload appeared to contribute most to excess deaths with rapid fluid resuscitation. These results should prompt a re-evaluation of evidence on fluid resuscitation for shock and a re-appraisal of the rate, composition and volume of resuscitation fluids. ISRCTN69856593.

Anxiety can significantly explain bolus perception in the context of hypotensive esophageal motility: Results of a large multicenter study in asymptomatic individuals.

PubMed

Cisternas, D; Scheerens, C; Omari, T; Monrroy, H; Hani, A; Leguizamo, A; Bilder, C; Ditaranto, A; Ruiz de León, A; Pérez de la Serna, J; Valdovinos, M A; Coello, R; Abrahao, L; Remes-Troche, J; Meixueiro, A; Zavala, M A; Marin, I; Serra, J

2017-09-01

Previous studies have not been able to correlate manometry findings with bolus perception. The aim of this study was to evaluate correlation of different variables, including traditional manometric variables (at diagnostic and extreme thresholds), esophageal shortening, bolus transit, automated impedance manometry (AIM) metrics and mood with bolus passage perception in a large cohort of asymptomatic individuals. High resolution manometry (HRM) was performed in healthy individuals from nine centers. Perception was evaluated using a 5-point Likert scale. Anxiety was evaluated using Hospitalized Anxiety and Depression scale (HAD). Subgroup analysis was also performed classifying studies into normal, hypotensive, vigorous, and obstructive patterns. One hundred fifteen studies were analyzed (69 using HRM and 46 using high resolution impedance manometry (HRIM); 3.5% swallows in 9.6% of volunteers were perceived. There was no correlation of any of the traditional HRM variables, esophageal shortening, AIM metrics nor bolus transit with perception scores. There was no HRM variable showing difference in perception when comparing normal vs extreme values (percentile 1 or 99). Anxiety but not depression was correlated with perception. Among hypotensive pattern, anxiety was a strong predictor of variance in perception (R 2 up to .70). Bolus perception is less common than abnormal motility among healthy individuals. Neither esophageal motor function nor bolus dynamics evaluated with several techniques seems to explain differences in bolus perception. Different mechanisms seem to be relevant in different manometric patterns. Anxiety is a significant predictor of bolus perception in the context of hypotensive motility. © 2017 John Wiley & Sons Ltd.

VIDEOFLUOROSCOPIC EVALUATION OF SWALLOWS IN ANOREXIA NERVOSA.

PubMed

Santos, Carla Manfredi; Cassiani, Rachel Aguiar; Dantas, Roberto Oliveira

2016-01-01

There are some studies in the literature about the feeding behavior and masticatory process in patients with feeding disorders; however, it is not very well known if there are alterations in oral-pharyngeal swallowing dynamics in subjects with anorexia nervosa. To evaluate the oral and pharyngeal bolus transit in patients with anorexia nervosa. The study was conducted with 8 individuals clinically diagnosed and in treatment for restricting-type anorexia nervosa (seven women and one man), and 14 healthy individuals with no digestive or neurological symptoms (10 women, 4 men). Swallows were evaluated by videofluoroscopy with three swallows of 5 mL liquid bolus and three swallows of 5 mL paste bolus consistency, given in a random sequence. The participants were asked after each swallow about the sensation of the bolus passage. In the analysis of oral-pharyngeal transit duration, the mean duration of pharyngeal transit with paste bolus in patients with anorexia was shorter than in healthy volunteers (P=0.02). In the duration of movement of the hyoid bone, longer movement was observed in anorexia than in healthy volunteers with liquid bolus (P=0.01). With liquid bolus, five (62.5%) patients and one (7.1%) control had sensation of the bolus passage (P<0.05). There seems to be no important alterations of swallowing in subjects with anorexia nervosa, although the results suggest that pharyngeal transit has shorter duration than that seen in healthy volunteers and the hyoid movement duration is longer in patients than in healthy volunteers. Fast pharyngeal transit may be the cause of bolus transit perception in patients with anorexia nervosa.

77 FR 45690 - Exemptions From Certain Prohibited Transaction Restrictions

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-01

... is made by a Plan fiduciary or Plan participant or IRA owner who is independent (as defined in... process; (d) A person is ``independent'' of JPMorgan Chase if the person is: (1) Not JPMorgan Chase or an... independent act of SPF as a corporate entity for business reasons which did not involve the Plan. As such, all...

Scenes of Devastation: Chasing Hawaii's Deadly Ohia Fungus | Hawaii Public

Science.gov Websites

Scenes of Devastation: Chasing Hawaii's Deadly Ohia Fungus By Molly Solomon * Mar 25, 2016 TweetShareGoogle+Email Molly Solomon Rapid Ohia Death has devastated native forests on Hawaii Island, especially in Lower Puna subdivisions like Leilani Estates. Credit Molly Solomon One of Hawai'i's oldest and most

76 FR 31955 - Jonathan and Jayne Chase; Notice of Application Accepted for Filing With the Commission, Intent...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-02

.... c. Date filed: July 23, 2010. d. Applicant: Jonathan and Jayne Chase. e. Name of Project: Troy Hydropower Project. f. Location: On the Missisquoi River, in the Town of Troy, Orleans County, Vermont. The... filing and is now ready for environmental analysis. l. Project Description: The Troy Project would...

The Psychophysics of Chasing: A Case Study in the Perception of Animacy

ERIC Educational Resources Information Center

Gao, Tao; Newman, George E.; Scholl, Brian J.

2009-01-01

Psychologists have long been captivated by the perception of animacy--the fact that even simple moving shapes may appear to engage in animate, intentional, and goal-directed movements. Here we report several new types of studies of a particularly salient form of perceived animacy: "chasing", in which one shape (the "wolf") pursues another shape…

Observations and reinterpretation of kingfisher-raptor interactions

USGS Publications Warehouse

Kirby, Ronald E.; Fuller, Mark R.

1978-01-01

Reported observations of Belted Kingfisher (Megaceryle alcyon)-raptor interactions have ranged from brief encounters where the kingfisher escaped the raptor and the hawk subsequently flew away to repeated chases (Johnson 1925, McCabe and McCabe 1928, Skinner 1928, Smith 1963). In some repetitive chases, kingfishers appeared to initiate the interaction (McCabe and McCabe 1928, Skinner 1928).

Engaging Experiential Service Learning through a Co-Curricular Club: The Chase Charlie Races

ERIC Educational Resources Information Center

Judge, Lawrence W.; Pierce, David; Petersen, Jeffrey; Bellar, David; Wanless, Elizabeth; Gilreath, Erin; Simon, Laura

2011-01-01

The efficacy of the "Chase Charlie Races" (an experiential learning activity) was demonstrated via program assessment. This was achieved via post-event evaluations of race participants and student club members, and with fitness assessments of 76 elementary students who participated in an eight-week training program. Paired sample t-tests revealed…

T-34C in flight

NASA Image and Video Library

1997-03-21

A NASA T-34C aircraft, used for safety chase, is shown flying above the Dryden Flight Research Center, Edwards, California in March 1997. The aircraft was previously used at the Lewis Research Center in propulsion experiments involving turboprop engines, and was used as a chase aircraft at Dryden for smaller and slower research projects. Chase aircraft accompany research flights for photography and video purposes, and also as support for safety and research. At Dryden, the T-34 is used mainly for smaller remotely piloted vehicles which fly slower than NASA's F-18's, used for larger scale projects. This aircraft was returned to the U.S. Navy in May of 2002. The T-34C, built by Beech, carries a crew of 2 and is nicknamed the Mentor.

Pharyngeal Pressure and Timing During Bolus Transit

PubMed Central

Walczak, Chelsea C.; Jones, Corinne A.; McCulloch, Timothy M.

2018-01-01

Determining intrabolus pressure (IBP) at the upper esophageal sphincter (UES) and in the esophagus has given compelling evidence that IBP can be a predictor for swallowing dysfunction. Studies have looked most superiorly at the low hypopharynx region but there has been no inquiry into what IBP measures throughout the entire pharynx can tell us. We present a study to describe the pressures within and surrounding the moving bolus throughout the pharynx and into the UES. Simultaneous HRM and videofluoroscopy were performed in 10 healthy subjects swallowing ten 10 mL thin-liquid barium boluses. Three events surrounding bolus movement were tracked via videofluoroscopy, two additional events were found using manometric measures. As the bolus passes through the pharynx, low pressure is created at and below the head of the bolus. A modest pressure increase is seen as the bolus passes through the pharynx and finally, high pressure is observed at the bolus tail, followed by an even larger pressure generation of a clearance event. HRM allows for greater resolution in data collection in the pharynx and in this study, aided in identifying semi unique characteristics around the hypopharynx and the UES which are consistent with the complex anatomy of the regions and the transition of the UES from active closure to relaxed opening. In the future, additional studies designed to look at aged and diseased populations may lead to better understanding of disease etiology, and treatment options. PMID:27565155

Evaluation of various boluses in dose distribution for electron therapy of the chest wall with an inward defect

PubMed Central

Mahdavi, Hoda; Jabbari, Keyvan; Roayaei, Mahnaz

2016-01-01

Delivering radiotherapy to the postmastectomy chest wall can be achieved using matched electron fields. Surgical defects of the chest wall change the dose distribution of electrons. In this study, the improvement of dose homogeneity using simple, nonconformal techniques of thermoplastic bolus application on a defect is evaluated. The proposed phantom design improves the capability of film dosimetry for obtaining dose profiles of a patient's anatomical condition. A modeled electron field of a patient with a postmastectomy inward surgical defect was planned. High energy electrons were delivered to the phantom in various settings, including no bolus, a bolus that filled the inward defect (PB0), a uniform thickness bolus of 5 mm (PB1), and two 5 mm boluses (PB2). A reduction of mean doses at the base of the defect was observed by any bolus application. PB0 increased the dose at central parts of the defect, reduced hot areas at the base of steep edges, and reduced dose to the lung and heart. Thermoplastic boluses that compensate a defect (PB0) increased the homogeneity of dose in a fixed depth from the surface; adversely, PB2 increased the dose heterogeneity. This study shows that it is practical to investigate dose homogeneity profiles inside a target volume for various techniques of electron therapy. PMID:27051169

An Adaptive Nonlinear Basal-Bolus Calculator for Patients With Type 1 Diabetes

PubMed Central

Boiroux, Dimitri; Aradóttir, Tinna Björk; Nørgaard, Kirsten; Poulsen, Niels Kjølstad; Madsen, Henrik; Jørgensen, John Bagterp

2016-01-01

Background: Bolus calculators help patients with type 1 diabetes to mitigate the effect of meals on their blood glucose by administering a large amount of insulin at mealtime. Intraindividual changes in patients physiology and nonlinearity in insulin-glucose dynamics pose a challenge to the accuracy of such calculators. Method: We propose a method based on a continuous-discrete unscented Kalman filter to continuously track the postprandial glucose dynamics and the insulin sensitivity. We augment the Medtronic Virtual Patient (MVP) model to simulate noise-corrupted data from a continuous glucose monitor (CGM). The basal rate is determined by calculating the steady state of the model and is adjusted once a day before breakfast. The bolus size is determined by optimizing the postprandial glucose values based on an estimate of the insulin sensitivity and states, as well as the announced meal size. Following meal announcements, the meal compartment and the meal time constant are estimated, otherwise insulin sensitivity is estimated. Results: We compare the performance of a conventional linear bolus calculator with the proposed bolus calculator. The proposed basal-bolus calculator significantly improves the time spent in glucose target (P < .01) compared to the conventional bolus calculator. Conclusion: An adaptive nonlinear basal-bolus calculator can efficiently compensate for physiological changes. Further clinical studies will be needed to validate the results. PMID:27613658

Complementary Reliability-Based Decodings of Binary Linear Block Codes

NASA Technical Reports Server (NTRS)

Fossorier, Marc P. C.; Lin, Shu

1997-01-01

This correspondence presents a hybrid reliability-based decoding algorithm which combines the reprocessing method based on the most reliable basis and a generalized Chase-type algebraic decoder based on the least reliable positions. It is shown that reprocessing with a simple additional algebraic decoding effort achieves significant coding gain. For long codes, the order of reprocessing required to achieve asymptotic optimum error performance is reduced by approximately 1/3. This significantly reduces the computational complexity, especially for long codes. Also, a more efficient criterion for stopping the decoding process is derived based on the knowledge of the algebraic decoding solution.

Personalized intensification of insulin therapy in type 2 diabetes - does a basal-bolus regimen suit all patients?

PubMed

Giugliano, D; Sieradzki, J; Stefanski, A; Gentilella, R

2016-08-01

Many patients with type 2 diabetes mellitus (T2DM) require insulin therapy. If basal insulin fails to achieve glycemic control, insulin intensification is one possible treatment intensification strategy. We summarized clinical data from randomized clinical trials designed to compare the efficacy and safety of basal-bolus and premixed insulin intensification regimens. We defined a between-group difference of ≥0.3% in end-of-study glycated hemoglobin (HbA1c) as clinically meaningful. A PubMed database search supplemented by author-identified papers yielded 15 trials which met selection criteria: randomized design, patients with T2DM receiving basal-bolus (bolus injection ≤3 times/day) vs. premixed (≤3 injections/day) insulin regimens, primary/major endpoint(s) HbA1c- and/or hypoglycemia-related, and trial duration ≥12 weeks. Glycemic control improved with both basal-bolus and premixed insulin regimens with - in most cases - acceptable levels of weight gain and hypoglycemia. A clinically meaningful difference between regimens in glycemic control was recorded in only four comparisons, all of which favored basal-bolus therapy. The incidence of hypoglycemia was significantly different between regimens in only three comparisons, one of which favored premixed insulin and two basal-bolus therapy. Of the four trials that reported a significant difference between regimens in bodyweight change, two favored basal-bolus therapy and two favored premixed insulin. Thus, on a population level, neither basal-bolus therapy nor premixed insulin showed a consistent advantage in terms of glycemic control, hypoglycemic risk, or bodyweight gain. It is therefore recommended that clinicians should adopt an individualized approach to insulin intensification - taking into account the benefits and risks of each treatment approach and the attitude and preferences of each patient - in the knowledge that both basal-bolus and premixed regimens may be successful.

WE-F-16A-05: Use of 3D-Printers to Create a Tissue Equivalent 3D-Bolus for External Beam Therapy

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

Burleson, S; Baker, J; Hsia, A

2014-06-15

Purpose: The purpose of this project is to demonstrate that a non-expensive 3D-printer can be used to manufacture a 3D-bolus for external beam therapy. The printed bolus then can be modeled in our treatment planning system to ensure accurate dose delivery to the patient. Methods: We developed a simple method to manufacture a patient-specific custom 3Dbolus. The bolus is designed using Eclipse Treatment Planning System, contoured onto the patients CT images. The bolus file is exported from Eclipse to 3D-printer software, and then printed using a 3D printer. Various tests were completed to determine the properties of the printing material.more » Percent depth dose curves in this material were measured with electron and photon beams for comparison to other materials. In order to test the validity of the 3D printed bolus for treatment planning, a custom bolus was printed and tested on the Rando phantom using film for a dose plane comparison. We compared the dose plane measured on the film to the same dose plane exported from our treatment planning system using Film QA software. The gamma-dose distribution tool was used in our film analysis. Results: We compared point measurements throughout the dose plane and were able to achieve greater than 95% passing rate at 3% dose difference and 3 mm distance to agreement, which is our departments acceptable gamma pixel parameters. Conclusion: The printed 3D bolus has proven to be accurately modeled in our treatment planning system, it is more conformal to the patient surface and more durable than other bolus currently used (wax, superflab etc.). It is also more convenient and less costly than comparable bolus from milling machine companies.« less

Comparison of Respiratory-Gated and Respiratory-Ungated Planning in Scattered Carbon Ion Beam Treatment of the Pancreas Using Four-Dimensional Computed Tomography

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

Mori, Shinichiro, E-mail: shinshin@nirs.go.j; Yanagi, Takeshi; Hara, Ryusuke

2010-01-15

Purpose: We compared respiratory-gated and respiratory-ungated treatment strategies using four-dimensional (4D) scattered carbon ion beam distribution in pancreatic 4D computed tomography (CT) datasets. Methods and Materials: Seven inpatients with pancreatic tumors underwent 4DCT scanning under free-breathing conditions using a rapidly rotating cone-beam CT, which was integrated with a 256-slice detector, in cine mode. Two types of bolus for gated and ungated treatment were designed to cover the planning target volume (PTV) using 4DCT datasets in a 30% duty cycle around exhalation and a single respiratory cycle, respectively. Carbon ion beam distribution for each strategy was calculated as a function ofmore » respiratory phase by applying the compensating bolus to 4DCT at the respective phases. Smearing was not applied to the bolus, but consideration was given to drill diameter. The accumulated dose distributions were calculated by applying deformable registration and calculating the dose-volume histogram. Results: Doses to normal tissues in gated treatment were minimized mainly on the inferior aspect, which thereby minimized excessive doses to normal tissues. Over 95% of the dose, however, was delivered to the clinical target volume at all phases for both treatment strategies. Maximum doses to the duodenum and pancreas averaged across all patients were 43.1/43.1 GyE (ungated/gated) and 43.2/43.2 GyE (ungated/gated), respectively. Conclusions: Although gated treatment minimized excessive dosing to normal tissue, the difference between treatment strategies was small. Respiratory gating may not always be required in pancreatic treatment as long as dose distribution is assessed. Any application of our results to clinical use should be undertaken only after discussion with oncologists, particularly with regard to radiotherapy combined with chemotherapy.« less

Quantitative myocardial perfusion from static cardiac and dynamic arterial CT

NASA Astrophysics Data System (ADS)

Bindschadler, Michael; Branch, Kelley R.; Alessio, Adam M.

2018-05-01

Quantitative myocardial blood flow (MBF) estimation by dynamic contrast enhanced cardiac computed tomography (CT) requires multi-frame acquisition of contrast transit through the blood pool and myocardium to inform the arterial input and tissue response functions. Both the input and the tissue response functions for the entire myocardium are sampled with each acquisition. However, the long breath holds and frequent sampling can result in significant motion artifacts and relatively high radiation dose. To address these limitations, we propose and evaluate a new static cardiac and dynamic arterial (SCDA) quantitative MBF approach where (1) the input function is well sampled using either prediction from pre-scan timing bolus data or measured from dynamic thin slice ‘bolus tracking’ acquisitions, and (2) the whole-heart tissue response data is limited to one contrast enhanced CT acquisition. A perfusion model uses the dynamic arterial input function to generate a family of possible myocardial contrast enhancement curves corresponding to a range of MBF values. Combined with the timing of the single whole-heart acquisition, these curves generate a lookup table relating myocardial contrast enhancement to quantitative MBF. We tested the SCDA approach in 28 patients that underwent a full dynamic CT protocol both at rest and vasodilator stress conditions. Using measured input function plus single (enhanced CT only) or plus double (enhanced and contrast free baseline CT’s) myocardial acquisitions yielded MBF estimates with root mean square (RMS) error of 1.2 ml/min/g and 0.35 ml/min/g, and radiation dose reductions of 90% and 83%, respectively. The prediction of the input function based on timing bolus data and the static acquisition had an RMS error compared to the measured input function of 26.0% which led to MBF estimation errors greater than threefold higher than using the measured input function. SCDA presents a new, simplified approach for quantitative perfusion imaging with an acquisition strategy offering substantial radiation dose and computational complexity savings over dynamic CT.

In-situ roundness measurement and correction for pin journals in oscillating grinding machines

NASA Astrophysics Data System (ADS)

Yu, Hongxiang; Xu, Mengchen; Zhao, Jie

2015-01-01

In the mass production of vehicle-engine crankshafts, pin chasing grinding using oscillating grinding machines is a widely accepted method to achieve flexible and efficient performance. However, the eccentric movement of pin journals makes it difficult to develop an in-process roundness measurement scheme for the improvement of contour precision. Here, a new in-situ roundness measurement strategy is proposed with high scanning speed. The measuring mechanism is composed of a V-block and an adaptive telescopic support. The swing pattern of the telescopic support and the V-block is analysed for an equal angle-interval signal sampling. Hence roundness error signal is extracted in frequency domain using a small-signal model of the V-block roundness measurement method and the Fast Fourier Transformation. To implement the roundness data in the CNC coordinate system of an oscillating grinding machine, a transformation function is derived according to the motion model of pin chasing grinding methodology. Computer simulation reveals the relationship between the rotational position of the crankshaft component and the scanning angle of the displacement probe on the V-block, as well as the influence introduced by the rotation centre drift. Prototype investigation indicates the validity of the theoretical analysis and the feasibility of the new strategy.

Evaluation of surface and shallow depth dose reductions using a Superflab bolus during conventional and advanced external beam radiotherapy.

PubMed

Yoon, Jihyung; Xie, Yibo; Zhang, Rui

2018-03-01

The purpose of this study was to evaluate a methodology to reduce scatter and leakage radiations to patients' surface and shallow depths during conventional and advanced external beam radiotherapy. Superflab boluses of different thicknesses were placed on top of a stack of solid water phantoms, and the bolus effect on surface and shallow depth doses for both open and intensity-modulated radiotherapy (IMRT) beams was evaluated using thermoluminescent dosimeters and ion chamber measurements. Contralateral breast dose reduction caused by the bolus was evaluated by delivering clinical postmastectomy radiotherapy (PMRT) plans to an anthropomorphic phantom. For the solid water phantom measurements, surface dose reduction caused by the Superflab bolus was achieved only in out-of-field area and on the incident side of the beam, and the dose reduction increased with bolus thickness. The dose reduction caused by the bolus was more significant at closer distances from the beam. Most of the dose reductions occurred in the first 2-cm depth and stopped at 4-cm depth. For clinical PMRT treatment plans, surface dose reductions using a 1-cm Superflab bolus were up to 31% and 62% for volumetric-modulated arc therapy and 4-field IMRT, respectively, but there was no dose reduction for Tomotherapy. A Superflab bolus can be used to reduce surface and shallow depth doses during external beam radiotherapy when it is placed out of the beam and on the incident side of the beam. Although we only validated this dose reduction strategy for PMRT treatments, it is applicable to any external beam radiotherapy and can potentially reduce patients' risk of developing radiation-induced side effects. © 2018 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine.

Use of nitroglycerin by bolus prevents intensive care unit admission in patients with acute hypertensive heart failure.

PubMed

Wilson, Suprat Saely; Kwiatkowski, Gregory M; Millis, Scott R; Purakal, John D; Mahajan, Arushi P; Levy, Phillip D

2017-01-01

The purpose of this study was to compare health care resource utilization among patients who were given intravenous nitroglycerin for acute heart failure (AHF) in the emergency department (ED) by intermittent bolus, continuous infusion, or a combination of both. We retrospectively identified 395 patients that received nitroglycerin therapy in the ED for the treatment of AHF over a 5-year period. Patients that received intermittent bolus (n=124) were compared with continuous infusion therapy (n=182) and combination therapy of bolus and infusion (n=89). The primary outcomes were the frequency of intensive care unit (ICU) admission and hospital length of stay (LOS). On unadjusted analysis, rates of ICU admission were significantly lower in the bolus vs infusion and combination groups (48.4% vs 68.7% vs 83%, respectively; P<.0001) and median LOS (interquartile range) was shorter (3.7 [2.5-6.2 days]) compared with infusion (4.7 [2.9-7.1 days]) and combination (5.0 [2.9-6.7 days]) groups; P=.02. On adjusted regression models, the strong association between bolus nitroglycerin and reduced ICU admission rate remained, and hospital LOS was 1.9 days shorter compared with infusion therapy alone. Use of intubation (bolus [8.9%] vs infusion [8.8%] vs combination [16.9%]; P=.096) and bilevel positive airway pressure (bolus [26.6%] vs infusion [20.3%] vs combination [29.2%]; P=.21) were similar as was the incidence of hypotension, myocardial injury, and worsening renal function. In ED patients with AHF, intravenous nitroglycerin by intermittent bolus was associated with a lower ICU admission rate and a shorter hospital LOS compared with continuous infusion. Copyright © 2016 Elsevier Inc. All rights reserved.

An additional bolus of rapid-acting insulin to normalise postprandial cardiovascular risk factors following a high-carbohydrate high-fat meal in patients with type 1 diabetes: A randomised controlled trial.

PubMed

Campbell, Matthew D; Walker, Mark; Ajjan, Ramzi A; Birch, Karen M; Gonzalez, Javier T; West, Daniel J

2017-07-01

To evaluate an additional rapid-acting insulin bolus on postprandial lipaemia, inflammation and pro-coagulation following high-carbohydrate high-fat feeding in people with type 1 diabetes. A total of 10 males with type 1 diabetes [HbA 1c 52.5 ± 5.9 mmol/mol (7.0% ± 0.5%)] underwent three conditions: (1) a low-fat (LF) meal with normal bolus insulin, (2), a high-fat (HF) meal with normal bolus insulin and (3) a high-fat meal with normal bolus insulin with an additional 30% insulin bolus administered 3-h post-meal (HFA). Meals had identical carbohydrate and protein content and bolus insulin dose determined by carbohydrate-counting. Blood was sampled periodically for 6-h post-meal and analysed for triglyceride, non-esterified-fatty acids, apolipoprotein B48, glucagon, tumour necrosis factor alpha, fibrinogen, human tissue factor activity and plasminogen activator inhibitor-1. Continuous glucose monitoring captured interstitial glucose responses. Triglyceride concentrations following LF remained similar to baseline, whereas triglyceride levels following HF were significantly greater throughout the 6-h observation period. The additional insulin bolus (HFA) normalised triglyceride similarly to low fat 3-6 h following the meal. HF was associated with late postprandial elevations in tumour necrosis factor alpha, whereas LF and HFA was not. Fibrinogen, plasminogen activator inhibitor-1 and tissue factor pathway levels were similar between conditions. Additional bolus insulin 3 h following a high-carbohydrate high-fat meal prevents late rises in postprandial triglycerides and tumour necrosis factor alpha, thus improving cardiovascular risk profile.

Influence of everyday bolus consistencies in different body positions on high-resolution esophageal pressure topography (HREPT) parameters.

PubMed

Hasan, Y; Go, J; Hashmi, S M; Valestin, J; Schey, R

2015-04-01

The standard protocol for esophageal manometry involves placing the patient in the supine position with head turned to left (supine head left [SHL]) while evaluating liquid bolus swallows. Routinely, semisolid or solid boluses are not evaluated. Currently, the daily American diet includes up to 40% solid or semisolid texture. Thus far, the data on the effect of different bolus on high-resolution esophageal pressure topography (HREPT) parameters are scarce. This study aims to evaluate the effect of every day bolus consistencies in different body positions on HREPT variables. HREPT was performed on healthy volunteers with a modified protocol including liquid swallows in the SHL position followed by applesauce (semisolid), cracker (solid), and marshmallow (soft solid) in three different positions (SHL, sitting, and standing). A total of 38 healthy adult subjects (22 males and 16 females, median age = 27, and mean body mass index = 25) were evaluated. The resting upper esophageal sphincter pressure was significantly different while subjects swallowed crackers, applesauce, and marshmallows in most positions compared with liquid SHL (P < 0.05). The lower esophageal sphincter, contractile front velocity, and distal contractile integral pressures did not differ in all different consistencies compared with SHL. The integrated relaxation period was significantly higher with solid bolus compared with liquid bolus only in SHL position. The intrabolus pressure was significantly different with solid and soft solid boluses in all postures compared to liquid SHL. The American diet consistency affects upper esophageal sphincter pressure and partially integrated relaxation period and intrabolus pressure in various positions. Semisolid bolus swallows do not cause substantial pressure changes and are safe for evaluation and maintaining adequate caloric intake in patients with dysphagia who cannot tolerate solids. © 2014 International Society for Diseases of the Esophagus.

Intravenous Tranexamic Acid Bolus plus Infusion Is Not More Effective than a Single Bolus in Primary Hip Arthroplasty: A Randomized Controlled Trial.

PubMed

Zufferey, Paul J; Lanoiselée, Julien; Chapelle, Céline; Borisov, Dmitry B; Bien, Jean-Yves; Lambert, Pierre; Philippot, Rémi; Molliex, Serge; Delavenne, Xavier

2017-09-01

Preoperative administration of the antifibrinolytic agent tranexamic acid reduces bleeding in patients undergoing hip arthroplasty. Increased fibrinolytic activity is maintained throughout the first day postoperation. The objective of the study was to determine whether additional perioperative administration of tranexamic acid would further reduce blood loss. This prospective, double-blind, parallel-arm, randomized, superiority study was conducted in 168 patients undergoing unilateral primary hip arthroplasty. Patients received a preoperative intravenous bolus of 1 g of tranexamic acid followed by a continuous infusion of either tranexamic acid 1 g (bolus-plus-infusion group) or placebo (bolus group) for 8 h. The primary outcome was calculated perioperative blood loss up to day 5. Erythrocyte transfusion was implemented according to a restrictive transfusion trigger strategy. The mean perioperative blood loss was 919 ± 338 ml in the bolus-plus-infusion group (84 patients analyzed) and 888 ± 366 ml in the bolus group (83 patients analyzed); mean difference, 30 ml (95% CI, -77 to 137; P = 0.58). Within 6 weeks postsurgery, three patients in each group (3.6%) underwent erythrocyte transfusion and two patients in the bolus group experienced distal deep-vein thrombosis. A meta-analysis combining data from this study with those of five other trials showed no incremental efficacy of additional perioperative administration of tranexamic acid. A preoperative bolus of tranexamic acid, associated with a restrictive transfusion trigger strategy, resulted in low erythrocyte transfusion rates in patients undergoing hip arthroplasty. Supplementary perioperative administration of tranexamic acid did not achieve any further reduction in blood loss.

CHASE Survey of Technology Needs

DTIC Science & Technology

2017-03-01

CHASE Survey of Technology Needs Shahed Enamul Quadir ECE Department University of Connecticut Storrs, CT, USA Daniel DiMase Honeywell, Inc...based on a survey conducted in late 2015. Counterfeits and Hardware Trojans have been identified as areas needing continued research and focus... survey of its advisory board and industry professionals to determine the technology needs in the area of IC counterfeits, hardware assurance

Saying the Right Word at the Right Time: Syntagmatic and Paradigmatic Interference in Sentence Production

ERIC Educational Resources Information Center

Dell, Gary S.; Oppenheim, Gary M.; Kittredge, Audrey K.

2008-01-01

Retrieving a word in a sentence requires speakers to overcome syntagmatic, as well as paradigmatic interference. When accessing "cat" in "The cat chased the string", not only are similar competitors such as "dog" and "cap" activated, but also other words in the planned sentence, such as "chase" and "string". We hypothesise that both types of…

Cheetahs, Acinonyx jubatus, balance turn capacity with pace when chasing prey

PubMed Central

Wilson, John W.; Mills, Michael G. L.; Wilson, Rory P.; Peters, Gerrit; Mills, Margaret E. J.; Speakman, John R.; Durant, Sarah M.; Bennett, Nigel C.; Marks, Nikki J.; Scantlebury, Michael

2013-01-01

Predator–prey interactions are fundamental in the evolution and structure of ecological communities. Our understanding, however, of the strategies used in pursuit and evasion remains limited. Here, we report on the hunting dynamics of the world's fastest land animal, the cheetah, Acinonyx jubatus. Using miniaturized data loggers, we recorded fine-scale movement, speed and acceleration of free-ranging cheetahs to measure how hunting dynamics relate to chasing different sized prey. Cheetahs attained hunting speeds of up to 18.94 m s−1 and accelerated up to 7.5 m s−2 with greatest angular velocities achieved during the terminal phase of the hunt. The interplay between forward and lateral acceleration during chases showed that the total forces involved in speed changes and turning were approximately constant over time but varied with prey type. Thus, rather than a simple maximum speed chase, cheetahs first accelerate to decrease the distance to their prey, before reducing speed 5–8 s from the end of the hunt, so as to facilitate rapid turns to match prey escape tactics, varying the precise strategy according to prey species. Predator and prey thus pit a fine balance of speed against manoeuvring capability in a race for survival. PMID:24004493

Cheetahs, Acinonyx jubatus, balance turn capacity with pace when chasing prey.

PubMed

Wilson, John W; Mills, Michael G L; Wilson, Rory P; Peters, Gerrit; Mills, Margaret E J; Speakman, John R; Durant, Sarah M; Bennett, Nigel C; Marks, Nikki J; Scantlebury, Michael

2013-10-23

Predator-prey interactions are fundamental in the evolution and structure of ecological communities. Our understanding, however, of the strategies used in pursuit and evasion remains limited. Here, we report on the hunting dynamics of the world's fastest land animal, the cheetah, Acinonyx jubatus. Using miniaturized data loggers, we recorded fine-scale movement, speed and acceleration of free-ranging cheetahs to measure how hunting dynamics relate to chasing different sized prey. Cheetahs attained hunting speeds of up to 18.94 m s(-1) and accelerated up to 7.5 m s(-2) with greatest angular velocities achieved during the terminal phase of the hunt. The interplay between forward and lateral acceleration during chases showed that the total forces involved in speed changes and turning were approximately constant over time but varied with prey type. Thus, rather than a simple maximum speed chase, cheetahs first accelerate to decrease the distance to their prey, before reducing speed 5-8 s from the end of the hunt, so as to facilitate rapid turns to match prey escape tactics, varying the precise strategy according to prey species. Predator and prey thus pit a fine balance of speed against manoeuvring capability in a race for survival.

A open loop guidance architecture for navigationally robust on-orbit docking

NASA Technical Reports Server (NTRS)

Chern, Hung-Sheng

1995-01-01

The development of an open-hop guidance architecture is outlined for autonomous rendezvous and docking (AR&D) missions to determine whether the Global Positioning System (GPS) can be used in place of optical sensors for relative initial position determination of the chase vehicle. Feasible command trajectories for one, two, and three impulse AR&D maneuvers are determined using constrained trajectory optimization. Early AR&D command trajectory results suggest that docking accuracies are most sensitive to vertical position errors at the initial conduction of the chase vehicle. Thus, a feasible command trajectory is based on maximizing the size of the locus of initial vertical positions for which a fixed sequence of impulses will translate the chase vehicle into the target while satisfying docking accuracy requirements. Documented accuracies are used to determine whether relative GPS can achieve the vertical position error requirements of the impulsive command trajectories. Preliminary development of a thruster management system for the Cargo Transfer Vehicle (CTV) based on optimal throttle settings is presented to complete the guidance architecture. Results show that a guidance architecture based on a two impulse maneuvers generated the best performance in terms of initial position error and total velocity change for the chase vehicle.

Global Positioning System Synchronized Active Light Autonomous Docking System

NASA Technical Reports Server (NTRS)

Howard, Richard T. (Inventor); Book, Michael L. (Inventor); Bryan, Thomas C. (Inventor); Bell, Joseph L. (Inventor)

1996-01-01

A Global Positioning System Synchronized Active Light Autonomous Docking System (GPSSALADS) for automatically docking a chase vehicle with a target vehicle comprising at least one active light emitting target which is operatively attached to the target vehicle. The target includes a three-dimensional array of concomitantly flashing lights which flash at a controlled common frequency. The GPSSALADS further comprises a visual tracking sensor operatively attached to the chase vehicle for detecting and tracking the target vehicle. Its performance is synchronized with the flash frequency of the lights by a synchronization means which is comprised of first and second internal clocks operatively connected to the active light target and visual tracking sensor, respectively, for providing timing control signals thereto, respectively. The synchronization means further includes first and second Global Positioning System receivers operatively connected to the first and second internal clocks, respectively, for repeatedly providing simultaneous synchronization pulses to the internal clocks, respectively. In addition, the GPSSALADS includes a docking process controller means which is operatively attached to the chase vehicle and is responsive to the visual tracking sensor for producing commands for the guidance and propulsion system of the chase vehicle.

Global Positioning System Synchronized Active Light Autonomous Docking System

NASA Technical Reports Server (NTRS)

Howard, Richard (Inventor)

1994-01-01

A Global Positioning System Synchronized Active Light Autonomous Docking System (GPSSALADS) for automatically docking a chase vehicle with a target vehicle comprises at least one active light emitting target which is operatively attached to the target vehicle. The target includes a three-dimensional array of concomitantly flashing lights which flash at a controlled common frequency. The GPSSALADS further comprises a visual tracking sensor operatively attached to the chase vehicle for detecting and tracking the target vehicle. Its performance is synchronized with the flash frequency of the lights by a synchronization means which is comprised of first and second internal clocks operatively connected to the active light target and visual tracking sensor, respectively, for providing timing control signals thereto, respectively. The synchronization means further includes first and second Global Positioning System receivers operatively connected to the first and second internal clocks, respectively, for repeatedly providing simultaneous synchronization pulses to the internal clocks, respectively. In addition, the GPSSALADS includes a docking process controller means which is operatively attached to the chase vehicle and is responsive to the visual tracking sensor for producing commands for the guidance and propulsion system of the chase vehicle.

Turnover of galactans and other cell wall polysaccharides during development of flax plants

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

Gorshkova, T.A.; Chemikosova, S.B.; Lozovaya, V.V.

1997-06-01

We investigated the synthesis and turnover of cell wall polysaccharides of the flax (Linum usitatissimum L.) plant during development of the phloem fibers. One-month-old flax plants were exposed to a 40-min pulse with {sup 14}CO{sub 2} followed by 8-h, 24-h, and 1-month periods of chase with ambient CO{sub 2}, and radioactivity in cell wall sugars was determined in various plant parts. The relative radioactivity of glucose in noncellulosic polysaccharides was the highest compared with all other cell wall sugars immediately after the pulse and decreased substantially during the subsequent chase. The relative radioactivities of the other cell wall sugars changedmore » with differing rates, indicating turnover of specific polysaccharides. Notably, after 1 month of chase there was a marked decrease in the proportional mass and total radioactivity in cell wall galactose, indicating a long-term turnover of the galactans enriched in the fiber-containing tissues. The ratio of radiolabeled xylose to arabinose also increased during the chase, indicating a turnover of arabinose-containing polymers and interconversion to xylose. The pattern of label redistribution differed between organs, indicating that the cell wall turnover processes are tissue- and cell-specific.« less

Comparison of Power Versus Manual Injection in Bolus Shape and Image Quality on Contrast-Enhanced Magnetic Resonance Angiography: An Experimental Study in a Swine Model.

PubMed

Tsuboyama, Takahiro; Jost, Gregor; Pietsch, Hubertus; Tomiyama, Noriyuki

2017-09-01

The aim of this study was to compare power versus manual injection in bolus shape and image quality on contrast-enhanced magnetic resonance angiography (CE-MRA). Three types of CE-MRA (head-neck 3-dimensional [3D] MRA with a test-bolus technique, thoracic-abdominal 3D MRA with a bolus-tracking technique, and thoracic-abdominal time-resolved 4-dimensional [4D] MRA) were performed after power and manual injection of gadobutrol (0.1 mmol/kg) at 2 mL/s in 12 pigs (6 sets of power and manual injections for each type of CE-MRA). For the quantitative analysis, the signal-to-noise ratio was measured on ascending aorta, descending aorta, brachiocephalic trunk, common carotid artery, and external carotid artery on the 6 sets of head-neck 3D MRA, and on ascending aorta, descending aorta, brachiocephalic trunk, abdominal aorta, celiac trunk, and renal artery on the 6 sets of thoracic-abdominal 3D MRA. Bolus shapes were evaluated on the 6 sets each of test-bolus scans and 4D MRA. For the qualitative analysis, arterial enhancement, superimposition of nontargeted enhancement, and overall image quality were evaluated on 3D MRA. Visibility of bolus transition was assessed on 4D MRA. Intraindividual comparison between power and manual injection was made by paired t test, Wilcoxon rank sum test, and analysis of variance by ranks. Signal-to-noise ratio on 3D MRA was statistically higher with power injection than with manual injection (P < 0.001). Bolus shapes (test-bolus, 4D MRA) were represented by a characteristic standard bolus curve (sharp first-pass peak followed by a gentle recirculation peak) in all the 12 scans with power injection, but only in 1 of the 12 scans with manual injection. Standard deviations of time-to-peak enhancement were smaller in power injection than in manual injection. Qualitatively, although both injection methods achieved diagnostic quality on 3D MRA, power injection exhibited significantly higher image quality than manual injection (P = 0.001) due to significantly higher arterial enhancement (P = 0.031) and less superimposition of nontargeted enhancement (P = 0.001). Visibility of bolus transition on 4D MRA was significantly better with power injection than with manual injection (P = 0.031). Compared with manual injection, power injection provides more standardized bolus shapes and higher image quality due to higher arterial enhancement and less superimposition of nontargeted vessels.

Total and regional deposition of inhaled aerosols in supine healthy subjects and subjects with mild-to-moderate COPD

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

Darquenne, Chantal; Lamm, Wayne J.; Fine, Janelle M.

Despite substantial development of sophisticated subject-specific computational models of aerosol transport and deposition in human lungs, experimental validation of predic- tions from these new models is sparse. We collected aerosol retention and exhalation profiles in seven healthy volunteers and six subjects with mild-to-moderate COPD (FEV1 ¼ 50–80%predicted) in the supine posture. Total deposition was measured during continuous breathing of 1 and 2.9 mm-diameter particles (tidal volume of 1 L, flow rate of 0.3 L/s and 0.75 L/s). Bolus inhalations of 1 mm particles were performed to penetration volumes of 200, 500 and 800 mL (flow rate of 0.5 L/s). Aerosolmore » bolus dispersion (H), deposition, and mode shift (MS) were calculated from these data. There was no significant difference in total deposition between healthy subjects and those with COPD. Total deposition increased with increasing particle size and also with increasing flow rate. Similarly, there was no significant difference in aerosol bolus deposition between subject groups. Yet, the rate of increase in dispersion and of decrease in MS with increasing penetration volume was higher in subjects with COPD than in healthy volunteers (H: 0.79870.205 vs. 0.52770.122 mL/mL, p¼ 0.01; MS: - 0.27170.129 vs. - 0.145 70.076 mL/mL, p¼ 0.05) indicating larger ventilation inhomogeneities (based on H) and increased flow sequencing (based on MS) in the COPD than in the healthy group. In conclusion, in the supine posture, deposition appears to lack sensitivity for assessing the effect of lung morphology and/or ventilation distribution alteration induced by mild-to- moderate lung disease on the fate of inhaled aerosols. However, other parameters such as aerosol bolus dispersion and mode shift may be more sensitive parameters for evaluating models of lungs with moderate disease.« less

SU-E-T-268: Proton Radiosurgery End-To-End Testing Using Lucy 3D QA Phantom

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

Choi, D; Gordon, I; Ghebremedhin, A

2014-06-01

Purpose: To check the overall accuracy of proton radiosurgery treatment delivery using ready-made circular collimator inserts and fixed thickness compensating boluses. Methods: Lucy 3D QA phantom (Standard Imaging Inc. WI, USA) inserted with GaFchromicTM film was irradiated with laterally scattered and longitudinally spread-out 126.8 MeV proton beams. The tests followed every step in the proton radiosurgery treatment delivery process: CT scan (GE Lightspeed VCT), target contouring, treatment planning (Odyssey 5.0, Optivus, CA), portal calibration, target localization using robotic couch with image guidance and dose delivery at planned gantry angles. A 2 cm diameter collimator insert in a 4 cm diametermore » radiosurgery cone and a 1.2 cm thick compensating flat bolus were used for all beams. Film dosimetry (RIT114 v5.0, Radiological Imaging Technology, CO, USA) was used to evaluate the accuracy of target localization and relative dose distributions compared to those calculated by the treatment planning system. Results: The localization accuracy was estimated by analyzing the GaFchromic films irradiated at gantry 0, 90 and 270 degrees. We observed 0.5 mm shift in lateral direction (patient left), ±0.9 mm shift in AP direction and ±1.0 mm shift in vertical direction (gantry dependent). The isodose overlays showed good agreement (<2mm, 50% isodose lines) between measured and calculated doses. Conclusion: Localization accuracy depends on gantry sag, CT resolution and distortion, DRRs from treatment planning computer, localization accuracy of image guidance system, fabrication of ready-made aperture and cone housing. The total deviation from the isocenter was 1.4 mm. Dose distribution uncertainty comes from distal end error due to bolus and CT density, in addition to localization error. The planned dose distribution was well matched (>90%) to the measured values 2%/2mm criteria. Our test showed the robustness of our proton radiosurgery treatment delivery system using ready-made collimator inserts and fixed thickness compensating boluses.« less

Closed-Loop- and Decision-Assist-Guided Fluid Therapy of Human Hemorrhage.

PubMed

Hundeshagen, Gabriel; Kramer, George C; Ribeiro Marques, Nicole; Salter, Michael G; Koutrouvelis, Aristides K; Li, Husong; Solanki, Daneshvari R; Indrikovs, Alexander; Seeton, Roger; Henkel, Sheryl N; Kinsky, Michael P

2017-10-01

We sought to evaluate the efficacy, efficiency, and physiologic consequences of automated, endpoint-directed resuscitation systems and compare them to formula-based bolus resuscitation. Experimental human hemorrhage and resuscitation. Clinical research laboratory. Healthy volunteers. Subjects (n = 7) were subjected to hemorrhage and underwent a randomized fluid resuscitation scheme on separate visits 1) formula-based bolus resuscitation; 2) semiautonomous (decision assist) fluid administration; and 3) fully autonomous (closed loop) resuscitation. Hemodynamic variables, volume shifts, fluid balance, and cardiac function were monitored during hemorrhage and resuscitation. Treatment modalities were compared based on resuscitation efficacy and efficiency. All approaches achieved target blood pressure by 60 minutes. Following hemorrhage, the total amount of infused fluid (bolus resuscitation: 30 mL/kg, decision assist: 5.6 ± 3 mL/kg, closed loop: 4.2 ± 2 mL/kg; p < 0.001), plasma volume, extravascular volume (bolus resuscitation: 17 ± 4 mL/kg, decision assist: 3 ± 1 mL/kg, closed loop: -0.3 ± 0.3 mL/kg; p < 0.001), body weight, and urinary output remained stable under decision assist and closed loop and were significantly increased under bolus resuscitation. Mean arterial pressure initially decreased further under bolus resuscitation (-10 mm Hg; p < 0.001) and was lower under bolus resuscitation than closed loop at 20 minutes (bolus resuscitation: 57 ± 2 mm Hg, closed loop: 69 ± 4 mm Hg; p = 0.036). Colloid osmotic pressure (bolus resuscitation: 19.3 ± 2 mm Hg, decision assist, closed loop: 24 ± 0.4 mm Hg; p < 0.05) and hemoglobin concentration were significantly decreased after bolus fluid administration. We define efficacy of decision-assist and closed-loop resuscitation in human hemorrhage. In comparison with formula-based bolus resuscitation, both semiautonomous and autonomous approaches were more efficient in goal-directed resuscitation of hemorrhage. They provide favorable conditions for the avoidance of over-resuscitation and its adverse clinical sequelae. Decision-assist and closed-loop resuscitation algorithms are promising technological solutions for constrained environments and areas of limited resources.

History Run Wild: The Alternate World of Joan Aiken's "The Wolves of Willoughby Chase" Series

ERIC Educational Resources Information Center

Dams, Isobel

2005-01-01

This article examines the historical fantasy world created by Joan Aiken in the eleven volumes of her "Wolves of Willoughby Chase" series. In particular it looks at her subversion of historical reality by the creation of an alternative yet recognisable representation of our own world, using a wide range of events, and the remoulding of aspects of…

The Effect of Laziness in Group Chase and Escape

NASA Astrophysics Data System (ADS)

Masuko, Makoto; Hiraoka, Takayuki; Ito, Nobuyasu; Shimada, Takashi

2017-08-01

The effect of laziness in the group chase and escape problem is studied using a simple model. Laziness is introduced as random walks in two ways: uniformly and in a "division of labor" way. It is shown that while the former is always ineffective, the latter can improve the efficiency of catching, through the formation of pincer attack configuration by diligent and lazy chasers.

The identification of N-linked oligosaccharides on the human CR2/Epstein-Barr virus receptor and their function in receptor metabolism, plasma membrane expression, and ligand binding.

PubMed

Weis, J J; Fearon, D T

1985-11-05

Human complement receptor type 2 (CR2) was biosynthetically labeled by pulsing SB B lymphoblastoid cells for 25 min with [35S]methionine followed by chase in the presence of excess unlabeled methionine. An Mr 134,000 polypeptide represented the major form of the receptor at the end of the pulse period, and within 1 h of chase this disappeared coincident with the appearance of the Mr 145,000 mature form of CR2. Precursor, but not mature, CR2 was sensitive to endoglycosidase H, indicating that maturation of CR2 represented processing of N-linked high mannose oligosaccharides to the complex type. The processing of precursor CR2 was impaired by monensin. In the presence of tunicamycin an Mr 111,000 form of CR2 was synthesized by SB cells, and this did not chase into either precursor or mature CR2. This Mr 111,000 form of CR2 did not incorporate [3H]glucosamine, indicating that it lacked both N- and O-linked oligosaccharide. The half-lives of mature CR2 and nonglycosylated CR2 pulse-labeled in the presence of tunicamycin were 13.8 and 2.8 h, respectively; the turnover rate of B1, a membrane protein normally lacking carbohydrate, was unaffected by the presence of the antibiotic. The percentage of pulse-labeled, nonglycosylated CR2 that was expressed at the cell surface after 1 h of chase in the presence of tunicamycin was 30%, identical to that of mature CR2 in cells chased in the absence of the antibiotic. However, after 6 h of chase there was no additional net accumulation of nonglycosylated CR2 at the plasma membrane, while the proportion of pulse-labeled mature CR2 at this site had risen to 81%. Therefore, N-linked oligosaccharides are essential for the stability of CR2 and have some role in its plasma membrane expression. In contrast, the observation that all three forms of CR2 bound to Sepharose C3 indicates that oligosaccharides are not necessary for the interaction between CR2 and its complement ligand.

Automatic Detection and Estimation of Unannounced Meals for Multivariable Artificial Pancreas System.

PubMed

Samadi, Sediqeh; Rashid, Mudassir; Turksoy, Kamuran; Feng, Jianyuan; Hajizadeh, Iman; Hobbs, Nicole; Lazaro, Caterina; Sevil, Mert; Littlejohn, Elizabeth; Cinar, Ali

2018-03-01

Automatically attenuating the postprandial rise in the blood glucose concentration without manual meal announcement is a significant challenge for artificial pancreas (AP) systems. In this study, a meal module is proposed to detect the consumption of a meal and to estimate the amount of carbohydrate (CHO) intake. The meals are detected based on qualitative variables describing variation of continuous glucose monitoring (CGM) readings. The CHO content of the meals/snacks is estimated by a fuzzy system using CGM and subcutaneous insulin delivery data. The meal bolus amount is computed according to the patient's insulin to CHO ratio. Integration of the meal module into a multivariable AP system allows revision of estimated CHO based on knowledge about physical activity, sleep, and the risk of hypoglycemia before the final decision for a meal bolus is made. The algorithm is evaluated by using 117 meals/snacks in retrospective data from 11 subjects with type 1 diabetes. Sensitivity, defined as the percentage of correctly detected meals and snacks, is 93.5% for meals and 68.0% for snacks. The percentage of false positives, defined as the proportion of false detections relative to the total number of detected meals and snacks, is 20.8%. Integration of a meal detection module in an AP system is a further step toward an automated AP without manual entries. Detection of a consumed meal/snack and infusion of insulin boluses using an estimate of CHO enables the AP system to automatically prevent postprandial hyperglycemia.

A retrospective comparison of smart prep and test bolus multi-detector CT pulmonary angiography protocols

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

Suckling, Tara; Smith, Tony; Reed, Warren

2013-06-15

Optimal arterial opacification is crucial in imaging the pulmonary arteries using computed tomography (CT). This poses the challenge of precisely timing data acquisition to coincide with the transit of the contrast bolus through the pulmonary vasculature. The aim of this quality assurance exercise was to investigate if a change in CT pulmonary angiography (CTPA) scanning protocol resulted in improved opacification of the pulmonary arteries. Comparison was made between the smart prep protocol (SPP) and the test bolus protocol (TBP) for opacification in the pulmonary trunk. A total of 160 CTPA examinations (80 using each protocol) performed between January 2010 andmore » February 2011 were assessed retrospectively. CT attenuation coefficients were measured in Hounsfield Units (HU) using regions of interest at the level of the pulmonary trunk. The average pixel value, standard deviation (SD), maximum, and minimum were recorded. For each of these variables a mean value was then calculated and compared for these two CTPA protocols. Minimum opacification of 200 HU was achieved in 98% of the TBP sample but only 90% of the SPP sample. The average CT attenuation over the pulmonary trunk for the SPP was 329 (SD = ±21) HU, whereas for the TBP it was 396 (SD = ±22) HU (P = 0.0017). The TBP also recorded higher maximum (P = 0.0024) and minimum (P = 0.0039) levels of opacification. This study has found that a TBP resulted in significantly better opacification of the pulmonary trunk than the SPP.« less

SU-F-T-87: Comparison of Advanced Radiotherapy Techniques for Post- Mastectomy Breast Cancer Patients

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

Heins, D; Zhang, R; Hogstrom, K

2016-06-15

Purpose: To determine if bolus electron conformal therapy (Bolus-ECT) combined with intensity modulated x-ray therapy (IMXT) and flattening filter free volumetric modulated arc therapy (FFF-VMAT (6x and 10x)) can maintain equal or better dose coverage than standard volumetric modulated arc therapy (Std-VMAT) while reducing doses to organs at risk (OARs). Methods: Bolus-ECT with IMXT, FFF-VMAT, and Std-VMAT treatment plans were produced for ten post-mastectomy radiotherapy (PMRT) patients previously treated at our clinic. The treatment plans were created on commercially available treatment planning system (TPS) and all completed treatment plans were reviewed and approved by a radiation oncologist. The plans weremore » evaluated based on planning target volume (PTV) coverage, tumor control probability (TCP), dose homogeneity index (DHI), conformity index (CI), and dose to organs at risk (OAR). Results: All techniques produced clinically acceptable PMRT plans. Overall, Bolus-ECT with IMXT exhibited higher maximum dose compared to all VMAT techniques. Bolus-ECT with IMXT and FFF-VMAT10x had slightly improved TCP over FFF-VMAT6x and Std-VMAT. However, all VMAT techniques showed improved CI and DHI over Bolus-ECT with IMXT. All techniques showed very similar mean lung dose. Bolus-ECT with IMXT exhibited a reduced mean heart dose over Std-VMAT. Both FFF-VMAT techniques had higher mean heart dose compared to Std-VMAT. In addition, Bolus-ECT with IMXT was able to reduce mean dose to the contralateral breast compared to Std-VMAT and both FFF-VMAT techniques had comparable but slightly reduced dose compared to Std-VMAT. Conclusion: This work has shown that Bolus-ECT with IMXT produces clinically acceptable plans while reducing OAR doses. Both FFF-VMAT techniques are comparable to Std-VMAT with slight improvements. Even though all VMAT techniques produce more homogenous and conformal dose distributions, Bolus-ECT with IMXT is a viable option for treating post-mastectomy patients possibly leading to reduced risks of normal tissue complications.« less

Randomized comparison of intracoronary tirofiban versus urokinase as an adjunct to primary percutaneous coronary intervention in patients with acute ST-elevation myocardial infarction: results of the ICTUS-AMI trial.

PubMed

Zhu, Tian-qi; Zhang, Qi; Ding, Feng-hua; Qiu, Jian-ping; Jin, Hui-geng; Jiang, Li; Lu, Lin; Zhang, Rui-yan; Hu, Jian; Yang, Zhen-kun; Shen, Ying; Shen, Wei-feng

2013-08-01

No randomized trial has been performed to compare the efficacy of an intracoronary bolus of tirofiban versus urokinase during primary percutaneous coronary intervention (PCI). We investigated whether the effects of adjunctive therapy with an intracoronary bolus of urokinase was noninferior to the effects of an intracoronary bolus of tirofiban in patients with ST-elevation myocardial infarction (STEMI) undergoing PCI. A total of 490 patients with acute STEMI undergoing primary PCI were randomized to an intracoronary bolus of tirofiban (10 µg/kg; n = 247) or urokinase (250 kU/20 ml; n = 243). Serum levels of P-selectin, von Willebrand factor (vWF), CD40 ligand (CD40L), and serum amyloid A (SAA) in the coronary sinus were measured before and after intracoronary drug administration. The primary endpoint was the rate of complete ( ≥ 70%) ST-segment resolution (STR) at 90 minutes after intervention, and the noninferiority margin was set to 15%. In the intention-to-treat analysis, complete STR was achieved in 54.4% of patients treated with an intracoronary bolus of urokinase and in 60.6% of those treated with an intracoronary bolus of tirofiban (adjusted difference: -7.0%; 95% confidence interval: -15.7% to 1.8%). The corrected TIMI frame count of the infarct-related artery was lower, left ventricular ejection fraction was higher, and the 6-month major adverse cardiac event-free survival tended to be better in the intracoronary tirofiban group. An intracoronary bolus of tirofiban resulted in lower levels of P-selectin, vWF, CD40L, and SAA in the coronary sinus compared with an intracoronary bolus of urokinase after primary PCI (P < 0.05). An intracoronary bolus of urokinase as an adjunct to primary PCI for acute STEMI is not equally effective to an intracoronary bolus of tirofiban with respect to improvement in myocardial reperfusion assessed by STR. This may be caused by less reduction in coronary circulatory platelet activation and inflammation.

Effect of body temperature on chondroitinase ABC's ability to cleave chondroitin sulfate glycosaminoglycans.

PubMed

Tester, Nicole J; Plaas, Anna H; Howland, Dena R

2007-04-01

Chondroitinase ABC (Ch'ase ABC) is a bacterial lyase that degrades chondroitin sulfate (CS), dermatan sulfate, and hyaluronan glycosaminoglycans (GAGs). This enzyme has received significant attention as a potential therapy for promoting central nervous system and peripheral nervous system repair based on its degradation of CS GAGs. Determination of the stability of Ch'ase ABC activity at temperatures equivalent to normal (37 degrees C) and elevated (39 degrees C) body temperatures is important for optimizing its clinical usage. We report here data obtained from examining enzymatic activity at these temperatures across nine lots of commercially available protease-free Ch'ase ABC. CS GAG degrading activity was assayed by using 1) immunohistochemical detection of unsaturated disaccharide stubs generated by digestion of proteoglycans in tissue sections and 2) fluorophore-assisted carbohydrate electrophoresis (FACE) and/or high-performance liquid chromatography (HPLC) to separate and quantify unsaturated disaccharide digestion products. Our results indicate that there is a significant effect of lot and time on enzymatic thermostability. Average enzymatic activity is significantly decreased at 1 and 3 days at 39 degrees C and 37 degrees C, respectively. Furthermore, the average activity seen after 1 day was significantly different between the two temperatures. Addition of bovine serum albumin as a stabilizer significantly preserved enzymatic activity at 1 day, but not 3 days, at 39 degrees C. These results show that the CS GAG degrading activity of Ch'ase ABC is significantly decreased with incubation at body temperature over time and that all lots do not show equal thermostability. These findings are important for the design and interpretation of experimental and potential clinical studies involving Ch'ase ABC. (c) 2007 Wiley-Liss, Inc.

Following isotopes in pulse-chase enriched aspen seedlings

NASA Astrophysics Data System (ADS)

Norris, C. E.; Wasylishen, R. E.; Landhäusser, S.; Quideau, S. A.

2011-12-01

One method to quantitatively trace biogeochemical fluxes through ecosystems, such as organic matter decomposition, is to use plant material enriched with stable isotopes. However, as plant macromolecules are known to vary in their rate of formation and decomposition, both the enrichment levels and the location of enrichment within the plant material should be characterized prior to decomposition and tracing studies. Aspen (Populus tremuloides Michx.) is a common tree species with a diverse organic matter chemical structure found in the western Canadian boreal forest. This study used a multi pulse and multi chase enrichment of stable isotopes (15N and 13C) on aspen seedlings to determine the seedling enrichment, isotope movement among plant tissues and translocation of isotopes within plant macromolecules e.g., carbohydrates and lignin. As expected, all tissues experienced increased enrichment with multiple pulses. An initial enrichment with 13C was observed in the leaves followed by translocation to the stems and roots while the 15N moved upward from the roots to leaves. The macromolecular chemistry of the organic carbon was further characterized using 13C solid state nuclear magnetic resonance spectroscopy. After the initial two hour chase period enrichment of the O-alkyl type (carbohydrate) carbon within the leaves was identified, followed by redistribution to more complex carbon compounds after the one week chase period. Root and stem tissues did not show the same pattern. Rather, changes in 13C enrichment were observed in shifting ethyl and methyl alkyl (lipid) carbon peak intensities for the stem samples while roots did not preferentially allocate 13C to a specific macromolecule. These results confirm that stable isotope enrichment of plants was non-uniform across macromolecules and tissue types. Enrichment of aspen seedlings was therefore dependant on the pulse-chase sequence used.

Insulin pump therapy: what is the evidence for using different types of boluses for coverage of prandial insulin requirements?

PubMed

Heinemann, Lutz

2009-11-01

Bolus infusion of insulin along with a meal is a standard procedure with continuous subcutaneous insulin infusion. Modern insulin pumps allow applying this bolus in four different ways: infusion of the total dose at once or splitting the dose into two boluses, infusion of a part of the bolus in the usual manner plus infusion of the other part over a prolonged period of time (with a higher infusion rate than the basal rate), or infusion of the total dose in the form of an elevated basal rate. Depending on the composition of the given meal and its glycemic index, this is an attempt to match the circulating insulin levels to the rate of glucose absorption from the gut in order to minimize postprandial glycemic excursions. However, in the framework of evidence-based medicine, the benefits of this approach should be proven in appropriately designed clinical studies. Performance of meal-related studies requires careful attention to many aspects in order to allow meaningful evaluation of a given intervention (i.e., type of bolus). Critical evaluation of the clinical experimental studies and the one clinical study published about the impact of different types of boluses on postprandial metabolic control revealed fundamental shortcomings in study design and performance in these studies. Insufficient establishment of comparable preprandial glycemia and insulinemia on the different study days within and between the patients studied is one key aspect. Therefore, the recommendation made in most of these studies (i.e., use of dual-wave bolus) has to be accepted with care, until we have better evidence.

The Role of Bolus Injection of Saline with Arm Elevation on Rocuronium onset Time: A Randomized Control Study

PubMed Central

Kulkarni, Malavika; Chuchendra, L. S.; Bhavya, P. J.

2018-01-01

Background: The onset time of neuromuscular blockade is a crucial time associated with the risk of hypoxia and pulmonary aspiration. Various strategies have been undertaken to shorten this onset time. Therefore, we investigated the effects of bolus of 20 ml saline followed by limb elevation after administration of rocuronium in a dose of 0.6 mg/kg to study the onset time. Methodology: Thirty patients were randomly allocated to the bolus saline group or control group. General anesthesia was induced and maintained with fentanyl and propofol. Rocuronium 0.6 mg/kg intravenous (IV) was administered followed by 20 ml saline bolus and limb elevation in the study group compared to administration of 0.6 mg/kg in a running drip only in the control. Onset of neuromuscular block was assessed by acceleromyography at the adductor pollicis muscle with train-of-four stimulation. Results: The lag time was shorter in bolus group (34 s median) than in control group (45 s median), P < 0.017. The onset time was shorter in bolus group (55 s median) than in control group (110 s median), P < 0.001. The T1 recovery to 25% was longer in bolus group (42 min median) than in control group (39 min median) which was statistically not significant. Conclusion: Rocuronium 0.6 mg/kg IV followed by bolus 20 ml saline and concomitant limb elevation resulted in shorter lag time, faster onset of neuromuscular blockade, good intubating conditions without prolonging clinical duration of action when compared to the control. PMID:29628555

Characterization of swallow modulation in response to bolus volume in healthy subjects accounting for catheter diameter.

PubMed

Ferris, Lara; Schar, Mistyka; McCall, Lisa; Doeltgen, Sebastian; Scholten, Ingrid; Rommel, Nathalie; Cock, Charles; Omari, Taher

2018-06-01

Characterization of the pharyngeal swallow response to volume challenges is important for swallowing function assessment. The diameter of the pressure-impedance recording catheter may influence these results. In this study, we captured key physiological swallow measures in response to bolus volume utilizing recordings acquired by two catheters of different diameter. Ten healthy adults underwent repeat investigations with 8- and 10-Fr catheters. Liquid bolus swallows of volumes 2.5, 5, 10, 20, and 30 mL were recorded. Measures indicative of distension, contractility, and flow timing were assessed. Pressure-impedance recordings with pressure-flow analysis were used to capture key distension, contractility, and pressure-flow timing parameters. Larger bolus volumes increased upper esophageal sphincter distension diameter (P < .001) and distension pressures within the hypopharynx and upper esophageal sphincter (P < .05). Bolus flow timing measures were longer, particularly latency of bolus propulsion ahead of the pharyngeal stripping wave (P < .001). Use of a larger-diameter catheter produced higher occlusive pressures, namely upper esophageal sphincter basal pressure (P < .005) and upper esophageal sphincter postdeglutitive pressure peak (P < .001). The bolus volume swallowed changed measurements indicative of distension pressure, luminal diameter, and pressure-flow timing; this is physiologically consistent with swallow modulation to accommodate larger, faster-flowing boluses. Additionally, catheter diameter predominantly affects lumen occlusive pressures. Appropriate physiological interpretation of the pressure-impedance recordings of pharyngeal swallowing requires consideration of the effects of volume and catheter diameter. NA. Laryngoscope, 128:1328-1334, 2018. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

Endoscopic evaluation of food bolus formation and its relationship with the number of chewing cycles.

PubMed

Fukatsu, H; Nohara, K; Kotani, Y; Tanaka, N; Matsuno, K; Sakai, T

2015-08-01

It is known that solid food is transported to the pharynx actively in parallel to it being crushed by chewing and mixed with saliva in the oral cavity. Therefore, food bolus formation should be considered to take place from the oral cavity to the pharynx. In previous studies, the chewed food was evaluated after the food had been removed from the oral cavity. However, it has been pointed out that spitting food out of the oral cavity interferes with natural food bolus formation. Therefore, we observed food boluses immediately before swallowing using an endoscope to establish a method to evaluate the food bolus-forming function, and simultaneously performed endoscopic evaluation of food bolus formation and its relationship with the number of chewing cycles. The subject was inserted the endoscope nasally and instructed to eat two coloured samples of boiled rice simultaneously in two ingestion conditions ('as usual' and 'chewing well'). The condition of the food bolus was graded into three categories for each item of grinding, mixing and aggregation and scored 2, 1 and 0. The score of aggregation was high under both ingestion conditions. The scores of grinding and mixing tended to be higher in subjects with a high number of chewing cycles, and the score of aggregation was high regardless of the number of chewing cycles. It was suggested that food has to be aggregated, even though the number of chewing cycles is low and the food is not ground or mixed for a food bolus to reach the swallowing threshold. © 2015 John Wiley & Sons Ltd.

Swallowing Mechanics Associated with Artificial Airways, Bolus Properties, and Penetration-Aspiration Status in Trauma Patients

ERIC Educational Resources Information Center

Dietsch, Angela M.; Rowley, Christopher B.; Solomon, Nancy Pearl; Pearson, William G., Jr.

2017-01-01

Purpose: Artificial airway procedures such as intubation and Sare common in the treatment of traumatic injuries, and bolus modifications may be implemented to help manage swallowing disorders. This study assessed artificial airway status, bolus properties (volume and viscosity), and the occurrence of laryngeal penetration and/or aspiration in…

Influence of hydration and starch digestion on the transient rheology of an aqueous suspension of comminuted potato snack food.

PubMed

Boehm, Michael W; Warren, Frederick J; Moore, Jackson E; Baier, Stefan K; Gidley, Michael J; Stokes, Jason R

2014-11-01

Oral processing of most foods is inherently destructive: solids are broken into particles before reassembly into a hydrated bolus while salivary enzymes degrade food components. In order to investigate the underlying physics driving changes during oral processing, we capture the transient rheological behaviour of a simulated potato chip bolus during hydration by a buffer with or without α-amylase. In the absence of amylase and for all oil contents and solids weight fractions tested, we find a collapse of the transient data when graphed according to simple Fickian diffusion. In the presence of amylase, we find effects on the transient and pseudo steady state bolus rheology. Within the first minute of mixing, the amylase degrades only ≈6% of the starch but that leads to an order of magnitude reduction in the bolus elasticity, as compared to the case without amylase. Thus, for an in vitro bolus, only a small amount of starch needs to be digested to have a large impact on the bolus rheology very soon after mixing.

Cheetah do not abandon hunts because they overheat.

PubMed

Hetem, Robyn S; Mitchell, Duncan; de Witt, Brenda A; Fick, Linda G; Meyer, Leith C R; Maloney, Shane K; Fuller, Andrea

2013-10-23

Hunting cheetah reportedly store metabolic heat during the chase and abandon chases because they overheat. Using biologging to remotely measure the body temperature (every minute) and locomotor activity (every 5 min) of four free-living cheetah, hunting spontaneously, we found that cheetah abandoned hunts, but not because they overheated. Body temperature averaged 38.4°C when the chase was terminated. Storage of metabolic heat did not compromise hunts. The increase in body temperature following a successful hunt was double that of an unsuccessful hunt (1.3°C ± 0.2°C versus 0.5°C ± 0.1°C), even though the level of activity during the hunts was similar. We propose that the increase in body temperature following a successful hunt is a stress hyperthermia, rather than an exercise-induced hyperthermia.

Cheetah do not abandon hunts because they overheat

PubMed Central

Hetem, Robyn S.; Mitchell, Duncan; de Witt, Brenda A.; Fick, Linda G.; Meyer, Leith C. R.; Maloney, Shane K.; Fuller, Andrea

2013-01-01

Hunting cheetah reportedly store metabolic heat during the chase and abandon chases because they overheat. Using biologging to remotely measure the body temperature (every minute) and locomotor activity (every 5 min) of four free-living cheetah, hunting spontaneously, we found that cheetah abandoned hunts, but not because they overheated. Body temperature averaged 38.4°C when the chase was terminated. Storage of metabolic heat did not compromise hunts. The increase in body temperature following a successful hunt was double that of an unsuccessful hunt (1.3°C ± 0.2°C versus 0.5°C ± 0.1°C), even though the level of activity during the hunts was similar. We propose that the increase in body temperature following a successful hunt is a stress hyperthermia, rather than an exercise-induced hyperthermia. PMID:23883578

Effects of different strategies of mineral supplementation (marine algae alone or combined with rumen boluses) in organic dairy systems.

PubMed

López-Alonso, M; Rey-Crespo, F; Orjales, I; Rodríguez-Bermúdez, R; Miranda, M

2016-10-01

This study was designed to evaluate the effect of marine algae supplementation alone or in combination with a regular mineral supplement (rumen boluses) to improve the mineral status in organic dairy cattle and their effect on the milk mineral composition, milk production, composition (% of fat and protein) and quality (SCC). Thirty-two Holstein Friesian lactating cows were randomly selected and assigned to the algae (A), boluses (B), algae+boluses (AB) and control group (C). For the algae groups (A, AB), a supplement composed of Sea Lettuce (80%), Japanese Wireweed (17.5%) and Furbelows (2.5%) was formulated to be given to the cows at the rate of 100 g/animal per day (A1) for the length of 4 weeks. In the second half of the experiment (weeks 5-8), the algae mixture was reformulated and the proportion of Furbelows was increased from 2.5% to 5.0% with a subsequent decrease of Lettuce to 77.5% (A2). In the boluses group (B), each cow received 2 boluses after calving. Blood (serum) and milk samples were collected at 2 and 4 week intervals, respectively, and analysed for trace element concentrations by ICP-MS. Information related to the milk composition and SCC during a 305-day lactation for each animal were obtained from the Dairy Records Management System. The supplementation with algae, boluses or the combination of both treatments showed a statistically significant effect on the iodine (algae), selenium (boluses) and cobalt (algae+boluses) status of the animals. In milk, treatments had a statistical significant increase on iodine, and a tendency to increase selenium concentrations. The assayed algae mixture combined with another source of selenium could be an effective tool to improve the mineral status in serum and milk. Journal of Animal Physiology and Animal Nutrition © 2016 Blackwell Verlag GmbH.

Onset and effectiveness of rocuronium for rapid onset of paralysis in patients with major burns: priming or large bolus

PubMed Central

Han, T.-H.; Martyn, J. A. J.

2009-01-01

Background Burn injury leads to resistance to the effects of non-depolarizing muscle relaxants. We tested the hypothesis that a larger bolus dose is as effective as priming for rapid onset of paralysis after burns. Methods Ninety adults, aged 18–59 yr with 40 (2)% [mean (se)] burn and 30 (2) days after injury, received rocuronium as a priming dose followed by bolus (0.06+0.94 mg kg−1), or single bolus of either 1.0 or 1.5 mg kg−1. Sixty-one non-burned, receiving 1.0 mg kg−1 as a primed (0.06+0.94 mg kg−1) or full bolus dose, served as controls. Acceleromyography measured the onset times. Results Priming when compared with 1.0 mg kg−1 bolus in burned patients shortened the time to first appearance of twitch depression (30 vs 45 s, P<0.05) and time to maximum twitch inhibition (135 vs 210 s, P<0.05). The onset times between priming and higher bolus dose (1.5 mg kg−1) were not different (30 vs 30 s for first twitch depression and 135 vs 135 s for maximal depression, respectively). The onset times in controls, however, were significantly (P<0.05) faster than burns both for priming and for full bolus (15 and 15 s, respectively, for first twitch depression and 75 and 75 s for maximal depression). Priming caused respiratory distress in 10% of patients in both groups. Intubating conditions in burns were significantly better with 1.5 mg kg−1 than with priming or full 1.0 mg kg−1 bolus. Conclusions A dose of 1.5 mg kg−1 not only produces an initial onset of paralysis as early as 30 s, which we speculate could be a reasonable onset time for relief of laryngospasm, but also has an onset as fast as priming with superior intubating conditions and no respiratory side-effects. PMID:19029093

Dose-response characteristics of intravenous ketamine on dissociative stereotypy, locomotion, sensorimotor gating, and nociception in male Sprague-Dawley rats.

PubMed

Radford, Kennett D; Park, Thomas Y; Lee, Bong Hyo; Moran, Sean; Osborne, Lisa A; Choi, Kwang H

2017-02-01

Clinicians administer subanesthetic intravenous (IV) ketamine infusions for treatment of refractory depression, chronic pain, and post-traumatic stress disorder in humans. However, ketamine is administered via the subcutaneous (SC) or intraperitoneal (IP) routes to rodents in most pre-clinical research, which may limit translational application. The present study characterized the dose-response of a subanesthetic IV ketamine bolus (2 and 5mg/kg) and 1-h infusion (5, 10, and 20mg/kg/h) on dissociative stereotypy, locomotion, sensorimotor gating, and thermal nociception in male Sprague-Dawley rats. The secondary aim was to measure ketamine and norketamine plasma concentrations following IV ketamine bolus at 1, 20, and 50min and at the conclusion of the 1-h infusion using liquid chromatography/mass spectrometry. The results showed that ketamine bolus and infusions produced dose-dependent dissociative stereotypy. Bolus (2 and 5mg/kg) and 20mg/kg/h infusion increased locomotor activity while 5mg/kg/h infusion decreased locomotor activity. Both 10 and 20mg/kg/h infusions reduced the acoustic startle reflex, while 5mg/kg bolus and 20mg/kg/h infusion impaired pre-pulse inhibition. Ketamine 5mg/kg bolus and the 10 and 20mg/kg/h infusions induced significant and prolonged antinociception to the hotplate test. Plasma concentrations of ketamine decreased quickly after bolus while norketamine levels increased from 1 to 20min and plateaued from 20 to 50min. The peak ketamine plasma concentrations [ng/ml] were similar between 5mg/kg bolus [4100] vs. 20mg/kg/h infusion [3900], and 2mg/kg bolus [1700] vs. 10mg/kg/h infusion [1500]. These results support the findings from previous ketamine injection studies and further validate the feasibility of administering subanesthetic doses of IV ketamine infusion to rats for neuropharmacological studies. Published by Elsevier Inc.

SU-F-T-325: On the Use of Bolus in Dosimetry and Dose Reduction for Pacemaker and Defibrillator

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

Liu, W; Kenneth, R; Higgins, S

Purpose: Special attention is required in planning and administering radiation therapy to patients with cardiac implantable electronic devices (CIEDs), such as pacemaker and defibrillator. The range of dose to CIEDs that can induce malfunction is very large among CIEDs. Significant defects have been reported at dose as low as 0.15Gy. Failures causing discomfort have been reported at dose as low as 0.05Gy. Therefore, accurate estimation of dose to CIED and dose reduction are both important even if the dose is expected to be less than the often-used 2Gy limit. We investigate the use of bolus in in vivo dosimetry formore » CIEDs. Methods: In our clinic, high-energy beams (>10MV) are not used for patients with CIED due to neutron production. Solid water phantom measurements of out-of-field dose for a 6MV beam were performed using parallel plate chamber at different depth with and without 2cm bolus covering the chamber. In vivo dosimetry at skin surface above the pacemaker was performed with and without bolus for 3 patients with pacemaker <5cm from the field edge. Results: Chamber measured dose at depth ∼1 to 1.5cm below the skin surface, where the CIED is normally located, was reduced by ∼6% – 20% with bolus. The dose reduction became smaller at deeper depth. In vivo dosimetry at skin surface also yielded ∼20% – 60% lower dose when using bolus for the 3 patients. In general, TPS calculation underestimated the dose. The dose measured with bolus is closer to the dose at the depth of the pacemaker and less affected by contaminant electrons and linac head leakage. Conclusion: In vivo CIED dose measurements should be performed with 1 to 2cm bolus covering the dosimeter on the skin above the CIED for more accurate CIED dose estimation. The use of bolus also reduces the dose delivered to CIED.« less

Multicenter study of crystalloid boluses and transfusion in pediatric trauma-When to go to blood?

PubMed

Polites, Stephanie F; Nygaard, Rachel M; Reddy, Pooja N; Zielinski, Martin D; Richardson, Chad J; Elsbernd, Terri A; Petrun, Branden M; Weinberg, Sean L; Murphy, Sherrie; Potter, Donald D; Klinkner, Denise B; Moir, Christopher R

2018-07-01

The 9th edition of Advanced Trauma Life Support recommends up to three crystalloid boluses in pediatric trauma patients with consideration of transfusion after the second bolus; however, this approach is debated. We aimed to determine if requirement of more than one fluid bolus predicts the need for transfusion. The 2010 to 2016 highest tier activation patients younger than 15 years from two ACS Level I pediatric trauma centers were identified from prospectively maintained trauma databases. Those with a shock index (heart rate/systolic blood pressure) greater than 0.9 were included. Crystalloid boluses (20 ± 10 mL/kg) and transfusions administered prehospital and within 12 hours of hospital arrival were determined. Univariate and multivariable analyses were conducted to determine association between crystalloid volume and transfusion. Among 208 patients, the mean age was 5 ± 4 years (60% male), 91% sustained blunt injuries, and median (interquartile range) Injury Severity Score was 11 (6,25). Twenty-nine percent received one bolus, 17% received two, and 10% received at least three. Transfusion of any blood product occurred in 50 (24%) patients; mean (range) red blood cells was 23 (0-89) mL/kg, plasma 8 (0-69), and platelets 1 (0-18). The likelihood of transfusion increased logarithmically from 11% to 43% for those requiring 2 or more boluses (Fig. 1). This relationship persisted on multivariable analysis that adjusted for institution, age, and shock index with good discrimination (Area under the Receiver Operating Characteristic, 0.84). Shock index was also strongly associated with transfusion. Almost half of pediatric trauma patients with elevated shock index require transfusion following two crystalloid boluses and the odds of requiring a transfusion plateau at this point in resuscitation. This supports consideration of blood with the second bolus in conjunction with shock index though prospective studies are needed to confirm this and its impact on outcomes. Therapeutic study, level IV.

Total intravenous anaesthesia by boluses or by continuous rate infusion of propofol in mute swans (Cygnus olor).

PubMed

Müller, Kerstin; Holzapfel, Judith; Brunnberg, Leo

2011-07-01

To investigate intravenous (IV) propofol given by intermittent boluses or by continuous rate infusion (CRI) for anaesthesia in swans. Prospective randomized clinical study. Twenty mute swans (Cygnus olor) (eight immature and 12 adults) of unknown sex undergoing painless diagnostic or therapeutic procedures. Induction of anaesthesia was with 8 mg kg(-1) propofol IV. To maintain anaesthesia, ten birds (group BOLI) received propofol as boluses, whilst 10 (group CRI) received propofol as a CRI. Some physiological parameters were measured. Anaesthetic duration was 35 minutes. Groups were compared using Mann-Whitney U-test. Results are median (range). Anaesthetic induction was smooth and tracheal intubation was achieved easily in all birds. Bolus dose in group BOLI was 2.9 (1.3-4.3) mg kg(-1); interval between and number of boluses required were 4 (1-8) minutes and 6 (4-11) boluses respectively. Total dose of propofol was 19 (12.3-37.1) mg kg(-1). Awakening between boluses was very abrupt. In group CRI, propofol infusion rate was 0.85 (0.8-0.9) mg kg(-1) minute(-1), and anaesthesia was stable. Body temperature, heart and respiratory rates, oxygen saturation (by pulse oximeter) and reflexes did not differ between groups. Oxygen saturations (from pulse oximeter readings) were low in some birds. Following anaesthesia, all birds recovered within 40 minutes. In 55% of all, transient signs of central nervous system excitement occurred during recovery. 8 mg kg(-1) propofol appears an adequate induction dose for mute swans. For maintenance, a CRI of 0.85 mg kg(-1) minute(-1) produced stable anaesthesia suitable for painless clinical procedures. In contrast bolus administration, was unsatisfactory as birds awoke very suddenly, and the short intervals between bolus requirements hampered clinical procedures. Administration of additional oxygen throughout anaesthesia might reduce the incidence of low arterial haemoglobin saturation. © 2011 The Authors. Veterinary Anaesthesia and Analgesia. © 2011 Association of Veterinary Anaesthetists and the American College of Veterinary Anesthesiologists.

Douglas Lowy and Nirali Shah discuss advancements in cancer treatment at the second annual Chasing Cancer Summit | Center for Cancer Research

Cancer.gov

On Monday, September 18, 2017, the second annual Chasing Cancer Summit was held at the Washington Post headquarters in downtown Washington, D.C. The live event brought together a group of experts, including CCR’s Douglas Lowy, M.D., and Nirali Shah, M.D., for discussions on the latest developments in cancer detection and treatment.  Read more...

The influence of complex and threatening environments in early life on brain size and behaviour.

PubMed

DePasquale, C; Neuberger, T; Hirrlinger, A M; Braithwaite, V A

2016-01-27

The ways in which challenging environments during development shape the brain and behaviour are increasingly being addressed. To date, studies typically consider only single variables, but the real world is more complex. Many factors simultaneously affect the brain and behaviour, and whether these work independently or interact remains untested. To address this, zebrafish (Danio rerio) were reared in a two-by-two design in housing that varied in structural complexity and/or exposure to a stressor. Fish experiencing both complexity (enrichment objects changed over time) and mild stress (daily net chasing) exhibited enhanced learning and were less anxious when tested as juveniles (between 77 and 90 days). Adults tested (aged 1 year) were also less anxious even though fish were kept in standard housing after three months of age (i.e. no chasing or enrichment). Volumetric measures of the brain using magnetic resonance imaging (MRI) showed that complexity alone generated fish with a larger brain, but this increase in size was not seen in fish that experienced both complexity and chasing, or chasing alone. The results highlight the importance of looking at multiple variables simultaneously, and reveal differential effects of complexity and stressful experiences during development of the brain and behaviour. © 2016 The Authors.

The influence of complex and threatening environments in early life on brain size and behaviour

PubMed Central

Neuberger, T.; Hirrlinger, A. M.; Braithwaite, V. A.

2016-01-01

The ways in which challenging environments during development shape the brain and behaviour are increasingly being addressed. To date, studies typically consider only single variables, but the real world is more complex. Many factors simultaneously affect the brain and behaviour, and whether these work independently or interact remains untested. To address this, zebrafish (Danio rerio) were reared in a two-by-two design in housing that varied in structural complexity and/or exposure to a stressor. Fish experiencing both complexity (enrichment objects changed over time) and mild stress (daily net chasing) exhibited enhanced learning and were less anxious when tested as juveniles (between 77 and 90 days). Adults tested (aged 1 year) were also less anxious even though fish were kept in standard housing after three months of age (i.e. no chasing or enrichment). Volumetric measures of the brain using magnetic resonance imaging (MRI) showed that complexity alone generated fish with a larger brain, but this increase in size was not seen in fish that experienced both complexity and chasing, or chasing alone. The results highlight the importance of looking at multiple variables simultaneously, and reveal differential effects of complexity and stressful experiences during development of the brain and behaviour. PMID:26817780

Production Support Flight Control Computers: Research Capability for F/A-18 Aircraft at Dryden Flight Research Center

NASA Technical Reports Server (NTRS)

Carter, John F.

1997-01-01

NASA Dryden Flight Research Center (DFRC) is working with the United States Navy to complete ground testing and initiate flight testing of a modified set of F/A-18 flight control computers. The Production Support Flight Control Computers (PSFCC) can give any fleet F/A-18 airplane an in-flight, pilot-selectable research control law capability. NASA DFRC can efficiently flight test the PSFCC for the following four reasons: (1) Six F/A-18 chase aircraft are available which could be used with the PSFCC; (2) An F/A-18 processor-in-the-loop simulation exists for validation testing; (3) The expertise has been developed in programming the research processor in the PSFCC; and (4) A well-defined process has been established for clearing flight control research projects for flight. This report presents a functional description of the PSFCC. Descriptions of the NASA DFRC facilities, PSFCC verification and validation process, and planned PSFCC projects are also provided.

Carotid MR angiography with traditional bolus timing: clinical observations and Fourier-based modelling of contrast kinetics.

PubMed

Menke, Jan

2009-11-01

This study analyses the relation between image quality and contrast kinetics in bolus-timed carotid magnetic resonance angiography (MRA) and interprets the findings by Fourier-based numerical modelling. One hundred patients prone to carotid stenosis were studied using contrast-enhanced carotid MRA with bolus timing. The carotid MRAs were timed to start relatively early without accounting for the injection time of the contrast medium. For interpretation different starting times were modelled, utilising the spectral information of the test bolus series. In the test bolus series the arterial time-to-peak showed a large 95% confidence interval of 12-27 s, indicating the need for individual MRA timing. All bolus-timed MRAs were of good diagnostic quality. The mean (+/-SD) arterial contrast-to-noise ratio was 53.0 (+/-12.8) and thus high, and 95% of the MRAs showed a slight venous contamination of 11.8% or less (median 5.6%). According to the Fourier-based modelling the central k-space may be acquired about 2 s before the arterial contrast peak. This results in carotid MRAs with sufficiently high arterial enhancement and little venous contamination. In conclusion, in bolus-timed carotid MRA a relatively short timing provides good arterial contrast with little venous contamination, which can be explained by Fourier-based numerical modelling of the contrast kinetics.

Randomized trial of intermittent or continuous amnioinfusion for variable decelerations.

PubMed

Rinehart, B K; Terrone, D A; Barrow, J H; Isler, C M; Barrilleaux, P S; Roberts, W E

2000-10-01

To determine whether continuous or intermittent bolus amnioinfusion is more effective in relieving variable decelerations. Patients with repetitive variable decelerations were randomized to an intermittent bolus or continuous amnioinfusion. The intermittent bolus infusion group received boluses of 500 mL of normal saline, each over 30 minutes, with boluses repeated if variable decelerations recurred. The continuous infusion group received a bolus infusion of 500 mL of normal saline over 30 minutes and then 3 mL per minute until delivery occurred. The ability of the amnioinfusion to abolish variable decelerations was analyzed, as were maternal demographic and pregnancy outcome variables. Power analysis indicated that 64 patients would be required. Thirty-five patients were randomized to intermittent infusion and 30 to continuous infusion. There were no differences between groups in terms of maternal demographics, gestational age, delivery mode, neonatal outcome, median time to resolution of variable decelerations, or the number of times variable decelerations recurred. The median volume infused in the intermittent infusion group (500 mL) was significantly less than that in the continuous infusion group (905 mL, P =.003). Intermittent bolus amnioinfusion is as effective as continuous infusion in relieving variable decelerations in labor. Further investigation is necessary to determine whether either of these techniques is associated with increased occurrence of rare complications such as cord prolapse or uterine rupture.

Cost-effectiveness analysis of IDegLira versus basal-bolus insulin for patients with type 2 diabetes in the Slovak health system

PubMed Central

Psota, Marek; Psenkova, Maria Bucek; Racekova, Natalia; Ramirez de Arellano, Antonio; Vandebrouck, Tom; Hunt, Barnaby

2017-01-01

Aims To investigate the cost-effectiveness of once-daily insulin degludec/liraglutide (IDegLira) versus basal-bolus therapy in patients with type 2 diabetes not meeting glycemic targets on basal insulin from a healthcare payer perspective in Slovakia. Methods Long-term clinical and economic outcomes for patients receiving IDegLira and basal-bolus therapy were estimated using the IMS CORE Diabetes Model based on a published pooled analysis of patient-level data. Results IDegLira was associated with an improvement in quality-adjusted life expectancy of 0.29 quality-adjusted life years (QALYs) compared with basal-bolus therapy. The average lifetime cost per patient in the IDegLira arm was EUR 2,449 higher than in the basal-bolus therapy arm. Increased treatment costs with IDegLira were partially offset by cost savings from avoided diabetes-related complications. IDegLira was highly cost-effective versus basal-bolus therapy with an incremental cost-effectiveness ratio of EUR 8,590 per QALY gained, which is well below the cost-effectiveness threshold set by the law in Slovakia. Conclusion IDegLira is cost-effective in Slovakia, providing a simple option for intensification of basal insulin therapy without increasing the risk of hypoglycemia or weight gain and with fewer daily injections than a basal-bolus regimen. PMID:29276398

21 CFR 520.2260b - Sulfamethazine sustained-release boluses.

Code of Federal Regulations, 2010 CFR

2010-04-01

.... Depending on the duration of therapeutic levels desired, administer boluses as a single dose as follows: 31... restricts this drug to use by or on the order of a licensed veterinarian. (b)(1) Sponsor. See No. 053501 in... of use—(i) Amount. 27 grams (1 bolus) for each 150 pounds of body weight as a single dose. (ii...

21 CFR 520.2260b - Sulfamethazine sustained-release boluses.

Code of Federal Regulations, 2011 CFR

2011-04-01

.... Depending on the duration of therapeutic levels desired, administer boluses as a single dose as follows: 31... restricts this drug to use by or on the order of a licensed veterinarian. (b)(1) Sponsor. See No. 053501 in... of use—(i) Amount. 27 grams (1 bolus) for each 150 pounds of body weight as a single dose. (ii...

21 CFR 520.1242b - Levamisole hydrochloride tablet or oblet (bolus).

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Levamisole hydrochloride tablet or oblet (bolus... § 520.1242b Levamisole hydrochloride tablet or oblet (bolus). (a) Chemical name. (-)-2,3,5,6-Tetrahydro... using in severely debilitated animals. (2) It is used in a tablet for sheep as follows: (i) Amount. 0...

Delivery confirmation of bolus electron conformal therapy combined with intensity modulated x-ray therapy

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

Kavanaugh, James A.; Hogstrom, Kenneth R.; Fontenot, Jonas P.

2013-02-15

Purpose: The purpose of this study was to demonstrate that a bolus electron conformal therapy (ECT) dose plan and a mixed beam plan, composed of an intensity modulated x-ray therapy (IMXT) dose plan optimized on top of the bolus ECT plan, can be accurately delivered. Methods: Calculated dose distributions were compared with measured dose distributions for parotid and chest wall (CW) bolus ECT and mixed beam plans, each simulated in a cylindrical polystyrene phantom that allowed film dose measurements. Bolus ECT plans were created for both parotid and CW PTVs (planning target volumes) using 20 and 16 MeV beams, respectively,more » whose 90% dose surface conformed to the PTV. Mixed beam plans consisted of an IMXT dose plan optimized on top of the bolus ECT dose plan. The bolus ECT, IMXT, and mixed beam dose distributions were measured using radiographic films in five transverse and one sagittal planes for a total of 36 measurement conditions. Corrections for film dose response, effects of edge-on photon irradiation, and effects of irregular phantom optical properties on the Cerenkov component of the film signal resulted in high precision measurements. Data set consistency was verified by agreement of depth dose at the intersections of the sagittal plane with the five measured transverse planes. For these same depth doses, results for the mixed beam plan agreed with the sum of the individual depth doses for the bolus ECT and IMXT plans. The six mean measured planar dose distributions were compared with those calculated by the treatment planning system for all modalities. Dose agreement was assessed using the 4% dose difference and 0.2 cm distance to agreement. Results: For the combined high-dose region and low-dose region, pass rates for the parotid and CW plans were 98.7% and 96.2%, respectively, for the bolus ECT plans and 97.9% and 97.4%, respectively, for the mixed beam plans. For the high-dose gradient region, pass rates for the parotid and CW plans were 93.1% and 94.62%, respectively, for the bolus ECT plans and 89.2% and 95.1%, respectively, for the mixed beam plans. For all regions, pass rates for the parotid and CW plans were 98.8% and 97.3%, respectively, for the bolus ECT plans and 97.5% and 95.9%, respectively, for the mixed beam plans. For the IMXT component of the mixed beam plans, pass rates for the parotid and CW plans were 93.7% and 95.8%. Conclusions: Bolus ECT and mixed beam therapy dose delivery to the phantom were more accurate than IMXT delivery, adding confidence to the use of planning, fabrication, and delivery for bolus ECT tools either alone or as part of mixed beam therapy. The methodology reported in this work could serve as a basis for future standardization of the commissioning of bolus ECT or mixed beam therapy. When applying this technology to patients, it is recommended that an electron dose algorithm more accurate than the pencil beam algorithm, e.g., a Monte Carlo algorithm or analytical transport such as the pencil beam redefinition algorithm, be used for planning to ensure the desired accuracy.« less

Comparison of the Effects of Intermittent Boluses to Simple Continuous Infusion on Patients' Global Perceived Effect in Intrathecal Therapy for Pain: A Randomized Double-Blind Crossover Study.

PubMed

Eldabe, Sam; Duarte, Rui V; Madzinga, Grace; Batterham, Alan M; Brookes, Morag E; Gulve, Ashish P; Perruchoud, Christophe; Raphael, Jon H; Lorenzana, David; Buchser, Eric

2017-05-01

Intrathecal drug delivery (ITDD) is commonly used for intractable pain management. A paucity of good-quality studies in chronic noncancer patients and concerns over increased dosages have focused interest on different modes of administration. The aim of this international multicenter randomized double-blind crossover trial was to compare the efficacy of the same daily dose of drugs administered by intermittent boluses vs simple continuous infusion. Eligible patients implanted with a programmable ITDD device were randomized to receive two weeks of either intermittent boluses or a simple continuous flow in period 1, followed by a crossover to the alternative mode of administration. The primary outcome measure was the Patients' Global Impression of Change (PGIC) scale. The mean proportion of positive responders (at least "minimally improved") was 38.4% in the continuous condition vs 37.3% in the bolus (difference in proportions = 1.1%, 95% confidence interval [CI] = -21.8-24.0%, P  = 0.93). The mean PGIC in the continuous condition was 3.8 vs 3.9 in the bolus (mean difference = -0.1, -0.6-0.4, P  = 0.72). Exploratory analyses revealed a tendency for the mean proportion of positive responders to be higher at low vs high flow rates for both bolus and continuous administrations. Two patients were withdrawn from the study due to adverse events during the bolus phase, both with symptoms of increased pain, and one patient with additional symptoms of numbness and urinary retention. The mean PGIC and proportion of positive responders was not substantially different after intermittent bolus vs continuous administration. © 2016 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Cardiac T1 mapping in congenital heart disease: bolus vs. infusion protocols for measurements of myocardial extracellular volume fraction.

PubMed

Al-Wakeel-Marquard, Nadya; Rastin, Sanaz; Muench, Frédéric; O H-Ici, Darach; Yilmaz, Sevim; Berger, Felix; Kuehne, Titus; Messroghli, Daniel R

2017-12-01

Myocardial extracellular volume fraction (ECV) reflecting diffuse myocardial fibrosis can be measured with T1 mapping cardiovascular magnetic resonance (CMR) before and after the application of a gadolinium-based extracellular contrast agent. The equilibrium between blood and myocardium contrast concentration required for ECV measurements can be obtained with a primed contrast infusion (equilibrium contrast-CMR). We hypothesized that equilibrium can also be achieved with a single contrast bolus to accurately measure diffuse myocardial fibrosis in patients with congenital heart disease (CHD). Healthy controls (n = 17; median age 24.0 years) and patients with CHD (n = 19; 25.0 years) were prospectively enrolled. Using modified Look-Locker inversion recovery T1 mapping before, 15 min after bolus injection, and during constant infusion of gadolinium-DOTA, T1 values were obtained for blood pool and myocardium of the left ventricle (LV), the interventricular septum (IVS), and the right ventricle (RV) in a single midventricular plane in short axis or in transverse orientation. ECV of LV, IVS and RV by bolus-only and bolus-infusion correlated significantly in CHD patients (r = 0.94, 0.95, and 0.74; p < 0.01, respectively) and healthy controls (r = 0.96, 0.89, and 0.64; p < 0.05, respectively). Bland-Altman plots revealed no significant bias between the techniques for any of the analyzed regions. ECV of LV and RV myocardium measured by bolus-only T1 mapping agrees well with bolus-infusion measurements in patients with CHD. The use of a bolus-only approach facilitates the integration of ECV measurements into existing CMR imaging protocols, allowing for assessment of diffuse myocardial fibrosis in CHD in clinical routine.

S-adenosylmethionine decreases the peak blood alcohol levels 3 h after an acute bolus of ethanol by inducing alcohol metabolizing enzymes in the liver.

PubMed

Bardag-Gorce, Fawzia; Oliva, Joan; Wong, Wesley; Fong, Stephanie; Li, Jun; French, Barbara A; French, Samuel W

2010-12-01

An alcohol bolus causes the blood alcohol level (BAL) to peak at 1-2 h post ingestion. The ethanol elimination rate is regulated by alcohol metabolizing enzymes, primarily alcohol dehydrogenase (ADH1), acetaldehyde dehydrogenase (ALDH), and cytochrome P450 (CYP2E1). Recently, S-adenosylmethionine (SAMe) was found to reduce acute BALs 3 h after an alcohol bolus. The question, then, was: what is the mechanism involved in this reduction of BAL by feeding SAMe? To answer this question, we investigated the changes in ethanol metabolizing enzymes and the epigenetic changes that regulate the expression of these enzymes during acute binge drinking and chronic drinking. Rats were fed a bolus of ethanol with or without SAMe, and were sacrificed at 3 h or 12 h after the bolus. RT-PCR and Western blot analyses showed that SAMe significantly induced ADH1 levels in the 3 h liver samples. However, SAMe did not affect the changes in ADH1 protein levels 12 h post bolus. Since SAMe is a methyl donor, it was postulated that the ADH1 gene expression up regulation at 3 h was due to a histone modification induced by methylation from methyl transferases. Dimethylated histone 3 lysine 4 (H3K4me2), a modification responsible for gene expression activation, was found to be significantly increased by SAMe at 3 h post bolus. These results correlated with the low BAL found at 3 h post bolus, and support the concept that SAMe increased the gene expression to increase the elimination rate of ethanol in binge drinking by increasing H3K4me2. Copyright © 2010 Elsevier Inc. All rights reserved.

Serum levels of bupivacaine after pre-peritoneal bolus vs. epidural bolus injection for analgesia in abdominal surgery: A safety study within a randomized controlled trial.

PubMed

Mungroop, Timothy H; van Samkar, Ganapathy; Geerts, Bart F; van Dieren, Susan; Besselink, Marc G; Veelo, Denise P; Lirk, Philipp

2017-01-01

Continuous wound infiltration (CWI) has become increasingly popular in recent years as an alternative to epidural analgesia. As catheters are not placed until the end of surgery, more intraoperative opioid analgesics might be needed. We, therefore, added a single pre-peritoneal bolus of bupivacaine at the start of laparotomy, similar to the bolus given with epidural analgesia. This was a comparative study within a randomized controlled trial (NTR4948). Patients undergoing hepato-pancreato-biliary surgery received either a pre-peritoneal bolus of 30ml bupivacaine 0.25%, or an epidural bolus of 10ml bupivacaine 0.25% at the start of laparotomy. In a subgroup of patients, we sampled blood and determined bupivacaine serum levels 20, 40, 60 and 80 minutes after bolus injection. We assumed toxicity of bupivacaine to be >1000 ng/ml. A total of 20 patients participated in this sub-study. All plasma levels measured as well as the upper limit of the predicted 99% confidence intervals per time point were well below the toxicity limit. In a mixed linear-effect model both groups did not differ statistically significant (p = 0.131). The intra-operative use of opioids was higher with CWI as compared to epidural (86 (SD 73) μg sufentanil vs. 50 (SD 32). In this exploratory study, the pre-peritoneal bolus using bupivacaine resulted in serum bupivacaine concentrations well below the commonly accepted toxic threshold. With CWI more additional analgesics are needed intraoperatively as compared to epidural analgesia, although this is compensated by a reduction in use of vasopressors with CWI. Netherlands Trial Register NTR4948.

Serum levels of bupivacaine after pre-peritoneal bolus vs. epidural bolus injection for analgesia in abdominal surgery: A safety study within a randomized controlled trial

PubMed Central

Geerts, Bart F.; van Dieren, Susan; Besselink, Marc G.; Veelo, Denise P.; Lirk, Philipp

2017-01-01

Background Continuous wound infiltration (CWI) has become increasingly popular in recent years as an alternative to epidural analgesia. As catheters are not placed until the end of surgery, more intraoperative opioid analgesics might be needed. We, therefore, added a single pre-peritoneal bolus of bupivacaine at the start of laparotomy, similar to the bolus given with epidural analgesia. Methods This was a comparative study within a randomized controlled trial (NTR4948). Patients undergoing hepato-pancreato-biliary surgery received either a pre-peritoneal bolus of 30ml bupivacaine 0.25%, or an epidural bolus of 10ml bupivacaine 0.25% at the start of laparotomy. In a subgroup of patients, we sampled blood and determined bupivacaine serum levels 20, 40, 60 and 80 minutes after bolus injection. We assumed toxicity of bupivacaine to be >1000 ng/ml. Results A total of 20 patients participated in this sub-study. All plasma levels measured as well as the upper limit of the predicted 99% confidence intervals per time point were well below the toxicity limit. In a mixed linear-effect model both groups did not differ statistically significant (p = 0.131). The intra-operative use of opioids was higher with CWI as compared to epidural (86 (SD 73) μg sufentanil vs. 50 (SD 32). Conclusions In this exploratory study, the pre-peritoneal bolus using bupivacaine resulted in serum bupivacaine concentrations well below the commonly accepted toxic threshold. With CWI more additional analgesics are needed intraoperatively as compared to epidural analgesia, although this is compensated by a reduction in use of vasopressors with CWI. Trial registration Netherlands Trial Register NTR4948 PMID:28614364

Cerebral Effect of Intratracheal Aerosolized Surfactant Versus Bolus Therapy in Preterm Lambs.

PubMed

Rey-Santano, Carmen; Mielgo, Victoria E; López-de-Heredia-y-Goya, Jon; Murgia, Xabier; Valls-i-Soler, Adolfo

2016-04-01

Aerosolization has been proposed as a useful alternative to rapid intratracheal instillation for the delivery of exogenous surfactant in neonatal respiratory distress syndrome. However, there is a lack of information regarding the likely safety of this new therapeutic approach for the neonatal brain. We aimed to compare the cerebral effects of aerosolized versus bolus surfactant administration in premature lambs with respiratory distress syndrome. Prospective randomized study. BioCruces Institute Animal Research Facility. Fourteen intensively monitored and mechanically ventilated preterm lambs. Preterm lambs were randomly assigned to receive intratracheal aerosolized surfactant or bolus surfactant. Brain hemodynamics (cerebral and regional cerebral blood flow) and cerebral oxygen metabolism (cerebral oxygen delivery, cerebral metabolic rate of oxygen, and oxygen extraction fraction) were measured every 30 minutes for 6 hours. We also performed cerebral biochemical and histological analysis. In preterm lambs with respiratory distress syndrome, cerebral blood flow, regional cerebral blood flow, cerebral oxygen delivery, and cerebral metabolic rate of oxygen increased significantly in the bolus surfactant group during the first 5 minutes, without changes in cerebral oxygen extraction fraction. By 60 minutes, all parameters had decreased in both groups, cerebral blood flow and regional cerebral blood flow (in inner and cerebellum brainstem regions) remaining higher in the bolus surfactant than in the aerosolized surfactant group. Overall, the impact of aerosol surfactant was not significantly different to that of bolus surfactant in terms of cerebral necrosis, edema, inflammation, hemorrhage, infarct, apoptosis, or oxidative stress. In preterm lambs with severe respiratory distress syndrome, aerosol surfactant administration seems to be as safe as bolus administration, showing more stable cerebral hemodynamics and cerebral oxygen metabolism to the same dose of surfactant administered as a standard bolus.

Fox Chase Cancer Center's Genitourinary Division: a national resource for research, innovation and patient care.

PubMed

Uzzo, Robert G; Horwitz, Eric M; Plimack, Elizabeth R

2016-04-01

Founded in 1904, Fox Chase Cancer Center remains committed to its mission. It is one of 41 centers in the country designated as a Comprehensive Cancer Center by the National Cancer Institute, is a founding member of the National Comprehensive Cancer Network, holds the magnet designation for nursing excellence, is one of the first to establish a family cancer risk assessment program, and has achieved national distinction because of the scientific discoveries made there that have advanced clinical care. Two of its researchers have won Nobel prizes. The Genitourinary Division is nationally recognized and viewed as one of the top driving forces behind the growth of Fox Chase due to its commitment to initiating and participating in clinical trials, its prolific contributions to peer-reviewed publications and presentations at scientific meetings, its innovations in therapies and treatment strategies, and its commitment to bringing cutting-edge therapies to patients.

STS-4 landing at Edwards Air Foce Base, California

NASA Technical Reports Server (NTRS)

1982-01-01

STS-4 landing at Edwards Air Foce Base, California. Actor Roy Rogers with Astronauts Jerry L. Ross, left, and Guy S. Gardner at Edwards for the STS-4 landing on July 1, 1982. Also present (behind Gardner at extreme right) was former Astronaut Edwin E. Aldrin, Jr. (33226); President Ronald Reagan and First Lady Nancy Reagan meet Astronauts Thomas K. Mattingly, II., right, and Henry W. Hartsfield, Jr., after the landing of the Columbia at Edwards (33227,33230); Space Shuttle Columbia, followed by two T-38 chase planes, touches down on Edwards Air Force Base's Runway 22 to complete mission. In this view, one chase plane appears to be directly above and behind the Columbia, whose nose wheels have not yet touched ground. The other plane appears to be further up front (33228); The rear wheels of the Columbia touch down on the Edwards AFB runway. There are no chase planes in sight in this photo (33229).

Technology Solutions Case Study: Duct in Conditioned Space in a Dropped Ceiling or Fur-down, Gainesville, Florida

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

None

2014-09-01

Forced-air distribution systems (duct systems) typically are installed out of sight for aesthetic reasons, most often in unconditioned areas such as attics or crawlspaces. Any leakage of air to or from the duct system in unconditioned space not only loses energy, but impacts home and equipment durability and indoor air quality. An obvious solution is to bring the duct system into the interior of the house, either by sealing the area where the ducts are installed (attic or crawlspace) or by building an interior cavity or chase above the ceiling plane (raised ceiling or fur-up chase) or below the ceilingmore » plane (dropped ceiling or fur-down) for the duct system. In this project, Building America Partnership for Improved Residential Construction team partnered with Tommy Williams Homes to implement an inexpensive, quick, and effective method of building a fur-down chase.« less

Gambling Harm and Crime Careers.

PubMed

May-Chahal, Corinne; Humphreys, Leslie; Clifton, Alison; Francis, Brian; Reith, Gerda

2017-03-01

Incarcerated populations across the world have been found to be consistently and significantly more vulnerable to problem gambling than general populations in the same countries. In an effort to gain a more specific understanding of this vulnerability the present study applied latent class analysis and criminal career theory to gambling data collected from a sample of English and Scottish, male and female prisoners (N = 1057). Theoretical links between gambling and crime were tested through three hypotheses: (1) that prisoners in the UK would have higher rates of problem gambling behaviour than the national population; (2) that if the link between gambling and crime is coincidental, gambling behaviour would be highly prevalent in an offending population, and (3) if connections between gambling behaviour and offending are co-symptomatic a mediating factor would show a strong association. The first of these was supported, the second was not supported and the third was partially supported. Latent class analysis found six gambling behaviour clusters measured by responses to the Problem Gambling Severity Index, primarily distinguished by loss chasing behaviour. Longitudinal offending data drawn from the Police National Computer database found four criminal career types, distinguished by frequency and persistence over time. A significant association was found between higher level loss chasing and high rate offending in criminal careers suggesting that impulse control may be a mediating factor for both gambling harm and criminal careers.

Impedance spectroscopy measurements as a tool for distinguishing different luminal content during bolus transit studies.

PubMed

Ruiz-Vargas, A; Mohd Rosli, R; Ivorra, A; Arkwright, J W

2018-01-08

Intraluminal electrical impedance is a well-known diagnostic tool used to study bolus movement in the human esophagus. However, it is use in the human colon it is hindered by the fact that the content cannot be controlled and may include liquid, gas, solid, or a mixture of these at any one time. This article investigates the use of complex impedance spectroscopy to study different luminal content (liquid and gas). An excised section of guinea pig proximal colon was placed in an organ bath with Krebs solution at 37°C and a custom built bioimpedance catheter was placed in the lumen. Liquid (Krebs) and gas (air) content was pumped through the lumen and the intraluminal impedance was measured at five different frequencies (1, 5.6, 31.6, 177.18 kHz and 1 MHz) at 10 samples per second. A numerical model was created to model the passage of bolus with different content and compared to the experimental data. Differences in mean impedance magnitude and phase angle were found (from 1 to 177.18 kHz) for different contents. The numerical results qualitatively agreed with those in the experimental study. Conductivities of bolus had an effect on detecting its passage. Complex impedance spectroscopy can distinguish between different luminal content within a range of measuring frequencies. The numerical model showed the importance of bolus conductivities for bolus transit studies in those where the bolus is controlled. © 2018 John Wiley & Sons Ltd.

Volitional chewing with a conscious effort alters and facilitates swallowing during feeding sequence.

PubMed

Furuya, J; Hara, A; Nomura, T; Kondo, H

2014-03-01

The key objective of mastication is to form a food bolus suitable for smooth swallowing. However, chewing is usually performed without a conscious effort. Poor bolus formation can cause pharyngeal residue and suffocation in elderly individuals with reduced swallowing function. Therefore, chewing with a conscious effort may help the bolus to more easily pass the pharynx. This study aimed to clarify the impact of mastication with a conscious effort on the feeding sequence. Subjects included 25 dentulous volunteers who were informed and provided written consent. Lateral videofluoroscopy was performed during the feeding of solid agar jelly under two conditions: chewing naturally in their usual manner (without volition) and chewing with a conscious effort (with volition). Temporal evaluation was performed for mastication, stage II transport (STII), swallow onset and oropharyngeal transit time. Moreover, bolus volume at swallow onset and subjective evaluation of swallowing easiness were measured. Volitional chewing with a conscious effort lengthened the duration of the chewing sequence before and after STII and delayed the swallow onset despite the fact that the bolus volume in the vallecula and hypopharynx (HYP) had significantly increased. Furthermore, with volition, the bolus transit time from swallow onset in the oral cavity, upper oropharynx and HYP was reduced, and subjective evaluation of swallowing easiness demonstrated significant improvement. These results suggest that volitional chewing with a conscious effort can alter bolus transport and swallowing, resulting in easier swallowing. © 2014 John Wiley & Sons Ltd.

An analysis of equine round pen training videos posted online: Differences between amateur and professional trainers

PubMed Central

Kydd, Erin; Padalino, Barbara; Henshall, Cathrynne; McGreevy, Paul

2017-01-01

Natural Horsemanship is popular among many amateur and professional trainers and as such, has been the subject of recent scientific enquiry. One method commonly adopted by Natural Horsemanship (NH) trainers is that of round pen training (RPT). RPT sessions are usually split into a series of bouts; each including two phases: chasing/flight and chasing offset/flight offset. However, NH training styles are heterogeneous. This study investigated online videos of RPT to explore the characteristics of RPT sessions and test for differences in techniques and outcomes between amateurs and professionals (the latter being defined as those with accompanying online materials that promote clinics, merchandise or a service to the public). From more than 300 candidate videos, we selected sample files for individual amateur (n = 24) and professional (n = 21) trainers. Inclusion criteria were: training at liberty in a Round Pen; more than one bout and good quality video. Sessions or portions of sessions were excluded if the trainer attached equipment, such as a lunge line, directly to the horse or the horse was saddled, mounted or ridden. The number of bouts and duration of each chasing and non-chasing phase were recorded, and the duration of each RPT session was calculated. General weighted regression analysis revealed that, when compared with amateurs, professionals showed fewer arm movements per bout (p<0.05). Poisson regression analysis showed that professionals spent more time looking up at their horses, when transitioning between gaits, than amateurs did (p<0.05). The probability of horses following the trainer was not significantly associated with amount of chasing, regardless of category. Given that, according to some practitioners, the following response is a goal of RPT, this result may prompt caution in those inclined to give chase. The horses handled by professionals showed fewer conflict behaviours (e.g. kicking, biting, stomping, head-tossing, defecating, bucking and attempting to escape), and fewer oral and head movements (e.g. head-lowering, licking and chewing) than those horses handled by amateurs Overall, these findings highlight the need for selectivity when using the internet as an educational source and the importance of trainer skill and excellent timing when using negative reinforcement in horse training. PMID:28922395

An analysis of equine round pen training videos posted online: Differences between amateur and professional trainers.

PubMed

Kydd, Erin; Padalino, Barbara; Henshall, Cathrynne; McGreevy, Paul

2017-01-01

Natural Horsemanship is popular among many amateur and professional trainers and as such, has been the subject of recent scientific enquiry. One method commonly adopted by Natural Horsemanship (NH) trainers is that of round pen training (RPT). RPT sessions are usually split into a series of bouts; each including two phases: chasing/flight and chasing offset/flight offset. However, NH training styles are heterogeneous. This study investigated online videos of RPT to explore the characteristics of RPT sessions and test for differences in techniques and outcomes between amateurs and professionals (the latter being defined as those with accompanying online materials that promote clinics, merchandise or a service to the public). From more than 300 candidate videos, we selected sample files for individual amateur (n = 24) and professional (n = 21) trainers. Inclusion criteria were: training at liberty in a Round Pen; more than one bout and good quality video. Sessions or portions of sessions were excluded if the trainer attached equipment, such as a lunge line, directly to the horse or the horse was saddled, mounted or ridden. The number of bouts and duration of each chasing and non-chasing phase were recorded, and the duration of each RPT session was calculated. General weighted regression analysis revealed that, when compared with amateurs, professionals showed fewer arm movements per bout (p<0.05). Poisson regression analysis showed that professionals spent more time looking up at their horses, when transitioning between gaits, than amateurs did (p<0.05). The probability of horses following the trainer was not significantly associated with amount of chasing, regardless of category. Given that, according to some practitioners, the following response is a goal of RPT, this result may prompt caution in those inclined to give chase. The horses handled by professionals showed fewer conflict behaviours (e.g. kicking, biting, stomping, head-tossing, defecating, bucking and attempting to escape), and fewer oral and head movements (e.g. head-lowering, licking and chewing) than those horses handled by amateurs Overall, these findings highlight the need for selectivity when using the internet as an educational source and the importance of trainer skill and excellent timing when using negative reinforcement in horse training.

Inversion-based propofol dosing for intravenous induction of hypnosis

NASA Astrophysics Data System (ADS)

Padula, F.; Ionescu, C.; Latronico, N.; Paltenghi, M.; Visioli, A.; Vivacqua, G.

2016-10-01

In this paper we propose an inversion-based methodology for the computation of a feedforward action for the propofol intravenous administration during the induction of hypnosis in general anesthesia. In particular, the typical initial bolus is substituted with a command signal that is obtained by predefining a desired output and by applying an input-output inversion procedure. The robustness of the method has been tested by considering a set of patients with different model parameters, which is representative of a large population.

The cost-effectiveness and budget impact of stepwise addition of bolus insulin in the treatment of type 2 diabetes: evaluation of the FullSTEP trial.

PubMed

Saunders, Rhodri; Lian, Jean; Karolicki, Boris; Valentine, William

2014-12-01

Abstract Background and aims: Intensification of basal insulin-only therapy in type 2 diabetes is often achieved through addition of bolus insulin 3-times daily. The FullSTEP trial demonstrated that stepwise addition (SWA) of bolus insulin aspart was non-inferior to full basal-bolus (FBB) therapy and reduced the rate of hypoglycemia. Here the cost-effectiveness and budget impact of SWA is evaluated. Cost-effectiveness and budget impact models were developed to assess the cost and quality-of-life (QoL) implications of intensification using SWA compared with FBB in the US setting. At assessment, SWA patients added one bolus dose to their current regimen if the HbA1c target was not met. SWA patients reaching three bolus doses used FBB event rates. Outcomes were evaluated at trial end and projected annually up to 5 years. Models captured hypoglycemic events, the proportion meeting HbA1c target, and self-measured blood glucose. Event rates and QoL utilities were taken from trial data and published literature. Costs were evaluated from a healthcare-payer perspective, reported in 2013 USD, and discounted (like clinical outcomes) at 3.5% annually. This analysis applies to patients with HbA1c 7.0-9.0% and body mass index <40 kg/m(2). SWA was associated with improved QoL and reduced costs compared with FBB. Improvement in QoL and cost reduction were driven by lower rates of hypoglycemia. Sensitivity analyses showed that outcomes were most influenced by the cost of bolus insulin and QoL impact of symptomatic hypoglycemia. Budget impact analysis estimated that, by moving from FBB to SWA, a health plan with 77,000 patients with type 2 diabetes, of whom 7.8% annually intensified to basal-bolus therapy, would save USD 1304 per intensifying patient over the trial period. SWA of bolus insulin should be considered a beneficial and cost-saving alternative to FBB therapy for the intensification of treatment in type 2 diabetes.

Strategic Studies Quarterly. Volume 6, Number 2. Summer 2012

DTIC Science & Technology

2012-06-01

Jr . Forging an Indian Partnership Capt Craig H. Neuman II, USAF Chasing Its Tail: Nuclear Deterrence in the Information Age? Stephen J. Cimbala Commentary Our Brick Moon William H. Gerstenmaier ...Su m m er 2012 SUMMER 2012 Vol. 6, No. 2 Commentary Our Brick Moon William H. Gerstenmaier Chasing Its Tail: Nuclear Deterrence in...Extended Deterrence: How Much Strategic Force Is Too Little? David J. Trachtenberg The Common Sense of Small Nuclear Arsenals James Wood Forsyth

Modeling Syntax for Parsing and Translation

DTIC Science & Technology

2003-12-15

20 CHAPTER 2. MONOLINGUAL PROBABILISTIC PARSING a the D cat snake D S O chased S O ran SS Mary O Figure 2.1: Part of a dictionary . the cat S chased S O...along with their training algorithms: a monolingual gen- erative model of sentence structure, and a model of the relationship between the structure of a...tasks of monolingual parsing and word-level bilingual corpus alignment, they are demonstrated in two additional applications. First, a new statistical

New periodic solutions for some planar N + 3-body problems with Newtonian potentials

NASA Astrophysics Data System (ADS)

Yuan, Pengfei; Zhang, Shiqing

2018-03-01

For some planar Newtonian N + 3-body problems, we use variational minimization methods to prove the existence of new periodic solutions satisfying that N bodies chase each other on a curve, and the other 3 bodies chase each other on another curve. From the definition of orbit spaces in our paper, we can find that they are new solutions which are also different from all the examples of Ferrario and Terracini (2004).

Effects of repeated simulated removal activities on feral swine movements and space use

USGS Publications Warehouse

Fischer, Justin W.; McMurtry , Dan; Blass, Chad R.; Walter, W. David; Beringer, Jeff; VerCauterren, Kurt C.

2016-01-01

Abundance and distribution of feral swine (Sus scrofa) in the USA have increased dramatically during the last 30 years. Effective measures are needed to control and eradicate feral swine populations without displacing animals over wider areas. Our objective was to investigate effects of repeated simulated removal activities on feral swine movements and space use. We analyzed location data from 21 feral swine that we fitted with Global Positioning System harnesses in southern MO, USA. Various removal activities were applied over time to eight feral swine before lethal removal, including trapped-and-released, chased with dogs, chased with hunter, and chased with helicopter. We found that core space-use areas were reduced following the first removal activity, whereas overall space-use areas and diurnal movement distances increased following the second removal activity. Mean geographic centroid shifts did not differ between pre- and post-periods for either the first or second removal activities. Our information on feral swine movements and space use precipitated by human removal activities, such as hunting, trapping, and chasing with dogs, helps fill a knowledge void and will aid wildlife managers. Strategies to optimize management are needed to reduce feral swine populations while preventing enlarged home ranges and displacing individuals, which could lead to increased disease transmission risk and human-feral swine conflict in adjacent areas.

Biofeedback defaecation training for anismus.

PubMed

Lestàr, B; Penninckx, F; Kerremans, R

1991-11-01

Anismus, paradoxical external sphincter function, spastic pelvic floor syndrome, rectoanal dysnergia, abdomino-levator incoordination for abdominopelvic asychronism, are all due to paradoxical contraction of the striated sphincter apparatus during voiding and is characterised by prolonged and excessive straining at stool. Biofeedback is the treatment of choice and has to be introduced at an early stage. We present the results of an ambulatory approach based on the integration of simulated balloon defaecation with small (50 ml) as well as constant rectal sensation volume, defaecometry and anal manometry. The pathophysiology visualised by the patient's own anorectal pressure recordings on the screen of a personal computer is explained and corrected. Sixteen patients were treated and followed for at least 1 year. Manometric data were normal except for an increased minimum residual pressure and rectal compliance. Nine patients could not evacuate a 50 ml bolus initially. Simulated defaecation became possible in seven out of these nine patients when the bolus was increased up to the individual constant rectal sensation volume. Two patients could not evacuate this volume either, while defaecation was made much less laborious in the other seven patients. Paradoxical contraction was immediately corrected in 7/16 cases. Also, as an immediate, objective benefit of a single training session, improved defaecation of a 50 ml bolus was observed in 11 patients. This effect was preserved after 6 weeks in nine cases; symptomatic recurrence did not occur in these patients during follow-up. This method of defaecation training has many advantages as compared with sphincter training using EMG electrodes eventually performed in the absence of a desire to defaecate or in lying position.(ABSTRACT TRUNCATED AT 250 WORDS)

Multichannel intraluminal impedance: general principles and technical issues.

PubMed

Tutuian, Radu; Castell, Donald O

2005-04-01

Multichannel intraluminal impedance (MII) is a new technology that allows detection of bolus movement without the use of external radiation or radiolabeled substances. The principles of MII are based on changes in resistance to alternating electrical current (impedance) induced by the presence of various boluses within the esophagus. The timing of changes in multiple impedance-measuring segments in the esophagus allows determination of the direction of bolus movement. Combined MII and manometry (MII-EM) provides simultaneous information on intraesophageal pressures and bolus transit, offers the ability to monitor all types of reflux, and allows the detection of the physical (liquid, gas, or mixed) and chemical (acid, nonacid) characteristics of the gastroesophageal refluxate.

The Impact of Injector-Based Contrast Agent Administration on Bolus Shape and Magnetic Resonance Angiography Image Quality.

PubMed

Jost, Gregor; Endrikat, Jan; Pietsch, Hubertus

2017-01-01

To compare injector-based contrast agent (CA) administration with hand injection in magnetic resonance angiography (MRA). Gadobutrol was administered in 6 minipigs with 3 protocols: (a) hand injection (one senior technician), (b) hand injection (6 less-experienced technicians), and (c) power injector administration. The arterial bolus shape was quantified by test bolus measurements. A head and neck MRA was performed for quantitative and qualitative comparison of signal enhancement. A significantly shorter time to peak was observed for protocol C, whereas no significant differences between protocols were found for peak height and bolus width. However, for protocol C, these parameters showed a much lower variation. The MRA revealed a significantly higher signal-to-noise ratio for injector-based administration. A superimposed strong contrast of the jugular vein was found in 50% of the hand injections. Injector-based CA administration results in a more standardized bolus shape, a higher vascular contrast, and a more robust visualization of target vessels.

Swallowing Mechanics Associated With Artificial Airways, Bolus Properties, and Penetration-Aspiration Status in Trauma Patients.

PubMed

Dietsch, Angela M; Rowley, Christopher B; Solomon, Nancy Pearl; Pearson, William G

2017-09-18

Artificial airway procedures such as intubation and tracheotomy are common in the treatment of traumatic injuries, and bolus modifications may be implemented to help manage swallowing disorders. This study assessed artificial airway status, bolus properties (volume and viscosity), and the occurrence of laryngeal penetration and/or aspiration in relation to mechanical features of swallowing. Coordinates of anatomical landmarks were extracted at minimum and maximum hyolaryngeal excursion from 228 videofluoroscopic swallowing studies representing 69 traumatically injured U.S. military service members with dysphagia. Morphometric canonical variate and regression analyses examined associations between swallowing mechanics and bolus properties based on artificial airway and penetration-aspiration status. Significant differences in swallowing mechanics were detected between extubated versus tracheotomized (D = 1.32, p < .0001), extubated versus decannulated (D = 1.74, p < .0001), and decannulated versus tracheotomized (D = 1.24, p < .0001) groups per post hoc discriminant function analysis. Tracheotomy-in-situ and decannulated subgroups exhibited increased head/neck extension and posterior relocation of the larynx. Swallowing mechanics associated with (a) penetration-aspiration status and (b) bolus properties were moderately related for extubated and decannulated subgroups, but not the tracheotomized subgroup, per morphometric regression analysis. Specific differences in swallowing mechanics associated with artificial airway status and certain bolus properties may guide therapeutic intervention in trauma-based dysphagia.

Effects of bolus doses of fat on small intestinal structure and on release of gastrin, cholecystokinin, peptide tyrosine-tyrosine, and enteroglucagon.

PubMed Central

Jenkins, A P; Ghatei, M A; Bloom, S R; Thompson, R P

1992-01-01

To investigate the enterotrophic effects of bolus doses of long chain triglycerides, two groups of eight female Wistar rats were fed identical diets with 48.2% total calories as the essential fatty acid rich oil Efamol. To one group the oil was given in twice daily bolus doses by gavage, while for the other group the oil was mixed with the remainder of the feed and thus consumed over 24 hours. The animals were killed after 20 to 22 days. Bolus dosing significantly increased parameters of mucosal mass along the length of the small intestine in association with an increase in two hour accumulation of vincristine arrested metaphases in small intestinal crypts. In a second experiment, four replicate studies were carried out, each involving two groups of 12 rats respectively fed as described above. After 21 days one animal from each group was killed every two hours, providing regular plasma samples over 24 hours for measurement of gastrin, cholecystokinin, peptide tyrosine-tyrosine and enteroglucagon. Bolus dosing markedly enhanced release of peptide tyrosine-tyrosine and enteroglucagon, but not of gastrin or cholecystokinin. Thus, the enhanced enterotrophic effects of bolus doses of long chain triglycerides could be mediated by release of a distally located gut peptide, perhaps enteroglucagon. PMID:1541417

Muscular activation during reverse and non-reverse chewing cycles in unilateral posterior crossbite.

PubMed

Piancino, Maria Grazia; Farina, Dario; Talpone, Francesca; Merlo, Andrea; Bracco, Pietro

2009-04-01

The aim of this study was to characterize the kinematics and masseter muscle activation in unilateral posterior crossbite. Eighty-two children (8.6 +/- 1.3 yr of age) with unilateral posterior crossbite and 12 children (8.9 +/- 0.6 yr of age) with normal occlusion were selected for the study. Electromyography (EMG) and kinematics were concurrently recorded during mastication of a soft bolus and a hard bolus. The percentage of reverse cycles in the group of patients was 59.0 +/- 33.1% (soft bolus) and 69.7 +/- 29.7% (hard bolus) when chewing on the crossbite side. When chewing on the non-affected side, the number of reverse cycles was 16.7 +/- 24.5% (soft bolus) and 16.7 +/- 22.3% (hard bolus). The reverse cycles on the crossbite side were narrower with respect to the cycles on the non-affected side. Although both types of cycles in patients resulted in lower EMG activity of the masseter of the crossbite side than of the contralateral masseter, the activity of the non-affected side was larger for reverse than for non-reverse cycles. It was concluded that when chewing on the crossbite side, the masseter activity is reduced on the mastication side (crossbite) and is unaltered (non-reverse cycles) or increased (reverse) on the non-affected side.

Effects of three types of trace element supplementation on the fertility of three commercial dairy herds.

PubMed

Black, D H; French, N P

2004-05-22

The effects on the fertility of three commercial dairy herds of three types of copper- and selenium-containing mineral supplements was investigated. As the cows on each farm were dried off they were allocated to one of three treatment groups, and treated with either subcutaneous injections of copper and selenium, or two matrix intraruminal trace element boluses, or two glass intraruminal trace element boluses. When the data from the 406 cows on the three farms were combined, there was a significant difference between the conception rates of the three groups (P < 0.001). The cows treated with the glass boluses conceived at a rate 1.8 times greater than those treated by injection (P < 0.001), and at a rate 1.5 times greater than those treated with matrix boluses (P = 0.002). These differences were associated with a significantly higher likelihood of service resulting in a conception in the group treated with glass boluses than in the group treated by injection (P = 0.004). After adjusting for time from calving, time from treatment, time of year and farm, there was a significant (P = 0.012) difference in glutathione peroxidase activities between the treatments, with the group treated by injection having a significantly lower activity than the groups treated with boluses.

A general dual-bolus approach for quantitative DCE-MRI.

PubMed

Kershaw, Lucy E; Cheng, Hai-Ling Margaret

2011-02-01

To present a dual-bolus technique for quantitative dynamic contrast-enhanced MRI (DCE-MRI) and show that it can give an arterial input function (AIF) measurement equivalent to that from a single-bolus protocol. Five rabbits were imaged using a dual-bolus technique applicable for high-resolution DCE-MRI, incorporating a time resolved imaging of contrast kinetics (TRICKS) sequence for rapid temporal sampling. AIFs were measured from both the low-dose prebolus and the high-dose main bolus in the abdominal aorta. In one animal, TRICKS and fast spoiled gradient echo (FSPGR) acquisitions were compared. The scaled prebolus AIF was shown to match the main bolus AIF, with 95% confidence intervals overlapping for fits of gamma-variate functions to the first pass and linear fits to the washout phase, with the exception of one case. The AIFs measured using TRICKS and FSPGR were shown to be equivalent in one animal. The proposed technique can capture even the rapid circulation kinetics in the rabbit aorta, and the scaled prebolus AIF is equivalent to the AIF from a high-dose injection. This allows separate measurements of the AIF and tissue uptake curves, meaning that each curve can then be acquired using a protocol tailored to its specific requirements. Copyright © 2011 Elsevier Inc. All rights reserved.

Modeling magnetization transfer effects of Q2TIPS bolus saturation in multi-TI pulsed arterial spin labeling.

PubMed

Petr, Jan; Schramm, Georg; Hofheinz, Frank; Langner, Jens; van den Hoff, Jörg

2014-10-01

To estimate the relaxation time changes during Q2TIPS bolus saturation caused by magnetization transfer effects and to propose and evaluate an extended model for perfusion quantification which takes this into account. Three multi inversion-time pulsed arterial spin labeling sequences with different bolus saturation duration were acquired for five healthy volunteers. Magnetization transfer exchange rates in tissue and blood were obtained from control image saturation recovery. Cerebral blood flow (CBF) obtained using the extended model and the standard model was compared. A decrease of obtained CBF of 6% (10%) was observed in grey matter when the duration of bolus saturation increased from 600 to 900 ms (1200 ms). This decrease was reduced to 1.6% (2.8%) when the extended quantification model was used. Compared with the extended model, the standard model underestimated CBF in grey matter by 9.7, 15.0, and 18.7% for saturation durations 600, 900, and 1200 ms, respectively. Results for simulated single inversion-time data showed 5-16% CBF underestimation depending on blood arrival time and bolus saturation duration. Magnetization transfer effects caused by bolus saturation pulses should not be ignored when performing quantification as they can cause appreciable underestimation of the CBF. Copyright © 2013 Wiley Periodicals, Inc.

Diacylglycerol oil does not affect portal vein transport of nonesterified fatty acids but decreases the postprandial plasma lipid response in catheterized pigs.

PubMed

Kristensen, Janni Brogaard; Jørgensen, Henry; Mu, Huiling

2006-07-01

Studies have shown several beneficial effects of dietary diacylglycerol oil (DAG oil), but the mechanism behind these effects is still not clear. One hypothesis is that an increase in portal vein transport of nonesterified fatty acids (NEFA) with subsequent oxidation in the liver might be responsible for the positive effects. We examined the portal vein transport of NEFA and other lipid related variables, in response to DAG and triacylglycerol (TAG) bolus feeding and a bolus of standard pig feed in 4 portal vein and mesenteric artery catheterized pigs. Also, the effect of the boluses on postprandial lipid variables was examined. Portal vein transport of NEFA did not differ when pigs were administered the 2 oil bolus diets, consistent with the similar portal plasma concentrations of oleic and linolenic acids during h 1 after feeding. Glycerol, on the contrary, was transported by the portal vein to a much higher degree after intake of DAG oil (P < 0.001; 20, 40, and 60 min). The postprandial arterial TAG response at 5 and 6 h postprandially was significantly lower after the DAG bolus intake. Analysis of Delta AUC for the 6-h postprandial period of selected and total fatty acids showed a lower concentration of vaccenic acid (P = 0.002) after the DAG bolus diet. In conclusion, DAG bolus feeding did not increase the portal transport of NEFA, but it did increase the portal transport of glycerol and lower the postprandial lipid concentration in arterial plasma.

The impact of injector-based contrast agent administration in time-resolved MRA.

PubMed

Budjan, Johannes; Attenberger, Ulrike I; Schoenberg, Stefan O; Pietsch, Hubertus; Jost, Gregor

2018-05-01

Time-resolved contrast-enhanced MR angiography (4D-MRA), which allows the simultaneous visualization of the vasculature and blood-flow dynamics, is widely used in clinical routine. In this study, the impact of two different contrast agent injection methods on 4D-MRA was examined in a controlled, standardized setting in an animal model. Six anesthetized Goettingen minipigs underwent two identical 4D-MRA examinations at 1.5 T in a single session. The contrast agent (0.1 mmol/kg body weight gadobutrol, followed by 20 ml saline) was injected using either manual injection or an automated injection system. A quantitative comparison of vascular signal enhancement and quantitative renal perfusion analyses were performed. Analysis of signal enhancement revealed higher peak enhancements and shorter time to peak intervals for the automated injection. Significantly different bolus shapes were found: automated injection resulted in a compact first-pass bolus shape clearly separated from the recirculation while manual injection resulted in a disrupted first-pass bolus with two peaks. In the quantitative perfusion analyses, statistically significant differences in plasma flow values were found between the injection methods. The results of both qualitative and quantitative 4D-MRA depend on the contrast agent injection method, with automated injection providing more defined bolus shapes and more standardized examination protocols. • Automated and manual contrast agent injection result in different bolus shapes in 4D-MRA. • Manual injection results in an undefined and interrupted bolus with two peaks. • Automated injection provides more defined bolus shapes. • Automated injection can lead to more standardized examination protocols.

Rapid Bolus Administration Does not Increase The Extravasation Rate of Albumin: A Randomized Controlled Trial in The Endotoxemic Pig.

PubMed

von Seth, Magnus; Lipcsey, Miklós; Engström, Peter; Larsson, Anders; Hillered, Lars; Maripuu, Enn; Widström, Charles; Sjölin, Jan

2017-04-01

Some experimental data suggest that rapid bolus administration of albumin causes less plasma-expanding effects than slow, continuous infusion. To determine whether rapid bolus administration, in comparison with slow infusion, results in greater extravasation of albumin in experimental septic shock we performed a randomized controlled trial with 32 endotoxemic pigs. The animals were monitored and ventilated with standard intensive care equipment and given 10 mL × kg 5% albumin labeled with Technetium-99m, either as a rapid 15-min bolus (Bolus group, n = 16) or as a 2-h infusion (Infusion group, n = 16). Radioactivity was monitored in plasma, extracellular microdialysate, and urine for 6 h. Physiological parameters were monitored hourly. Radioactivity in the liver, spleen, kidney, and lung was analyzed post mortem.The plasma area under the curve activity0-6 h was 4.4 ± 0.9 × 10 in the Bolus group and 4.4 ± 1.1 × 10 counts × min × mL × h in the Infusion group. Blood hemoglobin levels increased in both groups, suggesting severe capillary leakage. Yet, there were no group differences in albumin radioactivity in plasma, muscle tissue, urine, or in the post-mortem analysis of the organs. Following albumin administration, circulatory and respiratory parameters were similar in the two groups.In conclusion, the present results suggest that albumin might be given as a bolus without leading to increased extravasation of albumin, in contrast to previous animal experiments in rodents.

Combining Basal–Bolus Insulin Infusion for Tight Postprandial Glucose Control: An in Silico Evaluation in Adults, Children, and Adolescents

PubMed Central

Revert, Ana; Rossetti, Paolo; Calm, Remei; Vehí, Josep; Bondia, Jorge

2010-01-01

Background Achieving good postprandial glycemic control, without triggering hypoglycemia events, is a challenge of treatment strategies for type 1 diabetes subjects. Continuous subcutaneous insulin infusion, the gold standard of therapy, is based on heuristic adjustments of both basal and prandial insulin. Some tools, such as bolus calculators, are available to aid patients in selecting a meal-related insulin dose. However, they are still based on empiric parameters such as the insulin-to-carbohydrate ratio and on the physicians’ and patients’ ability to fit bolus mode to meal composition. Method In this article, a nonheuristic method for assessment of prandial insulin administration is presented and evaluated. An algorithm based on set inversion via interval analysis is used to coordinate basal and bolus insulin infusions to deal with postprandial glucose excursions. The evaluation is carried out through an in silico study using the 30 virtual patients available in the educational version of the Food and Drug Administration-accepted University of Virginia simulator. Results obtained using the standard bolus strategy and different coordinated basal–bolus solutions provided by the algorithm are compared. Results Coordinated basal–bolus solutions improve postprandial glucose performance in most cases, mainly in terms of reducing hypoglycemia risk, but also increasing the percentage of time in normoglycemia. Moreover, glycemic variability is reduced considerably by using these innovative solutions. Conclusions The algorithm presented here is a robust nonheuristic alternative to deal with postprandial glycemic control. It is shown as a powerful tool that could be integrated in future smart insulin pumps. PMID:21129338

Lubrication of chocolate during oral processing.

PubMed

Rodrigues, S A; Selway, N; Morgenstern, M P; Motoi, L; Stokes, J R; James, B J

2017-02-22

The structure of chocolate is drastically transformed during oral processing from a composite solid to an oil/water fluid emulsion. Using two commercial dark chocolates varying in cocoa solids content, this study develops a method to identify the factors that govern lubrication in molten chocolate and saliva's contribution to lubrication following oral processing. In addition to chocolate and its individual components, simulated boluses (molten chocolate and phosphate buffered saline), in vitro boluses (molten chocolate and whole human saliva) and ex vivo boluses (chocolate expectorated after chewing till the point of swallow) were tested. The results reveal that the lubrication of molten chocolate is strongly influenced by the presence of solid sugar particles and cocoa solids. The entrainment of particles into the contact zone between the interacting surfaces reduces friction such that the maximum friction coefficient measured for chocolate boluses is much lower than those for single-phase Newtonian fluids. The addition of whole human saliva or a substitute aqueous phase (PBS) to molten chocolate dissolves sugar and decreases the viscosity of molten chocolate so that thinner films are achieved. However, saliva is more lubricating than PBS, which results in lower friction coefficients for chocolate-saliva mixtures when compared to chocolate-PBS mixtures. A comparison of ex vivo and in vitro boluses also suggests that the quantity of saliva added and uniformity of mixing during oral processing affect bolus structure, which leads to differences in measured friction. It is hypothesized that inhomogeneous mixing in the mouth introduces large air bubbles and regions of non-emulsified fat into the ex vivo boluses, which enhance wetting and lubrication.

Lymphatic recovery of exogenous oleic acid in rats on long chain or specific structured triacylglycerol diets.

PubMed

Vistisen, Bodil; Mu, Huiling; Høy, Carl-Erik

2006-09-01

Specific structured triacylglycerols, MLM (M = medium-chain fatty acid, L = long-chain fatty acid), rapidly deliver energy and long-chain fatty acids to the body and are used for longer periods in human enteral feeding. In the present study rats were fed diets of 10 wt% MLM or LLL (L = oleic acid [18:1 n-9], M = caprylic acid [8:01) for 2 wk. Then lymph was collected 24 h following administration of a single bolus of 13C-labeled MLM or LLL. The total lymphatic recovery of exogenous 18:1 n-9 24 h after administration of a single bolus of MLM or LLL was similar in rats on the LLL diet (43% and 45%, respectively). However, the recovery of exogenous 18:1 n-9 was higher after a single bolus of MLM compared with a bolus of LLL in rats on the MLM diet (40% and 24%, respectively, P = 0.009). The recovery of lymphatic 18:1 n-9 of the LLL bolus tended to depend on the diet triacylglycerol structure and composition (P= 0.07). This study demonstrated that with a diet containing specific structured triacylglycerol, the lymphatic recovery of 18:1 n-9 after a single bolus of fat was dependent on the triacylglycerol structure of the bolus. This indicates that the lymphatic recovery of long-chain fatty acids from a single meal depends on the overall long-chain fatty acid composition of the habitual diet. This could have implications for enteral feeding for longer periods.

Initial Experience of the Application of Automated Tube Potential Selection Technique in High-pitch Dual-source CT Angiography of Whole Aorta Using Third-generation Dual-source CT Scanner.

PubMed

Kong, Lingyan; Liang, Jixiang; Xue, Huadan; Wang, Yining; Wang, Yun; Jin, Zhengyu; Zhang, Daming; Chen, Jin

2017-02-20

Objective To evaluate the application of automated tube potential selection technique in high-pitch dual-source CT aortic angiography on a third-generation dual-source CT scanner. Methods Whole aorta angiography were indiated in 59 patients,who were divided into 2 groups using a simple random method:in group 1 there were 31 patients who underwent the examination with automated tube potential selection using a vascular setting with a preferred image quality of 288 mA/100 kV;in group 2 there were 28 patients who underwent the examination with a tube voltage of 100 kV and automated tube current modulation using a reference tube current of 288 mA. Both groups were scanned on a third generation dual-source CT device operated in dual-source high-pitch ECG-gating mode with a pitch of 3.0,collimation of 2×192×0.6 mm,and a rotation time of 0.25 s. Iterative reconstruction algorithm was used. For group 1,the volume and flow of contrast medium and chasing saline were adapted to the tube voltage. For group 2,a contrast material bolus of 45 ml with a flow of 4.5 ml/s followed by a 50 ml saline chaser at 5 ml/s was used. CTA scan was automatically started using a bolus tracking technique at the level of the original part of aorta after a trigger threshold of 100 HU was reached. The start delay was set to 6 s in both groups. Effective dose (ED),signal to noise ratio (SNR),contrast to noise ratio (CNR),and subjective diagnostic quality of both groups were evaluated. Results The mean ED were 21.3% lower (t=-3.099,P=0.000) in group 1 [(2.48±0.80) mSv] than in group 2 [(3.15±0.86) mSv]. Two groups showed no significant difference in attenuation,SD,SNR,or CNR at all evaluational parts of aorta (ascending aorta,aortic arch,diaphragmatic aorta,or iliac bifurcation)(all P>0.05). There was no significant difference in subjective diagnostic quality values of two groups [(1.41±0.50) scores vs. (1.39±0.50) scores;W=828.5,P=0.837]. Conclusion Compared with automated tube current modulation,the automated tube potential selection technique in aorta CT angiography on a third-generation dual-source CT can dramatically reduce radiation dose without affecting image quality.

Vitamin D in newborns. A randomised controlled trial comparing daily and single oral bolus vitamin D in infants.

PubMed

Huynh, Julie; Lu, Thao; Liew, Danny; Doery, James Cg; Tudball, Ronald; Jona, Madeleine; Bhamjee, Roisin; Rodda, Christine P

2017-02-01

There are no published data to demonstrate the efficacy of bolus dose vitamin D in newborn infants. The study sought to evaluate this alternative approach of supplementation. This single centre, open randomised controlled trial was conducted from August 2013 to May 2014. It compared the efficacy and safety of daily (400 IU) versus a bolus dose (50 000 IU) of cholecalciferol in newborn infants of vitamin D deficient mothers. The primary outcome measure was the rate of 25 hydroxyvitamin D (25OHD) repletion-defined as 25OHD greater than 50 nmol/L. The secondary objective was determining safety using adjusted total serum calcium. Of 70 eligible infants, 36 received a daily dose and 34 received a single high-dose cholecalciferol. Mean 25OHD in the bolus group (154 nmol/L, 95% confidence interval (CI) 131-177) was higher than the daily group (48 nmol/L, 95% CI 42-54) at 1-2 weeks of age. This was reversed at 3-4 months, (65 nmol/L, 95% CI 59-71) compared with the daily group (81 nmol/L, 95% CI 77-85). More infants in the single bolus group achieved vitamin D repletion (100 vs. 31%) at 1-2 weeks. By 3-4 months, both groups achieved similar vitamin D repletion rates (91 vs. 89%). Mean adjusted total serum calcium in the bolus group were normal at 1-2 weeks (2.73 mmol/L) and 3-4 months (2.55 mmol/L). Single bolus dosing of 50 000 IU cholecalciferol achieves higher 25OHD repletion rates at 1-2 weeks of age compared with daily dosing, but repletion rates were similar by 3-4 months. There was no hypercalcaemia documented with single bolus dosing in this study. © 2016 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).

Implications for paediatric shock management in resource-limited settings: a perspective from the FEAST trial.

PubMed

Houston, Kirsty Anne; George, Elizabeth C; Maitland, Kathryn

2018-05-04

Although the African "Fluid Expansion as Supportive therapy" (FEAST) trial showed fluid resuscitation was harmful in children with severe febrile illness managed in resource-limited hospitals, the most recent evidence reviewed World Health Organization (WHO) guidelines continue to recommend fluid boluses in children with shock according to WHO criteria "WHO shock", arguing that the numbers included in the FEAST trial were too small to provide reasonable certainty. We re-analysed the FEAST trial results for all international definitions for paediatric shock including hypotensive (or decompensated shock) and the WHO criteria. In addition, we examined the clinical relevance of the WHO criteria to published and unpublished observational studies reporting shock in resource-limited settings. We established that hypotension was rare in children with severe febrile illness complicating only 29/3170 trial participants (0.9%). We confirmed that fluid boluses were harmful irrespective of the definitions of shock including the very small number with WHO shock (n = 65). In this subgroup 48% of bolus recipients died at 48 h compared to 20% of the non-bolus control group, an increased absolute risk of 28%, but translating to an increased relative risk of 240% (p = 0.07 (two-sided Fisher's exact test)). Examining studies describing the prevalence of the stringent WHO shock criteria in children presenting to hospital we found this was rare (~ 0.1%) and in these children mortality was very high (41.5-100%). The updated WHO guidelines continue to recommend boluses for a very limited number of children presenting at hospital with the strict definition of WHO shock. Nevertheless, the 3% increased mortality from boluses seen across FEAST trial participants would also include this subgroup of children receiving boluses. Recommendations aiming to differentiate WHO shock from other definitions will invariably lead to "slippage" at the bedside, with the potential of exposing a wider group of children to the harm of fluid-bolus therapy.

Machine Learning

DTIC Science & Technology

1990-04-01

DTIC i.LE COPY RADC-TR-90-25 Final Technical Report April 1990 MACHINE LEARNING The MITRE Corporation Melissa P. Chase Cs) CTIC ’- CT E 71 IN 2 11990...S. FUNDING NUMBERS MACHINE LEARNING C - F19628-89-C-0001 PE - 62702F PR - MOlE S. AUTHO(S) TA - 79 Melissa P. Chase WUT - 80 S. PERFORMING...341.280.5500 pm I " Aw Sig rill Ia 2110-01 SECTION 1 INTRODUCTION 1.1 BACKGROUND Research in machine learning has taken two directions in the problem of

National Program for Inspection of Non-Federal Dams. Chase Pond Dam (NH 00255), NHWRB Number 253.02, Merrimack River Basin, Wilmot, New Hampshire. Phase I Inspection Report.

DTIC Science & Technology

1980-03-01

STANDAROS-1963-A L ~.°.. o...... 1....MERRIMACK RIVER BASIN -!. WILMOT , NEW HAMPSHIRE ’,- CHASE POND DAM NH 00255 NHWRB NO. 253.02 r PHASE I...Continue on fewsorsp side #0 .o..oemay and Ientify by black Muthot) - DAMS, NSPECTION, PAM S’AFETY, Merrimack River Basin. * Wilmot , New Hampshire...MERRIMACK RIVER BASIN R WILMOT , NEW HAMPSHIRE - - PHASE I INSPECTION REPORT NATIONAL DAM INSPECTION PROGRAM :: : I

Application of curative therapy in the ward. 1920.

PubMed

Marble, Henry Chase

2009-06-01

This Classic article is a reprint of the original work by Henry Chase Marble, Application of Curative Therapy in the Ward. An accompanying biographical sketch on Henry Chase Marble, MD, is available at DOI 10.1007/s11999-009-0789-7 . The Classic Article is (c)1920 by the Journal of Bone and Joint Surgery, Inc. and is reprinted with permission from Marble HC. Application of curative therapy in the ward. J Bone Joint Surg Am. 1920;2:136-138.

The F-18 simulator at NASA's Dryden Flight Research Center, Edwards, California

NASA Image and Video Library

2004-10-04

The F-18 simulator at NASA's Dryden Flight Research Center, Edwards, California. Simulators offer a safe and economical alternative to actual flights to gather data, as well as being excellent facilities for pilot practice and training. The F-18 Hornet is used primarily as a safety chase and mission support aircraft at NASA's Dryden Flight Research Center, Edwards, California. As support aircraft, the F-18's are used for safety chase, pilot proficiency, aerial photography and other mission support functions.

Triphasic contrast enhanced CT simulation with bolus tracking for pancreas SBRT target delineation.

PubMed

Godfrey, Devon J; Patel, Bhavik N; Adamson, Justus D; Subashi, Ergys; Salama, Joseph K; Palta, Manisha

Bolus-tracked multiphasic contrast computed tomography (CT) is often used in diagnostic radiology to enhance the visibility of pancreas tumors, but is uncommon in radiation therapy pancreas CT simulation, and its impact on gross tumor volume (GTV) delineation is unknown. This study evaluates the lesion conspicuity and consistency of pancreas stereotactic body radiation therapy (SBRT) GTVs contoured in the different contrast phases of triphasic CT simulation scans. Triphasic, bolus-tracked planning CT simulation scans of 10 consecutive pancreas SBRT patients were acquired, yielding images of the pancreas during the late arterial (LA), portal venous (PV), and either the early arterial or delayed phase. GTVs were contoured on each phase by a gastrointestinal-specialized radiation oncologist and reviewed by a fellowship-trained abdominal radiologist who specializes in pancreatic imaging. The volumes of the registered GTVs, their overlap ratio, and the 3-dimensional margin expansions necessary for each GTV to fully encompass GTVs from the other phases were calculated. The contrast difference between tumor and normal pancreas was measured, and 2 radiation oncologists rank-ordered the phases according to their value for the lesion-contouring task. Tumor-to-pancreas enhancement was on average much larger for the LA and PV than the delayed phase or early arterial phases; the LA and PV phases were also consistently preferred by the radiation oncologists. Enhancement differences among the phases resulted in highly variable GTV volumes with no observed trends. Overlap ratios ranged from 18% to 75% across all 3 phases, improving to 43% to 91% when considering only the preferred LA and PV phases. GTV expansions necessary to encompass all GTVs ranged from 0.3 to 1.8 cm for all 3 phases, improving slightly to 0.1 to 1.4 cm when considering just the LA and PV phases. For pancreas SBRT, we recommend combining the GTVs from a multiphasic CT simulation with bolus-tracking, including, at a minimum, a Boolean "OR" of the LA and PV phases. Copyright © 2017 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.

Social grouping: perceptual grouping of objects by cooperative but not competitive relationships in dynamic chase.

PubMed

Yin, Jun; Ding, Xiaowei; Zhou, Jifan; Shui, Rende; Li, Xinyu; Shen, Mowei

2013-10-01

Historically, perceptual grouping is associated with physical principles. This article reports a novel finding that social information-cooperative but not competitive relationships-can drive perceptual grouping of objects in dynamic chase. Particularly, each relationship was constructed with human-generated chasing motions (i.e., two predators and one prey), and its role on perceptual grouping was examined by grouping-induced effect-attentional consequences. The results showed that: (1) Predators can be perceived as a group due to their cooperative relationship, causing attention to automatically spread within grouped predators, thus the response to target appearing on uncued predator is also facilitated; and (2) The attentional effect on competitive predators has no difference from any condition which controls low-level motion patterns, even including the random-motion condition wherein no grouping factor was contained. These findings extend perceptual grouping into the social field, implying that social information gets involved in visual cognition at an early perceptual stage. Copyright © 2013 Elsevier B.V. All rights reserved.

Building America Case Study: Duct in Conditioned Space in a Dropped Ceiling or Fur-down, Gainesville, Florida (Fact Sheet)

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

Not Available

2014-09-01

Forced air distribution systems (duct systems) typically are installed out of sight for aesthetic reasons, most often in unconditioned areas such as an attic or crawlspace. Any leakage of air to or from the duct system (duct leakage) in unconditioned space not only loses energy, but impacts home and equipment durability and indoor air quality. An obvious solution to this problem is to bring the duct system into the interior of the house, either by sealing the area where the ducts are installed (sealed attic or crawlspace) or by building an interior cavity or chase above the ceiling plane (raisedmore » ceiling or fur-up chase) or below the ceiling plane (dropped ceiling or fur-down) for the duct system. This case study examines one Building America builder partner's implementation of an inexpensive, quick and effective method of building a fur-down or dropped ceiling chase.« less

Pattern production through a chiral chasing mechanism

NASA Astrophysics Data System (ADS)

Woolley, Thomas E.

2017-09-01

Recent experiments on zebrafish pigmentation suggests that their typical black and white striped skin pattern is made up of a number of interacting chromatophore families. Specifically, two of these cell families have been shown to interact through a nonlocal chasing mechanism, which has previously been modeled using integro-differential equations. We extend this framework to include the experimentally observed fact that the cells often exhibit chiral movement, in that the cells chase, and run away, at angles different to the line connecting their centers. This framework is simplified through the use of multiple small limits leading to a coupled set of partial differential equations which are amenable to Fourier analysis. This analysis results in the production of dispersion relations and necessary conditions for a patterning instability to occur. Beyond the theoretical development and the production of new pattern planiforms we are able to corroborate the experimental hypothesis that the global pigmentation patterns can be dependent on the chirality of the chromatophores.

Goal attribution to inanimate moving objects by Japanese macaques (Macaca fuscata)

PubMed Central

Atsumi, Takeshi; Koda, Hiroki; Masataka, Nobuo

2017-01-01

Humans interpret others’ goals based on motion information, and this capacity contributes to our mental reasoning. The present study sought to determine whether Japanese macaques (Macaca fuscata) perceive goal-directedness in chasing events depicted by two geometric particles. In Experiment 1, two monkeys and adult humans were trained to discriminate between Chasing and Random sequences. We then introduced probe stimuli with various levels of correlation between the particle trajectories to examine whether participants performed the task using higher correlation. Participants chose stimuli with the highest correlations by chance, suggesting that correlations were not the discriminative cue. Experiment 2 examined whether participants focused on particle proximity. Participants differentiated between Chasing and Control sequences; the distance between two particles was identical in both. Results indicated that, like humans, the Japanese macaques did not use physical cues alone to perform the discrimination task and integrated the cues spontaneously. This suggests that goal attribution resulting from motion information is a widespread cognitive phenotype in primate species. PMID:28053305

Pre-lung transplant measures of reflux on impedance are superior to pH testing alone in predicting early allograft injury

PubMed Central

Lo, Wai-Kit; Burakoff, Robert; Goldberg, Hilary J; Feldman, Natan; Chan, Walter W

2015-01-01

AIM: To evaluate pre-lung transplant acid reflux on pH-testing vs corresponding bolus reflux on multichannel intraluminal impedance (MII) to predict early allograft injury. METHODS: This was a retrospective cohort study of lung transplant recipients who underwent pre-transplant combined MII-pH-testing at a tertiary care center from January 2007 to November 2012. Patients with pre-transplant fundoplication were excluded. Time-to-event analysis was performed using a Cox proportional hazards model to assess associations between measures of reflux on MII-pH testing and early allograft injury. Area under the receiver operating characteristic (ROC) curve (c-statistic) of the Cox model was calculated to assess the predictive value of each reflux parameter for early allograft injury. Six pH-testing parameters and their corresponding MII measures were specified a priori. The pH parameters were upright, recumbent, and overall acid reflux exposure; elevated acid reflux exposure; total acid reflux episodes; and acid clearance time. The corresponding MII measures were upright, recumbent, and overall bolus reflux exposure; elevated bolus reflux exposure; total bolus reflux episodes; and bolus clearance time. RESULTS: Thirty-two subjects (47% men, mean age: 55 years old) met the inclusion criteria of the study. Idiopathic pulmonary fibrosis (46.9%) represented the most common pulmonary diagnosis leading to transplantation. Baseline demographics, pre-transplant cardiopulmonary function, number of lungs transplanted (unilateral vs bilateral), and post-transplant proton pump inhibitor use were similar between reflux severity groups. The area under the ROC curve, or c-statistic, of each acid reflux parameter on pre-transplant pH-testing was lower than its bolus reflux counterpart on MII in the prediction of early allograft injury. In addition, the development of early allograft injury was significantly associated with three pre-transplant MII measures of bolus reflux: overall reflux exposure (HR = 1.18, 95%CI: 1.01-1.36, P = 0.03), recumbent reflux exposure (HR = 1.25, 95%CI: 1.04-1.50, P = 0.01) and bolus clearance (HR = 1.09, 95%CI: 1.01-1.17, P = 0.02), but not with any pH-testing parameter measuring acid reflux alone. CONCLUSION: Pre-transplant MII measures of bolus reflux perform better than their pH-testing counterparts in predicting early allograft injury post-lung transplantation. PMID:26290637

The predictive ability of six pharmacokinetic models of rocuronium developed using a single bolus: evaluation with bolus and continuous infusion regimen.

PubMed

Sasakawa, Tomoki; Masui, Kenichi; Kazama, Tomiei; Iwasaki, Hiroshi

2016-08-01

Rocuronium concentration prediction using pharmacokinetic (PK) models would be useful for controlling rocuronium effects because neuromuscular monitoring throughout anesthesia can be difficult. This study assessed whether six different compartmental PK models developed from data obtained after bolus administration only could predict the measured plasma concentration (Cp) values of rocuronium delivered by bolus followed by continuous infusion. Rocuronium Cp values from 19 healthy subjects who received a bolus dose followed by continuous infusion in a phase III multicenter trial in Japan were used retrospectively as evaluation datasets. Six different compartmental PK models of rocuronium were used to simulate rocuronium Cp time course values, which were compared with measured Cp values. Prediction error (PE) derivatives of median absolute PE (MDAPE), median PE (MDPE), wobble, divergence absolute PE, and divergence PE were used to assess inaccuracy, bias, intra-individual variability, and time-related trends in APE and PE values. MDAPE and MDPE values were acceptable only for the Magorian and Kleijn models. The divergence PE value for the Kleijn model was lower than -10 %/h, indicating unstable prediction over time. The Szenohradszky model had the lowest divergence PE (-2.7 %/h) and wobble (5.4 %) values with negative bias (MDPE = -25.9 %). These three models were developed using the mixed-effects modeling approach. The Magorian model showed the best PE derivatives among the models assessed. A PK model developed from data obtained after single-bolus dosing can predict Cp values during bolus and continuous infusion. Thus, a mixed-effects modeling approach may be preferable in extrapolating such data.

Preexercise aminoacidemia and muscle protein synthesis after resistance exercise.

PubMed

Burke, Louise M; Hawley, John A; Ross, Megan L; Moore, Daniel R; Phillips, Stuart M; Slater, Gary R; Stellingwerff, Trent; Tipton, Kevin D; Garnham, Andrew P; Coffey, Vernon G

2012-10-01

We have previously shown that the aminoacidemia caused by the consumption of a rapidly digested protein after resistance exercise enhances muscle protein synthesis (MPS) more than the amino acid (AA) profile associated with a slowly digested protein. Here, we investigated whether differential feeding patterns of a whey protein mixture commencing before exercise affect postexercise intracellular signaling and MPS. Twelve resistance-trained males performed leg resistance exercise 45 min after commencing each of three volume-matched nutrition protocols: placebo (PLAC, artificially sweetened water), BOLUS (25 g of whey protein + 5 g of leucine dissolved in artificially sweetened water; 1 × 500 mL), or PULSE (15 × 33-mL aliquots of BOLUS drink every 15 min). The preexercise rise in plasma AA concentration with PULSE was attenuated compared with BOLUS (P < 0.05); this effect was reversed after exercise, with two-fold greater leucine concentrations in PULSE compared with BOLUS (P < 0.05). One-hour postexercise, phosphorylation of p70 S6K(thr389) and rpS6(ser235/6) was increased above baseline with BOLUS and PULSE, but not PLAC (P < 0.05); furthermore, PULSE > BOLUS (P < 0.05). MPS throughout 5 h of recovery was higher with protein ingestion compared with PLAC (0.037 ± 0.007), with no differences between BOLUS or PULSE (0.085 ± 0.013 vs. 0.095 ± 0.010%.h(-1), respectively, P = 0.56). Manipulation of aminoacidemia before resistance exercise via different patterns of intake of protein altered plasma AA profiles and postexercise intracellular signaling. However, there was no difference in the enhancement of the muscle protein synthetic response after exercise. Protein sources producing a slow AA release, when consumed before resistance exercise in sufficient amounts, are as effective as rapidly digested proteins in promoting postexercise MPS.

Bolus and continuous infusion mitoxantrone in newly diagnosed adult acute lymphoblastic leukemia: results of two consecutive phase II clinical studies.

PubMed

Koc, Y; Akpek, G; Kansu, E; Kars, A; Tekuzman, G; Baltali, E; Güler, N; Barista, I; Güllü, I; Ozisik, Y; Firat, D

1998-01-01

Two consecutive phase II clinical studies were designed to evaluate the efficacy and safety of bolus and continuous infusion (CI) mitoxantrone (MTZ) in 39 patients with newly diagnosed acute lymphocytic leukemia (ALL). MTZ was used as part of the classical ALL induction regimen. Twenty patients were treated with bolus MTZ (10 mg/m2 for 3 days) combined with vincristine and prednisone. The same regimen was given to a second set of 19 patients, except that MTZ was administered as a 24-hr CI. Both groups received bimonthly intensifications with vincristine and prednisone for 3 years, along with oral maintenance therapy. Patients in the CI-MTZ study arm received additional MTZ on the first day of intensification cycles. Seventeen patients (85%) in the bolus arm and 15 patients (79%) in the CI arm achieved complete remission (CR). Median disease-free survivals (DFS) in the bolus and CI groups were 11 and 15 months after median follow-ups of 16 (3.5-96) and 13 (2.3-32) months, respectively. At 2.5 years, DFS rates were 29.4% and 34.4% in the bolus and CI groups (p > 0.05). There were no significant differences between two groups in rates of early death, degree of organ toxicity, or duration of neutropenia and thrombocytopenia. Significant cardiac toxicity was not observed in either group. Bolus or CI administration of MTZ was equally effective and was well tolerated. Neither the mode of administration nor increasing the dose intensity of MTZ by incorporating intensification cycles reduced relapse rates. Development of new antileukemia agents and novel treatment approaches are still needed to improve the high relapse rates in adult ALL once a complete response is achieved.

Extended versus Bolus Infusion of Broad Spectrum β-Lactams for Febrile Neutropenia: an Unblinded Randomized Trial.

PubMed

Ram, Ron; Halavy, Yael; Amit, Odelia; Paran, Yael; Katchman, Eugene; Yachini, Bruria; Kor, Svetlana; Avivi, Irit; Ben-Ami, Ronen

2018-03-28

Febrile neutropenia may be a sign of severe infection, and is associated with significant morbidity and mortality in high-risk patients with hematologic malignancies. Extended infusion of β-lactam antibiotics is associated with greater clinical response than is bolus infusion in non-neutropenic critically ill patients, but data are lacking for febrile neutropenic patients. We designed a single-center, non-blinded randomized trial comparing extended infusion (4 hours) and bolus infusion (30 minutes) of piperacillin-tazobactam or ceftazidime in high-risk patients with febrile neutropenia. The primary end-point was overall response on day 4, defined as the combination of resolution of fever, sterile blood cultures, resolution of clinical signs and symptoms, and no need for a change in the antibiotic regimen. Outcome was adjudicated by investigators blinded to treatment allocation. Of 123 enrolled patients, 105 had febrile neutropenia and were included in the intention-to-treat analysis: 47 in the extended infusion arm and 58 in the bolus infusion arm. Overall response occurred in 35 (74.4%) patients treated with extended infusion and 32 (55.1%) patients treated with bolus infusion (P=0.044). The superiority of extended infusion compared with bolus infusion was greatest for patients with clinically documented infections (overall response, 68.4% [13/19] versus 35.7% [10/28]; P=0.039), and specifically for those with pneumonia (80% [4/5] versus 0% [0/8]; P=0.007). Extended infusion of β-lactams is associated with superior treatment outcomes as compared with bolus infusion for high-risk patients with febrile neutropenia. The benefit of extended β-lactam infusion may be greatest for patients with pulmonary infections.

An audit of combined multichannel intraluminal impedance manometry in the assessment of dysphagia.

PubMed

Burgess, Nicholas G; Wyeth, John W

2011-04-01

Multichannel Intraluminal Impedance (MII) Monitoring is a method of examining oesophageal bolus transit without the need for radiation. In combination with oesophageal manometry it allows correlation of bolus transit with peristaltic activity. The clinical application of impedance manometry is still being refined. This audit looked to examine whether impedance manometry had advantages over standard manometry in assessment of patients with dysphagia. 41 patients with the presenting symptom of dysphagia were assessed by combined MII and oesophageal manometry at a Wellington Hospital between February 2008 and December 2009. Each underwent manometry and MII using standardised techniques. Achalasia was diagnosed in 23 patients (56.1%), Ineffective oesophageal motility (IEM) in 5 patients (12.2%), Diffuse oesophageal Spasm (DES) in 7 patients (17.1%), and Nutcracker oesophagus in 2 patients (4.9%). 4 patients had normal manometry studies (9.8%). All patients with achalasia, IEM, and DES had abnormal bolus transit. All patients with normal manometry had abnormal bolus transit. Both patients with nutcracker oesophagus had normal bolus transit. 4 patients with achalasia had undergone previous Hellers myotomy. Two of these patients (50.0%) now had normal LES relaxation pressures, but all four still had abnormal oesophageal peristalsis and abnormal bolus transit. Multichannel Intraluminal Impedance manometry has advantages over standard manometry in characterising the physiological abnormalities associated with dysphagia. Patients in this study had severe defects including achalasia where bolus transit was invariably poor meaning little further information was gained. Extension of this study to include a wider group of patients with dysphagia may yield different results. © 2011 Journal of Gastroenterology and Hepatology Foundation and Blackwell Publishing Asia Pty Ltd.

Deposition and dispersion of 1-micrometer aerosol boluses in the human lung: effect of micro- and hypergravity

NASA Technical Reports Server (NTRS)

Darquenne, C.; West, J. B.; Prisk, G. K.

1998-01-01

We performed bolus inhalations of 1-micrometer particles in four subjects on the ground (1 G) and during parabolic flights both in microgravity (microG) and in approximately 1.6 G. Boluses of approximately 70 ml were inhaled at different points in an inspiration from residual volume to 1 liter above functional residual capacity. The volume of air inhaled after the bolus [the penetration volume (Vp)] ranged from 200 to 1,500 ml. Aerosol concentration and flow rate were continuously measured at the mouth. The deposition, dispersion, and position of the bolus in the expired gas were calculated from these data. For Vp >/=400 ml, both deposition and dispersion increased with Vp and were strongly gravity dependent, with the greatest deposition and dispersion occurring for the largest G level. At Vp = 800 ml, deposition and dispersion increased from 33.9% and 319 ml in microG to 56.9% and 573 ml at approximately 1.6 G, respectively (P < 0.05). At each G level, the bolus was expired at a smaller volume than Vp, and this volume became smaller with increasing Vp. Although dispersion was lower in microG than in 1 G and approximately 1.6 G, it still increased steadily with increasing Vp, showing that nongravitational ventilatory inhomogeneity is partly responsible for dispersion in the human lung.

Pro-inflammatory adjuvant properties of pigment-grade titanium dioxide particles are augmented by a genotype that potentiates interleukin 1β processing.

PubMed

Riedle, Sebastian; Pele, Laetitia C; Otter, Don E; Hewitt, Rachel E; Singh, Harjinder; Roy, Nicole C; Powell, Jonathan J

2017-12-08

Pigment-grade titanium dioxide (TiO 2 ) particles are an additive to some foods (E171 on ingredients lists), toothpastes, and pharma-/nutraceuticals and are absorbed, to some extent, in the human intestinal tract. TiO 2 can act as a modest adjuvant in the secretion of the pro-inflammatory cytokine interleukin 1β (IL-1β) when triggered by common intestinal bacterial fragments, such as lipopolysaccharide (LPS) and/or peptidoglycan. Given the variance in human genotypes, which includes variance in genes related to IL-1β secretion, we investigated whether TiO 2 particles might, in fact, be more potent pro-inflammatory adjuvants in cells that are genetically susceptible to IL-1β-related inflammation. We studied bone marrow-derived macrophages from mice with a mutation in the nucleotide-binding oligomerisation domain-containing 2 gene (Nod2 m/m ), which exhibit heightened secretion of IL-1β in response to the peptidoglycan fragment muramyl dipeptide (MDP). To ensure relevance to human exposure, TiO 2 was food-grade anatase (119 ± 45 nm mean diameter ± standard deviation). We used a short 'pulse and chase' format: pulsing with LPS and chasing with TiO 2 +/- MDP or peptidoglycan. IL-1β secretion was not stimulated in LPS-pulsed bone marrow-derived macrophages, or by chasing with MDP, and only very modestly so by chasing with peptidoglycan. In all cases, however, IL-1β secretion was augmented by chasing with TiO 2 in a dose-dependent fashion (5-100 μg/mL). When co-administered with MDP or peptidoglycan, IL-1β secretion was further enhanced for the Nod2 m/m genotype. Tumour necrosis factor α was triggered by LPS priming, and more so for the Nod2 m/m genotype. This was enhanced by chasing with TiO 2 , MDP, or peptidoglycan, but there was no additive effect between the bacterial fragments and TiO 2 . Here, the doses of TiO 2 that augmented bacterial fragment-induced IL-1β secretion were relatively high. In vivo, however, selected intestinal cells appear to be loaded with TiO 2 , so such high concentrations may be 'exposure-relevant' for localised regions of the intestine where both TiO 2 and bacterial fragment uptake occurs. Moreover, this effect is enhanced in cells from Nod2 m/m mice indicating that genotype can dictate inflammatory signalling in response to (nano)particle exposure. In vivo studies are now merited.

Dysautonomia (Autonomic Dysfunction)

MedlinePlus

... the head of the bed, water bolus (rapid infusion of water given intravenously), a high-salt diet, ... the head of the bed, water bolus (rapid infusion of water given intravenously), a high-salt diet, ...

Autonomous docking ground demonstration (category 3)

NASA Technical Reports Server (NTRS)

Lamkin, Steve L.; Eick, Richard E.; Baxter, James M.; Boyd, M. G.; Clark, Fred D.; Lee, Thomas Q.; Othon, L. T.; Prather, Joseph L.; Spehar, Peter T.; Teders, Rebecca J.

1991-01-01

The NASA Johnson Space Center (JSC) is involved in the development of an autonomous docking ground demonstration. The demonstration combines the technologies, expertise and facilities of the JSC Tracking and Communications Division (EE), Structures and Mechanics Division (ES), and the Navigation, Guidance and Control Division (EG) and their supporting contractors. The autonomous docking ground demonstration is an evaluation of the capabilities of the laser sensor system to support the docking phase (12ft to contact) when operated in conjunction with the Guidance, Navigation and Control Software. The docking mechanism being used was developed for the Apollo Soyuz Test Program. This demonstration will be conducted using the Six-Degrees of Freedom (6-DOF) Dynamic Test System (DTS). The DTS environment simulates the Space Station Freedom as the stationary or target vehicle and the Orbiter as the active or chase vehicle. For this demonstration the laser sensor will be mounted on the target vehicle and the retroreflectors on the chase vehicle. This arrangement was used to prevent potential damage to the laser. The sensor system. GN&C and 6-DOF DTS will be operated closed-loop. Initial condition to simulate vehicle misalignments, translational and rotational, will be introduced within the constraints of the systems involved. Detailed description of each of the demonstration components (e.g., Sensor System, GN&C, 6-DOF DTS and supporting computer configuration) including their capabilities and limitations will be discussed. A demonstration architecture drawing and photographs of the test configuration will be presented.

Autonomous docking ground demonstration (category 3)

NASA Astrophysics Data System (ADS)

Lamkin, Steve L.; Eick, Richard E.; Baxter, James M.; Boyd, M. G.; Clark, Fred D.; Lee, Thomas Q.; Othon, L. T.; Prather, Joseph L.; Spehar, Peter T.; Teders, Rebecca J.

The NASA Johnson Space Center (JSC) is involved in the development of an autonomous docking ground demonstration. The demonstration combines the technologies, expertise and facilities of the JSC Tracking and Communications Division (EE), Structures and Mechanics Division (ES), and the Navigation, Guidance and Control Division (EG) and their supporting contractors. The autonomous docking ground demonstration is an evaluation of the capabilities of the laser sensor system to support the docking phase (12ft to contact) when operated in conjunction with the Guidance, Navigation and Control Software. The docking mechanism being used was developed for the Apollo Soyuz Test Program. This demonstration will be conducted using the Six-Degrees of Freedom (6-DOF) Dynamic Test System (DTS). The DTS environment simulates the Space Station Freedom as the stationary or target vehicle and the Orbiter as the active or chase vehicle. For this demonstration the laser sensor will be mounted on the target vehicle and the retroreflectors on the chase vehicle. This arrangement was used to prevent potential damage to the laser. The sensor system. GN&C and 6-DOF DTS will be operated closed-loop. Initial condition to simulate vehicle misalignments, translational and rotational, will be introduced within the constraints of the systems involved. Detailed description of each of the demonstration components (e.g., Sensor System, GN&C, 6-DOF DTS and supporting computer configuration) including their capabilities and limitations will be discussed. A demonstration architecture drawing and photographs of the test configuration will be presented.

Supervised retinal vessel segmentation from color fundus images based on matched filtering and AdaBoost classifier.

PubMed

Memari, Nogol; Ramli, Abd Rahman; Bin Saripan, M Iqbal; Mashohor, Syamsiah; Moghbel, Mehrdad

2017-01-01

The structure and appearance of the blood vessel network in retinal fundus images is an essential part of diagnosing various problems associated with the eyes, such as diabetes and hypertension. In this paper, an automatic retinal vessel segmentation method utilizing matched filter techniques coupled with an AdaBoost classifier is proposed. The fundus image is enhanced using morphological operations, the contrast is increased using contrast limited adaptive histogram equalization (CLAHE) method and the inhomogeneity is corrected using Retinex approach. Then, the blood vessels are enhanced using a combination of B-COSFIRE and Frangi matched filters. From this preprocessed image, different statistical features are computed on a pixel-wise basis and used in an AdaBoost classifier to extract the blood vessel network inside the image. Finally, the segmented images are postprocessed to remove the misclassified pixels and regions. The proposed method was validated using publicly accessible Digital Retinal Images for Vessel Extraction (DRIVE), Structured Analysis of the Retina (STARE) and Child Heart and Health Study in England (CHASE_DB1) datasets commonly used for determining the accuracy of retinal vessel segmentation methods. The accuracy of the proposed segmentation method was comparable to other state of the art methods while being very close to the manual segmentation provided by the second human observer with an average accuracy of 0.972, 0.951 and 0.948 in DRIVE, STARE and CHASE_DB1 datasets, respectively.

The time-adjusted gradual replacement injection method enables better visualization of the right heart.

PubMed

Nakahara, Takehiro; Jinzaki, Masahiro; Niwamae, Nogiku; Saito, Yuuichirou; Arai, Masashi; Tsushima, Yoshito; Kuribayashi, Sachio; Kurabayashi, Masahiko

2014-01-01

Despite the improvement of cardiac CT, right heart visualization remains challenging. We herein describe a new method, called the time-adjusted gradual replacement injection protocol. The aim of this study was to compare this protocol with the split-bolus injection protocol. Fifty-two patients who had undergone dual-source cardiac CT were retrospectively recruited. Twenty-six patients were injected by using the split-bolus injection protocol, and 26 patients were injected by using the time-adjusted gradual replacement injection protocol. For this method, we injected contrast medium for 10 seconds at a flow rate of 0.07 × body weight mL/s, then gradually replaced the contrast material with saline until 2 seconds before finishing the scans. The CT attenuation was measured in 4 chambers, the aorta, and the coronary arteries. The visualization of the anatomic structures and the occurrence and severity of streak artifacts were scored for the cardiac structures in the heart. For the analyses, either Welch t-test or Student t-test was performed. In the right heart, the CT values and visualization scores were significantly higher in the time-adjusted replacement injection group than in the split-bolus injection group, whereas the artifact scores were comparable between the 2 groups. The CT values, visualization scores, and artifact scores of the left heart were not significantly different between the 2 groups. In this study, the time-adjusted gradual replacement injection protocol provided excellent attenuation for visualization of the right heart. This method may help to accurately evaluate the right cardiac anatomy and thereby identify any potential diseases. Copyright © 2014 Society of Cardiovascular Computed Tomography. Published by Elsevier Inc. All rights reserved.

Detection of thoracic vascular structures by electrical impedance tomography: a systematic assessment of prominence peak analysis of impedance changes.

PubMed

Wodack, K H; Buehler, S; Nishimoto, S A; Graessler, M F; Behem, C R; Waldmann, A D; Mueller, B; Böhm, S H; Kaniusas, E; Thürk, F; Maerz, A; Trepte, C J C; Reuter, D A

2018-02-28

Electrical impedance tomography (EIT) is a non-invasive and radiation-free bedside monitoring technology, primarily used to monitor lung function. First experimental data shows that the descending aorta can be detected at different thoracic heights and might allow the assessment of central hemodynamics, i.e. stroke volume and pulse transit time. First, the feasibility of localizing small non-conductive objects within a saline phantom model was evaluated. Second, this result was utilized for the detection of the aorta by EIT in ten anesthetized pigs with comparison to thoracic computer tomography (CT). Two EIT belts were placed at different thoracic positions and a bolus of hypertonic saline (10 ml, 20%) was administered into the ascending aorta while EIT data were recorded. EIT images were reconstructed using the GREIT model, based on the individual's thoracic contours. The resulting EIT images were analyzed pixel by pixel to identify the aortic pixel, in which the bolus caused the highest transient impedance peak in time. In the phantom, small objects could be located at each position with a maximal deviation of 0.71 cm. In vivo, no significant differences between the aorta position measured by EIT and the anatomical aorta location were obtained for both measurement planes if the search was restricted to the dorsal thoracic region of interest (ROIs). It is possible to detect the descending aorta at different thoracic levels by EIT using an intra-aortic bolus of hypertonic saline. No significant differences in the position of the descending aorta on EIT images compared to CT images were obtained for both EIT belts.

An automatic bolus injector for use in radiotracer studies of blood flow: design and evaluation.

PubMed

Snyder, R E; Overton, T R; Boisvert, D P; Petruk, K C

1976-12-01

An electromechanical device is described which automatically injects the radiotracer bolus used in the measurement of cerebral blood flow. It consists of two electronically controlled, solenoid operated syringes, one containing the radiotracer solution and the other heparinized saline. Results are presented which show that use of the automatic bolus injector in place of hand injection leads to an improvement in the precision of measured flow values. Additional advantages of the device are discussed.

Long-term US energy outlook

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

Friesen, G.

Chase Econometrics summarizes the assumptions underlying long-term US energy forecasts. To illustrate the uncertainty involved in forecasting for the period to the year 2000, they compare Chase Econometrics forecasts with some recent projections prepared by the DOE Office of Policy, Planning and Analysis for the annual National Energy Policy Plan supplement. Scenario B, the mid-range reference case, is emphasized. The purpose of providing Scenario B as well as Scenarios A and C as alternate cases is to show the sensitivity of oil price projections to small swings in energy demand. 4 tables.

Combat History Analysis Study Effort (CHASE) Data Enhancement Study (CDES). Volume 1. Introductory Materials and Bioliography.

DTIC Science & Technology

1986-01-31

Operations, France and Belgium, 1914: Mons, the Retreat to the Seine , the Marne , the Aisne, August-October 1914. London, 1922. Edmonds, Brig. Gen...7-175 712 COMBAT HISTORY ANAL YSIS STUDY EFFORT (CHASE) DATA l/f ENHANCEMENT STUDY CDES (U) DATA MEMORY SYSTEMS INC FAIRFAX VA HERO DIV B R BADER ET ...Fleville 350 Noyon-Montdidier 378 Hill 212 351 Champagne- Marne 379 Bois de Boyon- 352 Aisne- Marne I Montrefagne 353 Missy aux Bois Ravine 380 Hill 272 354

[Chronic inflammatory demyelinating polyradiculoneuropathy in childhood: outcomes after methylprednisolone pulse therapy].

PubMed

Rafai, M A; Moutaouakil, F; El Otmani, H; Fadel, H; Boulaajaj, F Z; El Moutawakil, B; Gam, I; Slassi, I

2006-06-01

Chronic inflammatory demyelinating polyneuropathy (CIDP) in children is relatively rare and treatment is based primarily on intravenous immunoglobulins or oral corticosteroids. Boluses of methylprednisolone (MP) are a seldom used alternative. We report the case of an 8-year-old child, first presented at the age of 3 years, with recurring episodes of functional impotence of both lower limbs and walking impairment, partially reversible without treatment. Clinical, progressive, and electrophysiological data and the analysis of the cerebrospinal fluid were compatible with CIDP. MP boluses were administered: after a total eight monthly boluses, very satisfactory progression on the clinical and electrophysiological fronts was noted after 24 months. Childhood CIDP presents clinical, electrophysiological, progressive, and prognostic particularities, they recur readily and the outcome is good. Boluses of methylprednisolone are an alternative to the treatment of these neuropathies in childhood.

Glucagon Is a Safe and Inexpensive Initial Strategy in Esophageal Food Bolus Impaction.

PubMed

Haas, Jason; Leo, Julia; Vakil, Nimish

2016-03-01

Controversy exists about the utility of pharmacologic agents and endoscopic technique used for esophageal food bolus impaction. To evaluate the utility of glucagon and the technique used for endoscopic removal, including the rate of success and the adverse events of the techniques. The database of the largest healthcare provider in southeastern Wisconsin was retrospectively reviewed for patients presenting with esophageal food bolus impaction. Data extracted included glucagon administration and its success rate, outcome of radiographic studies, and the endoscopic method of removal and adverse events associated with it, including 30-day mortality. A total of 750 patients were identified with food bolus impaction from 2007 to 2012. Glucagon was administered in 440 patients and was successful in 174 (39.5%). Endoscopic removal was performed in 470 patients and was successful in 469 (99.8%). The push technique was utilized in 209 patients, reduction in the bolus size by piecemeal removal followed by the push technique was utilized in 97 patients, and the pull technique was utilized in 107 patients. There were no perforations with endoscopic removal. Only 4.5% of the X-rays performed reported a possible foreign body within the esophagus. Glucagon was a significantly less-expensive strategy than endoscopic therapy (p < 0.0001). Glucagon is low cost, is moderately effective, and may be considered as an initial strategy. Endoscopic removal regardless of technique is safe and effective. The yield of radiography is poor in the setting of food bolus impaction.

Safety and effectiveness of biphasic insulin aspart 30 in people with type 2 diabetes switching from basal-bolus insulin regimens in the A1chieve study.

PubMed

Dieuzeide, Guillermo; Chuang, Lee-Ming; Almaghamsi, Abdulrahman; Zilov, Alexey; Chen, Jian-Wen; Lavalle-González, Fernando J

2014-07-01

Biphasic insulin aspart 30 allows fewer daily injections versus basal-bolus insulin regimens, which may improve adherence and treatment outcome. This sub-analysis of the observational A1chieve study assessed clinical safety and effectiveness of biphasic insulin aspart 30 in people with type 2 diabetes previously receiving basal-bolus insulin regimens. A1chieve was an international, open-label, 24-week study in people with type 2 diabetes starting/switching to biphasic insulin aspart 30, insulin detemir or insulin aspart. This sub-analysis assessed patients switching from insulin glargine- or neutral protamine Hagedorn insulin-based basal-bolus insulin regimens to biphasic insulin aspart 30. 1024 patients were included. At 24 weeks, glycated haemoglobin and fasting plasma glucose were significantly reduced from baseline in both cohorts (all p<0.001). The proportion reporting any hypoglycaemia, major hypoglycaemia or nocturnal hypoglycaemia was significantly reduced after 24 weeks (all p<0.05). No serious adverse drug reactions were reported. Both cohorts had significantly improved health-related quality of life (HRQoL; p<0.001). 24 weeks after switching from basal-bolus insulin regimens to biphasic insulin aspart 30, glycaemic control and HRQoL were significantly improved, and hypoglycaemia was significantly reduced. This suggests that people with type 2 diabetes inadequately controlled on basal-bolus insulin regimens can consider biphasic insulin aspart 30. Copyright © 2013 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.

Biosynthesis, targeting, and processing of lysosomal proteins: pulse-chase labeling and immune precipitation.

PubMed

Pohl, Sandra; Hasilik, Andrej

2015-01-01

Incorporation of radioactive precursors of amino acids and/or modifier groups into proteins, isolation and sizing of polypeptide species of interest, and finally their detection and characterization provide a robust handle to examine the life cycle and varied modifications of any protein. A prerequisite in application of these techniques to lysosomal enzymes is the availability of an avid and specific antibody, because lysosomal proteins represent a very minor fraction of the cellular protein and must be purified without a significant loss many 1000-fold as conveniently as possible. Pulse-chase labeling and good knowledge on organelle-specific modifications of lysosomal proteins may enhance the information that can be obtained from such experiments. We describe procedures for pulse-chase labeling experiments that have proven to work with a commercially available antibody against a mouse and a human lysosomal protease and can be used as a reference in establishing the technique in any laboratory that has an access to a certified isotope facility and the knowledge to handle radioactivity safely. We discuss the crucial steps and refer to alternatives described in the literature. The present model protein cathepsin Z is synthesized as a larger proenzyme that contains two N-linked oligosaccharides and matures to a shorter single chain enzyme retaining the processed oligosaccharides. A pulse-chase experiment demonstrates the conversion of the precursor into the mature form. In addition, results on deglycosylation of metabolically labeled cathepsin Z are shown and the alterations in the apparent size of the glycopeptides are explained. Copyright © 2015 Elsevier Inc. All rights reserved.

Duration of effects of acute environmental changes on food anticipatory behaviour, feed intake, oxygen consumption, and cortisol release in Atlantic salmon parr.

PubMed

Folkedal, Ole; Torgersen, Thomas; Olsen, Rolf Erik; Fernö, Anders; Nilsson, Jonatan; Oppedal, Frode; Stien, Lars H; Kristiansen, Tore S

2012-01-18

We compared behavioural and physiological responses and recovery time after different acute environmental challenges in groups of salmon parr. The fish were prior to the study conditioned to a flashing light signalling arrival of food 30 s later to study if the strength of Pavlovian conditioned food anticipatory behaviour can be used to assess how salmon parr cope with various challenges. The effect on anticipatory behaviour was compared to the effect on feed intake and physiological responses of oxygen hyper-consumption and cortisol excretion. The challenges were temperature fluctuation (6.5C° over 4 h), hyperoxia (up to 380% O(2) saturation over 4 h), and intense chasing for 10 min. Cortisol excretion was only elevated after hyperoxia and chasing, and returned to baseline levels after around 3 h or less. Oxygen hyper-consumption persisted for even shorter periods. Feed intake was reduced the first feeding after all challenges and recovered within 3 h after temperature and hyperoxia, but was reduced for days after chasing. Food anticipatory behaviour was reduced for a longer period than feed intake after hyperoxia and was low at least 6 h after chasing. Our findings suggest that a recovery of challenged Atlantic salmon parr to baseline levels of cortisol excretion and oxygen consumption does not mean full recovery of all psychological and physiological effects of environmental challenges, and emphasise the need for measuring several factors including behavioural parameters when assessing fish welfare. Copyright © 2011 Elsevier Inc. All rights reserved.

Measure Guideline: Summary of Interior Ducts in New Construction, Including an Efficient, Affordable Method to Install Fur-Down Interior Ducts

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

Beal, D.; McIlvaine , J.; Fonorow, K.

2011-11-01

This document illustrates guidelines for the efficient installation of interior duct systems in new housing, including the fur-up chase method, the fur-down chase method, and interior ducts positioned in sealed attics or sealed crawl spaces. This document illustrates guidelines for the efficient installation of interior duct systems in new housing. Interior ducts result from bringing the duct work inside a home's thermal and air barrier. Architects, designers, builders, and new home buyers should thoroughly investigate any opportunity for energy savings that is as easy to implement during construction, such as the opportunity to construct interior duct work. In addition tomore » enhanced energy efficiency, interior ductwork results in other important advantages, such as improved indoor air quality, increased system durability and increased homeowner comfort. While the advantages of well-designed and constructed interior duct systems are recognized, the implementation of this approach has not gained a significant market acceptance. This guideline describes a variety of methods to create interior ducts including the fur-up chase method, the fur-down chase method, and interior ducts positioned in sealed attics or sealed crawl spaces. As communication of the intent of an interior duct system, and collaboration on its construction are paramount to success, this guideline details the critical design, planning, construction, inspection, and verification steps that must be taken. Involved in this process are individuals from the design team; sales/marketing team; and mechanical, insulation, plumbing, electrical, framing, drywall and solar contractors.« less

Quantitative measurement of regional blood flow with gadolinium diethylenetriaminepentaacetate bolus track NMR imaging in cerebral infarcts in rats: validation with the iodo[14C]antipyrine technique.

PubMed Central

Wittlich, F; Kohno, K; Mies, G; Norris, D G; Hoehn-Berlage, M

1995-01-01

NMR bolus track measurements were correlated with autoradiographically determined regional cerebral blood flow (rCBF). The NMR method is based on bolus infusion of the contrast agent gadolinium diethylenetriaminepentaacetate and high-speed T*2-sensitive NMR imaging. The first pass of the contrast agent through the image plane causes a transient decrease of the signal intensity. This time course of the signal intensity is transformed into relative concentrations of the contrast agent in each pixel. The mean transit time and relative blood flow and volume are calculated from such indicator dilution curves. We investigated whether this NMR technique correctly expresses the relative rCBF. The relative blood flow data, calculated from NMR bolus track experiments, and the absolute values of iodo[14C]antipyrine autoradiography were compared. A linear relationship was observed, indicating the proportionality of the transient NMR signal change with CBF. Excellent interindividual reproducibility of calibration constants is observed (r = 0.963). For a given NMR protocol, bolus track measurements calibrated with autoradiography after the experiment allow determination of absolute values for rCBF and regional blood volume. Images Fig. 2 Fig. 3 PMID:7892189

A fully resolved fluid-structure-muscle-activation model for esophageal transport

NASA Astrophysics Data System (ADS)

Kou, Wenjun; Bhalla, Amneet P. S.; Griffith, Boyce E.; Johnson, Mark; Patankar, Neelesh A.

2013-11-01

Esophageal transport is a mechanical and physiological process that transfers the ingested food bolus from the pharynx to the stomach through a multi-layered esophageal tube. The process involves interactions between the bolus, esophageal wall composed of mucosal, circular muscle (CM) and longitudinal muscle (LM) layers, and neurally coordinated muscle activation including CM contraction and LM shortening. In this work, we present a 3D fully-resolved model of esophageal transport based on the immersed boundary method. The model describes the bolus as a Newtonian fluid, the esophageal wall as a multi-layered elastic tube represented by springs and beams, and the muscle activation as a traveling wave of sequential actuation/relaxation of muscle fibers, represented by springs with dynamic rest lengths. Results on intraluminal pressure profile and bolus shape will be shown, which are qualitatively consistent with experimental observations. Effects of activating CM contraction only, LM shortening only or both, for the bolus transport, are studied. A comparison among them can help to identify the role of each type of muscle activation. The support of grant R01 DK56033 and R01 DK079902 from NIH is gratefully acknowledged.

Artificial selection for food colour preferences.

PubMed

Cole, Gemma L; Endler, John A

2015-04-07

Colour is an important factor in food detection and acquisition by animals using visually based foraging. Colour can be used to identify the suitability of a food source or improve the efficiency of food detection, and can even be linked to mate choice. Food colour preferences are known to exist, but whether these preferences are heritable and how these preferences evolve is unknown. Using the freshwater fish Poecilia reticulata, we artificially selected for chase behaviour towards two different-coloured moving stimuli: red and blue spots. A response to selection was only seen for chase behaviours towards the red, with realized heritabilities ranging from 0.25 to 0.30. Despite intense selection, no significant chase response was recorded for the blue-selected lines. This lack of response may be due to the motion-detection mechanism in the guppy visual system and may have novel implications for the evolvability of responses to colour-related signals. The behavioural response to several colours after five generations of selection suggests that the colour opponency system of the fish may regulate the response to selection. © 2015 The Author(s) Published by the Royal Society. All rights reserved.

Geology and hydrogeology of Naval Air Station Chase Field and Naval Auxiliary Landing Field Goliad, Bee and Goliad counties, Texas

USGS Publications Warehouse

Snyder, G.L.

1995-01-01

Large vertical hydraulic-head gradients are present between the unconfined Evangeline aquifer and confined Fleming aquifers at Naval Air Station Chase Field and Naval Auxiliary Landing Field Goliad. These gradients, together with the results of the aquifer test at Naval Air Station Chase Field and assumed characteristics of the confining units, indicate that downward flow of ground water probably occurs from the water-table aquifer to the underlying aquifers. The rate of downward flow between the two confined Fleming aquifers (from A-sand to B-sand) can be approximated using an estimate of vertical hydraulic conductivity of the intervening confining unit obtained from assumed storage characteristics and data from the aquifer test. Under the relatively high vertical hydraulic-head gradient induced by the aquifer test, ground-water movement from the A-sand aquifer to the B-sand aquifer could require about 490 years; and about 730 years under the natural gradient. Future increases in ground-water withdrawals from the B-sand aquifer might increase downward flow in the aquifer system of the study area.

Magnetic state selected by magnetic dipole interaction in the kagome antiferromagnet NaBa2Mn3F11

NASA Astrophysics Data System (ADS)

Hayashida, Shohei; Ishikawa, Hajime; Okamoto, Yoshihiko; Okubo, Tsuyoshi; Hiroi, Zenji; Avdeev, Maxim; Manuel, Pascal; Hagihala, Masato; Soda, Minoru; Masuda, Takatsugu

2018-02-01

We haved studied the ground state of the classical kagome antiferromagnet NaBa2Mn3F11 . Strong magnetic Bragg peaks observed for d spacings shorter than 6.0 Å were indexed by the propagation vector of k0=(0 ,0 ,0 ) . Additional peaks with weak intensities in the d -spacing range above 8.0 Å were indexed by the incommensurate vector of k1=[0.3209 (2 ) ,0.3209 (2 ) ,0 ] and k2=[0.3338 (4 ) ,0.3338 (4 ) ,0 ] . Magnetic structure analysis unveils a 120∘ structure with the tail-chase geometry having k0 modulated by the incommensurate vector. A classical calculation of the Heisenberg kagome antiferromagnet with antiferromagnetic second-neighbor interaction, for which the ground state a k0120∘ degenerated structure, reveals that the magnetic dipole-dipole (MDD) interaction including up to the fourth neighbor terms selects the tail-chase structure. The observed modulation of the tail-chase structure is attributed to a small perturbation such as the long-range MDD interaction or the interlayer interaction.

Artificial selection for food colour preferences

PubMed Central

Cole, Gemma L.; Endler, John A.

2015-01-01

Colour is an important factor in food detection and acquisition by animals using visually based foraging. Colour can be used to identify the suitability of a food source or improve the efficiency of food detection, and can even be linked to mate choice. Food colour preferences are known to exist, but whether these preferences are heritable and how these preferences evolve is unknown. Using the freshwater fish Poecilia reticulata, we artificially selected for chase behaviour towards two different-coloured moving stimuli: red and blue spots. A response to selection was only seen for chase behaviours towards the red, with realized heritabilities ranging from 0.25 to 0.30. Despite intense selection, no significant chase response was recorded for the blue-selected lines. This lack of response may be due to the motion-detection mechanism in the guppy visual system and may have novel implications for the evolvability of responses to colour-related signals. The behavioural response to several colours after five generations of selection suggests that the colour opponency system of the fish may regulate the response to selection. PMID:25740894

Coevolution in management fashion: an agent-based model of consultant-driven innovation.

PubMed

Strang, David; David, Robert J; Akhlaghpour, Saeed

2014-07-01

The rise of management consultancy has been accompanied by increasingly marked faddish cycles in management techniques, but the mechanisms that underlie this relationship are not well understood. The authors develop a simple agent-based framework that models innovation adoption and abandonment on both the supply and demand sides. In opposition to conceptions of consultants as rhetorical wizards who engineer waves of management fashion, firms and consultants are treated as boundedly rational actors who chase the secrets of success by mimicking their highest-performing peers. Computational experiments demonstrate that consultant-driven versions of this dynamic in which the outcomes of firms are strongly conditioned by their choice of consultant are robustly faddish. The invasion of boom markets by low-quality consultants undercuts popular innovations while simultaneously restarting the fashion cycle by prompting the flight of high-quality consultants into less densely occupied niches. Computational experiments also indicate conditions involving consultant mobility, aspiration levels, mimic probabilities, and client-provider matching that attenuate faddishness.

Plastic ingestion by Black-footed Albatross Phoebastria nigripes from Kure Atoll, Hawai'i: Linking chick diet remains and parental at-sea foraging distributions

USGS Publications Warehouse

Hyrenbach, K. David; Hester, Michelle M.; Adams, Josh; Titmus, Andrew J.; Michael, Pam; Wahl, Travis; Chang, Chih-Wei; Marie, Amarisa; Vanderlip, Cynthia

2017-01-01

We quantified the incidence (percentage of samples with plastic) and loads (mass, volume) of four plastic types (fragments, line, sheet, foam) ingested by Black-footed Albatross Phoebastria nigripes chicks raised on Kure Atoll, the westernmost Hawaiian colony. All 25 samples contained plastic, mostly in the form of foam and line. On average (± SD), boluses and stomachs contained 28.2 ± 14.3 g and 40.3 ± 29.0 g of plastic, respectively. Plastic was the dominant indigestible material in the boluses and the stomach samples, accounting for 48.8%-89.7% of the bolus mass (mean 67.4 ± 12.1%, median 67.5%, n = 20), and for 18.2%-94.1% of the stomach content mass (mean 70.0 ± 30.3%, median 75.6%, n = 5). Although the ingested plastic fragments ranged widely in size, most (92% in boluses, 91% in stomachs) were mesoplastics (5-25 mm), followed by macroplastics (>25 mm; 7% in boluses, 6% in stomachs), and microplastics (1-5 mm; 1% in boluses, 4% in stomachs). Yet the two fragment size distributions were significantly different, with more small-sized items (3-8 mm) in stomachs and with more large-sized items (46-72 mm) in boluses. To investigate where albatross parents collect this material, we tracked seven provisioning adults during 14 foraging trips using satellite-linked transmitters. The tracked birds foraged west of Kure Atoll (180–150°E, 30-40°N) and spent most of their time over pelagic waters (>2000 m deep; averaging 89 ± 9%), with substantial time over seamounts (averaging 11 ± 7%). Together, these results indicate that Black-footed Albatross chicks at Kure Atoll ingest plastics sourced by their parents foraging in waters of the western North Pacific. Provisioning adults forage within an area of surface convergence, downstream from the Kuroshio Current, and frequently visit seamounts northwest of the Hawaiian archipelago.

An in vitro evaluation of the pressure generated during programmed intermittent epidural bolus injection at varying infusion delivery speeds.

PubMed

Klumpner, Thomas T; Lange, Elizabeth M S; Ahmed, Heena S; Fitzgerald, Paul C; Wong, Cynthia A; Toledo, Paloma

2016-11-01

Programmed intermittent bolus injection of epidural anesthetic solution results in decreased anesthetic consumption and better patient satisfaction compared with continuous infusion, presumably by better spread of the anesthetic solution in the epidural space. It is not known whether the delivery speed of the bolus injection influences analgesia outcomes. The objective of this in vitro study was to determine the pressure generated by a programmed intermittent bolus pump at 4 infusion delivery speeds through open-ended, single-orifice and closed-end, multiorifice epidural catheters. In vitro observational study. Not applicable. Not applicable. A CADD-Solis Pain Management System v3.0 with Programmed Intermittent Bolus Model 2110 was connected via a 3-way adapter to an epidural catheter and a digital pressure transducer. Pressures generated by delivery speeds of 100, 175, 300, and 400 mL/h of saline solution were tested with 4 epidural catheters (2 single orifice and 2 multiorifice). These runs were replicated on 5 pumps. Analysis of variance was used to compare the mean peak pressures of each delivery speed within each catheter group (single orifice and multiorifice). Thirty runs at each delivery speed were performed with each type of catheter for a total of 240 experimental runs. Peak pressure increased with increasing delivery speeds in both catheter groups (P<.001). Peak pressures were higher with the multiorifice catheter compared with the single-orifice catheter at all delivery speeds (P<.001, for all). Using a pump designed for programmed intermittent infusion boluses, the delivery speed of saline solution through epidural catheters was directly related to the peak pressures. Future work should evaluate whether differences in the delivery speed of anesthetic solution into the epidural space correlate with differences in the duration and quality of analgesia during programmed intermittent epidural bolus delivery. Copyright © 2016 Elsevier Inc. All rights reserved.

Plastic consumption and diet of Glaucous-winged Gulls (Larus glaucescens).

PubMed

Lindborg, Valerie A; Ledbetter, Julia F; Walat, Jean M; Moffett, Cinamon

2012-11-01

We analyzed dietary habits and presence of plastic in 589 boluses of Glaucous-winged Gulls (Larus glaucescens) as one of two studies on the impact of plastics on marine life in the US Salish Sea. Volunteers dissected boluses collected (2007-2010) from Protection Island, Washington. Components were separated into 23 food and non-food categories. Plastic was found in 12.2% of boluses, with plastic film being the most common plastic form. No diet specialization was observed. Vegetation was the most abundant component, found in 91.3% of boluses. No relationship was observed between any dietary items and occurrence or type of plastic found. Load and potential ecological impact in the marine environment can be expected to increase concurrently with increasing plastic use and number and variety of plastic sources. Future studies are necessary to understand the impacts of plastic ingestion on this species. Copyright © 2012 Elsevier Ltd. All rights reserved.

Orbiter "Enterprise" rides "piggy-back" atop NASA 747 carrier

NASA Image and Video Library

1977-09-23

S77-28649 (23 Sept 1977) --- The shuttle Orbiter 101 "Enterprise" sits atop the NASA 747 carrier aircraft in a piggy-back configuration prior to separation for the third free flight of the Shuttle Approach and Landing Tests (ALT) conducted on September 23, 1977, at the Dryden Flight Research Center (DFRC) in Southern California. The crew of the "enterprise" consisted of astronauts Fred W. Haise Jr., commander, and C. Gordon Fullerton, pilot. This photo was shot from one of the T-38 chase planes accompanying the ALT craft. Three other T-38 chase planes are pictured.

A fully resolved active musculo-mechanical model for esophageal transport

NASA Astrophysics Data System (ADS)

Kou, Wenjun; Bhalla, Amneet Pal Singh; Griffith, Boyce E.; Pandolfino, John E.; Kahrilas, Peter J.; Patankar, Neelesh A.

2015-10-01

Esophageal transport is a physiological process that mechanically transports an ingested food bolus from the pharynx to the stomach via the esophagus, a multi-layered muscular tube. This process involves interactions between the bolus, the esophagus, and the neurally coordinated activation of the esophageal muscles. In this work, we use an immersed boundary (IB) approach to simulate peristaltic transport in the esophagus. The bolus is treated as a viscous fluid that is actively transported by the muscular esophagus, and the esophagus is modeled as an actively contracting, fiber-reinforced tube. Before considering the full model of the esophagus, however, we first consider a standard benchmark problem of flow past a cylinder. Next a simplified version of our model is verified by comparison to an analytic solution to the tube dilation problem. Finally, three different complex models of the multi-layered esophagus, which differ in their activation patterns and the layouts of the mucosal layers, are extensively tested. To our knowledge, these simulations are the first of their kind to incorporate the bolus, the multi-layered esophagus tube, and muscle activation into an integrated model. Consistent with experimental observations, our simulations capture the pressure peak generated by the muscle activation pulse that travels along the bolus tail. These fully resolved simulations provide new insights into roles of the mucosal layers during bolus transport. In addition, the information on pressure and the kinematics of the esophageal wall resulting from the coordination of muscle activation is provided, which may help relate clinical data from manometry and ultrasound images to the underlying esophageal motor function.

A fully resolved active musculo-mechanical model for esophageal transport

PubMed Central

Kou, Wenjun; Bhalla, Amneet Pal Singh; Griffith, Boyce E.; Pandolfino, John E.; Kahrilas, Peter J.; Patankar, Neelesh A.

2015-01-01

Esophageal transport is a physiological process that mechanically transports an ingested food bolus from the pharynx to the stomach via the esophagus, a multilayered muscular tube. This process involves interactions between the bolus, the esophagus, and the neurally coordinated activation of the esophageal muscles. In this work, we use an immersed boundary (IB) approach to simulate peristaltic transport in the esophagus. The bolus is treated as a viscous fluid that is actively transported by the muscular esophagus, and the esophagus is modeled as an actively contracting, fiber-reinforced tube. Before considering the full model of the esophagus, however, we first consider a standard benchmark problem of flow past a cylinder. Next a simplified version of our model is verified by comparison to an analytic solution to the tube dilation problem. Finally, three different complex models of the multi-layered esophagus, which differ in their activation patterns and the layouts of the mucosal layers, are extensively tested. To our knowledge, these simulations are the first of their kind to incorporate the bolus, the multi-layered esophagus tube, and muscle activation into an integrated model. Consistent with experimental observations, our simulations capture the pressure peak generated by the muscle activation pulse that travels along the bolus tail. These fully resolved simulations provide new insights into roles of the mucosal layers during bolus transport. In addition, the information on pressure and the kinematics of the esophageal wall resulting from the coordination of muscle activation is provided, which may help relate clinical data from manometry and ultrasound images to the underlying esophageal motor function. PMID:26190859

Intrathecal chemotherapy for refractory disseminated medulloblastoma.

PubMed

Yoshimura, Junichi; Nishiyama, Kenichi; Mori, Hiroshi; Takahashi, Hideaki; Fujii, Yukihiko

2008-05-01

To analyze the effect of intrathecal (IT) chemotherapy for disseminated medulloblastoma. Twenty-one patients received IT chemotherapy using the chemotherapeutic agents of methotrexate (MTX) and nitrosoureas (ACNU, MCNU) including nine patients for residual leptomeningeal lesions after initial surgery and radiation, and 12 for a recurrence with leptomeningeal dissemination. Of these 21 patients, 12 received a lumbar and/or ventricular bolus injection of the chemotherapeutic agents, one received the ventriculolumbar perfusion of the agents, and eight received both the perfusion and bolus injection. The doses ranged from 6-7 mg/m(2) of ACNU for perfusion and 3-3.5 mg/m(2) of ACNU, MCNU, or MTX for the bolus injection, and the cycles were administered from 3 to 12 times for perfusion and from 5 to 54 times for the bolus injection. The effects of chemotherapy were assessed by both radiological and cytological examinations, and the clinical symptoms were also assessed. Radiological and/or cytological responses were observed in 10 of 21 patients (47.6%), including seven cases demonstrating a complete remission. The 5-year overall survival rate and 5-year survival rate after dissemination were 61.5 and 46.4%, respectively. Five patients who received a lumbar bolus injection of nitrosoureas experienced paraplegia and double incontinence. One patient who received a ventricular injection of nitrosoureas experienced truncal ataxia. IT chemotherapy was found to be effective in some cases with refractory disseminated medulloblastoma and it seems to be an appropriate treatment choice for leptomeningeal recurrence. However, the frequent bolus injections of nitrosoureas should be avoided to prevent the side effects.

Poster - 38: On the physical and dosimetric properties of 3D printed electron bolus fabricated using polylactic acid

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

Sasaki, David; Jensen, Martin; Rickey, Daniel W

Purpose: 3D printing technology could simplify and improve electron bolus fabrication. The purpose of this study was to characterize the density, dimensional accuracy, uniformity, and attenuation of PLA boluses fabricated with a low-cost 3D printer. Methods: Several solid square slabs were printed with specific requested dimensions and 100% infill using different fill patterns. These pieces were imaged using an x-ray flat panel imager in order to check for uniformity of the prints. Percentage depth doses (PDDs) were measured downstream of the slabs in solid water using a parallel plate chamber and compared to measurements in water in order to characterizemore » attenuation. The dimensions of the PLA slabs were measured using digital calipers. The slabs were also weighed to find their density. Results: The fill pattern used to create boluses can affect the attenuation of the bolus. Fill patterns should be chosen carefully and quality assurance should be done for each printed piece. PLA causes the electron PDD to shift towards shallower depths, compared to water, by 1.7 mm for each centimeter of PLA. Agreement with design dimensions was within 1 mm in the plane of the printer bed, and within 1/3 of a millimeter (roughly the thickness of a single layer), perpendicular to the printer bed. Average density was in the range 1.20 – 1.22. Conclusions: 3D printing shows great promise for use in fabricating electron bolus. This work indicates that printed PLA can be a suitable material provided the increased attenuation is properly accounted for.« less

The value of oropharyngoesophageal scintigraphy in the management of aspiration into the tracheobronchial tree in neurological patients.

PubMed

Grosso, M; Fattori, B; Volterrani, D; Chondrogiannis, S; Boni, G; Nacci, A; Marzola, M C; Rubello, D

2015-01-01

Dysphagia and bolus aspiration are two of the most frequent and invalidating symptoms of various neurological diseases. Swallowing disorders often lead to tracheobronchial aspiration with consequent pneumonia episodes. Aspiration pneumonia per se constitutes the most frequent cause of death in these patients, with mortality rate ranging from 20% to 62%. Oropharyngoesophageal scintigraphy (OPES) permits functional quantitative assessment of the different stages of swallowing, together with the detection and quantitative measurement of bolus aspiration. In this work, we analyzed the role of OPES in patients with different neurological conditions to evaluate swallowing and to detect and quantify bolus aspiration. We enrolled 43 neurological patients (25 women and 18 men, mean age 67.3±12.4 yr) complaining of dysphagia with suspected inhalation. All patients underwent OPES with (99m)Tc-nanocolloid using a liquid bolus first, followed by a semi-solid bolus. We evaluated the following parameters: Oral, Pharyngeal and Esophageal Transit Time, Oro-Pharyngeal Retention Index, Esophageal Emptying Rate, and Aspiration Rate (% AR). OPES detected some airway aspiration in 26/43 patients. 19 patients had tracheal aspiration (with a mean 18.1% AR) and the remaining 7 patients had bilateral broncho-pulmonary aspiration (mean 44.9% AR). OPES is a feasible, repeatable and noninvasive method that allows quantitative assessment of bolus aspiration into the tracheobronchial tract, thus representing a useful and accurate tool to guide the most appropriate treatment and to monitor response to therapy in neurological patients with dysphagia. Copyright © 2015 Elsevier España, S.L.U. and SEMNIM. All rights reserved.

Comparison of visual and electronic devices for individual identification of dromedary camels under different farming conditions.

PubMed

Caja, G; Díaz-Medina, E; Salama, A A K; Salama, O A E; El-Shafie, M H; El-Metwaly, H A; Ayadi, M; Aljumaah, R S; Alshaikh, M A; Yahyahoui, M H; Seddik, M M; Hammadi, M; Khorchani, T; Amann, O; Cabrera, S

2016-08-01

The camel industry uses traditional (i.e., iron brands and ear tags) and modern (i.e., microchips) identification (ID) systems without having performance results of reference. Previously iron-branded ( = 45; 1 yr) and microchipped ( = 59; 7 yr) camels showed problems of healing (8.6% of brands) and reading (only 42.9% of brands and 69.5% of microchips were readable), which made their use inadvisable. With the aim of proposing suitable ID systems for different farming conditions, an on-field study was performed using a total of 528 dromedaries at 4 different locations (Egypt, = 83; Spain, = 304; Saudi Arabia, = 90; and Tunisia, = 51). The ID devices tested were visual (button ear tags, 28.5 mm diameter, = 178; double flag ear tags, 50 by 15 mm, = 83; both made of polyurethane) and electronic (ear tags, = 90, and rumen boluses, = 555). Electronic ear tags were polyurethane-loop type (75 by 9 mm) with a container in which a 22-mm transponder of full-duplex technology was lodged. Electronic boluses of 7 types, varying in dimensions (50 to 76 mm length, 11 to 21 mm width, and 12.7 to 82.1 g weight) and specific gravity (SG; 1.49 to 3.86) and each of them containing a 31-mm transponder of half-duplex technology, were all administered to the dromedaries at the beginning of the study. When a low-SG bolus was lost, a high-SG bolus was readministered. Readability rates of each ID system were evaluated during 1 to 3 yr, according to device and location, and yearly values were estimated for comparison. On a yearly basis, visual ear tag readability was not fully satisfactory; it was lower for rectangular ear tags (66.3%) than for button ear tags (80.9%). Yearly readability of electronic ear tags was 93.7%. Bolus readability dramatically varied according to their SG; the SG < 2.0 boluses were fully lost after 8 mo. In contrast, the SG > 3.0 boluses were efficiently retained (99.6 to 100%) at all locations. In conclusion, according to the expected long lifespan of camels, low ID performances were observed for iron brands, injectable microchips, and ear tags (visual and electronic), making their use inadvisable as unique ID systems in camels. The high readability of dense electronic boluses recommended their use as a permanent ID device of reference in camels.

When enough is enough: how the decision was made to stop the FEAST trial: data and safety monitoring in an African trial of Fluid Expansion As Supportive Therapy (FEAST) for critically ill children

PubMed Central

2013-01-01

In resource-rich countries, bolus fluid expansion is routinely used for the treatment of poor perfusion and shock, but is less commonly used in many African settings. Controversial results from the recently completed FEAST (Fluid Expansion As Supportive Therapy) trial in African children have raised questions about the use of intravenous bolus fluid for the treatment of shock. Prior to the start of the trial, the Independent data monitoring committee (IDMC) developed stopping rules for the proof of benefit that bolus fluid resuscitation would bring. Although careful safety monitoring was put in place, there was less expectation that bolus fluid expansion would be harmful and differential stopping rules for harm were not formulated. In July 2010, two protocol amendments were agreed to increase the sample size from 2,880 to 3,600 children, and to increase bolus fluid administration. There was a non-significant trend against bolus treatment, but although the implications were discussed, the IDMC did not comment on the results, or on the amendments, in order to avoid inadvertent partial unblinding of the study. In January 2011, the trial was stopped for futility, as the combined intervention arms had significantly higher mortality (relative risk 1.46, 95% CI 1.13 to 1.90, P = 0.004) than the control arm. The stopping rule for proof of benefit was not achieved, and the IDMC stopped the trial with a lower level of significance (P = 0.01) due to futility and an increased risk of mortality from bolus fluid expansion in children enrolled in the trial. The basis for this decision was that the local standard of care was not to use bolus fluid for the care of children with shock in these African countries, and this was a different standard of care to that used in the UK. These decisions emphasize two important principles: firstly, the IDMC should avoid inadvertent unblinding of the trial by commenting on amendments, and secondly, when considering stopping a trial, the IDMC should be guided by the local standard of care rather than standards of care in other parts of the world. PMID:23531379

When enough is enough: how the decision was made to stop the FEAST trial: data and safety monitoring in an African trial of Fluid Expansion As Supportive Therapy (FEAST) for critically ill children.

PubMed

Todd, Jim; Heyderman, Robert S; Musoke, Philippa; Peto, Tim

2013-03-26

In resource-rich countries, bolus fluid expansion is routinely used for the treatment of poor perfusion and shock, but is less commonly used in many African settings. Controversial results from the recently completed FEAST (Fluid Expansion As Supportive Therapy) trial in African children have raised questions about the use of intravenous bolus fluid for the treatment of shock. Prior to the start of the trial, the Independent data monitoring committee (IDMC) developed stopping rules for the proof of benefit that bolus fluid resuscitation would bring. Although careful safety monitoring was put in place, there was less expectation that bolus fluid expansion would be harmful and differential stopping rules for harm were not formulated.In July 2010, two protocol amendments were agreed to increase the sample size from 2,880 to 3,600 children, and to increase bolus fluid administration. There was a non-significant trend against bolus treatment, but although the implications were discussed, the IDMC did not comment on the results, or on the amendments, in order to avoid inadvertent partial unblinding of the study.In January 2011, the trial was stopped for futility, as the combined intervention arms had significantly higher mortality (relative risk 1.46, 95% CI 1.13 to 1.90, P = 0.004) than the control arm. The stopping rule for proof of benefit was not achieved, and the IDMC stopped the trial with a lower level of significance (P = 0.01) due to futility and an increased risk of mortality from bolus fluid expansion in children enrolled in the trial. The basis for this decision was that the local standard of care was not to use bolus fluid for the care of children with shock in these African countries, and this was a different standard of care to that used in the UK. These decisions emphasize two important principles: firstly, the IDMC should avoid inadvertent unblinding of the trial by commenting on amendments, and secondly, when considering stopping a trial, the IDMC should be guided by the local standard of care rather than standards of care in other parts of the world.

Use of cornmeal bolus as an aid in obtaining cranial four-vessel angiograms.

PubMed

Weathers, R M; Lee, A

1975-01-01

In cranial angiography it has always been difficult to visualize extracranial vessels of the cervico-thoracic region, upon one radiograph, by using the same exposure factors for both regions. For this reason, we experimented and found that by applying a dry cornmeal bolus on specific areas of the neck a technically superior radiograph of these regions can be achieved. This bolus simulated added soft tissue to the cervical region. The density of the cervical region is now similar to that of the upper thoracic. As a result, factors set for one exposure will adequately penetrate both areas.

Effect of programmed intermittent epidural boluses and continuous epidural infusion on labor analgesia and obstetric outcomes: a randomized controlled trial.

PubMed

Ferrer, Leopoldo E; Romero, David J; Vásquez, Oscar I; Matute, Ednna C; Van de Velde, Marc

2017-11-01

Continuous epidural infusion and programmed intermittent epidural boluses are analgesic techniques routinely used for pain relief in laboring women. We aimed to assess both techniques and compare them with respect to labor analgesia and obstetric outcomes. After Institutional Review Board approval, 132 laboring women aged between 18 and 45 years were randomized to epidural analgesia of 10 mL of a mixture of 0.1% bupivacaine plus 2 µg/mL of fentanyl either by programmed intermittent boluses or continuous infusion (66 per group). Primary outcome was quality of analgesia. Secondary outcomes were duration of labor, total drug dose used, maternal satisfaction, sensory level, motor block level, presence of unilateral motor block, hemodynamics, side effects, mode of delivery, and newborn outcome. Patients in the programmed intermittent epidural boluses group received statistically less drug dose than those with continuous epidural infusion (24.9 vs 34.4 mL bupivacaine; P = 0.01). There was no difference between groups regarding pain control, characteristics of block, hemodynamics, side effects, and Apgar scores. Our study evidenced a lower anesthetic consumption in the programmed intermittent boluses group with similar labor analgesic control, and obstetric and newborn outcomes in both groups.

Oral Samples as Non-Invasive Proxies for Assessing the Composition of the Rumen Microbial Community.

PubMed

Tapio, Ilma; Shingfield, Kevin J; McKain, Nest; Bonin, Aurélie; Fischer, Daniel; Bayat, Ali R; Vilkki, Johanna; Taberlet, Pierre; Snelling, Timothy J; Wallace, R John

2016-01-01

Microbial community analysis was carried out on ruminal digesta obtained directly via rumen fistula and buccal fluid, regurgitated digesta (bolus) and faeces of dairy cattle to assess if non-invasive samples could be used as proxies for ruminal digesta. Samples were collected from five cows receiving grass silage based diets containing no additional lipid or four different lipid supplements in a 5 x 5 Latin square design. Extracted DNA was analysed by qPCR and by sequencing 16S and 18S rRNA genes or the fungal ITS1 amplicons. Faeces contained few protozoa, and bacterial, fungal and archaeal communities were substantially different to ruminal digesta. Buccal and bolus samples gave much more similar profiles to ruminal digesta, although fewer archaea were detected in buccal and bolus samples. Bolus samples overall were most similar to ruminal samples. The differences between both buccal and bolus samples and ruminal digesta were consistent across all treatments. It can be concluded that either proxy sample type could be used as a predictor of the rumen microbial community, thereby enabling more convenient large-scale animal sampling for phenotyping and possible use in future animal breeding programs aimed at selecting cattle with a lower environmental footprint.

Endoscopic Management of Foreign Bodies in the Upper Gastrointestinal Tract of Adults

PubMed Central

Yao, Chih-Chien; Wu, I-Ting; Lu, Lung-Sheng; Lin, Sheng-Chieh; Liang, Chih-Ming; Kuo, Yuan-Hung; Yang, Shih-Cheng; Wu, Cheng-Kun; Wang, Hsing-Ming; Kuo, Chung-Huang; Chiou, Shue-Shian; Wu, Keng-Liang; Chiu, Yi-Chun; Chuah, Seng-Kee; Tai, Wei-Chen

2015-01-01

Background. Foreign object ingestion and food bolus impaction are a common clinical problem. We report our clinical experiences in endoscopic management for adults, foreign body ingestion, and food bolus impaction. Method. A retrospective chart review study was conducted on adult patients with foreign body ingestion and food bolus impaction between January 2011 and November 2014. Patients with incomplete medical records were excluded. Results. A total of 198 patients (226 incidents) were included in the study (male/female: 1.54/1; age 57 ± 16 years). Among them, 168 foreign bodies were found successfully (74.3%). 75.6% of the foreign bodies were located in the esophagus. Food bolus impaction was most common (41.6%). 93.5% of foreign bodies in current study cohort were successfully extracted and 5 patients required surgical interventions. Comparisons between symptomatic and asymptomatic patients revealed that locations of foreign bodies in the pharynx and esophagus were the significant relevant factors (P < 0.001). Shorter time taken to initiate endoscopic interventions increased detection rate (289.75 ± 465.94 versus 471.06 ± 659.93 minutes, P = 0.028). Conclusion. Endoscopic management is a safe and highly effective procedure in extracting foreign body ingestion and food bolus impaction. Prompt endoscopic interventions can increase the chance of successful foreign bodies' detection. PMID:26258140

Endoscopic Management of Foreign Bodies in the Upper Gastrointestinal Tract of Adults.

PubMed

Yao, Chih-Chien; Wu, I-Ting; Lu, Lung-Sheng; Lin, Sheng-Chieh; Liang, Chih-Ming; Kuo, Yuan-Hung; Yang, Shih-Cheng; Wu, Cheng-Kun; Wang, Hsing-Ming; Kuo, Chung-Huang; Chiou, Shue-Shian; Wu, Keng-Liang; Chiu, Yi-Chun; Chuah, Seng-Kee; Tai, Wei-Chen

2015-01-01

Foreign object ingestion and food bolus impaction are a common clinical problem. We report our clinical experiences in endoscopic management for adults, foreign body ingestion, and food bolus impaction. A retrospective chart review study was conducted on adult patients with foreign body ingestion and food bolus impaction between January 2011 and November 2014. Patients with incomplete medical records were excluded. A total of 198 patients (226 incidents) were included in the study (male/female: 1.54/1; age 57 ± 16 years). Among them, 168 foreign bodies were found successfully (74.3%). 75.6% of the foreign bodies were located in the esophagus. Food bolus impaction was most common (41.6%). 93.5% of foreign bodies in current study cohort were successfully extracted and 5 patients required surgical interventions. Comparisons between symptomatic and asymptomatic patients revealed that locations of foreign bodies in the pharynx and esophagus were the significant relevant factors (P < 0.001). Shorter time taken to initiate endoscopic interventions increased detection rate (289.75 ± 465.94 versus 471.06 ± 659.93 minutes, P = 0.028). Endoscopic management is a safe and highly effective procedure in extracting foreign body ingestion and food bolus impaction. Prompt endoscopic interventions can increase the chance of successful foreign bodies' detection.

Oral Samples as Non-Invasive Proxies for Assessing the Composition of the Rumen Microbial Community

PubMed Central

Tapio, Ilma; Shingfield, Kevin J.; McKain, Nest; Bonin, Aurélie; Fischer, Daniel; Bayat, Ali R.; Vilkki, Johanna; Taberlet, Pierre; Snelling, Timothy J.; Wallace, R. John

2016-01-01

Microbial community analysis was carried out on ruminal digesta obtained directly via rumen fistula and buccal fluid, regurgitated digesta (bolus) and faeces of dairy cattle to assess if non-invasive samples could be used as proxies for ruminal digesta. Samples were collected from five cows receiving grass silage based diets containing no additional lipid or four different lipid supplements in a 5 x 5 Latin square design. Extracted DNA was analysed by qPCR and by sequencing 16S and 18S rRNA genes or the fungal ITS1 amplicons. Faeces contained few protozoa, and bacterial, fungal and archaeal communities were substantially different to ruminal digesta. Buccal and bolus samples gave much more similar profiles to ruminal digesta, although fewer archaea were detected in buccal and bolus samples. Bolus samples overall were most similar to ruminal samples. The differences between both buccal and bolus samples and ruminal digesta were consistent across all treatments. It can be concluded that either proxy sample type could be used as a predictor of the rumen microbial community, thereby enabling more convenient large-scale animal sampling for phenotyping and possible use in future animal breeding programs aimed at selecting cattle with a lower environmental footprint. PMID:26986467

Sensory and instrumental analysis for slipperiness and compliance of food during swallowing.

PubMed

Seo, H-S; Hwang, I K; Han, T R; Kim, I S

2007-11-01

In spite of its importance, there have been few attempts to evaluate the sensory attributes of the food bolus during swallowing. In the current study, the slipperiness, the degree of slide for the food bolus through the mucosal surface of the oro-pharynx, and the compliance, how easily the shape of a food bolus can be transformed for automatic and comfortable swallowing, were derived among several sensory attributes related to the swallowing. Therefore, the study aims were twofold: (1) to develop the methods of sensory and instrumental analyses for determining the slipperiness and compliance of the food bolus during swallowing and (2) to examine the appropriateness of the newly designed devices by correlating the data between the sensory and instrumental analyses. Six commercial food products were evaluated by 10 trained panelists for each attribute. The devices for assessing each attribute were developed in consideration of the oro-pharyngeal movements. The sensory and instrumental analyses showed high correlation and regression coefficients as well as intensity differences of the 6 samples for each attribute. In conclusion, the slipperiness and the compliance were suitable for acquiring a better understanding of the sensory attributes of the food bolus during swallowing, and the newly developed devices showed a high potential for determining those attributes.

Relationship between stage II transport and number of chewing strokes as mastication progresses.

PubMed

Yamashita, Shuichiro; Sugita, Daisuke; Matsuo, Koichiro

2013-10-02

As mastication progresses, little is known about the occurrence of the stage II transport (oro-pharyngeal bolus transport). This study aimed to investigate the relationship between stage II transport and bolus aggregation in the pharynx and the number of chewing strokes. Twenty-five clinical residents with natural dentitions were recruited. The subjects were asked to chew gummy jelly with their preferred rhythm and to swallow the bolus at their preferred timing. To investigate stage II transport and bolus aggregation in the pharynx, a transnasal endoscope was used. The number of chewing strokes was measured by electromyographic activity from the masseter muscle. The mean numbers of chewing strokes of pre-stage II transport and post-stage II transport were 29.8 and 8.1, respectively; the difference was significant (p<0.01). The ratio of the number of chewing strokes of pre-stage II transport to that of post-stage II transport was 4.0 to 1.0. This study showed that stage II transport started at four-fifths of the way along the progress of mastication, and that stage II transport and bolus aggregation in the pharynx are related to the number of chewing strokes. © 2013. Published by Elsevier Inc. All rights reserved.

Use of a marshmallow bolus for evaluating lower esophageal mucosal rings.

PubMed

Ott, D J; Kelley, T F; Chen, M Y; Gelfand, D W; Wu, W C

1991-07-01

Sixty-three patients (35 women, 28 men; mean age 55 yr) with lower esophageal mucosal ring shown radiographically were examined with a semi-solid bolus consisting of a portion of a standard marshmallow. The most common symptom was dysphagia, present in 46 (73%) patients. Impaction of the marshmallow bolus by the ring occurred in 40 (63%) of the 63 patients, and produced symptoms in 27 (68%) of these 40 patients. Nine (14%) rings were detected radiographically only with a solid bolus; eight of these patients had dysphagia and seven rings were 20 mm or less in caliber. Impaction related to ring caliber, and was found in all 17 (100%) rings that were 13 mm or less in diameter, in 17/24 (71%) 14- to 19-mm rings, and in 6/22 (27%) rings 20 mm or more in caliber. Endoscopy in 23 patients detected 16 (70%) rings, and also depended on ring caliber: less than or equal to 13 mm, 6/6 (100%); 14-19 mm, 5/9 (56%); greater than or equal to 20 mm, 5/8 (63%). Marshmallow impaction occurred in 17 (74%) of 23 patients who had endoscopy; three of the 23 patients had normal endoscopy. In conclusion, radiographic examination supplemented by the use of a marshmallow bolus best detects lower esophageal mucosal ring.

Methamphetamine-induced striatal apoptosis in the mouse brain: Comparison of a binge to an acute bolus drug administration

PubMed Central

Zhu, Judy P.Q.; Xu, Wenjing; Angulo, Nieves; Angulo, Jesus A.

2010-01-01

Methamphetamine (METH) is a psychostimulant that induces neural damage in experimental animals and humans. A binge (usually in the 5–10 mg/kg dose range 4× at 2 h intervals) and the acute bolus drug administration (20–40 mg/kg) of METH have been employed frequently to study neurotoxicity in the brain. In this study we have compared these drug delivery schedules to determine their efficacy to induce striatal apoptosis. Exposure of male mice to a binge of METH at 10 mg/kg 4× at 2 h intervals (cumulative dose of 40 mg/kg) was approximately four times less effective in inducing apoptotic cell death (TUNEL staining) 24 h after METH treatment in the striatum than a single bolus administration of 30 mg/kg of METH. The residual TUNEL staining observed three days after METH treatment is proportionately equivalent between a binge and the acute bolus drug administration. Interestingly, a binge of METH induces a hyperthermic response of longer duration. This study demonstrates that an acute bolus drug administration of METH is more effective inducing striatal apoptosis in mice, and therefore, is more suitable for studies assessing the impact of METH on sites post-synaptic to the striatonigral dopamine terminals. PMID:16165214

Energetics and evasion dynamics of large predators and prey: pumas vs. hounds.

PubMed

Bryce, Caleb M; Wilmers, Christopher C; Williams, Terrie M

2017-01-01

Quantification of fine-scale movement, performance, and energetics of hunting by large carnivores is critical for understanding the physiological underpinnings of trophic interactions. This is particularly challenging for wide-ranging terrestrial canid and felid predators, which can each affect ecosystem structure through distinct hunting modes. To compare free-ranging pursuit and escape performance from group-hunting and solitary predators in unprecedented detail, we calibrated and deployed accelerometer-GPS collars during predator-prey chase sequences using packs of hound dogs ( Canis lupus familiaris , 26 kg, n  = 4-5 per chase) pursuing simultaneously instrumented solitary pumas ( Puma concolor , 60 kg, n  = 2). We then reconstructed chase paths, speed and turning angle profiles, and energy demands for hounds and pumas to examine performance and physiological constraints associated with cursorial and cryptic hunting modes, respectively. Interaction dynamics revealed how pumas successfully utilized terrain (e.g., fleeing up steep, wooded hillsides) as well as evasive maneuvers (e.g., jumping into trees, running in figure-8 patterns) to increase their escape distance from the overall faster hounds (avg. 2.3× faster). These adaptive strategies were essential to evasion in light of the mean 1.6× higher mass-specific energetic costs of the chase for pumas compared to hounds (mean: 0.76 vs. 1.29 kJ kg -1  min -1 , respectively). On an instantaneous basis, escapes were more costly for pumas, requiring exercise at ≥90% of predicted [Formula: see text] and consuming as much energy per minute as approximately 5 min of active hunting. Our results demonstrate the marked investment of energy for evasion by a large, solitary carnivore and the advantage of dynamic maneuvers to postpone being overtaken by group-hunting canids.

How do dairy cows chew?--particle size analysis of selected feeds with different particle length distributions and of respective ingested bolus particles.

PubMed

Schadt, I; Ferguson, J D; Azzaro, G; Petriglieri, R; Caccamo, M; Van Soest, P; Licitra, G

2012-08-01

Not only feed but also respective bolus particle size could alter diet efficiency and cow performance. The objective of this project was to characterize particle size of selected feeds and respective swallowed boli. Feed samples included 6 different particle length rye grass hay samples, 1 grass silage, 1 corn silage, and 1 total mixed ration (TMR). Rye grass hay samples consisted of long hay and chopped hay particles retained on the 19- (19_PSPS hay), 8- (8_PSPS hay), and 1.18-mm (1.18_PSPS hay) Penn State Particle Separator (PSPS) screens and those collected on the pan (PSPS_pan hay). A sixth hay treatment was rye grass forage cut at 50-mm lengths and dried to hay (50-mm hay). Treatments were offered to 4 nonlactating and 4 lactating cows following rumen evacuation. Swallowed boli were collected and the number of chews per gram of ingested feed dry matter was determined. Feed and bolus particles of lengths ≥5mm were collected on a 1.6-mm screen using a horizontal wet sieving technique. This cut point was chosen, as the literature suggests that most fecal particles are shorter than 5mm. Dry matter proportions on this screen (PROP_1.6) were determined and particle lengths of retained particles were measured by image analysis. Mean particle lengths (ML) were calculated considering particles ≥5mm in length. Boli of long hay, of 19_PSPS hay, of 8_PSPS hay, and of 50-mm hay had similar ML of 10 to 11mm. Bolus PROP_1.6 were also similar between these treatments, ranging from 0.54 to 0.69. Bolus particle lengths and distributions of these treatments were not related to respective hay particles. Bolus of 1.18_PSPS hay had PROP_1.6 of 0.51 and a smaller ML of 8mm. The PSPS_pan hay had PROP_1.6 of only 0.33, but was still chewed intensely. Apparently, little particle size reduction occurred when cows ate the TMR or the silages. Feed and respective bolus PROP_1.6 were as follows: 0.66 and 0.59 in grass silage, 0.52 and 0.55 in corn silage, and 0.44 and 0.38 in the TMR. Feed and respective bolus ML were as follows: 13.8 and 11.6mm in grass silage, 12.0 and 11.2mm in corn silage, and 13.1 and 12.5mm in the TMR. Rye grass hay particles retained on PSPS screens ≥8mm, with ML of at least 25mm were longer compared with TMR particles, but respective bolus particles were shorter. Bolus particle size is not associated with the size of large feed particles chewed to a constant size that is appropriate for deglutition. This size may be related to feed chemical composition. Copyright © 2012 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Comparative effects of rapid bolus administration of aqueous amiodarone versus 10-minute cordarone I.v. infusion on mean arterial blood pressure in conscious dogs.

PubMed

Somberg, John Charin; Cvetanovic, Ivana; Ranade, Vasant; Molnar, Janos

2004-09-01

This study was designed to test the hypothesis that rapid bolus administration of an aqueous formulation of intravenous amiodarone causes less hypotension than a 10-minute infusion of the standard formulation, Cordarone IV. Hypotension was the most common adverse event reported with Cordarone IV. The hypotension was not dose related, but related to the rate of infusion. Therefore, product labeling calls Cordarone and its generic formulations to be administered over 10 minutes. Cordarone IV contains polysorbate 80 and benzyl alcohol, each causes hypotension. A new aqueous formulation of amiodarone (Amio-Aqueous) does not contain these agents and therefore may cause less hypotension. Six conscious beagle dogs were instrumented with a telemetric device for blood pressure monitoring. The study was conducted on 5 days. On the first 2 days, a 10-min infusion or a bolus of D(5)W was administered (placebo). Over the following 3 days, the dogs received (in randomized order, one per day) a 10-min infusion of 2.5 mg/kg Cordarone IV and boluses of 2.5 mg/kg and 5.0 mg/kg Amio-Aqueous injected over 2 to 5 sec. The dogs were monitored for 2 hrs after dosing. Compared to placebo, boluses of aqueous amiodarone produced no significant changes in the mean arterial blood pressure (MABP). In contrast, Cordarone infusion produced significant decreases in MABP that lasted for at least 2 hrs (p < 0.001). Amio-Aqueous had significantly better hemodynamic profile permitting rapid intravenous administration. This is a significant advantage over the standard formulation, because Cordarone cannot be administered by rapid bolus due to excipient-related hypotension.

Multiple Rapid Swallow Maneuver Enhances the Clinical Utility of High-Resolution Manometry in Patients Showing Ineffective Esophageal Motility

PubMed Central

Min, Yang Won; Shin, Inseub; Son, Hee Jung; Rhee, Poong-Lyul

2015-01-01

Abstract The clinical significance of ineffective esophageal motility (IEM) together with multiple rapid swallow (MRS) has not been yet evaluated in the Chicago Classification v3.0. This study evaluated the adjunctive role of MRS in IEM and determined the criteria of abnormal MRS to maximize the utility of IEM. We analyzed 186 patients showing IEM or normal esophageal motility (NEM), who underwent esophageal high-resolution impedance–manometry for esophageal symptoms. Two different criteria for abnormal MRS were applied to IEM subjects, resulting in 2 corresponding subgroups: IEM-A when distal contractile integral (DCI) ratio between an average wet swallows and MRS contraction was <1 and IEM-B when MRS contraction DCI was <450 mm Hg-s-cm. One IEM subject inadequately performed MRS. Among the remaining 52 IEM subjects, 18 (34.6%) were classified into IEM-A and 23 (44.2%) into IEM-B. IEM subjects showed less complete bolus transit (median 0.0%, interquartile range 0.0–20.0% vs 60.0%, 30.0–80.0; P < 0.001) resulting in higher impaired bolus transit than NEM subjects (98.1% vs 66.9%, P = 0.001). IEM-B subjects showed additionally higher pathologic bolus exposure than NEM subjects (55.6% vs 29.3%, P = 0.001), whereas IEM-A subjects could not. Although IEM-B subjects had the highest prevalence of gastroesophageal reflux disease among the subjects groups, it did not reach statistical significance. In conclusion, IEM patients with abnormal MRS contraction have an increased risk of prolonged bolus clearance, poor bolus transit, and pathologic bolus exposure. IEM patients need to be assessed concerning whether MRS contraction DCI is <450 mm Hg-s-cm to segregate clinically relevant patients. PMID:26448010

Development of the movement of the epiglottis in infant and juvenile pigs

PubMed Central

Crompton, Alfred W.; German, Rebecca Z.; Thexton, Allan J.

2008-01-01

Although backward folding of the epiglottis is one of the signal events of the mammalian adult swallow, the epiglottis does not fold during the infant swallow. How this functional change occurs is unknown, but we hypothesize that a change in swallow mechanism occurs with maturation, prior to weaning. Using videofluoroscopy, we found three characteristic patterns of swallowing movement at different ages in the pig: an infant swallow, a transitional swallow and a post-weaning (juvenile or adult) swallow. In animals of all ages, the dorsal region of the epiglottis and larynx was held in an intranarial position by a muscular sphincter formed by the palatopharyngeal arch. In the infant swallow, increasing pressure in the oropharynx forced a liquid bolus through the piriform recesses on either side of a relatively stationary epiglottis into the esophagus. As the infant matured, the palatopharyngeal arch and the soft palate elevated at the beginning of the swallow, so exposing a larger area of the epiglottis to bolus pressure. In transitional swallows, the epiglottis was tilted backward relatively slowly by a combination of bolus pressure and squeezing of the epiglottis by closure of the palatopharyngeal sphincter. The bolus, however, traveled alongside but never over the tip of the epiglottis. In the juvenile swallow, the bolus always passed over the tip of the epiglottis. The tilting of the epiglottis resulted from several factors, including the action of the palatopharyngeal sphincter, higher bolus pressure exerted on the epiglottis and the allometry of increased size. In both transitional and juvenile swallows, the subsequent relaxation of the palatopharyngeal sphincter released the epiglottis, which sprang back to its original intranarial position. PMID:18387794

Practical approaches to four-dimensional heavy-charged-particle lung therapy.

PubMed

Mori, Shinichiro; Wu, Ziji; Folkert, Michael R; Kumagai, Motoki; Dobashi, Suguru; Sugane, Toshio; Baba, Masayuki

2010-01-01

We have developed new design algorithms for compensating boli to facilitate the implementation of four-dimensional charged-particle lung therapy in clinical applications. Four-dimensional CT (4DCT) data for eight lung cancer patients were acquired with a 16-slice CT under free breathing. Six compensating boli were developed that may be categorized into three classes: (1) boli-based on contoured gross tumor volumes (GTV) from a 4DCT data set during each respiratory phase, subsequently combined into one (GTV-4DCT bolus); (2) boli-based on contoured internal target volume (ITV) from image-processed 3DCT data only [temporal-maximum-intensity-projection (TMIP)/temporal-average-intensity-projection (TAIP)] with calculated boli (ITV-TMIP and ITV-TAIP boli); and (3) boli-based on contoured ITV utilizing image-processed 3DCT data, applied to 4DCT for design of boli for each phase, which were then combined. The carbon beam dose distribution within each bolus was calculated as a function of time and compared to plans in which respiratory-ungated/gated strategies were used. The GTV-4DCT treatment plan required a prohibitively long time for contouring the GTV manually for each respiratory phase, but it delivered more than 95% of the prescribed dose to the target volume. The TMIP and TAIP treatments, although more time-efficient, resulted in an unacceptable excess dose to normal tissues and underdosing of the target volume. The dose distribution for the ITV-4DCT bolus was similar to that for the GTV-4DCT bolus and required significantly less practitioner time. The ITV-4DCT bolus treatment plan is time-efficient and provides a high-quality dose distribution, making it a practical alternative to the GTV-4DCT bolus treatment plan.

Experiences with Lean Six Sigma as improvement strategy to reduce parenteral medication administration errors and associated potential risk of harm.

PubMed

van de Plas, Afke; Slikkerveer, Mariëlle; Hoen, Saskia; Schrijnemakers, Rick; Driessen, Johanna; de Vries, Frank; van den Bemt, Patricia

2017-01-01

In this controlled before-after study the effect of improvements, derived from Lean Six Sigma strategy, on parenteral medication administration errors and the potential risk of harm was determined. During baseline measurement, on control versus intervention ward, at least one administration error occurred in 14 (74%) and 6 (46%) administrations with potential risk of harm in 6 (32%) and 1 (8%) administrations. Most administration errors with high potential risk of harm occurred in bolus injections: 8 (57%) versus 2 (67%) bolus injections were injected too fast with a potential risk of harm in 6 (43%) and 1 (33%) bolus injections on control and intervention ward. Implemented improvement strategies, based on major causes of too fast administration of bolus injections, were: Substitution of bolus injections by infusions, education, availability of administration information and drug round tabards. Post intervention, on the control ward in 76 (76%) administrations at least one error was made (RR 1.03; CI95:0.77-1.38), with a potential risk of harm in 14 (14%) administrations (RR 0.45; CI95:0.20-1.02). In 40 (68%) administrations on the intervention ward at least one error occurred (RR 1.47; CI95:0.80-2.71) but no administrations were associated with a potential risk of harm. A shift in wrong duration administration errors from bolus injections to infusions, with a reduction of potential risk of harm, seems to have occurred on the intervention ward. Although data are insufficient to prove an effect, Lean Six Sigma was experienced as a suitable strategy to select tailored improvements. Further studies are required to prove the effect of the strategy on parenteral medication administration errors.

Experiences with Lean Six Sigma as improvement strategy to reduce parenteral medication administration errors and associated potential risk of harm

PubMed Central

van de Plas, Afke; Slikkerveer, Mariëlle; Hoen, Saskia; Schrijnemakers, Rick; Driessen, Johanna; de Vries, Frank; van den Bemt, Patricia

2017-01-01

In this controlled before-after study the effect of improvements, derived from Lean Six Sigma strategy, on parenteral medication administration errors and the potential risk of harm was determined. During baseline measurement, on control versus intervention ward, at least one administration error occurred in 14 (74%) and 6 (46%) administrations with potential risk of harm in 6 (32%) and 1 (8%) administrations. Most administration errors with high potential risk of harm occurred in bolus injections: 8 (57%) versus 2 (67%) bolus injections were injected too fast with a potential risk of harm in 6 (43%) and 1 (33%) bolus injections on control and intervention ward. Implemented improvement strategies, based on major causes of too fast administration of bolus injections, were: Substitution of bolus injections by infusions, education, availability of administration information and drug round tabards. Post intervention, on the control ward in 76 (76%) administrations at least one error was made (RR 1.03; CI95:0.77-1.38), with a potential risk of harm in 14 (14%) administrations (RR 0.45; CI95:0.20-1.02). In 40 (68%) administrations on the intervention ward at least one error occurred (RR 1.47; CI95:0.80-2.71) but no administrations were associated with a potential risk of harm. A shift in wrong duration administration errors from bolus injections to infusions, with a reduction of potential risk of harm, seems to have occurred on the intervention ward. Although data are insufficient to prove an effect, Lean Six Sigma was experienced as a suitable strategy to select tailored improvements. Further studies are required to prove the effect of the strategy on parenteral medication administration errors. PMID:28674608

Current Trends in Heparin Use During Arterial Vascular Interventional Radiology

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

Durran, Alexandra C., E-mail: durranjobs@hotmail.com; Watts, Christopher, E-mail: Christopher.watts@salisbury.nhs.uk

2012-12-15

Purpose: This study was designed to assess the current use of heparinized saline and bolus doses of heparin in non-neurological interventional radiology and to determine whether consensus could be reached to produce guidance for heparin use during arterial vascular intervention. Methods: An interactive electronic questionnaire was distributed to members of the British Society of Interventional Radiology regarding their current practice in the use, dosage, and timing of heparin boluses and heparinized flushing solutions.ResultsA total of 108 completed questionnaires were received. More than 80% of respondents used heparinized saline with varying concentrations; the most prevalent was 1,000 IU/l (international units ofmore » heparin per liter) and 5,000 IU/l. Fifty-one percent of interventionalists use 3,000 IU as their standard bolus dose; however, the respondents were split regarding the timing of bolus dose with {approx}60% administering it after arterial access is obtained and 40% after crossing the lesion. There was no consensus on altering dose according to body weight, and only 4% monitored clotting parameters. Conclusions: There seems to be some coherence among practicing interventionalists regarding heparin administration. We hypothesize that heparinized saline should be used at a recognized standard concentration of 1,000 IU/l as a flushing concentration in all arterial vascular interventions and that 3,000 IU bolus is considered the standard dose for straightforward therapeutic procedures and 5000 IU for complex, crural, and endovascular aneurysm repair work. The bolus should be given after arterial access is obtained to allow time for optimal anticoagulation to be achieved by the time of active intervention and stenting. Further research into clotting abnormalities following such interventional procedures would be an interesting quantifiable follow-up to this initial survey of opinions and practice.« less

A Review of the “Bolus Guide,” A New Insulin Bolus Dosing Support Tool Based on Selection of Carbohydrate Ranges

PubMed Central

Pańkowska, Ewa

2010-01-01

In this issue of Journal of Diabetes Science and Technology, Shapira and colleagues present new concepts of carbohydrate load estimation in intensive insulin therapy. By using a mathematical model, they attempt to establish how accurately carbohydrate food content should be maintained in order to keep postprandial blood glucose levels in the recommended range. Their mathematical formula, the “bolus guide” (BG), is verified by simulating prandial insulin dosing and responding to proper blood glucose levels. Different variants such as insulin sensitivity factor, insulin-to-carbohydrate ratio, and target blood glucose were taken into this formula in establishing the calculated proper insulin dose. The new approach presented here estimates the carbohydrate content by rearranging the carbohydrate load instead of the simple point estimation that the current bolus calculators (BCs) use. Computerized estimations show that the BG directives, as compared to a BC, result in more glucose levels above 200 mg/dl and thus indicate less hypoglycemia readings. PMID:20663454

Effects of copper oxide wire particle bolus therapy on trichostrongyle fecal egg counts in exotic artiodactylids.

PubMed

Fontenot, Deidre K; Kinney-Moscona, Allyson; Kaplan, Ray M; Miller, James

2008-12-01

Four species of artiodactylids (scimitar-horned oryx [Oryx dama]), roan antelope [Hippotragus equinus], blackbuck [Antilope cervicapra]), and blesbok [Damaliscus pygargus phillipsi]) totaling 13 animals were treated with a one-time 12.5-g dose of copper oxide wire particles (COWPs) in a bolus form. Pretreatment, individual trichostrongyle fecal egg counts (FECs) were performed using the McMaster technique. Individual posttreatment FECs were performed every 7 days for 35 days beginning 7 days after bolus administration, and FEC reduction ratios (FECRRs) expressed as percentage reductions from pretreatment values were calculated every 7 days. Mean FECRRs for the 13 animals were 93% +/- 16%, 98% +/- 7%, 91% +/- 28%, 94% +/- 16%, and 90% +/- 13% at 7, 14, 21, 28, and 35 days posttreatment, respectively. These data demonstrate that COWPs in a bolus form were an effective method for reducing FEC in exotic artiodactylids. Based on this limited data, COWPs show promise as an anthelmintic alternative for exotic artiodactylids in zoologic collections.

Wars of the holographic world

NASA Astrophysics Data System (ADS)

Preskill, John

2008-12-01

In the popular imagination, the iconic American theoretical physicist is Richard Feynman, in all his safe-cracking, bongo-thumping, woman-chasing glory. I suspect that many physicists, if asked to name a living colleague who best captures the spirit of Feynman, would give the same answer as me: Leonard Susskind. As far as I know, Susskind does not crack safes, thump bongos, or chase women, yet he shares Feynman's brash cockiness (which in Susskind's case is leavened by occasional redeeming flashes of self-deprecation) and Feynman's gift for spinning fascinating anecdotes. If you are having a group of physicists over for dinner and want to be sure to have a good time, invite Susskind.

Pilot Ed Lewis with T-34C aircraft on ramp

NASA Image and Video Library

1998-03-04

NASA pilot Ed Lewis with the T-34C aircraft on the Dryden Flight Research Center Ramp. The aircraft was previously used at the Lewis Research Center in propulsion experiments involving turboprop engines, and was used as a chase aircraft at Dryden for smaller and slower research projects. Chase aircraft accompany research flights for photography and video purposes, and also as support for safety and research. At Dryden, the T-34 is used mainly for smaller remotely piloted vehicles which fly slower than NASA's F-18's, used for larger scale projects. This aircraft was returned to the U.S. Navy in May of 2002.

Inhibition of processing of plant N-linked oligosaccharides by castanospermine.

PubMed

Hori, H; Pan, Y T; Molyneux, R J; Elbein, A D

1984-02-01

Castanospermine (1,6,7,8-tetrahydroxyoctahydroindolizine) is a plant alkaloid that inhibits lysosomal alpha- and beta-glucosidase. It also inhibits processing of influenza viral glycoproteins by inhibiting glucosidase I and leads to altered glycoproteins with Glc3Man7GlcNAc2 structures. Castanospermine was tested as an inhibitor of glycoprotein processing in suspension-cultured soybean cells. Soybean cells were pulse-labeled with [2-3H]mannose and chased for varying periods in unlabeled medium. In normal cells, the initial glycopeptides contained oligosaccharides having Glc3Man9GlcNAc2 to Glc1Man9GlcNAc2 structures and these were trimmed during the chase to Man9GlcNac2 to Man7GlcNAc2 structures. In the presence of castanospermine, no trimming of glucose residues occurred although some mannose residues were apparently still removed. Thus, the major oligosaccharide in the glycopeptides of castanospermine-incubated cells after a 90-min chase was a Glc3Man7GlcNAc2 structure. Smaller amounts of Glc3Man6GlcNAc2 and Glc3Man5GlcNAc2 were also identified. Thus, in plant cells, castanospermine also prevents the removal of the outermost glucose residue.

Dynamic properties of chasers in a moving queue based on a delayed chasing model

NASA Astrophysics Data System (ADS)

Ning, Guo; Jian-Xun, Ding; Xiang, Ling; Qin, Shi; Reinhart, Kühne

2016-05-01

A delayed chasing model is proposed to simulate the chase behavior in the queue, where each member regards the closest one ahead as the target, and the leader is attracted to a target point with slight fluctuation. When the initial distances between neighbors possess an identical low value, the fluctuating target of the leader can cause an amplified disturbance in the queue. After a long period of time, the queue recovers the stable state from the disturbance, forming a straight-line-like pattern again, but distances between neighbors grow. Whether the queue can keep stable or not depends on initial distance, desired velocity, and relaxation time. Furthermore, we carry out convergence analysis to explain the divergence transformation behavior and confirm the convergence conditions, which is in approximate agreement with simulations. Project supported by the National Natural Science Foundation of China (Grant Nos. 71071044, 71001001, 71201041, and 11247291), the Doctoral Program of the Ministry of Education of China (Grant Nos. 20110111120023 and 20120111120022), the Postdoctoral Fund Project of China (Grant No. 2013M530295), the National Basic Research Program of China (Grant No. 2012CB725404), and 1000 Plan for Foreign Talent, China (Grant No. WQ20123400070).

Steering a virtual blowfly: simulation of visual pursuit.

PubMed

Boeddeker, Norbert; Egelhaaf, Martin

2003-09-22

The behavioural repertoire of male flies includes visually guided chasing after moving targets. The visuomotor control system for these pursuits belongs to the fastest found in the animal kingdom. We simulated a virtual fly, to test whether or not experimentally established hypotheses on the underlying control system are sufficient to explain chasing behaviour. Two operating instructions for steering the chasing virtual fly were derived from behavioural experiments: (i) the retinal size of the target controls the fly's forward speed and, thus, indirectly its distance to the target; and (ii) a smooth pursuit system uses the retinal position of the target to regulate the fly's flight direction. Low-pass filters implement neuronal processing time. Treating the virtual fly as a point mass, its kinematics are modelled in consideration of the effects of translatory inertia and air friction. Despite its simplicity, the model shows behaviour similar to that of real flies. Depending on its starting position and orientation as well as on target size and speed, the virtual fly either catches the target or follows it indefinitely without capture. These two behavioural modes of the virtual fly emerge from the control system for flight steering without implementation of an explicit decision maker.

Design of the LBNF Beamline Target Station

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

Tariq, S.; Ammigan, K.; Anderson, K.

2016-10-01

The Long Baseline Neutrino Facility (LBNF) project will build a beamline located at Fermilab to create and aim an intense neutrino beam of appropriate energy range toward the DUNE detectors at the SURF facility in Lead, South Dakota. Neutrino production starts in the Target Station, which consists of a solid target, magnetic focusing horns, and the associated sub-systems and shielding infrastructure. Protons hit the target producing mesons which are then focused by the horns into a helium-filled decay pipe where they decay into muons and neutrinos. The target and horns are encased in actively cooled steel and concrete shielding inmore » a chamber called the target chase. The reference design chase is filled with air, but nitrogen and helium are being evaluated as alternatives. A replaceable beam window separates the decay pipe from the target chase. The facility is designed for initial operation at 1.2 MW, with the ability to upgrade to 2.4 MW, and is taking advantage of the experience gained by operating Fermilab’s NuMI facility. We discuss here the design status, associated challenges, and ongoing R&D and physics-driven component optimization of the Target Station.« less

A Novel Pulse-Chase Paradigm to Visualize the Trafficking of Transport Vesicles in Neurons

NASA Astrophysics Data System (ADS)

Al-Bassam, Sarmad

In neurons transmembrane proteins are targeted to dendrites in vesicles that traffic solely within the somatodendritic compartment. How these vesicles are retained within the somatodendritic domain is unknown. Here we adapt a novel pulse chase system that allows synchronous release of exogenous transmembrane proteins from the endoplasmic reticulum using FKBP12 and Rapamycin. We demonstrate proof-of-concept and establish protein trafficking controls in incremental steps. We demonstrate the utility of this approach in studying protein trafficking and establish parameters for analysis of time-lapse images. We implement this novel pulse-chase strategy to track the movements of post-Golgi transport vesicles. Surprisingly, we found that post-Golgi vesicles carrying dendritic proteins were equally likely to enter axons and dendrites. However, once such vesicles entered the axon they very rarely moved beyond the axon initial segment, but instead either halted or reversed direction in an actin and Myosin Va-dependent manner. In contrast, vesicles carrying either an axonal or a nonspecifically localized protein only rarely halted or reversed and instead generally proceeded to the distal axon. Thus, our results are consistent with the axon initial segment behaving as a vesicle filter that mediates the differential trafficking of transport vesicles.

Stepped leaders observed in ground operations of ADELE

NASA Astrophysics Data System (ADS)

Smith, D. M.; Kelley, N.; Lowell, A.; Martinez-McKinney, F.; Dwyer, J. R.; Splitt, M. E.; Lazarus, S. M.; Cramer, E. S.; Levine, S.; Cummer, S. A.; Lu, G.; Shao, X.; Ho, C.; Eastvedt, E. M.; Trueblood, J.; Edens, H. E.; Hunyady, S. J.; Winn, W. P.; Rassoul, H. K.

2010-12-01

While the Airborne Detector for Energetic Lightning Emissions (ADELE) was designed primarily to study high-energy radiation associated with thunderstorms at aircraft altitude, it can also be used as a mobile ground-based instrument when mounted in a van. ADELE contains scintillation detectors optimized for faint and bright events and a flat-plate antenna measuring dE/dt. In July and August 2010, ADELE was brought to Langmuir Laboratory in New Mexico as a stationary detector and to the Florida peninsula (based at the Florida Institute of Technology in Melbourne) for rapid-response (storm-chasing) operations. In ten days of chasing, stepped-leader x-ray emission was observed from at least four close CG flashes, a much higher rate of success than can be achieved from a stationary detector or array. We will present these four events as well as the results of a study of candidate events of lesser statistical significance. We will also discuss the optimization of lightning-chasing strategies, science goals for future ground campaigns, and what additional instrumentation would be most scientifically beneficial. In the latter category, a proximity sensor (comparing flash and thunder arrival times) and a field mill are particularly important.

Economic Synergy between Dry Cow Diet Improvement and Monensin Bolus Use to Prevent Subclinical Ketosis: An Experimental Demonstration Based on Available Literature.

PubMed

Raboisson, Didier; Barbier, Maxime

2017-01-01

The prevention of subclinical ketosis (SCK) is based on maintaining adequate nutrition in dairy cows during the dry period and close to calving. Recently, an oral-route monensin bolus to prevent SCK was approved in Europe. The present study aims to define the allocation of resources for SCK management at the herd level and evaluate the profitability of administering monensin boluses in cows at risk for SCK. A stochastic model was used to calculate the total cost of SCK for a population with a given prevalence of cows at risk for SCK. This model included the ability of the farmer to correctly target and preventatively treat these cows at risk for SCK. The results clearly demonstrated economic synergy between two management practices. First, reducing the prevalence of cows at risk for SCK dramatically reduces the total cost of SCK and seems profitable in most situations. Second, monensin bolus use to reduce the occurrence of SCK in cows already at risk for SCK is cost-effective. The results also highlighted three economic strategies to manage SCK in the dairy industry in Europe. First, monensin bolus use throughout an entire herd when the prevalence of cows at risk for SCK is high is only profitable in the short-term as a tool to correct acute deterioration at the herd level. Second, decreasing the prevalence of cows at risk for SCK through adequate feeding in the dry period is of financial interest as a baseline strategy when prevalence is high, assuming moderate additional cost linked to the new diet. Third, monensin bolus use when the prevalence of cows at risk for SCK is low is also profitable as a long-term strategy when only cows at high risk for SCK (such as cows that are over-conditioned, old, or have a previous history of SCK-related disorders) are targeted for preventative treatment. Authors suggest to use the present results considering that farmers have a correct, but not perfect, ability to target animals to be preventively targeted with the monensin bolus. Further work is required to facilitate the early identification of cows at risk for SCK.

INDUCED SPUTUM DERIVES FROM THE CENTRAL AIRWAYS: CONFIRMATION USING A RADIOLABELED AEROSOL BOLUS DELIVERY TECHNIQUE

EPA Science Inventory

Indirect evidence suggests that induced sputum derives from the surfaces of the bronchial airways. To confirm this experimentally, we employed a radiolabeled aerosol bolus delivery technique that preferentially deposits aerosol in the central airways in humans. We hypothesized th...

Effect of oral calcium bolus administration on milk production, concentrations of minerals and metabolites in serum, early-lactation health status, and reproductive performance of Holstein dairy cows.

PubMed

Jahani-Moghadam, M; Chashnidel, Y; Teimouri-Yansari, A; Mahjoubi, E; Dirandeh, E

2018-05-01

To determine the effects of oral Ca bolus administration in the early postpartum period of cows on milk yield and composition, blood metabolites, early-lactation health status, and reproductive performance. Multiparous Holstein dry cows (n=66) with a mean parity of 3.1 (SD 0.35) were fed a diet with a positive dietary cation-anion difference (DCAD) prior to calving. They were randomly assigned to receive no treatment (Control; n=33) or two oral Ca boluses (n=33, 45 g of Ca per bolus); one was administered immediately after calving (Day 0) and the second 24 hours (±30 minutes) later. Blood samples were collected at calving, and on Days 2 and 7 to determine concentrations in serum of Ca, P, Mg, glucose, non-esterified fatty acids (NEFA), and β-hydroxybutyric acid (BHBA). Milk yield was recorded daily and milk composition was determined weekly from calving until 28 day postpartum. Health and outcomes were determined during the first 30 days postpartum and reproductive outcomes to 180 days postpartum. Mean milk yields and composition over the first month of lactation were similar between cows in the two treatment groups (p>0.1). Mean concentrations of Ca in serum were not different between treatment groups on Day 0, but were higher on Day 2 for cows that received oral Ca boluses (1.77 (SE 0.07)) compared with Control cows (1.54 (SE 0.08)) (p=0.04). Concentrations in serum of P, Mg, glucose, NEFA and ΒHBA did not differ between treatment groups on any day of measurement. Fewer cows that received oral Ca were diagnosed with hypocalcaemia (total concentrations of Ca in serum <1.5 mmol/L) by Day 2 (2/33; 6%) compared with Control cows (12/33; 36%) (p=0.01). There was no difference in the prevalence of other health outcomes between treatment groups. The proportion of cows conceiving to first insemination was greater in cows that received an oral Ca bolus (19/29; 65%) than Control cows (12/29; 41%) (p=0.01). Oral Ca bolus administration increased concentrations of Ca in serum on Day 2 postpartum, and increased first service conception rates, in cows fed a diet with a positive DCAD prior to calving compared to cows that received no oral Ca bolus supplementation. Because of the small number of cows used in this study, further studies in large-scale dairy farms should be carried out to confirm these findings.

The potential to control Haemonchus contortus in indigenous South African goats with copper oxide wire particles.

PubMed

Vatta, A F; Waller, P J; Githiori, J B; Medley, G F

2009-06-10

The high prevalence of resistance of Haemonchus contortus to all major anthelmintic groups has prompted investigations into alternative control methods in South Africa, including the use of copper oxide wire particle (COWP) boluses. To assess the efficacy of COWP against H. contortus in indigenous South African goats, 18 male faecal egg-count-negative goats were each given ca.1200 infective larvae of H. contortus three times per week during weeks 1 and 2 of the experiment. These animals made up an "established" infection group (ESTGRP). At the start of week 7, six goats were each given a 2-g COWP bolus orally; six goats received a 4-g COWP bolus each and six animals were not treated. A further 20 goats constituted a "developing" infection group (DEVGRP). At the beginning of week 1, seven of the DEVGRP goats were given a 2-g COWP bolus each; seven goats were treated with a 4-g COWP bolus each and no bolus was given to a further six animals. During weeks 1-6, each of these DEVGRP goats was given ca. 400 H. contortus larvae three times per week. All 38 goats were euthanized for worm recovery from the abomasa and small intestines in week 11. In the ESTGRP, the 2-g and 4-g COWP boluses reduced the worm burdens by 95% and 93%, respectively compared to controls (mean burden+/-standard deviation, SD: 23+/-33, 30+/-56 and 442+/-518 worms, P=0.02). However, in the DEVGRP goats, both the 2-g and 4-g COWP treatments were ineffective in reducing the worm burdens relative to the controls (mean burdens+/-SD: 1102+/-841, 649+/-855, 1051+/-661 worms, P=0.16). Mean liver copper levels did not differ between the ESTGRP goats treated with 2-g COWP, 4-g COWP or no COWP (mean+/-standard error of the mean, SEM, in ppm: 93.7+/-8.3; 101.5+/-8.3; 71.8+/-8.3, P=0.07) nor did they differ between the DEVGRP goats (mean+/-SEM, in ppm: 74.1+/-9.1; 75.4+/-9.1; 74.9+/-10.0, P>0.99). The copper values were considered adequate, but not high, for goats. The COWP boluses have the potential to be used in the place of conventional anthelmintics for the control of established H. contortus infections in indigenous South African goats, but their use as part of an integrated approach to control H. contortus in the field must be fully investigated.

High-resolution manometry combined with impedance measurements discriminates the cause of dysphagia in children.

PubMed

Rommel, Nathalie; Omari, Taher I; Selleslagh, Margot; Kritas, Stamatiki; Cock, Charles; Rosan, Rachel; Rodriguez, Leonel; Nurko, Samuel

2015-12-01

Pressure-flow analysis allows assessing esophageal bolus transport in relation to esophageal pressures. This study aimed to characterize pressure-flow metrics in relation to dysphagia in paediatric patients. We analysed esophageal pressure-impedance recordings of 5 ml liquid and viscous swallows from 35 children (17 M, mean 10.5 ± 0.8 years). Primary indication for referral was gastroesophageal reflux disease (GERD) (9), post-fundoplication dysphagia (5), idiopathic dysphagia (16), trachea-esophageal fistula (2) and other (3). Peristaltic function was assessed using the 20 mmHg iso-contour defect and the timing between bolus pressure and flow was assessed using the Pressure Flow Index, a metric elevated in relation to dysphagia. Patients were stratified in relation to dysphagia and to peristaltic defect size. Dysphagia was characterized by a weaker peristalsis for liquids and higher Pressure Flow Index for viscous. When patients were stratified based on weak or normal peristalsis, dysphagia with weak peristalsis related to a larger iso-contour defect size and dysphagia with normal peristalsis related to higher Pressure Flow Index. Pressure-flow analysis enables differentiation of patients with dysphagia due to weak peristalsis (poor bolus clearance) from abnormal bolus flow resistance (esophageal outflow obstruction). This new dichotomous categorization of esophageal function may help guide the selection of optimal treatment such as pharmacological or endoscopic therapy. • Pressure-flow analysis (PFA) can detect abnormalities in esophageal motility using integrated analysis of bolus propulsion and bolus flow during swallowing. • AIM analysis has recently been reported to be useful in identifying subtle pre-operative esophageal dysfunction in adult patients who developed post-fundoplication dysphagia as well as in patients with non-obstructive dysphagia. • Pressure-flow parameters can distinguish the cause of dysphagia in paediatric patients. • Combined high-resolution manometry and impedance measurements with pressure-flow analysis can differentiate paediatric patients with dysphagia symptoms in relation to either weak peristalsis (poor bolus clearance) or over-pressurization (abnormal bolus flow resistance). HOW MIGHT IT IMPACT ON CLINICAL PRACTICE IN THE FUTURE? • This study supports the use of a novel objective analysis method on recordings that are readily used in paediatric clinical practice. • The pressure-flow approach allows discriminating esophageal dysfunction in relation to dysphagia symptoms in children. This has not been achieved in children with current analysis methods. • The new findings of this study allow a dichotomous categorization of esophageal function, which may help to guide the selection of the most optimal treatment such as pharmacological or endoscopic therapy.

Regular intermittent bolus provides similar incidence of maternal fever compared with continuous infusion during epidural labor analgesia.

PubMed

Feng, Shan-Wu; Xu, Shi-Qin; Ma, Li; Li, Cai-Juan; Wang, Xian; Yuan, Hong-Mei; Wang, Fu-Zhou; Shen, Xiao-Feng; Ding, Zheng-Nian

2014-10-01

To compare the effects of regular intermittent bolus versus continuous infusion for epidural labor analgesia on maternal temperature and serum interleukin-6 (IL-6) level. This randomized trial was performed in Nanjing Maternity and Child Health Care Hospital, Nanjing, Jiangsu Province, China between October 2012 and February 2014. Either regular intermittent bolus (RIB, n=66) or continuous infusion (CI, n=66) was used for epidural labor analgesia. A bolus dose (10 ml of 0.08% ropivacaine + 0.4 ug·ml-1 sufentanil) was manually administrated once an hour in the RIB group, whereas the same solution was continuously infused at a constant rate of 10 ml·h-1 in the CI group. Maternal tympanic temperature and serum IL-6 level were measured hourly from baseline to one hour post partum. The incidences of fever (>/=38 degree celsius ) were calculated. The incidence of maternal fever was similar between the 2 groups. There was a rising trend in mean temperature over time in both groups, but no statistical difference was detected between the groups at respective time points; maternal serum IL-6 showed similar changes. Compared with continuous infusion, regular intermittent bolus presents with the same incidence of maternal fever for epidural labor analgesia. Interleukin-6 elevation could be involved in mean maternal temperature increase. 

Pre-shift fluid intake: effect on physiology, work and drinking during emergency wildfire fighting.

PubMed

Raines, Jenni; Snow, Rodney; Petersen, Aaron; Harvey, Jack; Nichols, David; Aisbett, Brad

2012-05-01

Wildfire fighters are known to report to work in a hypohydrated state, which may compromise their work performance and health. To evaluate whether ingesting a bolus of fluid before the shift had any effect on firefighters' fluid consumption, core temperature, or the time they spent in high heart rate and work activity zones when fighting emergency wildfires. Thirty-two firefighters were divided into non-bolus (AD) and pre-shift drinking bolus (PS, 500 ml water) groups. Firefighters began work hypohydrated as indicated by urine colour, specific gravity and plasma osmolality (P(osm)) results. Post-shift, firefighters were classified as euhydrated according to P(osm) and hypohydrated by urinary markers. No significant differences existed between the drinking groups in pre- or post-shift hydration status, total fluid intake, activity, heart rate or core temperature. Consuming a bolus of fluid, pre-shift provided no benefit over non-consumption as both groups had consumed equivalent ad libitum volumes of fluid, 2.5 h into the shift. No benefits of bolus consumption were observed in firefighter activity, heart rate response or core temperature response across the shift in the mild weather conditions experienced. Ad libitum drinking was adequate to facilitate rehydration in firefighters upon completion of their emergency firefighting work shift. Copyright © 2011 Elsevier Ltd and The Ergonomics Society. All rights reserved.

Biased visualization of hypoperfused tissue by computed tomography due to short imaging duration: improved classification by image down-sampling and vascular models.

PubMed

Mikkelsen, Irene Klærke; Jones, P Simon; Ribe, Lars Riisgaard; Alawneh, Josef; Puig, Josep; Bekke, Susanne Lise; Tietze, Anna; Gillard, Jonathan H; Warburton, Elisabeth A; Pedraza, Salva; Baron, Jean-Claude; Østergaard, Leif; Mouridsen, Kim

2015-07-01

Lesion detection in acute stroke by computed-tomography perfusion (CTP) can be affected by incomplete bolus coverage in veins and hypoperfused tissue, so-called bolus truncation (BT), and low contrast-to-noise ratio (CNR). We examined the BT-frequency and hypothesized that image down-sampling and a vascular model (VM) for perfusion calculation would improve normo- and hypoperfused tissue classification. CTP datasets from 40 acute stroke patients were retrospectively analysed for BT. In 16 patients with hypoperfused tissue but no BT, repeated 2-by-2 image down-sampling and uniform filtering was performed, comparing CNR to perfusion-MRI levels and tissue classification to that of unprocessed data. By simulating reduced scan duration, the minimum scan-duration at which estimated lesion volumes came within 10% of their true volume was compared for VM and state-of-the-art algorithms. BT in veins and hypoperfused tissue was observed in 9/40 (22.5%) and 17/40 patients (42.5%), respectively. Down-sampling to 128 × 128 resolution yielded CNR comparable to MR data and improved tissue classification (p = 0.0069). VM reduced minimum scan duration, providing reliable maps of cerebral blood flow and mean transit time: 5 s (p = 0.03) and 7 s (p < 0.0001), respectively). BT is not uncommon in stroke CTP with 40-s scan duration. Applying image down-sampling and VM improve tissue classification. • Too-short imaging duration is common in clinical acute stroke CTP imaging. • The consequence is impaired identification of hypoperfused tissue in acute stroke patients. • The vascular model is less sensitive than current algorithms to imaging duration. • Noise reduction by image down-sampling improves identification of hypoperfused tissue by CTP.

Extracellular volume quantification by dynamic equilibrium cardiac computed tomography in cardiac amyloidosis.

PubMed

Treibel, Thomas A; Bandula, Steve; Fontana, Marianna; White, Steven K; Gilbertson, Janet A; Herrey, Anna S; Gillmore, Julian D; Punwani, Shonit; Hawkins, Philip N; Taylor, Stuart A; Moon, James C

2015-01-01

Cardiac involvement determines outcome in patients with systemic amyloidosis. There is major unmet need for quantification of cardiac amyloid burden, which is currently only met in part through semi-quantitative bone scintigraphy or Cardiovascular Magnetic Resonance (CMR), which measures ECVCMR. Other accessible tests are needed. To develop cardiac computed tomography to diagnose and quantify cardiac amyloidosis by measuring the myocardial Extracellular Volume, ECVCT. Twenty-six patients (21 male, 64 ± 14 years) with a biopsy-proven systemic amyloidosis (ATTR n = 18; AL n = 8) were compared with twenty-seven patients (19 male, 68 ± 8 years) with severe aortic stenosis (AS). All patients had undergone echocardiography, bone scintigraphy, NT-pro-BNP measurement and EQ-CMR. Dynamic Equilibrium CT (DynEQ-CT) was performed using a prospectively gated cardiac scan prior to and after (5 and 15 minutes) a standard Iodixanol (1 ml/kg) bolus to measure ECVCT. ECVCT was compared to the reference ECVCMR and conventional amyloid measures: bone scintigraphy and clinical markers of cardiac amyloid severity (NT-pro-BNP, Troponin, LVEF, LV mass, LA and RA area). ECVCT and ECVCMR results were well correlated (r(2) = 0.85 vs r(2) = 0.74 for 5 and 15 minutes post bolus respectively). ECVCT was higher in amyloidosis than AS (0.54 ± 0.11 vs 0.28 ± 0.04, p<0.001) with no overlap. ECVCT tracked clinical markers of cardiac amyloid severity (NT-pro-BNP, Troponin, LVEF, LV mass, LA and RA area), and bone scintigraphy amyloid burden (p<0.001). Dynamic Equilibrium CT, a 5 minute contrast-enhanced gated cardiac CT, has potential for non-invasive diagnosis and quantification of cardiac amyloidosis. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

Maximizing Information From Routine Staging Computed Tomography in Functional Neuroendocrine Neoplasms: Are There Findings Indicating the Presence of Carcinoid Heart Disease?

PubMed

Baur, Alexander Daniel Jacques; Kunz, Florian; Schwenke, Carsten; Pschowski, René; Röpke, Torsten Kai; Pavel, Marianne; Denecke, Timm

2016-01-01

The aim of this study was to evaluate signs of right-sided heart dysfunction on staging computed tomography (CT) as indirect indicators of carcinoid heart disease. Patients with functionally active neuroendocrine neoplasm and different grades of tricuspid valve regurgitation (TR) were identified. Two readers independently reviewed contrast-enhanced staging CT performed within 90 days before or after echocardiography. Logistic regression and receiver operating analyses were used to asses the predictive value of right ventricle-left ventricle ratio (RV-LV ratio), ventricular septal bowing, retrograde contrast filling of the hepatic veins during contrast injection, and time to aortal enhancement greater than 100 Hounsfield units during bolus tracking for TR. Forty-four examinations were evaluated (11 with TR = 0, 16 with TR = 1, 9 with TR = 2, and 8 with TR = 3). Right ventricle-LV ratio was found to predict TR less than or equal to 1 versus TR greater than 1 (P = 0.0188) and TR less than or equal to 1 versus TR equals 2 (P = 0.0082). A prolonged time to aortal enhancement greater than 100 Hounsfield units during bolus tracking predicted TR less than or equal to 1 versus TR greater than 1 (P = 0.0077). Area under the curve for RV-LV ratio was 0.86 when differentiating TR less than or equal to 1 versus TR equals 2. With a cutoff of 1.07, sensitivity was 0.89, and specificity was 0.72. In patients with functionally active neuroendocrine neoplasm, an RV-LV ratio of more than 1.07 predicted TR with a relatively high sensitivity and moderate specificity and thus could serve as an indicator of subclinical carcinoid heart disease on routine staging CT.

Effect of Bolus Viscosity on the Safety and Efficacy of Swallowing and the Kinematics of the Swallow Response in Patients with Oropharyngeal Dysphagia: White Paper by the European Society for Swallowing Disorders (ESSD).

PubMed

Newman, Roger; Vilardell, Natàlia; Clavé, Pere; Speyer, Renée

2016-04-01

Fluid thickening is a well-established management strategy for oropharyngeal dysphagia (OD). However, the effects of thickening agents on the physiology of impaired swallow responses are not fully understood, and there is no agreement on the degree of bolus thickening. To review the literature and to produce a white paper of the European Society for Swallowing Disorders (ESSD) describing the evidence in the literature on the effect that bolus modification has upon the physiology, efficacy and safety of swallowing in adults with OD. A systematic search was performed using the electronic Pubmed and Embase databases. Articles in English available up to July 2015 were considered. The inclusion criteria swallowing studies on adults over 18 years of age; healthy people or patients with oropharyngeal dysphagia; bolus modification; effects of bolus modification on swallow safety (penetration/aspiration) and efficacy; and/or physiology and original articles written in English. The exclusion criteria consisted of oesophageal dysphagia and conference abstracts or presentations. The quality of the selected papers and the level of research evidence were assessed by standard quality assessments. At the end of the selection process, 33 articles were considered. The quality of all included studies was assessed using systematic, reproducible, and quantitative tools (Kmet and NHMRC) concluding that all the selected articles reached a valid level of evidence. The literature search gathered data from various sources, ranging from double-blind randomised control trials to systematic reviews focused on changes occurring in swallowing physiology caused by thickened fluids. Main results suggest that increasing bolus viscosity (a) results in increased safety of swallowing, (b) also results in increased amounts of oral and/or pharyngeal residue which may result in post-swallow airway invasion, (c) impacts the physiology with increased lingual pressure patterns, no major changes in impaired airway protection mechanisms, and controversial effects on oral and pharyngeal transit time, hyoid displacements, onset of UOS opening and bolus velocity-with several articles suggesting the therapeutic effect of thickeners is also due to intrinsic bolus properties, (d) reduces palatability of thickened fluids and (e) correlates with increased risk of dehydration and decreased quality of life although the severity of dysphagia may be an confounding factor. The ESSD concludes that there is evidence for increasing viscosity to reduce the risk of airway invasion and that it is a valid management strategy for OD. However, new thickening agents should be developed to avoid the negative effects of increasing viscosity on residue, palatability, and treatment compliance. New randomised controlled trials should establish the optimal viscosity level for each phenotype of dysphagic patients and descriptors, terminology and viscosity measurements must be standardised. This white paper is the first step towards the development of a clinical guideline on bolus modification for patients with oropharyngeal dysphagia.

21 CFR 520.2520e - Trichlorfon boluses.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Trichlorfon boluses. 520.2520e Section 520.2520e Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) ANIMAL...). (3) Limitations. Do not fast horses before or after treatment. Treatment of mares in late pregnancy...

21 CFR 520.1802b - Piperazine-carbon disulfide complex boluses.

Code of Federal Regulations, 2012 CFR

2012-04-01

....1802b Section 520.1802b Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN...) per 500 pounds body weight; removal of large strongyles, pinworms, and bots, 1 bolus per 250 pounds body weight.1 (2) Indications for use. For removing ascarids (large roundworms, Parascaris equorum...

21 CFR 520.1802b - Piperazine-carbon disulfide complex boluses.

Code of Federal Regulations, 2011 CFR

2011-04-01

....1802b Section 520.1802b Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN...) per 500 pounds body weight; removal of large strongyles, pinworms, and bots, 1 bolus per 250 pounds body weight.1 (2) Indications for use. For removing ascarids (large roundworms, Parascaris equorum...

21 CFR 520.1802b - Piperazine-carbon disulfide complex boluses.

Code of Federal Regulations, 2014 CFR

2014-04-01

....1802b Section 520.1802b Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN...) per 500 pounds body weight; removal of large strongyles, pinworms, and bots, 1 bolus per 250 pounds body weight.1 (2) Indications for use. For removing ascarids (large roundworms, Parascaris equorum...

21 CFR 520.1802b - Piperazine-carbon disulfide complex boluses.

Code of Federal Regulations, 2013 CFR

2013-04-01

....1802b Section 520.1802b Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN...) per 500 pounds body weight; removal of large strongyles, pinworms, and bots, 1 bolus per 250 pounds body weight.1 (2) Indications for use. For removing ascarids (large roundworms, Parascaris equorum...

21 CFR 520.1197 - Ivermectin sustained-release bolus.

Code of Federal Regulations, 2014 CFR

2014-04-01

... withdrawal time has not been established, do not use in female dairy cattle of breeding age. Do not slaughter cattle within 180 days of treatment. Consult your veterinarian for assistance in the diagnosis, treatment..., and ticks Amblyomma americanum. (3) Limitations. The bolus was specifically designed for use in cattle...

21 CFR 520.1197 - Ivermectin sustained-release bolus.

Code of Federal Regulations, 2011 CFR

2011-04-01

... withdrawal time has not been established, do not use in female dairy cattle of breeding age. Do not slaughter cattle within 180 days of treatment. Consult your veterinarian for assistance in the diagnosis, treatment..., and ticks Amblyomma americanum. (3) Limitations. The bolus was specifically designed for use in cattle...

21 CFR 520.1197 - Ivermectin sustained-release bolus.

Code of Federal Regulations, 2010 CFR

2010-04-01

... withdrawal time has not been established, do not use in female dairy cattle of breeding age. Do not slaughter cattle within 180 days of treatment. Consult your veterinarian for assistance in the diagnosis, treatment..., and ticks Amblyomma americanum. (3) Limitations. The bolus was specifically designed for use in cattle...

21 CFR 520.1197 - Ivermectin sustained-release bolus.

Code of Federal Regulations, 2013 CFR

2013-04-01

... withdrawal time has not been established, do not use in female dairy cattle of breeding age. Do not slaughter cattle within 180 days of treatment. Consult your veterinarian for assistance in the diagnosis, treatment..., and ticks Amblyomma americanum. (3) Limitations. The bolus was specifically designed for use in cattle...

21 CFR 520.1197 - Ivermectin sustained-release bolus.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 6 2012-04-01 2012-04-01 false Ivermectin sustained-release bolus. 520.1197 Section 520.1197 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) ANIMAL DRUGS, FEEDS, AND RELATED PRODUCTS ORAL DOSAGE FORM NEW ANIMAL DRUGS § 520.1197 Ivermectin...

21 CFR 520.420 - Chlorothiazide tablets and boluses.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 6 2014-04-01 2014-04-01 false Chlorothiazide tablets and boluses. 520.420 Section 520.420 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) ANIMAL DRUGS, FEEDS, AND RELATED PRODUCTS ORAL DOSAGE FORM NEW ANIMAL DRUGS § 520.420...

21 CFR 520.420 - Chlorothiazide tablets and boluses.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 6 2013-04-01 2013-04-01 false Chlorothiazide tablets and boluses. 520.420 Section 520.420 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) ANIMAL DRUGS, FEEDS, AND RELATED PRODUCTS ORAL DOSAGE FORM NEW ANIMAL DRUGS § 520.420...

21 CFR 520.1120b - Haloxon boluses.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 6 2014-04-01 2014-04-01 false Haloxon boluses. 520.1120b Section 520.1120b Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) ANIMAL... not use any drug, pesticide or other chemical having cholinesterase inhibiting activity either...

21 CFR 520.1120b - Haloxon boluses.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Haloxon boluses. 520.1120b Section 520.1120b Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) ANIMAL... not use any drug, pesticide or other chemical having cholinesterase inhibiting activity either...

21 CFR 520.1120b - Haloxon boluses.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 6 2011-04-01 2011-04-01 false Haloxon boluses. 520.1120b Section 520.1120b Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) ANIMAL... not use any drug, pesticide or other chemical having cholinesterase inhibiting activity either...

21 CFR 520.1120b - Haloxon boluses.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 6 2012-04-01 2012-04-01 false Haloxon boluses. 520.1120b Section 520.1120b Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) ANIMAL... not use any drug, pesticide or other chemical having cholinesterase inhibiting activity either...

21 CFR 520.2260b - Sulfamethazine sustained-release boluses.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 6 2013-04-01 2013-04-01 false Sulfamethazine sustained-release boluses. 520.2260b Section 520.2260b Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... weight. (ii) Indications for use. Beef and nonlactating cattle for sustained treatment of shipping fever...

21 CFR 520.2260b - Sulfamethazine sustained-release boluses.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 6 2014-04-01 2014-04-01 false Sulfamethazine sustained-release boluses. 520.2260b Section 520.2260b Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... weight. (ii) Indications for use. Beef and nonlactating cattle for sustained treatment of shipping fever...

21 CFR 520.2260b - Sulfamethazine sustained-release boluses.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 6 2012-04-01 2012-04-01 false Sulfamethazine sustained-release boluses. 520.2260b Section 520.2260b Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... weight. (ii) Indications for use. Beef and nonlactating cattle for sustained treatment of shipping fever...

Simple and rapid quantification of serotonin transporter binding using [11C]DASB bolus plus constant infusion.

PubMed

Gryglewski, G; Rischka, L; Philippe, C; Hahn, A; James, G M; Klebermass, E; Hienert, M; Silberbauer, L; Vanicek, T; Kautzky, A; Berroterán-Infante, N; Nics, L; Traub-Weidinger, T; Mitterhauser, M; Wadsak, W; Hacker, M; Kasper, S; Lanzenberger, R

2017-04-01

In-vivo quantification of serotonin transporters (SERT) in human brain has been a mainstay of molecular imaging in the field of neuropsychiatric disorders and helped to explore the underpinnings of several medical conditions, therapeutic and environmental influences. The emergence of PET/MR hybrid systems and the heterogeneity of SERT binding call for the development of efficient methods making the investigation of larger or vulnerable populations with limited scanner time and simultaneous changes in molecular and functional measures possible. We propose [ 11 C]DASB bolus plus constant infusion for these applications and validate it against standard analyses of dynamic PET data. [ 11 C]DASB bolus/infusion optimization was performed on data acquired after [ 11 C]DASB bolus in 8 healthy subjects. Subsequently, 16 subjects underwent one scan using [ 11 C]DASB bolus plus constant infusion with K bol 160-179min and one scan after [ 11 C]DASB bolus for inter-method reliability analysis. Arterial blood sampling and metabolite analysis were performed for all scans. Distribution volumes (V T ) were obtained using Logan plots for bolus scans and ratios between tissue and plasma parent activity for bolus plus infusion scans for different time spans of the scan (V T-70 for 60-70min after start of tracer infusion, V T-90 for 75-90min, V T-120 for 100-120min) in 9 subjects. Omitting blood data, binding potentials (BP ND ) obtained using multilinear reference tissue modeling (MRTM2) and cerebellar gray matter as reference region were compared in 11 subjects. A K bol of 160min was observed to be optimal for rapid equilibration in thalamus and striatum. V T-70 showed good intraclass correlation coefficients (ICCs) of 0.61-0.70 for thalamus, striatal regions and olfactory cortex with bias ≤5.1% compared to bolus scans. ICCs increased to 0.72-0.78 for V T-90 and 0.77-0.93 for V T-120 in these regions. BP ND-90 had negligible bias ≤2.5%, low variability ≤7.9% and ICCs of 0.74-0.87; BP ND-120 had ICCs of 0.73-0.90. Low-binding cortical regions and cerebellar gray matter showed a positive bias of ~8% and ICCs 0.57-0.68 at V T-90 . Cortical BP ND suffered from high variability and bias, best results were obtained for olfactory cortex and anterior cingulate cortex with ICC=0.74-0.75 for BP ND-90 . High-density regions amygdala and midbrain had a negative bias of -5.5% and -22.5% at V T-90 with ICC 0.70 and 0.63, respectively. We have optimized the equilibrium method with [ 11 C]DASB bolus plus constant infusion and demonstrated good inter-method reliability with accepted standard methods and for SERT quantification using both V T and BP ND in a range of different brain regions. With as little as 10-15min of scanning valid estimates of SERT V T and BP ND in thalamus, amygdala, striatal and high-binding cortical regions could be obtained. Blood sampling seems vital for valid quantification of SERT in low-binding cortical regions. These methods allow the investigation of up to three subjects with a single radiosynthesis. Copyright © 2017 Elsevier Inc. All rights reserved.

Observations on intravenous administration of lignocaine in patients with myocardial infarction.

PubMed Central

Campbell, N P; Kelly, J G; Adgey, A A; McDevitt, D G; Pantridge, J F

1978-01-01

Lignocaine was administered intravenously to 36 patients with acute myocardial infarction. A bolus of 100 mg followed by an infusion of 2 mg/minute failed to maintain plasma levels above 2 microgram/ml. A bolus of 100 mg followed by 4 mg/minute also failed to maintain satisfactory plasma concentrations during the first hour of therapy. A bolus of 75 mg was combined with an infusion of 10 mg/minute for 20 minutes followed by 1.5 mg/minute. Satisfactory plasma concentrations during the first hour were observed in 94 per cent of the estimations. No important adverse side effects occurred during the infusion of 10 mg/minute. PMID:737094

NASA HS3 Global Hawk on the Wing

NASA Image and Video Library

2013-08-30

The NASA Wallops T-34 chase aircraft intercepted Global Hawk 872 on its descent to runway 28 at NASA's Wallops Flight Facility in Wallops Island, Va. This photo of the Global Hawk was taken from the chase plane after finishing its third science flight. For more information about NASA's HS3 mission, visit: www.nasa.gov/HS3 Credit: NASA/ Brea Reeves NASA image use policy. NASA Goddard Space Flight Center enables NASA’s mission through four scientific endeavors: Earth Science, Heliophysics, Solar System Exploration, and Astrophysics. Goddard plays a leading role in NASA’s accomplishments by contributing compelling scientific knowledge to advance the Agency’s mission. Follow us on Twitter Like us on Facebook Find us on Instagram

The Chase to Capture Gamma Ray Bursts

NASA Technical Reports Server (NTRS)

Gehrels, Neil

2008-01-01

Gamma-ray bursts are the most powerful explosions in the universe, thought to be the birth cries of black holes. It has taken 40 years of international cooperation and competition to begin to unravel the mystery of their origin. The most recent chapter in this field is being written by the SWIFT mission, a fast-response satellite with 3 power telescopes. An international team from countries all over the world participates in the chase to capture the fading light of bursts detected by SWIFT. This talk will discuss the challenges and excitement of building this space observatory. New results will be presented on our growing understanding of exploding stars and fiery mergers of orbiting stars.

21 CFR 520.1242b - Levamisole hydrochloride tablet or oblet (bolus).

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 6 2012-04-01 2012-04-01 false Levamisole hydrochloride tablet or oblet (bolus). 520.1242b Section 520.1242b Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) ANIMAL DRUGS, FEEDS, AND RELATED PRODUCTS ORAL DOSAGE FORM NEW ANIMAL DRUGS...

Effects of Verbal Cue on Bolus Flow during Swallowing

ERIC Educational Resources Information Center

Daniels, Stephanie K.; Schroeder, Mae Fern; DeGeorge, Pamela C.; Corey, David M.; Rosenbek, John C.

2007-01-01

Purpose: To examine the effects of verbal cuing to initiate swallowing on bolus flow measures in healthy adults. Method: Videofluoroscopic examinations were completed in 12 healthy older adults (median age = 69 years) as they swallowed 5 ml of self-administered liquid barium in 2 conditions: verbally cued and noncued swallows. In the cued…

Oesophageal intraluminal impedance can identify subtle bolus transit abnormalities in patients with mild oesophagitis.

PubMed

Sifrim, Daniel; Tutuian, Radu

2005-03-01

In a subgroup of patients with non-erosive gastroesophageal reflux disease (GORD) or mild oesophagitis, acid clearance is prolonged in spite of favourable gravity and normal or minimally impaired oesophageal peristalsis. Dysphagia is rare in this group but might also be present or develop after anti-reflux surgery. The causal relationship between prolonged clearance or dysphagia and oesophageal body dysmotility in these patients is not completely clear. New techniques are now available to assess oesophageal motility and transit and might help to detect more subtle defects underlying functional impairment in patients with GORD. Combined video-fluoroscopy and intraluminal impedance indicate an excellent correlation between both methods in detecting oesophageal bolus transit. Combined intraluminal impedance and manometry has the capability to evaluate oesophageal contractions and bolus transit without the use of radiation. Subtle bolus transit abnormalities were identified in a small proportion of patients with mild oesophagits and normal oesophageal peristalsis. Outcome data are needed to evaluate the prognostic value of combined manometry-impedance in patients with GORD undergoing anti-reflux surgery.

An implantable bolus infusion pump for use in freely moving, nontethered rats

PubMed Central

HOLSCHNEIDER, D. P.; MAAREK, J.-M. I.; HARIMOTO, J.; YANG, J.; SCREMIN, O. U.

2014-01-01

One of the current constraints on functional neuroimaging in animals is that to avoid movement artifacts during data acquisition, subjects need to be immobilized, sedated, or anesthetized. Such measures limit the behaviors that can be examined, and introduce the additional variables of stress or anesthetic agents that may confound meaningful interpretation. This study provides a description of the design and characteristics of a self-contained, implantable microbolus infusion pump (MIP) that allows triggering of a bolus injection at a distance in conscious, behaving rats that are not restrained or tethered. The MIP is externally triggered by a pulse of infrared light and allows in vivo bolus drug delivery. We describe application of this technology to the intravenous bolus delivery of iodo[14C]antipyrine in a freely moving animal, followed immediately by lethal injection, rapid removal of the brain, and analysis of regional cerebral blood flow tissue radioactivity with the use of autoradiography. The ability to investigate changes in brain activation in nonrestrained animals makes the MIP a powerful tool for evaluation of complex behaviors. PMID:12234827

Neuromechanical factors involved in the formation and propulsion of fecal pellets in the guinea-pig colon.

PubMed

Costa, M; Wiklendt, L; Simpson, P; Spencer, N J; Brookes, S J; Dinning, P G

2015-10-01

The neuromechanical processes involved in the formation and propulsion of fecal pellets remain incompletely understood. We analyzed motor patterns in isolated segments of the guinea-pig proximal and distal colon, using video imaging, during oral infusion of liquid, viscous material, or solid pellets. Colonic migrating motor complexes (CMMCs) in the proximal colon divided liquid or natural semisolid contents into elongated shallow boluses. At the colonic flexure these boluses were formed into shorter, pellet-shaped boluses. In the non-distended distal colon, spontaneous CMMCs produced small dilations. Both high- and low-viscosity infusions evoked a distinct motor pattern that produced pellet-shaped boluses. These were propelled at speeds proportional to their surface area. Solid pellets were propelled at a speed that increased with diameter, to a maximum that matched the diameter of natural pellets. Pellet speed was reduced by increasing resistive load. Tetrodotoxin blocked all propulsion. Hexamethonium blocked normal motor patterns, leaving irregular propagating contractions, indicating the existence of neural pathways that did not require nicotinic transmission. Colonic migrating motor complexes are responsible for the slow propulsion of the soft fecal content in the proximal colon, while the formation of pellets at the colonic flexure involves a content-dependent mechanism in combination with content-independent spontaneous CMMCs. Bolus size and consistency affects propulsion speed suggesting that propulsion is not a simple reflex but rather a more complex process involving an adaptable neuromechanical loop. © 2015 John Wiley & Sons Ltd.

Bolus intrathecal injection of ziconotide (Prialt®) to evaluate the option of continuous administration via an implanted intrathecal drug delivery (ITDD) system: a pilot study.

PubMed

Mohammed, Salma I; Eldabe, Sam; Simpson, Karen H; Brookes, Morag; Madzinga, Grace; Gulve, Ashish; Baranidharan, Ganesan; Radford, Helen; Crowther, Tracey; Buchser, Eric; Perruchoud, Christophe; Batterham, Alan Mark

2013-01-01

This study evaluated efficacy and safety of bolus doses of ziconotide (Prialt®, Eisai Limited, Hertfordshire, UK) to assess the option of continuous administration of this drug via an implanted intrathecal drug delivery system. Twenty adults with severe chronic pain who were under consideration for intrathecal (IT) therapy were enrolled in this open label, nonrandomized, pilot study. Informed consent was obtained. Demographics, medical/pain history, pain scores, and concomitant medications were recorded. A physical examination was performed. Creatine kinase was measured. Initial visual analog scale (VAS), blood pressure, heart rate, and respiratory rate were recorded. All patients received an initial bolus dose of 2.5 mcg ziconotide; the dose in the subsequent visits was modified according to response. Subsequent doses were 2.5 mcg, 1.2 mcg, or 3.75 mcg as per protocol. A good response (≥30% reduction in baseline pain VAS) with no side-effects on two occasions was considered a successful trial. Data were analyzed using a generalized estimating equations model, with pain VAS as the outcome and time (seven time points; preinjection and one to six hours postinjection) as the predictor. Generalized estimating equations analysis of summary measures showed a mean reduction of pain VAS of approximately 25% at the group level; of 11 responders, seven underwent pump implantation procedure, two withdrew because of adverse effects, one refused an implant, and one could not have an implant (lack of funding from the Primary Care Trust). Our data demonstrated that mean VAS was reduced by approximately 25% at the group level after IT ziconotide bolus. Treatment efficacy did not vary with sex, center, age, or pain etiology. Ziconotide bolus was generally well tolerated. Larger studies are needed to determine if bolus dosing with ziconotide is a good predictor of response to continuous IT ziconotide via an intrathecal drug delivery system. © 2012 International Neuromodulation Society.

Intermittent furosemide administration in patients with or at risk for acute kidney injury: Meta-analysis of randomized trials

PubMed Central

Bove, Tiziana; Belletti, Alessandro; Putzu, Alessandro; Pappacena, Simone; Denaro, Giuseppe; Bagshaw, Sean M.; Zangrillo, Alberto

2018-01-01

Background Furosemide is the most common loop diuretic used worldwide. The off-label administration of furosemide bolus(es) for the prevention or to reverse acute kidney injury (AKI) is widespread but not supported by available evidence. We conducted a meta-analysis of randomized trials (RCTs) to investigate whether bolus furosemide to prevent or treat AKI is detrimental on patients’ survival. Methods Electronic databases were searched through October 2017 for RCTs comparing bolus furosemide administration versus any comparator in patients with or at risk for AKI. The primary endpoint was all-cause longest follow-up mortality. Secondary endpoints included new or worsening AKI, receipt of renal replacement therapy, length of hospital stay, and peak serum creatinine after randomization. Results A total of 28 studies randomizing 3,228 patients were included in the analysis. We found no difference in mortality between the two groups (143/892 [16%] in the furosemide group versus 141/881 [16%] in the control group; odds ratio [OR], 0.84; 95% confidence interval [CI], 0.63 to 1.13; p = 0.25). No significant differences in secondary outcomes were found. A significant improvement in survival was found in the subgroup of patients receiving furosemide bolus(es) as a preventive measure (43/613 [7.0%] versus 67/619 [10.8%], OR 0.62; 95% CI, 0.41 to 0.94; p = 0.03) Conclusions Intermittent furosemide administration is not associated with an increased mortality in patients with or at risk for AKI, although it may reduce mortality when used as a preventive measure. Future high-quality RCTs are needed to define the role of loop diuretics in AKI prevention and management. Trial registration The study protocol was registered on PROSPERO database for systematic reviews (Registration no. CRD42017078607 – http://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42017078607). PMID:29689116

Cost-effectiveness of once daily GLP-1 receptor agonist lixisenatide compared to bolus insulin both in combination with basal insulin for the treatment of patients with type 2 diabetes in Norway.

PubMed

Huetson, Pernilla; Palmer, James L; Levorsen, Andrée; Fournier, Marie; Germe, Maeva; McLeod, Euan

2015-01-01

Lixisenatide is a potent, selective and short-acting once daily prandial glucagon-like peptide-1 receptor agonist which lowers glycohemoglobin and body weight by clinically significant amounts in patients with type 2 diabetes treated with basal insulin, with limited risk of hypoglycemia. To assess the cost-effectiveness of lixisenatide versus bolus insulin, both in combination with basal insulin, in patients with type 2 diabetes in Norway. The IMS CORE Diabetes Model, a non-product-specific and validated simulation model, was used to make clinical and cost projections. Transition probabilities, risk adjustments and the progression of complication risk factors were derived from the UK Prospective Diabetes Study, supplemented with Norwegian data. Patients were assumed to receive combination treatment with basal insulin, lixisenatide or bolus insulin therapy for 3 years, followed by intensification of a basal-bolus insulin regimen for their remaining lifetime. Simulated healthcare costs, taken from the public payer perspective, were derived from microcosting and diagnosis related groups, discounted at 4% per annum and reported in Norwegian krone (NOK). Productivity costs were also captured based on extractions from the Norwegian Labor and Welfare Administration. Health state utilities were derived from a systematic literature review. Sensitivity and scenario analyses were performed. Lixisenatide in combination with basal insulin was associated with increased quality-adjusted life years (QALYs) and reduced lifetime healthcare costs compared to bolus insulin in combination with basal insulin in patients with Type 2 diabetes, and can be considered dominant. The net monetary benefit of lixisenatide versus bolus insulin was NOK 39,369 per patient. Results were sensitive to discounting, the application of excess body weight associated disutility and uncertainty surrounding the changes in HbA1c. Lixisenatide may be considered an economically efficient therapy in combination with basal insulin in the Norwegian setting, due to cost savings, weight loss and associated gains in health-related quality of life.

SU-F-T-86: Electron Dosimetric Effects of Bolus and Lens Shielding in Treating Superficial Eye Lesions

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

Young, L; Wootton, L; Gopan, O

Purpose: Electron therapy for the treatment of ocular lymphomas requires the lens to be shielded to prevent secondary cataracts. This work evaluates the dosimetry under a suspended eyeshield with and without bolus for low energy electron fields. Methods: Film (GafChromic EBT3) dosimetry and relative output factors were measured for 6, 8, and 10 MeV electron energies. A customized 5 cm diameter circle electron orbital cutout was constructed for a 6×6 cm applicator with a lens shield, 1 cm diameter Cerrobend cylinder with 2.2 cm length, suspended from an XV film covering the open field. Relative output factors were measured usingmore » a Scanditronix electron diode in a solid water phantom. Depth dose profiles were collected for bolus thicknesses of 0, 3, and 5 mm in solid water at a source to surface distance (SSD) of 100 cm. These measurements were repeated in a Rando phantom. Results: At 5 mm, the approximate distance of the lens from the surface of the cornea, the estimated dose in solid water under the suspended lens shield was reduced to 16%, 14%, and 13% of the unblocked dose at the same depth, for electron energies of 6, 8, and 10 MeV, respectively. Applying bolus increased estimated doses under the block to 22% for 3-mm and 32% for 5-mm thicknesses for a 6 MeV incident electron beam. This effect is reduced for higher energies where the corresponding values were 15.5% and 18% for 3-mm and 5-mm for an 8 MeV electron beam. Conclusion: The application of bolus to treat superficial eye lesions of the conjunctiva increases lens dose at a depth of 5-mm under the shielding block with decreasing electron energy. Careful selection of electron energy is needed to account for electron scatter under the lens shield with the application of bolus in order to prevent cataracts.« less

Dual-energy CT iodine maps as an alternative quantitative imaging biomarker to abdominal CT perfusion: determination of appropriate trigger delays for acquisition using bolus tracking.

PubMed

Skornitzke, Stephan; Fritz, Franziska; Mayer, Philipp; Koell, Marco; Hansen, Jens; Pahn, Gregor; Hackert, Thilo; Kauczor, Hans-Ulrich; Stiller, Wolfram

2018-05-01

Quantitative evaluation of different bolus tracking trigger delays for acquisition of dual energy (DE) CT iodine maps as an alternative to CT perfusion. Prior to this retrospective analysis of prospectively acquired data, DECT perfusion sequences were dynamically acquired in 22 patients with pancreatic carcinoma using dual source CT at 80/140 kV p with tin filtration. After deformable motion-correction, perfusion maps of blood flow (BF) were calculated from 80 kV p image series of DECT, and iodine maps were calculated for each of the 34 DECT acquisitions per patient. BF and iodine concentrations were measured in healthy pancreatic tissue and carcinoma. To evaluate potential DECT acquisition triggered by bolus tracking, measured iodine concentrations from the 34 DECT acquisitions per patient corresponding to different trigger delays were assessed for correlation to BF and intergroup differences between tissue types depending on acquisition time. Average BF measured in healthy pancreatic tissue and carcinoma was 87.6 ± 28.4 and 38.6 ± 22.2 ml/100 ml min -1 , respectively. Correlation between iodine concentrations and BF was statistically significant for bolus tracking with trigger delay greater than 0 s (r max = 0.89; p < 0.05). Differences in iodine concentrations between healthy pancreatic tissue and carcinoma were statistically significant for DECT acquisitions corresponding to trigger delays of 15-21 s (p < 0.05). An acquisition window between 15 and 21 s after exceeding bolus tracking threshold shows promising results for acquisition of DECT iodine maps as an alternative to CT perfusion measurements of BF. Advances in knowledge: After clinical validation, DECT iodine maps of pancreas acquired using bolus tracking with appropriate trigger delay as determined in this study could offer an alternative quantitative imaging biomarker providing functional information for tumor assessment at reduced patient radiation exposure compared to CT perfusion measurements of BF.

High-dose, single-bolus eptifibatide: a safe and cost-effective alternative to conventional glycoprotein IIb/IIIa inhibitor use for elective coronary interventions.

PubMed

Fischell, Tim A; Attia, Tamer; Rane, Santosh; Salman, Waddah

2006-10-01

Adjunctive pharmacotherapy with eptifibatide, a glycoprotein (GP) IIb/IIIa inhibitor, as an intravenous bolus followed by infusion has been shown to improve outcomes in elective coronary interventions (PCI). However, bleeding complications and costs have limited the routine adoption of this regimen. The goal of this study was to examine the safety, efficacy and cost-effectiveness of high-dose, single-bolus eptifibatide, without post-intervention infusion, in "real-world" patients undergoing elective PCI. We studied 401 patients with stable and unstable angina who were treated with a high-dose (20 mg), single bolus of eptifibatide plus heparin prior to the start of elective PCI. Exclusion criteria included recent MI, stenting of bypass graft(s), rotational atherectomy and/or brachytherapy. The primary study endpoints were major adverse clinical events (MACE), defined as the in-hospital and 30-day incidence of death from any cause, Q-wave or non-Q-wave MI, repeat target vessel revascularization and/or major bleeding complications. Relevant demographic and procedural characteristics included mean age: 66.4 +/- 11.2; male gender: 242/401 (61%); number of vessels treated per patient: 1.46 +/- 0.42; and number of stents deployed per patient: 1.82 +/- 0.65. In-hospital non-Q-wave MI (CPK and/or CPK-MB > 3 times the upper limit of normal) occurred in 7/401 patients (1.75%) and MACE was 2.25%. Major bleeding complications were seen in 2/401 patients (0.49%). There were 4 additional MACE events at 30-day follow up (total MACE and bleeding = 3.25%). The average anticoagulation cost was 66 dollars/patient. Intravenous eptifibatide, administered as a high-dose (20 mg) single-vial bolus, is a safe, effective and highly cost-effective alternative to the conventional regimens of bolus plus prolonged intravenous GP IIb/IIIa inhibitor infusion for patients undergoing elective PCI.

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

Kalavagunta, C; Lin, M; Snider, J

Purpose: To quantify the factors leading to thermoplastic mask bolus-associated-increased skin dose in head and neck IMRT/VMAT using EBT2 film. Methods: EBT2 film placed beneath a dual layer 3-point ORFIT head, neck and shoulder mask was used to test the effect of mask thickness, beam modulation, air gap, and beam obliquity on bolus effect. Mask thickness was varied based on the distribution of 1.6mm Orfilight layer on top of 2 mm Efficast layer. Beam modulation was varied by irradiating the film with an open field (no beam modulation) and a step and shoot field (beam modulation). Air gap between maskmore » and film was varied from 0 to 5mm. Beam obliquity was varied by irradiating the film at gantry angles of 0°, 35°, and 70°.Finally, film strips placed on a Rando phantom under an Orfit mask, in regions of expected high dose, were irradiated using 5 IMRT and 5 VMAT plans with various modulation levels (modulation factor 2 to 5) and the results were compared with those obtained placing OSLDs at the same locations. Results: An 18–34% increase in mask bolus effect was observed for three factors where the effect of beam obliquity ≥ beam modulation > mask thickness. No increase in mask bolus effect was observed for change in air gap. A 6–13% increase in dose due to mask bolus effect was observed on film strips. Conclusion: This work underlines the role of beam obliquity and beam modulation combined with thermoplastic mask thickness in increasing mask bolus-associated skin dose in head and neck IMRT/VMAT. One possible method of dose reduction, based on knowledge gained from this work, is inclusion of skin as an avoidance structure in treatment planning. Another approach is to design a mask with the least amount of thermoplastic material necessary for immobilization.« less

SU-E-T-72: Commissioning of a Standardized SRS Cone Set: Determination of the Bolus Gap Factors in a Passively Scattered Proton Beam

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

Simpson, R; Gordon, I; Ghebremedhin, A

2014-06-01

Purpose: To determine the proton output factors for an SRS cone set using standardized apertures and varied range compensators (bolus blanks); specifically, to determine the best method for modeling the bolus gap factor (BGF) and eliminate the need for patient specific calibrations. Methods: A Standard Imaging A-16 chamber was placed in a Plastic Water phantom to measure the change in dose/MU with different treatment combinations for a proton SRS cone, using standardized apertures and range compensators. Measurements were made with all apertures in the SRS cone set, with four different range compensator thicknesses and five different air gaps between themore » end of the SRS cone and the surface of the phantom. The chamber was located at iso-center and maintained at a constant depth at the center of modulation for all measurements. Each aperture was placed in the cone to measure the change in MU needed to maintain constant dose at the chamber, as the air gap was increased with different thicknesses of bolus. Results: The dose/MU varied significantly with decreasing aperture size, increasing bolus thickness, or increasing air gap. The measured data was fitted with the lowest order polynomials that accurately described the data, to create a model for determining the change in output for any potential combination of devices used to treat a patient. For a given standardized aperture, the BGF could be described by its constituent factors: the bolus thickness factor (BTF) and the nozzle extension factor (NEF). Conclusion: The methods used to model the dose at the calibration point could be used to accurately predict the change in output for SRS proton beams due to the BGF, eliminating the need for patient specific calibrations. This method for modeling SRS treatments could also be applied to model other treatments using passively scattered proton beams.« less

Economic Synergy between Dry Cow Diet Improvement and Monensin Bolus Use to Prevent Subclinical Ketosis: An Experimental Demonstration Based on Available Literature

PubMed Central

Raboisson, Didier; Barbier, Maxime

2017-01-01

The prevention of subclinical ketosis (SCK) is based on maintaining adequate nutrition in dairy cows during the dry period and close to calving. Recently, an oral-route monensin bolus to prevent SCK was approved in Europe. The present study aims to define the allocation of resources for SCK management at the herd level and evaluate the profitability of administering monensin boluses in cows at risk for SCK. A stochastic model was used to calculate the total cost of SCK for a population with a given prevalence of cows at risk for SCK. This model included the ability of the farmer to correctly target and preventatively treat these cows at risk for SCK. The results clearly demonstrated economic synergy between two management practices. First, reducing the prevalence of cows at risk for SCK dramatically reduces the total cost of SCK and seems profitable in most situations. Second, monensin bolus use to reduce the occurrence of SCK in cows already at risk for SCK is cost-effective. The results also highlighted three economic strategies to manage SCK in the dairy industry in Europe. First, monensin bolus use throughout an entire herd when the prevalence of cows at risk for SCK is high is only profitable in the short-term as a tool to correct acute deterioration at the herd level. Second, decreasing the prevalence of cows at risk for SCK through adequate feeding in the dry period is of financial interest as a baseline strategy when prevalence is high, assuming moderate additional cost linked to the new diet. Third, monensin bolus use when the prevalence of cows at risk for SCK is low is also profitable as a long-term strategy when only cows at high risk for SCK (such as cows that are over-conditioned, old, or have a previous history of SCK-related disorders) are targeted for preventative treatment. Authors suggest to use the present results considering that farmers have a correct, but not perfect, ability to target animals to be preventively targeted with the monensin bolus. Further work is required to facilitate the early identification of cows at risk for SCK. PMID:28382302

Digital data sets that describe aquifer characteristics of the Central Oklahoma Aquifer in central Oklahoma

USGS Publications Warehouse

Runkle, D.L.; Christenson, S.C.; Rea, Alan

1997-01-01

ARC/INFO export files The data sets in this report include digitized aquifer boundaries and maps of hydraulic conductivity, recharge, and ground-water level elevation contours for the Central Oklahoma aquifer in central Oklahoma. This area encompasses all or part of Cleveland, Lincoln, Logan, Oklahoma, Payne, and Pottawatomie Counties. The Central Oklahoma aquifer includes the alluvial and terrace deposits along major streams, the Garber Sandstone and Wellington Formations, and the Chase, Council Grove, and Admire Groups. The Quaternary-age alluvial and terrace deposits consist of unconsolidated clay, silt, sand, and gravel. The Permian-age Garber Sandstone and Wellington Formations consist of sandstone with interbedded siltstone and mudstone. The Permian-age Chase, Council Grove, and Admire Groups consist of sandstone, shale, and thin limestone. The Central Oklahoma aquifer underlies about 3,000 square miles of central Oklahoma where the aquifer is used extensively for municipal, industrial, commercial, and domestic water supplies. Most of the usable ground water within the aquifer is from the Garber Sandstone and Wellington Formations. Substantial quantities of usable ground water also are present in the Chase, Council Grove, and Admire Groups, and in alluvial and terrace deposits associated with the major streams. The aquifer boundaries, hydraulic conductivity and recharge values, and ground-water level elevation contours are from previously published reports.

Real-time measurements of nitrogen oxide emissions from in-use New York City transit buses using a chase vehicle.

PubMed

Shorter, Joanne H; Herndon, Scott; Zahniser, Mark S; Nelson, David D; Wormhoudt, Joda; Demerjian, Kenneth L; Kolb, Charles E

2005-10-15

New diesel engine technologies and alternative fuel engines are being introduced into fleets of mass transit buses to try to meet stricter emission regulations of nitrogen oxides and particulates: Real-time instruments including an Aerodyne Research tunable infrared laser differential absorption spectrometer (TILDAS) were deployed in a mobile laboratory to assess the impact of the implementation of the new technologies on nitrogen oxide emissions in real world driving conditions. Using a "chase" vehicle sampling strategy, the mobile laboratory followed target vehicles, repeatedly sampling their exhaust. Nitrogen oxides from approximately 170 in-use New York City mass transit buses were sampled during the field campaigns. Emissions from conventional diesel buses, diesel buses with continuously regenerating technology (CRT), diesel hybrid electric buses, and compressed natural gas (CNG) buses were compared. The chase vehicle sampling method yields real world emissions that can be included in more realistic emission inventories. The NO, emissions from the diesel and CNG buses were comparable. The hybrid electric buses had approximately one-half the NOx emissions. In CRT diesels, NO2 accounts for about one-third of the NOx emitted in the exhaust, while for non-CRT buses the NO2 fraction is less than 10%.

Optimization of initial propofol bolus dose for EEG Narcotrend Index-guided transition from sevoflurane induction to intravenous anesthesia in children.

PubMed

Dennhardt, Nils; Boethig, Dietmar; Beck, Christiane; Heiderich, Sebastian; Boehne, Martin; Leffler, Andreas; Schultz, Barbara; Sümpelmann, Robert

2017-04-01

Sevoflurane induction followed by intravenous anesthesia is a widely used technique to combine the benefits of an easier and less traumatic venipuncture after sevoflurane inhalation with a recovery with less agitation, nausea, and vomiting after total intravenous anesthesia (TIVA). Combination of two different anesthetics may lead to unwanted burst suppression in the electroencephalogram (EEG) during the transition phase. The objective of this prospective clinical observational study was to identify the optimal initial propofol bolus dose for a smooth transition from sevoflurane induction to TIVA using the EEG Narcotrend Index (NI). Fifty children aged 1-8 years scheduled for elective pediatric surgery were studied. After sevoflurane induction and establishing of an intravenous access, a propofol bolus dose range 0-5 mg·kg -1 was administered at the attending anesthetist's discretion to maintain a NI between 20 and 64, and sevoflurane was stopped. Anesthesia was continued as TIVA with a propofol infusion dose of 15 mg·kg -1 ·h -1 for the first 15 min, followed by stepwise reduction according to McFarlan's pediatric infusion regime, and remifentanil 0.25 μg·kg -1 ·min -1 . Endtidal concentration of sevoflurane, NI, and hemodynamic data were recorded during the whole study period using a standardized case report form. Propofol plasma concentrations were calculated using the paedfusor dataset and a TIVA simulation program. Median endtidal concentration of sevoflurane at the time of administration of the propofol bolus was 5.1 [IQR 4.7-5.9] Vol%. The median propofol bolus dose was 1.2 [IQR 0.9-2.5] mg·kg -1 and median NI thereafter was 33 [IQR 23-40]. Nine children presented with a NI 13-20 and three children with burst suppression in the EEG (NI 0-12); all of them received an initial propofol bolus dose >2 mg·kg -1 . Regression equation demonstrated that NI 20-64 was achieved with a 95% probability when using a propofol bolus dose of 1 mg·kg -1 after sevoflurane induction. Decrease in mean arterial blood pressure correlated significantly with propofol bolus dose (P = 0.038). After 25 min of TIVA, children younger than 2 years had a higher NI (median difference 14.0, 95%CI: 6.0-20.0, P = 0.001), higher deviations from the expected Narcotend Index (median difference 4.1, 95%CI: 3.9-4.2, P < 0.001) and lower calculated propofol plasma concentrations (median difference 0.2 μg·ml -1 , 95% CI: 0.1-0.3 μg·ml -1 , P < 0.001) than older children. After sevoflurane induction, a reduced propofol bolus dose of 1 mg·kg -1 followed by TIVA according to McFarlan's regime resulted in a NI within the recommended range in children aged 1-8 years. During the course of TIVA, children younger than 2 years displayed higher NI values and more pronounced interindividual variation. Processed EEG monitoring is recommended to find adequate individual age-dependent doses. © 2017 John Wiley & Sons Ltd.

Proper medical diagnosis and treatment with computer aided system

NASA Astrophysics Data System (ADS)

Pedowski, Tomasz; Wasiewicz, Piotr; Maciejewski, Ryszard; Wallner, Grzegorz

2009-06-01

Nowadays computers successfully analyze medical data giving results used for futher treatment. Every year we develop new technology which gives us better and more precise diagnose. We chose esophageal manometry (EFT) which has been considered as a "gold standard" test for the evaluation of esophageal motility. EFT allows physicians to get informations about esophageal peristalsis, amplitude and duration of the esophageal contraction and liquid/viscous bolus transit time from mouth through stomach. We examined 80 patients during 2008 year. Everybody got EFT, endoscopy and X-Ray examination. It was important to ask about symptoms which we correlate and connect with data from EFT. We tried to find a good algorithm for this job in order to do a simple and helpful tool for physician to make right diagnose. Connection between data and symptoms seems to be right and clear, but finding a good algorithm for given data is the main problem.

Gadolinium-enhanced computed tomographic angiography: current status.

PubMed

Rosioreanu, Alex; Alberico, Ronald A; Litwin, Alan; Hon, Man; Grossman, Zachary D; Katz, Douglas S

2005-01-01

This article reviews the research to date, as well as our clinical experience from two institutions, on gadolinium-enhanced computed tomographic angiography (gCTA) for imaging the body. gCTA may be an appropriate examination for the small percentage of patients who would benefit from noninvasive vascular imaging, but who have contraindications to both iodinated contrast and magnetic resonance imaging. gCTA is more expensive than CTA with iodinated contrast, due to the dose of gadolinium administered, and gCTA has limitations compared with CTA with iodinated contrast, in that parenchymal organs are not optimally enhanced at doses of 0.5 mmol/kg or lower. However, in our experience, gCTA has been a very useful problem-solving examination in carefully selected patients. With the advent of 16-64 detector CT, in combination with bolus tracking, we believe that the overall dose of gadolinium needed for diagnostic CTA examinations, while relatively high, can be safely administered.

Automated Monitoring and Analysis of Social Behavior in Drosophila

PubMed Central

Dankert, Heiko; Wang, Liming; Hoopfer, Eric D.; Anderson, David J.; Perona, Pietro

2009-01-01

We introduce a method based on machine vision for automatically measuring aggression and courtship in Drosophila melanogaster. The genetic and neural circuit bases of these innate social behaviors are poorly understood. High-throughput behavioral screening in this genetically tractable model organism is a potentially powerful approach, but it is currently very laborious. Our system monitors interacting pairs of flies, and computes their location, orientation and wing posture. These features are used for detecting behaviors exhibited during aggression and courtship. Among these, wing threat, lunging and tussling are specific to aggression; circling, wing extension (courtship “song”) and copulation are specific to courtship; locomotion and chasing are common to both. Ethograms may be constructed automatically from these measurements, saving considerable time and effort. This technology should enable large-scale screens for genes and neural circuits controlling courtship and aggression. PMID:19270697

Detection of BrdU-label Retaining Cells in the Lacrimal Gland: Implications for Tissue Repair

PubMed Central

You, Samantha; Tariq, Ayesha; Kublin, Claire L.; Zoukhri, Driss

2011-01-01

The purpose of the present study was to determine if the lacrimal gland contains 5-bromo-2’-deoxyuridine (BrdU)-label retaining cells and if they are involved in tissue repair. Animals were pulsed daily with BrdU injections for 7 consecutive days. After a chase period of 2, 4, or 12 weeks, the animals were sacrificed and the lacrimal glands were removed and processed for BrdU immunostaining. In another series of experiments, the lacrimal glands of 12-week chased animals were either left untreated or were injected with interleukin 1 (IL-1) to induce injury. Two and half day post-injection, the lacrimal glands were removed and processed for BrdU immunostaining. After 2 and 4 week of chase period, a substantial number of lacrimal gland cells were BrdU+ (11.98 ± 1.84 and 7.95 ± 1.83 BrdU+ cells/mm2, respectively). After 12 weeks of chase, there was a 97% decline in the number of BrdU+ cells (0.38 ± 0.06 BrdU+ cells/mm2), suggesting that these BrdU-label retaining cells may represent slow-cycling adult stem/progenitor cells. In support of this hypothesis, the number of BrdU labeled cells increased over 7-fold during repair of the lacrimal gland (control: 0.41 ± 0.09 BrdU+ cells/mm2, injured: 2.91 ± 0.62 BrdU+ cells/mm2). Furthermore, during repair, among BrdU+ cells 58.2 ± 3.6 % were acinar cells, 26.4 ± 4.1% were myoepithelial cells, 0.4 ± 0.4% were ductal cells, and 15.0 ± 3.0% were stromal cells. We conclude that the murine lacrimal gland contains BrdU-label retaining cells that are mobilized following injury to generate acinar, myoepithelial and ductal cells. PMID:22101331

Energetics and evasion dynamics of large predators and prey: pumas vs. hounds

PubMed Central

Wilmers, Christopher C.; Williams, Terrie M.

2017-01-01

Quantification of fine-scale movement, performance, and energetics of hunting by large carnivores is critical for understanding the physiological underpinnings of trophic interactions. This is particularly challenging for wide-ranging terrestrial canid and felid predators, which can each affect ecosystem structure through distinct hunting modes. To compare free-ranging pursuit and escape performance from group-hunting and solitary predators in unprecedented detail, we calibrated and deployed accelerometer-GPS collars during predator-prey chase sequences using packs of hound dogs (Canis lupus familiaris, 26 kg, n = 4–5 per chase) pursuing simultaneously instrumented solitary pumas (Puma concolor, 60 kg, n = 2). We then reconstructed chase paths, speed and turning angle profiles, and energy demands for hounds and pumas to examine performance and physiological constraints associated with cursorial and cryptic hunting modes, respectively. Interaction dynamics revealed how pumas successfully utilized terrain (e.g., fleeing up steep, wooded hillsides) as well as evasive maneuvers (e.g., jumping into trees, running in figure-8 patterns) to increase their escape distance from the overall faster hounds (avg. 2.3× faster). These adaptive strategies were essential to evasion in light of the mean 1.6× higher mass-specific energetic costs of the chase for pumas compared to hounds (mean: 0.76 vs. 1.29 kJ kg−1 min−1, respectively). On an instantaneous basis, escapes were more costly for pumas, requiring exercise at ≥90% of predicted \\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{upgreek} \\usepackage{mathrsfs} \\setlength{\\oddsidemargin}{-69pt} \\begin{document} }{}$\\dot {\\mathrm{V }}{\\mathrm{O}}_{2\\mathrm{MAX}}$\\end{document}V ˙O2MAX and consuming as much energy per minute as approximately 5 min of active hunting. Our results demonstrate the marked investment of energy for evasion by a large, solitary carnivore and the advantage of dynamic maneuvers to postpone being overtaken by group-hunting canids. PMID:28828280

Pilots' Attention Distributions Between Chasing a Moving Target and a Stationary Target.

PubMed

Li, Wen-Chin; Yu, Chung-San; Braithwaite, Graham; Greaves, Matthew

2016-12-01

Attention plays a central role in cognitive processing; ineffective attention may induce accidents in flight operations. The objective of the current research was to examine military pilots' attention distributions between chasing a moving target and a stationary target. In the current research, 37 mission-ready F-16 pilots participated. Subjects' eye movements were collected by a portable head-mounted eye-tracker during tactical training in a flight simulator. The scenarios of chasing a moving target (air-to-air) and a stationary target (air-to-surface) consist of three operational phases: searching, aiming, and lock-on to the targets. The findings demonstrated significant differences in pilots' percentage of fixation during the searching phase between air-to-air (M = 37.57, SD = 5.72) and air-to-surface (M = 33.54, SD = 4.68). Fixation duration can indicate pilots' sustained attention to the trajectory of a dynamic target during air combat maneuvers. Aiming at the stationary target resulted in larger pupil size (M = 27,105, SD = 6565), reflecting higher cognitive loading than aiming at the dynamic target (M = 23,864, SD = 8762). Pilots' visual behavior is not only closely related to attention distribution, but also significantly associated with task characteristics. Military pilots demonstrated various visual scan patterns for searching and aiming at different types of targets based on the research settings of a flight simulator. The findings will facilitate system designers' understanding of military pilots' cognitive processes during tactical operations. They will assist human-centered interface design to improve pilots' situational awareness. The application of an eye-tracking device integrated with a flight simulator is a feasible and cost-effective intervention to improve the efficiency and safety of tactical training.Li W-C, Yu C-S, Braithwaite G, Greaves M. Pilots' attention distributions between chasing a moving target and a stationary target. Aerosp Med Hum Perform. 2016; 87(12):989-995.

Lung Volume during Swallowing: Single Bolus Swallows in Healthy Young Adults

ERIC Educational Resources Information Center

Hegland, Karen M. Wheeler; Huber, Jessica E.; Pitts, Teresa; Sapienza, Christine M.

2009-01-01

Purpose: This study examined the relationship between swallowing and lung volume initiation in healthy adults during single swallows of boluses differing in volume and consistency. Differences in lung volume according to respiratory phase surrounding the swallow were also assessed. Method: Nine men and 11 women between the ages of 19 and 28 years…

Financial stress, attitudes toward money, and scores on a Dream Inventory.

PubMed

Kroth, Jerry; Mann, Sonia; Cervantes, Carolina; Jaffe, Matthew; Ristic, Vera

2010-08-01

During stock market losses in 2009 and high unemployment, ratings on the KJP Dream Inventory were correlated with factors of the Money Attitude Scale and items on the Contemporary Financial Stress Inventory for 71 graduate students in Counseling Psychology and Education. Correlations were significant for Retention on the Money Attitude Scale with Dissociative Avoidance (-.31), Dreams of falling (.26), Risk-taking in dreams (.24), and Dreaming of being chased (.28). Also, ratings for the Money Attitude Scale of Distrust correlated with Discontentedness in dreams (.33) and Dreams of being chased (.26), Repetitive trauma (.33), Nightmares (.30), and Recurring nightmares (.35). Concern about retention in graduate school due to finances correlated with recalled frequencies of nightmares (.27) and dreams of flying (.25).

76 FR 77593 - Proposed Exemptions From Certain Prohibited Transaction Restrictions

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-13

...This document contains notices of pendency before the Department of Labor (the Department) of proposed exemptions from certain of the prohibited transaction restrictions of the Employee Retirement Income Security Act of 1974 (ERISA or the Act) and/or the Internal Revenue Code of 1986 (the Code). This notice includes the following proposed exemptions: D-11517, JPMorgan Chase & Co. and its Current and Future Affiliates and Subsidiaries (JPMorgan Chase); D- 11579, Delaware Charter Guarantee & Trust Co. d\\b\\a\\ Principle Trust Company (Principle Trust); D-11628, Aztec Well Servicing Company and Related Companies Medical Plan Trust Fund (the Plan); D-11669, Genzyme Corporation 401(k) Plan (the Plan or the Applicant); and Retirement Program for Employees of EnPro Industries (the Plan), D-11662 et al.

Comparison of double intravenous vasopressor automated system using nexfin versus manual vasopressor bolus administration for maintenance of haemodynamic stability during spinal anaesthesia for caesarean delivery: A randomised double-blind controlled trial.

PubMed

Sng, Ban Leong; Du, Wei; Lee, Man Xin; Ithnin, Farida; Mathur, Deepak; Leong, Wan Ling; Sultana, Rehena; Han, Nian-Lin R; Sia, Alex Tiong Heng

2018-05-01

Hypotension is a common side effect of spinal anaesthesia during caesarean delivery and is associated with maternal and foetal adverse effects. We developed an updated double intravenous vasopressor automated (DIVA) system that administers phenylephrine or ephedrine based on continuous noninvasive haemodynamic monitoring using the Nexfin device. The aim of our present study is to compare the performance and reliability of the DIVA system against Manual Vasopressor Bolus administration. A randomised, double-blind controlled trial. Single-centre, KK Women's and Children's Hospital, Singapore. Two hundred and thirty-six healthy women undergoing elective caesarean delivery under spinal anaesthesia. The primary outcome was the incidence of maternal hypotension. The secondary outcome measures were reactive hypertension, total vasopressor requirement and maternal and neonatal outcomes. The DIVA group had a significantly lower incidence of maternal hypotension, with 39.3% (46 of 117) patients having any SBP reading less than 80% of baseline compared with 57.5% (65 of 113) in the manual vasopressor bolus group (P = 0.008). The DIVA group also had fewer hypotensive episodes than the manual vasopressor bolus group (4.67 versus 7.77%; P < 0.0001). There was no difference in the incidence of reactive hypertension or the total vasopressor requirement. The DIVA group had less wobble in system performance. Maternal and neonatal outcomes were similar. The DIVA system achieved better control of maternal blood pressure after spinal anaesthesia than manual vasopressor bolus administration. Clinicaltrials.gov identifier: NCT02277730.

Effect of Admission Oral Diuretic Dose on Response to Continuous versus Bolus Intravenous Diuretics in Acute Heart Failure: An Analysis from DOSE-AHF

PubMed Central

Shah, Ravi V.; McNulty, Steven; O'Connor, Christopher M.; Felker, G. Michael; Braunwald, Eugene; Givertz, Michael M.

2014-01-01

Background Results from the Diuretic Optimization Strategies in Acute Heart Failure (DOSE-AHF) study suggest that an initial continuous infusion of loop diuretics is not superior to bolus dosing with regard to clinical endpoints in AHF. We hypothesized that outpatient furosemide dose was associated with congestion and poorer renal function, and explored the hypothesis that a continuous infusion may be more effective in patients on higher outpatient diuretic doses. Methods DOSE-AHF randomized 308 patients within 24 hours of admission to high vs. low initial intravenous diuretic dose given as either a continuous infusion or bolus. We compared baseline characteristics and assessed associations between mode of administration (bolus vs. continuous) and outcomes in patients receiving high-dose (≥120 mg furosemide equivalent, n=177) versus low-dose (<120 mg furosemide equivalent, n=131) outpatient diuretics. Results Patients on higher doses of furosemide were less frequently on renin-angiotensin system inhibitors (P=.01), and had worse renal function and more advanced symptoms. There was a significant interaction between outpatient dose and mode of therapy (P=0.01) with respect to net fluid loss at 72 hours after adjusting for creatinine and intensification strategy. Admission diuretic dose was associated with an increased risk of death or rehospitalization at 60 days (adjusted HR=1.08 per 20-mg increment in dose, 95% CI 1.01–1.16, P=.03). Conclusions In acute HF, patients on higher diuretic doses have greater disease severity, and may benefit from an initial bolus strategy. PMID:23194486

Prevalence of penetration and aspiration on videofluoroscopy in normal individuals without dysphagia.

PubMed

Allen, Jacqui E; White, Cheryl J; Leonard, Rebecca J; Belafsky, Peter C

2010-02-01

To determine the prevalence of penetration and aspiration on videofluoroscopic swallow studies (VFSS) in normal individuals without dysphagia. Case series with planned data collection. A tertiary urban university hospital. Normal adult volunteers without dysphagia, neurological disease, or previous surgery underwent VFSS. Studies were recorded and then reviewed for evidence of penetration or aspiration. The degree of penetration was assessed with the penetration-aspiration scale (PAS). The effect of age, bolus size, and consistency was evaluated. A total of 149 VFSS (596 swallows) were reviewed. The mean age of the cohort was 57 years (+/-19 years); 56 percent were female. Only one (0.6%) individual aspirated on VFSS. Seventeen (11.4%) individuals demonstrated penetration. The mean PAS for the entire cohort was 1.17 (+/-0.66). Prevalence of penetration by swallow was 2.85 percent (17/596). Prevalence of penetration was 9.3 percent in elderly individuals aged >65 years and 14.3 percent in adults aged <65 years (P = 0.49). Prevalence of penetration on a liquid bolus was 3.4 percent (15/447) and on paste was 1.3 percent (2/149) (P > 0.05). Prevalence of penetration for a bolus <30 cc was 2.34 percent (7/298) and for a bolus >30 cc was 5.4 percent (8/149) (P > 0.05). Aspiration on VFSS is not a normal finding. Penetration is present in 11.4 percent of normal adults and is more common with a liquid bolus. Copyright 2010 American Academy of Otolaryngology-Head and Neck Surgery Foundation. Published by Mosby, Inc. All rights reserved.

Impaired bolus clearance in combined high-resolution esophageal manometry and impedance measurement helps to differentiate between esophagogastric junction outflow obstruction and achalasia.

PubMed

Zizer, Eugen; Seufferlein, Thomas; Hänle, Mark Martin

2017-02-01

Introduction and aims  High-resolution esophageal manometry (HRM) has improved the diagnostic work-up of esophageal motility disorders. Simultaneous evaluation of bolus clearance delivers useful information about the function of tubular esophagus. We assessed bolus clearance in a combined HRM-impedance examination for esophagogastric junction outflow obstruction (EGJOO) in comparison to achalasia patients. The collected data were assessed in a retrospective analysis. Patients and methods  After gastroscopy excluded a mechanical esophageal or gastric obstruction, 142 consecutive patients underwent combined HRM-impedance examination. The assessment and interpretation of the manometry results were done according to the Chicago Classification of esophageal motility disorders v3.0. After classifying the motility disorder, the evaluation of bolus clearance was done according to published studies. Results  All patients with achalasia (n = 24) showed a significantly impaired bolus clearance (< 80 %). Patients with unaffected peristalsis (n = 56) or patients with EGJOO (n = 14) each showed impaired clearance in 7 %, respectively. The evidence of axial hernia was not associated with impaired clearance. Conclusion  Our results demonstrate a significant difference in impedance measurements between EGJOO and achalasia cases. This might be helpful as an additional tool to differentiate between achalasia and EGJOO patients. Furthermore, the role of the combined impedance-HRM investigation for early diagnosis of achalasia in "pre-achalasia" condition or in evaluation of potential progress of EGJOO to achalasia should be evaluated in a prospective study. © Georg Thieme Verlag KG Stuttgart · New York.

Prospective Evaluation of Severe Skin Toxicity and Pain During Postmastectomy Radiation Therapy

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

Pignol, Jean-Philippe, E-mail: j.p.pignol@erasmusmc.nl; Vu, Thi Trinh Thuc; Mitera, Gunita

Purpose: To prospectively capture acute toxicities and pain associated with postmastectomy radiation therapy (PMRT), to analyze patient and treatment risk factors for severe side effects. Methods and Materials: Women referred for PMRT were prospectively enrolled and assessed weekly during and after radiation therapy. The endpoint included severe National Cancer Institute Common Terminology Criteria for Adverse Effects grade 3 moist desquamation, other skin symptoms, and pain. Results: Of 257 patients, 73 (28.4%) experienced extensive moist desquamation, 84 (32.7%) Common Terminology Criteria for Adverse Effects skin toxicity grade 3, and 57 (22.2%) a pain impacting on daily life activities. Among symptoms only grademore » 3 moist desquamation was significantly associated with severe pain (P<.001). On multivariate analysis, smoking, high-energy photons, and skin bolus were significantly associated with severe moist desquamation. Skin toxicity doubled for smokers, with 40% severe pain, 48% grade 3 moist desquamation, and 64% grade 3 skin toxicity. Without skin bolus 4.2% had severe pain, none moist desquamation, and 2.1% grade 3 skin toxicity. When skin bolus was used on alternate days, the frequency increased to 15% for pain, 22% for moist desquamation, and 26% for grade 3 skin toxicity. When bolus was used daily, 32% had pain, 41% moist desquamation, and 47% grade 3 skin toxicity. Symptoms peaked 1 to 2 weeks after the end of PMRT. Conclusions: The present cohort study suggests excessive radiation toxicity after PMRT. Among factors associated with an increase of toxicity are smoking habits and the use of skin bolus.« less

Trans-oral partial epiglottidectomy to treat dysphagia in post-treatment head and neck cancer patients: a preliminary report

PubMed Central

Jamal, Nausheen; Erman, Andrew; Chhetri, Dinesh K.

2013-01-01

Objectives To determine symptoms and findings in patients with dysphagia related to epiglottic dysfunction. To analyze outcomes in patients who underwent partial epiglottidectomy due to dysphagia related to epiglottic dysfunction Study Design Review and analysis of clinical data obtained as part of the diagnosis and treatment of patients with dysphagia related to epiglottic dysfunction. Methods A retrospective review was performed of all post-treatment head and neck cancer patients who underwent epiglottidectomy at a single tertiary care referral center. Objective pre- and post-procedure swallow findings, endoscopic evaluation, and subjective improvement based on patient self-report were reviewed. Results Seven patients were identified based on endoscopic evaluation and modified barium swallow study (MBSS) as having epiglottic pathology leading to dysphagia. Specific anatomic and functional findings included thickening of the epiglottis, absence of epiglottic deflection, vallecular bolus retention during and after the swallow, and bolus backflow from the pharynx to the oral or nasal cavity. Partial epiglottidectomy was performed in these patients. Post-operative MBSS was analyzed for changes in swallow efficiency and safety. Nearly all patients demonstrated improved pharyngeal bolus passage with little to no added swallowing morbidity. Conclusions Preliminary findings suggest a role for partial epiglottidectomy in post-treatment head and neck cancer patients with swallowing disorders. Ideal candidates have intact tongue base contraction and poor retroflexion of the epiglottis, which result in bolus obstruction at the level of the valleculae. Partial epiglottic resection enables improved bolus passage in the pharyngeal phase. Minimal post-operative morbidity occurs in the appropriately selected patient. PMID:23794244

A Simple, Inexpensive Model to Demonstrate How Contraction of GI Longitudinal Smooth Muscle Promotes Propulsion

ERIC Educational Resources Information Center

Lujan, Heidi L.; DiCarlo, Stephen E.

2015-01-01

Peristalis is a propulsive activity that involves both circular and longitudinal muscle layers of the esophagus, distal stomach, and small and large intestines. During peristalsis, the circular smooth muscle contracts behind (on the orad side) the bolus and relaxes in front (on the aborad side) of the bolus. At the same time, the longitudinal…

21 CFR 520.2380c - Thiabendazole bolus.

Code of Federal Regulations, 2010 CFR

2010-04-01

...) Limitations. As a single oral dose; may repeat once in 2 to 3 weeks; do not treat animals within 3 days of...) Chemical name. 2-(4-Thiazolyl) benzimidazole. (b) Specifications. Conforms to N.F. XII. (c) Sponsor. See No...) Limitations. As a single oral dose; as a drench or bolus; may repeat once in 2 to 3 weeks; do not treat...

21 CFR 520.2380c - Thiabendazole bolus.

Code of Federal Regulations, 2011 CFR

2011-04-01

...) Limitations. As a single oral dose; may repeat once in 2 to 3 weeks; do not treat animals within 3 days of...) Chemical name. 2-(4-Thiazolyl) benzimidazole. (b) Specifications. Conforms to N.F. XII. (c) Sponsor. See No...) Limitations. As a single oral dose; as a drench or bolus; may repeat once in 2 to 3 weeks; do not treat...

Dysphagia in Children with Esophageal Atresia: Current Diagnostic Options.

PubMed

Rayyan, Maissa; Allegaert, Karel; Omari, Taher; Rommel, Nathalie

2015-08-01

Dysphagia or swallowing disorder is very common (range, 15-52%) in patients with esophageal atresia. Children present with a wide range of symptoms. The most common diagnostic tools to evaluate esophageal dysphagia, such as upper barium study and manometry, aim to characterize anatomy and function of the esophageal body and the esophagogastric junction (EGJ). Using these technologies, a variety of pathological motor patterns have been identified in children with esophageal atresia. However, the most challenging part of diagnosing patients with esophageal dysphagia lies in the fact that these methods fail to link functional symptoms such as dysphagia with the esophageal motor disorders observed. A recent method, called pressure-flow analysis (PFA), uses simultaneously acquired impedance and manometry measurements, and applies an integrated analysis of these recordings to derive quantitative pressure-flow metrics. These pressure-flow metrics allow detection of the interplay between bolus flow, motor patterns, and symptomatology by combining data on bolus transit and bolus flow resistance. Based on a dichotomous categorization, flow resistance at the EGJ and ineffective esophageal bolus transit can be determined. This method has the potential to guide therapeutic decisions for esophageal dysmotility in pediatric patients with esophageal atresia. Georg Thieme Verlag KG Stuttgart · New York.

Causes of death after fluid bolus resuscitation: new insights from FEAST.

PubMed

Myburgh, John; Finfer, Simon

2013-03-14

The Fluid Expansion as Supportive Therapy (FEAST study) was an extremely well conducted study that gave unexpected results. The investigators had reported that febrile children with impaired perfusion treated in low-income countries without access to intensive care are more likely to die if they receive bolus resuscitation with albumin or saline compared with no bolus resuscitation at all. In a secondary analysis of the trial, published in BMC Medicine, the authors found that increased mortality was evident in patients who presented with clinical features of severe shock in isolation or in conjunction with features of respiratory or neurological failure. The cause of excess deaths was primarily refractory shock and not fluid overload. These features are consistent with a potential cardiotoxic or ischemia-reperfusion injury following resuscitation with boluses of intravenous fluid. Although these effects may have been amplified by the absence of invasive monitoring, mechanical ventilation or vasopressors, the results provide compelling insights into the effects of intravenous fluid resuscitation and potential adverse effects that extend beyond the initial resuscitation period. These data add to the increasing body of literature about the safety and efficacy of intravenous resuscitation fluids, which may be applicable to management of other populations of critically ill patients.

Evaluation of the esophagus with a marshmallow bolus: clarifying the cause of dysphagia.

PubMed

Ott, D J; Kelley, T F; Chen, M Y; Gelfand, D W

1991-01-01

We reviewed the radiographic examinations of the esophagus and medical records in 117 patients (55 women and 62 men; mean age, 52 years) in which a marshmallow bolus was also given. A one-third to one-half piece of a standard marshmallow was used with a mean size of 23 mm (+/- 4.5 mm SD) measured in vivo. In 62 patients with no intrinsic structural narrowing of the esophagus, impaction occurred in only seven (11%). Four of these patients had an esophageal motility disorder, and three had a previous Nissen fundoplication. The remaining 55 patients had lower esophageal mucosal rings (47) or peptic strictures (8). Marshmallow impaction was seen in 27 of 47 rings (57%) and was inversely related to ring size, and in six of eight strictures (75%). Also, impaction was related to the ratio of bolus size to ring caliber, and invariably occurred when this ratio was greater than 1.5. Dysphagia was the presenting complaint in 76 (65%) patients, but was found equally in those without intrinsic narrowing and in those with ring or stricture. However, dysphagia was reproduced by the marshmallow bolus only in patients with esophageal narrowing or abnormal motility.

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

Nielsen, Yousef W., E-mail: yujwni01@heh.regionh.d; Eiberg, Jonas P.; Logager, Vibeke B.

The purpose of this investigation was to determine if addition of infragenicular steady-state (SS) magnetic resonance angiography (MRA) to first-pass imaging improves diagnostic performance compared with first-pass imaging alone in patients with peripheral arterial disease (PAD) undergoing whole-body (WB) MRA. Twenty consecutive patients with PAD referred to digital-subtraction angiography (DSA) underwent WB-MRA. Using a bolus-chase technique, first-pass WB-MRA was performed from the supra-aortic vessels to the ankles. The blood-pool contrast agent gadofosveset trisodium was used at a dose of 0.03 mmol/kg body weight. Ten minutes after injection of the contrast agent, high-resolution (0.7-mm isotropic voxels) SS-MRA of the infragenicular arteriesmore » was performed. Using DSA as the 'gold standard,' sensitivities and specificities for detecting significant arterial stenoses ({>=}50% luminal narrowing) with first-pass WB-MRA, SS-MRA, and combined first-pass and SS-MRA were calculated. Kappa statistics were used to determine intermodality agreement between MRA and DSA. Overall sensitivity and specificity for detecting significant arterial stenoses with first-pass WB-MRA was 0.70 (95% confidence interval 0.61 to 0.78) and 0.97 (0.94 to 0.99), respectively. In first-pass WB-MRA, the lowest sensitivity was in the infragenicular region, with a value of 0.42 (0.23 to 0.63). Combined analysis of first-pass WB-MRA and SS-MRA increased sensitivity to 0.81 (0.60 to 0.93) in the infragenicular region, with specificity of 0.94 (0.88 to 0.97). Sensitivity and specificity for detecting significant arterial stenoses with isolated infragenicular SS-MRA was 0.47 (0.27 to 0.69) and 0.86 (0.78 to 0.91), respectively. Intermodality agreement between MRA and DSA in the infragenicular region was moderate for first-pass WB-MRA ({kappa} = 0.49), fair for SS-MRA ({kappa} = 0.31), and good for combined first-pass/SS-MRA ({kappa} = 0.71). Addition of infragenicular SS-MRA to first-pass WB MRA improves diagnostic performance.« less

Acoustic analysis of swallowing sounds: a new technique for assessing dysphagia.

PubMed

Santamato, Andrea; Panza, Francesco; Solfrizzi, Vincenzo; Russo, Anna; Frisardi, Vincenza; Megna, Marisa; Ranieri, Maurizio; Fiore, Pietro

2009-07-01

To perform acoustic analysis of swallowing sounds, using a microphone and a notebook computer system, in healthy subjects and patients with dysphagia affected by neurological diseases, testing the positive/negative predictive value of a pathological pattern of swallowing sounds for penetration/aspiration. Diagnostic test study, prospective, not blinded, with the penetration/aspiration evaluated by fibreoptic endoscopy of swallowing as criterion standard. Data from a previously recorded database of normal swallowing sounds for 60 healthy subjects according to gender, age, and bolus consistency was compared with those of 15 patients with dysphagia from a university hospital referral centre who were affected by various neurological diseases. Mean duration of the swallowing sounds and post-swallowing apnoea were recorded. Penetration/aspiration was verified by fibreoptic endoscopy of swallowing in all patients with dysphagia. The mean duration of swallowing sounds for a liquid bolus of 10 ml water was significantly different between patients with dysphagia and healthy patients. We also described patterns of swallowing sounds and tested the negative/positive predictive values of post-swallowing apnoea for penetration/aspiration verified by fibreoptic endoscopy of swallowing (sensitivity 0.67 (95% confidence interval 0.24-0.94); specificity 1.00 (95% confidence interval 0.56-1.00)). The proposed technique for recording and measuring swallowing sounds could be incorporated into the bedside evaluation, but it should not replace the use of more diagnostic and valuable measures.

The potential to control Haemonchus contortus in indigenous South African goats with copper oxide wire particles

PubMed Central

Vatta, A.F.; Waller, P.J.; Githiori, J.B.; Medley, G.F.

2009-01-01

The high prevalence of resistance of Haemonchus contortus to all major anthelmintic groups has prompted investigations into alternative control methods in South Africa, including the use of copper oxide wire particle (COWP) boluses. To assess the efficacy of COWP against H. contortus in indigenous South African goats, 18 male faecal egg-count-negative goats were each given ca.1200 infective larvae of H. contortus three times per week during weeks 1 and 2 of the experiment. These animals made up an “established” infection group (ESTGRP). At the start of week 7, six goats were each given a 2-g COWP bolus orally; six goats received a 4-g COWP bolus each and six animals were not treated. A further 20 goats constituted a “developing” infection group (DEVGRP). At the beginning of week 1, seven of the DEVGRP goats were given a 2-g COWP bolus each; seven goats were treated with a 4-g COWP bolus each and no bolus was given to a further six animals. During weeks 1–6, each of these DEVGRP goats was given ca. 400 H. contortus larvae three times per week. All 38 goats were euthanized for worm recovery from the abomasa and small intestines in week 11. In the ESTGRP, the 2-g and 4-g COWP boluses reduced the worm burdens by 95% and 93%, respectively compared to controls (mean burden ± standard deviation, SD: 23 ± 33, 30 ± 56 and 442 ± 518 worms, P = 0.02). However, in the DEVGRP goats, both the 2-g and 4-g COWP treatments were ineffective in reducing the worm burdens relative to the controls (mean burdens ± SD: 1102 ± 841, 649 ± 855, 1051 ± 661 worms, P = 0.16). Mean liver copper levels did not differ between the ESTGRP goats treated with 2-g COWP, 4-g COWP or no COWP (mean ± standard error of the mean, SEM, in ppm: 93.7 ± 8.3; 101.5 ± 8.3; 71.8 ± 8.3, P = 0.07) nor did they differ between the DEVGRP goats (mean ± SEM, in ppm: 74.1 ± 9.1; 75.4 ± 9.1; 74.9 ± 10.0, P > 0.99). The copper values were considered adequate, but not high, for goats. The COWP boluses have the potential to be used in the place of conventional anthelmintics for the control of established H. contortus infections in indigenous South African goats, but their use as part of an integrated approach to control H. contortus in the field must be fully investigated. PMID:19346076

Blood flow measurement using digital subtraction angiography for assessing hemodialysis access function

NASA Astrophysics Data System (ADS)

Koirala, Nischal; Setser, Randolph M.; Bullen, Jennifer; McLennan, Gordon

2017-03-01

Blood flow rate is a critical parameter for diagnosing dialysis access function during fistulography where a flow rate of 600 ml/min in arteriovenous graft or 400-500 ml/min in arteriovenous fistula is considered the clinical threshold for fully functioning access. In this study, a flow rate computational model for calculating intra-access flow to evaluate dialysis access patency was developed and validated in an in vitro set up using digital subtraction angiography. Flow rates were computed by tracking the bolus through two regions of interest using cross correlation (XCOR) and mean arrival time (MAT) algorithms, and correlated versus an in-line transonic flow meter measurement. The mean difference (mean +/- standard deviation) between XCOR and in-line flow measurements for in vitro setup at 3, 6, 7.5 and 10 frames/s was 118+/-63 37+/-59 31+/-31 and 46+/-57 ml/min respectively while for MAT method it was 86+/-56 57+/-72 35+/-85 and 19+/-129 ml/min respectively. The result of this investigation will be helpful for selecting candidate algorithms while blood flow computational tool is developed for clinical application.

Continuous Transversus Abdominis Plane Nerve Blocks: Does Varying Local Anesthetic Delivery Method-Automatic Repeated Bolus Versus Continuous Basal Infusion-Influence the Extent of Sensation to Cold?: A Randomized, Triple-Masked, Crossover Study in Volunteers.

PubMed

Khatibi, Bahareh; Said, Engy T; Sztain, Jacklynn F; Monahan, Amanda M; Gabriel, Rodney A; Furnish, Timothy J; Tran, Johnathan T; Donohue, Michael C; Ilfeld, Brian M

2017-04-01

It remains unknown whether continuous or scheduled intermittent bolus local anesthetic administration is preferable for transversus abdominis plane (TAP) catheters. We therefore tested the hypothesis that when using TAP catheters, providing local anesthetic in repeated bolus doses increases the cephalad-caudad cutaneous effects compared with a basal-only infusion. Bilateral TAP catheters (posterior approach) were inserted in 24 healthy volunteers followed by ropivacaine 2 mg/mL administration for a total of 6 hours. The right side was randomly assigned to either a basal infusion (8 mL/h) or bolus doses (24 mL administered every 3 hours for a total of 2 bolus doses) in a double-masked manner. The left side received the alternate treatment. The primary end point was the extent of sensory deficit as measured by cool roller along the axillary line at hour 6 (6 hours after the local anesthetic administration was initiated). Secondary end points included the extent of sensory deficit as measured by cool roller and Von Frey filaments along the axillary line and along a transverse line at the level of the anterior superior iliac spine at hours 0 to 6. Although there were statistically significant differences between treatments within the earlier part of the administration period, by hour 6 the difference in extent of sensory deficit to cold failed to reach statistical significance along the axillary line (mean = 0.9 cm; SD = 6.8; 95% confidence interval -2.0 to 3.8; P = .515) and transverse line (mean = 2.5 cm; SD = 10.1; 95% confidence interval -1.8 to 6.8; P = .244). Although the difference between treatments was statistically significant at various early time points for the horizontal, vertical, and estimated area measurements of both cold and mechanical pressure sensory deficits, no comparison remained statistically significant by hour 6. No evidence was found in this study involving healthy volunteers to support the hypothesis that changing the local anesthetic administration technique (continuous basal versus hourly bolus) when using ropivacaine 0.2% and TAP catheters at 8 mL/h and 24 mL every 3 hours significantly influences the cutaneous effects after 6 hours of administration. Additional research is required to determine whether changing variables (eg, local anesthetic concentration, basal infusion rate, bolus dose volume, and/or interval) would provide different results.

Clinical performance of three bolus calculators in subjects with type 1 diabetes mellitus: a head-to-head-to-head comparison.

PubMed

Zisser, Howard; Wagner, Robin; Pleus, Stefan; Haug, Cornelia; Jendrike, Nina; Parkin, Chris; Schweitzer, Matthias; Freckmann, Guido

2010-12-01

Insulin pump systems now provide automated bolus calculators (ABCs) that electronically calculate insulin boluses to address carbohydrate intake and out-of-range blood glucose (bG) levels. We compared the efficacy of three ABCs (Accu-Chek(®) Combo [Roche Insulin Delivery Systems (IDS), Inc., Fishers, IN, a member of the Roche Group], Animas(®) 2020 [Animas Corp., West Chester, PA, a Johnson and Johnson company], and MiniMed Paradigm Bolus Wizard(®) [Medtronic MiniMed, Northridge, CA]) to safely reduce postprandial hyperglycemia in type 1 diabetes mellitus (T1DM). T1DM subjects (n = 24) were recruited at a single center for a prospective, triple crossover study. ABCs with the programmed target range (80-140 mg/dL) were used in random order. Postprandial hyperglycemia was induced by reducing the calculated bolus by 25%. Two hours after test meals, the ABCs were allowed to determine whether a correction bolus was needed. Differences between 6-h bG values after test meals that achieved 2-h postprandial hyperglycemia and the mean of the target range (110 mg/dL) were determined. The mean difference between 6-h bG levels following test meals and the 110 mg/dL bG target with the MiniMed device (47.4 ± 31.8 mg/dL) was significantly higher than the Animas (17.3 ± 30.9 mg/dL) and Roche IDS (18.8 ± 33.8 mg/dL) devices (P = 0.0022 and P = 0.0049, respectively). The number of meals with 2-h postprandial hyperglycemia and bG levels at 2 h was similar. Roche IDS and Animas devices recommended correction boluses significantly (P = 0.0001 and P = 0.0002, respectively) more frequently than the MiniMed device. ABC use was not associated with severe hypoglycemia. There was no significant difference in the rate of mild hypoglycemia (bG <60 mg/dL not requiring assistance) among the three groups (Roche IDS and Animas, n = 2; MiniMed, n = 0). In this study, the Roche IDS and Animas devices were more efficacious in controlling postprandial hyperglycemia than the MiniMed device. This may be due, in part, to differences in ABC setup protocols and algorithms. Use of ABCs can assist in controlling postprandial glycemia without significant hypoglycemia.

Continuous versus bolus intragastric tube feeding for preterm and low birth weight infants with gastro-oesophageal reflux disease.

PubMed

Richards, Robyn; Foster, Jann P; Psaila, Kim

2014-07-17

Gastro-oesophageal reflux disease is a particularly common condition in preterm and low birth weight infants. These infants are also more likely to have excessive regurgitation, as they do not have a fully developed antireflux mechanism. Preterm and low birth weight infants who are unable to suck oral feeds are required to be fed via an intragastric tube for varying lengths of time. Intragastric tube feeding can be delivered by the intermittent bolus or continuous feeding method. Use of continuous or intermittent bolus intragastric feeding may have a positive or negative effect on the incidence or severity of gastro-oesophageal reflux disease. To determine whether continuous or intermittent bolus intragastric tube feeding reduces the number of episodes and the duration of gastro-oesophageal reflux disease (GORD) in preterm and low birth weight infants.We intended to perform subgroup analyses for gestational age; birth weight; age in days from birth at full enteral feeding via intragastric tube (breast vs bottle); frequency of intermittent bolus feed; and type of medication for treatment of GORD (only if medication prescribed and given similarly to both intervention groups). We used the standard search strategy of the Cochrane Neonatal Group as described in The Cochrane Library (www.thecochranelibrary.com) to search for randomised controlled trials (RCTs) in the Cochrane Central Register of Controlled Trials (CENTRAL) (2013, Issue 9), MEDLINE (1966 to September 2013), EMBASE (1980 to September 2013) and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) (1982 to September 2013). We also searched previous reviews, including cross-references, abstracts and conference and symposia proceedings of the Perinatal Society of Australia and New Zealand and the Pediatric Academic Societies (American Pediatric Society/Society for Pediatric Research and European Society for Paediatric Research) from 1990 to 2012. Published and unpublished RCTs and quasi-RCTs were eligible for inclusion in this review, as were cluster-randomised and cross-over randomised trials that compared the effects of continuous versus intermittent bolus intragastric tube feeding on gastro-oesophageal reflux disease in preterm and low birth weight infants. Two review authors independently assessed study eligibility and quality. We found no trials that met the inclusion criteria for this review. We did not identify any randomised trials that evaluated the effects of continuous versus intermittent bolus intragastric tube feeding on gastro-oesophageal reflux disease in preterm and low birth weight infants. Well-designed and adequately powered trials are needed.

Environmental Effects on Compulsive Tail Chasing in Dogs

PubMed Central

Tiira, Katriina; Hakosalo, Osmo; Kareinen, Lauri; Thomas, Anne; Hielm-Björkman, Anna; Escriou, Catherine; Arnold, Paul; Lohi, Hannes

2012-01-01

Obsessive Compulsive Disorder (OCD) is a neuropsychiatric disorder observed both in humans and animals. Examples of Canine Compulsive Disorder (CD) include excessive tail chasing (TC), light/shadow chasing and flank sucking. We performed a questionnaire survey to investigate the characteristics of compulsive (TC) and its possible associations with environmental correlates and personality in a pet population of 368 dogs from four dog breeds. We observed an early onset of TC at 3–6 months of age and a large variation in TC frequency in all breeds, with an overrepresentation of milder cases. Almost half of the TC dogs showed lowered responsiveness during bouts and displayed also other types of compulsions more often than the controls. Interestingly, dogs that received dietary supplements, especially vitamins and minerals, expressed less TC compared to dogs that did not receive any supplements. Neutered females had less TC, suggesting an influence of ovarian hormones on TC. Tail chasers were shyer and had separated earlier from their mothers than the controls. Finally, our genetic study did not find an association between TC and CDH2, a locus previously associated with the canine flank sucking compulsion. In conclusion, the early-onset and the variable nature of the repetitive behaviour, which is affected by environmental factors such as micronutrients, neutering and maternal care, share several similar components between canine and human compulsions and supports canine TC as a model for human OCD. PMID:22844513

Cryptic sexual conflict in gift-giving insects: chasing the chase-away.

PubMed

Sakaluk, Scott K; Avery, Rachel L; Weddle, Carie B

2006-01-01

The chase-away model of sexual selection posits that elaborate male sexual displays arise because they exploit preexisting biases in females' sensory systems and induce females to mate in a suboptimal manner. An essential element of this hypothesis is that such manipulation should quickly lead to female resistance to male displays. Nuptial food gifts may be a frequent conduit by which males attempt to influence the mating behavior of females against females' own reproductive interests. In decorated crickets Gryllodes sigillatus, such inducements come in the form of a spermatophylax, a gelatinous mass forming part of the male's spermatophore and consumed by the female after mating. We conducted experiments in which spermatophylaxes obtained from male G. sigillatus were offered as novel food gifts to females of a non-gift-giving species (Acheta domesticus) having no evolutionary history of spermatophylax consumption. Female A. domesticus that were allowed to consume the spermatophylax took significantly longer to remate than when given no such opportunity. In contrast, when female G. sigillatus were prevented from consuming their partners' nuptial gifts, there was no difference in their propensity to remate relative to females permitted to consume a food gift after mating. These results suggest that the spermatophylax synthesized by male G. sigillatus contains substances designed to inhibit the sexual receptivity of their mates but that female G. sigillatus have evolved reduced responsiveness to these substances.

Development and testing of a prototype tool for integrated assessment of chemical status in marine environments.

PubMed

Andersen, Jesper H; Murray, Ciarán; Larsen, Martin M; Green, Norman; Høgåsen, Tore; Dahlgren, Elin; Garnaga-Budrė, Galina; Gustavson, Kim; Haarich, Michael; Kallenbach, Emilie M F; Mannio, Jaakko; Strand, Jakob; Korpinen, Samuli

2016-02-01

We report the development and application of a prototype tool for integrated assessment of chemical status in aquatic environments based on substance- and matrix-specific environmental assessment criteria (thresholds). The Chemical Status Assessment Tool (CHASE) integrates data on hazardous substances in water, sediments and biota as well as bio-effect indicators and is based on a substance- or bio-effect-specific calculation of a 'contamination ratio' being the ratio between an observed concentration and a threshold value. Values <1.0 indicate areas potentially 'unaffected', while values >1.0 indicate areas potentially 'affected'. These ratios are combined within matrices, i.e. for water, sediment and biota and for biological effects. The overall assessment used a 'one out, all out principle' with regard to each matrix. The CHASE tool was tested in the Baltic Sea and the North Sea in 376 assessment units. In the former, the chemical status was >1.0 in practically all areas indicating that all areas assessed were potentially affected. The North Sea included areas classified as unaffected or affected. The CHASE tool can in combination with temporal trend assessments of individual substances be advantageous for use in remedial action plans and, in particular, for the science-based evaluation of the status and for determining which specific substances are responsible for a status as potentially affected.

Guidance on Nanomaterial Hazards and Risks

DTIC Science & Technology

2015-05-21

and at room temperature and 37 C°– solid separation by centrifugation, filtration , or chemical techniques (more experimental techniques combining...members in this potency sequence using bolus in vivo testing, verify the bolus results with selective inhalation testing. The potency of members of...measures in in vitro and limited in vivo experimental systems would facilitate the characterization of dose-response relationships across a set of ENMs

Jason Roadman | NREL

Science.gov Websites

using trained raptors, metrology, storm chasing, and wind tunnel testing of atmospheric turbulence. He Wind tunnel testing of atmospheric turbulence Education B.S. in Aerospace Engineering from Virginia

Efficacy and safety of closing postcatheterisation pseudoaneurysms with ultrasound-guided thrombin injections using two approaches: bolus versus slow injection. A prospective randomised trial.

PubMed

Lewandowski, Paweł; Maciejewski, Paweł; Wąsek, Wojciech; Pasierski, Tomasz; Budaj, Andrzej

2011-01-01

Thrombin injection is a widely accepted treatment of an iatrogenic arterial pseudoaneurysm. However, the optimal mode of injection and type of pseudoaneurysm amenable to this therapy have yet been established. To compare efficacy and safety of two approaches to ultrasound-guided thrombin injections into a femoral artery pseudoaneurysm with or without long neck that developed as an iatrogenic complication of cardiac catheterisation. Patients were randomised to thrombin administration in a bolus or slow injection. The length and width of aneurysm neck and blood flow velocity in the neck were measured with color Doppler ultrasonography before the closure procedure. Thrombin dose, time to thrombotic occlusion, blood oxygen saturation in a toe of the extremity with the pseudoaneurysm (a marker of silent microembolisation), and clinical signs of distal embolisation were recorded. Between 2006 and 2009, 73 consecutive patients (33 males; mean age 67.8 ± 11.9 years) with femoral pseudoaneurysms complicating cardiac catheterisation were randomised into two groups that were treated with thrombin bolus (n = 40) or slow injection (n = 33). The efficacy of aneurysm closure with either method was similarly high (100% vs 96.8%, NS, respectively) and did not depend on the length and width of the aneurysm neck. Independent risk factors for distal embolisation were: thrombin dose (OR 4.2; 95% CI 0.92-19.3), the length of aneurysm neck (OR 4.66; 95% CI 1.1-19.9), age above 80 years (OR 10.9; 95% CI 1.0-116.8), and bolus treatment (OR 7.6; 95% CI 1.3-44.9). We observed silent microembolisation phenomenon that was common (occurring in 38% of patients in the bolus group vs 33% of patients in the slow injection group) but in most cases asymptomatic. Femoral pseudoaneurysm closure with a low dose of thrombin is a valid and beneficial treatment. Either method (bolus or slow injection) was similarly efficacious and safe even in the subgroup of patients with neckless aneurysms. We observed and confirmed silent microembolisation phenomenon during thrombin injections.

PubMed Central

FARNETI, D.; FATTORI, B.; NACCI, A.; MANCINI, V.; SIMONELLI, M.; RUOPPOLO, G.; GENOVESE, E.

2014-01-01

SUMMARY This study evaluated the intra- and inter-rater reliability of the Pooling score (P-score) in clinical endoscopic evaluation of severity of swallowing disorder, considering excess residue in the pharynx and larynx. The score (minimum 4 - maximum 11) is obtained by the sum of the scores given to the site of the bolus, the amount and ability to control residue/bolus pooling, the latter assessed on the basis of cough, raclage, number of dry voluntary or reflex swallowing acts (< 2, 2-5, > 5). Four judges evaluated 30 short films of pharyngeal transit of 10 solid (1/4 of a cracker), 11 creamy (1 tablespoon of jam) and 9 liquid (1 tablespoon of 5 cc of water coloured with methlyene blue, 1 ml in 100 ml) boluses in 23 subjects (10 M/13 F, age from 31 to 76 yrs, mean age 58.56±11.76 years) with different pathologies. The films were randomly distributed on two CDs, which differed in terms of the sequence of the films, and were given to judges (after an explanatory session) at time 0, 24 hours later (time 1) and after 7 days (time 2). The inter- and intra-rater reliability of the P-score was calculated using the intra-class correlation coefficient (ICC; 3,k). The possibility that consistency of boluses could affect the scoring of the films was considered. The ICC for site, amount, management and the P-score total was found to be, respectively, 0.999, 0.997, 1.00 and 0.999. Clinical evaluation of a criterion of severity of a swallowing disorder remains a crucial point in the management of patients with pathologies that predispose to complications. The P-score, derived from static and dynamic parameters, yielded a very high correlation among the scores attributed by the four judges during observations carried out at different times. Bolus consistencies did not affect the outcome of the test: the analysis of variance, performed to verify if the scores attributed by the four judges to the parameters selected, might be influenced by the different consistencies of the boluses, was not significant. These initial data validate the clinical use of the P-score in the management of patients with deglutition disorders by a multidisciplinary team. PMID:24843220

Microbe Hunting

PubMed Central

Lipkin, W. Ian

2010-01-01

Summary: Platforms for pathogen discovery have improved since the days of Koch and Pasteur; nonetheless, the challenges of proving causation are at least as daunting as they were in the late 1800s. Although we will almost certainly continue to accumulate low-hanging fruit, where simple relationships will be found between the presence of a cultivatable agent and a disease, these successes will be increasingly infrequent. The future of the field rests instead in our ability to follow footprints of infectious agents that cannot be characterized using classical microbiological techniques and to develop the laboratory and computational infrastructure required to dissect complex host-microbe interactions. I have tried to refine the criteria used by Koch and successors to prove linkage to disease. These refinements are working constructs that will continue to evolve in light of new technologies, new models, and new insights. What will endure is the excitement of the chase. Happy hunting! PMID:20805403

Reefing Line Tension in CPAS Main Parachute Clusters

NASA Technical Reports Server (NTRS)

Ray, Eric S.

2013-01-01

Reefing lines are an essential feature to manage inflation loads. During each Engineering Development Unit (EDU) test of the Capsule Parachute Assembly System (CPAS), a chase aircraft is staged to be level with the cluster of Main ringsail parachutes during the initial inflation and reefed stages. This allows for capturing high-quality still photographs of the reefed skirt, suspension line, and canopy geometry. The over-inflation angles are synchronized with measured loads data in order to compute the tension force in the reefing line. The traditional reefing tension equation assumes radial symmetry, but cluster effects cause the reefed skirt of each parachute to elongate to a more elliptical shape. This effect was considered in evaluating multiple parachutes to estimate the semi-major and semi-minor axes. Three flight tests are assessed, including one with a skipped first stage, which had peak reefing line tension over three times higher than the nominal parachute disreef sequence.

Formula for the rms blur circle radius of Wolter telescope based on aberration theory

NASA Technical Reports Server (NTRS)

Shealy, David L.; Saha, Timo T.

1990-01-01

A formula for the rms blur circle for Wolter telescopes has been derived using the transverse ray aberration expressions of Saha (1985), Saha (1984), and Saha (1986). The resulting formula for the rms blur circle radius over an image plane and a formula for the surface of best focus based on third-, fifth-, and seventh-order aberration theory predict results in good agreement with exact ray tracing. It has also been shown that one of the two terms in the empirical formula of VanSpeybroeck and Chase (1972), for the rms blur circle radius of a Wolter I telescope can be justified by the aberration theory results. Numerical results are given comparing the rms blur radius and the surface of best focus vs the half-field angle computed by skew ray tracing and from analytical formulas for grazing incidence Wolter I-II telescopes and a normal incidence Cassegrain telescope.

Removal of Gross Air Embolization from Cardiopulmonary Bypass Circuits with Integrated Arterial Line Filters: A Comparison of Circuit Designs.

PubMed

Reagor, James A; Holt, David W

2016-03-01

Advances in technology, the desire to minimize blood product transfusions, and concerns relating to inflammatory mediators have lead many practitioners and manufacturers to minimize cardiopulmonary bypass (CBP) circuit designs. The oxygenator and arterial line filter (ALF) have been integrated into one device as a method of attaining a reduction in prime volume and surface area. The instructions for use of a currently available oxygenator with integrated ALF recommends incorporating a recirculation line distal to the oxygenator. However, according to an unscientific survey, 70% of respondents utilize CPB circuits incorporating integrated ALFs without a path of recirculation distal to the oxygenator outlet. Considering this circuit design, the ability to quickly remove a gross air bolus in the blood path distal to the oxygenator may be compromised. This in vitro study was designed to determine if the time required to remove a gross air bolus from a CPB circuit without a path of recirculation distal to the oxygenator will be significantly longer than that of a circuit with a path of recirculation distal to the oxygenator. A significant difference was found in the mean time required to remove a gross air bolus between the circuit designs (p = .0003). Additionally, There was found to be a statistically significant difference in the mean time required to remove a gross air bolus between Trial 1 and Trials 4 (p = .015) and 5 (p =.014) irrespective of the circuit design. Under the parameters of this study, a recirculation line distal to an oxygenator with an integrated ALF significantly decreases the time it takes to remove an air bolus from the CPB circuit and may be safer for clinical use than the same circuit without a recirculation line.

Institution of basal-bolus therapy at diagnosis for children with type 1 diabetes mellitus.

PubMed

Adhikari, Soumya; Adams-Huet, Beverley; Wang, Yu-Chi A; Marks, James F; White, Perrin C

2009-04-01

We studied whether the institution of basal-bolus therapy immediately after diagnosis improved glycemic control in the first year after diagnosis for children with newly diagnosed type 1 diabetes mellitus. We reviewed the charts of 459 children > or =6 years of age who were diagnosed as having type 1 diabetes between July 1, 2002, and June 30, 2006 (212 treated with basal-bolus therapy and 247 treated with a more-conventional neutral protamine Hagedorn regimen). We abstracted data obtained at diagnosis and at quarterly clinic visits and compared groups by using repeated-measures, mixed-linear model analysis. We also reviewed the records of 198 children with preexisting type 1 diabetes mellitus of >1-year duration who changed from the neutral protamine Hagedorn regimen to a basal-bolus regimen during the review period. Glargine-treated subjects with newly diagnosed diabetes had lower hemoglobin A1c levels at 3, 6, 9, and 12 months after diagnosis than did neutral protamine Hagedorn-treated subjects (average hemoglobin A1c levels of 7.05% with glargine and 7.63% with neutral protamine Hagedorn, estimated across months 3, 6, 9, and 12, according to repeated-measures models adjusted for age at diagnosis and baseline hemoglobin A1c levels; treatment difference: 0.58%). Children with long-standing diabetes had no clinically important changes in their hemoglobin A1c levels in the first year after changing regimens. The institution of basal-bolus therapy with insulin glargine at the time of diagnosis of type 1 diabetes was associated with improved glycemic control, in comparison with more-conventional neutral protamine Hagedorn regimens, during the first year after diagnosis.

Doxorubicin: Comparison between 3-h continuous and bolus intravenous administration paradigms on cardio-renal axis, mitochondrial sphingolipids and pathology

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

Kamendi, Harriet, E-mail: harriet_kamendi@kandih.com; Zhou, Ying, E-mail: yingzhou526@gmail.com; Crosby, Meredith, E-mail: Meredith.crosby@astrazeneca.com

Doxorubicin (DOX) is a potent and effective broad-spectrum anthracycline antitumor agent, but its clinical usefulness is restricted by cardiotoxicity. This study compared pharmacokinetic, functional, structural and biochemical effects of single dose DOX bolus or 3-h continuous iv infusion (3-h iv) in the Han–Wistar rat to characterize possible treatment-related differences in drug safety over a 72 h observation period. Both DOX dosing paradigms significantly altered blood pressure, core body temperature and QA interval (indirect measure of cardiac contractility); however, there was no recovery observed in the bolus iv treatment group. Following the 3-h iv treatment, blood pressures and QA interval normalizedmore » by 36 h then rose above baseline levels over 72 h. Both treatments induced biphasic changes in heart rate with initial increases followed by sustained decreases. Cardiac injury biomarkers in plasma were elevated only in the bolus iv treatment group. Tissue cardiac injury biomarkers, cardiac mitochondrial complexes I, III and V and cardiac mitochondrial sphingolipids were decreased only in the bolus iv treatment group. Results indicate that each DOX dosing paradigm deregulates sinus rhythm. However, slowing the rate of infusion allows for functional compensation of blood pressure and may decrease the likelihood of cardiac myocyte necrosis via a mechanism associated with reduced mitochondrial damage. - Highlights: • Despite damaging cardiomyocytes, continuous iv doxorubicin improves cardiovascular outcomes. • This study supports administration of doxorubicin via slow continuous iv infusion limits acute cardio-toxicity. • This study supports use of metabolomic-derived lipid biomarkers for improved quantification of cardiovascular risk. • This study supports systems-based physiological approach to generate a data that can greatly inform risk assessments.« less

Lung disease severity in idiopathic pulmonary fibrosis is more strongly associated with impedance measures of bolus reflux than pH parameters of acid reflux alone.

PubMed

Gavini, S; Borges, L F; Finn, R T; Lo, W-K; Goldberg, H J; Burakoff, R; Feldman, N; Chan, W W

2017-05-01

Gastroesophageal reflux (GER) has been associated with idiopathic pulmonary fibrosis (IPF). Pathogenesis may be related to chronic micro-aspiration. We aimed to assess objective measures of GER on multichannel intraluminal impedance and pH study (MII-pH) and their relationship with pulmonary function testing (PFT) results, and to compare the performance of pH/acid reflux parameters vs corresponding MII/bolus parameters in predicting pulmonary dysfunction in IPF. This was a retrospective cohort study of IPF patients undergoing prelung transplant evaluation with MII-pH off acid suppression, and having received PFT within 3 months. Patients with prior fundoplication were excluded. Severe pulmonary dysfunction was defined using diffusion capacity of the lung for carbon monoxide (DLCO) ≤40%. Six pH/acid reflux parameters with corresponding MII/bolus reflux measures were specified a priori. Multivariate analyses were applied using forward stepwise logistic regression. Predictive value of each parameter for severe pulmonary dysfunction was calculated by area-under-the-receiver-operating-characteristic-curve or c-statistic. Forty-five subjects (67% M, age 59, 15 mild-moderate vs 30 severe) met criteria for inclusion. Patient demographics and clinical characteristics were similar between pulmonary dysfunction groups. Abnormal total reflux episodes and prolonged bolus clearance time were significantly associated with pulmonary dysfunction severity on univariate and multivariate analyses. No pH parameters were significant. The c-statistic of each pH parameter was lower than its MII counterpart in predicting pulmonary dysfunction. MII/bolus reflux, but not pH/acid reflux, was associated with pulmonary dysfunction in prelung transplant patients with IPF. MII-pH may be more valuable than pH testing alone in characterizing GER in IPF. © 2016 John Wiley & Sons Ltd.

Optimized enhancement in helical CT: experiences with a real-time bolus tracking system in 628 patients.

PubMed

Kirchner, J; Kickuth, R; Laufer, U; Noack, M; Liermann, D

2000-05-01

Ultrafast detector technology enables bolus-triggered application of contrast media. In a prospective study we investigated the benefit of this new method with the intention of optimizing enhancement during examination of the chest and abdomen. In total, we examined 548 patients under standardized conditions. All examinations were performed on a Somatom Plus 4 Power CT system (Siemens Corp., Forchheim, Germany) using the CARE-Bolus software. This produces repetitive low-dose test images (e.g. for the lung: 140 kV, 43 mA, TI 0.5 s) and measures the Hounsfield attenuation in a pre-selected region of interest. After exceeding a defined threshold, a diagnostic spiral CT examination was begun automatically. The data obtained from 321 abdominal CT and 179 lung CT examinations were correlated with different parameters such as age, weight and height of the patients and parameters of vascular access. In a group of 80 patients, the injection of contrast medium was stopped after reaching a pre-defined threshold of an increase of 100 HU over the baseline. Then, we assessed the maximal enhancement of liver, pulmonal artery trunk and aortic arch. There was no correlation between bolus geometry and age, body surface or weight. In helical CT of the abdomen the threshold was reached after a mean trigger time of 27 s (range 13-67 s) and only 65 ml (range 41-105 ml) of contrast medium were administered. In helical CT of the lung the threshold was reached after 21 s (range 12-48 s) and the mean amount of administered contrast medium was 48 ml (range 38-71 ml). Bolus triggering allows optimized enhancement of the organs and reduces the dose of contrast material required compared with standard administration. Copyright 2000 The Royal College of Radiologists.

Sour taste increases swallowing and prolongs hemodynamic responses in the cortical swallowing network

PubMed Central

Kamarunas, Erin; Ludlow, Christy L.

2016-01-01

Sour stimuli have been shown to upregulate swallowing in patients and in healthy volunteers. However, such changes may be dependent on taste-induced increases in salivary flow. Other mechanisms include genetic taster status (Bartoshuk LM, Duffy VB, Green BG, Hoffman HJ, Ko CW, Lucchina LA, Weiffenbach JM. Physiol Behav 82: 109–114, 2004) and differences between sour and other tastes. We investigated the effects of taste on swallowing frequency and cortical activation in the swallowing network and whether taster status affected responses. Three-milliliter boluses of sour, sour with slow infusion, sweet, water, and water with infusion were compared on swallowing frequency and hemodynamic responses. The sour conditions increased swallowing frequency, whereas sweet and water did not. Changes in cortical oxygenated hemoglobin (hemodynamic responses) measured by functional near-infrared spectroscopy were averaged over 30 trials for each condition per participant in the right and left motor cortex, S1 and supplementary motor area for 30 s following bolus onset. Motion artifact in the hemodynamic response occurred 0–2 s after bolus onset, when the majority of swallows occurred. The peak hemodynamic response 2–7 s after bolus onset did not differ by taste, hemisphere, or cortical location. The mean hemodynamic response 17–22 s after bolus onset was highest in the motor regions of both hemispheres, and greater in the sour and infusion condition than in the water condition. Genetic taster status did not alter changes in swallowing frequency or hemodynamic response. As sour taste significantly increased swallowing and cortical activation equally with and without slow infusion, increases in the cortical swallowing were due to sour taste. PMID:27489363

Comparison of an Electronic Glycemic Management System Versus Provider-Managed Subcutaneous Basal Bolus Insulin Therapy in the Hospital Setting.

PubMed

Aloi, Joseph; Bode, Bruce W; Ullal, Jagdeesh; Chidester, Paul; McFarland, Raymie S; Bedingfield, Amy E; Mabrey, Melanie; Booth, Robby; Mumpower, April; Wallia, Amisha

2017-01-01

American Diabetes Association (ADA) guidelines recommend a basal bolus correction insulin regimen as the preferred method of treatment for non-critically ill hospitalized patients. However, achieving ADA glucose targets safely, without hypoglycemia, is challenging. In this study we evaluated the safety and efficacy of basal bolus subcutaneous (SubQ) insulin therapy managed by providers compared to a nurse-directed Electronic Glycemic Management System (eGMS). This retrospective crossover study evaluated 993 non-ICU patients treated with subcutaneous basal bolus insulin therapy managed by a provider compared to an eGMS. Analysis compared therapy outcomes before Glucommander (BGM), during Glucommander (DGM), and after Glucommander (AGM) for all patients. The blood glucose (BG) target was set at 140-180 mg/dL for all groups. The safety of each was evaluated by the following: (1) BG averages, (2) hypoglycemic events <40 and <70 mg/dL, and (3) percentage of BG in target. Percentage of BG in target was BGM 47%, DGM 62%, and AGM 36%. Patients' BGM BG average was 195 mg/dL, DGM BG average was 169 mg/dL, and AGM BG average was 174 mg/dL. Percentage of hypoglycemic events <70 mg/dL was 2.6% BGM, 1.9% DGM, and 2.8% AGM treatment. Patients using eGMS in the DGM group achieved improved glycemic control with lower incidence of hypoglycemia (<40 mg/dL and <70 mg/dl) compared to both BGM and AGM management with standard treatment. These results suggest that an eGMS can safely maintain glucose control with less hypoglycemia than basal bolus treatment managed by a provider.

A Phase 1, Single-center, Double-blind, Placebo-controlled Study in Healthy Subjects to Assess the Safety, Tolerability, Clinical Effects, and Pharmacokinetics-Pharmacodynamics of Intravenous Cyclopropyl-methoxycarbonylmetomidate (ABP-700) after a Single Ascending Bolus Dose.

PubMed

Struys, Michel M R F; Valk, Beatrijs I; Eleveld, Douglas J; Absalom, Anthony R; Meyer, Peter; Meier, Sascha; den Daas, Izaak; Chou, Thomas; van Amsterdam, Kai; Campagna, Jason A; Sweeney, Steven P

2017-07-01

Cyclopropyl-methoxycarbonylmetomidate (ABP-700) is a new "soft" etomidate analog. The primary objectives of this first-in-human study were to describe the safety and efficacy of ABP-700 and to determine its maximum tolerated dose. Secondary objectives were to characterize the pharmacokinetics of ABP-700 and its primary metabolite (cyclopropyl-methoxycarbonyl acid), to assess the clinical effects of ABP-700, and to investigate the dose-response and pharmacokinetic/pharmacodynamic relationships. Sixty subjects were divided into 10 cohorts and received an increasing, single bolus of either ABP-700 or placebo. Safety was assessed by clinical laboratory evaluations, infusion-site reactions, continuous monitoring of vital signs, physical examination, adverse event monitoring, and adrenocorticotropic hormone stimulation testing. Clinical effects were assessed with modified observer's assessment of alertness/sedation and Bispectral Index monitoring. Pharmacokinetic parameters were calculated. Stopping criteria were met at 1.00 mg/kg dose. No serious adverse events were reported. Adverse events were dose-dependent and comprised involuntary muscle movement, tachycardia, and ventilatory effects. Adrenocorticotropic hormone stimulation evoked a physiologic cortisol response in all subjects, no different from placebo. Pharmacokinetics were dose-proportional. A three-compartment pharmacokinetic model described the data well. A rapid onset of anesthesia/sedation after bolus administration and also a rapid recovery were observed. A quantitative concentration-effect relationship was described for the modified observer's assessment of alertness/sedation and Bispectral Index. This first-in-human study of ABP-700 shows that ABP-700 was safe and well tolerated after single-bolus injections up to 1.00 mg/kg. Bolus doses of 0.25 and 0.35 mg/kg were found to provide the most beneficial clinical effect versus side-effect profile.

Association of Regulatory Boards of Optometry

MedlinePlus

... Fraud contact number) or https://www.chase.com/credit-cards/customer-service . In addition, individuals may also consider reviewing their current credit reports at https://www.annualcreditreport.com/index.action . ...

Energetic cost of feeding territories in an Hawaiian honeycreeper.

PubMed

Carpenter, F Lynn; MacMillen, Richard E

1976-09-01

By analysis of time budgets the daily energy expenditure in territorial individuals of a Hawaiian honeycreeper (Vestiaria coccinea, Fam. Drepanididae) were estimated during the nonbreeding season and compared to that of nonterritorial individuals. The mean rise in living costs was 2.3 kcal/24 h or 17% of the nonterritorial energy budget. The most costly territorial behavior was advertisement rather than chasing, and total territorial cost was seen to be little affected by the number of intruders or the size of the territory. These results are compared with data on feeding (nonbreeding) territories of other nectar-feeding birds. The suggestion is made that hummingbirds may be more likely to develop nonbreeding territorial behavior in any set of environmental circumstances than are honeycreepers because of relatively lower total cost of advertisement plus chasing.

NRC, SPI, and chasing arrows: Is there common ground

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

Rabasca, L.

After negotiating for 15 months, issuing three white papers, and conducting consumer research, the National Recycling Coalition (NRC, Washington, DC) and the Society of the Plastics Industry, Inc. (SPI, Washington, DC), have agreed to disagree on the use of the familiar chasing arrows logo in SPI's seven-number resin identification code. The desired end result of the talks and debates was supposed to be a plan to change legislation requiring 39 states to use SPI's current resin identification code and a commitment to remove the old code from durable goods and flexible packaging. Ultimately, these actions could have improved markets formore » polyethylene terephthalate (PET) and high-density polyethylene (HDPE) by reducing contamination caused by confusion over what is actually recycled versus what is merely recyclable.« less

Management and endoscopic techniques for digestive foreign body and food bolus impaction.

PubMed

Chauvin, Armelle; Viala, Jerome; Marteau, Philippe; Hermann, Philippe; Dray, Xavier

2013-07-01

Ingested foreign bodies, food bolus impaction, migration or retention of medical devices are frequent, in children as well as in adults. Most of these foreign bodies will naturally pass through the gastro-intestinal tract. Complications are rare but sometimes severe (oesophageal perforations are the most frequent and most feared). We aimed to review the literature on therapeutic management of digestive foreign bodies and food bolus impaction, with special focus on endoscopic indications, material, timing and techniques for removal. The role of the gastroenterologist is to recognise specific situations and to plan endoscopic removal in a timely manner with the most adequate conditions and extraction tools. Risk factors and underlying pathology, for example eosinophilic esophagitis, must be investigated and if necessary treated. Copyright © 2012 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

Eating and rumination activity in 10 cows over 10 days.

PubMed

Braun, U; Zürcher, S; Hässig, M

2015-08-01

Eating and rumination activities were evaluated in 10 Brown Swiss cows over 10 days, and the coefficients of variation (CV) were calculated for the investigated variables. A pressure sensor integrated into the noseband of a halter recorded jaw movements during chewing, which allowed the recording of eating and rumination times and the number of regurgitated boluses. The mean CVs ranged from 5.9 to 12.7% and were smaller for rumination (chewing cycles per bolus, 5.9%; daily number of cuds, 8.4%; rumination time, 9.1%) than for eating (eating time, 12.0%; chewing cycles related to eating, 12.7%). We concluded that of eating and rumination variables examined, the number of chewing cycles per regurgitated bolus is the most robust with little variation in individual cows. Copyright © 2015 Elsevier Ltd. All rights reserved.

F-18 chase craft with NASA test pilots Schneider and Fulton

NASA Technical Reports Server (NTRS)

1992-01-01

Ed Schneider, (left), is the project pilot for the F-18 High Angle of Attack program at NASA's Dryden Flight Research Center, Edwards, California. He has been a NASA research pilot at Dryden since 1983. In addition to his assignment with the F-18 High Angle of Attack program, Schneider is a project pilot for the F-15B aeronautical research aircraft, the NASA NB-52B launch aircraft, and the SR-71 'Blackbird' aircraft. He is a Fellow and was the 1994 President of the Society of Experimental Test Pilots. In 1996 he was awarded the NASA Exceptional Service Medal. Schneider is seen here with Fitzhugh L. Fulton Jr., (right), who was a civilian research pilot at Dryden. from August 1, 1966, until July 3, 1986, following 23 years of service as a pilot in the U.S. Air Force. Fulton was the project pilot on all early tests of the 747 Shuttle Carrier Aircraft (SCA) used to air launch the Space Shuttle prototype Enterprise in the Approach and Landing Tests (ALT) at Dryden in l977. For his work in the ALT program, Fulton received NASA's Exceptional Service Medal. He also received the Exceptional Service Medal again in 1983 for flying the 747 SCA during the European tour of the Space Shuttle Enterprise. During his career at Dryden, Fulton was project pilot on NASA's NB-52B launch aircraft used to air launch a variety of piloted and unpiloted research aircraft, including the X-15s and lifting bodies. He flew the XB-70 prototype supersonic bomber on both NASA-USAF tests and NASA research flights during the late 1960s, attaining speeds exceeding Mach 3. He was also a project pilot on the YF-12A and YF-12C research program from April 14, 1969, until September 25, 1978. The F/A-18 Hornet seen behind them is used primarily as a safety chase and support aircraft at NASA's Dryden Flight Research Center, Edwards, Calif. As support aircraft, the F-18's are used for safety chase, pilot proficiency and aerial photography. As a safety chase aircraft, F-18's, flown by research pilots, accompany research missions as another 'set of eyes' to visually observe the research event, experiment or test to help make sure the flights are carried out safely. The 'chase' pilots are in constant communication with the research pilots and mission control to report abnormalities that may be seen from the support aircraft. Pilots must also stay proficient by flying a certain number of missions per month. F-18's are used for this. A two-seat support aircraft is also used when research missions require an engineer or photographer on the flights.

A fully coupled bolus-esophageal-gastric model for esophageal emptying based on the immersed boundary method

NASA Astrophysics Data System (ADS)

Kou, Wenjun; Pandolfino, John E.; Kahrilas, Peter J.; Patankar, Neelesh A.

2016-11-01

In this work, we develop a fully coupled bolus-esophageal-gastric model to study esophageal emptying based on the immersed boundary method. The model includes an esophageal segment, an ellipsoid-shaped stomach, and a bolus. It can easily handle the passive and active function of the lower esophageal sphincter (LES). Two groups of case studies are presented. The first group is about the influence from tissue anisotropy. Simulation shows that the weaker (or more compliant) part suffers from a higher wall shear stress and higher pressure load when the bolus is filled in and emptied from the LES segment. This implies a degradation cycle in which a weaker tissue becomes much weaker due to an increased load, a possible pathway to the esophageal lower diverticulum. The second group is about bulge formation resulting from asymmetric anatomy and a compliant LES. In particular, we find a right bulge tends to develop for a compliant LES. The bulge is most pronounced with a highest stiffness of the gastric wall. This implies that the competition between the LES stiffness and gastric wall stiffness might be another factor related to the esophageal lower diverticulum. The support of Grant R01 DK56033 and R01 DK079902 from NIH is gratefully acknowledged.

Pathological bolus exposure may define gastro-esophageal reflux better than pathological acid exposure in patients with globus.

PubMed

Sinn, Dong Hyun; Kim, Beom Jin; Son, Hee Jung; Kim, Jae J; Rhee, Jong Chul; Rhee, Poong-Lyul

2012-01-01

Conventionally, pathological acid exposure (PAE), defined by acid reflux only, is used to identify gastro-esophageal reflux disease (GERD). However, weak acid reflux or non-acid reflux also induces reflux symptoms. Defining abnormal reflux based on all reflux episodes may better identify GERD and would be more useful among patients with atypical GERD symptoms, such as globus. Impedance-pHmetry results of 31 globus patients, off acid suppressants, were analysed. A median of 24 episodes of reflux were observed. Of the reflux episodes, 54% were non-acid reflux and 50% reached the proximal extent. PAE was observed in 6 patients (19%). For 5 patients (16%) without PAE, there was evidence of increased bolus exposure compared to normal controls (an intraesophageal bolus exposure for more than 1.4% of the recording time, defined as pathological bolus exposure, PBE). When GERD was defined by PAE or esophagitis, the prevalence of GERD was 29%. When GERD was defined by PBE, PAE or esophagitis, the prevalence was 42%. PBE identified 13% of the patients who otherwise would have been missed. A significant proportion of patients without PAE had evidence of PBE. PBE may be a more useful definition for identifying patients with abnormal increase in reflux in patients with globus. Further studies are warranted.

Esophageal function testing using multichannel intraluminal impedance.

PubMed

Srinivasan, R; Vela, M F; Katz, P O; Tutuian, R; Castell, J A; Castell, D O

2001-03-01

Multichannel intraluminal impedance (MII) is a new technique for evaluation of bolus transport. We evaluated esophageal function using bolus transport time (BTT) and contraction wave velocity (CWV) of liquid, semisolid, and solid boluses. Ten healthy subjects underwent MII swallow evaluation with various boluses of sterile water (pH 5), applesauce, three different sized marshmallows, and iced and 130 degrees F water. The effect of bethanechol was also studied. There was no difference in BTT or CWV for all water volumes from 1 to 20 ml. There was significant linear increase of BTT with progressively larger volumes of applesauce, and BTT of applesauce was longer than for water. BTT was significantly longer with large marshmallows vs. small and medium and was longer than for water. BTT for iced water was similar to 130 degrees F water. Applesauce showed a significant linear decrease of CWV with progressively larger volumes and was slower than water. Marshmallow showed significantly slower CWV with the large vs. small, and CWV for ice water was significantly slower than 130 degrees F water. Therefore, BTT of liquid is constant, whereas BTT of semisolid and solid are volume dependent and longer than liquids. CWV of semisolids and solids are slower than liquids. CWV of cold liquids is slower than warm liquids. MII can be used as a discriminating test of esophageal function.

A novel pen-based Bluetooth-enabled insulin delivery system with insulin dose tracking and advice.

PubMed

Bailey, Timothy S; Stone, Jenine Y

2017-05-01

Diabetes is growing in prevalence internationally. As more individuals require insulin as part of their treatment, technology evolves to optimize delivery, improve adherence, and reduce dosing errors. Insulin pens outperform vial and syringe in simplicity, dosing accuracy, and user preference. Bolus advisors improve dosing confidence and treatment adherence. The InPen System offers a novel approach to treatment via a wireless pen that syncs to a mobile application featuring a bolus advisor, enabling convenient insulin dose tracking and more accurate bolus advice among other features. Areas covered: Existing technology for insulin delivery and bolus advice are reviewed. The mechanics and functionality of the InPen device are delineated. Findings from formative testing and usability studies of the InPen system are reported. Future directions for the InPen system in the treatment of diabetes are discussed. Expert opinion: Diabetes management is complex and largely data-driven. The InPen System offers a promising new opportunity to avail insulin pen-users of features known to improve treatment efficacy, which have otherwise primarily been available to those using pumps. Given that the majority of insulin users do not use insulin pumps, the InPen System is poised to improve glucose control in a significant portion of the diabetes population.

A phase I trial of Flavopiridol in relapsed multiple myeloma

PubMed Central

Hofmeister, Craig C.; Poi, Ming; Bowers, Mindy A.; Zhao, Weiqiang; Phelps, Mitch A.; Benson, Don M.; Kraut, Eric H.; Farag, Sherif; Efebera, Yvonne A.; Sexton, Jennifer; Lin, Thomas S.; Grever, Michael; Byrd, John C.

2014-01-01

Purpose Flavopiridol is primarily a cyclin-dependent kinase (CDK)-9 inhibitor and we performed a dose escalation trial to determine the maximum tolerated dose, safety, and generate a pharmacokinetic profile. Methods Patients with a diagnosis of relapsed myeloma after at least two prior treatments were included. Flavopiridol was administered as a bolus then continuous infusion weekly for 4 weeks in a 6 week cycle. Results Fifteen patients were treated at three dose levels (30 mg/m2 bolus, 30 mg/m2 CIV to 50 mg/m2 bolus, 50 mg/m2 CIV). Cytopenias were significant and elevated transaminases (grade 4 in 3 patients, grade 3 in 4 patients, and grade 2 in 3 patients) were noted but were transient. Diarrhea (grade 3 in 6 patients, grade 2 in 5 patients) did not lead to hospital admission. There were no confirmed partial responses although one patient with t(4;14) had a decrease in his monoclonal protein greater than 50% percent that did not persist. Pharmacokinetic properties were similar to prior publications and immunohistochemical staining for cyclin D1 and phospho-retinoblastoma did not predict response. Conclusions Flavopiridol as a single agent given by bolus then infusion caused significant diarrhea, cytopenias, and transaminase elevation but only achieved marginal responses in relapsed myeloma (ClinicalTrials.gov identifier NCT00112723). PMID:24241210

Optical bedside monitoring of cerebral perfusion: technological and methodological advances applied in a study on acute ischemic stroke

NASA Astrophysics Data System (ADS)

Steinkellner, Oliver; Gruber, Clemens; Wabnitz, Heidrun; Jelzow, Alexander; Steinbrink, Jens; Fiebach, Jochen B.; MacDonald, Rainer; Obrig, Hellmuth

2010-11-01

We present results of a clinical study on bedside perfusion monitoring of the human brain by optical bolus tracking. We measure the kinetics of the contrast agent indocyanine green using time-domain near-IR spectroscopy (tdNIRS) in 10 patients suffering from acute unilateral ischemic stroke. In all patients, a delay of the bolus over the affected when compared to the unaffected hemisphere is found (mean: 1.5 s, range: 0.2 s to 5.2 s). A portable time-domain near-IR reflectometer is optimized and approved for clinical studies. Data analysis based on statistical moments of time-of-flight distributions of diffusely reflected photons enables high sensitivity to intracerebral changes in bolus kinetics. Since the second centralized moment, variance, is preferentially sensitive to deep absorption changes, it provides a suitable representation of the cerebral signals relevant for perfusion monitoring in stroke. We show that variance-based bolus tracking is also less susceptible to motion artifacts, which often occur in severely affected patients. We present data that clearly manifest the applicability of the tdNIRS approach to assess cerebral perfusion in acute stroke patients at the bedside. This may be of high relevance to its introduction as a monitoring tool on stroke units.

Causes of death after fluid bolus resuscitation: new insights from FEAST

PubMed Central

2013-01-01

The Fluid Expansion as Supportive Therapy (FEAST study) was an extremely well conducted study that gave unexpected results. The investigators had reported that febrile children with impaired perfusion treated in low-income countries without access to intensive care are more likely to die if they receive bolus resuscitation with albumin or saline compared with no bolus resuscitation at all. In a secondary analysis of the trial, published in BMC Medicine, the authors found that increased mortality was evident in patients who presented with clinical features of severe shock in isolation or in conjunction with features of respiratory or neurological failure. The cause of excess deaths was primarily refractory shock and not fluid overload. These features are consistent with a potential cardiotoxic or ischemia-reperfusion injury following resuscitation with boluses of intravenous fluid. Although these effects may have been amplified by the absence of invasive monitoring, mechanical ventilation or vasopressors, the results provide compelling insights into the effects of intravenous fluid resuscitation and potential adverse effects that extend beyond the initial resuscitation period. These data add to the increasing body of literature about the safety and efficacy of intravenous resuscitation fluids, which may be applicable to management of other populations of critically ill patients. PMID:23497460

Comparison of build-up region doses in oblique tangential 6 MV photon beams calculated by AAA and CCC algorithms in breast Rando phantom

NASA Astrophysics Data System (ADS)

Masunun, P.; Tangboonduangjit, P.; Dumrongkijudom, N.

2016-03-01

The purpose of this study is to compare the build-up region doses on breast Rando phantom surface with the bolus covered, the doses in breast Rando phantom and also the doses in a lung that is the heterogeneous region by two algorithms. The AAA in Eclipse TPS and the collapsed cone convolution algorithm in Pinnacle treatment planning system were used to plan in tangential field technique with 6 MV photon beam at 200 cGy total doses in Breast Rando phantom with bolus covered (5 mm and 10 mm). TLDs were calibrated with Cobalt-60 and used to measure the doses in irradiation process. The results in treatment planning show that the doses in build-up region and the doses in breast phantom were closely matched in both algorithms which are less than 2% differences. However, overestimate of doses in a lung (L2) were found in AAA with 13.78% and 6.06% differences at 5 mm and 10 mm bolus thickness, respectively when compared with CCC algorithm. The TLD measurements show the underestimate in buildup region and in breast phantom but the doses in a lung (L2) were overestimated when compared with the doses in the two plannings at both thicknesses of the bolus.

Dynamic microbubble contrast-enhanced US to measure tumor response to targeted therapy: a proposed clinical protocol with results from renal cell carcinoma patients receiving antiangiogenic therapy.

PubMed

Williams, Ross; Hudson, John M; Lloyd, Brendan A; Sureshkumar, Ahthavan R; Lueck, Gordon; Milot, Laurent; Atri, Mostafa; Bjarnason, Georg A; Burns, Peter N

2011-08-01

To develop and implement an evidence-based protocol for characterizing vascular response of renal cell carcinoma (RCC) to targeted therapy by using dynamic contrast material-enhanced (DCE) ultrasonography (US). The study was approved by the institutional research ethics board; written informed consent was obtained from all patients. Seventeen patients (four women; median age, 58 years; range, 42-72 years; 13 men, median age, 62 years; range, 45-81 years) with metastatic RCC were examined by using DCE US before and after 2 weeks of treatment with sunitinib (May 2007 to October 2009). Two contrast agent techniques--bolus injection and disruption-replenishment infusion of microbubbles--were compared. Changes in tumor blood velocity and fractional blood volume were measured with both methods, together with reproducibility and effect of compensation for respiratory motion. Tumor changes were assessed with computed tomography, by using the best response with the Response Evaluation Criteria in Solid Tumors (RECIST) and progression-free survival (PFS). Follow-up RECIST measurements were performed at 6-week intervals until progressive disease was detected. In response to treatment, median tumor fractional blood volume measured with the disruption-replenishment infusion method decreased by 73.2% (interquartile range, 46%-87%) (P < .002), with repeated-measure reproducibility of 9%-15%. Significant decreases were also seen with the bolus method, but with poor correlation of changes in bolus peak (r = 0.46, P = .066) and area under the curve (r = 0.47, P = .058), compared with infusion measurements. Changes in DCE US parameters over 2 weeks did not correlate with PFS and could not be used to predict long-term assessment of best response by using RECIST. Follow-up times ranged 28-501 days; the median was 164 days. DCE US provides reproducible and sensitive assessment of vascular changes in response to antiangiogenic therapy. The disruption-replenishment infusion protocol is a flexible method suitable for many tumor types, but further studies are needed to assess whether this protocol may be predictive of patient outcome. © RSNA, 2011.

75 FR 51293 - [Disaster Declaration greek-i12272 and greek-i12273

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-19

... on 08/10/2010, Private Non- Profit organizations that provide essential services of governmental... Counties: Atchison, Brown, Butler, Chase, Clay, Cloud, Comanche, Doniphan, Ellis, Franklin, Greenwood...

Arterial pressure-based cardiac output monitoring: a multicenter validation of the third-generation software in septic patients.

PubMed

De Backer, Daniel; Marx, Gernot; Tan, Andrew; Junker, Christopher; Van Nuffelen, Marc; Hüter, Lars; Ching, Willy; Michard, Frédéric; Vincent, Jean-Louis

2011-02-01

Second-generation FloTrac software has been shown to reliably measure cardiac output (CO) in cardiac surgical patients. However, concerns have been raised regarding its accuracy in vasoplegic states. The aim of the present multicenter study was to investigate the accuracy of the third-generation software in patients with sepsis, particularly when total systemic vascular resistance (TSVR) is low. Fifty-eight septic patients were included in this prospective observational study in four university-affiliated ICUs. Reference CO was measured by bolus pulmonary thermodilution (iCO) using 3-5 cold saline boluses. Simultaneously, CO was computed from the arterial pressure curve recorded on a computer using the second-generation (CO(G2)) and third-generation (CO(G3)) FloTrac software. CO was also measured by semi-continuous pulmonary thermodilution (CCO). A total of 401 simultaneous measurements of iCO, CO(G2), CO(G3), and CCO were recorded. The mean (95%CI) biases between CO(G2) and iCO, CO(G3) and iCO, and CCO and iCO were -10 (-15 to -5)% [-0.8 (-1.1 to -0.4) L/min], 0 (-4 to 4)% [0 (-0.3 to 0.3) L/min], and 9 (6-13)% [0.7 (0.5-1.0) L/min], respectively. The percentage errors were 29 (20-37)% for CO(G2), 30 (24-37)% for CO(G3), and 28 (22-34)% for CCO. The difference between iCO and CO(G2) was significantly correlated with TSVR (r(2) = 0.37, p < 0.0001). A very weak (r(2) = 0.05) relationship was also observed for the difference between iCO and CO(G3). In patients with sepsis, the third-generation FloTrac software is more accurate, as precise, and less influenced by TSVR than the second-generation software.

Extracellular volume quantification by dynamic equilibrium cardiac computed tomography in cardiac amyloidosis

PubMed Central

Treibel, Thomas A.; Bandula, Steve; Fontana, Marianna; White, Steven K.; Gilbertson, Janet A.; Herrey, Anna S.; Gillmore, Julian D.; Punwani, Shonit; Hawkins, Philip N.; Taylor, Stuart A.; Moon, James C.

2015-01-01

Background Cardiac involvement determines outcome in patients with systemic amyloidosis. There is major unmet need for quantification of cardiac amyloid burden, which is currently only met in part through semi-quantitative bone scintigraphy or Cardiovascular Magnetic Resonance (CMR), which measures ECVCMR. Other accessible tests are needed. Objectives To develop cardiac computed tomography to diagnose and quantify cardiac amyloidosis by measuring the myocardial Extracellular Volume, ECVCT. Methods Twenty-six patients (21 male, 64 ± 14 years) with a biopsy-proven systemic amyloidosis (ATTR n = 18; AL n = 8) were compared with twenty-seven patients (19 male, 68 ± 8 years) with severe aortic stenosis (AS). All patients had undergone echocardiography, bone scintigraphy, NT-pro-BNP measurement and EQ-CMR. Dynamic Equilibrium CT (DynEQ-CT) was performed using a prospectively gated cardiac scan prior to and after (5 and 15 minutes) a standard Iodixanol (1 ml/kg) bolus to measure ECVCT. ECVCT was compared to the reference ECVCMR and conventional amyloid measures: bone scintigraphy and clinical markers of cardiac amyloid severity (NT-pro-BNP, Troponin, LVEF, LV mass, LA and RA area). Results ECVCT and ECVCMR results were well correlated (r2 = 0.85 vs r2 = 0.74 for 5 and 15 minutes post bolus respectively). ECVCT was higher in amyloidosis than AS (0.54 ± 0.11 vs 0.28 ± 0.04, p<0.001) with no overlap. ECVCT tracked clinical markers of cardiac amyloid severity (NT-pro-BNP, Troponin, LVEF, LV mass, LA and RA area), and bone scintigraphy amyloid burden (p<0.001). Conclusion Dynamic Equilibrium CT, a 5 minute contrast-enhanced gated cardiac CT, has potential for non-invasive diagnosis and quantification of cardiac amyloidosis. PMID:26209459

2. Overview of site, looking southeast Naval Air Station ...

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

2. Overview of site, looking southeast - Naval Air Station Chase Field, Building 1001, Independence Street, .45 mile south of intersection of Texas State Highway & Independence Street, Beeville, Bee County, TX

7. Overview of site, looking southwest Naval Air Station ...

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

7. Overview of site, looking southwest - Naval Air Station Chase Field, Building 1001, Independence Street, .45 mile south of intersection of Texas State Highway & Independence Street, Beeville, Bee County, TX

1. Overview of site, looking northwest Naval Air Station ...

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

1. Overview of site, looking northwest - Naval Air Station Chase Field, Building 1001, Independence Street, .45 mile south of intersection of Texas State Highway & Independence Street, Beeville, Bee County, TX

8. Overview of site, looking northeast Naval Air Station ...

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

8. Overview of site, looking northeast - Naval Air Station Chase Field, Building 1001, Independence Street, .45 mile south of intersection of Texas State Highway & Independence Street, Beeville, Bee County, TX

ARC-2007-ACD07-0189-018

NASA Image and Video Library

2007-10-02

International Space Station (ISS) National Laboratory Workshop L-R Lynn Harper, Ames and Baruch Blumberg, Nobel Laureate, Fox Chase Cancer Center during talk on Science on the international Space Station, Past and Future.

Removal of foreign bodies in the upper gastrointestinal tract in adults: European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline.

PubMed

Birk, Michael; Bauerfeind, Peter; Deprez, Pierre H; Häfner, Michael; Hartmann, Dirk; Hassan, Cesare; Hucl, Tomas; Lesur, Gilles; Aabakken, Lars; Meining, Alexander

2016-05-01

This Guideline is an official statement of the European Society of Gastrointestinal Endoscopy (ESGE). It addresses the removal of foreign bodies in the upper gastrointestinal tract in adults. Recommendations Nonendoscopic measures 1 ESGE recommends diagnostic evaluation based on the patient's history and symptoms. ESGE recommends a physical examination focused on the patient's general condition and to assess signs of any complications (strong recommendation, low quality evidence). 2 ESGE does not recommend radiological evaluation for patients with nonbony food bolus impaction without complications. We recommend plain radiography to assess the presence, location, size, configuration, and number of ingested foreign bodies if ingestion of radiopaque objects is suspected or type of object is unknown (strong recommendation, low quality evidence). 3 ESGE recommends computed tomography (CT) scan in all patients with suspected perforation or other complication that may require surgery (strong recommendation, low quality evidence). 4 ESGE does not recommend barium swallow, because of the risk of aspiration and worsening of the endoscopic visualization (strong recommendation, low quality evidence). 5 ESGE recommends clinical observation without the need for endoscopic removal for management of asymptomatic patients with ingestion of blunt and small objects (except batteries and magnets). If feasible, outpatient management is appropriate (strong recommendation, low quality evidence). 6 ESGE recommends close observation in asymptomatic individuals who have concealed packets of drugs by swallowing ("body packing"). We recommend against endoscopic retrieval. We recommend surgical referral in cases of suspected packet rupture, failure of packets to progress, or intestinal obstruction (strong recommendation, low quality evidence). Endoscopic measures 7 ESGE recommends emergent (preferably within 2 hours, but at the latest within 6 hours) therapeutic esophagogastroduodenoscopy for foreign bodies inducing complete esophageal obstruction, and for sharp-pointed objects or batteries in the esophagus. We recommend urgent (within 24 hours) therapeutic esophagogastroduodenoscopy for other esophageal foreign bodies without complete obstruction (strong recommendation, low quality evidence). 8 ESGE suggests treatment of food bolus impaction in the esophagus by gently pushing the bolus into the stomach. If this procedure is not successful, retrieval should be considered (weak recommendation, low quality evidence). The effectiveness of medical treatment of esophageal food bolus impaction is debated. It is therefore recommended, that medical treatment should not delay endoscopy (strong recommendation, low quality evidence). 9 In cases of food bolus impaction, ESGE recommends a diagnostic work-up for potential underlying disease, including histological evaluation, in addition to therapeutic endoscopy (strong recommendation, low quality evidence). 10 ESGE recommends urgent (within 24 hours) therapeutic esophagogastroduodenoscopy for foreign bodies in the stomach such as sharp-pointed objects, magnets, batteries and large/long objects. We suggest nonurgent (within 72 hours) therapeutic esophagogastroduodenoscopy for medium-sized blunt foreign bodies in the stomach (strong recommendation, low quality evidence). 11 ESGE recommends the use of a protective device in order to avoid esophagogastric/pharyngeal damage and aspiration during endoscopic extraction of sharp-pointed foreign bodies. Endotracheal intubation should be considered in the case of high risk of aspiration (strong recommendation, low quality evidence). 12 ESGE suggests the use of suitable extraction devices according to the type and location of the ingested foreign body (weak recommendation, low quality evidence). 13 After successful and uncomplicated endoscopic removal of ingested foreign bodies, ESGE suggests that the patient may be discharged. If foreign bodies are not or cannot be removed, a case-by-case approach depending on the size and type of the foreign body is suggested (weak recommendation, low quality evidence). © Georg Thieme Verlag KG Stuttgart · New York.

[Marshmallow for investigating functional disturbances of the esophageal body].

PubMed

Keren, S; Argaman, E

1992-09-01

Manometric studies using water boluses do not always demonstrate disturbances in esophageal motility. We tested the use of a marshmallow bolus to induce abnormal manometric patterns in patients with dysphagia in whom manometric studies using water boluses were normal or nearly so. The study group included 12 normal volunteers and 22 patients with dysphagia and nearly normal manometric studies. Pressure was recorded along the esophageal body using 10 "wet" swallows followed by 10 "solid" swallows of marshmallow. In normal subjects there were fewer abnormal contractions after solid swallows than after wet swallows. In 15 patients solid swallows induced abnormal motility patterns which were not observed after wet swallows. The probability of inducing abnormal contractions in patients after solid swallows is significantly greater than after wet swallows (p < 0.0001). Solid swallowing is therefore useful in evaluating functional disturbances of the esophagus in patients with dysphagia.

Healthy Weight: You Can Do It, Too

MedlinePlus

... diet") and gets regular exercise. Photos: Russell Morgan Russell Morgan changed the way he eats and exercises, ... a recent eight-month period, public health expert Russell Morgan, 66, of Chevy Chase, Md., dropped 60 ...

EC79-11481

NASA Image and Video Library

1979-08-20

A chase plane view of the tufts on the KC-135 winglet. The use of tufts in flight research dates back to the early days of the NACA, and remains an effective means of observing airflow even today. In this procedure, rows of strings are attached to an airplane's surface, with one end of each string taped to the airplane and the other end free to swing about in the airflow. The movements of the tufts are photographed by on-board cameras or a chase plane. If the tufts are arrayed in neat rows, as seen here, then the airflow is smooth over the airplane's surface. If, however, they are moving about violently, it suggests turbulent airflow. Such motions may indicate high drag, flow separation (such as in a stall), or buffeting. In some cases, tufts will actually point forward, indicating the airflow has reversed direction.

Significance chasing in research practice: causes, consequences and possible solutions.

PubMed

Ware, Jennifer J; Munafò, Marcus R

2015-01-01

The low reproducibility of findings within the scientific literature is a growing concern. This may be due to many findings being false positives which, in turn, can misdirect research effort and waste money. We review factors that may contribute to poor study reproducibility and an excess of 'significant' findings within the published literature. Specifically, we consider the influence of current incentive structures and the impact of these on research practices. The prevalence of false positives within the literature may be attributable to a number of questionable research practices, ranging from the relatively innocent and minor (e.g. unplanned post-hoc tests) to the calculated and serious (e.g. fabrication of data). These practices may be driven by current incentive structures (e.g. pressure to publish), alongside the preferential emphasis placed by journals on novelty over veracity. There are a number of potential solutions to poor reproducibility, such as new publishing formats that emphasize the research question and study design, rather than the results obtained. This has the potential to minimize significance chasing and non-publication of null findings. Significance chasing, questionable research practices and poor study reproducibility are the unfortunate consequence of a 'publish or perish' culture and a preference among journals for novel findings. It is likely that top-down change implemented by those with the ability to modify current incentive structure (e.g. funders and journals) will be required to address problems of poor reproducibility. © 2014 Society for the Study of Addiction.

Evidence for carboxyl-terminal processing and glycolipid-anchoring of human carcinoembryonic antigen.

PubMed

Takami, N; Misumi, Y; Kuroki, M; Matsuoka, Y; Ikehara, Y

1988-09-05

We have investigated the post-translational modification of carcinoembryonic antigen (CEA) for membrane-anchoring in QGP-1 cells derived from a human pancreatic carcinoma. Pulse-chase experiments with [3H]leucine demonstrated that CEA was initially synthesized as a precursor form with Mr 150,000 having N-linked high-mannose-type oligosaccharides, which was then converted to a mature form with Mr 200,000 containing the complex type sugar chains. The mature protein thus labeled was found to be released from the cell surface by treatment with phosphatidylinositol-specific phospholipase C, suggesting that CEA is a phosphatidylinositol-linked membrane protein. This was confirmed by metabolic incorporation into CEA of 3H-labeled compounds such as ethanolamine, myo-inositol, palmitic acid, and stearic acid. The 3H-labeled fatty acids incorporated were specifically removed from the protein by nitrous acid deamination as well as by phosphatidylinositol-specific phospholipase C treatment. Since the available cDNA sequence predicts that CEA contains a single methionine residue only in its carboxyl-terminal hydrophobic domain, processing of the carboxyl terminus was examined by pulse-chase experiments with [35S]methionine. It was found that CEA with Mr 150,000 was initially labeled with [35S]methionine but its radioactivity was immediately lost with chase. Taken together, these results suggest that CEA is anchored to the membrane by simultaneously occurring proteolysis of the carboxyl terminus and replacement by the glycophospholipid immediately after the synthesis.

Significance chasing in research practice: Causes, consequences, and possible solutions

PubMed Central

Ware, Jennifer J.; Munafò, Marcus R.

2016-01-01

Background and Aims The low reproducibility of findings within the scientific literature is a growing concern. This may be due to many findings being false positives, which in turn can misdirect research effort and waste money. Methods We review factors that may contribute to poor study reproducibility and an excess of ‘significant’ findings within the published literature. Specifically, we consider the influence of current incentive structures, and the impact of these on research practices. Results The prevalence of false positives within the literature may be attributable to a number of questionable research practices, ranging from the relatively innocent and minor (e.g., unplanned post hoc tests), to the calculated and serious (e.g., fabrication of data). These practices may be driven by current incentive structures (e.g. pressure to publish), alongside the preferential emphasis placed by journals on novelty over veracity. There are a number of potential solutions to poor reproducibility, such as new publishing formats that emphasise the research question and study design, rather than the results obtained. This has the potential to minimise significance chasing and non-publication of null findings. Conclusions Significance chasing, questionable research practices, and poor study reproducibility are the unfortunate consequence of a “publish or perish” culture and a preference among journals for novel findings. It is likely that top-down change implemented by those with the ability to modify current incentive structure (e.g., funders and journals) will be required to address problems of poor reproducibility. PMID:25040652

Neural correlates of effective learning in experienced medical decision-makers.

PubMed

Downar, Jonathan; Bhatt, Meghana; Montague, P Read

2011-01-01

Accurate associative learning is often hindered by confirmation bias and success-chasing, which together can conspire to produce or solidify false beliefs in the decision-maker. We performed functional magnetic resonance imaging in 35 experienced physicians, while they learned to choose between two treatments in a series of virtual patient encounters. We estimated a learning model for each subject based on their observed behavior and this model divided clearly into high performers and low performers. The high performers showed small, but equal learning rates for both successes (positive outcomes) and failures (no response to the drug). In contrast, low performers showed very large and asymmetric learning rates, learning significantly more from successes than failures; a tendency that led to sub-optimal treatment choices. Consistently with these behavioral findings, high performers showed larger, more sustained BOLD responses to failed vs. successful outcomes in the dorsolateral prefrontal cortex and inferior parietal lobule while low performers displayed the opposite response profile. Furthermore, participants' learning asymmetry correlated with anticipatory activation in the nucleus accumbens at trial onset, well before outcome presentation. Subjects with anticipatory activation in the nucleus accumbens showed more success-chasing during learning. These results suggest that high performers' brains achieve better outcomes by attending to informative failures during training, rather than chasing the reward value of successes. The differential brain activations between high and low performers could potentially be developed into biomarkers to identify efficient learners on novel decision tasks, in medical or other contexts.

Characterization of the Photon Counting CHASE Jr., Chip Built in a 40-nm CMOS Process With a Charge Sharing Correction Algorithm Using a Collimated X-Ray Beam

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

Krzyżanowska, A.; Deptuch, G. W.; Maj, P.

This paper presents the detailed characterization of a single photon counting chip, named CHASE Jr., built in a CMOS 40-nm process, operating with synchrotron radiation. The chip utilizes an on-chip implementation of the C8P1 algorithm. The algorithm eliminates the charge sharing related uncertainties, namely, the dependence of the number of registered photons on the discriminator’s threshold, set for monochromatic irradiation, and errors in the assignment of an event to a certain pixel. The article presents a short description of the algorithm as well as the architecture of the CHASE Jr., chip. The analog and digital functionalities, allowing for proper operationmore » of the C8P1 algorithm are described, namely, an offset correction for two discriminators independently, two-stage gain correction, and different operation modes of the digital blocks. The results of tests of the C8P1 operation are presented for the chip bump bonded to a silicon sensor and exposed to the 3.5- μm -wide pencil beam of 8-keV photons of synchrotron radiation. It was studied how sensitive the algorithm performance is to the chip settings, as well as the uniformity of parameters of the analog front-end blocks. Presented results prove that the C8P1 algorithm enables counting all photons hitting the detector in between readout channels and retrieving the actual photon energy.« less

The Pooling-score (P-score): inter- and intra-rater reliability in endoscopic assessment of the severity of dysphagia.

PubMed

Farneti, D; Fattori, B; Nacci, A; Mancini, V; Simonelli, M; Ruoppolo, G; Genovese, E

2014-04-01

This study evaluated the intra- and inter-rater reliability of the Pooling score (P-score) in clinical endoscopic evaluation of severity of swallowing disorder, considering excess residue in the pharynx and larynx. The score (minimum 4 - maximum 11) is obtained by the sum of the scores given to the site of the bolus, the amount and ability to control residue/bolus pooling, the latter assessed on the basis of cough, raclage, number of dry voluntary or reflex swallowing acts (< 2, 2-5, > 5). Four judges evaluated 30 short films of pharyngeal transit of 10 solid (1/4 of a cracker), 11 creamy (1 tablespoon of jam) and 9 liquid (1 tablespoon of 5 cc of water coloured with methlyene blue, 1 ml in 100 ml) boluses in 23 subjects (10 M/13 F, age from 31 to 76 yrs, mean age 58.56±11.76 years) with different pathologies. The films were randomly distributed on two CDs, which differed in terms of the sequence of the films, and were given to judges (after an explanatory session) at time 0, 24 hours later (time 1) and after 7 days (time 2). The inter- and intra-rater reliability of the P-score was calculated using the intra-class correlation coefficient (ICC; 3,k). The possibility that consistency of boluses could affect the scoring of the films was considered. The ICC for site, amount, management and the P-score total was found to be, respectively, 0.999, 0.997, 1.00 and 0.999. Clinical evaluation of a criterion of severity of a swallowing disorder remains a crucial point in the management of patients with pathologies that predispose to complications. The P-score, derived from static and dynamic parameters, yielded a very high correlation among the scores attributed by the four judges during observations carried out at different times. Bolus consistencies did not affect the outcome of the test: the analysis of variance, performed to verify if the scores attributed by the four judges to the parameters selected, might be influenced by the different consistencies of the boluses, was not significant. These initial data validate the clinical use of the P-score in the management of patients with deglutition disorders by a multidisciplinary team.

Evaluation of Oxygen Concentrators and Chemical Oxygen Generators at Altitude and Temperature Extremes

DTIC Science & Technology

2015-04-22

ceased. Oxygen concentration was continuously measured with a fast laser diode oxygen analyzer (O2CAP, Oxigraf, Inc., Mountain View, CA) throughout the...duration of operation. The output generated from the COGs was analyzed by a gas mass spectrometer (QGA model HAS 301, Hiden Analytical, Livonia, MI...throughout the range of bolus volumes with each device at respiratory rates of 20 and 30 breaths /min with each bolus setting. Data were recorded every

Noninvasive Methods for Determining Lesion Depth from Vesicant Exposure

DTIC Science & Technology

2007-01-01

LDPI. Chilcott et al19 used several noninvasive bio- a bolus through a central or peripheral venous line. engineering methods to monitor wound healing...ade- bolus through a central or peripheral venous line. The quate NBF into the tissue, two parallel cuts approxi- first two range finding pigs were...not more than 5.0%), its use creasing the size of the scan area, and/or decreasing is contraindicated in patients with a history of allergy the number

The Potential Benefits of Applying Recent Advances in Esophageal Motility Testing in Patients with Esophageal Atresia

PubMed Central

Rommel, Nathalie; Rayyan, Maissa; Scheerens, Charlotte; Omari, Taher

2017-01-01

Infants and children with esophageal atresia commonly present with swallowing dysfunction or dysphagia. Dysphagia can lead to a range of significant consequences such as aspiration pneumonia, malnutrition, dehydration, and food impaction. To improve oral intake, the clinical diagnosis of dysphagia in patients with esophageal atresia should focus on both the pharynx and the esophagus. To characterize the complex interactions of bolus flow and motor function between mouth, pharynx, and esophagus, a detailed understanding of normal and abnormal deglutition is required through the use of adequate and objective assessment techniques. As clinical symptoms do not correlate well with conventional assessment methods of motor function such as radiology or manometry but do correlate with bolus flow, the current state-of-the-art diagnosis involves high-resolution manometry combined with impedance measurements to characterize the interplay between esophageal motor function and bolus clearance. Using a novel pressure flow analysis (PFA) method as an integrated analysis method of manometric and impedance measurements, differentiation of patients with impaired esophago-gastric junction relaxation from patients with bolus outflow disorders is clinically relevant. In this, pressure flow matrix categorizing the quantitative PFA measures may be used to make rational therapeutic decisions in patients with esophageal atresia. Through more advanced diagnostics, improved understanding of pathophysiology may improve our patient care by directly targeting the failed biomechanics of both the pharynx and the esophagus. PMID:28680874

The Potential Benefits of Applying Recent Advances in Esophageal Motility Testing in Patients with Esophageal Atresia.

PubMed

Rommel, Nathalie; Rayyan, Maissa; Scheerens, Charlotte; Omari, Taher

2017-01-01

Infants and children with esophageal atresia commonly present with swallowing dysfunction or dysphagia. Dysphagia can lead to a range of significant consequences such as aspiration pneumonia, malnutrition, dehydration, and food impaction. To improve oral intake, the clinical diagnosis of dysphagia in patients with esophageal atresia should focus on both the pharynx and the esophagus. To characterize the complex interactions of bolus flow and motor function between mouth, pharynx, and esophagus, a detailed understanding of normal and abnormal deglutition is required through the use of adequate and objective assessment techniques. As clinical symptoms do not correlate well with conventional assessment methods of motor function such as radiology or manometry but do correlate with bolus flow, the current state-of-the-art diagnosis involves high-resolution manometry combined with impedance measurements to characterize the interplay between esophageal motor function and bolus clearance. Using a novel pressure flow analysis (PFA) method as an integrated analysis method of manometric and impedance measurements, differentiation of patients with impaired esophago-gastric junction relaxation from patients with bolus outflow disorders is clinically relevant. In this, pressure flow matrix categorizing the quantitative PFA measures may be used to make rational therapeutic decisions in patients with esophageal atresia. Through more advanced diagnostics, improved understanding of pathophysiology may improve our patient care by directly targeting the failed biomechanics of both the pharynx and the esophagus.

Feasibility of low contrast media volume in CT angiography of the aorta.

PubMed

Seehofnerová, Anna; Kok, Madeleine; Mihl, Casper; Douwes, Dave; Sailer, Anni; Nijssen, Estelle; de Haan, Michiel J W; Wildberger, Joachim E; Das, Marco

2015-01-01

Using smaller volumes of contrast media (CM) in CT angiography (CTA) is desirable in terms of cost reduction and prevention of contrast-induced nephropathy (CIN). The purpose was to evaluate the feasibility of low CM volume in CTA of the aorta. 77 patients referred for CTA of the aorta were scanned using a standard MDCT protocol at 100 kV. A bolus of 50 ml CM (Iopromide 300 mg Iodine/ml) at a flow rate of 6 ml/s was applied (Iodine delivery rate IDR = 1.8 g/s; Iodine load 15 g) followed by a saline bolus of 40 ml at the same flow rate. Scan delay was determined by the test bolus method. Subjective image quality was assessed and contrast enhancement was measured at 10 anatomical levels of the aorta. Diagnostic quality images were obtained for all patients, reaching a mean overall contrast enhancement of 324 ± 28 HU. Mean attenuation was 350 ± 60 HU at the thoracic aorta and 315 ± 83 HU at the abdominal aorta. A straightforward low volume CM protocol proved to be technically feasible and led to CTA examinations reaching diagnostic image quality of the aorta at 100 kV. Based on these findings, the use of a relatively small CM bolus can be incorporated into routine clinical imaging.

How much Dillenia indica seed predation occurs from Asian elephant dung?

NASA Astrophysics Data System (ADS)

Sekar, Nitin; Giam, Xingli; Sharma, Netra Prasad; Sukumar, Raman

2016-01-01

Elephants are thought to be effective seed dispersers, but research on whether elephant dung effectively protects seeds from seed predation is lacking. Quantifying rates of seed predation from elephant dung will facilitate comparisons between elephants and alternative dispersers, helping us understand the functional role of megaherbivores in ecosystems. We conducted an experiment to quantify the predation of Dillenia indica seeds from elephant dung in Buxa Reserve, India from December 2012 to April 2013. Using dung boluses from the same dung pile, we compared the number of seeds in boluses that are a) opened immediately upon detection (control boluses), b) made available only to small seed predators (<3 mm wide) for 1-4 months, and c) made available to all seed predators and secondary dispersers for 1-4 months. Using a model built on this experiment, we estimated that seed predation by small seed predators (most likely ants and termites) destroys between 82.9% and 96.4% of seeds in elephant dung between the time of defecation and the median germination date for D. indica. Exposure to larger seed predators and secondary dispersers did not lead to a significant additional reduction in the number of seeds per dung bolus. Our findings suggest that post-dispersal seed predation by small insects (<3 mm) substantially reduces but does not eliminate the success of elephants as dispersers of D. indica in a tropical moist forest habitat.

Treatment of extensive scalp lesions with segmental intensity-modulated photon therapy.

PubMed

Bedford, James L; Childs, Peter J; Hansen, Vibeke Nordmark; Warrington, Alan P; Mendes, Ruheena L; Glees, John P

2005-08-01

To compare static electron therapy, electron arc therapy, and photon intensity-modulated radiation therapy (IMRT) for treatment of extensive scalp lesions and to examine the dosimetric accuracy of the techniques. A retrospective treatment-planning study was performed to evaluate the relative merits of static electron fields, arcing electron fields, and five-field photon IMRT. Thermoluminescent dosimeters (TLD) were used to verify the accuracy of the techniques. The required thickness of bolus was investigated, and an anthropomorphic phantom was also used to examine the effects of air gaps between the wax bolus used for the IMRT technique and the patient's scalp. Neither static nor arcing electron techniques were able to provide a reliable coverage of the planning target volume (PTV), owing to obliquity of the fields in relation to the scalp. The IMRT technique considerably improved PTV dose uniformity, though it irradiated a larger volume of brain. Either 0.5 cm or 1.0 cm of wax bolus was found to be suitable. Air gaps of up to 1 cm between the bolus and the patient's scalp were correctly handled by the treatment-planning system and had negligible influence on the dose to the scalp. Photon IMRT provides a feasible alternative to electron techniques for treatment of large scalp lesions, resulting in improved homogeneity of dose to the PTV but with a moderate increase in dose to the brain.

Effect of bolus fluid intake on energy expenditure values as determined by the doubly labeled water method

NASA Technical Reports Server (NTRS)

Drews, D.; Stein, T. P.

1992-01-01

The doubly labeled water (DLW, 2H(2)18O) method is a highly accurate method for measuring energy expenditure (EE). A possible source of error is bolus fluid intake before body water sampling. If there is bolus fluid intake immediately before body water sampling, the saliva may reflect the ingested water disproportionately, because the ingested water may not have had time to mix fully with the body water pool. To ascertain the magnitude of this problem, EE was measured over a 5-day period by the DLW method. Six subjects were dosed with 2H2(18)O. After the reference salivas for the two-point determination were obtained, subjects drank water (700-1,000 ml), and serial saliva samples were collected for the next 3 h. Expressing the postbolus saliva enrichments as a percentage of the prebolus value, we found 1) a minimum in the saliva isotopic enrichments were reached at approximately 30 min with the minimum for 2H (95.48 +/- 0.43%) being significantly lower than the minimum for 18O (97.55 +/- 0.44, P less than 0.05) and 2) EE values calculated using the postbolus isotopic enrichments are appreciably higher (19.9 +/- 7.5%) than the prebolus reference values. In conclusion, it is not advisable to collect saliva samples for DLW measurements within approximately 1 h of bolus fluid intake.

Videofluoroscopic Predictors of Penetration-Aspiration in Parkinson's Disease Patients.

PubMed

Argolo, Natalie; Sampaio, Marília; Pinho, Patrícia; Melo, Ailton; Nóbrega, Ana Caline

2015-12-01

Parkinson's disease (PD) patients show a high prevalence of swallowing disorders and tracheal aspiration of food. The videofluoroscopic study of swallowing (VFSS) allows clinicians to visualize the visuoperceptual and temporal parameters associated with swallowing disorders in an attempt to predict aspiration risk. However, this subject remains understudied in PD populations. Our aim was to identify the predictors of penetration-aspiration in PD patients using the VFSS. Consecutive patients were evaluated using VFSS with different consistencies and volumes of food. A speech-language pathologist measured the type of intra-oral bolus organization, loss of bolus control, bolus location at the initiation of the pharyngeal swallow, the presence of multiple swallows, piecemeal deglutition, bolus residue in the pharyngeal recesses and temporal measures. Scores ≥3 on the penetration-aspiration scale (PAS) indicated the occurrence of penetration-aspiration. Using logistic marginal regression, we found that residue in the vallecula, residue in the upper esophageal sphincter and piecemeal deglutition were associated with penetration-aspiration (odds ratio (OR) = 4.09, 2.87 and 3.83; P = 0.0040, 0.0071 and 0.0009, respectively). Penetration/aspiration occurred only with fluids (both of thin and thick consistency), and no significant differences were observed between fluid types or food volumes. The mechanisms underlying dysphagia and penetration/aspiration in PD patients and indications for further studies are discussed.

Cerebral arterial bolus arrival time is prolonged in multiple sclerosis and associated with disability

PubMed Central

Paling, David; Thade Petersen, Esben; Tozer, Daniel J; Altmann, Daniel R; Wheeler-Kingshott, Claudia AM; Kapoor, Raju; Miller, David H; Golay, Xavier

2014-01-01

Alterations in the overall cerebral hemodynamics have been reported in multiple sclerosis (MS); however, their cause and significance is unknown. While potential venous causes have been examined, arterial causes have not. In this study, a multiple delay time arterial spin labeling magnetic resonance imaging sequence at 3T was used to quantify the arterial hemodynamic parameter bolus arrival time (BAT) and cerebral blood flow (CBF) in normal-appearing white matter (NAWM) and deep gray matter in 33 controls and 35 patients with relapsing–remitting MS. Bolus arrival time was prolonged in MS in NAWM (1.0±0.2 versus 0.9±0.2 seconds, P=0.031) and deep gray matter (0.90±0.18 versus 0.80±0.14 seconds, P=0.001) and CBF was increased in NAWM (14±4 versus 10±2 mL/100 g/min, P=0.001). Prolonged BAT in NAWM (P=0.042) and deep gray matter (P=0.01) were associated with higher expanded disability status score. This study demonstrates alteration in cerebral arterial hemodynamics in MS. One possible cause may be widespread inflammation. Bolus arrival time was longer in patients with greater disability independent of atrophy and T2 lesion load, suggesting alterations in cerebral arterial hemodynamics may be a marker of clinically relevant pathology. PMID:24045400

Wedge-shaped slice-selective adiabatic inversion pulse for controlling temporal width of bolus in pulsed arterial spin labeling

PubMed Central

Guo, Jia; Buxton, Richard B.; Wong, Eric C.

2015-01-01

Purpose In pulsed arterial spin labeling (PASL) methods, arterial blood is labeled via inverting a slab with uniform thickness, resulting in different temporal widths of boluses in vessels with different flow velocities. This limits the temporal resolution and signal-to-noise ratio (SNR) efficiency gains in PASL-based methods intended for high temporal resolution and SNR efficiency, such as Turbo-ASL and Turbo-QUASAR. Theory and Methods A novel wedge-shaped (WS) adiabatic inversion pulse is developed by adding in-plane gradient pulses to a slice-selective (SS) adiabatic inversion pulse to linearly modulate the inversion thicknesses at different locations while maintaining the adiabatic properties of the original pulse. A hyperbolic secant (HS) based WS inversion pulse was implemented. Its performance was tested in simulations, phantom and human experiments, and compared to an SS HS inversion pulse. Results Compared to the SS inversion pulse, the WS inversion pulse is capable of inducing different inversion thicknesses at different locations. It can be adjusted to generate a uniform temporal width of boluses in arteries at locations with different flow velocities. Conclusion The WS inversion pulse can be used to control the temporal widths of labeled boluses in PASL experiments. This should benefit PASL experiments by maximizing labeling duty cycle, and improving temporal resolution and SNR efficiency. PMID:26451521

Comparison of Gavage, Water Bottle, and a High-Moisture Diet Bolus as Dosing Methods for Quantitative D-xylose Administration to B6D2F1 (Mus musculus) Mice

NASA Technical Reports Server (NTRS)

Zimmer, J. Paul; Lewis, Sherry M.; Moyer, Jerry L.

1993-01-01

Gavage, water bottle, and diet incorporation are 3 dosing methods used orally to administer test compounds to rodents. These 3 methods were compared in mice to determine which represented the most quantitative delivery system. For dietary incorporation, a high-moisture bolus form of NIH-31 rodent meal was developed using hydroxypropyl methylcellulose as an autoclave-stable binding agent. A high-moisture bolus were selected to increase the acceptability of the dosed diet and to promote quantitative consumption through reduced wastage. The test compound used was D-xylose, a pentose sugar that may be quantitatively detected, colorimetrically, in urine following oral dosing. Six male and 6 female B6D2FI mice were placed in metabolism cages and dosed with a known quantity of D-xylose by each of the 3 methods. Urine was collected before and after each method of administration and analysed for total D-xylose; the per cent recovery was based upon the amount of D-xylose consumed. Quantitative consumption was apparently greatest for water bottle dosing with an average recovery of 56.0% of the original D-xylose dose. High-moisture bolus incorporation ranked second with 50.0% D-xylose recovery, and gavage was third with 41.0% D-xylose recovery.